Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
610 Cards in this Set
- Front
- Back
Cardinal Symptoms of Cardiovascular Disease
|
•Chest pain or discomfort
•Dyspnea, orthopnea, paroxysmal nocturnal dyspnea, wheezing •Palpitations, dizziness, syncope •Cough, hemoptysis •Fatigue, weakness •Pain in extremities with exertion (claudication) |
|
Components for differential diagnosis of palpitations
|
•Atrial or ventricular extrasystoles (extra beats)
•Ventricular or supraventricular tachyarrhythmias •Anatomic abnormalities such as mitral valve prolapse |
|
NYHA Class I
|
No limitation of physical activity; no symptoms with ordinary exertion
|
|
NYHA Class II
|
Slight limitation of physical activity; ordinary activity causes symptoms
|
|
NYHA Class III
|
Marked limitation of physical activity; less than ordinary activity causes symptoms; ASYMPTOMATIC at rest
|
|
NYHA Class IV
|
Inability to carry out any physical activity without discomfort; SYMPTOMATIC at rest
|
|
Acyanotic congential heart disease with a Left-to-Right shunt
|
•Atrial Septal defect
•Ventricular septal defect •Patent ductus arteriosus |
|
Acyanotic congenital heart disease without a shunt
|
•valvular defects (can be valvular, subvalvular, or supravalvular)
•Coarctation (narrowing) of the aorta |
|
Cyanotic congential heart disease
|
•Causes decreased pulmonary blood flow
•Tetrology of Fallot |
|
Coarctation of the aorta
|
•Fibrotic narrowing of the aortic lumen
•Produces obstruction to LV outflow → LV hypertrophy develops to maintain SV in the face of increased afterload |
|
Most common extracardiac abnormality with coarctation of aorta
|
aneurysm of Circle of Willis
|
|
Pulmonic Valve Stenosis results in:
|
Results in RV hypertrophy
|
|
Physical exam findings in pulmonic valve stenosis
|
•Physical Exam may reflect right ventricular lift, normal S1, opening click, systolic murmur best heard at left upper sternal border
|
|
Most common cyanotic congenital heart lesion in adults
|
Tetrology of Fallot
|
|
Components of Tetrology of Fallot
|
Pulmonic valve stenosis which causes right ventricular outflow obstruction
Ventricular septal defect (VSD) – allowing blood to pass between left and right ventricles; right to left shunt results from right ventricular hypertrophy Overriding aorta across the VSD -- this aorta is between the left and right ventricles, directly over the VSD; As a result, oxygen poor blood from the right ventricle can flow directly into the aorta instead of into the pulmonary artery to the lungs Right ventricular hypertrophy -- the right ventricle thickens because the heart has to pump harder than it should to move blood through the narrowed pulmonary valve |
|
Atrial Septal Defect
|
Hole or defect in the atrial septum
Symptoms usually secondary to RV dysfunction (fatigue, dyspnea) |
|
Ventricular septal defect
|
•Oxygenated blood from LV is shunted through the VSD into the RV
•If defect is large, RV dilates and pulmonary blood flow increases; if uncorrected, pulmonary vascular obstruction could ensue, causing right-to-left shunting and cyanosis (Eisenmenger’s complex) |
|
Patent Ductus Arteriosus
|
This opening allows blood to flow directly from the aorta into the pulmonary artery, which can put a strain on the heart and increase the blood pressure in the lung arteries
•Physical exam reflects loud, continuous machinery-like murmur in left infraclavicular region |
|
Most reliable enzymes reflecting heart damage
|
•Troponin I and T
|
|
Cardiac Enzymes
|
Creatine Kinase (MB)
Troponin I and T Myoglobin Lactic Dehydrogenase |
|
Onset, Peak, Return to normal of Creatine Kinase (MB)
|
Onset: 6-12h
Peak: 24h Normal: 3-4days |
|
Onset, Peak, Return to normal of Troponin I and T
|
Onset: 1-3h
Peak: 24h Normal: 14-15days |
|
Onset, Peak, Return to normal of Myoglobin
|
Onset: 2h
Peak: 6-8h Normal: 20-36h |
|
Onset, Peak, Return to normal of Lactic Dehydrogenase
|
Onset: 24h
Peak: 3days Normal: 8-9days |
|
Echocardiogram
|
•Noninvasive technique to determine heart size, position, chambers, and velocity of blood flow
|
|
Indications for Echocardiogram
|
suspected valve, chamber disturbances, evaluation of pericardial effusion
|
|
Indications for cardiac MRI
|
examine size and thickness of heart chambers, determine extent of damage caused by MI or progressive heart disease
|
|
Contraindications for cardiac MRI
|
implanted metal devices pacemaker
pregnancy |
|
Gold Standard for NONINVASIVE cardiac assessment
|
Echocardiogram
|
|
Indications for Cardiac catheterization
|
suspected myocardial ischemia and/or valvular abnormalities
|
|
Conditions associated w/ Mitral Valve Prolapse
|
o Marfan Syndrome
o Ehlers-Danlos Syndrome – Types I, II, and IV collagen disorders o Rheumatic endocarditis o Acquired collagen-vascular disorders |
|
physiolgic consequences of Mitral Regurgitation
|
•Places volume overload on LV; LV responds with hypertrophy and dilation to increase SV; eventually LV dysfunction develops if volume overload is uncorrected
|
|
Symptoms of Mitral Regurgitation
|
o Dyspnea
o Orthopnea o PND |
|
Physiologic consequences of Mitral Stenosis
|
• Obstruction to LV inflow increases LA pressure and limits cardiac output; mitral valve obstruction increases the pressure work of RV, which is also adversely affected by the pulmonary hypertension that develops
|
|
Common cause of mitral stenosis
|
rheumatic fever
|
|
Physiologic consequences of Aortic Stenosis
|
• Pressure overload on the LV with compensation by LV hypertrophy; as disease advances, reduced coronary flow causes angina; hypertrophy and afterload excess lead to systolic and diastolic LV dysfunction
|
|
Physical exam findings in Aortic Regurgitation
|
o Quinke’s pulse = visible pulse in nail beds
o Corrigan’s pulse = bounding pulse o Musset’s sign = head nodding with each heartbeat o Hill’s sign = extremely elevated BP in lower extremities o Austin Flint Murmur = diastolic “blowing” murmur |
|
Quinke’s pulse
|
visible pulse in nail beds
|
|
Corrigan’s pulse
|
bounding pulse
|
|
Musset’s sign
|
head nodding with each heartbeat
|
|
Hill’s sign
|
extremely elevated BP in lower extremities
|
|
Austin Flint Murmur
|
diastolic “blowing” murmur
|
|
Physical exam findings in Pulmonic Valve Stenosis
|
o Palpable lift due to RVH
o Loud, harsh systolic murmur o Murmur increases with inspiration |
|
What are the three acyanotic congential heart diseases?
|
Atrial Septal Defect
Ventricular Septal Defect Patent Ductus Arteriosus |
|
What is the most serious complication of statin drugs?
|
Rhabdomyolysis
|
|
Action of Statins
|
o Inhibit synthesis of cholesterol by cells
o Lower LDL cholesterol o Promotes LDL clearance |
|
What are the 9 valvular diseases?
|
MVP
aortic stenosis mitral valve stensosis Mitral regurg aortic regurg tricuspid stenosis pulmonary stenosis |
|
What are the three signs and symptoms associated with Printz metals angina
|
Elevated ST,
Symptoms in the morning, Female less than 50 |
|
What are the three main coronary arterties assoc. with MI?
|
LAD, RCA, and circumflex
|
|
According to ATPIII (2002) a high risk pt. is what and what is your LDL goal?
|
2 or more risk factors and diabetes, CAD, peripheral disease
LDL goal is under 70 |
|
What are 4 EKG findings assoc. with MI?
|
Elevated ST
peaked T wave Q wave development then t wave inversion. |
|
Hallmarks of acute bacterial endocarditis?
|
osler’s nodules
janeway lesions roth spots on eyes |
|
What are 7 lifestyle risk factors in hyperlipidemia?
|
Smoking , diet, sedentary lifestyle, alcohol, elevated Trig., low HDL, metabolic syndrome, HTN (130/85), waist circumference (35 for female, 40 for male), high blood sugar (over 110)
|
|
First line therapy for MI?
|
MONA= morphine, oxygen, nitroglycerine, aspirin
|
|
List Duke’s criteria for positive bacterial endocarditis.
|
2 majors
1 major and 3 minors 5 minors |
|
Describe Duke's Major and Minor criteria for positive bacterial endocarditis
|
Major: 2 positive blood cultures and evidence of vegetation on prosthetic valve
Minor: predisposing condition, fever, immunologic signs (Osler's nodes, Roth spots, Janeway lesions), positive echo not meeting major criteria |
|
What are 7 of the secondary causes of HTN?
|
Pheochromocytoma, kidney dz, diabetic nephropathy, thyroid dz (myxedema), drug reaction, stress, oral contraceptives.
|
|
What are three uncontrollable risk factors for ischemic heart disease?
|
Age, gender, family history
|
|
What are the 12 initial labs you are going to order to evaluate HTN?
|
TG’s, LDL, HDL (lipid panel), kidney function, liver function, thyroid test, echo, chest xray, UA, glucose, electrolytes, CBC
|
|
Whats the drug of choice for acute anginal attack?
|
Sublingual nitroglycerin
|
|
What antihypertensive medication would you avoid in a pt. with past history of asthma?
|
Beta-blockers
|
|
According to JNC 7 what are the four bp classifications and what are the systolic and diastolic readings for each?
|
Optimal (<120/80)
Pre HTN (120-139/80-89) Stage I (140-159/ 90-99) Stage II (>160/100) |
|
What are the 9 risk factors for thrombis or embolis?
|
Birth control, sedentary, blunt trauma, Afib, previous DVT or PE, post op lower extremity sx, hyercoaguable state, obesity
|
|
What are the 8 most common causes of acute pericarditis?
|
Infection (viral, TB, bacteria, fungal)
autoimmune drug reaction trauma post MI uremia |
|
Which AV block is a gradual progression of the PR with at least one non conducted P wave?
|
Mobitz Type I (Weinkebach’s)
|
|
Describe the electrical conduction of the heart?
|
SA node, propogates to the atrium, AV node, Bundle of his, left and right bundle branches, perkinje fibers
|
|
What is the most common cause of acute bacterial endocarditis?
|
Staph. Aureus
|
|
What are the four systems to evaluate for end organ damage for HTN?
|
Kidneys (kidney failure, proteniur, hematuria)
Heart (cardiomegaly (LVH), ischemia, EKG changes) Brain (stroke, hemorrhage, encephalopathy) Eyes (copper wire, hemorrhages) |
|
Drug of choice for HTN pt. with diabetes?
|
ACE Inhibitor
|
|
What is the intrinsic rate for SA node, atrial tissue, bundle of His and ventricles?
|
SA is 60 or greater,
atrial is 60 or greater AV node is 50-60, Bundle of His is 30-40 Ventricles are less than 30 |
|
Correlate the electrical components of the heart with the EKG
|
P wave is atrial depol.
QRS is ventricle depol. T is ventricle repol. PR interval is conduction through AV node |
|
What is the classic EKG finding in most anginas?
|
ST depression (Printzmetals is the only one with elevation)
|
|
What are the 10 factors associated with the worst prognosis of HTN?
|
Obesity, hyperlipidema, end organ damage, smoking, diastolic blood pressure that is over 115, diabetes, African American, young, male, excess of alcohol intake
|
|
What is the most common cause of subacute bacterial endocarditis?
|
Strep. Viridans
|
|
What are the 5 general treatments for CHF?
|
Diuretics, Beta blockers, ACE-I, intrinsic agents, Vasodilators
|
|
What are the 3 types of cardiomyopathies and what is the most common?
|
Dilated, restrictive, obstructed hypertrophic and non obstructed hypertrophic. Most common is dilated.
|
|
Which arrythmia is classic for a saw tooth pattern?
|
Atrial Flutter
|
|
Describe four of the signs & symptoms of Raynaud’s?
|
Vasoconstriction in the hands, aggrevated by cold and stress, gangrene, tingling, white red and blue changes, clubbing of fingers, 2nd-4th decade, females greater than men, worse with smoking and beta
blockers |
|
What is the tx. of choice for cardiac tamponade?
|
Pericardiocentesis
|
|
What are the best post MI management options?
|
Beta blockers, CCB, ACE I, identify the risk factors and control the risk factors, and anti platlet agents (aspirin)
|
|
What’s the primary organism in acute rheumatic fever?
|
Beta hemolytic Strep
|
|
In order to diagnosis PE what is the most noninvasive test?
|
Doppler Echo
|
|
Which AV block has every other P wave non conducted?
|
Mobitz Type II (2nd degree AV block)
|
|
What's Virchow’s triad?
|
Trauma to vessel, blood stasis and hypercoaguable state
|
|
Which AV block has every P wave conducted?
|
1st degree AV block
|
|
AV block where no P waves conducted and requires a pacer?
|
3rd degree
|
|
What antihypertensive med do u avoid in a pt. with hx. Of gout?
|
Thiazide diuretics
|
|
On Phys.Exam how would you differentiate ASD,VSD and PDA?
|
ASD is wide fixed
VSD is holosystolic left sternal murmur PDA is loud continuous machinery murmur on left upper back |
|
Gold standard for Pulmonary Embolism
|
Pulmonary Angiography
|
|
Gold standard for DVT?
|
venogram
|
|
Criteria of Metabolic Syndrome
|
Any 3 of:
Waist Circumf. (Men > 40in. Women >35 inches) Triglycerides >/= 150 HDL (Men <40, Women <50) BP >/= 130/85 Fasting glucose >/= 110 |
|
ATP III classification of triglycerides
|
Normal <150
Borderline High 150-199 High 200-499 Very High >/= 500 |
|
Pericarditis: physical findings
|
• Pericardial friction rub
– Scratchy, like creaking leather – Best heard while patient sitting up, leaning forward, & in full expiration |
|
Use of Jones Criteria
|
Diagnosis of Acute Rheumatic fever; Need 2 major or 1 major and 2 minor for diagnosis
|
|
Major and minor Jones Criteria for Acute Rheumatic Fever
|
Major criteria:
Carditis Erythema marginatum and subcutaneous nodules Sygenham’s chorea Polyarthritis Minor: Fever, polyarthralgias, reversible prolongation of the PR interval, rapid ESR rate, positive throat culture or rising streptococcal antibody titers |
|
most common pathologic condition associated with aortic aneurysm
|
atherosclerosis
|
|
Cardiac causes of A. Fib
|
Sick Sinus syndrome
HTN Valvular dz Ischemic dz |
|
Non-cardiac causes of A. Fib
|
Thyroid dz
Alcohol COPD |
|
3 problems caused by A. Fib
|
Thromboembolic events (clots and stroke)
Loss of atrial – ventricular synchrony (atrial kick) Rapid Irregular Ventricular Rate |
|
Mechanism of Atrial Flutter
|
A single reentrant wave of activity circles in the right atrium at ~ 300bpm
the AV node filters the atrial activity resulting in 2:1 or even 3:1 or 4:1 conduction |
|
Most common arrhythmia in ASD pts
|
A. fib
|
|
2nd degree, Mobitz Type 2 AV block
|
At least one non-conducted P wave
No prior PR prolongation preceding block |
|
3rd degree AV block
|
No conducted P waves
More P waves than QRS’s Permanent pacemaker required if chronic |
|
Etiology of Cardiac Tamponade
|
MEDICAL EMERGENCY!!compression of heart due to accumulation of fluid in pericardial sac which may lead to hemodynamic compromise
|
|
Signs & symptoms of Acute Cardiac Tamponade
|
Tachycardia
JVD Distant heart sounds-also present in subacute Pulsus paradoxus=Fall in systolic BP by >10mmHg with inspiration |
|
Treatment for Cardiac Tamponade
|
pericardiocentesis
|
|
Physical exam findings of Dilated Cardiomyopathy
|
Enlargement of all cardiac chambers; hypocontractile heart
S3 gallop Mitral regurgitation may be present due to LV dilation |
|
2 common causes of dilated cardiomyopathy
|
Alcoholism
Peri-partum |
|
Physical exam findings of Hypertrophic Cardiomyopathy
|
S4 gallop
Heart murmur: Systolic Increases with valsalva, standing, post-PVC Decreases with squatting, beta-blockers May be confused with aortic stenosis |
|
General Principles of CHF Treatment
|
1. Diuretics
2. ACEI/ARB 3. B-Blockers 4. Spironolactone 5. Vasodilators 6. Inotropic agents |
|
What drug improves survival rates for pt's post-MI?
|
Beta-Blockers
|
|
Most important test in diagnosing pericardial effusion
|
Echocardiogram
|
|
Treatment of pericardial effusion
|
percardiocentesis
|
|
Etiology of pericardial effusion
|
any cause of pericarditis can lead to pericardial effusion (abnormal amt. of fluid in pericardial space)
|
|
Describe Osler's nodes and Janeway lesions; What disease are they present in?
|
Osler's nodes = small tender nodules on the finger and toes
Janeway Lesions = small hemorrhages on the palms and soles Seen in Bacterial endocarditis (acute and subacute) |
|
Gold standard for diagnosing myocarditis
|
Biopsy of myocardium
|
|
Pt. complains of pain, erythema, swelling, swelling is inferior & Medial to the right lower lid, and sup. Lat. to the nose, what is the most likely diagnosis?
|
Dacryocystitis
|
|
What are the diseases that cause cotton wool spots?
|
Trauma, HIV, Diabetes, HTN
|
|
What are the four hallmarks for acute glaucoma?
|
Pain, steamy cornea, fixed dialated pupil, red eye
|
|
Lifeguard who does not wear sunscreen, has a yellow wedge shape growth on the lateral aspect of his eye, affects his cornea, but not the vision?
|
Pterygium
|
|
What are the six causes of vitreous hemorrhage?
|
Trauma, diabetes, HTN, detached retina, CRVO, bleeding disorders
|
|
A pt. presents with c/o red eyes, purulent discharge for three days, preauricular lymph nodes enlarged, what is diagnosis?
|
Bacterial Conjunctivitis
|
|
Open angle glaucoma is usually asymptomatic what is the primary signs you are looking for on physical exam?
|
Cup:disc ratio
|
|
What are the three most common organisms assoc. with bacterial conjunctivitis?
|
Staph Aureus, Strep. Pneumo, H. Flu
|
|
Acid burns to the eye have a better outcome than alkaline burns, what sign is a poor prognosis of an acid burn?
|
Blanching of vessels (white); the redder, the better
|
|
What are the 9 causes of red eye?
|
Conjuctivitis, corneal disease second. to trauma, allergic conjunctivitis, episcleritis, subconjuctivial hemorrhage, scleritis, dry eyes, ant. uveitis, acute glaucoma and blepharitis
|
|
Pt. presents with severe photophobia, pain and decreased vision in right eye, right pupil is injected and cells in ant. chamber on slit lamp exam what is the diagnosis?
|
Anterior uveitis
|
|
describe the pathway of the aqueous humor?
|
produced in ciliary body, travels to posterior chamber, thru pupil to anterior chamber thru trabecular meshwork to Canal of Schlemm
|
|
Which photoreceptor are responsible for differentiating colors?
|
Cones
|
|
Pt. complains of bloody appearance in sclera only after giving birth to baby two days ago?
|
Subconjuctival hemorrahage (anything that causes increased pressure)
|
|
What is the most common ocular complication of systemic steroids?
|
Posterior Subcapsular cataract
|
|
What is the systemic dz associated w/ dry eyes?
|
Sjogren’s syndrome
|
|
What is one of the major complications assoc. w/ hyphema?
|
Secondary glaucoma
|
|
What is the primary dz assoc. w/ Argyll Robertson pupil?
|
Tertiary syphilis
|
|
Drusen’s are assoc. with what disease?
|
AMD (age related macular degeneration)
|
|
What are the 7 causes of double vision?
|
Head injuries, cataracts, strabismus, lesions that affect CN 2, 4 and 6, amblyopia, misalignment of the eyes, masses or tumors
|
|
Define hyperopia and kind of lens do you use to correct it?
|
Far-sighted, use convex (plus)
|
|
What is the medical term for wall eyes?
|
Exotropia
|
|
What is the normal range for IOP?
|
13 +/- 3 mmHg
|
|
AMD (age related macular degeneration) is the leading cause of permanent blindness in the elderly what are two of the five risk factors assoc. with AMD?
|
Age over 50, smoking, female gender, family hx
|
|
What disease is the “cherry red spots” associated with?
|
Central retinal artery occlusion (CRAO)
|
|
Pt complains of nonpainful nodule on upper eyelid for 6 weeks?
|
Chalazion
|
|
What organism is most commonly assoc. hordeolum?
|
Staph. Aureus
|
|
What is the triad of Horner’s syndrome?
|
Myosis, ptosis, and ipsilateral anhydrosis
|
|
what is the cause of Horner's syndrome
|
Tumor in apex of lung compressing sympathetic chain
|
|
What are the eleven ocular conditions that are a result of blunt trauma?
|
Retinal detachement, hyphema, and vitreous hemorrahage, acute angle glaucoma, blow out fracture, subconjuctivial hemorrhage, diplopia, ruptured globe, blurred vision, lens dislocation and eye muscle swelling (myoedema)
|
|
What is the medical term for cross eyes?
|
Esotropia
|
|
Glaucoma is the leading cause of irreversible blindness in the world, what are the 4 risk factors?
|
Family history, age, elevated IOP, race
|
|
Which cranial nerve or nerves is responsible for ptosis?
|
CN III-Oculomotor
|
|
What are the 7 systemic dz’s assoc. w/ optic neuritis?
|
Multiple Sclerosis, Lyme Dz, Syphilis, Sarcoidosis, Wegner’s Granulomatous, SLE, Vit B12 Def
|
|
A lesion in the optic chiasm results in which visual field defect?
|
bilat temporal vision loss
|
|
Which CN is responsible for pupil reaction?
|
CN III- Oculomotor
|
|
A disease that gives you Beriberi is caused by a def. in what?
|
Vit. B1- thiamine
|
|
What are the 4 main signs and symptoms of a detached retina?
|
Flashing lights, curtain over vision, floaters, decrease in visual fields
|
|
Which CN is responsible for lid lag (closing of the upper eye lid)?
|
CN VII- Facial
|
|
Common child hood disease is varicella zoster, name the 5 ocular complications?
|
Conjunctivitis, swollen lids, vesicular lesions, uveitis, optic neuritis
|
|
What are the 7 conditions that predispose a pt. to corneal infection?
|
Corneal abrasion, contact lens wearer (no.1), trauma, structural eyelid abnormality, exotropia, esotropia, dry eyes, chronic epithelial disease, topical medication toxicity, immunosupression
|
|
Pt. presents with c/o painful red nodule on right upper lid for three days, no change of vision, what is most likely diagnosis?
|
Hordeolum
|
|
What are three of five symptoms for keratoconjuctivitis sicca?
|
Irritation, redness, dryness (this is dry, scratchy eyes)
|
|
What are the 3 CN responsible for eye movements?
|
CN III, IV, VI
|
|
What are the 2 most common organisms found in orbital cellulitis?
|
Step. Pneumonia, H. Flu
|
|
What are the 8 causes of papillodema?
|
HTN, cerebral tumor, abscesses, subdural hematoma, AV malformation, meningitis, encephalitis, subarachnoid hemorrhage
|
|
A pt. presents with red eyes, watery discharge for 2 days, no allergy symptoms, what is the most likely diagnosis?
|
Viral conjunctivitis
|
|
Which pathogen is a zanck smear used to detect?
|
Herpes
|
|
What is the most worrisome side effect of isotreniton (accutane)?
|
Birth defects- also want to test liver and lipids
|
|
Name the two pathogenic types of contact derm
|
Irritant and allergic (irritant will be more localized to where the thing touched the person)
|
|
Molluscum contagiosum- is it a wart?
|
No- it is a viral infection caused by the pox virus
|
|
Which bacteria is the most common cause of skin infection?
|
Staph. Aureus
|
|
Which skin lesion is associated with a pos. dimple sign?
|
Dermatofibroma
|
|
What is the most common cause of acute urticaria?
|
Allergic reaction
|
|
Hanson’s disease is also known as?
|
Leprosy
|
|
What disease process is characterized by skin that is smooth, ivory colored and tight along the fingers with violaceous streaks?
|
Scleroderma
|
|
What drug is usually associated with erythema nodosum?
|
Birth control pills- most commonly seen in young women- it is tiny red nodules on the tibia
|
|
What is the most common pustular skin eruption?
|
Acne vulgaris
|
|
Name a medical condition that is associated with really bad seb. Derm.?
|
HIV, Parkinson’s disease
|
|
Name the disease associated with the term spaghetti and meatballs
|
Tinea (any type) and it represents the budding hyphae
|
|
What is the name of the skin condition that will fluoresce coral red under the lamp?
|
Erythrasma
|
|
MOHS surgery is used to treat what?
|
Basal Cell Carcinoma
|
|
What is the proper medical term for a skin tag?
|
Acrochordon
|
|
What is the pathological condition of pulling all your hair out?
|
Trichlilomania
|
|
What is the rash of lyme disease called?
|
Erythema migrans
|
|
Name the disease characterized by superficial, stuck on honey colored crust?
|
Impetigo
|
|
What is alopecia totalis?
|
Loss of hair over the entire body
|
|
In dealing with topical steroids, category 1 is in low potency or super potency?
|
Super Potency
|
|
What is the most common cause of green nails?
|
Pseudomonas infection
|
|
What is the official dermatological terminology for slapped cheeks disease?
|
Fifth’s disease, erythema infectiosum, parvovirus (B19)
|
|
Which virus causes purpura of the hands and feet in children?
|
Parvovirus B19
|
|
In little kids, blisters on palm and soles of feet and sometimes in mouth (hand, foot and mouth disease) is caused by what virus?
|
Coxsackie virus
|
|
Broken shafts of hair are pathopneumonic for what condition?
|
Tinea capitis
|
|
What class of drugs is the most common cause of anaphylaxis?
|
Penicillins
|
|
Which class of drugs commonly causes angioedema?
|
ACE-I
|
|
What compound causes the most cases of contact derm?
|
Nickel
|
|
In atopic derm. which comes first, the rash or the itch?
|
The itch (it’s called the itch that rashes)
|
|
What derm. condition has either the Kevner’s phenomenon or the Auspitz’s sign?
|
Psoriasis- Auspitz’s is when you scrape it and underneath they have little tiny specks of bleeding. Kevner’s phenomenon is the predilection to lichenification
|
|
What is the diagnostic test of choice for a pt. presenting with a suspected syphilis chancre on his penis?
|
Dark field microscopy- look for spirochetes under the microscope
|
|
This lesion is flat, circumscribed skin discoloration that lacks elevation or depression?
|
Macule
|
|
In what stage of syphilis do you see neurologic symptoms?
|
Tertiary
|
|
Treatment for leprosy (Hansen’s Disease)?
|
Rifampin, Dapsone
|
|
What is the vector for leichmeniasis?
|
Sand fly
|
|
Give three cutaneous side effects from topical steroids?
|
Atrophy of skin, hypopigmentation, striae, increased incidence of infection
|
|
What are the 4 charc. Noted on a Tympanic Membrane exam?
|
Pearly grey tympanic membrane, landmarks (cone of light, malleus, umbo), intact Pars flaccida and Pars Tensa, make sure the tympanic membrane is mobile
|
|
What are the 12 systems you examine in a head and neck exam?
|
ears, nose, throat, thyroid, lymph nodes, sinuses, oral pharynx, nasal pharynx, larynx, face, neck scalp, skin, and neuro
|
|
Whats the frequency of the tuning fork you use for weber and renee?
|
512 mHz
|
|
Name 5 drugs that leads to ototoxic hearing loss?
|
Salicylates, asa, loop diuretics, erythromycin
|
|
What is bell’s palsy?
|
Idiopathic, unilateral facial droop. It’s sudden onset, usually after viral syndrome
|
|
What is the most common cause of conductive hearing loss in adults?
|
Cerumun impaction
|
|
Five indications of bilateral PE tubes?
|
Chronic OM lasting over 3 months, hearing loss over 30 decibles, 3 infections in 6 months, poor response to antibiotics, complications
|
|
5 complications to untreated OM?
|
sensiorneural Hearing loss, mastoidis, parotitis, labrynthitis, tympanic perforation, cholesteoma, meningitis, brain abcess
|
|
5 symptoms for cholesteoma?
|
Progressive conductive hearing loss, crusting form tympanic perforation, TM perforation, chronic ear infections
|
|
What are the 9 major causes of sensiorneural hearing loss?
|
Presbycupia, hereditary, occ. Noise exposure, oto toxicity of drugs, immune related, idiopathic, Menieres, infections
|
|
What is otomycosis and how is it treated
|
Fungal infection of the ears and treat with antifungals (topical)
|
|
What are the 5 ENT differential diagnosis for dizziness?
|
Meiniere’s, aucostic neroma, viral labryntthisi, benign parxosysml postional vertigo, migraines
|
|
What are the three most common causes of traumatic tympanic perforation?
|
Trauma (head slap), foreign body, gun fire
|
|
What is dix hall- pike maneuver used for?
|
This is testing for benign paroxysmal positional vertigo
|
|
What is the most common site for ant. Epistaxis and what is the most common cause?
|
Kesselbachs and trauma (digital)
|
|
What are salute signs and allergic shiners and first step for TX
|
Allergic Rhinitis and removing allergic agent (environment)
|
|
Why are younger children predisposed to Otitis Media
|
Their Eustachian tube is more horizontal and adult becomes wider and more angled.
|
|
What three organisms are most common cause of OM?
|
Strep Pneumo, H. flu, Moraxella Catarrhalis
|
|
Whats the first line of treatment for AOM
|
Amoxicillin or Augmentin
|
|
What is the Meinere’s triad?
|
Vertigo, tinnitus, progressive permanent hearing loss
|
|
What is the treatment for motion sickness
|
Scopolamine patch
|
|
What are three oral cancers of the oropharynx
|
Squamous cell carcinoma, leukoplakia, erythroplakia
|
|
What are the nine common causes of salivary gland enlargement?
|
Silothiasis, paromyxovirus (mumps), morten’s duct stones, tumors, TB, lead toxicity, alcoholism
|
|
What is Sampter’s triad?
|
Aspirin allergy, rhinitis (polyposis), asthma. Also watch these people for urticaria
|
|
What is thrush? Whats the most common cause in children? And how is it diagnosed?
|
It’s a yeast infection (oral candidiasis) and usually caused in children from overuse of antibiotics and diagnosed b/c you can scrape off with tongue depressor and do KOH stain
|
|
Whats the most common sinusitis and whats the three most common bacterial causes and whats the drug of choice?
|
Maxillary sinus. Strep. Pneumo, H. flu, Moraxella Catarrhalis, drug of choice is Augmentin or Amoxicillin
|
|
Pt. presents with trismus, uvular deviation, dysphonia, hot potato voice, drooling and fever, what is diagnosis?
|
peritonsillar abcess
tx is I&D |
|
What are the 10 most common causes of hoarseness?
|
Laryngyl cancer, tonsillitis, vocal fold mucocele, nodule, polyp, cyst, hypothyroidism, sinusitis with Post nasal drip, GERD, recent intubation
|
|
What are the 6 signs and symptoms of Croup and whats the most common cause?
|
Barking cough, inspiratory stridor, fever, steeple sign, n/v, child b/w 3-6 yo, occurs in fall and winter Most common cause is parainfluenza.
|
|
S&S of epiglottis?
|
Drooling, tripod, appears ill. Most common organism is H. influenza. This is a medical emergency. Have to keep quiet
|
|
Which type of leukemia is identified by a smudge cell?
|
CLL
|
|
Which leukemia has the philidelphia chromosome?
|
CML
|
|
Which of the leukemias has the best cure rate?
|
ALL
|
|
What is the life span of the RBC in a patient with sickle cell?
|
14 days
|
|
What is the definitive test to diagnose sickle cell?
|
Hemoglobin electrophoresis
|
|
In the diagnosis of multiple myeloma what is the definitive abnormal protein that defines MM?
|
Bence Jones proteins in urine
|
|
What is the most common presenting symptom in patients with MM?
|
Bone pain
|
|
Name a drug that has received FDA approval to reduce breast cancer risks that are at increased risk for breast cancer?
|
Tamoxifen
|
|
What is the most common malignancy of the oral pharynx?
|
Squamous Cell Carcinoma
|
|
How is cervical cancer diagnosed?
|
Tissue biopsy
|
|
Women w/ Sickle cell anemia who use Oral contraceptives are at higher risk for?
|
thromboembolism and MI
|
|
What cell is pathopneumonic for hodkin’s disease?
|
Reed Sternberg cell ("eye" cell)
|
|
In what bone is osteosarcoma most commonly found in?
|
Femur
|
|
lay term for nephroblastoma?
|
Kidney tumor (Wilm’s tumor)
|
|
What is the single best test to discriminate b/w iron def. anemia and anemia of chronic disease?
|
Ferritin
|
|
What does the MCV have to be to be a megaloblastic anemia?
|
Greater than 100
|
|
What are seven cancer screening tests as the pop. ages for people that are at average risk
|
Colonoscopy, pap smear, mammogram, PSA, DRE, fecal occult blood test and a clinical breast exam
|
|
What is the most common presentation for esophageal cancer?
|
Dysphagia
|
|
What is the primary treatment for tumors of the colon and rectum?
|
Excision
|
|
3 pop. susceptible to Iron def. anemia
|
Women of child bearing age, toddlers, adolescent females (also vegetarians)
|
|
Clinical signs of Iron def. anemia:
|
Pica (eating clay,paper,coal), glottitis, angular chelitis (corner of mouth irritation), kolionychia(spoon shaped nails), pallor, fatigue, decrease exercise tolerability
|
|
Side Effects of oral iron supplement
|
Consitipation, abdo. Pain, diarrhea
|
|
Megaloblastic anemia is def. of what? Found in whom?
|
B12 and Folate: Found in alcoholics and pernicious anemia
|
|
What is Schilling test used to diagnose?
|
Pernicious Anemia
|
|
What is G6PD deficiency?
|
genetic disorder common in African Americans
Medications like antimalarial drugs (primaquine) and sulfonamides will cause hemolysis (jaundice, pallor, back pain, and dark urine); G6PD is an enzyme for red cell integrity; deficiency results in acute hemolytic anemia with hemoglobinuria |
|
Patient with sickle cell will have what type of anemia symptoms?
|
Mild until crisis
|
|
What is polycythemia?
|
Increase in cells, increase in hematocrit and platlets
|
|
What is Wilson’s disease
|
Copper accumulation in tissues
|
|
Patient pop. suspect for Hodgkin’s disease:
|
bimodal: 15-40 and greater than 55
|
|
Area of oral cavity most associated with malignancy
|
Lips
|
|
Most common causes of esophageal cancer
|
smoking and alcohol
|
|
Most common virus implicated in aplastic crisis of sickle cell anemia?
|
Parvovirus (B19- fifth’s disease)
|
|
Treatment for sickle cell crisis
|
oxygen, hydration and pain control
|
|
Most common cause of sudden death in MI
|
V.Fib
|
|
photoreceptor most sensitive to light
|
Rods
|
|
Area of eye with highest concentration of cones
|
macula
|
|
What is myopia and what kind of lens corrects it?
|
Near sighted; Minus lens (concave lens)
|
|
Eye condition containing drusens
|
AMD (Age related macular degeneration)
|
|
S&S of AMD
|
Loss of central vision
Assoc. w/ aging |
|
leading cause of blindness in patients >65 y/o
|
AMD
|
|
Differentiate between "wet" and "dry" drusen
|
Wet = white and exudative
Dry = yellow and non-exudative |
|
Crucial test for wet drusens in AMD
|
Fluorescein Angiography
|
|
What is amblyopia?
|
Lazy Eye
|
|
Differentiate between anterior and posterior uveitis
|
Anterior= Inflammation of the iris and ciliary body
Posterior= inflammation of the choroid |
|
2 diseases assoc. w/ anterior uveitis
|
Herpes Zoster and Sarcoidosis
|
|
Most common cause of anterior uveitis
|
Trauma
|
|
Used to measure gas diffusion in lungs
|
Carbon Monoxide (CO)
|
|
Total lung capacity
|
Vol. in lungs at end of maximum inspiration (IRV + TV + ERV + RV)
|
|
Tidal Volume
|
Air inspired or expired during normal respiration
|
|
Inspiratory Reserve Volume
|
Add'l air that can be inhaled after tidal breath in
|
|
Functional Residual Capacity
|
Amount of air left in lung at end of normal breathing exhalation (ERV + RV)
|
|
Vital Capacity
|
Amount of air that can be forced out after maximum inspiration (IRV + TV + ERV)
|
|
Residual Volume
|
Amount of air left in lung after maximum exhalation
|
|
Inspiratory capacity
|
volume that can be inhaled after a tidal breath out (TV + IRV)
|
|
Expiratory Reserve Volume
|
Amount of additional air that can be breathed out after normal expiration
|
|
Oxygen is transported in the blood by
|
Either dissoved in plasma or bound to hemoglobin
|
|
Oxygen content in the blood depends on:
|
Arterial PO2 and hemoglobin level
|
|
Tissue oxygen delivery depends on:
|
Oxygen content in the arterial blood and cardiac output
|
|
CO2 is carried in blood as:
|
HCO3- or CO2 dissolved in plasma
|
|
True or False: Disorders that affect the airway reduce the diffusing capacity of Oxygen
|
False; only disorders that affect the lung tissue (parenchyma) will reduce the oxygen diffusion capacity
|
|
What are the normal values for arterial blood gases - pH, PaO2, PaCO2, HCO3
|
pH 7.35-7.45
PaO2 >80 mmHg PaCO2 35-45 mmHg HCO3 24-28 mEq/L |
|
Describe the relationship between pH and PaCO2
|
They are INVERSELY related; when PaCO2 increases, then pH decreases (acidic)
|
|
Describe the relationship between pH and HCO3-
|
They are DIRECTLY related; when HCO3- increases, then pH increases (Basic)
|
|
Describe the level of pH, CO2, and HCO3- in Respiratory Acidosis
|
pH is decreased
CO2 is increased HCO3- is increased |
|
Describe the level of pH, CO2, and HCO3- in Respiratory Alkalosis
|
pH is increased
CO2 is decreased HCO3- is decreased |
|
Describe the level of pH, CO2, and HCO3- in Metabolic Acidosis
|
pH is decreased
CO2 is decreased HCO3- is decreased |
|
Describe the level of pH, CO2, and HCO3- in Metabolic Alkalosis
|
pH is increased
CO2 is increased HCO3- is increased |
|
Condition that is assoc. with an elevated anion gap
|
Metabolic acidosis (anion gap >12; normal is 10-12 mEq/L)
|
|
How do you calculate anion gap
|
Na - (Cl + HCO3)
|
|
MUDPIES
|
pneumonic for causes of anion gap indicating metabolic acidosis:
Methanol Uremia (renal failure) Diabetic Ketoacidosis Paraldehyde Infarction (MI) or Isoniazid (TB tx) Ethylene glycol Salicylate |
|
Valuable tool in characterizing diseases of the chest wall, pleura, hilum, and mediastinum
|
Computed tomography (CT)
|
|
Use for bronchoscopy
|
visualization of airways - foreign body
mucous plug visualization |
|
Use of Thoracocentesis
|
Used to remove air or fluid from pleural space
Frequently used in pleural effusion |
|
Name 3 categories of info given by Pulmonary function tests
|
Lung volumes
Flow rates diffusing capacity |
|
What is FEV1/FVC and what does it indicate?
|
The ratio of forced expiratory volume in 1 second and forced vital capacity;
Indicates OBSTRUCTION to airflow |
|
What happens to FEV1, FEV1/FVC, and RV in obstructive dz's such as COPD or Asthma
|
FEV1 decreases
FEV1/FVC decreases RV increases (due to increased lung volume) Flow rate decreases |
|
What happens to FEV1/FVC and TLC in restrictive dz's such as Cystic fibrosis
|
FEV1/FVC remains normal
TLC decreases Diffusion capacity decreases |
|
Clinical features of pulmonary effusion
|
dyspnea
pleuritic chest pain dullness to percussion decreased tactile fremitus decreased breath sounds pleural friction rub |
|
Clinical features of pneumothorax
|
acute onset of chest pain
dyspnea decreased breath sounds over affected area Hyperresonant to percussion |
|
Physiolgic conditions that cause Metabolic Acidosis
|
This is assoc. w/ an accumulation of acids and/or a loss of a buffer
Diarrhea—loss of bicarbonate • Renal failure—inadequate formation and reabsorption of bicarbonate and the inability to excrete acids • Accumulation of organic acids • Certain drugs—salicylates, methanol |
|
Physiolgic conditions that cause Metabolic Alkalosis
|
This is associated with an accumulation of bicarbonate and/or a decrease in acid
• Vomiting—loss of stomach acid • Nasogastric suctioning—again, loss of stomach acid • Loss of potassium • Exogenous alkali—use of NaCO3 (baking soda), antacids • Drugs—diuretics, corticosteroids |
|
Acute bronchitis is usually caused by
|
Virus (95% of the time)
|
|
S&S of acute bronchitis
|
Productive Cough (worse lying down & at night)
• Malaise • Variable crackle, rhonchi & wheezing up to 6 weeks • Fever absent or mild • Fever may be prominent with H. flu |
|
Describe sputum production in acute bronchitis
|
Initially, dry & nonproductive, small amount sputum
After a few hrs or days, sputum more abundant & mucoid |
|
Most common type of lung cancer
|
adenocarcinoma
|
|
Most aggressive and easily metastasizing lung cancer
|
small cell (oat cell) carcinoma
|
|
Describe exudative pleural effusion
|
occurs when LOCAL factors change the formation and absorption of pleural fluid
Examples: TB, hemorrhage, malignant neoplasm |
|
Describe transudative pleural effusion
|
occurs when SYSTEMIC factors change formation & absorptio of pleural fluid
Examples: CHF, Cirrhosis, nephrotic syndrome |
|
clinical sign of tension pneumothorax
|
Trachea deviated to unaffected side due to positive pressure from pneumothorax
|
|
Hyaline Membrane Disease
|
Disease of infants that do not have enough surfactant;
also called respiratory distress syndrome |
|
Tumor that causes Horner's syndrome
|
Pancoast Tumor (apical lung tumor)
|
|
What causes Mesothelioma
|
Asbestosis exposure
|
|
What is Hamartoma
|
Benign mass in lung composed of normal tissue
|
|
What is characterized by "popcorn calcification" in the lung on CXR
|
Hamartoma
|
|
Empyema
|
pus in the pleural space
|
|
What is a chronic multisystem dz where abnormal collections of inflamm. cells (granulomas) form in many organs of the body?
|
Sarcoidosis
|
|
Hampton's Hump and Westermark's Sign on CXR are hallmarks for what condition
|
Pulmonary Embolism
|
|
What is a laboratory test used to detect DVT/PE
|
d-dimer
|
|
Hallmark of Sarcoidosis
|
Lofgrens Syndrome (Erythema Nodosum on lower extremities and Bilateral hilar adenopathy)
Noncaseating epitheloid granulomas Polyarthritis |
|
Nodular opacities and eggshell calcifications of hilar lymph nodes on CXR is indicative of?
|
Silicosis
|
|
Lung condition caused by exposure to silica thru mining, stone cutting, and sand blasting that is rapidly fatal?
|
Silicosis
|
|
S&S of Foreign body aspiration
|
wheezing
non-productive cough decreased breath sounds stridor dyspnea cyanosis |
|
Hereditary dz that causes certain glands to produce abnormal secretions resulting in tissue and organ damage
|
Cystic Fibrosis
|
|
GI problems in Cystic Fibrosis
|
Pancreatic insufficiency
Protein & Fat malabsorption Frequent bulky, foul-smelling stools Vit. E & K deficiency |
|
Diagnostic test for CF
|
Sweat Test to analyze Na & Cl levels
|
|
Most common cause of Pulmonary HTN
|
Left Heart Failure
|
|
Controller of choice for asthma
|
Inhaled corticosteroid
|
|
Hallmarks of COPD
|
EXPIRATORY FLOW LIMITATION
• Compromises ability of pt to expel air • Hyperinflation and air trapping occurs • Rib cage reconfigures over time • Ventilatory muscles adapt temporarily |
|
Tx's of COPD based on stages of FEV1
|
Stage I (>50%) Short acting B2 agonist PRN
• Stage II (35-49%) Add Anticholinergic • Stage III (<35%) Add long acting B2 agonist and/or SR theophyline – consider oral glucocorticoid |
|
Cor Pulmonale
|
Right ventricular hypertrophy caused by any factor that increases pulmonary artery pressure e.g. PE, COPD
|
|
2 conditions that make up COPD
|
Ephysema
Chronic Bronchitis |
|
pathogen that causes Croup
|
Parainfluenza Virus type 1
|
|
"Hour glass" and "Steeple Sign" are indicative of?
|
Croup
|
|
barking, spasmodic cough followed by horseness usually seen at night accompanied by stridor, rhonchi, and wheezes
|
Croup
|
|
Disease with airway narrowing (which increases airway resistance), Barrel-chest,and Decrease in elastic recoil and collapse of airways during exhalation
|
Emphysema
|
|
"pink puffers"
|
Emphysema
|
|
"Blue bloaters"
|
Chronic Bronchitis
|
|
Infant w/ Cyanosis,Flaring nostrils, Tachypnea, Grunting sounds with breathing, Chest retractions
|
Hyaline Membrane Dz (Resp. Distress Syndrome)
|
|
S&S of Influenza
|
Sudden chills & fever, malaise & myalgias, sore throat, severe headaches, weakness, coughing
|
|
Cough producing foul-smelling sputum (feculent)
|
Lung abcess
|
|
Bronchiectasis
|
Chronic dilatation of bronchi or bronchioles as a sequel of inflammatory disease or obstruction.
|
|
hallmarks of Asthma
|
decrease in airway diameter
• increased airway resistance • airway obstruction |
|
Clinical features of asthma
|
Cough
• Dyspnea • Chest tightness • Wheezing |
|
Common causes of fungal pneumonias
|
histoplasmosis, cryptococcosis, aspergillosis
|
|
Coal Miner's Lung
|
Pneumoconiosis/Silicosis
|
|
Pneumonia
|
An acute infection of lung parenchyma including alveolar spaces & interstitial tissue
|
|
Cough (sounds like a whooping sound),Sneezing, Low grade fever, Rhinorrhea, Conjunctivitis and increased lacrimation are indicative of what condition?
|
Whooping cough (Pertussis)
|
|
An infectious atypical pneumonia transmitted to humans by birds thru inhalation of dried excrement
|
Chlamydia psittaci
|
|
Most common cause of Community Acquired Pneumonia
|
Streptococcus Pneumoniae
|
|
3 typical organisms implicated in community acquired pneumonia
|
1. Streptococcus pneumoniae 40-60%
2. Haemophilus influenzae 3. Staphyloccus aureus |
|
S&S of Comm. Acq. Pneumonia
|
Abrupt onset
–Fever / chills –Cough with purulent sputum –Pleuritic chest pain –Tachycardia / tachypnea |
|
Organism of ATYPICAL CAP
|
Mycoplasma pneumoniae
|
|
most common respiratory infection in 5 - 35 y.o., students and military
|
Atypical CAP (walking pneumonia)
|
|
Most common fungal infection in AIDS pts
|
Pneumocystis carinii pneumonia(PCP)
|
|
Most common organisms of HAP (hospital acquired pneumo)
|
Pseudomonas aeruginosa and Staph. Aureus
|
|
Red Currant Jelly sputum indicates what organism?
|
Klebsiella Pneumoniae
|
|
Severe pneumonia seen in older men from the air conditioning, in patients > 50 y/o and smokers
|
Legionella pneumophila
|
|
Most common cause of bronchiolitis and pneumonia among infants and children under 1 year of age
|
Respiratory syncytial virus (RSV)
|
|
Tx for CAP
|
Cephalosporins (Rocephin)
• Fluoroquinolones (Cipro) •Macrolide/Azalides/Ketolides (Zithromax) • Aminopenicillins (Augmentin) • Tetracyclines (Doxycycline) • TMP/SMX (Bactrim |
|
Useful screening tool to R/O PE
|
V/Q scan (ventilation/perfusion scan)
|
|
Gold Standard for detecting Pulm. Embolism
|
Pulmonary angiography
|
|
Organism that causes TB
|
Mycobacterium tuberculosis
|
|
S&S of TB
|
• weight loss
• Fever • Cough • night sweats • Hemoptysis |
|
Interpretation of positive PPD test for HIV, high risk settings, no risk factors
|
Must be indurated to be positive
• 5 mm or greater if HIV positive or immunosuppressed • 10 mm or greater in high risk setting • 15 mm or greater if no known risk factors |
|
Trench Mouth, Vincent’s angina is?
|
Acute Necrotizing Ulcerative Gingivitis
|
|
“Punched out” ulcerations on interdental papillae, Spontaneous bleeding,Odor, and Pain are indiciative of?
|
Acute Necrotizing Ulcerative Gingivitis
|
|
Most common pathogens causing acute otitis media
|
Strep Pneumonia
H. Influenza Moraxella catarrhalis |
|
S&S of Acute OM
|
•Otalgia
•Otorrhea •Hearing loss |
|
Condition that lasts up to 4 weeks with complete resolution of symptoms characterized by Facial pain/pressure, Nasal congestion/discharge and Cough
|
Acute Sinusitis
|
|
Allergic shiners, Allergic salute (salute sign), Allergic crease (nose), Adenoid facies, and Denie’s line are hallmarks of?
|
Allergic Rhinitis
|
|
Ulcers located on lip and gingival mucosa with raised yellow borders with surrounding erythema
|
Apthous Ulcer (Canker sore)
|
|
Small, red, pink dome shaped lump with pearly borders
|
Basal Cell Carcinoma
|
|
Facial Drooping due to damage of facial nerve (VII)
|
Bell's Palsy
|
|
Ear condition that starts after latency period, Crescendo-decrescendo manner, Lasts 20-30 seconds, Nystagmus, but No hearing Loss
|
BPPV (benign paroxysmal positional vertigo)
|
|
Cancer Risk Factors
|
Tobacco
Alcohol Sunlight Exposure Age Gender Race |
|
White plaques easily removed
Can be seen after treatment with antibiotic Can be seen after chronic treatment with steroids Common in pts with diabetes or HIV Common in infants |
Oral Candidiasis (thrush)
|
|
Often first sign of HIV infection
|
Oral candidiasis (thrush)
|
|
S&S of chronic OM
|
Perforation
Discharge Mastoiditis Hearing Loss |
|
Unilateral facial swelling lateral to nose with redness & typical loss of the nasolabial fold
|
Dental abcess
|
|
Organism that causes membranous pharyngitis
|
Diphtheria (Corynebacterium diphtheriae)
|
|
"thumb sign" is hallmark of
|
Epiglottitis
|
|
Procedure to remove insect from ear
|
apply lidocaine before irrigation
|
|
Child presents with a purulent unilateral nasal discharge
|
Foreign body
|
|
Organism that causes Herpangina
|
Group A coxsackieviruses
|
|
Painful vesiculoulcerative mucosal lesions most commonly in infants & children on soft palate or tonsils
|
Herpangina
|
|
Most common neck space infection life-threatening, bilateral, cellulitis of the sublingual & submandibular spaces that usually starts in an infected lower molar and may cause airway compromise
|
Ludwig's Angina
|
|
History of increasing ear fullness, Roaring tinnitus followed by a sensation of blocked hearing, nausea, vomiting, and lasting more than 20 min
|
Meniere's dz
|
|
The eardrum becomes inflamed, and small, fluid-filled blisters (vesicles) form on its surface & caused by mycoplasma
|
Myringitis
|
|
Painful blisters & vesicular lesions along the vermilion border
|
Oral herpes simplex (HSV-1)
|
|
Any white lesion that cannot be removed by scraping the mucosal surface (unlike candidiasis)
|
Oral Leukoplakia (can be pre-cancerous)
|
|
Similar to leukoplakia except has a definite erythematous component and often becomes cancerous
|
Oral Erythroplakia
|
|
Most common pathogen of Otitis Externa
|
Pseudomonas Aeruginosa
|
|
Acute or chronic, aggressive, invasive, & destructive inflammatory process of the ear canal commonly caused by Pseudomonas Aeruginosa
|
Malignant (Necrotizing) OE
|
|
Organism that causes Mumps (parotitis)
|
Paramyxovirus
|
|
painful enlargement of salivary glands, most commonly the parotids, with pain on chewing or swallowing acidic liquids such as vinegar or lemon juice
|
Parotitis (Mumps)
|
|
Long term complication of Mumps
|
Sterility
|
|
Severe sore throat, Uvula deviation, and “hot-potato” voice are characteristic of?
|
Peritonsillar Abcess (Quinsy's Abcess)
|
|
Organisms implicated in Pharyngitis & Tonsillitis
|
Group A Beta Hemolytic Strep
|
|
Criteria to determine presence of Group A Beta Hemolytic Strep in Pharyngitis
|
1. Fever
2. Adenopathy 3. Exudate 4. No cough or rhinorrhea |
|
associated with Varicella-zoster virus (VZV), Painful red rash with fluid filled blisters on the eardrum, external ear canal, roof of the mouth or tongue, Facial palsy on the same side as the affected ear, Difficulty closing one eye, Hearing loss, Tinnitus, Vertigo, Loss of taste are symptoms of?
|
Ramsey-Hunt Syndrome
|
|
an infection with group A streptococcus bacteria that can cause the scarlet-colored rash with classic red streaks that turn white when you press on them
|
Scarlet Fever
|
|
Most common pathogens in acute sinusitis
|
Streptococcus Pneumoniae
Haemophilus influenza Moraxella Catarrhalis |
|
Swelling in submandibular area that starts after a meal
Purulent D/C from Sialolith in salivary duct Pain & swelling eating tart foods |
Sialadenitis
|
|
This virus is assoc. w/ Oral Hairy Leukoplakia
|
Epstein-Barr Virus
|
|
most common malignancy of the endocrine system
|
Thyroid cancer
|
|
S&S of Thyroid cancer
|
Hoarseness
– Neck Pain – Enlarged thyroid nodules – Swollen lymph nodes |
|
Neuropathic disorder of Trigeminal nerve (CN V)
characterized by Intense pain of the eyes, lips, nose, scalp, forehead and jaw |
Tic Douloureux (trigeminal neuralgia)
|
|
Schwann Cell Tumor (Tumor of CN VIII)
|
Acoustic Neuroma
|
|
Most common type of thyroid cancer and tends to grow very slowly
|
papillary thyroid cancer
|
|
Blood & Thunder, tortuous veins, flame-shaped hemorrhage and cotton wool spots characterize this condition
|
Central Retinal Vein Occlusion
|
|
Condition involves the maxillary bone and posterior medial floor ethmoid bone, Eye appears sunken in, and best seen on Water's view x-ray
|
Blow Out Fracture
|
|
Snowflake” cataract is Hallmark for?
|
Diabetes
|
|
"box-carring" and "cherry-red spots" seen in the eyes are indicative of?
|
Central Retinal Artery Occlusion -- Ophthalmic Emergency!
|
|
A chronic inflammation of the meibomian gland in the eyelid
|
Chalazion
|
|
Abnormal development of blood vessels (telangiectasia) behind the retina, leaving cholesterol deposits and damaging the retina
|
Coat's Disease
|
|
Leading cause of visual loss in AIDS pts
|
Cytomegalovirus retinopathy
|
|
Key finding in Proliferative Diabetic Retinopathy
|
Neovascularization of the disc
|
|
3 findings in pre-proliferative diabetic retinopathy
|
Hemorrhages, hard exudates, Cotton Wool Spots
|
|
Tool used to measure intraocular pressure to detect glaucoma
|
tonometer
|
|
Condition characterized by painless, insidious raise in IOP, normal acuity until late stages
|
Open angle glaucoma
|
|
Condition with sudden rise in IOP, painful, Nausea/Vomiting, Steamy cornea, fixed, mid-dilated pupil, EMERGENCY
|
Closed angle glaucoma
|
|
Tx for open angle glaucoma
|
decrease aqueous production
|
|
Tx for closed angle glaucoma
|
Miotics increase trabecular meshwork outflow e.g. Pilocarpine
|
|
- A special contact lens on the topically anesthetized cornea to examine a patient with suspected glaucoma that can examine the anterior chamber angle structures
|
Goinoscopy
|
|
Dendritic staining pattern in the eye
|
Herpes Simplex Keratitis
|
|
CWS, flame shaped hemorrhages, macular edema (rare), disc edema, macular star/ring of exudates are findings in this condition
|
Hypertensive Retinopathy
|
|
Differentiate between Diabetic retinopathy and HTN retinopathy
|
HTN retinopathy is mostly a dry eye condition ( multiple CWS, rare hemorrhage, edema, and exudates) whereas diabetic retinopathy is a wet eye condition, rare CWS, extensive hemorrhages, edema, and exudates)
|
|
classic “ketchup” and “pizza” retina is found in?
|
AIDS pts
|
|
Infection/ inflammation of the cornea accompanied by pain, red eye
|
Keratitis
|
|
White reflex that is an emergency in children
and may signify retinoblastoma or cataract |
Leukocoria
|
|
Most common intraocular tumor in adults and demonstrates metastasis to liver
|
Melanoma
|
|
finding during the swinging-flashlight test whereupon the patient's pupils appear to dilate instead of constrict when the light swings from the unaffected "good" eye to the affected "bad" eye
|
Marcus Gunn Pupil
|
|
This is an acute infection of the tissues immediately surrounding the eye, including the eyelids, eyebrow, and cheek and needs immediate attention to prevent blindness
|
Orbital Cellulitis
|
|
inflammation of the optic disc only with a
central field defect |
Papillitis
|
|
disc swelling due to increased intracranial pressure where both optic discs are equally affected
|
Papilledema
|
|
yellow-white deposit on the conjunctiva adjacent to the limbus often due to aging
|
Pinguecula
|
|
Loss of accommodation reflex due to age
|
presbyopia
|
|
inherited disorders where individuals first experience defective dark adaptation or nyctalopia (night blindness), followed by constriction of the peripheral visual field and, eventually, loss of central vision late in the course of the disease
|
Retinitis Pigementosa
|
|
defined as a fleeting loss of vision caused by transient
occlusion of the retinal circulation. This symptom should prompt investigation of the ipsilateral carotid circulation for atheroma which may be the source of the retinal emboli. |
Retinal Vascular Occlusion or
Amaurosis Fugax |
|
Most common INTRAOCULAR malignancy in children characterized by Leukocoria (white reflex)
|
Retinoblastoma
|
|
Most common primary pediatric ORBITAL malignancy with very rapid onset of unilateral proptosis
|
Rhabdomyosarcoma
|
|
These are retinal hemorrhages with white or pale centers composed of coagulated fibrin observed in leukemia, diabetes, subacute bacterial endocarditis, pernicious anemia, ischemic events associated with elevated venous pressure and systemic vascular conditions with capillary fragility.
|
Roth Spots
|
|
Misalignment of eyes sometimes caused by lesion on CN III or lack of innervation to orbital muscles; also may be a sign of increased intracranial pressure
|
strabismus
|
|
bleeding in the vitreous cavity that may occur in response to direct trauma or those conditions
causing retinal neovascularization (diabetes, retinal vein occlusion) |
Vitreous Hemorrhage
|
|
transparent, colorless, gelatinous mass that fills the space between the lens of the eye and the retina lining the back of the eye.
|
Vitreous Humor
|
|
This leukemia has a variation called "Hairy Cell Leukemia"
|
CLL
|
|
Areas of metastasis for lung cancer?
|
adrenal glands and brain
|
|
Areas of metastasis for breast cancer?
|
bone, liver and lung
|
|
Areas of metastasis for Colon Cancer?
|
liver and lung
|
|
Areas of metastasis for prostate cancer
|
bone
|
|
Areas of metastasis for cancers of connective tissue (sarcomas), and testicular cancer
|
lung
|
|
Organism that causes Burkitt's Lymphoma
|
Epstein-Barr Virus
|
|
Organism that causes cervical cancer
|
Human Papilloma Virus
|
|
Condition that causes hepatocellular carcinoma
|
Hepatitis B and C
|
|
This virus causes Adult T-Cell Leukemia
|
HTLV-I (assoc. w/ ALL)
|
|
Organism that causes genital cancers
|
Human Papillomavirus
|
|
Dz where Auer rods are seen on blood smear
|
AML
|
|
In this condition, chronic renal failure causes defective platelet function and/or decreased platelets
|
Uremia
|
|
is a destruction of leukemic WBC’s leading to acute rises in uric acid (hyperuricemia) which may cause renal failure; is a side effect of chemotherapy
|
Tumor Lysis Syndrome
|
|
is a disorder caused by an inherited mutation in the beta-globins component of hemoglobin molecule
|
Sickle Cell Syndrome
|
|
Complications of Sickle Cell disease
|
Renal defects (Renal insufficiency)
Chronic skin ulcers of leg and ankle Sepsis (most common cause of death in children) Pneumonia Bone infarctions |
|
Condition where X-ray shows "punched out" bone lesions due to osteoclasts
|
Multiple Myeloma
|
|
Condition with proliferation of monoclonal IgM protein with symptoms of anemia, hypercalcemia, and BONE PAIN primarily in back and chest
|
Multiple Myeloma
|
|
Condition of over-production of RBC
|
Polycythemia Vera
|
|
Anemia where key clinical feature is a normocytic anemia with increased reticulocyte count
|
Hemolytic Anemia (Cells are being destroyed & bone marrow responds by increased production of reticulocytes)
|
|
Kayser-Fleischer rings and “sunflower” cataracts are ophthalmic findings in what condition?
|
Wilson's dz
|
|
"Target Cells" are seen in these 2 conditions
|
Sickle cell anemia and Thalassemia
|
|
Howell-Jolly Bodies
|
Nuclear remnants in RBC
|
|
Basophilic stippling is seen in this condition
|
Lead poisoning
|
|
TAILS is a pneumonic for what condition
|
Microcytic Anemia:
Thalassemia Anemia of Chronic dz Iron Deficiency Lead poisoning Sideroblastic Anemia |
|
Thalassemia defects that are incompatible with life
|
defect in 3 of 4 alpha chains
or defect in both beta chains |
|
Procedure to diagnose sideroblastic anemia
|
bone marrow biopsy
|
|
Condition caused by defect in binding of iron onto heme molecule
|
Sideroblastic anemia
|
|
sore tongue is indicative of this deficiency
|
Vitamin B12 and/or Folic acid deficiency
|
|
Conditions that lead to Macrocytic anemias
|
B12 and Folic acid deficiency
Hypothyroidism Chronic liver disease Alcoholism |
|
Pernicious Anemia is due to:
|
Lack of intrinsic factor which is needed for B12 absorption; this results in B12 deficiency
|
|
Burr cells and spur cells are due to:
|
Decreased erythropoietin production due to renal failure
|
|
painful, red, tender nodules on lower legs
|
Erythema Nodosum
|
|
any eruption of the skin accompanied by inflammation, such as measles, scarlatina, or erysipelas
|
Exanthems
|
|
Derm. condition w/ increased serum IgE levels
|
Atopic Derm (Eczema)
|
|
Papule or pustule surrounded by an erythematous halo caused by shaving hairy regions such as the beard area, axillae, or legs facilitates Staph. infection
|
Folliculitis
|
|
Grouped vesicles on an erythematous base; Once infected it persists in sensory ganglia for life
|
Herpes Simplex Virus
|
|
Unilateral pain and vesicular or bullous eruption limited to dermatomes innervated by corresponding sensory ganglion
|
Herpes Zoster (Varicella Zoster) AKA “shingles"
|
|
chronic disease of axilla, anogenital region and scalp can be associated with severe nodulocystic acne; “bridge” scars and "double comedomes" present
|
Hidradenitis Suppurativa
|
|
2 Organisms that commonly cause Impetigo
|
Staph aureus and strep pyogenes
|
|
violaceous lesions and lymphedema of the lower extremeties often seen in immunocompromised/HIV pts
|
Kaposi's Sarcoma
|
|
dome-shaped nodule with a central keratotic plug mimics basal cell carcinoma; usually found on face and has rapid growth rate
|
Keratoacanthoma
|
|
Head lice
|
Pediculosis Capitis
|
|
Pubic lice
|
Pediculosis Pubis
|
|
Flat-topped violaceous, shiny, pruritic papules on skin with white lines (Wickhams striae) on mouth, wrists, and sun-exposed sites
|
Lichen Planus
|
|
Area of cutaneous thickening and hardening from continued irritation/itching; area is like an erogenous zone
|
Lichen Simplex Chronicus
|
|
the simplest dermatological lesion; It is flat and can only be seen and not felt
|
Macule
|
|
Precursors of Cutaneous Melanoma
|
1. Congenital nevomelanocytic nevus (giant or small)
2. Clark’s (dysplastic) melanocytic nevus 3. Lentigo maligna |
|
tumor from the beginning is in the “vertical growth” phase
"blueberry-like” nodule |
Nodular Melanoma
|
|
mask of pregnancy
|
Melasma
|
|
Skin colored papules, often umbilicated with central keratotic plug caused by MC virus (poxvirus); severe in HIV pts
|
Molluscum contagiosum
|
|
Localized cutaneous sclerosis where hair follicle and sweat duct holes disappear; considered to be localized scleroderma
|
Morphea
|
|
Coin shaped plaques with small grouped papules and vesicles on erythematous base
Common in lower legs of older males during winter |
Nummular eczema
|
|
Infection of finger or toenail caused by fungi, yeasts and molds
|
Onycomycosis
|
|
Superficial solid lesions less than 1 cm in diameter
Palpable May invade epidermis and upper dermis but not sub Q |
Papule
|
|
Fungal infection of nails with pus
|
Paronychia
|
|
Most common photodermatosis characterized by abnormal reactions to UV radiation,
pruritus and parasthesia |
Photo Light eruption
|
|
Begins w/ “herald plaque”
Lesions cleavage in “Christmas tree” pattern |
Pityriasis rosea
|
|
Inflammatory reaction caused by an antigen (allergen)
Elicits type IV hypersensitivity reaction Confined to the site of exposure to allergen |
Allergic contact dermatitis
|
|
Can be life threatening
Starts with burning erythema that spreads in hours Fiery red skin “Lakes” filled with purulent fluid |
Psoriasis Erythroderma
|
|
o Infestation by mite
o "7 year itch" |
Scabies
|
|
o Yellow, greasy scaling where sebaceous glands are
o Scalp: dandruff or cradle cap in infants o High incidence in HIV and Parkinson’s |
Seborrhic Dermatitis
|
|
o Lesion has stuck on appearance, with “warty” surface
o “horn cysts” |
Seborrheic keratosis
|
|
Malignant tumor of epithelial keratinocytes
|
Squamous cell carcinoma (SCC)
|
|
Drug induced or idiopathic skin tenderness and erythema of skin and mucosa
o Variant of erythema multiforme o Target like lesions Can be life threatening |
Steven-Johnson syndrome
|
|
Painless Chancre indicates this disease
|
Primary Syphilis
|
|
GUMMA lesions indicate what disease
|
Tertiary Syphilis
|
|
Mutlisystem disease of connective tissue and blood vessels that mostly occurs in black females w/ symptoms of Skin lesions and Arthritis
|
Systemic Lupus Erythematous (SLE)
|
|
Fungal infection of scalp resulting in scarring and alopecia
|
Tinea capitis
|
|
Ringworm; Fungal infection of the trunk, legs and arms
|
Tinea corporis
|
|
Jock Itch; Fungal infection of inguinal folds
|
Tinea cruris
|
|
Athlete’s Foot
|
Tinea Pedis
|
|
Tinea ungium
|
Also known as Onychomycosis; Fungal infection of finger
|
|
Lesions on the palms and soles that appear 2-6 months after initial painless chancre is indicative of what disease
|
Secondary syphilis
|
|
"oil spot" and "pitting" on nails is indicative of?
|
Psoriasis Vulgaris
|
|
Systemic disease caused by Staph characterized by
o Fever o Malaise o N/V/D o Red rash that looks like sunburn |
Toxic Shock Syndrome
|
|
Wheals that develop upon dermographism; can be detected with "ice cube" test
|
Urticaria
|
|
Dew drops on a rose petal
|
Varicella (Chicken pox)
|
|
Common Warts
|
Verruca Vulgaris
|
|
diffuse, velvety thickening and hyperpigmentation of the skin, chiefly in axillae, around the neck, and other body folds
|
Acanthosis nigricans
|
|
o Development of chalk white macules, round, elongated with convex margins
Absence of melanocytes (hypopigmentation) |
Vitiligo
|
|
Condition of the face characterized by rhinophyma, that is exacerbated by hot liquids, spicy foods, and sun exposure
|
Acne Rosacea
|
|
most common type of skin cancer
|
Basal cell carcinoma (BCC)
|
|
This malignant tumor is locally invasive, aggressive, and destructive, but there is a limited capacity to metastasize.
|
Basal cell carcinoma (BCC)
|
|
Ulcerated nodule or papule with rolled "pearly" border
|
Basal cell carcinoma (BCC)
|
|
eruption is an adverse hypersensitivity reaction to an ingested or parenterally administered drug characterized by a cutaneous eruption that mimics measles
|
Exanthematous Drug
Eruption |
|
This lesion is derived from epidermis or the epithelium of the hair follicle, and is formed by cystic enclosure of epithelium within the dermis that becomes filled with keratin and lipid-rich debris.
|
Epidermal Cysts
|
|
Button-like dermal nodule usually occuring on extremities and has "dimple" sign
|
Dermatofibroma
|
|
Dermal condtion characterized by "spaghetti and meatballs" on KOH prep
|
Tinea Versicolor
|
|
Blue/green fluorescence of scales under Wood's Lamp
|
Tinea Versicolor (Pityriasis versicolor)
|
|
Iris or target lesions are typical on the dorsa of hands, palms, and soles; forearms; feet; face; elbows and knees
|
Erythema Multiforme
|
|
potential precursor of superficial spreading melanoma and also a marker of persons at risk for developing primary malignant melanoma of the skin
|
Clark’s (dysplastic) melanocytic nevus
|
|
Tapioca-like vesicles on fingers, palms, and soles
|
Dyshidrotic Eczematous Dermatitis
|
|
Papulopustules, comedomes, or nodulocystic lesions on the face that can lead to pitted or hypertrophic scars
|
Acne Vulgaris
|
|
Positive Nikolsky sign (blister formation from slight pressure) is seen in these 2 conditions
|
Erythema Multiforme Major (Severe form)
Pemphigus Vulgaris |
|
Destructive ulcers of the genital region that have beefy-red granulated tissue base with sharply defined edges; late sequela is SCC of genital skin
|
Donovanosis
|
|
Congenital gray-blue macular lesion of lumbosacral area that disappears in early childhood
|
Mongolian Spot
|
|
Single or multiple benign subcutaneous tumors composed of fat cells that are movable against overlying skin
|
Lipoma
|
|
This dermal tumor is in the "vertical growth" phase from the beginning
|
Nodular Melanoma
|
|
excessive hair growth in androgen dependent hair patterns; women w/ excessive facial hair
|
Hirsutism
|
|
hickey
|
Annular Erythematus Erogeniosum
|
|
ANA test is used to diagnose this condition
|
Systemic Lupus Erythematosus
|
|
Sexually transmitted painful ulcer at inoculation site caused by Hemophilus Ducreyi
|
Chancroid
|
|
This condition develops from precancerous lesions often found on the lips and other sun-exposed sites and has great capacity to metastasize
|
Squamous Cell Carcinoma
|
|
These lesions show initial radial growth followed by vertical growth and can become cancerous
|
Melanoma
|
|
Condition where loss of scalp hair is in an "M" shaped recession
|
Androgenetic Alopecia
|
|
Describe phases of hair growth: telogen, anagen, catagen
|
Telogen = resting phase
Anagen = active growth Catagen = transition phase |
|
Hair loss caused by crash dieting, giving birth, or cessation of oral contraceptives; pt will bring in "bags of shed hair"
|
Telogen Effluvium
|
|
Cafe au lait spots are indicative of what condition?
|
Neurofibromatosis
|
|
This condition causes fine, downy hair to cover the body and is usually a harbinger of malignancy
|
Hypertrichosis
|
|
Disease w/ factor VIII deficiency and how it affects PT and PTT
|
Hemophilia A
PT is normal PTT is prolonged (reflecting that Factor VIII is in the intrinsic pathway) |
|
Disease w/ factor IX deficiency and how it affects PT and PTT
|
Hemophilia B
PT is normal PTT is prolonged ((reflecting that Factor IX is in the intrinsic pathway) |
|
Deficiency in this vitamin causes decreased production of factors II, VII, IX, X in the liver
|
Vitamin K
|
|
assesses integrity of extrinsic coagulation pathway (extrinsic requires Factor VII and X)
|
Prothrombin time (PT)
PT is prolonged (increased) if there are deficiencies of clotting factors in extrinsic pathway and the common pathway |
|
this test assesses integrity of intrinsic coagulation pathway (intrinsic pathway requires Factors VIII, IX, X)
|
Partial Thromboplastin Time (PTT)
|
|
This factor is required for adhesion of platelets to injured endothelium (formation of platelet plug)
|
VonWillebrand Factor
|
|
A condition characterized by massive, uncontrolled intravascular coagulation eventually leading to depletion of blood clotting components; usually due to massive trauma or sepsis
|
Disseminated Intravascular Coagulation (DIC)
|
|
Christmas Dz
|
Hemophilia B
|
|
Primary Hemostasis
|
Inability to form a platelet plug due to platelet defects or decreased number of platelets
|
|
Secondary Hemostasis
|
Inability to form an adequate fibrin clot due to decrease or absence of plasma coagulation factors
|
|
An autoimmune dz where body produces antibodies against own platelets; condition is improved w/ splenectomy
|
Idiopathic Thrombocytopenia Purpura
|
|
Zoster Sine Zoster
|
Nerve involvement that occurs without cutaneous involvement
|
|
melanoma can be recognized by these 3 physical characteristics
|
color, contour, and size of the lesion
|
|
4 predisposing risk factors for Melanoma
|
1. Presence of precursor lesions (Clark’s dysplastic melanocytic nevus, congenital melanocytic nevus)
2. Family history of melanoma in parents, children, or siblings 3. Light skin color with inability to tan with ease (skin phototypes I and II) 4. Excessive sun exposure, especially during preadolescence |
|
pigmented lesions of the skin usually present at birth, may be any size from very small to very large and are benign neoplasms but may be precursors of malignant melanoma
|
Congenital Nevomelanocytic Nevus
|
|
Precursor of malignancy, this is a dermal lesion with variations in hues of brown and black, appears like a “stain,” haphazard network of black on a background of brown; has irregular borders, often with a notch, “geographic” shape with inlets and peninsulas
|
Lentigo Maligna
|
|
an acute, chronic, or recurrent dermatosis of the fingers, palms, and soles, characterized by a sudden onset of many deep-seated pruritic, clear vesicles; later, scaling, fissures and lichenification occur
|
Dyshidrosis
|
|
an acute beta-hemolytic group A streptococcal infection of the skin involving the
superficial dermal lymphatics that causes marked swelling, high fevers, shaking, chills, fatigue, headaches, vomiting, and general illness within 48 hours of the initial infection |
Erysipelas
|
|
Hallmarks of Asthma
|
decrease in airway diameter
• increased airway resistance • airway obstruction |
|
Definition of Chronic Bronchitis
|
• Chronic/recurrent cough with excess mucus production (for most days at least 3 months during 2 consecutive years) in absence of other illness
• Airway narrowing from inflammation / hyperplasia and hypertrophy of mucous glands edema which increases airway resistance • Loss of ciliary transport • V/Q mismatch from bronchial narrowing and mucous plugging |
|
describe the physiology of Cystic Fibrosis
|
↑ Na absorption and ↓ CL secretion → thick, sticky mucus→ impaired lung defense against infection
|
|
Cystic Fibrosis pt's get chronic infections from these 2 organisms
|
Staph. Aureus and Pseudomonas aeruginosa
|
|
CXR findings in pt's w/ Emphysema
|
Hyperinflated lung field (hyperlucency)
• Bullae – local radiolucencies • Vertically elongated lung field • Low flattend diaghrams • Increased retrosteral airspace |
|
Most virulent type of Influenza
|
Influenza A
|
|
Describe Reye's Syndrome
|
acute fatty deterioration of liver, encephalopathy, hypoglycemia, lipidemia in children treated with Aspirin or Salicylates
|
|
Risk factors for Pulm. Embolism
|
• Immobilization
• Post-operative states • Chronic venous insufficiency • Use of oral contraceptives • Obesity • Cancer or chemotherapy • Post-partum state • Indwelling central venous catheter • Deficiency of proteins of antithrombotic activity – Antithrombin III – Protein C – Protein S • Presence of Factor V Leiden |
|
S&S of Pulm. HTN
|
shortness of breath
dizziness fainting fatigue nonproductive cough peripheral edema hemoptysis |
|
"helmet" cells are seen in?
|
Poikilocytosis (abnormally shaped blood cells)
|
|
Acute bacterial infection causes an increase of this cell type in circulation
|
neutrophils
|
|
Most common Thalassemia type
|
Thalassemia Minor = less severe form; has 2 alpha globin and 1 beta globin
|
|
Most common presenting sign in CML
|
Splenomegaly
|
|
Leukemia characterized by splenomegaly, hepatomegaly, lymphadenopathy, and pancytopenia
|
ALL
|
|
Leukemia assoc. with HTLV-1 (human T lymphocyte virus 1)
|
ALL
|
|
What is the most aggressive malignant disease of humans?
|
AML
|
|
2 leukemia types characterized by increased blast (immature) cells
|
ALL and AML
|
|
Leukemia characterized by a chronic stable phase followed by "blast crisis" when disease becomes very aggressive
|
CML
|
|
Leukemia w/ onset at age >50
|
CLL
|
|
"B symptoms" carry an unfavorable prognosis in this disease
|
Hodgkin's Disease
|
|
Organism that causes infectious mononucleosis
|
Epstein-Barr virus
|
|
Virus assoc. with Hodgkin's disease
|
Epstein-Barr virus
|
|
2 aggressive variations of Non-Hodgkins Lymphoma
|
Burkitt's Lymphoma
Lymphoblastic lymphomas |
|
What are the components of "B symptoms"?
|
Intermittent fever >100.5
Night sweats Weight loss >10% of normal body weight |
|
Describe stages of assessing Hodgkin's diseases
|
Stage I= involves single lymph node region
Stage II= involves 2 or more lymph node chains on same side of diaphragm (above or below) Stage III= involves lymph node chains on both sides of diaphragm (above and below) Stage IV= Diffuse or disseminated dz involving lung, liver, or bone marrow |
|
What condition is characterized by "fragile blood"
|
Spherocytosis: RBCs lack spectrin, a cytoskeletal membrane protein, making RBC's fragile and osmotic forces cause cells to break
|
|
Priapism (persistent painful erections) is assoc. w/ crisis of what disease?
|
Sickle cell
|