Term
| in randomized clinical control trials, researcher's belief in tx affects results |
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Definition
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Term
|
Definition
Calculate risk in each group
ex. risk (smokers) 6/80, and divide by risk (non-smokers) 4/120 |
|
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Term
|
Definition
| chance that findings of study were due to chance is <5% |
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Term
|
Definition
| accepts alt hypothesis (rejects null hypothesis) when there is in fact no difference |
|
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Term
|
Definition
| There is a difference, but the study did not find it (did not reject the null hypothesis) |
|
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Term
|
Definition
| measure of how far above and below a mean a value was in terms of # of std deviations* |
|
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Term
|
Definition
| used when population parameters are estimates* rather than known values; common and effectively replace z scores |
|
|
Term
|
Definition
| diagnosis, nature of intervention, risk/benefits and alternatives, assessment of understanding, acceptance |
|
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Term
|
Definition
| the smallest amount possible that can be detected in healthy population |
|
|
Term
| randomized clinical controlled trials |
|
Definition
|
|
Term
|
Definition
Power = 1 - Beta (risk of type II error)
**avoid accepting a false null hypothesis
Type II error - when null hypothesis is false and is accepted
Type I error (alpha) - null hypothesis is incorrectly rejected
Note: INC in type I will INC power |
|
|
Term
| physician paid a contracted rate for each member assigned regardless of # or nature of services provided |
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Definition
| capitation - used by HMOs to reimburse a flat fee per pt regardless of services rendered |
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Term
|
Definition
|
|
Term
|
Definition
| Odds ratio = ad/bc a = exposure + dz b = exposure, no dz c = dz, no exposure d = no dz, no exposure |
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|
Term
| prospective (forward-looking) observational studies - take healthy population with an exposure (eg EtOH use in pregnancy) to look at # ppl who develop an outcome (eg failure to thrive) |
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Definition
| Retrospective cohort study - most likely to produce unbiased results as EtOH use could be investigated thru asking pt & thru blood tests if study was well funded to remove the risk of prospective mothers misrepresenting their EtOH consumption |
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Term
|
Definition
| "do no harm" - should not provide ineffective tx to pts as these offer risk w/ no possibility of beneft and thus have a chance of harming pt |
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|
Term
| Positive predictive value (PPV) |
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Definition
TP / total pos tests (TP + FP)
How likely a person who tests pos does in fact have the dz |
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Term
|
Definition
68% pop in normal distribution will be w/in 1 SD (above and below)
95% of pop in normal distrib within 2 SD |
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Term
|
Definition
"the thing that speaks for itself":
accident does not ordinarily occur without negligence, pt did not contribute to accident |
|
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Term
| all treatments must be for the good of the patient |
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Definition
| beneficence (4 principles of ethics) |
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Term
|
Definition
| test hypotheses which seek to compare differences in proportions bet nominal groups |
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Term
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Definition
| used when there's one set of interval data and one or more sets of nominal data |
|
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Term
| Pearson product-moment correlation |
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Definition
| how well 2 sets of interval data correlate |
|
|
Term
|
Definition
| used for interval data, but one set of interval data with only 2 groups of nominal data |
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|
Term
|
Definition
|
|
Term
| phases of clinical trials |
|
Definition
I - healthy volunteers
II - small # disease sufferers
III - large-scale trial, randomized and double-blinded
IV - general surveillance of drug after its release |
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|
Term
| positive predictive value |
|
Definition
| proportion of positive results that are true positives for a screening test |
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Term
|
Definition
| 1/absolute risk reduction |
|
|
Term
| holosystolic murmur w/ palpable thrill, loudest at 4th left ICS |
|
Definition
| VSD - complications: endocarditis (need prophylaxis if cyanotic), heart failure, pulm HTN, aortic regurg, Eisenmenger's |
|
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Term
|
Definition
sxs >2 days/wk, nighttime awakenings 3-4x/mon
Tx: inhaled low-dose GC + SABA prn |
|
|
Term
|
Definition
Tx: inhaled low-dose GC + LABA + SABA prn
(may add leukotriene-R antag) |
|
|
Term
|
Definition
sxs thruout day, nighttime awakenings daily
Tx: inhaled high-dose GC + inhaled LABA (+/- oral GC) + SABA prn
(may add leukotriene-R antag) |
|
|
Term
| anemia, thrombocytopenia, renal failure, prev E coli infxn, signs of hemolysis (elev LDH, DEC haptoglobin, elev unconj bilirubin) |
|
Definition
hemolytic uremic syndrome (HUS)
Tx - supportive |
|
|
Term
| acute renal failure, fever, anemia, thrombocytopenia (<100,000), microangiopathic anemia (indirect bili, schistocytes), elev LDH), neuro sxs, ADAMTS13 ab (dx) |
|
Definition
thrombotic thrombocytopenic purpura (TTP)
Tx - urgent fresh frozen plasma |
|
|
Term
| DEC platelet, plasma fibrinogen ELEV PT, PTT, fibrin degradation products, and d-dimer; schistocytes |
|
Definition
| disseminated intravascular coag (DIC) - uncontrolled thrombosis and hemorrhage
Cause: infxn, malignancy, chock, tissue injury
Tx - underlying cause, platelet transfusion, FFP |
|
|
Term
| immune destruction of platelets preceded by viral URI; low platelets, normal peripheral smear |
|
Definition
| idiopathic thrombocytopenic purpura (ITP) |
|
|
Term
| palpable purpura (LE petechiae), abd pain, arthralgia; glomerulonephritis (hematuria), renal bx - IgA deposits |
|
Definition
| Henoch Schonlein purpura (HSP) - vasculitic dz mediated by IgA
Tx - Self-limited
If have abd pain --> abd US bc INC risk intussuception |
|
|
Term
| fever, dysuria, painful genital vesicles, tender inguinal LAD |
|
Definition
genital HSV - confirmatory test not necessary if clear clinically
Initial test - Tzanck smear (cheap)
Tx - valacyclovir, acyclovir, famciclovir |
|
|
Term
| asymptomatic (maybe RUQ pain), US/CT - "central scar" on hepatic tumor |
|
Definition
| focal nodular hyperplasia - benign liver tumor affects women of repro age; does not grow rapidly, not assoc w/ OCPs, leave alone unless symptomatic |
|
|
Term
| fever, cervical LAD, pharyngitis, fatigue |
|
Definition
infectious mononucleosus - usually EBV
Lab - lymphocytosis, elev aminotransferases
Dx - heterophile antibody test **Avoid amoxicillin and ampicillin -- RASH |
|
|
Term
| elev gastrin despite secretin injection test |
|
Definition
Zollinger-Ellison syndrome
Tx - PPI (omeprazole), surgery likely necessary once tumor localized |
|
|
Term
| acute onset fever, cough, tachypnea, malaise, vomiting, lobar consolidation, crackles, dull to percuss |
|
Definition
CAP - MC S pneumo
Tx - amoxicillin/ampicillin or 3rd gen cephalosporin |
|
|
Term
| cough, tachypnea in infants <8 wk, h/o neonatal conjunctivitis, CXR - bilat interstitial infiltrates |
|
Definition
Chlamydia trachomatis
Tx - erythromycin |
|
|
Term
| hematuria and abd pain*, HTN, palpable bilat kidneys, ESRD by 40-50s, back pain (initial complaint), autosom dom |
|
Definition
Polycystic kidney dz (PKD) - assoc w/ MVP, diverticulosis
Dx - US (initial)
Complications: cerebral berry aneurysms, liver cysts, thoracic aortic aneurysm |
|
|
Term
| d/t Lewy bodies and loss of dopaminergic neurons in substantia nigra and locus ceruleus; resting tremor (worsens w/ emotional stress), bradykinesia, rigidity, micrographia |
|
Definition
| Parkinson's dz - occur after age 50 |
|
|
Term
| autonomic insufficiency + Parkinson-like sxs |
|
Definition
|
|
Term
| Kayser-Fleischer ring, parkinson-like sxs, affects renal, liver, psych fr copper accum, DEC ceruloplasmin (DEC total, INC free copper), hypoalbumin, elev aminotrans, elev urinary copper excretion |
|
Definition
Wilson's dz - under age 30
Tx - penicillamine (promotes excretion), liver transplant (doesn't respond to rx) |
|
|
Term
|
Definition
|
|
Term
| IgG and C3 at basement membrane |
|
Definition
|
|
Term
| glomerular basement membrane splitting |
|
Definition
|
|
Term
| prox symmetric mm weakness, elev CK, EMG - high freq action potentials, (+) ANA and anti-jo antibody test |
|
Definition
Polymyositis - spares face mm, dysphagia, CK levels correspond to severity
Dx: muscle bx
Women, Blacks, age 40-50 |
|
|
Term
| mm fatigue after use (ie face, ocular, mastication) EMG - decremental response to repetitive stim of motor nn |
|
Definition
myasthenia gravis
Dx - Tensilon test (initial), acetylcholine-R ab test (most spec), EMG (confirmatory), ice-pack test for ptosis (bedside test)
Tx - pyridostrigmine* (Ach-esterase inhib - INC cholinergic) |
|
|
Term
| hip, shoulder and neck pain; assoc w/ temporal arteritis |
|
Definition
| polymyalgia rheumatic (PMR) |
|
|
Term
| maternal fever, tachycardia in mother, fetus, tender uterus, foul oder of amniotic fluid |
|
Definition
Chorioamnionitis - infxn of membranes/amniotic fluid
Dx - amniocentesis
Tx - broad spec abx |
|
|
Term
| dysmenorrhea, pelvic pain, foul lochia, post-partum fever |
|
Definition
endometritis
Risk - C secion (MC), prolonged labor, prolonged membrane rupture, chorioamnionitis
Tx - IV clindamycin + gentamycin (broad spec anaerobe/aerobe) |
|
|
Term
| fever, abd pain, sausage shaped mass near umbilicus |
|
Definition
| septic pelvic vein thrombophlebitis |
|
|
Term
| high BP after 20 wks gestation w/out proteinuria |
|
Definition
|
|
Term
| high BP after 20 wks gestation, proteinuria, end organ damage -- elev Cre, platelet <100,000, elev AST/ALT, pulm edema, CNS sx (HA, visual changes, hyperreflexia) |
|
Definition
|
|
Term
| preeclampsia + new onset seizures |
|
Definition
|
|
Term
| hemolysis, elevated liver enzymes, low platelets |
|
Definition
| HELLP (seen in eclampsia) |
|
|
Term
[image]
symptomatic with pulses |
|
Definition
Ventricular tachycardia - wide QRS complex, regular
Tx: ABCs, O2, check if stable
Stable - amiodarone 150 IV over 10 min
Unstable - IV access, sedation, synchronized cardioversion
V tach - narrow QRS complex, reg
Tx: vagal maneuvers, adenosine 6 mg rapid IV push
|
|
|
Term
| Purple, polygonal, pruritic, papules (4 P's), Wickham striae - fine white reticulations in oral cavity |
|
Definition
Lichen planus (LP) - cell-mediated, inflamm dermatitis w/ lesions on flexural surfaces of ext; affects mucous membranes, hair, nails, genitals. Erythematous to violaceous, polygonal, flat with small central dimple and coalesced into a grp
Histo - 1) damaged basal epidermal keratinocytes, 2) linera lymphocytic infiltrate in papillary dermis at interface w/ epidermis ("lichenoid" pattern)
Course - chronic, relapsing up to 5 yrs
Tx - med-high potency topical corticosteroids |
|
|
Term
| flushing erythema of central portion of face, rhinophyma (sebaceous hyperplasia of nose) |
|
Definition
rosacea
Tx - metronidazole gel, oral tetracycline |
|
|
Term
| mm rigidity, tachycardia, acidosis, elev temp; first sign: masseter mm spasm |
|
Definition
Malignant hyperthermia - d/t halogenated inhal anesthetics (halothane, enflurane, isoflurane, desflurane, sevoflurane) or succinylcholine (depol mm relaxant)
MOA - rel of Ca fr sarcoplasmic retic --> rigidity and hypermetabolism
Tx - D/C offending then switch, stabilize, dantrolene (prevents intracel Ca rel) 2.5 mg/kg bolus, then 1-2 mg/kg q 5 min until normal sxs, cancel surg, observe
Note: untx'd - rhabdo, hyperK, myoglobinnuria |
|
|
Term
| large adnexal mass, hyperestrogenism, large usually asymptomatic abd mass; youger - precocious puberty, premenopausal - menstrual irreg, postmeeno - bleeding |
|
Definition
| granulosa-theca cell tumor |
|
|
Term
| oligomenorrhea/amenorrhea, obesity, hirsutism, acne, male-pattern baldness, LH:FSH at least 2:1 |
|
Definition
PCOS
Dx - OGTT
Tx - OCP +/- spironolactone (testot antag), metformin if needed, clomiphene (if want to become prego), leuprolide (3rd line) |
|
|
Term
| large adnexal mass, virilization |
|
Definition
| Sertoli-Leydig cell tumor - androgen-secreting ovarian tumor |
|
|
Term
| anti-tissue transglutaminase IgA, anti-endomysium IgA, anti-gliadin IgA autoabs |
|
Definition
Celiac dz - intermit abd pain, loose stools, nausea. Other - iron defic anemia, delayed puberty, osteopenia, hypertransaminasemia.
Confirm - esophagogastroduodenoscopy w/ bx of small bowel (blunted villi and crypt hyperplasia) or skin bx of dermatitis herpetiformis
At risk for chronic lymphocytic thyroiditis - common cause of hypothyroidism |
|
|
Term
| fatigue, wt loss, abd discomfort, hyperpig, hypoNa+, hyperK+, hypotension, DEC cortisol |
|
Definition
Addison dz - primary adrenal inssuf, hyperK, hypoglycemia, hyponatremia bc can't produce mineralocort; tan bc of high ACTH
Dx - rapid ACTH stim test - measure fxn'l capacity of adrenal cortex to prod cortisol |
|
|
Term
medullary thyroid CA
pheochromocytoma
marfanoid body habitus
mucosal neuroma (tumor of tongue) |
|
Definition
|
|
Term
| pituitary, parathyroid, pancreatic (islet) tumor |
|
Definition
| MEN I (diamond) or Wermer's syndrome - prolactinoma, hyperparathyroidism, insulinoma, gastrinoma (Zollinger-Ellison), acromegaly |
|
|
Term
| medullary thyroid CA, parathyroid tumor, pheochromocytoma, adrenal hyperplasia |
|
Definition
|
|
Term
| proteinuria (>3.5 g/day) - foamy urine, hypoalbuminemia, gen edema |
|
Definition
Nephrotic syndrome
Path - hepatic synthesis (hence hyperlipid) compensates protein lost in urine |
|
|
Term
| MC nephrotic syndrome in HIV, IVDA, sickle cell, present w/ refractory HTN |
|
Definition
Focal segmental glomerulosclerosis (FSGS)
Tx - prednisone, cyclophosphamide |
|
|
Term
| MC nephrotic syndrome in adults; assoc w/ HBV, HCV, malaria, syphilis, gold salts, peniciillamine, SLE, malignancy |
|
Definition
Membranous glomerulonephritis
Tx - prednisone, cyclophosphamide |
|
|
Term
| MC nephrotic syndrome in kids; causes: food allergies, meds, hematologic malig |
|
Definition
Minimal change dz
Tx - prednisone |
|
|
Term
| uncommon nephrotic syndrome, immune complex deposits, low C3, "tram track" (capillary BM thickening by interposition of mesangial cells & matrix into capillary wall); assoc w/ autoimmune dz & hepatitis |
|
Definition
| membranoproliferative glomerulonephritis |
|
|
Term
| nephritic syndrome, within days of infxn |
|
Definition
|
|
Term
| bronze skin, hepatomegaly, elev iron, ferritin, and transferrin sat, low TIBC |
|
Definition
hemochromatosis - assoc w/ restrictive cardiomyopathy (impaired ventricular filling - enlarged R/L atria),
also dilated cardio (cardiomegaly)
Dx - liver bx, genetic test HFe gene
Tx - phlebotomy |
|
|
Term
| harsh systolic murmur heard across precordium, INC w/ maneuvers that DEC EDV (valsalva, exercise, vasodilators, dehydration) |
|
Definition
| hypertrophic cardiomyopathy |
|
|
Term
| bone pain, UPEP - Bence Jones proteins, SPEP - monoclonal "M spike" of IgG or IgA, bone marrow bx - INC plasma cells, rouleaux formation, Beta 2 microglobulin - tumor marker (measures dz burden) |
|
Definition
Multiple myeloma (MM)
Sx - anemia, hyperCa2+, renal failure |
|
|
Term
|
Definition
| "BLT w/ Mayo and Kosher Pickle": Breast, Lung, Thyroid, Multiple myeloma, Kidney, Prostate |
|
|
Term
[image]
palpitaitons, exertional dyspnea |
|
Definition
A fib - absent P waves, unorganize electrical activity, irreg R-R interval (d/t irreg conduction of impulses to ventricles),
Cause: HTN (common), hyperthyroidism
Stable - BB or CCB (rate control)
Unstable - immediate DC cardioversion
Afib >48 h (time unknown) - warfarin 3-4 wks prior to cardioversion, then 4 wks after |
|
|
Term
| colon + multiple CA (esp endometrial CA); famhx of multiple CA |
|
Definition
HNPCC (aka Lynch syndrome) - colorectal CA + ovarian, gastric, biliary tact, brain, prostate, skin; autodom
Management - Colonoscopy w/ fam hx q1-2 yr starting at age 20-25 |
|
|
Term
| adenomatous polyps + osteomas, lipomas, fibromas, cysts, dental abnorm |
|
Definition
|
|
Term
| multiple pigmented spots on lips, oral mucosa, GI mucosa; Hamartomas on colonscopy |
|
Definition
|
|
Term
| familial adenomatous polyposis + CNS malignancy |
|
Definition
|
|
Term
| bilious vomiting, pull legs to chest, red currant jelly stool, palpable sausage abd mass |
|
Definition
Intussusception - at iliocecal jxn, small bowel invag into distal seg of intestine (telescoping), age 3-36 mon
Clear presentation --> barium, water-sol or air-contrast (pneumatic) enema = diagnostic/therapeutic; confirmatory
Not clear --> US (100% sens/spec) = coiled spring or bulls-eye sign |
|
|
Term
| newborn: tachypnea, grunting, cyanosis, subcostal/intercostal retractions |
|
Definition
respiratory distress syndrome (aka hyaline membrane dz) - premie infants
CXR - poor expansion, air bronchograms, bilat diffuse pattern, "ground glass"
Tx - surfactant, ventilation |
|
|
Term
| primitive lung tissue (solid/cystic) does not communicate w/ tracheobronchial tree -- thought to originate fr accesory lung bud; cause of chronic cough and recurrent pneumonia |
|
Definition
pulmonary sequestration
Tx - surg resection |
|
|
Term
| delievered by C sec or precipitous delivery; resp distress sxs, CXR - fluid in pulmonary fissues, self-limiting (resolves w/in 72 h) |
|
Definition
| transient tachypnea of newborn - delay in clearance of fetal lung liquid |
|
|
Term
| boggy, soft, enlarged uterus, menorrhagia (MC), dysmenorrhea, age >40 |
|
Definition
Adenomyosis - endometrial tissue "stuck" in myometrium, cannot slough causing dysmenorrhea
Dx - transvag US or MRI, def dx - histo
Tx - hysterectomy |
|
|
Term
| menorrhagia, dysmenorrhea, dyschezia, dyspareunia, pelvic pain, during repro yrs (20-30s), "chocolate cysts" |
|
Definition
endometriosis - endometrial tissue on ovary (MC), cul-de-sac (2nd MC), adnexal enlargement
Dx - laparoscopy (gold std)
Tx - NSAIDs + OCP (cause atrophy of endometrial tissue) |
|
|
Term
| obese pt, PCOS, unopposed estrogen tx, abnorm vag bleeding |
|
Definition
endometrial hyperplasia
Dx - histo |
|
|
Term
|
Definition
Mobitz type II 2nd-degree AV block
partial block in His-purkinje; constant PR interval w/ sudden dropped QRS, 3:1 or 4:1 block
Path - interruption of impulse fr atria --> ventricles
Tx - pacemaker, if symptomatic bradycardia present |
|
|
Term
| serous or bloody nipple discharge ("straw colored"), peri/postmeno |
|
Definition
Intraductal papilloma - solitary papilloma is benign, multiple = premalig
Tx - duct resection |
|
|
Term
| confined to ducts, precursor of invasive breast CA/intraductal CA |
|
Definition
ductal carcinoma in situ (DCIS) - MC type non-invasive breast CA
Tx - lumpectomy vs masctectomy +/- radiation; tamoxifen for after surg of estrogen-R (+) DCIS |
|
|
Term
| premenopausal, incidental finding on breast bx, asymptomatic, not precursor of intraductal invasive breast CA, assoc w/ INC risk invasive breast CA |
|
Definition
Lobular carcinoma in situ (LCIS) - less common
Dx - core needle bx followed by excisional bx to r/o ductal carcinoma in situ or invasive CA
Tx - monitor for invasive breast CA; tamoxifen |
|
|
Term
| MC invasive breast CA; lump, nipple retraction, microcalcif on mammo |
|
Definition
invasive ductal carcinoma
Tx - lumpectomy (excision) w/ SLN bx + postop radiation + chemo (if LN mets) |
|
|
Term
| pre-meno, breast lump, premenstrual TENDERNESS, swelling |
|
Definition
fibrocystic dz
Dx - FNA prior to tx
Tx - acetominophen, NSAIDs |
|
|
Term
| vocal tic (sniffling, clearing throat, repeating words, coprolalia) + multiple motor tics > 1yr |
|
Definition
Tourette's syndrome - onset before 21
Tx - clonidine, pimozide, typical antipsych (haloperidol, fluphenaine), Assoc w/ OCD |
|
|
Term
| neuro deficiencies separated by space and time, parasthesia in ext (MC initial) |
|
Definition
| multiple sclersosis Dx - MRI brain, spinal cord |
|
|
Term
| initial complaint - mm weakness + atrophy; involves UMN (hyperreflexia, mm spasticity, Babinski's sign) + LMN (mm weakness, atrophy, fasciculations) |
|
Definition
ALS (Lou Gehrig's) - degen MOTOR neurons, emotional lability
Dx - EMG - confirm LMN lesion, r/o MG; nerve conduction studies - r/o MG, MS, carpel tunnel, GBS
MCC death - aspiration pneumonia
Tx - riluzole (slows progression, block Na channel assoc w/ neuron damage; prolong 4 mon) |
|
|
Term
| polyuria, polydipsia, dilute urine, no change in urine osmolality with water depriv, responds with desmopressin (urine osmolarity INC) |
|
Definition
| central diabetes insipidus - ADH defic |
|
|
Term
| HTN, hypernatremia, hypoK+, low renin |
|
Definition
| Conn's syndrome - primary hyperALD d/t adrenal adenoma |
|
|
Term
| euvolemic, hyponatremia, DEC BUN and uric acid, low serum osmolality and low urine vol |
|
Definition
|
|
Term
| polyuria, polydipsia, no response to desmopressin (urine osmolality will INC minimally or not at all) |
|
Definition
| nephrogenic diabetes insipidus - kidney has DEC or lack of response to ADH |
|
|
Term
| Beck's triad: JVD, faint heart sounds, hypotension; pulsus paradoxus, electrical alternans, enlarged cardiac silhouette |
|
Definition
cardiac tamponade
Dx - echo |
|
|
Term
| tetany, seizures, perioral numbness, confusion, Chvostek sign (tetany w/ facial nn tapping), Trousseau sign (mm spasm w/ BP cuff), prolonged QT interval** |
|
Definition
Hypocalcemia - post thyoirdectomy fr injury to parathy
Tx - oral calcium carbonate, calcitriol (if refractory), IV calcium gluconate if severe (<7.5 mg/dL or arrhythmia sxs)
Do NOT give oral Mg -- causes Ca excretion by kidney
HypoMg+ (asymp) leads to hypK+ |
|
|
Term
| renal failure, arrhythmogenic (EKG-peaked T waves) |
|
Definition
| HyperK+ Tx - Ca gluconate (pref), sodium bicarb, insulin w/glucose, furosemide |
|
|
Term
| PAINLESS goiter, post-partum; starts hyperthyroid, followed by hypothyroid, finally euthyroid |
|
Definition
| subacute lymphocytic thyroiditis |
|
|
Term
| sudden onset unilat awakening scrotal pain, absent cremasteric reflex |
|
Definition
testicular torsion - testicular asym, swelling, tenderness
Causes - spinal injuries L1-2, UMN/LMN lesions
Tx - surgical detorsion and BILAT orchiopexy (fixation) |
|
|
Term
| macrocytosis, hypersegmented NT |
|
Definition
megaloblastic anemia
Cause - B12 (pernicious anemia, Crohn's, Diphyllobothrium latum, gastric resec, poor diet, alcoholism) and folic acid defic
B12 affects lower ext
Dx - homocysteine and methylmalonic acid (MMA) levels
B12 defic = INC MMA, INC homo
folic defic = normal MMA, INC homo |
|
|
Term
| patchy hair loss on scalp, or gen loss of body hair |
|
Definition
alopecia areata - autoimmune vs hair follicle bulb (young adults, kids)
Tx - systemic, topical and intralesional glucocorticoid, systemic cyclosporine, psoralen plus UV A (PUVA)
Types: cicatricial (scarring) and non-cicatricial (non-scarring) |
|
|
Term
| diffuse shedding of hair d/t rapid progression of hairs fr anagen phase to telogen phase. Mostly women, after illness, surg, childbirth, meds, nutritional dz or systemic illness |
|
Definition
|
|
Term
| pruritis, scaly plaques, patchy hair loss |
|
Definition
tinea capitis - fungal infxn, young males
Dx - KOH of scale fr scalp
Tx - systemic antifungal (griseofulvin) |
|
|
Term
|
Definition
androgenetic alopecia - DEC duration of anagen (growth) phase and INC in telogen (rest) phase d/t androgen (DHT)
Male - hair loss vertix/frontotemporal
women - frontal region
Tx - finasteride, minoxidil |
|
|
Term
| fever, wt loss, abd pain, night sweats, jt/mm pain, skin ulcers, tender nodules, mononeuritis multiplex (2 or more non-contiguous nn affected), assoc w/ Hep B* |
|
Definition
Polyarteritis nodosa (PAN) - systemic vasculitis, spares lungs, neg ANCA
Dx - tissue bx (fibrinoid necrosis), angiography (aneurysm)
Tx - antiviral: interferon alpha (mainstay), other vs hep B (telbivudine, adenovir, entecavir, tenofovir) |
|
|
Term
| hematuria, flank pain, flank mass; fever, anemia, wt loss |
|
Definition
renal cell carcinoma
risks: age >50, smoking, male, adult PKD, ESRD, heavy metal exposure, von Hippel-Lindau
Dx/staging - CT
new onset varicocele (esp left) - raise suspicion (tumor can compress gonadal vein)
Can cause paraneoplastic syndromes, ie polycythemia (EPO secretion), thrombocytosis (IL-6 secretion), hypercalcemia (PTH secretion) |
|
|
Term
| auto dom, resis to inactivation by protein C, form clots |
|
Definition
|
|
Term
| infant - hearing loss, cerebral calcif, petechiae, seizures |
|
Definition
|
|
Term
| infant - cerebral calcif* (esp basal ganglia), chorioretinitis*, hydrocephaly |
|
Definition
Toxoplasmosis gondii
Tx - pyrimethamine, sulfadiazine |
|
|
Term
| infant - cataracts*, hearing loss*, cardiac defect |
|
Definition
|
|
Term
| infant - Hutchinson's teeth, deafness, interstitial keratitis |
|
Definition
Treponema pallidum (syphilis)
Dx - RPR or VDRL (intial), then FTA-ABS or MHA-TP (confirm)
Tx - IM PCN G |
|
|
Term
| lung, skin, bone involvement; broad based budding organism (KOH), midwest, southcentral |
|
Definition
blastomycosis - fever, cough, wt loss, chest pain, fatigue, painless, well-demarcated ulcer lesions, bone lesions, CNS dz
Tx - itraconazole; if disseminated - amphotericin B |
|
|
Term
|
Definition
|
|
Term
|
Definition
Supraventricular tachycardia (SVT)
Tx - ABCs, O2
Stable with narrow QRS and reg - vagal maneuver, adenosine
Unstable (AMS, hypotn, cheset pain) - IV access, sedate, cardiovert |
|
|
Term
| Myasthenia gravis pt w/ SOB, hoarseness, dysphagia, chest pain, SVC syndrome; Dx'd w/ CT and CXR |
|
Definition
Thymoma
Tx - thymectomy, even in absence of thymoma |
|
|
Term
| HIV pt w/ fever, dry cough, tachypnea, INC LDH, CXR - bilat diffuse infiltrates |
|
Definition
PCP - occurs when CD4 <250
Tx - TMP-SMP (also prophylaxis for toxoplasmosis CD4 <100) |
|
|
Term
|
Definition
amphotericin - cryptococcus
azithromycin - MAC |
|
|
Term
| joint dz fr interrupted blood supply to epiphysis w/ subsequent necrosis, ex avascular necrosis (Legg-Calve-Perthes) |
|
Definition
|
|
Term
| sexual arousal watching ppl nude, undressing, having sex |
|
Definition
|
|
Term
| rubbing vs unsuspecting persons for sexual arousal |
|
Definition
|
|
Term
| sexual arousal fr inflicting pain, humuliation |
|
Definition
|
|
Term
| sexual arousal fr receiving pain or humuliation |
|
Definition
|
|
Term
| dandruff, pruritis, affects sebaceous glands |
|
Definition
seborrheic dermatitis
Tx - selenium sulfide shampoo, hydrocortisone for other areas |
|
|
Term
| "stuck on" plaque, face/trunk |
|
Definition
|
|
Term
| herniation - ipsi dilated pupil that cannot constrict to light |
|
Definition
| uncal herniation - supratentorial brain herniates downward and compresses CN III |
|
|
Term
| hernation - AMS, tear of basilar aa (fatal Duret hemorrhage), hyperventilation, Cheyne-Strokes respirations (breathing in cycles of tachypnia and apnea) |
|
Definition
|
|
Term
| herniation - HA; no well defined sxs |
|
Definition
| cingulate, sphenoid herniation |
|
|
Term
| herniation - resp and cardiac dysfxn |
|
Definition
| tonsillar herniation - downward cerebellar tonsils thru foramen magnum, compressing medulla |
|
|
Term
|
Definition
Carbidopa-levodopa
INC dopa (levodopa, pramipexole, ropinerole; amantidine)
DEC dopa metab (selegiline - MAO-B, tolcapone - COMT)
INC anticholinergic (benztropine, trihexyphenidyl; amytriptyline) |
|
|
Term
| arachnodactylyl, scoliosis, pectus excavatum (pigeon chest), ectopic lentis, long ext, hypermobile joints, aortic aneurysm |
|
Definition
Marfain's - fibrillin-1 defect
Complications - dissection, spont pneumo, MVP, regurg
Tx - BB (DEC stress on aortic root) |
|
|
Term
| parathyroid hormone (PTH) role |
|
Definition
INC PTH d/t low levels of Ca
Cause: DEC GFR --> INC phosphate which binds Ca leading to PTH
Renal failure --> DEC Vit D syn bc calcitriol requires hydroxylation in kidney
PTH - activ osteoclasts --> bone resorp (frx); INC vitD prod, INC Ca reabsorp at kidney; INC GI Ca uptake |
|
|
Term
|
Definition
| CD4 <200 or AIDS defining illness: candidiasis of esophagus, lungs or trachea, cryptococcal, intestinal isosporiasis, cryptosporidiosis, Kaposi's sarcoma, cerebral lymphoma, PCP, cerebral toxoplasmosis, invasive cervical CA, HIV wasting syndrome |
|
|
Term
|
Definition
| mod-severe cervical dysplasia (CIN II, CIN III, or carcinoma in situ), bacillary angiomatosis, peripheral neuropathy, herpes zoster (shingles), thrush |
|
|
Term
| hypokalemia, HTN, hypernatremia, elev ALD, DEC renin; imaging - bilat adrenal hyperplasia |
|
Definition
itiopathic bilat hyperplasia - primary hyperALD
Tx - spironolactone, surg (if other tx fails) |
|
|
Term
|
Definition
late decel = uteroplacental insufficiency
Cause - maternal hypotension (sepsis), uterine hyperstimulation (strong contractions), postdate gestation, placental abruption, preeclampsia, DM |
|
|
Term
|
Definition
| variable decel = umbilical cord compression |
|
|
Term
| pulsatile abd mass w/ abd pain, flank ecchhymoses (Grey-Turner's) |
|
Definition
AAA - 90% occur below renal aa
Tx - surg
Complication of AAA repair - ant spinal cord syndrome (loss of motor control and pain and temp fr injury to artery of Adamkiewicz that supplies ant spinal cord |
|
|
Term
| barking cough, inspiratory stridor, hoarseness, age <3, winter, AP neck xray - "steeple sign" (tapering of trachea) |
|
Definition
Croup (laryngotracheitis) - parainfluenza
Tx - humidified air, epinephrine, steroids (dexamethasone), O2 |
|
|
Term
|
Definition
crystalloid (lactated ringers) Parkland formula: 3-4 ml/kg/% body surface area (BSA) burned
Half of fluid given over first 8 hrs, other half remaining 16 hr
BSA rule of 9: head and neck 9%, each arm 9, each leg 18, ant and post trunk 18, perineum 1
Endotracheal intub - airway difficulties, neck swelling, burns inside/near mouth, carbonaceous sputum Escharotomy - circumferential burns, performed later |
|
|
Term
|
Definition
|
|
Term
| flipper-like appearance of hands |
|
Definition
|
|
Term
|
Definition
|
|
Term
| iron deposits in cytoplasm on Prussian blue stain, INC iron, ferritin, normal/DEC/INC TIBC |
|
Definition
sideroblastic anemia
Cause - alcohol, INH, chloramphenicol, lead poisoning, neoplastic dz, genetics
Lab
Tx - remove offending agent, trial of pyridoxine (vit B6) |
|
|
Term
| mental retardation, polydactyly, holoprosencephaly, meningomyelocele, rocker-bottom feet, cleft palate, eye malform, GI/cardiac/renal dz |
|
Definition
|
|
Term
| mental retardation, microcephaly, micrognathia (small jaw), clenched fist, prominent occiput, rocker-bottom feet, wide-spaced eyes; renal/cardiac/GI malform |
|
Definition
|
|
Term
| long face, large body size, mental retard, hand clapping/biting |
|
Definition
|
|
Term
|
Definition
Stable pt - SC LMWH
Unstable - IV/SC unfractionated heparin
IVC - if anticoag contraindicated, in cases ie intracranial bleed, severe active bleeding, malig HTN, recent brain/eye/spinal cord srg - IV |
|
|
Term
|
Definition
CHD equivalents (DM, PAD, CAD, AAA): LDL <100, optimal <70
2 or more risk factors: LDL <130
age (men >45, women >55)
fam hx premature CAD (men <55, women <65)
Low HDL (<40)
HTN
Smoking
Note: subtract 1 risk factor if HDL >60 |
|
|
Term
| agitation, INC alertness, bruxism, euphoria, diaphoresis, dilated pupils, confusion, anorexia, tachycardia, HTN, fever, dental erosion |
|
Definition
amphetamine intox
withdrawal: sleepiness, INC appetite
note: cocaine users - no dental erosion |
|
|
Term
| pin point pupils*, sedation, slurred speech, resp depression, euphoria, constipation |
|
Definition
|
|
Term
| impulsiveness, psychosis, violent, HTN, tachycardia, agitation, nystagmus* (horizontal, vertical, rotary, rhabdomyolosis |
|
Definition
|
|
Term
| mild fever, chills, dyspnea after blood transfusion |
|
Definition
non-hemolytic febrile rxn - MC transfusion rxn, 2nd to rxn of recipient to donor WBC, more common if had past transfusions
Tx - D/C blood product, keep IV open w/ NS, monitor vitals, use leukocyte washed RBCs**, TRALI (supportive, ventilator support, IV fluid, vasopressor) |
|
|
Term
| ABO-incompatible RBCs -- fever, flank pain, hemoglobinuria |
|
Definition
|
|
Term
| resp failure, fevers/chills within 6 hr after transfusion |
|
Definition
| transfusion-related acute lung injury |
|
|
Term
| hypotension, urticaria, resp distress, rapid onset after transfusion |
|
Definition
| anaphylactic rxn to blood products |
|
|
Term
| personality changes, DEC concentration, neuropsych, asterixis, h/o liver dz, fetor hepaticus (sweet fecal odor breath, late sign), hepatic failure (spinder telangiectasia, gynecomastia, palmar erythema, ascites, edema, mm wasting; elev ammonia* |
|
Definition
Hepatic encephalopathy - caused by hypokalemia (fr diuretics), metabolic alkalosis, sedatives, infxn, hypovolemia, hypoglycemia, GI bleed
Tx - lactulose - promote ammonia excretion |
|
|
Term
| mental impairment, hypotonia, hypogonadism, short limbs, almond eyes, poor feeding, hyperphagia by age 1 |
|
Definition
| Prader-Willi syndrome - PATERNAL chrom 15 del |
|
|
Term
| fever, rash, arthralgia, elev Cre, IgE and eosinophiluria/eosinophilia 10-14 days after starting new med (esp PCN and NDAIDs) |
|
Definition
acute interstitial nephritis (AIN) - d/t abxs, allopurinol, PPI, phenytoin; can also arise in lupus, transplant rejection, infxn
UA - RBCs, WBCs |
|
|
Term
|
Definition
3rd degree AV block (complete block)
no relationship bet P wave and QRS (AV dissoc)
atrial impulse unsuccessful at reaching ventricle; maintained by escape junctional (narrow QRS) or ventricular (wide QRS) pacemaker
Tx - pacemaker, regardless if symptomatic (similar to 2nd deg Mobitz II) |
|
|
Term
| present first 6 mon, severe hypotonia, gen weakness, inability to feed, normal extraocular movements |
|
Definition
Werdnig-Hoffman dz - spinal muscular atrophy type 1 (auto recess), progressive apoptosis of motor neurons
Dx - molecular genetic testing of SMN1 gene
Tx - supportive; eventually die fr resp failure |
|
|
Term
[image]
translucent, pearly papule w/ telangiectasia, palisading histo |
|
Definition
| basal cell carcinoma (BCC) - MC skin malig, little mets risk |
|
|
Term
| aortic-iliac occlusion, claudicaiton, ED fr atherosclerosis, DEC femoral pulses |
|
Definition
|
|
Term
| flat shoulder, loss of arm abduction |
|
Definition
|
|
Term
| mucosal bleeding, prolonged bleeding time and PTT |
|
Definition
|
|
Term
| sudden, painless loss of vision |
|
Definition
amaurosis fugax - central retinal aa occlusion; usually in TIA, resolves within 24 h, MCC dislodged atherosclerotic plaque fr internal carotid or thrombus fr heart d/t afib
Dx - carotid doppler US if TIA suspected, endarterectomy if stenosis >70% in symptomatic pts |
|
|
Term
| sudden, painless, unilat loss of vision, no TIA sxs |
|
Definition
| occlusion of central retinal vv |
|
|
Term
| flashes of light, floaters, followed by sudden painless unilat vision loss |
|
Definition
|
|
Term
| loss of vision in center of visual field while maintaining peripheral vision, bilat |
|
Definition
| retinal degen/macular degen - MCC of blindness in age >50 |
|
|
Term
| cloudy apperance, may lead to blindness if untx'd |
|
Definition
|
|
Term
| vertigo, tinnitus, hearing loss; lasts hrs-days, NV, ear fullness, sweating, nystagmus; overprod endolymph |
|
Definition
Meniere's dz
Tx - benzo (diazepam-dizziness, NV), antihistamine (meclizine), anticholinergic, diuretic, low salt diet - DEC endolymph |
|
|
Term
| 1 wk after viral infxn -- vertigo, NV, hearing loss, nystagmus |
|
Definition
labyrinthitis
tx - steroids |
|
|
Term
| painful, erythematous cord, can progress to DVT |
|
Definition
superficial thrombophlebitis - Virchow's triad, h/o varicose vv, recent IVDU, IV tx
Tx - repeat exam in 7-10 days; NSAID, elevation, stockings. Anticoag if >5cm in length |
|
|
Term
| ear pain, hearing loss, drainage/pruritis fr ear, pain when pulling auricle |
|
Definition
| external otitis - MCC pseudomonas |
|
|
Term
| chronic ear drainage/bleeding, hearing loss, tinnitis, facial nn weakness; white mass behind TMs |
|
Definition
| cholesteatoma - squamous epi lined sac that fill w/ keratin, erodes bone (mastoid, mid ear, facial nn) |
|
|
Term
|
Definition
| 100% sensitive for drug-induced lupus (procainamide, hydralazine, quinidine, INH) |
|
|
Term
| malignant gastrointestinal stromal tumor (GISTs) tx |
|
Definition
20% malignant neoplasms of small bowel (jejunum, ileum), age 50-60s
Tx - excision, postop imatinib - if (+) c-kit mut (tyrosine kinase mut that causes prolif) |
|
|
Term
| adenocarcinoma of small bowel tx |
|
Definition
Tx - 5-FU, cisplatin
adenocarcinomas make up 50% small bowel tumors, poor prog |
|
|
Term
anti-TPO abs, antimicrosomal ab, lymphocytes infiltrate thyroid gland, non-tender goiter
Sx - weakness, faitgue, constipation, cold intolerance, menorrhagia, wt gain, depression, dry skin, bradycardia, hair loss, hoarseness, myxedema |
|
Definition
Hashimoto's thyroiditis - MCC hypothyroidism; temporary hyperthyroid bc of rel T3/4
Tx - levothyroxine |
|
|
Term
| urge to urinate, involuntary loss before reaching bathroom |
|
Definition
|
|
Term
| leakage fr autonomic neuropathy (multiple sclerosis, DM), bladder gets full then leaks |
|
Definition
|
|
Term
| leak during INC intra-abd pressure, weak pelvic floor mm, multip |
|
Definition
|
|
Term
| tender erythematous nodules on ant legs; assoc w/ sarcoidosis and IBD, age 20-40 |
|
Definition
erythema nodosum
Lab - elev ESR
Tx - underlying etiology, leg elev, aspirin, NSAIDs |
|
|
Term
| fever, foul smelling sputum, night sweats, wt loss, CXR - cavitation w/ air-fluid levels in dep lung |
|
Definition
aspiration pneumonia - klebsiella
tx - clindamycin |
|
|
Term
elev PTH and Ca, DEC phos
usually asymptomatic |
|
Definition
parathyroid adenoma - hyperparathyroidism
Sx - "bones, sotnes, groans, psychiatric overtones" |
|
|
Term
| DEC TSH, INC T4, sympathetic hyperactivity sx |
|
Definition
| primary hyperparathyroidism |
|
|
Term
| elev PTH, low or normal Ca |
|
Definition
| secondary hyperparathyroidism |
|
|
Term
|
Definition
|
|
Term
| opening snap w/ high-pitched diastolic rumble at lower left sternal border, intensifies on inspiration |
|
Definition
| tricuspid stenosis - 2ndary to rheumatic heart dz or congenital |
|
|
Term
[image]
painless LN in cervical/supraclavicular area |
|
Definition
Hodgkin's lymphoma
20s and >50
poor prog w/ "B" Sx (fever, night sweats, wt loss), pruritis (initial sign)
CXR - enlarged mediastrinal node
Bx - Reed-Sternberg cells (binucleated)
Tx - radiation and ABVD chemo (adriamycin, bleomycin, vincristine, dacarbazine) |
|
|
Term
| cough, coryza, conjunctivitis; Koplik spots, maculopapular rash within 1 wk (face to caudal) |
|
Definition
Rubeola (measles) - paramyxovirus
Tx - Vit A (DEC morbidity/mortality), return to school 4 days after rash onset
(contagious 5 days before onset) |
|
|
Term
| painless, enlarged LN, immunocompromised |
|
Definition
|
|
Term
| age >60, leukocytosis, LAD, bone tenderness, mature lymphocytes, smudge cells*, CD5* protein |
|
Definition
| chronic lymphocytic leukemia (CLL) |
|
|
Term
| Ann Arbor staging of Hodgkin's lymphoma |
|
Definition
I - 1 LN involved
II - 2 or more LN, same side diaphragm
III - both sides diaphragm + one organ near LN or spleen
IV - extralymphatic tissue (liver, bone marrow, lungs) |
|
|
Term
| suboccipital and postauricular LAD, maculopapular rash (face to caudal), arthralgia |
|
Definition
| Rubella (german measles) - Togavirus |
|
|
Term
| fever 2-5 days, followed by maculopapular rash starts on trunk spread to neck/ext |
|
Definition
| HHV 6 - roseola infantum / exanthem subitum / 6th dz; self limiting |
|
|
Term
| mm weakness, hyperreflexia, DEC sensation, loss of sphincter tone, urinary/fecal incontinence (late), back pain |
|
Definition
spinal cord compression - CA mets to spine
Dx - MRI
Tx - high dose corticosteroids (initial) |
|
|
Term
| early dementia, mood disturb, chorea, Parkinson's like sx, CAG repeat chrom 4 |
|
Definition
Huntinton's dz
Tx - tetrabenazine (for chorea - inhib VMAT, rel dopamine into synaptic cleft) |
|
|
Term
|
Definition
seen on transvag US with BhCG >1,500 mIU/ml
abd US with BhCG >6,500
BhCG normally double q 48-72 h
Ectopics cause low rise in hCG --> repeat hCG in 48-72 hr
Risk factors: IUD, tubal ligation, prev PID, prev ectopic |
|
|
Term
| cont. machine-like murmur loudest at left 2nd ICS |
|
Definition
PDA - normally closes within 10 h
CXR - INC pulm vascular markings (bc of R->L shunt)
Tx - indomethacin or ibuprofen, surg if large |
|
|
Term
|
Definition
| aortic dissection, esophageal rupture, mediastinitis |
|
|
Term
| perianal pruritis, esp at night |
|
Definition
enterobius vermicularis (pinworm)
Dx - scotch tape test
Tx - mebendazole |
|
|
Term
| acute scrotum pain in sup/inf pole of testicle, age 7-14, "blue-dot" sign, normal cremasteric reflex |
|
Definition
torsion of appendix testes - remnant of paramesonpehric duct
Tx - supportive (pain control, bed rest, scrotal support); relieved in 1 wk |
|
|
Term
| DEC peripheral pulse, BP diff bet UE/LE, Asian women |
|
Definition
|
|
Term
| vasculitis in young smokers, cold & painful fingers |
|
Definition
|
|
Term
|
Definition
| CREST syndrome (calcinosis, Raynaud's, esophageal dysmotility, sclerodactyly, telangiectasia) - type of limited scleroderma, age 30-50 women |
|
|
Term
|
Definition
| drug-induced lupus - procainamide, hydralazine, minocycline, anti-TNF drugs |
|
|
Term
| gumma (destructive granulomatous lesion), Argyll-Robertson pupils (accomdates, but doesn't react to light), CV/CNS |
|
Definition
|
|
Term
| periorbital edema, propstosis, eye pain, conjunctival injection, blurry vision, limited extraocular motion |
|
Definition
orbital cellulitis - infxn post to orbital septum by Staph or strep; sinusitis predisposes,
Dx - CT |
|
|
Term
| unilat periorbital swelling, no elev intraocular pressure |
|
Definition
|
|
Term
| conjunctival edema, erythema, ocular d/c, bilat eye involvement, purulent dc, eyes crusted shut in am |
|
Definition
acute bacterial conjunctivitis - H flu, strep
Tx - topical abx |
|
|
Term
| high PTH, skeletal abnorm, mental retard |
|
Definition
| pseudohypoparathyroidism - kidney unresponsive to PTH |
|
|
Term
|
Definition
|
|
Term
| migratory polyarthritis, carditis, subcut nodules, erythema marginatum, Sydenham's chorea; recent group A strep |
|
Definition
rheumatic fever
Tx - PCN (give regardless of sxs) |
|
|
Term
| compression frx of surgical neck humerus, dislocated humeral head; weak shoulder abd |
|
Definition
| axillary - teres minor and deltoid |
|
|
Term
| wrist extensors, digits, forearm pronators -- "wrist drop"; mid-humerus frx or after using crutches |
|
Definition
|
|
Term
| psychosis (usually auditory hallucination, delusions, disorg thoughts) + mood disorder |
|
Definition
|
|
Term
early - ambiguous genitalia, salt wasting, hypotension, hyperK+, hypoglycemia, failure to thrive
late onset - hirsutism, clitoromegaly, INC growth, early puberty |
|
Definition
CAH - MCC 21-hydroxylase deficiency
Dx - elev 17-hydroprogesterone DEC cortisol, INC ACTH (d/t loss of neg FB)
Tx - IV hydrocortisone (GC and MC actions, TOC in kids) |
|
|
Term
|
Definition
otitis media (OM) - bulging, pale TM, loss of light reflex, DEC hearing
MCC (in order): S pneumo, H flu, moraxella, S pyogenes
Tx - amoxicillin |
|
|
Term
|
Definition
Tx - ciprofloxacin + hydrocortisone - ear suspension
kids - polymyxin B-neomycin-hydrocortisone (Corticosporin otic suspension) |
|
|
Term
|
Definition
hyperthyroidism
TSH initial test |
|
|
Term
|
Definition
| TSH-producing pitutiary adenoma |
|
|
Term
| small round papules w/ gray to brown |
|
Definition
| verrucae vulgaris - common warts; HPV |
|
|
Term
| "slapped cheek" followed by lace-like rash on arms -> trunk, butt, thigh; starts with non spec (fever, nasal congestion, sore throat, fatigue) |
|
Definition
| B19 - parvo - erythema infectiosum |
|
|
Term
| parasthesia, weakness, paralysis, resp failure after magnesium sulfate |
|
Definition
magnesium toxicity
Tx - IV calcium gluconate, dialysis for renal failure |
|
|
Term
| hemoptysis (fr pulmonary hemorrhage)-lower resp tract, linear deposit Ig |
|
Definition
| Goodpasture's syndrome - anti-GBM abs targeting type IV collagen |
|
|
Term
| upper (nasal ulcers, sinusitis, OM, saddle nose) AND lower resp tract (dyspnea, cough, hemoptysis) + kidneys (GN) |
|
Definition
| Wegener's granulomatosis (granulomatosis w/ polyangitis) - (+) c-ANCA (specific - autoabs vs proteinase-3), granulomas |
|
|
Term
| renal bx - apple green birefringence on congo red stain |
|
Definition
renal amyloidosis - MM, Crohn's, RA Screening - abd fat pad bx
Tx - prednisone, melphalan |
|
|
Term
| mm ischemia, kidney failure; caused by trauma, electrocution, heat stroke, immobilized |
|
Definition
rhabdomyolysis - mm ischemia rel myoglobin toxic to kidneys --> acute tubular necrosis (ATN)
Tx - IV fluid, sodium bicarb (alkalinize urine) |
|
|
Term
|
Definition
>45 oral succimer (kids)
>70 IV chelation (kids)
First: investigate lead dust hazard |
|
|
Term
| "bronze diabetes", elev iron and ferritin, DEC TIBC, INC serum iron/TIBC |
|
Definition
Hemochromatosis
Dx - liver bx or genetic testing (HFe gene)
Tx - life-long phlebotomy |
|
|
Term
| Horner's syndrome, ulnar nn distrib numbness, paralysis of intrinsic mm |
|
Definition
| Klumpke's paralysis - injury to C8-T1 nn root |
|
|
Term
| MC familial hyperlipoprot, very high LDL |
|
Definition
| hyperlipoproteinemia type IIa |
|
|
Term
| DEC lipoprotein lipase, INC chylomicrons |
|
Definition
| hyperlipoproteinemia type I - eruptive xanthoma |
|
|
Term
| DEC LDL-R, INC ApoB --> INC LDL and VLDL |
|
Definition
| hyperlipoproteinemia type IIb |
|
|
Term
|
Definition
| hyperlipoproteinemia type IV - eruptive xanthoma |
|
|
Term
| defect apolipoprotein C-II gene, elev chylomicrons, VLDL, trig |
|
Definition
| hyperlipoproteinemia type V - eruptive xanthoma |
|
|
Term
| lateral extension of lesion when pressure applied |
|
Definition
| Asboe-Hansen sign -- blistering dz: pemphigus vulgaris, bullous pemphigoid |
|
|
Term
| erythema and pruritus after striking skin |
|
Definition
| Darrier's sign - (+) in mastocytosis, urticarial dz |
|
|
Term
| dimpling of skin w/ lateral pressure |
|
Definition
| dermatofribroma - mass tethered to subq tissue causing dimpling |
|
|
Term
|
Definition
| Early decel (mirror image) = fetal head compression |
|
|
Term
|
Definition
| INC oxytocin, INC bonding, DEC allergies, DEC availability of iron to intestinal bacteria, IgA (protect vs infxn) |
|
|
Term
| non-anion gap hyperchloremic metabolic acidosis, hyperK+* |
|
Definition
RTA type IV = HYPOALD - hyponatremia, hyperCl-, hyperK+
Seen in diabetes, interstitial nephritis (result in hyporeninemic state)
Tx - loop/thiazide diuretic +/- sodium bicarb; IV calcium (if + EKG changes) |
|
|
Term
| non-anion gap hyperchloremic metabolic acidosis, urine pH >6*, may have nephrolithiasis |
|
Definition
RTA type 1 - distal tubular defect; defic H+ secretion (pH >6) --> higher dispo for kidney stones d/t INC Ca and phos excretion caused by alkaline urine
Causes: Sjogren's, SLE, autoimmune
Tx - sodium bicarb |
|
|
Term
| non-anion gap hyperchloremic met acidosis, hypoK+, urine low pH* (<5.5) |
|
Definition
RTA type II - lack of bicarb reabsorp at prox tubule
Fanconi's syndrome (abnorm excretion of glucose, aa, citrate, phosphate into urine, vitD defic, hypoK+)
MM, carbonic anhydrase inhibitor use |
|
|
Term
|
Definition
1) hyperchloremic acidosis w/ normal anion gap, near normal GFR, no diarrhea = RTA
2) Look at K+, higher than norm (2.5-4.5) = RTA IV... if not
3) Look at urine pH, <5.5 = RTA II, if higher then...
4) Look at bicarb, if near normal = RTA I, if markedly DEC = RTA II
5) confirm dx:
RTA I - give ammonium chloride (acid), confirmed if urine pH does not drop below 5.5 as serum pH DEC
RTA II - give bicarb, confirmed if urine pH rises
RTA IV - salt restrictive diet, confirmed if urine sodium persis high while serum Na DEC |
|
|
Term
|
Definition
hand-foot syndrome (dactylitis) - MC initial by age 3, painful crises cause severe bone pain, acute chest syndrome (pulm infarct --> chest pain, hypoxia), asplenia by repeated splenic infarcts, renal papillary necrosis, MI, CVA, priaprism, retinal infarcts, chronic leg ulcers, pigmented cholelithiasis
Tx - IV fluid, hydroxyuriea - INC FbF to DEC painful crises; folic acid - d/t hemolysis
sickle + parvo B19 = aplastic crises, parvo has prediliction for rapidly dividing cell lines (bone marrow arythroid progenitor cells)
Tx - blood transfusion |
|
|
Term
| dysphagia to solids + liquids, heartburn, barium swallow (initial) - birds beak |
|
Definition
achalasia
Dx - manometry (confirm) - INC LES, incomplete relaxation w/ swallowing, esophageal spasms or lack of peristalsis
Endoscopy to r/o CA (more likely squamous cell carcinoma)
Tx - myotomy (TOC) |
|
|
Term
[image]
dysphagia, chest pain, barium swallow - corkscrew if spasms occur |
|
Definition
diffuse esophageal spasm (DES)
Dx - barium (diagnostic), EGD (always for dysphagia), manometry
Tx - CCB (diltiazem)*, botulism toxin (temp), nitrates, TCA (imipramine)-helpful |
|
|
Term
| dysphagia started with solids, followed by liquids; barium - "apple-core" |
|
Definition
| esophageal CA (adenocarcinoma-Barrets or squamous cell) |
|
|
Term
| sustained/paroxysmal HTN, HA, palpitations, sweating, tremor, CT/MRI - localizes adrenal mass |
|
Definition
Pheochromocytoma - orig in chromaffin cells, age 30-40s, may present as feature of MEN 2 or von-Hippel-Lindau
Dx - INC 24-hr urinary metanephrines and catecholamines (100% sens)
Note: False pos w/ sympathomimetics, ie cold meds, phenoxybenzamine, acetominphoen, TCA)
MRI - more sensitive; CT - pre-op planning
Tx - alpha blocker + phenoxybenzamine (initial, control BP) followed by BB or CCB, ultimately surgery* |
|
|
Term
| flushing, diarrhea, wheezing, pruritis, heart valve damage, >24 h urine 5-HIAA (metabolite of serotonin) |
|
Definition
| carcinoid syndrome - secretes serotonin (diarrhea, heart valve damage), histamine (flushing, wheezing, pruritis), kallikrein (flushing) |
|
|
Term
| liverdo reticularis (lace like in LE), renal failure, eosinophilia -- after vasc intervention |
|
Definition
| cholesterol embolism syndrome |
|
|
Term
|
Definition
pre-renal azotemia - poor perfusion of kidneys
hypotensive pts - renal aa constrict to preserve BP |
|
|
Term
|
Definition
at least 2:
1) temp >38.5 or <36
2) HR >90
3) RR >20
4) WBC >12,000 or <4000
SIRS + infxn = sepsis
SIRS + infxn + end organ damage = severe sepsis
severe sepsis + hypotension unresponsive to fluid = septic shock |
|
|
Term
| somnabalism (sleep walking) |
|
Definition
| Tx - benzo (clonazepam) shortens stage 3-4 os sleep (sleepwalking) |
|
|
Term
|
Definition
If height <5% --> Tx: human growth hormone (stop once epiphyseal fusion occurs)
Also, estrogen/progestin therapy
Surgery for coarctation |
|
|
Term
[image]
intermit chest palpitations |
|
Definition
A fib - clear QRS complex, absent P waves
< 48 h --> TEE look for L atrial clot
>48 h --> anticoag x 3-6 wks, INR 2-3, TEE then cardiovert |
|
|
Term
| age 3-4, aniridia, GU malform (abd pain, mass, hemihypertrophy, hematuria, HTN), mental retardation |
|
Definition
Wilms tumor
Dx - US, f/u CT abd and chest for mets
Tx - nephrectomy, chemo, radiation |
|
|
Term
| transmural tear in distal esophagus, h/o vomiting, retching, retrosternal chest pain |
|
Definition
Boerhaave's syndrome - subcut emphysema, pleural effusion, pneumothorax
Dx - CXR (initial) - pneumomediastinum; contrast esophagram or chest CT (confirm)
Tx - NG, NPO, IV fluid and abx; emergency surg* |
|
|
Term
| tremulousness, confusion, dyarthria, dystonia, hyperreflexia, ataxia |
|
Definition
|
|
Term
| EPS sx*, tardive dyskinesia, akathisia, insomnia, anticholinergic effets, gynecomastia, galactorrhea |
|
Definition
|
|
Term
| somnolence, hepatotoxicity, wt/appetitite changes, alopecia, insomnia, thrombocytopenia |
|
Definition
|
|
Term
| agranulocytosis*, wt gain, lethargy, sedation, miosis |
|
Definition
|
|
Term
| cocaine and amphetamine withdrawal |
|
Definition
| dysphoria, excessive sleep, hunger |
|
|
Term
|
Definition
| rhinorrhea, lacrimation, yawning, abd/leg cramping, piloerection, NV, diarrhea, dilated pupils |
|
|
Term
| renal papillary necrosis - flank pain, fever, abd pain, hematuria |
|
Definition
slouphing on UA; anatomical defects, hydronephrosis
Risk: NSAID, acetominophen, sickle cell anemia, urinary tract obstruction, diabetes
Dx - CT or IV pyelography - medullary ring shadows
Tx - supportive |
|
|
Term
|
Definition
| struvite crystals - infxn by proteus --> urease which INC pH causing calculi in renal pelvis |
|
|
Term
| sciatica, LBP, DEC DTR, saddle anesthesia, bladder/bowel dysfxn, motor/sensory deficits in LE |
|
Definition
Cauda equina syndrome
Causes - trauma, CA, epidural abscess, disc dz
Dx - MRI |
|
|
Term
| ant displacement of vertebrae; LBP, waddling gait, tight hamgstrings |
|
Definition
|
|
Term
| inflamm arthritis of spin, age 20-30, LBP improves w/ activity |
|
Definition
|
|
Term
| pars interarticularis, LBP |
|
Definition
|
|
Term
| degenerative vertebrae, radicular LBP |
|
Definition
|
|
Term
|
Definition
| aminoglycoside (streptomycin) |
|
|
Term
| stained teeth, abnormal bone growth |
|
Definition
| tetracycline (doxycycline) |
|
|
Term
| memory loss w/ changes in personality |
|
Definition
| frontotemporal (Pick's) dementia |
|
|
Term
| memory loss w/ hallucinations, parkinsonian sxs |
|
Definition
|
|
Term
| rapid dementia, usually young |
|
Definition
| Creutzfeldt-Jakob dz - caused by infectious prions |
|
|
Term
| Auer rods, M3 subtype, pancytopenia (anemia, thyromcytopenia, leukopenia -- bleeding, infxn, fatigue) |
|
Definition
Acute myelogenous leukemia (AML)
Dx - peripheral smear (initial), bone marrow bx (diagnostic), react w/ myeloperoxidase and sudan black
Tx - retinoic acid (VitA)*, chemo |
|
|
Term
| confusion, ataxia, nystagmus*, alcoholic |
|
Definition
| Wernicke's encephalopathy - thiamine (B1) defic Tx - IV thiamine followed by glucose |
|
|
Term
| confabulation, anterograde/retrograde amnesia, alcoholic |
|
Definition
|
|
Term
| diarrhea, dermatitis, dementia, death (pellagra) |
|
Definition
|
|
Term
| infant: high-pitched cry, convulsions, irritability, tachypnea, sweating, diarrhea, vomiting |
|
Definition
| opiate withdrawal - presents 48-72 hr after birth |
|
|
Term
| impaired consciousness + tonic phase (rigid) followed by clonic phase (repetitive movements) followed by postictal phase (confusion) |
|
Definition
|
|
Term
| impaired consciousness seizure |
|
Definition
|
|
Term
| impaired consciousness, involuntary movements, postictal confusion |
|
Definition
| complex partial - majority in temporal lobe (olfactory, auditory, visual hallucinations reported) |
|
|
Term
| blind pouch vagina, no uterus/cervix, testost in male range, primary amenorrhea, inguinal masses |
|
Definition
androgen insensitivity syndrome (XY) - testicular feminization
Tx - orchiectomy (prevent CA) |
|
|
Term
| hypogonadism, lack of smell, DEC GnRH and LH/FSH, heart defect, cleft lip/palate, delayed puberty, infertility, ED, DEC mm mass; females - amenorrhea, infertility |
|
Definition
|
|
Term
|
Definition
RBBB - common, not serious, prev MI
QRS complex INC >120 (3 small boxes), rSR' in V1 (and usually V2), slurred S waves in leads I and V7
Tx - if symptomatic - pacemaker |
|
|
Term
|
Definition
| seborrheic keratosis - benign, orig fr keratinocytes, INC w/ age, >65, tan/brown flat patch, "stuck on" |
|
|
Term
| MCV <80, DEC iron and TIBC, normal/high ferritin |
|
Definition
|
|
Term
| elev retic count*, may be micro, normo or macrocytic, INC RDW, DEC haptoglobin, elev LDH, indirect hyperbilirubinemia |
|
Definition
|
|
Term
| microcytic anemia, normal iron and TIBC |
|
Definition
|
|
Term
| low iron, high TIBC and transferrin, INC RDW |
|
Definition
|
|
Term
| sustained spasm/contraction, oculogyric crisis (fixed), starts hrs-days after initiation of antipsychotic |
|
Definition
acute dystonia - oculogyric crises, protrusion of tongue, trismus (locked jaw), torticollis
Tx - benztropine (anticholinergic), diphenhydramine (antihistamine) |
|
|
Term
| involuntary movements of face (grimacing, tongue protrusion, lip smaking, puckering), twisting and tapping of LE |
|
Definition
Tardive dyskinesia - within months of antipych
Tx - dc or DEC typical, switch to atypical (clozapine)* |
|
|
Term
| inner restlessness, urge to move |
|
Definition
akathisia - starts within days of antipsychotic
Tx - propranolol (BB), benzo, benztropine (anticholin) |
|
|
Term
| age >50, elev ESR, fever, anemia, HA, cranial nn involvement, cord-like thickening of cranial nn, jaw and tongue claudication |
|
Definition
Giant cell arteritis - medium to large systemic vasculitis
Assoc w/ PMR (prox mm pain), may be complicated by aortic dissection
Dx - arterial bx
Tx - low dose glucocorticoids and low dose aspirin (don't wait for bx to prevent blindness if having ocular sxs) |
|
|
Term
|
Definition
| pulm and renal vasculitides (Churg-Strauss, microscopic polyangitis, granulomatosis w/ polyangitis) |
|
|
Term
| thrombocytopenia, eczema, immunodeficiency (low IgM); male child w/ petechiae, dry skin, h/o recurrent infxn |
|
Definition
Wiskott-Aldrich syndrome - x-linked reces
Tx - IV Ig, corticosteroids, platelet transfusion, splenectomy
Monitor for hematologic malig, autoimmune dz |
|
|
Term
| isolated thrombocytopenia, petechieae, purpura, bruising, epistaxis, menorrhagia |
|
Definition
| immune thrombocytopenic purpura (ITP) |
|
|
Term
| easy bruising, excessive bleeding; famhx of clotting factors; prolonged PTT and bleeding time |
|
Definition
von Willebrand dz - auto dom, low vWF
Path - involved in intrinsic pathway, primary hemostasis, forms adhesive bridges (prolonged bleeding time), carrier of factor VIII (thus prolonged PTT)
Tx - DDAVP (desmopressin) |
|
|
Term
| white curdy d/c, burning, irritation, dyspareunia, normal vag pH (3.8-4.5) |
|
Definition
Candida vulvovaginitis
Dx - KOH budding yeast/pseudohyphae
Tx - oral fluconazole, topical -azole |
|
|
Term
| tremor, ataxia, asymmetric sensory deficits, delirium, eating excess canned tuna |
|
Definition
Mercury poisoning
Tx - dimercaprol (aka BAL) |
|
|
Term
| professional boxer, progressive cognitive decline over mon-yrs, mid age |
|
Definition
| acute dementia pugilistica |
|
|
Term
| pruritis after showering, HA, vertigo, DEC EPO, INC RBC, WBC, platelets, leukocyte alk phos, bilirubin, B12 and uric acid, JAK2 mut |
|
Definition
| Polycythemia vera - prolif of RBC, complication: thrombosis Tx - chronic phlebotomy, hydroxyurea |
|
|
Term
[image]
no pulse, unconscious |
|
Definition
V fib - random, unrelated waves, no recog P waves or QRS complexes
MCC - inadequate blood flow d/t CAD
Tx - manual biphasic shock, CPR
|
|
|
Term
|
Definition
birth - 3 mon: GBS (strep agalactiae) (beta-hemolytic gram +, group B Lancefield Ag); 2nd MCC - E Coli (rod shaped, gram -)
3 mon - 9 yrs, after age 30: strep pneumo (lancet shaped, gram +, alpha-hemolytic, encapsulated, optochin sens)
teens, young adults: neisseria (gram -, diplococcal, oxidase +, choco agar) |
|
|
Term
| usually asymptomatic, may have abd pain after d/c for acute pancreatitis, pancreatic fluid enclosed by wall |
|
Definition
pancreatic pseudocyst - occur 1-2 wks after acute pancreatitis
Dx - CT, if <6cm and no infxn --> NPO, observe; if >6 cm and does not resolve within 8 wks --> endoscopic cystgastrostomy or cystduodenostomy (drain into stomach) |
|
|
Term
| h/o radioactive ablation for hyperthyroidism, galactorrhea, INC TRH |
|
Definition
hypothyroidism - stim TSH and PRL
MCC - elev PRL, meds (antipsychotics) |
|
|
Term
|
Definition
lip - repair at 3 mon
palate - special feeding, surg after 6 mon |
|
|
Term
| B cell neoplasm, sequela of EBV, African kids, mandibular facial tumor, histo: "starry-sky" (macrophages engulfing, apoptotic neoplastic cells) |
|
Definition
|
|
Term
| "fried egg" on bone marrow (reticular chromatin, cytoplasmic projections) |
|
Definition
|
|
Term
| full term infant, persis jaundice, acholic stools, dark urine, hepatomegaly |
|
Definition
biliary atresia - congenital, conj hyperbilirubinemia by discontinuity of extrahepatic biliary duct sys
Dx - intraop cholangiography
Tx - surgery |
|
|
Term
| poor feeding hepatomegaly, cataracts, unconj or mixed hyperbilirubinemia, susceptible to E coli sepsis |
|
Definition
| galactosemia - galactose-1-phosphate uridyltransferase defic |
|
|
Term
| baby sleeps alot, course facial, large fontanelle, macroglossia, goiter, large umbilical hernia, jaundice, hypotonia |
|
Definition
| congenital hypothyroidism |
|
|
Term
| early unconj hyperbili (up to 50), dev kernicterus (hypotonia, deafness, lethargy, oculomotor palsy) if not tx'd w/ exchange transfusion or long-term phototherapy |
|
Definition
| Crigler-Najjar type 1 - complete absence of UGT |
|
|
Term
| unconj hyperbili (up to 20), response to tx of phenobarbital (induces expression of UGT) |
|
Definition
| Crigler-Najjar type 2 - less severe than Type 1 |
|
|
Term
| anchovy paste fr liver mass, abd pain, fever, abd tenderness, hepatomegaly, anorexia, wt loss, diarrhea, jaundice |
|
Definition
amebic abscess (E histolytica) - subtropical (Africa, India, Mexico, central/south america)
Tx - metronidazole, aspiration (if resis to rx) |
|
|
Term
|
Definition
pyogenic liver abscess
Tx - IV abx, aspiration (culture to guide tx) |
|
|
Term
| acute painless, monocular vision d/t embolus, pale retina w/ cherry-red macula (maintains blood supply fr ciliary aa) |
|
Definition
|
|
Term
| painless gradual loss of vision, INC cup-to-disk ratio (optic disc cupping) |
|
Definition
|
|
Term
| severe ocular pain, halos, rock-hard eye, frontal HA, inc cup-to-disk ratio (optic disc cupping) |
|
Definition
|
|
Term
| bilat, painless lens thickening, opacifications w/ glare, slow progressive vision loss |
|
Definition
cataracts - can be seen w/ naked eye
risk factors - age, smoking, DM, EtOH, HTN, obesity, UV exposure |
|
|
Term
| port wine stain (nevus flemmeus), seizures, intracranial calcif of vasc angiomas on skull xray, CT or MRI (most sens) |
|
Definition
Sturge-Weber - also mental retard, hemianopsia, hemiparesis
Tx - control seizures |
|
|
Term
| AMS, fever, HA, seizures, olfactory hallucinations* |
|
Definition
herpetic encephalitis - prediliction for temporal lobes
Tx - IV acyclovir |
|
|
Term
| MC malig CNS neoplasm in kids; cerebellar vermis (can compress 4th ventricle leading to obstructive hydrocephalus) |
|
Definition
|
|
Term
| stone in CBD, INC bili, alk phos, GGT |
|
Definition
choledocholithiasis
Dx - ERCP (gold std), US (initial) |
|
|
Term
| INC fasting serum gastrin, INC gastrin w/ secretin injection (supposed to injib gastrin); diarrhea, refractory peptic ulcers |
|
Definition
Gastrinoma (Zollinger-Ellison syndrome) - found in duodenum; high malignancy
Dx: US or radionuclide octreotide scanning - locates tumor |
|
|
Term
| body dysmorphic disorder tx |
|
Definition
|
|
Term
effacement and dilation up to 5-6 cm
Normal: up to 20 h nullip, 14 hr multip |
|
Definition
|
|
Term
dilation 5 cm until complete
Normal 1.2 cm/h in null
1.5 cm/h in mult |
|
Definition
active phase (1st stage)
If no changes after 2 hr = arrested active phase |
|
|
Term
| abd pain, bloody diarrhea, tenesmus, fever, wt loss; colonscopy/sigmoidoscopy (dx) - friable mucosa, erythema, pseudopolyps |
|
Definition
Ulcerative colitis - inflamm of mucosa/submucosa of colon and rectum; assoc w/ cholangriocarcinoma, sclerosing cholangitis, colon CA
Tx - 5-ASA / mesalamine or sulfasalazine |
|
|
Term
|
Definition
| triple therapy: amoxicillin, clarithromycin, PPI; bismuth subsalicylate may be added or replace PPI |
|
|
Term
| PUD types (Johnson classif) |
|
Definition
I - gastric ulcer lesser curve (MC)
II - duodenal ulcer
III - prepyloric ulcer
IV - prox gastroesophageal ulcer
V - gastric body (MC for NSAID) |
|
|
Term
| pheochromocytoma rule of 10s |
|
Definition
| recurrence after surg, familial, bilat, extra-adrenal, malig, kids |
|
|
Term
|
Definition
etio: "Pee SAC" - phenacetin, smoking, aniline dyes, cyclphosphamide
Dx - cytoscopy - exophytic mass, confirm w/ bx, CT |
|
|
Term
| tumor at confluence of hepatic ducts, risk factor: primary sclerosing cholangitis; painless jaundice |
|
Definition
Klatskin tumor - poor prog
Dx - elev CEA and CA19-9, mass on US
Tx - surg resection, chemo |
|
|
Term
|
Definition
|
|
Term
| prox mm weakness, hyporeflexia, small cell lung CA (in 40% cases, smokers); hypoK+ causes mm weakness and constipation |
|
Definition
Lambert-Eaton syndrome - improve with mm use
Path - autoabs vs PREsynaptic Ca channels
Dx - antiacetylcholine-R abs, Tensilon (edrophonium, ACHesterase inhib) test improves sxs
Tx - prednisone, IVIG, tx underlying CA |
|
|
Term
|
Definition
| INR 5-9 no bleeding - withhold warfarin (vit K antag) until desired level >10 oral vit K active bleeding - fresh frozen plasma transfusion (quicker) |
|
|
Term
| abd pain, no rash, elev urine aminolevulinic acid and porphobilinogen (red urine) |
|
Definition
| acute intermit porphyria - precip by smoking, stress, drugs |
|
|
Term
| cheilosis (fissured corner of lips) |
|
Definition
|
|
Term
| neuropathy, cardiac failure |
|
Definition
|
|
Term
|
Definition
|
|
Term
| mild anemia, splenomegaly, peripheral smear w/ teardrop cells and dry marrow aspiration |
|
Definition
| primary myelofibrosis - myeloprolif disorder |
|
|
Term
|
Definition
| essential tremor, thyrotoxicosis, migrains, some arrhythmias |
|
|
Term
|
Definition
| osteoporosis, kidney stones (DEC Ca excretion in urine) |
|
|
Term
|
Definition
Raynaud's, esophageal spasm, some arrhythmias
SE: pedal edema |
|
|
Term
|
Definition
BPH
SE: orthostatic hypotension |
|
|
Term
|
Definition
after 48 h: pneumonia, UTI, phlebitis
after 5 days: if febrile --> abd CT r/o intraabd abscess |
|
|
Term
| secondary amenorrhea, galactorrhea, bitemp vision loss |
|
Definition
prolactinoma - hyperPRL
Dx - MRI
Tx - symptomatic >2cm - bromocriptine or cabergoline; debulking surg (if resis to rx) |
|
|
Term
| thrombosis of hepatic vv or IVC |
|
Definition
Budd-Chiari syndrome - hypercoagulable
Dx - hepatic venography, US (initial)
Tx - thrombolytics (tPA), diuretics, anticoag |
|
|
Term
| shiny nipple with peeling around areola, pain, burning, redness of nipple, breastfeeding |
|
Definition
|
|
Term
acetominophen poisoning
Phase 1 (0-24 h) - asymp, NV, malaise
2 (18-72 h) - RUQ pain
3 (72-96 h) - hepatic necrosis
4 (4 d - 3 wk) - resolution of organ failure |
|
Definition
presents within
1 hr - oral activated charcoal (DEC absorp)
Obtain serum levels at 4, 6, and 8 hr to determine need for NAC
>8 h - NAC (INC glutathione to eliminate toxic NAPQI) |
|
|
Term
| young athlete baseball pitcher, lat elbow pain, overuse causing avascular necrosis of capitellum w/ premature bone |
|
Definition
|
|
Term
| avascular necrosis of capitellum after bone matures |
|
Definition
| osteochondritis dissecans |
|
|
Term
| freckling in axillary/inguinal, Lisch's nodules (iris hamartomas), bony lesions; cafe au lait spots, neurofibromas, CNS tumors |
|
Definition
| Neurofibromatosis Type I (von Recklinghausen) |
|
|
Term
| bilat acoustic neuromas, cataracts; cafe au lait spots, neurofibromas, CNS tumors |
|
Definition
| Neurofibromatosis type II |
|
|
Term
| multisys CA syndrome - clear renal cell carcinoma, phemochromocytoma, hemangioblastomas |
|
Definition
|
|
Term
| seizures, hamartomas, learning disability, ash-leaf (hypopig) on trunk/ext; affects eyes, heart, lung, kindey |
|
Definition
|
|
Term
| painless jaundice, distended gallbladder; unexplained pancreatitis, NV, clay colored stools, dark urine, steatorrhea, wt loss |
|
Definition
Courvosier's sign --> adenocarcinoma of head of pancreas
Dx - abd CT w/ contrast; ERCP if no mass on CT; bx - definitive dx, guides tx |
|
|
Term
|
Definition
3rd degree AV block (complete block) - no atrial impulse reach ventricle, no relationship bet P waves and QRS complex (AV dissociation)
narrow QRS - junctional escape
wide QRS - ventricular escape
Tx - pacemaker |
|
|
Term
| female, age <5, affects 4 or less joints, painless lump/knee swelling |
|
Definition
| Pauciarticular onset JRA - complications: uveitis, iridocyclitis, asymm leg length |
|
|
Term
| females, age <5, involves 5 or more joints |
|
Definition
|
|
Term
| tender bony prominence at tibial tuberosity, knee pain, NO swelling or joint effusion, active kids age 9-15 |
|
Definition
Osgood-Schlatter dz - taller kids, jumping hurts
Tx - self limited, RICE, NSAIDs |
|
|
Term
| arthritis, uveitis, urethritis ("can't see, pee, climb tree") |
|
Definition
|
|
Term
| dry mouth, drowsiness, nausea, constipation, sedation, blurry vision, urinary retention |
|
Definition
anticholinergic SE d/t TCA
*Avoid in elderly |
|
|
Term
[image]
splenomegaly, anemia, hyperbilirubinemia; INC retic, elev RDW, MCHC, normal/low MCV |
|
Definition
hereditary spherocytosis - defect in spectrin (RBC membrane); central palor
Tx - splenectomy (proph pneuomo vaccine prior) |
|
|
Term
| neonatal conjunctivitis within first 24 h |
|
Definition
chemical conjunctivitis (fr erythromycin drops)
Tx - saline wash, reassurance |
|
|
Term
| pleural fluid: lymphocytes >80%, adenosine deaminase >40, low glucose, INC total protein |
|
Definition
|
|
Term
exudative effusion:
1) ratio PF:serum protein >0.5 AND
2) PF LDH >2/3 ULN (60+)
Anything other is Transudative (CHF) |
|
Definition
|
|
Term
| low glucose pleural fluid |
|
Definition
|
|
Term
| PF white/milky, trig >110 |
|
Definition
|
|
Term
|
Definition
| MCC: pulm embolism, malignancy |
|
|
Term
|
Definition
premature ventric contraction (PVC) - wide QRS, unrelated P wave; heartbeat initiated by ventricles; common; sx - skipped beat, palpitaitons
Tx - none, BB if symptomatic |
|
|
Term
| age 2-5 days, purulent eye discharge |
|
Definition
gonorrheal conjunctivitis
Tx - IM or IV cefotaxime (single) |
|
|
Term
| water then mucopurulent discharge w/ palpebral erythema, 5-14 days |
|
Definition
chlamydial (inclusion) conjunctivitis
Tx - erythromycin oral (prevent pneumonia) |
|
|
Term
| bilat lid edema, conjunctival erythema, 6-14 days, MCC HSV |
|
Definition
|
|
Term
|
Definition
| uterine massage*, oxytocin, carboprost, misopristol, methylergonovine |
|
|
Term
|
Definition
| CBT + SSRI or clomipramine (TCA) |
|
|
Term
| solid testicular tumor, age 15-35, elev bHCG, "fried egg" histo, assoc w/ cryptorchidism, infertility, h/o testic ca, Klinefelter |
|
Definition
seminoma - type of germ cell tumor (germ cell tumors make up 90% of testicular CA), good prog
Dx - US, bx
Tx - radiation, radical orchiectomy (affected side) |
|
|
Term
| less common malig germ cell tumor, age 25-35 |
|
Definition
|
|
Term
| elev AFP*, prepubescent males, Schiller-Duvall bodies* |
|
Definition
| yolk sac (endodermal sinus) tumor - embryonal |
|
|
Term
| elev HCG, syncytiotrophoblasts + cytotrophoblasts, agressive, poor prog |
|
Definition
|
|
Term
| elev serum calcitonin, firm solitary thyroid nodule, cervical LAD |
|
Definition
| medullary thyroid carcinoma - fr parafollicular cells (C cells = calcitonin) |
|
|
Term
| hoarseness, h/o neck irradiation dysphagia, cervical LAD, firm solitary nodules, hypoactive (cold) on scintigraphy |
|
Definition
thyroid CA, order of INC malig:
papillary (MC), follicular, medullary, anaplastic |
|
|
Term
| calcif psammoma bodies, Orphan Annie nucleus |
|
Definition
| papillary thyroid CA - MCC thyroid CA |
|
|
Term
| pulm edema, ARDS vs cardiogenic pulm edema |
|
Definition
| Dx - echo* (disting if PCWP <18 --> not ARDs) |
|
|
Term
| anti-nuclear, anti-topoisomerase (anti Scl 70), anti-centromere abs; affects skin (sclerodacyly, Raynaud) and organs (fibrosis of vasc - lung, GI, heart, kidneys) |
|
Definition
systemic sclerosis - limited form affects skin (CREST), diffuse affects internal organs (rapidly progressive)
Tx - cyclophosphamide, methotrexate, mycophenolate mofetil |
|
|
Term
| dry eyes/mouth, infiltration of exocrine glands, ie lacrimal and salivary, assoc w/ other autoimmune, anti-SSA and SSB abs |
|
Definition
|
|
Term
| high spiking fever, salmon rash, arthritis |
|
Definition
|
|
Term
|
Definition
regardless of gestational age:
airway, IV mag sulfate, betamethasone, induction of vag delivery (if <34 wks give steroid for fetal lung maturity) |
|
|
Term
[image]
pruritic, sudden outbreak on hands/feet, no hx of drugs or travel |
|
Definition
Erythema multiforme minor - MCC HSV
Note: erythema multiforme major, aka SJS, secondary to meds |
|
|
Term
| non-pruiritic macules on palms and soles |
|
Definition
| secondary syphillis - treponema pallidum |
|
|
Term
|
Definition
| occlusion of left main coronary aa |
|
|
Term
| ST-T elev in II, III, aVF |
|
Definition
| inferior MI - RCA marginal branch |
|
|
Term
| ECG changes V1-6 (septal 1-4) |
|
Definition
| ant LV and septum - LAD coronary aa |
|
|
Term
|
Definition
| apex - Left marginal branch |
|
|
Term
| MC cardiac abnorm in Turner's syndrome |
|
Definition
1st - bicuspid aorta
2nd - coarctation of aorta |
|
|
Term
| similar to Turner's syndrome, affects m/f, normal puberty/fertility |
|
Definition
| Noonan's syndrome - assoc w/ valvar pulmonic stenosis (MC heart defect) |
|
|
Term
| vaginal dimple, primary amenorrhea |
|
Definition
|
|
Term
| normal hymenal opening, lower vag leads to blind pouch |
|
Definition
| transverse vaginal septum - horizontal "wall" during embryo, blocks vagina |
|
|
Term
| mass on side walls of vagina |
|
Definition
| Gartner's duct cyst - remnant of Wolffian duct |
|
|
Term
| dull, steady, "boring" pain, groin pain, NV, hemodynamic changes |
|
Definition
AAA - risk factors: peripheral atherosclerotic dz, smoking, HTN; assoc w/ Marfan's
Dx - US |
|
|
Term
| h/o alcohol, biliary tract dz, acute-onset NV, sharp epigastric pain, radiate to back, fever, tachycardia, elev lipase (more spec/sens) and amylase, abd xray - "sentinel loop" or "colon cutoff sign" |
|
Definition
acute pancreatitis
MCC - gallstones, 2nd MC - EtOH
Gallstone pancreatitis - INC ALT
Dx - CT, US r/o gallstone pancreatitis
Tx - analgesic, IV fluid, bowel rest; ERCP and sphincterotomy if gallstone panc; chole after stabilization; hyperlipid and hyperCa higher risk; if CT shows necrosis/abscess add abx |
|
|
Term
| required for extrinsic pathway factors 2, 7, 9, 10 |
|
Definition
| vit K - warfarin is vit k antag therefore PT INC first bc factor 7 has shortest HL; platelet and bleeding time not affected |
|
|
Term
| paralysis of arms, hands, LE after gen seizure |
|
Definition
|
|
Term
|
Definition
mild - topical steroids
severe >10% body - UVB, psoralin + PUVA (photochemo) if UVB doesn't work,
extreme - acitretin (synthetic retinoid) + PUVA/UVB, infliximab |
|
|
Term
|
Definition
2nd degree AV block, Mobitz type I (Wenckebach) - partial/complete block of impulse fr atria to ventricles; complication of inferior MI; PR interval progressively lengthens until QRS dropped
Tx - pacemaker if symptomatic |
|
|
Term
| resp changes (dyspnea, tachypnea, cough, hypoxia), neuro (AMS), petechial rash (1-3 days after), post fracture or during surg |
|
Definition
|
|
Term
|
Definition
surgery if symptomatic of any size AND asymptomatic aneurysms >5.5
Surveillance if 3.5-4.5
<3.5 q 3 yrs
3.5-4 q 1-2 yr
4-4.5 q 6-12 mon
>4.5 q 3-6 mon |
|
|
Term
|
Definition
1st line - dopamine agonist (pramipexole, ropinirole, levodopa/carbidopa, bromocriptine); iron supp
other: gabapentin (anticonvulsant) - don't use if allergic, also used for neuropathy |
|
|
Term
| hyponatremia, low serum osmolality, low urine vol; DEC BUN and uric acid |
|
Definition
SIADH - "hypotonic euvolemic hyponatremia"
h/o small cell lung CA, HIV, CNS, pulm lesions, surg, rxs (fluoxetine, sertraline, desmopressin, chlorpropamide, cyclophosphamide)
Tx - fluid restriction, avoid quick correction to avoid central pontine myelinolysis; others: demeclocycline if unresponsive to fluid restriction and saline w/ furosemide |
|
|
Term
| newborn w/ urinary tract obstruction |
|
Definition
posterior urethral valves (PUV)
Dx - voiding cystourethrogram (VCUG)
Note: prenatal US shows oligo (may cause pulm hypoplasia), bilat hydronephrosis, dilated bladder |
|
|
Term
| confusion, slurred speech, miosis, resp depression, hypoxia, euphoria, constipation |
|
Definition
opioid toxicity
Tx - IV naloxone |
|
|
Term
| Ranson criteria - determine severity/mortality of acute pancreatitis |
|
Definition
Admission criteria:
age >55
WBC >16,000
glucose >200
LDH >350
AST >250
Mortality:
<3 = 0-3%
>3 = 11-15%
>6 = 40% |
|
|
Term
[image]
asymptomatic or chest pain |
|
Definition
Wolff-Parkinson-White syndrome - pre-excitation of ventricles d/t accessory pathway (bundle of Kent); delta wave (slurred upstroke on QRS), short PR, widened QRS
Tx - catheter radiofrequency ablation of accessory pathway |
|
|
Term
| amenorrhea/oligo, galactorrhea, vag dryness, infertility |
|
Definition
hyperprolactinemia - DEC LH and FSH, low estrogen (risk for osteoporosis)
Dx - MRI of pituitary and hypothalm; prego test, thyroid, review meds
Causes - prolactinoma (MC), meds (verapamil, dopamine antag), hypothyroidism, pregnancy, stress ie trauma, exercise, renal failure, hypothalamic dz or pituitary stalk section, suckling, chronic renal failure, cirrhosis |
|
|
Term
|
Definition
IV abx (ciprofloxacin, metronidazole), IV fluids, bowel rest
Complications: fistula (colovesicular leading to recurrent UTI and pneumaturia), abscess, macro-perforation, large bowel obstruction |
|
|
Term
| watery diarrhea (then hypoK+), flushing, dehydration, hypchlorhydria, hyperglycemia |
|
Definition
vasoactive intestinal peptide tumor - neuroendocrine
Dx - CT, somatostatin-R scintigraphy to localize
Tx - resection*, if unresectable (most mets to liver by time of dx): octreotide (somatostatin for flushing, diarrhea), theophylline/albuterol (wheezing) |
|
|
Term
| severe hypoglycemia, tumor of pancreas (fr beta cells), elev insulin and C peptide |
|
Definition
insulinoma
Dx - 72 hr fast (dx, stop once reach glucose 45), CT or US (localization)
Tx - resection; poor surg candidate - diazoxide |
|
|
Term
| dermatitis herpetiformis tx |
|
Definition
| dapsone (diaminodiphenyl sulfone) and gluten free diet |
|
|
Term
| anion gap metabolic acidosis, tinnitis |
|
Definition
salicylate/aspirin toxicity - intial: resp alkalosis in resp ctr of brain followed by AGMA
Tx - gastric lavage (within 1 hr), activ charcoal (within few hrs), alkalinization of urine (NaHCO3), dialysis (severe) |
|
|
Term
| methanol or ethylene toxicity |
|
Definition
|
|
Term
| hyperthermia, blurred vision, mydriasis, dry mouth/skin, urinary retention, constipation, vasodilation, dizziness, hallucinations |
|
Definition
organophosphate poisoning - "hot as a hare, blind as a bat, dry as a bone, red a beet, mad as a hatter"
Tx - pralidoxime, atropine |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| menorrhagia (MC), dysmenorrhea, pelvic pressure, enlarged uterus |
|
Definition
Fibroids (uterine leiomyoma) - common in AA, mostly intramural, submucosal fibroids = infertility, OCPs INC size bc of it has estrogen/progestin-R, shrink at menopause
Dx - US (solid, concentric, hypoechoic mass)
Tx - GnRH agonist (initial), hysterectomy vs myomectomy (wants kids) |
|
|
Term
| akathisia (inner restlessness) tx |
|
Definition
| BB (propranolol) or benzodiazepine; benztropine (used more for acute dystonia and Parkinsonism) |
|
|
Term
| conjug hyperbili, black liver, 80% coproporphyrin I makes up urine coproporphyrin (which is of normal level), gallbladder NOT visualized on oral cholecystopgraphy |
|
Definition
Dubin-Johnson syndrome - usually asymptomatic, but may have abd pain, fatigue, jaundice, scleral icterus
Tx - not necessary |
|
|
Term
| conj hyperbilirubinemia, unchanged color of liver, INC level total urine coproporphyrin and coproporphyrin III, gallbladder VISUALIZED on oral cholecystography |
|
Definition
|
|
Term
| skin and hepatic probs, uroporphyrinogenuria |
|
Definition
|
|
Term
| fatigue, anemia, osteoporosis, leukopenia, neutropenia -- defic? |
|
Definition
| copper defic - occurs in premies, absorp and genetic disorders |
|
|
Term
| garlic breath, hair loss, nn damage |
|
Definition
selenium excess
defic - Keshan dz, cardiomyopathy, mm weakness |
|
|
Term
| hypothyroidism, goiter, stunted mental and physical growth (cretinism) |
|
Definition
|
|
Term
| dry, leathery, eschar burn without sensation |
|
Definition
full thickeness burn (3rd degree)
Tx - immediate excision, skin grafting |
|
|
Term
| multiple fractures, hearing loss, blue sclera |
|
Definition
| osteogenesis imperfecta - abnorm Type 1 collagen |
|
|
Term
| severe HA, nuchal rigidity, photophobia, fever |
|
Definition
Subarachnoid hemorrhage
Dx - CT (hyperdense within subarachnoid space), if neg --> LP (xanthochromia fr RBC breakdown)
Tx - nimodipine (CCB - prevent cerebral vessel vasoconstriction), embolization with coil intravascularly (prevent rebleed), phenytoin (prevent seizure) |
|
|
Term
| HA, elev ICP (papilledema, nausea, CN VI palsy), obese female, elev opening pressure on LP |
|
Definition
Pseudotumor cerebri - idiopathic intracranial HTN, assoc w/ drugs, venous sinus thrombosis, vitA tox
Tx - acetazolamide (DEC CSF vol), emergency surg w/ CSF shunt or optic nn decompression (prevent blindness) |
|
|
Term
| warfarin induced skin necorsis |
|
Definition
| protein C defic - has shortest HL and appears first |
|
|
Term
| paracentesis --> eval for cell count and differential, serum ascites albumin gradient (SAAG), amylase, glucose, and culture. SAAG guideline |
|
Definition
SAAG GREATER than 1.1 = portal HTN: pre-hepatic (portal vein thrombosis), intra-hepatic (cirrhosis, hepatic fibrosis, hepatocellular CA), or post-hepatic (CHF, constrictive pericarditis, Budd-Chiari syndrome)
SAAG LESS than 1.1 = tuberculous peritonitis, pancreatic ascites, nephritic/nephrotic syndrome |
|
|
Term
| fever, unilat sore throat, voice change, odynophagia, trismus (lock jaw), uvula displaced toward unaffected side |
|
Definition
peritonsillar abscess - MC GAS
Tx - airway, drainage, clindamycin |
|
|
Term
| US shows nonviable pregnancy, + vag bleeding and cramping, closed cervical os |
|
Definition
|
|
Term
| age 50s, leukocytosis, BCR-ABL, 9:22 chrom translocation (Philadelphia chrom), immature granulocytes on smear, DEC leukocyte alk phosphatase |
|
Definition
CML
Tx - imatinib (tyrosine kinase inhibitor) |
|
|
Term
| compression of ulnar nn at medial elbow |
|
Definition
|
|
Term
| diabetes, steatorrhea, pancreatic calcif (CT) |
|
Definition
|
|
Term
| RVH, wide fixed splitting of S2, usually asymptomatic until adulthood when Eisenmenger's syndrome occurs (dyspnea, chcest pain, peripheral edema, syncope |
|
Definition
|
|
Term
| initial diagnostic test for hyperthyroidism |
|
Definition
TSH w/ reflex to T4
Tx - methimazole or PTU, radioiodine (131-I) ablastion (MC), BB (for sxs) |
|
|
Term
[image]
new onset palpitations |
|
Definition
Paroxysmal SVT - usually AV nodal reentrant tachy, narrow QRS, P waves at terminal portion of QRS
Tx - vagus nn and block reentry mechanism; if doesn't work -- IV adenosine or verapamil |
|
|
Term
|
Definition
SaO2 <88%
PaO2 of 55 or less
other:
PaO2 56-59 + corpulmonale
Hct 55% or greater
pulm HTN (pulm aa pressure >25)
edema d/t CHF |
|
|
Term
| esophageal varices prevention |
|
Definition
| Tx: BB (prevent bleeding), if actively bleeding -- vasopressin and octreotide, last resort - TIPS |
|
|
Term
| neck/chest or anbd pain, mediastinal/supraclavicular crepitus |
|
Definition
Esophageal perforation
Dx - contrast esophagogram (w/ water sol gastrograffin)
Prog - closure within 24 h has 80-90% survival, after 24 h less than 50%
Tx - surgery |
|
|
Term
[image]
dysphagia, halitosis, regurg of undig food, clearing throat, neck mass, wt loss |
|
Definition
Zenker diverticulum - outpouching, upper third (MC)
Dx - barium swallow
Tx - myotomy (cricopharyngeus) +/- diverticulectomy |
|
|
Term
|
Definition
| irrigation, human rabies immune globulin, vaccination, abx (if deep laceration) |
|
|
Term
| infant diabetes complications |
|
Definition
| macrosomia, RDS, hypoglycemia, hypocalcemia (low PTH), polycythemia (high EPO), hypoMg (elev secretin of Mg in diabetic mom), hyperbilirubinemia (INC hemolysis), premature delivery, hypertrophic cardiomyopathy (elev insulin) |
|
|
Term
| small pruritic pustules in area that's shaved or after hot tub |
|
Definition
folliculitis - Staph
Self limiting |
|
|
Term
|
Definition
| CBT + venlafaxine, buspirone, SSRI |
|
|
Term
| almond breath, CNS depression, resp/cardiac arrest |
|
Definition
cyanide OD
Tx - amyl nitrite |
|
|
Term
| yellow-green vision, CNS depression, bradycardia, heart block |
|
Definition
|
|
Term
| Torsades de pointes, sinchonism (tinnitus, flushed skin, CNS) |
|
Definition
quinidine OD
Tx - IV magnesium |
|
|
Term
| recurrent oral/genital ulcers; arthritis, ocular/CNS involvement |
|
Definition
Pehcet's syndrome - autoimmmune
Tx - corticosteroids |
|
|
Term
| can't see, pee, climb tree |
|
Definition
|
|
Term
| cold, painful arms/hands and ulcerated digits |
|
Definition
|
|
Term
| blowing holosystolic murmur best at left lower sternal border, INC w/ inspiration, RHF, EKG - RV and atrial enlargement |
|
Definition
Tricuspid regurg
Causes - LHF, Ebstein's, Eisenmenger, infective endocarditis, rheum heart dz, pulm HTN |
|
|
Term
|
Definition
gAstric ulcers - A
duOdenal ulcer - O |
|
|
Term
|
Definition
age >55 + alarming sxs = endoscopy w/ bx
<50, no alarm sxs = urea breath test |
|
|
Term
|
Definition
| <36 wks = repeat US and determine route of delivery (placenta could move, vag may be attempted w/ marginal previa) |
|
|
Term
| leak w/ INC abd pressure (laugh, sneeze, cough) |
|
Definition
stress incontinence
Tx - urethropexy, sling; pelvic floor exercises |
|
|
Term
| urge to urinate, don't make it to bathroom |
|
Definition
Urge incontinence - hyperactive detrusor causes unexpected urge
Dx - cytometric eval
Tx - anticholinergic (oxybutynin) - relax detrusor |
|
|
Term
| continuous loss of urine entire day/night after gyn surg |
|
Definition
urogenital fistula
Tx - surg repair |
|
|
Term
|
Definition
| PCN G (IM) one dose - interfere w/ cell wall of spirochite |
|
|
Term
|
Definition
| SSRI (citalopram), prazosin (DEC nightmares), desensitization-exposure psychotherapy; inpatient monitor if suicidal |
|
|
Term
| h/o infxn of mid ear, nsaopharynx, paranasal sinus; fever, odynophagia, dysphagia, trismus, neck pain, torticollis, muffled voice, midline swelling of post pharynx, resp distress |
|
Definition
retropharyngeal abscess - strep, staph, anaerobic
Dx - neck CT w/ contrast (disting fr retropharyngeal cellulitis)
Tx - IV clindamycin, ampicillin-sulbactam, surg drainage |
|
|
Term
|
Definition
| BUN/Cr, thyroid, prego test |
|
|
Term
| check before valproic and carbamazepine |
|
Definition
|
|
Term
|
Definition
First degree AV heart block - normal P waves and QRS, prolonged PR (>0.2 sec or 5 small boxes), common in athletes, or drug induced (digoxin, magnesium, CCB, BB, antiarrthymics)
Tx - reassurance; if symptomatic (rare) - pacemaker |
|
|
Term
| weak arm adduction and extension |
|
Definition
| latissimus dorsi - thoracodorsal nn |
|
|
Term
| colonoscopy: cherry red lesion w/ radiating vessels |
|
Definition
| angiodysplasia (aka AV malformation or vasc ectasia) - prox colon (MC), assoc w/ ESRD, aortic stenosis, von Willebrand Tx - supportive; if persis bleed - electrocoag, sclerotherapy |
|
|
Term
| nephritic syndrome days within URI or GI (hematuria, proteinuria, RBC casts), assoc w/ HSP |
|
Definition
|
|
Term
| granular (muddy brown) casts, renal tubular casts |
|
Definition
acute tubular necrosis (ATN) - d/t nephrotoxicty (aminoglycosides, NSAIDs, radiocontrast, cisplatin) or ischemia
intrinsic renal failure - BUN:Cr <20:1, FENa >2%, urine Na >40, urine osmolal <350 |
|
|
Term
| BUN:Cre ratio >20:1, urine Na 500 mOsm/kg; hylaline casts |
|
Definition
prerenal acture renal failure - kidneys work (able to reabsorb urea, water and Na)
Etio: vol depletion, CHF, liver failure, sepsis, anti-HTN meds renal artery stenosis |
|
|
Term
| acute productive cough, low grade fever, arthralgia; can be up to 20 day |
|
Definition
acute bronchitis
Tx - supportive ie dextromethorphan (antitussive), acetominophen |
|
|
Term
| rhinorrhea, pharyngitis, scattered rales, wheezes, DRY cough that lasts up to 8 wks |
|
Definition
Mycoplasma pneumo bronchitis
Tx - erythromycin, azythromycin |
|
|
Term
| Spinal cord injury w/ diaphoresis, HTN, HA, flushing, bradycardia |
|
Definition
autonomic dysreflexia/hyperreflexia - spinal cord lesion T6 and above
MCC - distended bladder, 2nd - rectal distension (d/t constipation), 3rd - painful stimuli
Tx - cath, CCB (HTN) |
|
|
Term
| MC sequelae of meningitis |
|
Definition
|
|
Term
hypercalcemic crisis tx
Sx - NV, fatigue, mm weakness, confusion, 2ndary to uncontrolled PTH (PTH-rp) |
|
Definition
| hydration NS, furosemide (promote Ca excretion); if fails -- calcitonin, hemodialysis |
|
|
Term
| aris fr chromaffin cells (adrenal medulla); HA, sweating, palpitations |
|
Definition
pheochromocytoma
Dx - urinary/plasma metanephrine, normetanephrine, VMA |
|
|
Term
| sore throat, arthralgia, HA, cough, fever, conjunctival erythema, coughing |
|
Definition
Influenza
Dx - viral detection nasal swab
Tx - oseltamivir or zanamivir (within 48 hr) |
|
|
Term
| spontaneous pneomothorax tx |
|
Definition
| <15% hemithorax, <3 cm fr apex of lung to parietal pleura - observe, O2, repeat xray within 24 h |
|
|
Term
| hearing loss, pruritis, drainage, otalgia, pain pulling tragus or auricle, TM moveable |
|
Definition
Otitis externa - Staph, pseudomonas
Tx - cleaning, topical acidic abx (cipro) and steroids |
|
|
Term
[image]
pleuritc chest pain, pericardial rub, neg cardiac enzymes |
|
Definition
Acute pericarditis - diffuse ST elev, PR dep
Etio: viral/bacterial infxn, uremia, Dressler's (autoimmune inflamm rxn post-MI), post-cardiac surg, SLE, amyloidosis, procainamide-induced lupus pericarditis
Tx - NSAIDs |
|
|
Term
| alopecia, dermatitis, central and peripheral neuropathy, NV - defic? |
|
Definition
|
|
Term
| xerophthalmia, night blindness - defic? |
|
Definition
|
|
Term
| ecchymosis, petechiae, bleeding - defic? |
|
Definition
|
|
Term
trigeminal neuralgia tx
age >50, along CN V distrib
Dx - MRI (r/o MS and tumors) |
|
Definition
| anticonvulsant (carbamazepine); adjunct to anticonvus - baclofen |
|
|
Term
| spike and dome on electron microscopy |
|
Definition
| Membranous glomerulonephritis (nephrotic syndrome) - assoc w/ syphillis, HBV, HCV, occult malig, SLE, malaria, penicillamine, gold salts |
|
|
Term
| blue, rhomboid crystals, weakly positive birefringence |
|
Definition
calcium pyrophosphate deposition dz (CPDD) aka pseudogout Dx - xray (chondrocalcinosis), synovial fluid aspiration
Tx - NSAIDs |
|
|
Term
[image]
knee pain, normal WBC, elev ESR
Xray - bony changes |
|
Definition
gout - monosodium urate crystals - yellow (when parallel) needle shaped, negatively birefringent crystals
EtOH --> elev urate
Chronic - xray shows tophi, "rat-bite erosions" |
|
|
Term
complete dilation (10 cm) to delivery
Normal - nullip <2 hr, multip <1 hr |
|
Definition
|
|
Term
| primary hyperALD -- HTN, hypoK+, metabolic alkalosis |
|
Definition
| Conn syndrome Dx - abd CT (adrenal gland - adenoma, or adrenal hyperplasia) Tx - surgery |
|
|
Term
|
Definition
1st trim - PTU
2nd/3rd trim - methimazole |
|
|
Term
| wt loss, cheilitis, necrotizing migratory erythema, DM, glossitis, stomatitis |
|
Definition
glucagonoma - alpha cells pancreas
Dx - US or CT
Tx - octreotide (sx relief), surg vs chemo |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| ST seg elev leads I, aVL and V5-6 |
|
Definition
| lateral MI - left circumflex of LCA |
|
|
Term
| gross hematuria 1-2 days post URI w/ abd pain, petechial rash on LE |
|
Definition
| IgA nephropathy (Berger's dz) - IgA deposit in glomerular mesangium |
|
|
Term
| splitting of BM (tram-track), mesangial/endothelial prolif |
|
Definition
| membranoproliferative GN (MPGN)- nephrotic Etio: autoimmune, hematologic malig, infxn (HBV, HCV) |
|
|
Term
| nephrotic syndrome in autoimmune dz (SLE), drugs (penicillamine and gold), infxn (HBV, HCV symphillis), malig, kidney transplant |
|
Definition
| membranous glonerulonephritis |
|
|
Term
| sleep paralysis, hypnagogic/hypnopompic hallucinations, cataplexy (mm weakness) w/ strong emotions |
|
Definition
Narcolepsy - DEC REM
Dx - sleep study
Tx - momdafanile (sleepiness) + venlafaxine, fluoxetine or atomoxetine (cataplexy); 2nd line cataplexy -gamma hydroxybutyrate |
|
|
Term
| spots on lips, oral mucosa, GI mucosa; colonoscopy - hamartomas (<100) in small bowel |
|
Definition
Peutz-Jeghers
Complications - malig, intussusception, obstruction
Assoc w/ testicular, uterine, overian, breast CA |
|
|
Term
| blowing early diastolic mumur at left sternal border or right 2nd ICS, PMI displaced, wide pulse pressure (>40 bet sys/dias) |
|
Definition
aortic regurg - idiopathic, 2nd to rheum (MC), primary congenital, assoc w/ syphillis, Marfan or damage fr IE
Dx - echo
Tx - vasodilators, surg |
|
|
Term
| low pitched apical diastolic murmur w/ opening snap heard best in left lateral decubitus position, INC w/ expiration |
|
Definition
mitral stenosis
EKG - left atrial hypertrophy
Dx - Echo
Tx - diuretics/surg if symptomatic |
|
|
Term
| apical soft, late diastolic rumble |
|
Definition
| Austin flint murmur - may be caused by aortic regurg |
|
|
Term
wt loss, epigastric pain
Risks - low fiber, obesity, EBV, high salt intake N-nitroso, smoked foods, smoking, alcohol, blood type A, gastric surg, H pylori |
|
Definition
gastric CA
Dx - endoscopy
Tx - surg resection |
|
|
Term
| leukocytosis after infxn, INC leukocyte alk phosphatase |
|
Definition
|
|
Term
| numbness, tingling, pain at upper outer thigh - worse w/ stalking or standing |
|
Definition
meralgia paresthetica
Dx - clinical, tap inguinal ligament or extend thigh rep sxs
Tx - supportive, lidocaine and corticosteroid injection |
|
|
Term
| weak extendign big toe, numbness/pain top of foot, pain may radiate fr butt |
|
Definition
|
|
Term
| loss of ankle reflex, numbness/pain sole of foot |
|
Definition
|
|
Term
| knee pain w/ knee flexion and contraction of quads |
|
Definition
|
|
Term
| abx proph for infective endocarditis |
|
Definition
| artifical heart valve, h/o endocarditis, heart transplant w/ abnorm heart valve fxn, cyanotic congenital heart dz; procedures of resp tract, major dental, infected skin, under skin, MSK tissue |
|
|
Term
Nephrogenic diabetes insipidus tx
Kidney doesn't respond to ADH
Causes - lithium, amphotericin B, demeclocycline
HypoK+ and hyperCa2+ |
|
Definition
Tx - Na restriction, thiazide +/- amiloride (DEC polyuria by contracting intravasc vol, INC prox fluid resorp, less free water exretion in collecting duct)
Amiloride pref in lithium induced DI |
|
|
Term
| indications for transrectal US (TRUS) w/ bx of prostate |
|
Definition
PSA <10 ng/mL
PSA velocity <0.75ng/ml/yr |
|
|
Term
|
Definition
After ovulation --> oocyte dev into corpus luteum, driven by LH
Ovarian follicle - secretes estrogen
Proges - made by corpus luteum after ovulation, maintains endometrial lining to prep for implantation
If no implant -> corpus lut regresses, rapid DEC proges/estrogen
If implant -> trophoblast secrets HCG (maintains corpus lut, cont proges), 8-10th wk placenta takes over proges prod |
|
|
Term
|
Definition
Tx - phenoxybenzame (alpha blocker control HTN) followed by propranolol for 1 wk, then surg (adrenalectomy)
Recheck urinary catecholamines and metanephrines after surg |
|
|
Term
| vasculitis, digit infarction, young male smokers |
|
Definition
Buerger's dz (thromboangitis obliterans)
Angiography - corkscrew pattern of vessels prox to lesions
Tx - smoking cessation |
|
|
Term
| asthma, eosinophilia, vasculitis, mononeuritis multiplex, foot/wrist drop, sinusitis and cutan nodules over ext surface |
|
Definition
Churg-Strauss syndrome
Lab - (+) p-ANCA, eosinophilia
Tx - steroids |
|
|
Term
| DEC ACTH, TSH, FSH, LH, GH, prolactin |
|
Definition
| ant pituitary infarction (Sheehan's syndrome) - h/o postpart hemorrhage, hypotension |
|
|
Term
|
Definition
Multifocal atrial tachycardia (MAT) - 3 or more diff P wave morph in same lead, HR >100
Path - multiple pacemakers in atria resulting in irreg irreg rhythm, MC in COPD
Tx - verapamil, underlying case |
|
|
Term
| 3 or more diff P wave morph in same lead, HR <100 |
|
Definition
|
|
Term
[image]
abd pain, distension, vomiting, constipation |
|
Definition
Volvulus - sigmoid (MC), also in small bowel, elderly (MC than kids)
Dx - xray (TOC), sigmoidoscopy (diagnostic/tx)
Tx - sigmoidoscopy (decompress, untwist) |
|
|
Term
| varicella-zoster in prego |
|
Definition
If onset within...
5 days or 2 days after delivery - VariZIG, isolation
after 2 days - normal post-natal, cont bfeeding (if not on breast) |
|
|
Term
| tachycardia, peripheral edema, dyspnea on exertion, CXR - cardiomegaly, EtOH use |
|
Definition
Wet beriberi - prolonged thiamine (vit B1) defic
Dx - echo (dilated cardiomyopathy - dilated LV, DEC EF)
Tx - thiamine, immediate cessation of EtOH |
|
|
Term
|
Definition
Solitary lung nodule - usually granuloma
Low risk - age <50, nonsmoker - serial chest xray, if no growth after 2 yrs = benign |
|
|
Term
|
Definition
|
|
Term
|
Definition
Proph tx - CCB (verapamil), prednisone, valproic acid, topiramate, ergotamine
Tx - sumatriptan, 100% O2* (cheaper) |
|
|
Term
| PAINFUL, diffusely enlarged thyroid gland, hyperthyroidism, after URI |
|
Definition
Subacute granulomatous thyroiditis (de Quervain's thyroiditis) - stored hormones released fr inflamed gland
DEC uptake on radioactive iodide uptake scan (RIUS) - bc not overprod prob
low TSH, elev T4/3 and ESR
Tx - NSAIDs, self-lim |
|
|
Term
| PAINLESS thyroiditis, diffusely enlarged thyroid, hyperthyroid sxs |
|
Definition
| subacute lymphocytic thyroiditis |
|
|
Term
| hands/feet growth, big fontanelle, macrognathia, macroglossia, deep voice, organomegaly, sweating |
|
Definition
Acromegaly - excess GH AFTER epiphyseal plate closure, MCC pituitary adenoma
Dx - insulin-like growth factor (IGF-1) (initial), MRI* (r/o pituitary adenoma)
Complications - DM, cardiac failure, HTN, carpal tunnel, sleep apnea
Tx - transphenoidal surg resection*
If not surg candidate - octreotide (inhib GH), if that fails - radiation |
|
|
Term
| growth hormone secreting factor, CRH, prolacting-inhib hormone (dopamine), GnRH, TRH, somatostatin |
|
Definition
|
|
Term
| mining, sand-blasting, glass, ceramic work; fever, dyspnea on exertion, fatigue, cyanosis, chest pain, cough |
|
Definition
Silicosis
CXR - nodular opacities in upper lobe
Tx - glucocorticoids |
|
|
Term
| cough, dysnea on exertion, wt loss, fever; worked in metal machinery, scrap metal, nuclear power, aerospace, electronics |
|
Definition
Berylliosis
Dx - (+) Beryllium lymphocyte prolif (definitive test)
CXR - bilat hilar adenopathy (indisting fr sarcoidosis)
Tx - glucocorticoids |
|
|
Term
| shipbuilding, asbestos mining/milling, textiles, insulation, building demolition |
|
Definition
Asbestosis - presents w/ dyspnea 25 yr after exposure
CXR - bilat opacities w/ pleural plaques |
|
|
Term
|
Definition
Pulm angiograpm (gold std)
Helical CT chest (diagnostic TOC)
Pulm vent/perfusion scan (initial)
CXR - rare: Hampton's hump (wedge-shaped consolidation in lung periphery), Westermark sign (dilationg of pulm aa prox to embolus and collapse of distal vasc)
Tx - first time: warfarin 3-6 mon
prev hx: lifetime |
|
|
Term
| low/normal Ca, elev PTH, h/o chronic renal failure |
|
Definition
| secondary hyperparathyroidism - can't synthesize active form vitD |
|
|
Term
| asymptomatic (MC), elev Ca2+ and PTH |
|
Definition
primary hyperparathyroidism - parathyroid adenoma (85%), usually singular
Dx - Sestamibi scan (localize)
Tx - resection |
|
|
Term
| fever, HA, photophobia, nuchal rigidity |
|
Definition
Meningitis - MCC:
adults - strep pneumo
neonates - GBS
recent brain surg/indwelling cath - staph
immunocompromised/elderly - listeria
AIDS CD4 <100 - cryptococcus
concurrent pulm TB - meningitis 2nd to TB
Camper w/ targe like rash - Lyme dz (Borrelia)
Camper w/ centripetal spread petechial rash (ext to trunk) - Rocky Mtn spotted fever (RIckettsia)
Young w/ petechial rash - Neisseria |
|
|
Term
| CF: elev protein, DEC glucose, no RBC, WBC 1000s+, mostly neutrophils (PMNs)* |
|
Definition
bacterial meningitis
Tx - vancomycin, ceftriaxone, steroids
Neisseria - cipro or rifampin for close contacts
Add ampicillin for Listeria (immunocomp, elderly)
Protein high as immunoglobulins fr plasma cells to opsonize bacteria
NTs high for phagocytosis
Except Lyme dz or Rocky Mtn - modest WBC, mostly lymphocytes |
|
|
Term
| CF: Normal protein and glucose, WBC 100s, mostly lymphocytes |
|
Definition
|
|
Term
| CF: bloody tap, normal protein and glucose, WBC 1000s, mostly lymphocytes |
|
Definition
|
|
Term
| CF: elev protein, WBC 100s, mostly lymphocytes |
|
Definition
|
|
Term
| tender points, >3 mon, assoc w/ fatigue, mm stiffness, insomnia, memory difficulties, anxiety, depression, worse w/exericse |
|
Definition
Fibromyalgia
TPs (occiput, traps, supraspinatus, ant cervical, 2nd rib, lateral epicondyles, gluteal region, greater trochanter, medial knee)
Tx - TCA (amitriptyline, sleep), SNRI (duloxetine, anxiety/depression), low level aerobics, yoga, CBT |
|
|
Term
| "weird, wild, and worried" |
|
Definition
personality disorders
A (weird) - paranoid, schizoid, schizotypal
B (wild) - borderline, histrionic, narcissistic, antisocial
C (worried) - obsessive-compulsive, avoidant, dependent |
|
|
Term
| anti-insulin abs*, INC insulin, DEC C-peptide, DEC proinsulin |
|
Definition
factitious hypoglycemia
Note: will have DEC pro-insulin bc of exogenous insulin |
|
|
Term
| large vol painless rectal bleeding in <2 yo |
|
Definition
Meckel's diverticulum - vitelline (omphalomesenteric) duct fail to obliterate
Dx - Tc99m pertechnetate scan
Rule of 2s - 2 ft fr ileocecal valve, 2 in long, 2 ectopic tissue(gastric, pancreatic), 2% pop, first 2 yrs |
|
|
Term
| fabricate illness to assume "sick role" (primary gain), knowledgeable in medical conditions/tx |
|
Definition
|
|
Term
| fabricate sxs for secondary gain (financial, getting out of jail, obtaining drugs) |
|
Definition
|
|
Term
| preoccupation about having serious illness |
|
Definition
|
|
Term
| CT (non-contrast) indications after trauma |
|
Definition
| amnesia, progressive HA, repeated vomiting, prolonged LOC, seizures, Glasgow coma <12, focal neuro deficits |
|
|
Term
| necrotizing soft tissue infxn (erythema, swelling, pain, necrosis, crepitus, fever, shock) of male genitals and perineum |
|
Definition
Fournier gangrene
Risk factors - DM, EtOH, immunocomp, indwelling cath, perirectal infxn
Tx - debridgement, drainage, broad-spec abx (ampicillin, gentamicin, clindamycin) |
|
|
Term
|
Definition
sodium restric, ACEI, furosemide
Give ACEI for EF <40% to prolong survival
Avoid BB |
|
|
Term
| Hyperkalemia tx >8 = QRS-T complexes form sine waves (can lead to tachy, fib, asystole) |
|
Definition
1) IV calcium chloride or calcium gluconate (membrane stabilization)
2) B agonist (ie nebulized albuterol) + IV sodium bicarb or insulin + glucose to prevent hypoglycemia (shift K+into cells)
3) Furosemide (renal excretion), polystyrene sulfonate (GI excretion), or hemodialysis (removal) |
|
|
Term
| MCC epididymitis (pain, fever/chills, erythematous and tender scrotum, urgency, dysuria) |
|
Definition
under 35 = chlamydia
older = E coli
Tx - ceftriaxone, doxycycline, azithromycin, pain relief |
|
|
Term
| female pt w/ microcephaly, autism like behavior, stereotpic hand movements, lose prior speech by 18 mon |
|
Definition
|
|
Term
| may cause fistulas, fissures, ulcerations, abscesses; skip lesions, creeping fat, small bowel obstruction, barium swallow - "string sign" |
|
Definition
|
|
Term
|
Definition
| cholinesterase inhib - donepezil, rivastigmine, galantamine |
|
|
Term
| young female, HA, HTN, abd bruit, angriography - beading pattern |
|
Definition
| fibromuscular dysplasia - beading pattern leads to activ RAAS Dx - angiography |
|
|
Term
| LGA, hypoglycemia after birth, macroglossia, organomegaly, hemihypertrophy, Wilms tumor, GU defect, ant abd wall defect, abnorm chrom 11p |
|
Definition
| Beckwith-Wiedemann syndrome |
|
|
Term
| lab to monitor heparin tx |
|
Definition
| PTT (will INC after 6 hr of admin) |
|
|
Term
|
Definition
2nd degree AV block, Mobitz type II - constant PR interval w/ sudden dropped QRS (2:1, 3:1, 4:1)
Tx - pacemaker regardless of sxs |
|
|
Term
| fatigue, pruritis (elev bile acids), women, jaundice, hypercholesteroemia, elev alk phos, IgM; antimitochondrial abs |
|
Definition
Primary biliary cirrhosis
Tx - supportive, ursodiol (ursodeoxycholic acid - UDCA), (slow progression of liver dz), cholestyramine or colestipol (pruritis) |
|
|
Term
| hypoxia, low lung compliance, low FRC, right-to-left shunting (thru ductus arteriosis and foramen ovale) |
|
Definition
| respiratory distress syndrome - premies; gives steroids if 34 wks or under |
|
|
Term
| projectile vomiting, papilledema (optic disc margin blurring), HA |
|
Definition
|
|
Term
|
Definition
| cotton wool spots (damage to nn fibers) - DM or HTN |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
exudative pleural effusion - caused fr lung dz causing leaky BV or impaired lymph drainage
Protein ratio >0.5, LDH ratio >0.6, LDH >2/3 ULN (180) |
|
Definition
| Causes - lung CA, TB, penumonia, trauma, asbestosis |
|
|
Term
precocious puberty tx
before age 7-8, baseline LH/FSH puberal levels, GnRH stim cause INC (if doesn't INC --> pseudopuberty) |
|
Definition
Tx - GnRH analog (histrelin, leuprolide, buserlin, nafarelin) - tx before closed epiphyseal plates
Dx - MRI can show hypothalamic lesion |
|
|
Term
Spontaneous bacterial peritonitis (SBP) tx
infxn of ascites |
|
Definition
Tx - 3rd gen cephalosporin (cefotaxime)
Dx - culture, ascitic fluid has PMN leukocyte count > 250 |
|
|
Term
| premie up to 3 mon, poor feeding, diarrhea, emesis, rectal bleeding, abd xray - pnneumatosis intestinalis (gas bubbles in small bowel) |
|
Definition
necrotizing enterocolitis
Tx - bowel rest, abxs, surgical consult |
|
|
Term
| osteomyelitis tx response monitoring |
|
Definition
|
|
Term
| amaurosis fugax, brief ipsi visual loss |
|
Definition
| opthalmic aa occlusion (branches off internal carotid) |
|
|
Term
| painless blister dorsum hands and sun exposed areas, facial hair, hyperpigmentation; INC plasma, urine and fecal porphyrin; lack of abd pain |
|
Definition
porphyria cutanea tarda - hereditary, assoc w/ hep C, HIV, EtOH, INC iron levels, estrogen use
Tx - chloroquine, phelobotomy (if Fe overload) |
|
|
Term
| occurs within 2 wks heparin use, isolated thrombocytopenia |
|
Definition
Heparin induced thrombocytopenia (HIT)
LMWH better |
|
|
Term
| IgG and C3 at basement membrane, spike and dome appearance |
|
Definition
| membranous glonerulonephritis |
|
|
Term
| low serum C3 and IgG/C3 in granular pattern on bx |
|
Definition
| postinfectious glomerulonephritis |
|
|
Term
|
Definition
within 24 hr surg - GAS, clostridium
4-10 days after - staph aureus |
|
|
Term
| CHF sxs, CXR - dilated cardiomyopathy |
|
Definition
Causes - EtOH, cocaine, doxorubicin
Tx - diuretic, BB, ACEI |
|
|
Term
| bleeding esophageal varices tx |
|
Definition
| endoscopic ligation, IV octreotide |
|
|
Term
| blisters on skin (except oral mucosa), over 65, bx - linear deposit of IgG abs (vs adhesion desmogelin) at jxn of dermis and epidermis, (-) Nikolsky |
|
Definition
|
|
Term
| blisters start in mouth may spread to skin, bx - IgG bet epidermal , (+) Nikolsky |
|
Definition
pemphigus vulgaris - age 30-60s, fatal
Tx - high-dose systemic corticosteroids |
|
|
Term
| HA, abd pain, fever followed by rash on palms/soles then to trunk (centripetally) |
|
Definition
Rocky Mtn Spotted fever (RMSF)
Dx - indirect fluorescent ab test
Tx - doxycycline |
|
|
Term
| erythema migrans rash (red border, central clearing) |
|
Definition
|
|
Term
| child nocturnal enuresis tx |
|
Definition
bed-wetting alarm (TOC)
imipramine, desmopressin - temp relief |
|
|
Term
| first 2 decdaes, progressive distal limb weakness, DEC proprioception, reflexes, tremors, spinal deform, pes cavus |
|
Definition
|
|
Term
| retching/vomiting followed by hematemesis |
|
Definition
Mallory-Weiss syndrome - mucosal tear at GE jxn
Tx - self limiting; epi, electrocautery, vasopressin if not |
|
|
Term
| transient coronary vasopasms (midnight-8am), assoc w/ cocaine use, ST elev during episodes |
|
Definition
variant angina (Prinzmetal)
Dx - ergonovine admin (provokes sxs)
Tx - CCB (diltiazem), nitrates |
|
|
Term
|
Definition
|
|
Term
| 10-14 days after strep/skin infxn, elev ASO, low C3, IgG and C3 in granular pattern (lumpy bumpy) on EM |
|
Definition
| Poststreptococcal glomerulonerphritis (PSGN) |
|
|
Term
| ataxia, confusion, eye disorders (ACE) |
|
Definition
Wernicke encephalopathy
Path - thiamine defic
Imaging - mammilary bodies of brain
Tx - thiamine |
|
|
Term
|
Definition
spironolactone +/- furosemide, sodium restrictive diet
large vol paracentesis, transjugular intrahepatic ortosystemic shunting (TIPS) |
|
|
Term
| crampy abd pain, NV, obstipation, dehyration; "high pitched" or hypoactive BS |
|
Definition
Small bowel obstruction (SBO)
ABC: adhesion, bulges (hernia), cancer
(Crohn's)
Dx - abd xray
Tx - IV fluid, NG, +/- abx |
|
|
Term
| murmurs that INC w/ Valsalva, standing, squatting |
|
Definition
hypertrophic cardiomyopathy - systolic ejection murmur head best at lower left sternal border
Dx - echo
Tx - BB (propranolol) or verapamil |
|
|
Term
Burns - adults:
head 9%
UE 9%
ant trunk 18% (abd/chest)
post trunk 18% (upper-mid/low back-butt)
LE 18%
Genitalia 1% |
|
Definition
Burns - kids:
head 18% (minus 1 for every yr up to age 10)
ant trunk 18%
post trunk 18%
UE 9%
LE 15% (add 0.5 every yr until age 10) |
|
|
Term
| SOB, dry cough, assoc w/ smoking, CXR/CT - bilat nodules and cysts |
|
Definition
Lahngerhans cell histiocytosis
Tx - smoking cessation, corticosteroids |
|
|
Term
| INC TBG (d/t INC estrogen), INC total and bound T4 and T3 d/t INC TBG-binding, hCG similar to TSH and act as thyroid stimulatory may slightly DEC TSH, normal free thyroxine |
|
Definition
|
|
Term
| avascular necrosis of hip, males 4-10, painless limp, knee pain, or hip stiffness, NO tenderness or inflamm, xray - flattened, fragmented femoral epiphysis |
|
Definition
Legg-Calve-Perthes - assoc w/ delayed bone age
Tx - splinting, DEC wt bearing |
|
|
Term
| occult GI bleeding, profound microcytic anemia |
|
Definition
|
|
Term
| hematochezia, changes in bowel habits/stool caliber |
|
Definition
|
|
Term
| ALD antag - DEC mortality in HF w/ EF <25% |
|
Definition
spironolactone - SE: gynecomastia, amenorrhea
eplerenone - lacks antiandrogen effects |
|
|
Term
| good for HTN w/ osteoporosis or nephrolithiasis; also 1st line for HTN w/out diabetes or CKD |
|
Definition
| HCTZ (thiazide) - less Ca2+ excretion leading to fewer renal stones and better bone mineralization |
|
|
Term
|
Definition
|
|
Term
| hospitalized pt w/ normal TSH, DEC T3, normal T4 |
|
Definition
euthyroid sick syndrome
No tx necessary, goes away w/ resolution of underlying illness |
|
|
Term
| male adolescent absent puberty, undetectable LH and FSH (gonadotropins), X-linked, absent smell |
|
Definition
| Kallman syndrome - hypothalamic hypogonadism and anosmia |
|
|
Term
| cervical protrusion, large tumor, inconsis shape w/ areas of necrosis and hemorrhage, Blacks |
|
Definition
| Leiomyosarcoma - aggressive, malig tumor |
|
|
Term
| malig, aggressive neoplasma in placenta, often spreads to lungs |
|
Definition
|
|
Term
|
Definition
sickle cell dz - salmonella, staph
Tx - vancomycin, nafcillin, cefazolin |
|
|
Term
| prev GI surg, hypoglycemia sxs (palpitations, anxiety, sweating, tremors) after eating, lab - hypoglycemia, normal insulin, C-peptide, proinsulin levels |
|
Definition
reactive hypoglycemia
Path - rapid glucose absorp provokes insulin response to meal. Body responds by DEC insulin, then INC glucagon and epi. Occurs when glucose <60
Tx - avoid simple sugars, smaller freq meals |
|
|
Term
| cleft palate, micrognathia, high/broad nasal bridge, conotruncal heart defect (TOF, truncus arteriosus, interrupted arch or VSD), neonatal hypocalcemia (parathyroid hypoplasia), lack of thymus, recurrent infxn fr impaired T-cell fxn |
|
Definition
DiGeorge syndrome
Dx - FISH to confirm chrom 22q11.2 del |
|
|
Term
Primary causes - MCD, FSGS, membranous nephropathy
Secondary - diabetes, lupus, amyloid, viruses (HIV, Hep B/C), pre-eclampsia |
|
Definition
|
|
Term
[image]
kid, fever, bullae, sheetlike desquamation of skin, (+) Nikolsky sign |
|
Definition
Staph scalded skin syndrome
Tx - nafcillin |
|
|
Term
| DEC CORT, ACTH, hypoglycemia |
|
Definition
secondary or tertiary adrenal insuff (causes - HPA suppression by chronic GC use or sudden withdrawal)
Tx - glucocorticoid
ALD not affected |
|
|
Term
|
Definition
primary adrenal insuff - path at adrenal gland (ACTH will be INC d/t lack of suppression)
Tx - mineralocorticoid (prenisone) + glucocorticoide rep (fludrocortisone) |
|
|
Term
| up to age 2, URI sxs develop into resp distress, exp wheezing, tachypea, cyanosis, nasal flaring, intercostal retractions |
|
Definition
Bronchiolitis - RSV (winter)
Tx - O2, IV, trial bronchodilators |
|
|
Term
| hilar LAD, erythema nodosum, polyarthritis, fever, elev ACE, hyperCa2+ and hypercalciuria |
|
Definition
Lofgren's syndrome - classic in sarcoidosis
Dx - CXR, bx - non-caseating granulomas |
|
|
Term
Cushing's dx test options
syndrome - caused by exogenous steroids (autoimmune dz, COPD/asthma)
disease - ACTH secreting pituitary adenoma |
|
Definition
1) 24 h urinary free CORT
2) low dose dexamethasone suppression test
3) late night serum/salivary CORT |
|
|
Term
| Cosyntropin (ACTH analog) test |
|
Definition
| Dx - Addison's dz (adrenal insuffic) |
|
|
Term
| severe flank pain, hematuria, NV, constantly moving to relieve pain |
|
Definition
Urolithiasis
Dx - US (initial), non contrast CT (dx - picks up almost all stones) |
|
|
Term
| common benign cause of unconj hyperbilirubinemia, asymptomatic |
|
Definition
Gilbert's syndrome - DEC UGT
Tx - none |
|
|
Term
| microcytic anemia, pica, koilonychia, esophageal webs |
|
Definition
| Plummer-Vinson syndomre - iron defic |
|
|
Term
| fever, lower abd pain, dyspareunia, vag d/c, cervical motion tenderness, adnexal tenderness |
|
Definition
PID (salpingitis)
MCC - chlamydia and neisseria
Tx - ceftriaxone, toxycycline |
|
|
Term
[image]
initial - scaly plaques,
pruritic, erythematous. Progresses to cutaneous tumors and LAD.
Bx - abnorm T cell infiltrates |
|
Definition
| Mycosis fungoides - Blacks, MC type of cutaneous T-cell lymphoma |
|
|
Term
| delusions, hallucinations, disorg speech, bizarre behavior <1 mon |
|
Definition
|
|
Term
systolic mmurmur
INC BV, HR, CO, SV
DEC BP and SVR |
|
Definition
|
|
Term
| URI sxs, persis cough, vomiting, normal CXR |
|
Definition
Bordetella pertusis (whooping coough)
Dx - nasopharyngeal swabs, CR, serology or IF
Tx - macrolide (azithromycin, erythromycin, clarithromycin) - within 3 wks of cough |
|
|
Term
| differentiate fetal/neonatal blood fr maternal |
|
Definition
| Apt test - used to find source of bleeding (ex neonatal hematemesis) |
|
|
Term
| gardener, painful, ulcerated nodule, cigar shaped yeast |
|
Definition
Sporotrichosis
Tx - itraconazole |
|
|
Term
[image]
chest pain, SOB, no coronary lesions |
|
Definition
| Pulmonary embolism - RBBB, sinus tachy, S1-Q3-T3 |
|
|
Term
|
Definition
seborrheic keratosis - benigin, elderly, "stuck-on", wart-like, velvety, assoc w/ sunlight exposure
Dx - bx
Tx - curretted or cryotherapy |
|
|
Term
| AMS, hypothermia, hypotension, hypoventilation |
|
Definition
Myxedema coma - hypothyroid complications
Precip factors - uncontrolled hypothyroidism, infxn, cold exposure, meds
Tx - IV T3/T4 + hydrocortisone, fluids, blanket, resp tx |
|
|
Term
| elev conj hyperbili, elev urobilinogen (also caused by hemolytic process, cirrhosis) |
|
Definition
Dubin-Johnson - mild jaundice, dark liver
Rotor syndrome - normal color, CAN see gallbladder on cholecystography, INC total urinary copraporphyrin
both benign, asymptomatic |
|
|
Term
| mental retard, seizures, adenoma sebaceum, ash leaf spots, shagreen patches (plaques on trunk), cardiac rhabdomyoma |
|
Definition
|
|
Term
| caufe au lait spots (hyperpig macultes), neurofibromas on skin |
|
Definition
|
|
Term
| severe mental retard, self mutilation, elev uric acid (gout and kidney stones) |
|
Definition
|
|
Term
| ipsi hemiparesis, loss of proprioception and vibration, contralat loss pain and temp |
|
Definition
Brown-Sequard syndrome - stab yound to spinal cord (hemisection)
Post column - ipsi position/vibration
Corticospinal tract - ipsi hemiparesis (weakness)
Spinothalamic - contra pain/temp |
|
|
Term
| UE areflexia, bilat loss pain/temp in cape-like distrib, assoc w/ Arnold-Chiari malform (cerebellum protrudes into cervical spinal cord) |
|
Definition
Syringomyelia - cyst (syrinx) in spinal cord, destroys center of cord
Dx - MRI
Tx - decompression, drainage |
|
|
Term
| DEC reflexes, unsteady gait, formication (feel ants), impaired proprioception, Argll Robertson pupils (accommodates but fails to constrict) |
|
Definition
| Tabes dorsalis - caused by tertiary syphillis |
|
|
Term
| one sided flaccid paralysis, absent DTR |
|
Definition
Poliomyelitis
Dx - virus isolated fr oral secretion, CSF - elev PMN and protein
Tx - supportive |
|
|
Term
| pruritis, jaundice, cholangiography - bead-like pattern (inflamm and narrowing of intra-/extrahepatic bile ducts), elev aminotrans, alk phos, bili; risk factor - ulcerative colitis |
|
Definition
primary sclerosing cholangitis
Tx - liver transplant |
|
|
Term
| malodorous frothy, yellow-green vag d/c, flagellated, motile, "strawberry cervix" (cervix w/ punctate hemorrhages), vag pH >4.5 |
|
Definition
Trichomoniasis - INC risk HIV
Tx - metronidazole for pt/partner (men usually asymp, but tx anyway) |
|
|
Term
| "FEVER" - Fever, Encephalopathy, Vital sign instability, Elev enzymes esp CK, Rigidity; started antipsychotic in last 10 days |
|
Definition
Neuroleptic malignant syndrome - common w/ typicals (haloperidol, fluphenazine, chlorpromazine)
Tx - stop med, IV fluids, dantrolene (mm relaxant), bromocriptine (dopa agonist), amantadine (optional) |
|
|
Term
| AMS, hyperthermia, myoclonus, hyperreflexia, HTN, tachycardia, dilated pupils, tremor |
|
Definition
|
|
Term
| "DUMBELS" - diarrhea, urinary incont, miosis/mm weakness, bronchospasm/bradycardia, emesis, lacrimation, salivation |
|
Definition
| organophosphate poisoning (cholinergic excess) - insecticides, herbicides |
|
|
Term
| AMS, early osmolal then AGMA, tachypnea, calcium oxalate crystalluria and renal failure (late) |
|
Definition
athylene glycol poisoning - antifreeze, hydraulic brake fluid
Tx - fomepizole (alcohol dehhydrogenase inhib) |
|
|
Term
| AMS, osmolal gap then AGMA, VISION LOSS |
|
Definition
methanol poisoning - paint stripper, moonshine
Complication - permanent blindness
Tx - fomepizole (alcohol dehhydrogenase inhib) |
|
|
Term
| prodrome fever, HA, malaise; behavioral changes, seizures, memory loss, focal neuro deficits, involves temporal lobes, NO rash |
|
Definition
HSV encephalitis
Tx - IV acyclovir (SE - crystal-induced nephropathy -- hydrate!!) |
|
|
Term
| petechiae, purpura, hypotension, DIC, acidosis, adrenal hemorrhage, multi organ failure, sometimes coma |
|
Definition
Meningococcemia
Dx - LP (CT w/ contrast first if have neuro sx), tx right away if petechiae/purpura present
Tx - IV vanc + IV ceftriaxone, if meningitis suspected - add IV dexamethasone |
|
|
Term
[image]
Convulsion, Confusion/Coma, Cardiac Conduction |
|
Definition
TCA overdose - amitriptyline, nortriptyline, imipramine, cyclobenzaprine, clomipramine, desipramin, doxepin
prolonged QRS -> V tach, vfib |
|
|
Term
| resp depression, mental status changes |
|
Definition
opiate overdose (oxycodon, meperidinee)
Tx - natrexone, naloxone |
|
|
Term
| amniocentesis - INC MSAFP, AFAFP, AchE activity |
|
Definition
|
|
Term
| short, cafe au lait spots, precocious puberty, bone lesions (polyostotic fibrous dysplasia), endocrinopathies |
|
Definition
|
|
Term
| INC EDV and ESV, DEC EF; lived in central america |
|
Definition
Dilated cardiomyopathy - d/t Chagas dz
Other causes - thyroid dysfxn, acromegaly, EtOH, coxsackie virus, HIV, HTN |
|
|
Term
| radioopaque stones (seen on abd xray) |
|
Definition
| calcium oxalate (MC), Ca phosphate, struvite, cysteine |
|
|
Term
| painful limp after URI, afebrile, normal ESR and WBC |
|
Definition
transient synovitis
Tx - NSAIDs |
|
|
Term
|
Definition
Torsade de pointes - polymorphic v tach (can lead to v fib)
Tx - magnesium sulfate
Causes - QT syndrome, rxs that prolong QT (antiarrhythmics, antispych, antimicrob), diarrhea, hypoMg+, hypoK+ |
|
|
Term
| ibsi arm exercised, CNS sxs (syncope, vertigo, confusion, ataxia, dysarthria), UE claudication |
|
Definition
Subclavian steal syndrome -
Dx - carotid duplex US (retrograde flow thru vertebral aa), angiography of subclavian aa (confirm)
Tx - angioplasty, stent, surgical bypass |
|
|
Term
| edema, JVD, pericardial knock, ascites |
|
Definition
constrictive pericarditis
CXR - calcif around heart, normal bx
Tx - surg removal of pericardium |
|
|
Term
|
Definition
EM minor - target lesion on ext, no mucosal
EM major - ext (<10% BSA), mucosa
SJS and TEN - widespread blister, face and trunk (SJS <10%, TEN >30% BSA) |
|
|
Term
[image]
sinus brady and prolonged intervals |
|
Definition
J or Osborne wave - extra deflection at end of QRS, leads I and avL
Cause - hypthermia |
|
|
Term
| HyperPRL tx (pituitary adenoma) |
|
Definition
| bromocriptine - dopa agonist |
|
|
Term
|
Definition
| metoclopramide - dopa antag (will INC PRL) |
|
|
Term
| vertigo, hearing loss, NV, preceding viral illness |
|
Definition
Labyrinthitis - self limiting
Dx - audiogram |
|
|
Term
|
Definition
Ct w/out contrast (sensitive in first 12 hr)
If neg and high suspicion --> LP (xanthochromia) |
|
|
Term
|
Definition
Marjolin - chronic wound (old burn) 30+ yrs ago; assoc w/ SCC, Tx - excision
Curling's - duodenal ulcer, occurs after burn
Cushing - gastric/dudodenal ulcer caused by elev ICP
Marginal - ulcer in jejunum after gastrojejunostomy
Buruli ulcer - Mycobacterium ulcerans |
|
|
Term
| postherpetic neuralgia (tx zoster within 72 hr to prevent this) |
|
Definition
| Tx - TCA, topical analgesic, opioid, gabapentin, pregabalin |
|
|
Term
| failure to thrive, cataracts, liver dz (jaundice, hepatomegaly, vomiting), susceptible to E coli infxn |
|
Definition
Galactosemia - galactose-1-phosphate uridyl transferase enzyme defic
Tx - avoid galactose (soy-based milk) |
|
|
Term
| retarded, "musty odor" urine and sweat, hypopigmentation |
|
Definition
PKU - phennylalanine hydroxylase defic
Tx - avoid phenylalanine |
|
|
Term
| tall stature, lens subluxation, mental retard, osteoporosis, hypercoag, methionine metab d/o |
|
Definition
Homocystinuria
Tx - Vit B6 (life) |
|
|
Term
PROM/PPROM risk factors
(<37 wks) |
|
Definition
| genital tract infxn, grand multiparity, polyhydramnios, smoking, prev PROM/PPROM |
|
|
Term
| infant - head edema soft, nonpitting, caused by passage thru birth canal, CROSSES suture lines |
|
Definition
|
|
Term
| swelling of head does NOT cross suture line; blood collects under berosteium of one of calvarial bones (mostly unilat) |
|
Definition
|
|
Term
|
Definition
Tx - PCN, desensitize if allergic (prego)
2nd line - ceftriaxone (NOT for prego) |
|
|
Term
| MDD augment tx (if resis to monotx w/ antidepressant) |
|
Definition
| Lithium, antidepressants in different class, atypical antipsychotics (aripiprazole, olanzepine, quetiapine; except clozpine bc of agranulocytosis) |
|
|
Term
| rabies post exposure prophylaxis in prev vaccinated |
|
Definition
| irrigation and repeat rabies vaccine |
|
|
Term
| rabies post exposure prophylaxis in unvaccinated |
|
Definition
| irrigation, rabies immunoglobulin, rabies vaccine x4 |
|
|
Term
| progressive dysphagia, wt loss, hoarseness, recurrent aspiration |
|
Definition
Esophageal CA
Dx - barium swalllow (initial - "apple core"), followed by endoscopy
Risk factors - smoking, EtOH; other - betel nuts, nitrosamines, achalasia, HPV 16/18, hot foods/drinks
Adenocarcinoma - Barret's, smoking |
|
|
Term
high obstruction (past pylorus) - vomiting
late (close to ileocecal valve) - feculent vomiting, abd distension |
|
Definition
small bowel obstruction (SBO)
MC - adhesions, followed by hernias and neoplasms |
|
|
Term
| allergic rhinitis, asthma, blood eosinophilia, (+) p-ANCA; affects skin, nervous, CV, GI sys |
|
Definition
Churg-Strauss syndrome (allergic granulomatosis) - small-med vasculitis
Tx - glucocorticoids, immunosuppressive rxs |
|
|
Term
| fever, chills, nausea, cough, SOB after exposure to specific antigen |
|
Definition
| Hypersensitivity pneuomonitis (extrinsic allergic alveolitis) |
|
|
Term
| angina sx at rest, non-ST elev MI |
|
Definition
Unstable angina
Tx - BB, aspirin, O2, morphine, nitro, IV heparin |
|
|
Term
| fever, rash, eosinophilia, WBC casts, eosinophiluria, MCC allergic drug rxn (PCN, cephalosporin, NSAIDs, phenytoin, diuretics, sulfonamides) |
|
Definition
Acute interstitial nephritis
Other causes - Sjoren, SLE, sarcoidosis
BUN:Cre ratio <20:1, urine Na >40, FENa >2%, hyperK+
Impaired H2O reabsorp -> osmolality <250 |
|
|
Term
| non-anion gap, hyperchloremic metabolic acidosis |
|
Definition
| renal tubular acidosis (RTA) |
|
|
Term
| breaking open of wound along suture line |
|
Definition
| wound dehiscence - INC risk evisceration (organs protruding out); occurs 1-20 days postop |
|
|
Term
| complication of avascular necrosis, physically active adolescents, crepitus, effusion, tenderness |
|
Definition
| osteochondritis dissecans |
|
|
Term
| syncope during prolonged standing, stress, hyperthermia, pain, fatigue, setting of blood or medical procedure |
|
Definition
neurocardiogenic (vasovagal) syncope - MCC syncope
Dx - (+) tilt table test (also pos in orthostatic hypotension in elderly taking diuretics, diabetics) |
|
|
Term
| bulging, thin, wrinkled abd, renal dysplasia, dilated ureters, enlarged bladder, cryptorchidism, pulm hypoplasia, cardiac/GU anomalies |
|
Definition
| Prune-belly syndrome - males |
|
|
Term
| Small cell carcinoma (SCC) - systemic dz begins in lung, by time of dx tx is... |
|
Definition
| Tx - chemo* (+/- radiation - depends if mets) |
|
|
Term
| non-small cell lung cancer tx |
|
Definition
| Tx - surg resection + chemo |
|
|
Term
|
Definition
FNA --> if pt euthyroid or hypothyroid
TSH (initial), US
if TSH low -> scintigraphy
if TSH high -> FNA for nodule > 1cm |
|
|
Term
| diabetes, diarrhea/steatorrhea, cholelithiasis, hypochlorhydria, wt loss |
|
Definition
somatostainoma - arise in duodenum, delta cells pancreas
Dx - US or CT
Tx - surg resection |
|
|
Term
| acute hypoxemia, ratio PaO2/FiO2 <200, CXR - bilat diffuse infiltrates |
|
Definition
ARDS
Disting fr cardiogenic pulm edema with pulm capillary wedge pressure |
|
|
Term
| RUQ pain, fever, jaundice; leukocytosis, conj hyperbili, elev alk phos, GGT |
|
Definition
ascending cholangitis (Charcot's triad) - infxn of biliary tree, complicated by choledocholithiasis
Dx - US (initial), ERCP (gold std)
Tx - IV abx, IV fluids, ERCP w/ sphinctereotomy/ stone removal |
|
|
Term
| Charcot's triad (RUQ pain, fever, jaundice) + AMS and hypotension |
|
Definition
|
|
Term
| overweight young female, HA worse at night, bilat papilledema, normal brain MRI; assoc w/ use of vit A, tetracycline, OCP, corticosteroid withdrawal |
|
Definition
Pseudotumor cerebri - idiopathic ICP
Dx - LP (INC pressure, normal CSF) |
|
|
Term
| acquired fr birds, dry cough, CXR - unilat lower lobe dense infiltrate |
|
Definition
|
|
Term
[image]
dyspnea, cyanosis, squats down
|
|
Definition
Tetrology of Fallot - boot shaped heart, "tet spells", pulm stenosis, RVH, VSD, overriding aorta
EKG - RVH
|
|
|
Term
| BUN/Cr >20, FENa <1%, urine Na <20 |
|
Definition
| Pre-renal - septic shock; kidney not perfused, activ RAAS to INC Na reabsorp |
|
|
Term
|
Definition
intra-renal - Goodpasture, ATN (d/t nephrotoxicty, ischemia)
post-renal - BPH, anticholinergics (urine retention) |
|
|
Term
| heliotrope/butterfly rash, Gottron's papules, Shawl sign, anti-Jo ab, + ANA, polymyositis sx |
|
Definition
|
|
Term
|
Definition
Molluscum contagiosum - poxvirus, dome shaped w/ central umbilication, affects face, thighs, trunk, genitals
Dx - clinical
Tx - self limited |
|
|
Term
| basophilic stippling, neoropathy, blue line along gums |
|
Definition
lead toxicity
Tx - succimer (kids), edetate calciium disodium, dimercaprol (also for mercury tox) |
|
|
Term
| antipsychotic parkinsonism |
|
Definition
| Tx - DEC dose, benztropine / diphenhydramine |
|
|
Term
| red-brown patches in intertriginous areas, asymptomatic |
|
Definition
| erythrasma - prolif of Corynebacterium minutissimum in stratum corneum |
|
|
Term
| arousal by clothing worn by opposite sex |
|
Definition
|
|
Term
|
Definition
Sabin - live (developing countries)
Salk - inactivated (US) |
|
|
Term
|
Definition
Check if tetanus in past 5 yrs
superficial - irrigation w/ NS
Deep - irrigation, suture if within 12 hrs and not located on hand, wrist or foot |
|
|
Term
| high fever, stomach cramps, diarrhea (mucousy, bloody), seizure |
|
Definition
Shigella
Dx - fecal leukocytes, stool culture |
|
|
Term
|
Definition
1st line - intranasal corticosteroids
2nd - intranasal or oral antihistamine (2nd gen, less drowsy - loratidine, fexofenadine, cetririzine)
Intranasal cromolyn sodium - mast cell stabilizer, helpful before allergen exposure |
|
|
Term
| thigh pain d/t head of femur, age 4-9 |
|
Definition
|
|
Term
| excess bleed during circumcision, hemarthrosis, famhx, prolonged PTT (factor VIII defic) rest normal |
|
Definition
Hemophilia A - X-linked reces
Tx - corticosteroids or acetaminophen + factor VIII concentrate; desmopressin (syn ADH) adjunct
Hemophilia B - less common, factor IX defic, prolonged PTT, Tx - factor IX concen |
|
|
Term
|
Definition
ACEI - DEC nephropathy, MI, stroke
NO thiazide... may exacerbate hyperglycemia in diabetics |
|
|
Term
| best test to disting nephrolithiasis fr G6PD defic |
|
Definition
urine microscopy
If UA has blood but no RBCs = hemolysis (G6PD), RBC = nephrolithiasis |
|
|
Term
| postprandial pain (esp w/ fatty food), wt loss, pre-existing atherosclerotic dz, abd bruit |
|
Definition
chronic (mesenteric) intestinal ischemia
Dx - angiogram
Tx - surg revascularization |
|
|
Term
| mood reactivity (improved mood when something good happens) + at least 2: wt gain, hypersomnia, leaden paralysis, excses sensitivity to rejection |
|
Definition
|
|
Term
| repro age, assoc w/ OCP, anabolic steroids, glycogen storage dz, US - hepatic tumor, usually asymptomatic but may have RUQ pain |
|
Definition
hepatic adenoma - benign
Dx - US, CT, MRI, angiography (incidentaloma)
Tx - surg resection if >5 cm or symptomatic, or do no regress after d/c OCP (repeat US 6 mon after) |
|
|
Term
| midsystolic click, late systolic murmur, occurs earlier w/ Valsalva and standing, disappear with squatting |
|
Definition
|
|
Term
| apical holosystolic murmur radiates to axilla or back |
|
Definition
|
|
Term
| occlusion: LE paraplegia, incontinence, motor aphasia, personality change |
|
Definition
| anterior cerebral aaa (ACA) - cerebral cortex, frontal pole, ant portion corpus callosum |
|
|
Term
| occlusion: contralat hemiplegia, affects face/arm, homonymous hemianopia, apraxia, aphasia |
|
Definition
| middle cerebral aa (MCA) - MC CVA**, temporal, anterolat frontal lobe, parietal lobe |
|
|
Term
| occlusion: homonymous hemianopsia w/ macular sparing, prosopagnosia (can't recog faces) |
|
Definition
| posterior cerebral aa (PCA) - midbrain, thalamus, part of temporal, occipital, occipitoparietal cortixes |
|
|
Term
| occlusion: ataxia, dysphonia, contralat loss pain and temp, ipsi loss pain temp fr face, ipsi Horner's, hoarseness, diminished gag reflex, diplopia, dysphagia |
|
Definition
| posterior inferior cerebellar aa (PICA) |
|
|
Term
| child w/ bone marrow failure (pancytopenia, recurrent infxn), thumb abnorm, multiple cafe au lait (hyperpig >5 mm), renal anomalies, microcephaly, short stature |
|
Definition
Fanconi anemia - genetic DNA repair, INC risk AML*
Dx - chromosome breakage test |
|
|
Term
| congenital telangiectatic erythema, photosensitivity, cafe au lait, growth delay, neoplasm susceptibility |
|
Definition
|
|
Term
| leukocoria, strabismus, abnormal red reflex (also seen in cataracts) |
|
Definition
| retinoblastoma - MC intraocular malig child, auto dom |
|
|
Term
| heavy vomiting, delirium, fatty liver followed by coma; kid tx'd at home for URI |
|
Definition
| Reye syndrome - fr salicylate admin (aspirin) under 12 |
|
|
Term
Tinea versicolor (malassezia furfur) tx
KOH - hyphae w/ budding spores (spaghetti and meatball) |
|
Definition
| Tx - selenium sulfide, topical terbinafine, ketoconazole, or oral -azole |
|
|
Term
cavernous hemangioma tx
(MC benign liver tumor), usually asymptomatic, growth assoc w/ pregnancy, estrogen rep, OCP
Dx - US, CT, MRI; avoid bx bc of rupture |
|
Definition
watch expectantly
surg for >5 cm or symptomatic |
|
|
Term
|
Definition
Atrial flutter - regular atrial activ, sawtooth, R-R int can be irreg
Etio: HTN, rheum heart dz, CAD, hyperthyroid
Tx - BB or CCB (rate control)
Unstable - synchronous DC cardioversion
Stable - synchronous DC or pharm cardioversion
Warfarin 3-4 wks prior ot cardioversion |
|
|
Term
| newborn cyanosis, CXR - "egg-on-string", narrow mediastinum, |
|
Definition
Transposiion of great vessels
Dx - echo
Tx - PG E1 or E2 (prevent PDA closure), cardiac cath, balloon atrial septostomy, surgery to follow |
|
|
Term
| single blood vessel arising fr RV/LV, VSD usually present, CXR - heart enlargement, fluid filled lungs |
|
Definition
|
|
Term
| newborn cyanosis, all 4 pulm vv drain into systemic vv or RA, CXR - "snowman" appearance |
|
Definition
| total anomalous pulmonary venous return - ASD or foramen ovale needed for survival |
|
|
Term
| complication of parapneumonic effusion, pH <7.3, low glucose, high LDH, + gram stain, Ct - loculation, thicken pleural membrane |
|
Definition
Empyema
Tx - drainage w/ thoracostomy, IV abx |
|
|
Term
| contrast-induced renal failure |
|
Definition
| D/C metformin before test and resume after 48 hr bc it's excreted by kidneys and can cause fatal lactic acidosis |
|
|
Term
| + Finkelstein (flexion of thumb across palm), pain on ulnar deviation of wrist, day-care workers fr lifting |
|
Definition
| De Quervain's tenosynovitis - thickening of tendons of abductor pollicis longus and ext pollicis brevis |
|
|
Term
| low calcium, low phos, elev PTH |
|
Definition
Vit D defic (causes 2ndary hyperparathyroidism:) - DEC Ca and phosphos absorp, leads to INC PTH which further DEC phos
Renal failure also causes secondary hyperparathyroidism (vitD defic = low phos, RF = high phos) |
|
|
Term
| low calcium, elev phos, elev PTH |
|
Definition
| Pseudohypoparathyroidism - target organ resis to PTH (assoc w/ Albright's hereditary osteodystrophy) |
|
|
Term
| elev Ca, normal phos, DEC PTH |
|
Definition
|
|
Term
| elev Ca, low phos, elev PTH |
|
Definition
primary hyperparathyroidism - adenoma (MC), hyperplasia (2nd MC), parathyroid CA (rare)
INC PTH leads to hyperCa2+ and low phos |
|
|
Term
| stomatitis, metabllic taste, difficulty swallowing, renal failure, neuro dz |
|
Definition
|
|
Term
[image]
pruritis or burning |
|
Definition
Mammary Paget dz - scaly red plaque spreads fr nipple to areola, underlying breast CA
Dx - skin bx (punch, wedge or excisional) |
|
|
Term
| warm, red breasts, peud'orange, no assoc breast maa |
|
Definition
| inflammatory breast CA - aggressive; misdx'd as cellulitis |
|
|
Term
|
Definition
MAOI - phenelzine
SE - HTN (d/t tyramine crisis, or combo w/ serotonergic drug, ie escitalopram)
Nonselective MAO-A or MAO-B (tranylcypromine, isocarboxazid, seleginine) - no tyramine restriction (cheese, wine) |
|
|
Term
| atypical antidepressant, alpha antag (INC serotonin, norepi in brain), SE - sedation, wt gain |
|
Definition
|
|
Term
| full blown mania +/- depression |
|
Definition
|
|
Term
|
Definition
|
|
Term
| 4 or more episodes of MDD, mania, hypomania mixed in 12 mon |
|
Definition
|
|
Term
| hypomania and mild depression alternating |
|
Definition
|
|
Term
| loss of early motor skills, HSM*, mental retard, cherry-red macula, Ashkenazi Jew, sphingomyelinase defic |
|
Definition
|
|
Term
| loss of motor skills, neuro deficits, cherry-red macula, NO HSM*, Ashkenazi Jew, heoxsaminidase A defic |
|
Definition
|
|
Term
| galactosidase A defic, neuro and renal dz, groin lesions |
|
Definition
|
|
Term
| glucocerebrosidase defic, affects bone, HSM, CNS |
|
Definition
|
|
Term
| INC glucagon, DM, wt loss, glossitis, stomatitis, cheilitis, DEC amino acids (gluconeogesnsis fr aa), necrotizing migratory erythema |
|
Definition
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Term
| sinusoidal pattern on fetal monitoring |
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Definition
| severe fetal anemia - d/t RH isoimmunization or severe hypoxia |
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Term
[image]
immigrant, adrenal insuffic (hypotension, fatigue, wt loss, hypK+, abd pain fever) |
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Definition
TB induced adrenal insuffic - MCC adrenal insuffic worldwide
Dx - low CORT, no response to cosyntropin stim (ACTH analog) (confirm)
Tx - corticosteroid |
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Term
| smoker, wt loss, hemoptysis, secretes ADH or ACTH, vol overload, DEC Na |
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Definition
| Small cell lung CA - advanced at discovery, NOT ressectable |
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Term
| smoker, wt loss, hemopytysis, seceretes PTHrp ,elev Ca2+, cavitates and calcifies, can caused SVC syndrome (facial edema, prom neck veins) |
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Definition
Squamous cell lung CA
Tx - surg resection |
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Term
| lungs probs (restrictive lung dz, coughing, hemoptysis, wheezing), erythema nodosum, uveitis, arrhythmia, elev Ca (fr INC vit D), elev ACE |
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Definition
sarcoidosis
CXR - perihilar LN, pulm infiltrate
Bx - non-caseating granuloma |
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Term
| rheum arthritis, neutropenia, splenomegaly |
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Definition
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Term
| skin depig, assoc w/ pernicious anemia, hypo/hyperthyroid, Addison's, T1DM, 1st/2nd decade |
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Definition
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Term
| surgical wound categories |
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Definition
clean - no entry into resp, alimentary, genital or urinary
clean-contaminated - planned entry into these tracts w/out unusual contamination
contaminated - open, fresh, accidental or surg wounds w/ break in sterile technique or GI spillage
dirty - old traumatic wounds or op fields w/ pre-existing infxn |
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Term
| anal CA (MCC is squamous cell) risk factors |
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Definition
| HPV, anal intercourse, smoking |
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Term
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Definition
initial - US
most sensitive - CT
most specific - ERCP |
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Term
| hard, non-mobile mass in prox tibia/distal femur, pain and swelling around knee, adolescent, xray - "sunburst" (radiodense and radioluscent) |
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Definition
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Term
| circumferential ring at distal esophagus, heartburn, dysphagia (solids) |
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Definition
Schatzki's ring
Tx - dilation |
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Term
| INC MMA (methylmalonic acid), INC homocysteine |
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Definition
| Vit B12 defic - B12 levels may or may not be DEC, +/- neuro sxs |
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Term
| normal MMA, INC homocysteine |
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Definition
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|
Term
| abs vs nicotinic post-synaptic Ach-R |
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Definition
myasthenia gravis - nicotinic-R found only on skeletal mm
Muscuarinic-R on cardiacs, smooth mm, glands |
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Term
| hyperCORT, low ACTH, next test |
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Definition
| CT of adrenals = hyperplasia causing INC CORT and suppression of ACTH |
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Term
| most specific tests for RA |
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Definition
| xray (jt space narrowing, erosions) and anti-CCP |
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Term
| aminoglycosides*, amphotericin B, cisplatin, ACEI, NSAIDs, loop diuretics, cyclosporine, tacrolimus, acyclovir |
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Definition
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|
Term
| mid-systolic crescendo-decrescendo murmur, right 2nd ICS, radiation to carotid aa and apex |
|
Definition
| aortic stenosis - assoc w/ pulsus parvus et tardus (pulse felt later than heart contraction) |
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|
Term
|
Definition
1st line - metformin (if normal kidney fxn)
If AIC 7-85%, add sulfonylurea (glyburide)
If >8.5%, add insulin instead |
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Term
| result of COPD / pulm HTN, CXR - dilated RA/RV, enlarged central pulm aa, EKG - RVH, R axis dev, RBBB, peaked P waves (lead II) |
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Definition
Cor pulmonale
Tx - O2, diuretic |
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Term
| erythemia migrans ("bulls-eye" 1-2 wks later), Bell's palsy, meningitis, arthralgia, carditis, camping on East coast |
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Definition
Lyme dz - Borrelia burdorferi 2nd to Ixodes tick
Tx - doxycycline (over 8), amoxicillin (<8 yo) |
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|
Term
| sinus tracts, sulfur granule discharge |
|
Definition
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|
Term
| normocytic normochromic anemia (DEC EPO), hyperphos, hypoCa2+, hyperK+, azotemia |
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Definition
| chronic renal failure - hypCa+ 2ndary to DEC renal clearance of phos and insufficient 1-hydroxylation of 25-hydroxyvit D (prod by liver) to make active 1,25 dihydroxycholecalciferol (calcitriol) |
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|
Term
| AEIOU: Acidosis, Electrolytes (hyperK+), Intoxications (lithium, aspirin, methanol, ethylene glycol), Overload (CHF), Uremia (uremic pericarditis) |
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Definition
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|
Term
| early morning growth hormone secretion (GH antag to insulin), hyperglycemic in middle of night (elev 3am glucose) |
|
Definition
dawn phenomenon
Tx - INC basal insulin at dinner |
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|
Term
| overtreated w/ NPH, low 3am glucose, counters and becomes hyperglycemic in AM |
|
Definition
Somogyi effect
Tx - DEC NPH at dinner (glargine and detemir more stable control of overnight insulin, pref to NPH) |
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|
Term
| low cardiac output, HIGH pulm capillary wedge pressure, high SVR |
|
Definition
Cardiogenic shock - only type to have high PCWP* and JVD
CXR - pulm congestion |
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Term
| low CO, low PCWP, low SVR |
|
Definition
| Neurogenic shock - ALL low, disurption of autonomic nervous (d/t trauma) |
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|
Term
| high CO, low PCWP, low SVR |
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Definition
| Septic shock - recent infxn, cause peripheral dilation, INC CO in response |
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Term
| low CO, low PCP, high SVR |
|
Definition
Hypovolemic shock (trauma, diarrhea, vomiting, GI bleed, SBO, burns)
DEC preload -> DEC CO, compensate w/ INC SVR |
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|
Term
Uncomplicated diverticulitis tx
Complications - fistula, obstruction, perforation, abscess |
|
Definition
| Oral abx - cover Gram neg and anaerobes: quinolone + metronidazole, amox-clavulanate, TMP-SMX + metronidazole), low residue diet |
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|
Term
[image]
abd pain, distension, no stool or flatus |
|
Definition
Volvulus - MC sigmoid, elderly, "bent inner tube" (dilated sigmoid w/ apex in RUQ), 3rd MC LBO (after colon CA and diverticulitis)
Tx - endoscopic decompression
If ischemic -> Hartmann's (sigmoidectomy w/ end colostomy) |
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|
Term
| interferon, lamivudine, telbivudine, adenovir, entecavir, tenofovir |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| protease inhib ("navir"), NRTI (zidovudine, didanosine, stavudine, zalcitabine), NNRTI (nevirapine, efavirenz, declaviridine), maraviroc (CCR5 inhib), enfuvirtide (fusion inhib), raltegravir (integrase inhib) |
|
Definition
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|
Term
|
Definition
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|
Term
| corticosteroid steroid (dexamethasone) MOA |
|
Definition
| DEC brain edema by reducing pressure, CSF prod, DEC cap permeability in tumor (bulk flow away fr tumor) |
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|
Term
|
Definition
| benzo, antihypertensives (BB), anticholinergics |
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|
Term
|
Definition
| nerve and vascular insufficiency |
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|
Term
|
Definition
clean (minor), no h/o vaccine (or over 10 yrs ago) - vaccine
wound, no h/o vaccine - vaccine + immune globulin (TIG)
wound, vaccine in beyond 5 yrs - vaccine |
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|
Term
| exogenous hyperthyroidism d/t excess ingestion of thyroid hormone |
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Definition
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|
Term
| postmeno fracture - type of bone |
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Definition
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|
Term
| cord-like structure by anus |
|
Definition
fistula - tracking into anal canal
etio - Crohn's, malig
Dx - anoscopy, proctoscopy |
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|
Term
| prenatal screen - mom has (+) D antibody |
|
Definition
| mom (Rh neg) is Rh alloimmunized - has antibody vs Rh+ fr prev Rh+ pregnancy |
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|
Term
|
Definition
normal 1.0-1.4
abnormal <0.9 = PAD |
|
|
Term
| translucent blue, dome-shaped fluctuant swelling on floor of mouth, d/t trauma |
|
Definition
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