Term
|
Definition
|
|
Term
| where does iron absorption occur in the body |
|
Definition
| stomach, duodenum, and upper jejunum |
|
|
Term
| In menstruating women, how much iron must be absorbed from the diet each day in order to avoid deficiency |
|
Definition
| 3-4mg per day - often requires supplementation |
|
|
Term
| MCC of iron deficiency anemia? other causes? |
|
Definition
MCC - blood loss other causes - prolonged ASA use, anti-inflammatory durgs, menorrhagia, repeated blood donations, deficient diets, decreased absorption, increased requirements (prego, lactation), hemoglobinuria, pulmonary hemosiderosis |
|
|
Term
| S&S of iron deficiency anemia |
|
Definition
| fatigue, pica, koilonychia, pallor, dysphagia, tachycardia, palpitations, tachypnea on exertion, impaired muscular performance, glossitis, angular stomatitis, gastritis, RLS |
|
|
Term
| what type of anemai is iron deficiency? |
|
Definition
|
|
Term
| tx for iron deficiency anemia |
|
Definition
| ferrous sulfate 325mg PO TID |
|
|
Term
| when PO ferrous sulfate is give to correct deficiency, how long does it take to work? |
|
Definition
3 wks hct should be halfway to normal 2m all values should be back to baseline should continue supplementation for 3-6m after correction |
|
|
Term
| when response to PO iron is poor, what should be added to help absorption? |
|
Definition
| ascorbic acid 500mg PO BID/TID and meat |
|
|
Term
| which food supplements inhibit the absorption of iron in the body |
|
Definition
calcium fiber tea coffee wine cholestyramine colestipol neomycin quinolone abx tetracycline magnesium manganese zinc |
|
|
Term
| what are some common sources of vitamin B12? how long is B12 stored in the liver? |
|
Definition
sources - meat, poultry, milk, eggs stores last 3+ years |
|
|
Term
| who is at risk for iron deficiency anemia? |
|
Definition
strict vegans hx of gastric/intestinal surgery hx of atrophic gastritis pernicious anemia gastric malabsorption people who take acid blockers/PPIs |
|
|
Term
| how does B12 deficiency present? |
|
Definition
| megaloblastic anemia but can also present with peripheral neuropathy and neuropsychiatric complaints |
|
|
Term
| sxs of B12 deficiency anemia |
|
Definition
parethesias ataxia decreased vibration sense + romberg pallor, petechiae glossitis, angular cheilitis cognitive impairment seizures, hypotonia |
|
|
Term
| labs in B12 deficiency anemia |
|
Definition
elevated MCV, low HCT low B12, low retic count High MMA, homocysteine, LDH, indirect bilirubin |
|
|
Term
|
Definition
asx = diet and PO B12 sxs = Im cyanocobalamin |
|
|
Term
| long term complications of B12 deficiency |
|
Definition
progrsesive neurologic damage progressive anemia, leukopenia, and thrombocytopenia gastric cancer - long term complication of untx pernicious anemia |
|
|
Term
| what is pernicious anemia |
|
Definition
| insufficiency of intrinsic factor (requiered for B12 absorption) |
|
|
Term
| what foods contain folic acid |
|
Definition
| fruits and green leafy veggies |
|
|
Term
| what are the causes of folate deficiency? (4) |
|
Definition
malabsorption (celiac) malnutrition (alcoholics) increased requirements (prego/lactation) drugs (phenytoin, bactrim, sulfasalazine, ethanol, pyrimethamine, diphenylhydration, barbituates) |
|
|
Term
| S&S of folate deficiency? |
|
Definition
sleep deprivation fatigue depression irritability forgetfulness prolonged diarrhea HA loss of apetite SOB pallor tachycardia, tachypnea |
|
|
Term
| tx of folic acid deficiency? |
|
Definition
|
|
Term
| complications of folate deficiency? |
|
Definition
leukopenia thrombocytopenia CV dz venous thrombosis colorectal cancer |
|
|
Term
| what is anemia of chronic disease? |
|
Definition
| normocytic, normochromic anemia in pts with long standing inflammatory disease, malignancy, AIDS, or chronic infection |
|
|
Term
| whaty is erythropoesis stimulating agent? |
|
Definition
| EPA - used in the tx of severely sx pts who have anemia of chronic disease, need urgent transfusions, jehovah's witnesses, rare blood types, and those with multiple alloantibodies |
|
|
Term
|
Definition
| mortality is increased when Hb is raised to > 12 because there is increased likelihood of vascular events. monitor weekly |
|
|
Term
|
Definition
|
|
Term
| hx of sickle cell offers protection against |
|
Definition
|
|
Term
| what provokes acute sickle cell crisis? |
|
Definition
infection dehydration hypoxia |
|
|
Term
| MC places affected by sickle cell crisis |
|
Definition
| bones (esp long bones and back), liver, heart, kidney, eyes, lungs |
|
|
Term
| MCC of death in a person with sickle cell anemia |
|
Definition
multiple organ failure life expectancy 40-50 years |
|
|
Term
| tx of acute sickle cell crisis |
|
Definition
| exchange transfusion and hydroxyurea |
|
|
Term
|
Definition
| non sickling disorder that produces mild jaundice with splenomegaly and pigment (calcium) gallstones |
|
|
Term
| causes of aplastic anemia |
|
Definition
| radiation, chemo, toxins, SLE/autoimmune suppression of hematopoiesis by a T cell mediated cell mechanism |
|
|
Term
| pancytopenia is often indicative of |
|
Definition
|
|
Term
| lab values of aplastic anemia |
|
Definition
2+ cytopenia decreased hb, platelet, and absolute neutrophil count low retic count hypocellular bone marrow - should be an absence of blasts |
|
|
Term
|
Definition
if not severe = supportive if infxn - abx only severe < 40 = allogenic stem cell transplant then immunosuppresive therapy > 40 = immunosuppressive therapy then allogenic stem cell transplant |
|
|
Term
| aplastic anemia is closely related with what disorder? |
|
Definition
| proxysmal nocturnal hemoglobinuria |
|
|
Term
| how often should pts with severe aplastic anemia follow up with their health care provider? |
|
Definition
|
|
Term
| complications of aplastic anemia |
|
Definition
graft failure following stem cell transplant graft vs host disease AVN following immunosuppressive therapy paroxysmal noctural hemoglobinuria myelodysplastic syndrome AML solid tumors |
|
|
Term
| how do hemolytic anemias present? |
|
Definition
| acute/subacute development of jaundice, pallor, SOB, dizziness, fatigue, orthostasis, mild splenomegaly, active infections, epidsodic dark urine (hemoglobinuria), exposure to cold |
|
|
Term
| what are the common lab values in hemolytic anemia? |
|
Definition
low hgb high MCHC, retic count, indirect bilirubin, LDH low haptoglobin abnormal cells in peripheral smear - schistocytes, spherocytes, elliptocytes, spur cells hemaglobinuria |
|
|
Term
| what does the direct antiglobulin test (coombs test) analyze in hemolytic anemia? |
|
Definition
+ = immune etiology - = nonimmune etiology |
|
|
Term
| mutation of JAK2V617 is strongly associated with what blood disorder? |
|
Definition
|
|
Term
| risk factors for polycythemia vera (3) |
|
Definition
> 40 Budd-Chiari Syndrome Affected Family Member |
|
|
Term
| common S&S of polycythemia vera |
|
Definition
thrombosis hemorrhage HA weakness/fatigue post-bathing pruritis erythromelalgia redness of ringers/palms/toes/heels facial redness splenomegaly |
|
|
Term
| common lab values seen in polycythemia vera |
|
Definition
elevated hgb, hct, wbc, platelet, serum uric acid low erythropoietin Bone Marrow bx shows hypercellularity |
|
|
Term
|
Definition
low dose ASA and phlebotomy phlebotomy - 250-500ml of blood is replaced with normal saline 2x/wk until hct <45% |
|
|
Term
| how often should a pt with polycytehmia vera follow up with a hematologist? |
|
Definition
| every 1-2 wks until stable and then every 2-3 after that |
|
|
Term
| complications of polycythemia vera |
|
Definition
thrombosis hemorrhage severe erthromelalgia acute leukemia |
|
|
Term
| lymphoproliferative disorder associated with monoclonal gammopathy that can present wiht an unexpected skeletal fx, renal failure, hematologic abnl, hypercalcemia, or a combo of these |
|
Definition
|
|
Term
|
Definition
bone pain anemia infections fatigue neuropathy renal failure heart failure |
|
|
Term
|
Definition
| pulse corticosteroids in combo with chemotherapy |
|
|
Term
| fever, sore throat, sandpaper rash, strawberry tongue |
|
Definition
|
|
Term
| renal complications following strep pharyngitis |
|
Definition
|
|
Term
| cardiac complication following strep pharyngitis |
|
Definition
|
|
Term
|
Definition
Major: carditis, erythema marginatum, subcutaneous nodules, chorea, arthritis Minor: fever, prolonged PR interval, elevated ESR and CRP, leukocytosis, polyarthralgias |
|
|
Term
| residual complication of rheumatic fever |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
| visual disturbances (diplopia, ptosis) followed by respiratory paralysis |
|
|
Term
| gram positive box-car shaped rods in chains |
|
Definition
|
|
Term
|
Definition
| cipro or another flouroquinolone, report to CDC |
|
|
Term
|
Definition
|
|
Term
| causative agent of uncontrolled spasm and exaggerated reflexes |
|
Definition
|
|
Term
| MC form of salmonella infection |
|
Definition
|
|
Term
| causative agent and tx of dysentery |
|
Definition
|
|
Term
| tenacious grey membrane covering the pharynx |
|
Definition
|
|
Term
|
Definition
| antitoxin obtained from CDC, PCN or erythromycin |
|
|
Term
| real name for whooping cough |
|
Definition
pertusis coughing fits followed by high picthed inspiration |
|
|
Term
|
Definition
|
|
Term
| mononucleosis and Burkitt's lymphoma are both associated with what virus? |
|
Definition
|
|
Term
| administration of amoxicillin to EBV patients induces |
|
Definition
|
|
Term
| antibodies associated with EBV? |
|
Definition
|
|
Term
| causative agent of genital warts |
|
Definition
|
|
Term
|
Definition
|
|
Term
| painful erruption following a dermatomal pattern |
|
Definition
|
|
Term
| hydrophobia - painful spasms caused by drinking water are associated with |
|
Definition
|
|
Term
| antigen to which HIV attaches |
|
Definition
|
|
Term
|
Definition
|
|
Term
| HIV diagnosed by which labs |
|
Definition
|
|
Term
| Infection similar to EBV without pharyngitis, respiratory sxs, or heterophile antibodies |
|
Definition
|
|
Term
| tissue biopsy of CMV reveals |
|
Definition
| intracytoplasmic inclusions "owl's eyes" |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| gram negative intracellular diplococci |
|
Definition
|
|
Term
|
Definition
| ceftriaxone IM and concurrent doxycycline/azithromycin for chlamydia |
|
|
Term
| MCC of urethritis and cervicitis |
|
Definition
|
|
Term
|
Definition
| azithromycin, doxycycline, erythromycin |
|
|
Term
| flagellated protozoan infects Skene's glands in females |
|
Definition
|
|
Term
|
Definition
| malodorous, frothy-green discharge, motil flagellates on wet mount |
|
|
Term
|
Definition
|
|
Term
| Bull's eye lesions are associated with |
|
Definition
|
|
Term
| drug of choice for pts with erythema migrans associated with Lyme Disease |
|
Definition
|
|
Term
| causative agent of Rocky Mountain Spotted Fever |
|
Definition
|
|
Term
|
Definition
|
|
Term
| painless nodules associated with punctures by plant thorns, may progress to LAD |
|
Definition
|
|
Term
| honey colored crusts common in children |
|
Definition
|
|
Term
| layers of skin superficial --> deep |
|
Definition
stratum corneum stratum lucidum stratum granulosum strautm spinosum stratum basale |
|
|
Term
| cells that provide pigment |
|
Definition
|
|
Term
| myelocytes (melanocytes) are present in what layer? |
|
Definition
|
|
Term
|
Definition
|
|
Term
| yellowish-grey scaly macules or patches with greasy appearance |
|
Definition
|
|
Term
|
Definition
| hyperpigmentation of lwoer extremities associated with venous insufficiency |
|
|
Term
|
Definition
| a pruritic plaque caused by excessive rubbing or scratching |
|
|
Term
| causative agent of fifths disease |
|
Definition
|
|
Term
|
Definition
| Fifth disease "slapped cheeks" |
|
|
Term
| herald patch followed by widespread popular rash |
|
Definition
|
|
Term
| Flesh colored umbilicated papules common in children |
|
Definition
|
|
Term
| "Tapioca" appearance of vessicles, common on hands and feet. Pruritic, sometimes painful |
|
Definition
|
|
Term
| pink plaque with silvery scales |
|
Definition
|
|
Term
| Type of psoriasis seen after viral illness |
|
Definition
|
|
Term
|
Definition
|
|
Term
| rash on rash triggered by heat, alcohol, sun, spicy foods, etc |
|
Definition
|
|
Term
| rhinophyma is associated with |
|
Definition
|
|
Term
| inflammation of hair follicles |
|
Definition
| folliculitis (caused by staph aureus) |
|
|
Term
| causative agent of hot tub folliculitis |
|
Definition
|
|
Term
| life threatening condition involving high fever, photophobia, sore throat, mucosal inflammation, followed by cutaneous lesion |
|
Definition
| Stevens Johnson Syndrome or Toxic Epidermal necrolysis |
|
|
Term
| Disease of apocrine glands |
|
Definition
|
|
Term
| deep seated infection of a single hair follicle |
|
Definition
|
|
Term
| conglomerate mass of multiple infected hair follicles |
|
Definition
|
|
Term
| swollen, hot, red, tender skin |
|
Definition
|
|
Term
| tinea versicolor causative agent |
|
Definition
|
|
Term
|
Definition
|
|
Term
| which scabies tx should be avoided in kids < 2 yo |
|
Definition
|
|
Term
|
Definition
|
|
Term
| actinic keratosis can progress to |
|
Definition
|
|
Term
|
Definition
|
|
Term
| most comomon neoplasm of the skin |
|
Definition
|
|
Term
| hyperpigmentation associated with Dm and obesity |
|
Definition
|
|
Term
| hyperpigmentations of sun exposed areas associated with pregnancy or OCP use |
|
Definition
|
|
Term
| hypopigmented skin commonly seen on hands |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| tx of vulvovaginal cadidiasis |
|
Definition
|
|
Term
| candidal fungemia (systemic fungal infection) tx? |
|
Definition
|
|
Term
| pt works with exotic birds and develops a cough |
|
Definition
|
|
Term
| common cause of pneumonia in HIV pts |
|
Definition
|
|
Term
|
Definition
|
|
Term
| mosquito that carries malaria |
|
Definition
| female anopheles mosquito |
|
|
Term
| tx and prophylaxis of malaria |
|
Definition
|
|
Term
| causative agent of syphilis |
|
Definition
|
|
Term
| painless ulcer with inderated margins in the inguinal region |
|
Definition
|
|
Term
|
Definition
|
|
Term
where is the infarct? weakness and cortical sensory loss in the contralateral leg and sometimes mild weakness of the arm, especially proximally. May be a contralateral grasp reflex, paratonic rigidity, and abulia or frank confusion. Can cause urinary incontinence. |
|
Definition
| anterior communicating artery |
|
|
Term
| brain infarction that can lead to behavioral changes |
|
Definition
| bilateral anterior communicating artery |
|
|
Term
where is the infarct? leads to contralateral hemiplegia, hemisensory loss, and homonymous hemianopia. can lead to Wernicke Aphasia |
|
Definition
|
|
Term
where is the infarct? thalamic syndrome in which conrtalateral hemisensory disturbance occurs, followed by development of spontaneous pain and hyperpathia |
|
Definition
| posterior cerebral artery |
|
|
Term
where is the infarct? ipsilateral spinothalamic sensory loss involving face, ninth and tenth cranial nerve lesions, ataxia and numbness, Horner syndrome, combined with contralateral spinothalamic sensory loss involving the limbs |
|
Definition
| posterior inferior cerebellar artery |
|
|
Term
where is the infarct? vertigo, N/V, nystagmus, ipsilateral limb ataxia, contralateral spinothalamic sensory loss in the limbs |
|
Definition
|
|
Term
| how long are thrombolytics a viable option for stroke? |
|
Definition
|
|
Term
| when is endarterectomy recommended for carotid arteries? |
|
Definition
|
|
Term
|
Definition
|
|
Term
| senile plaques, neurofibrillay tangles, neuronal loss, cortical atrophy |
|
Definition
|
|
Term
| hallmark sxs of Alzheimers (3) |
|
Definition
memory loss impairment of daily activities neurobehavioral abnormalities |
|
|
Term
|
Definition
supportive - caregiver support, mental health support, home safety, exercise cholinesterase inhibitors (aricept, exelon, razadyne,) enhances or prevents decline of cognitive function anti-depressants (zoloft, celexa, lexapro) depression is common, SSRI's are first line antipsychotics (risperdal, zyprexa, seroquel, abilify) management of insomnia moderate for severe AD = memantine |
|
|
Term
| characteristics of subcortical dementias |
|
Definition
motor impairments reduced attention psychomotor slowing loss of executive functioning personality change |
|
|
Term
| personality changes + compulsive behavior without visuospatial changes |
|
Definition
| Frontotemporal dementias (Pick Dz) associated with ALS |
|
|
Term
| caused by acute deficiency of thiamine in a susceptible host |
|
Definition
| Wernicke's Encephalopathy |
|
|
Term
| tx of Wernicke's Encephalopathy |
|
Definition
stabilize/resuscitate thiamine (250-500mg in 100ml NS over 30 min TID x 3d), Mg (2-4g/d), multivitamin |
|
|
Term
|
Definition
Eyes - 4 Verbal - 5 Motor - 6 worst score = 3 best score = 15 |
|
|
Term
| MCC of death in young people |
|
Definition
|
|
Term
| what are secondary insults to the brain? (2) |
|
Definition
|
|
Term
|
Definition
| injury to the middle meningeal artery |
|
|
Term
| triad of brain herniation |
|
Definition
coma fixed, dilated pupils decerebrate posturing |
|
|
Term
| likely location of bleeding in subdural hematomas |
|
Definition
|
|
Term
| MCC of subarachnoid hemorrhage |
|
Definition
| rupture of an aneurism or AV malformation |
|
|
Term
| carpal tunnel syndrome is associated with what electrolyte abnormality? |
|
Definition
|
|
Term
heat intolerance cold intolerance |
|
Definition
heat = hyperthyroid cold = hypothyroid |
|
|
Term
| polymorphonuclear neutrophils |
|
Definition
| acute tubulointerstitial nephritis |
|
|
Term
| mononuclear cell predominance |
|
Definition
| chronic tubulointerstitial nephritis |
|
|
Term
| 4 MCC of nephrotic syndrome |
|
Definition
minimal change disease focal glomerular sclerosis membranous membranoproliferative |
|
|
Term
| peripheral edema, hypoalbuminuria (< 3g/d), proteinuria (> 3.5 g/d), lipiduria |
|
Definition
|
|
Term
| bones, stone, abdominal groans, psychic moans, with fatigue overtones |
|
Definition
|
|
Term
| serm PTH, alk phos, and calcium are increased |
|
Definition
|
|
Term
| + Chovsteks and Trousseaus |
|
Definition
|
|
Term
| tx of hyperparathyroidism |
|
Definition
IV hydration loop diuretics bisphosphonates calcimimetics surgery - remove pathological parathyroid gland |
|
|
Term
| MCC of hypoparathyroidism |
|
Definition
|
|
Term
|
Definition
IV calcium gluconate calcium salts vitamin D calcitriol |
|
|
Term
|
Definition
|
|
Term
| one or more lesions having high bone turnover and disorganized osteoid formation. weak and deformed bone structure |
|
Definition
|
|
Term
normal calcium normal phosphate extremely increased alk phos normal PTH |
|
Definition
|
|
Term
| MCC subacute endocarditis |
|
Definition
|
|
Term
|
Definition
|
|
Term
| review rheumatoid antibodies |
|
Definition
|
|
Term
|
Definition
calcinosis Raynaud's esophageal dysfunction sclerodactyly telangiectasias (specific type of limited scleroderma) |
|
|
Term
|
Definition
no specific rx PPI for reflux ACEI for renal disease avoidance of triggers CCB for Raynaud's immunosuppressive drugs for HTN |
|
|
Term
| inflammatory disease of striated muscle affecting the limbps, neck, and pharynx |
|
Definition
polymyositis if it affects the skin as well = dermatomyositis (increased risk of malignancy) |
|
|
Term
|
Definition
| high dose steroids, methotrexate, azathioprine until sxs resolve |
|
|
Term
| dry mucous membranes + enlarged parotid glands |
|
Definition
|
|
Term
| test of Sjogren's Syndrome |
|
Definition
| Schrimer's test - decreased tear production |
|
|
Term
| increased risk of what disease with Sjogren's Syndrome |
|
Definition
|
|
Term
| disease associated with polyarteritis nodosa |
|
Definition
|
|
Term
|
Definition
|
|
Term
| upper and lwoer respiratory tract involvement, pauci-immune glomerulonephritis |
|
Definition
|
|
Term
| tests for thoracic outlet syndrome |
|
Definition
|
|
Term
| MCC of osteomyelitis in sickle cell pts |
|
Definition
|
|
Term
| MCC of osteomyelitis in normal population |
|
Definition
|
|
Term
| causative agent in osteo from penetrating injury to the foot |
|
Definition
|
|
Term
| most common benign bone tumor |
|
Definition
|
|
Term
| MC benign tumor of the hands |
|
Definition
|
|
Term
| highly malignant tumor that affects mostly children, typical "onion skin" reaction on xray |
|
Definition
|
|
Term
| MC primary malignant lesion of the bone, sunburst pattern on xray |
|
Definition
|
|
Term
|
Definition
1-2.5 = osteomalacia (osteopenia) 2.5 + = osteoperosis |
|
|
Term
| MC fracutres sites with osteoperosis |
|
Definition
| spine(lumbar vertebra) and hip |
|
|
Term
| proximal muscle weakness associated with fever, fatigue, weight loss, depression. also has an association with temporal arteritis |
|
Definition
|
|
Term
| difference between Steven Johnsons Syndrome and Toxic Epidermal Necrolysis |
|
Definition
SJS if < 10% BSA involved TEN if > 10% BSA involved |
|
|
Term
| common drugs associated with SJS and TEN (4) |
|
Definition
sulfonamides NSAIDs allopurinol anticonvulsants |
|
|
Term
| pearly or waxy papule with telangiectasias, erythematous patch, or non healing ulcer in sun exposed areas |
|
Definition
|
|
Term
|
Definition
|
|
Term
| lesions appear as small red, conical, hard nodules that occasionally ulcerate |
|
Definition
|
|
Term
| leading cause of death due to skin cancer |
|
Definition
|
|
Term
|
Definition
|
|
Term
| 1st line meds for neuropathic pain |
|
Definition
|
|
Term
| condition in which the pt has blindness, paralysis, or other nervous system symptoms which cannot be explained |
|
Definition
|
|
Term
| a belief that real or imagined physical symptoms are signs of serious illness, despite medical reassurance and other evidence to the contraray |
|
Definition
|
|
Term
| a long term condition in which a person has physical symptoms that are caused by psychological problems and no physical problem can be found |
|
Definition
|
|
Term
| mental disorders in which a person acts as if he or she has physical or menal illness when in fact, he or she has consciously created his or her symptoms |
|
Definition
|
|
Term
| 4 major compoenents of ABG's |
|
Definition
|
|
Term
|
Definition
rule out endocarditis assess LAE |
|
|
Term
| 3 categories of info provided by PFT's |
|
Definition
lung volume flow rate diffusing capacity |
|
|
Term
| contraindications to thoracentesis |
|
Definition
uncooperative pt coagulation/bleeding disorders |
|
|
Term
| complications of thoracentesis (5) |
|
Definition
pneumothorax hemothorax hemorrhage hypotension pulmonary edema |
|
|
Term
| indications for bronchoscopy (6) |
|
Definition
abnormal CXR hemoptysis opportunistic lung infection retained secretions and mucous plugs unexplained cough > 6 wks cancers |
|
|
Term
|
Definition
| gives info about cardiac output, ejection fraction, velocity, and wall motion abnormalities thru use of radiolabeled RBC's injected into the pt to assess the fxn of the heart |
|
|
Term
| best test to obtain info on peripheral vascular disease |
|
Definition
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