Medical Conditions and Treatments Quiz
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Petechiae are tiny, red, non-____ spots, commonly found in dependent areas. Causes may include thrombocytopenia, capillaritis, and ______ infections (e.g., dengue, rocky mountain spotted fever).

blanching, viral

What are the initial drugs of choice in a symptomatic patient with hypertrophic cardiomyopathy?

BBs

Monitor for adrenal crisis by checking _______, ______, and _______. Administer an increased hydrocortisone dose for major stress.

BP, HR, RR

Match the following terms with their corresponding definitions:

<p>Hirschsprung's Disease = Congenital disorder with absent ganglion cells in the distal colon, leading to functional obstruction SSPE = Progressive, fatal neurological disorder caused by persistent infection with the measles virus Chalazion = Chronic lesion of the meibomian gland in the eyelid, usually due to duct blockage</p> Signup and view all the answers

Which statement is true about acute pancreatitis?

<p>Alcoholism and hypertriglyceridemia are risk factors</p> Signup and view all the answers

Hyperprolactinemia can cause galactorrhea and infertility.

<p>True</p> Signup and view all the answers

____ is a common symptom of vertebrobasilar TIAs due to the involvement of vestibular pathways.

<p>Vertigo</p> Signup and view all the answers

Amaurosis fugax is a symptom of retinal or ophthalmic artery ___, not vertebrobasilar ischemia.

<p>Thrombosis</p> Signup and view all the answers

, hemiparesis, and ___ sensory deficits are more common in anterior circulation () TIAs.

<p>Facial, Hemisensory, Carotid</p> Signup and view all the answers

What are the first-line treatment for Raynaud's phenomenon?

<p>Calcium channel blockers</p> Signup and view all the answers

___ may worsen Raynaud's symptoms by reducing ___ blood flow.

<p>Smoking, Peripheral</p> Signup and view all the answers

Which is the most common congenital heart defect that can cause a murmur in neonates?

<p>Ventricular septal defect (VSD)</p> Signup and view all the answers

What is a normal finding in neonates that typically causes a murmur?

<p>Patent ductus arteriosus (PDA)</p> Signup and view all the answers

Abdominal Aortic Aneurysm (AAA) is often asymptomatic; may have ___ pain, pulsatile abdominal mass, or abdominal pain.

<p>Back</p> Signup and view all the answers

What is the first-line treatment for Hypercalcemia?

<p>Surgical removal of parathyroid adenoma</p> Signup and view all the answers

In Central Retinal Vascular Occlusion, sudden ___ visual loss often occurs.

<p>Painless</p> Signup and view all the answers

Myasthenia Gravis is an autoimmune disorder affecting the neuromuscular junction.

<p>True</p> Signup and view all the answers

What is the autoimmune attack target in Lambert-Eaton myasthenic syndrome (LEMS)?

<p>Voltage-gated calcium channels</p> Signup and view all the answers

Hematuria is present in ___ syndromes.

<p>Nephritic</p> Signup and view all the answers

Acute Respiratory Distress Syndrome (ARDS) is characterized by severe, acute lung injury causing noncardiogenic _ _ _ _ _ _ _ _ _.

<p>pulmonary edema</p> Signup and view all the answers

Which of the following are risk factors for Acute Respiratory Distress Syndrome (ARDS)? (Select all that apply)

<p>Pneumonia</p> Signup and view all the answers

What are the classic clinical features of Acute Respiratory Distress Syndrome (ARDS)?

<p>Acute onset dyspnea, tachypnea, hypoxemia</p> Signup and view all the answers

The Berlin criteria are used for the diagnosis of Acute Respiratory Distress Syndrome (ARDS) based on timing, chest imaging, origin of edema, and _ _ _ _ _ _ _ _ _ _ _ _ _ impairment.

<p>oxygenation</p> Signup and view all the answers

Mastoiditis: Generally treated with IV antibiotics such as _____ or _____, with potential need for _____otomy

Signup and view all the answers

What is Alcoholic cardiomyopathy caused by?

<p>chronic heavy alcohol use</p> Signup and view all the answers

What distinguishes allergic rhinitis from other rhinitis etiologies? RV, trapping

<p>eosinophilia</p> Signup and view all the answers

Which electrolyte abnormality is associated with U waves?

<p>Hypokalemia</p> Signup and view all the answers

G6PD deficiency can trigger drug-induced hemolysis.

<p>True</p> Signup and view all the answers

Match the following causes of Pulmonary Fibrosis with their respective category:

<p>Connective tissue diseases (e.g., RA, scleroderma) = Common Causes Environmental exposures (e.g., asbestos, silica dust) = Common Causes Idiopathic (unknown cause) = Common Causes Drug-Induced Pulmonary Fibrosis = Common Causes</p> Signup and view all the answers

What is the recommended initial treatment for non-severe C. difficile infection?

<p>metronidazole</p> Signup and view all the answers

What can trigeminal neuralgia be generally responsive to?

<p>Carbamazepine</p> Signup and view all the answers

Argyll-Robertson pupils can be associated with loss of DTRs.

<p>True</p> Signup and view all the answers

What is the most common associated abnormality in young adults with otherwise unexplained thrombosis?

<p>Factor 5 Leiden</p> Signup and view all the answers

What causes Raynaud's phenomenon?

<p>vascular spasm</p> Signup and view all the answers

Which nerve root is associated with weak biceps muscle?

<p>C6</p> Signup and view all the answers

Which nerve root is associated with weak wrist?

<p>C7</p> Signup and view all the answers

Which nerve root is associated with weak triceps muscle?

<p>C7</p> Signup and view all the answers

Which nerve root is associated with diminished brachioradialis reflex?

<p>C6</p> Signup and view all the answers

Which nerve root is associated with thumb/index finger paresthesias?

<p>C7</p> Signup and view all the answers

Which nerve root is associated with middle finger paresthesias?

<p>C8</p> Signup and view all the answers

Which nerve root is associated with pinky finger paresthesias?

<p>C8</p> Signup and view all the answers

What is the only medication indicated for reducing the frequency of migraine headaches?

<p>Propranolol</p> Signup and view all the answers

What is the characteristic presentation in patients with mitral valve prolapse?

<p>Auscultation would reveal a mid-systolic click with or without a late systolic murmur.</p> Signup and view all the answers

Consider - combo if EF <___% with syncope.

<p>metastatic carcinoid, 35</p> Signup and view all the answers

5-HIAA levels are elevated in ___ ___ tumors.

<p>Zollinger-Ellison, panc(reas), duodenum, ulcers, beta islet, tumor, MEN1, fasting</p> Signup and view all the answers

- syndrome:

  • Gastrin-secreting tumor (gastrinoma), usually in ___ or ___
  • Leads to excessive gastric acid secretion
  • Classic triad: severe , gastric acid hypersecretion, non- ___ cell ___ of pancreas
  • Associated with ___ syndrome in 20-25% of cases

<p>Zollinger-Ellison, stomach, duodenum, reflux, beta islet, tumor, MEN1</p> Signup and view all the answers

What is the diagnostic test involving measuring serum gastrin level?

<p>Secretin stimulation test</p> Signup and view all the answers

What is the main treatment for Zollinger-Ellison syndrome?

<p>PPI therapy, surgical resection of tumor</p> Signup and view all the answers

Uterine leiomyomata (fibroids) cause severe dysmenorrhea with agonizing, ___, spasmodic pelvic pain.

<p>crampy</p> Signup and view all the answers

Uterine leiomyomata (fibroids) can cause ___, abnormally heavy or prolonged menstrual bleeding.

<p>menorrhagia</p> Signup and view all the answers

Treatment for cobblestoning of the posterior pharynx is ___.

<p>supportive</p> Signup and view all the answers

What is the precipitating factor for Myxedema Coma?

<p>cold exposure, sedatives, other metabolic stressors</p> Signup and view all the answers

What is the main treatment for Myxedema Coma?

<p>IV thyroxine, glucocorticoids</p> Signup and view all the answers

Pathognomonic: Broad-based budding ? forms on histopathology

<p>yeast</p> Signup and view all the answers

Treatment Cornerstone: ? therapy with ? or ?

<p>antifungal</p> Signup and view all the answers

Type III allergic reaction: ? -mediated

<p>immune complex</p> Signup and view all the answers

What is the timing of Type II allergic reaction?

<p>3-10 hours</p> Signup and view all the answers

What syndrome is caused by maternal warfarin use during pregnancy?

<p>Fetal warfarin syndrome</p> Signup and view all the answers

Fetal warfarin syndrome can lead to mental retardation.

<p>True</p> Signup and view all the answers

What is the key feature associated with Fetal warfarin syndrome? Nasal hypoplasia, ? nasal bridge, ? nasal groove

<p>flat</p> Signup and view all the answers

Match the following types of anemia with their characteristics:

<p>Microcytic anemia (MCV &lt;80) = Consider iron deficiency anemia or <em>?</em> or anemia of chronic disease Normocytic anemia (MCV 80-100) = Consider hemorrhage (e.g., GI bleeding, trauma) or <em>?</em> anemias (e.g., autoimmune, microangiopathic) Macrocytic anemia (MCV &gt;100) = Includes megaloblastic causes (Vitamin B12 and/or folate deficiency) and non-megaloblastic causes (not characterized by the typical finding on blood smear)</p> Signup and view all the answers

What is a common cause of Binasal hemianopia?

<p>Bilateral optic nerve lesions</p> Signup and view all the answers

What is the therapeutic range for valproic acid (total) in terms of micrograms per milliliter?

<p>50-125</p> Signup and view all the answers

Alcoholism and cirrhosis can lead to elevated indirect bilirubin due to impaired liver synthesis of clotting factors.

<p>True</p> Signup and view all the answers

What can cause bilateral small pupils that constrict with near vision but do not react to light?

<p>Argyll Robertson (AR) pupils</p> Signup and view all the answers

Match the following maintenance drugs with their common adverse effects:

<p>Valproic acid (Depakote) = ADEs: Hepatotoxicity, thrombocytopenia Carbamazepine (Tegretol) = ADEs: Agranulocytosis, rash Phenytoin (Dilantin) = ADEs: Gingival hyperplasia, osteomalacia</p> Signup and view all the answers

This bluish discoloration is referred to as _ _ _ _ _ _ Sign

<p>Cullen</p> Signup and view all the answers

Fluid increase to _ _ +L/day

<p>2</p> Signup and view all the answers

Low _ _ _ _ _ _ _ intake

<p>sodium</p> Signup and view all the answers

Low _ _ _ _ _ _ _ intake

<p>protein</p> Signup and view all the answers

Calcium intake should be _ _ _ - _ _ _ mg/day

<p>600-800</p> Signup and view all the answers

Small, scattered, non-_ _ _ _ _ _ superficial bruises

<p>tender</p> Signup and view all the answers

Thrombocytopenia: platelet count below 100,000/uL. Surgical bleeding: typically happens when platelets are below _ _ ,000/uL

<p>50</p> Signup and view all the answers

What are the classic symptoms of Extrapyramidal Symptoms (EPS)?

<p>Akinesia, bradykinesia, mask-like facial expression, tremor, cogwheel rigidity, postural abnormalities</p> Signup and view all the answers

What are the treatment options for Antipsychotic-induced Tardive Dyskinesia (TD)?

<p>Reduce antipsychotic dose, switch to atypical antipsychotics, Anticholinergic medications, Monoamine inhibitors</p> Signup and view all the answers

Characteristic physical features of Down Syndrome include up-slanting eyes, flat facial profile, single palmar crease, hypotonia, and congenital _ _ _ _ _ defects

<p>heart</p> Signup and view all the answers

Lymphadenopathy, cardiac abnormalities such as Coarctation of the _ _ _ _ _ _, and renal anomalies are seen in Turner Syndrome.

<p>aorta</p> Signup and view all the answers

Hypothyroidism and renal causes should be considered in the differential diagnosis of Pericardial Effusion. Chest X-ray may show an enlarged cardiac silhouette with a water _ _ _ _ _ _ heart shape.

<p>bottle</p> Signup and view all the answers

Disseminated intravascular coagulation (DIC) leads to _ _ _ _ _sis in severe cases.

<p>necrosis</p> Signup and view all the answers

The Philadelphia chromosome is more common in Chronic Myeloid Leukemia (CML) CrML) and is a t(9;22) fusion gene involving BCR and _ _ _ oncogenes.

<p>ABL</p> Signup and view all the answers

What is the key difference in age of onset between Acute Lymphoblastic Leukemia (ALL) and Chronic Myeloid Leukemia (CML)?

<p>ALL more common in children, CML more common in adults</p> Signup and view all the answers

What are the common features of Hemophilia A and Hemophilia B?

<p>Decreased or absent clotting factor, X-linked recessive inheritance</p> Signup and view all the answers

Blastomycosis often presents with flu-like symptoms and is typically found in _ _ _ _ _ _ _ and _ _ _ _ _ _ _ regions.

<p>Midwest, South</p> Signup and view all the answers

Common causes of nephritic syndrome include: Acute ____________ glomerulonephritis

<p>poststreptococcal</p> Signup and view all the answers

Common causes of nephritic syndrome include: ____________ nephropathy

<p>IgA</p> Signup and view all the answers

Common causes of nephritic syndrome include: ____________ nephritis

<p>lupus</p> Signup and view all the answers

Common causes of nephritic syndrome include: Vasculitis (e.g., granulomatosis with polyangiitis, microscopic polyangiitis) ____________ syndrome

<p>Goodpasture's</p> Signup and view all the answers

Match the following causes with the corresponding syndrome: Nephritic Syndrome

<p>Acute poststreptococcal glomerulonephritis = Causes nephritic syndrome IgA nephropathy = Causes nephritic syndrome Lupus nephritis = Causes nephritic syndrome Goodpasture's syndrome = Causes nephritic syndrome</p> Signup and view all the answers

Nephritic syndrome involves glomerular inflammation, causing hematuria, proteinuria, hypertension, and edema. Diseases that can cause nephritic syndrome include: ____________glomerulonephritis

<p>membranoproliferative</p> Signup and view all the answers

Nephritic syndrome involves glomerular inflammation, causing hematuria, proteinuria, hypertension, and edema. Diseases that can cause nephritic syndrome include: ____________ nephropathy

<p>Berger's</p> Signup and view all the answers

Nephritic syndrome involves glomerular inflammation, causing hematuria, proteinuria, hypertension, and edema. Diseases that can cause nephritic syndrome include: ____________ nephritis

<p>membranoproliferative</p> Signup and view all the answers

Nephritic syndrome involves glomerular inflammation, causing hematuria, proteinuria, hypertension, and edema. Diseases that can cause nephritic syndrome include: ____________ syndrome

<p>ANCA-associated</p> Signup and view all the answers

Match the following causes with the corresponding syndrome: Nephrotic Syndrome

<p>Minimal change disease = Causes nephrotic syndrome Focal segmental glomerulosclerosis (FSGS) = Causes nephrotic syndrome Membranous nephropathy = Causes nephrotic syndrome Amyloidosis = Causes nephrotic syndrome</p> Signup and view all the answers

Sarcoid typically presents with ____________ lymphadenopathy and ____________ granulomas of the lungs (and other organs).

<p>hilar, noncaseating</p> Signup and view all the answers

Tuberculosis of the spine is also known as ____________. Seen on x-ray as ____________ and ____________ breakdown of vertebral bodies.

<p>Pott's</p> Signup and view all the answers

Lidocaine with ____________ both increases the ____________ of anesthesia and decreases blood flow to the area of injection.

<p>epinephrine</p> Signup and view all the answers

In Hemophilia A, Factor ____________ deficiency is seen.

<p>VIII</p> Signup and view all the answers

Typical treatment elements for acute asthma exacerbation include:

<p>Oxygen</p> Signup and view all the answers

For acute asthma exacerbation treatment, consider the acronym B.I.O.M.E.S where B stands for _____________.

<p>Beta-agonists</p> Signup and view all the answers

What is the normal variation in heart rate that occurs with breathing called?

<p>sinus arrhythmia</p> Signup and view all the answers

Pernicious anemia is an autoimmune destruction of the gastric parietal cells that make IF.

<p>True</p> Signup and view all the answers

Koilonychia refers to ____________-shaped nails often seen in ____________.

<p>spoon</p> Signup and view all the answers

What are the key characteristics of nephrotic syndrome?

<p>proteinuria, low albumin, hyperlipidemia, edema</p> Signup and view all the answers

Rheumatoid arthritis typically presents with asymmetric joint arthritis.

<p>False</p> Signup and view all the answers

Mastoiditis: Generally treated with IV antibiotics such as ______ or ______, with potential need for ______otomy.

Signup and view all the answers

Mastoiditis: Generally treated with IV antibiotics such as _____ or _____, with potential need for ______otomy

Signup and view all the answers

Study Notes

Here are the study notes for the provided text:

Petechiae

  • Defined as tiny, red, non-blanching spots, commonly found in dependent areas
  • Causes: thrombocytopenia, capillaritis, infections (e.g., dengue, Rocky Mountain spotted fever)

Adrenal Insufficiency

  • Primary (Addison's disease): caused by adrenal gland damage
  • Secondary: caused by pituitary dysfunction
  • Monitor for adrenal crisis: hypotension, hyponatremia, hyperkalemia
  • Treatment: glucocorticoid replacement (e.g., hydrocortisone), mineralocorticoid replacement (e.g., fludrocortisone) for primary adrenal insufficiency

Hirschsprung's Disease

  • Congenital disorder with absent ganglion cells in distal colon, causing functional obstruction and constipation in infants and children
  • Epidemiology: 1 in 5,000 live births, male predominance (4:1), associations with other congenital anomalies
  • Clinical presentation: delayed meconium passage, progressive constipation, abdominal distension, enterocolitis (life-threatening)
  • Diagnosis: rectal biopsy, anorectal manometry
  • Treatment: rectal irrigations, stool softeners, definitive surgery

Metastatic Cancer Node

  • Types: gastrointestinal, lung, breast, prostate cancers
  • Virchow's node (left supraclavicular) is a common site of metastasis

Viral Conjunctivitis

  • Presents with fever, coryza (runny nose), and conjunctivitis
  • Pathognomonic Koplik spots (small white spots on the buccal mucosa)

Subacute Sclerosing Panencephalitis (SSPE)

  • Definition: progressive, fatal brain disorder caused by persistent measles virus infection
  • Pathogenesis: virus persists in the brain, leading to chronic inflammation and progressive damage to the central nervous system
  • Symptoms: behavioral changes, memory loss, myoclonic jerks
  • Diagnosis: based on clinical history, characteristic EEG findings, elevated measles antibody titers in CSF, and typical MRI brain findings
  • Prognosis: usually fatal within 1-3 years after symptoms begin

Post-streptococcal Glomerulonephritis (PSGN)

  • Common cause of acute glomerulonephritis in children
  • Occurs 1-3 weeks after a streptococcal infection
  • Clinical features: hematuria, edema, hypertension, and decreased urine output
  • Diagnosis: confirmed by elevated ASO titers and low C3 complement levels
  • Treatment: supportive, and the condition usually resolves spontaneously within weeks to months

Dumping Syndrome

  • Common complication after gastric surgery
  • Early dumping syndrome: occurs within 30 minutes of eating, caused by rapid gastric emptying
  • Symptoms: abdominal fullness, nausea, flushing, palpitations, and lightheadedness
  • Treatment: dietary modifications, and in severe cases, octreotide analogs

Hyperprolactinemia

  • Causes: pituitary adenoma, dopamine antagonists, and chest trauma
  • Symptoms: amenorrhea, galactorrhea, and infertility
  • Treatment: dopamine agonists (e.g., bromocriptine, cabergoline), and pituitary MRI to rule out a prolactinoma

Malignant Otitis Externa

  • Invasive infection of the external auditory canal, typically caused by Pseudomonas aeruginosa
  • Risks: diabetes, antibiotic use
  • Symptoms: severe ear pain, purulent discharge, and cranial nerve palsies
  • Treatment: IV antibiotics, surgical debridement, and strict glucose control for diabetics

Type 2 Diabetes

  • Characterized by insulin resistance and progressive beta-cell dysfunction
  • Complications: cardiovascular disease, neuropathy, nephropathy, and retinopathy

Vitamin A Toxicity

  • Caused by excessive intake of vitamin A supplements or megavitamins
  • Symptoms: headache, blurred vision, dryness, nausea, and skin changes (peeling, pruritus)
  • Diagnosis: based on clinical presentation and elevated serum vitamin A levels
  • Treatment: discontinuation of vitamin A supplements and supportive care

Addison's Disease

  • Primary adrenal insufficiency caused by destruction of the adrenal cortex
  • Symptoms: fatigue, weight loss, hyperpigmentation, and electrolyte imbalances
  • Treatment: lifelong replacement of glucocorticoids (e.g., hydrocortisone) and mineralocorticoids (e.g., fludrocortisone)

Gout

  • Form of inflammatory arthritis caused by the deposition of monosodium urate crystals in the joints
  • Management: NSAIDs, colchicine, or corticosteroids, and urate-lowering therapy (e.g., allopurinol, febuxostat)

Thalassemia

  • Inherited blood disorder characterized by reduced hemoglobin production
  • Thalassemia major: presents in early childhood with severe anemia, failure to thrive, and hepatosplenomegaly
  • Treatment: regular blood transfusions, iron chelation therapy, and bone marrow transplant

Hyperthyroidism

  • Condition characterized by excessive production of thyroid hormones
  • Causes: Graves' disease, toxic multinodular goiter, thyroiditis, and exogenous thyroid hormone intake
  • Symptoms: tachycardia, weight loss, heat intolerance, anxiety, and tremors
  • Diagnosis: based on TSH, free T4, and free T3 levels
  • Treatment: antithyroid drugs, radioactive iodine ablation, and thyroidectomy

Bacterial Sinusitis

  • Infection of the paranasal sinuses, often following a viral upper respiratory infection
  • Symptoms: facial pain, purulent nasal discharge, fever, and dental pain
  • Diagnosis: based on clinical presentation and duration of symptoms (>10 days)
  • Treatment: antibiotics, nasal corticosteroids, and decongestants

Cushing's Syndrome

  • Condition characterized by excess glucocorticoid levels
  • Causes: endogenous (pituitary adenoma, adrenal tumors, ectopic ACTH secretion) or exogenous (steroid abuse)
  • Symptoms: central obesity, moon facies, buffalo hump, and proximal muscle weakness
  • Diagnosis: based on 24-hour urinary free cortisol, late-night salivary cortisol, and low-dose dexamethasone suppression test
  • Treatment: depends on the underlying cause and may include surgery, radiation, or medication

Vitamin D Deficiency

  • Condition characterized by low levels of serum 25-hydroxyvitamin D
  • Risk factors: limited sun exposure, dark skin pigmentation, malabsorption disorders, and obesity
  • Symptoms: bone pain, weakness, and increased risk of fractures
  • Diagnosis: based on serum 25-hydroxyvitamin D levels
  • Treatment: oral vitamin D supplementation (cholecalciferol or ergocalciferol)

Asthma Exacerbation

  • Acute worsening of asthma symptoms, often triggered by viral infections, allergens, or irritants
  • Severity assessed based on peak expiratory flow rate, oxygen saturation, and degree of respiratory distress
  • Treatment: depends on the severity of the exacerbation and may include SABA, prednisone, and oxygen therapy- Cardiovascular*
  • Tx: CCB + BB + nitrates for symptomatic relief
  • Consider additional therapies: CRT, heart transplantation, or mechanical circulatory support for end-stage disease
  • Cardiac surgery consult, CT, and intubation for a suspected AAA
  • Heparin therapy, dopamine, and Swan-Ganz catheter are not initial management for AAA
  • Pulmonary*
  • Chylothorax is associated with spontaneous pneumothorax, not bronchus, diaphragm, or esophagus rupture
  • Milky pleural effusion after a motor vehicle collision indicates chylothorax
  • Arrhythmia*
  • SVT in PEDS: Vagal maneuvers are first-line treatment, followed by adenosine or sync cardioversion if needed
  • Neurology*
  • TIA in the vertebrobasilar arterial system: vertigo, ischemia, and aphasia are symptoms
  • Amaurosis fugax is a symptom of retinal or ophthalmic artery ischemia, not vertebrobasilar ischemia
  • Congenital Heart Defects*
  • VSD is the most common congenital heart defect and can cause a holosystolic murmur in neonates
  • PDA typically presents with a continuous or machinery-like murmur
  • Hepatitis C*
  • Risk factors: IV drug use, high-risk sexual behavior, blood transfusion before 1992
  • First-line treatment: Direct-acting antivirals (DAAs) like sofosbuvir and ledipasvir
  • Hypercalcemia*
  • Common in postmenopausal women and patients with renal disease
  • Presents with bones, stones, abdominal groans, and psychic moans
  • First-line treatment: Surgical removal of parathyroid adenoma if present
  • Retina*
  • Central Retinal Vascular Occlusion: sudden, painless loss of vision, often unilateral
  • Funduscopic exam shows retinal edema and cherry-red spot
  • Myasthenia Gravis*
  • Chronic autoimmune disorder affecting the neuromuscular junction
  • Antibodies against AChR or muscle-specific kinase impair contraction
  • Presents with proximal muscle weakness, worsens with repetition, and improves with rest
  • Diagnosed with EMG, decremental response to repetitive nerve stimulation, and serum Anti-AChR or MuSK
  • Lambert-Eaton Myasthenic Syndrome (LEMS)*
  • Autoimmune disorder affecting the presynaptic neuromuscular junction
  • Antibodies against voltage-gated calcium channels impair ACh release
  • Presents with proximal muscle weakness, improving with repetition
  • Diagnosed with EMG showing incremental response to repetitive stimulation
  • Treated with 3,4-diaminopyridine, immunosuppressants, and cancer screening
  • Guillain-Barré Syndrome*
  • Acute inflammatory demyelinating syndrome
  • Autoimmune attack on peripheral nerve myelin sheaths
  • Presents with ascending muscle weakness and paresthesias
  • Diagnosed with clinical presentation, exam, and CSF analysis
  • Treated with supportive care, IVIG or plasmapheresis in acute phase
  • Gout*
  • Meds that worsen gout: thiazide diuretics, beta blockers, ACE inhibitors, loop diuretics
  • Renal Cell Carcinoma*
  • Risk factors: smoking, hypertension, end-stage kidney disease, family history
  • Symptoms: flank pain, hematuria, palpable abdominal mass
  • Diagnosed with CT or MRI, and tissue analysis after nephrectomy
  • Adjuvant pembrolizumab for intermediate-high risk after nephrectomy
  • Nephritic and Nephrotic Syndromes*
  • Nephritic syndrome: glomerular inflammation, hematuria, proteinuria, hypertension, and edema
  • Nephrotic syndrome: heavy proteinuria, hypoalbuminemia, hyperlipidemia, and edema
  • Causes of nephritic syndrome: post-streptococcal glomerulonephritis, IgA nephropathy, lupus nephritis
  • Causes of nephrotic syndrome: minimal change disease, focal segmental glomerulosclerosis, membranous nephropathyHere are the study notes for the text:

Childhood Viral Exanthems

  • Rubeola (Measles): • Prodrome of 3Cs (cough, coryza, conjunctivitis) • Koplik spots (small white spots on buccal mucosa) appear 2 days before rash onset • Maculopapular rash begins on the face and spreads downward, becoming confluent • Rash appears around day 4 of illness • Contagious from 4 days before to 4 days after rash onset
  • Roseola (Exanthem subitum): • Primarily affects infants and young children (6-30 months old) • High fever (>39.5°C or 103°F) for 3-5 days, followed by rapid defervescence • Pink maculopapular rash appears as fever subsides, starting on the trunk and spreading to the extremities • Rash typically lasts 1-2 days • Caused by human herpesvirus 6 (HHV6)
  • Erythema infectiosum (Fifth disease): • Caused by parvovirus B19 • "Slapped cheek" appearance: bright red, well-demarcated rash on cheeks • Lacy, reticular rash on trunk and extremities follows the facial rash • Rash may wax and wane for several weeks, exacerbated by heat, stress, or exercise • Prodromal symptoms (low-grade fever, malaise) may occur 7-10 days before rash onset
  • Rubella (German measles): • Mild, post-auricular cervical lymphadenopathy • Maculopapular rash begins on the face and spreads downward, lasting 3-5 days • Rash is less confluent and fades more quickly than measles rash

Other Medical Conditions

  • Nephrotic syndrome: • Proteinuria, hypoalbuminemia, hyperlipidemia, and edema • No hypertension or hematuria
  • Sarcoidosis: • Hilar adenopathy, uveitis, elevated ACE levels
  • Rheumatoid arthritis: • Symmetric small joint arthritis, elevated ESR, 20% RF negative
  • Female Infertility: • Consider hysterosalpingogram to evaluate tubal scarring/adhesions if hx of PID or appendicitis

Pharmacology

  • Mycoplasma pneumonia during pregnancy: • Erythromycin is the drug of choice
  • Thrombocytopenia: • Platelet count below 100,000/μL • Causes: pregnancy, hepatitis B & C, HIV, chronic liver disease, medications, malignancies • Spontaneous bleeding: usually occurs when platelets are below 10,000/μL • Surgical bleeding: typically happens when platelets are below 50,000/μL • Treatment: address the underlying cause and maintain platelets above 20,000/μL

Genetics

  • Down Syndrome: • Trisomy 21 confirmed by karyotyping • Physical: up-slanting eyes, flat facial profile, single palmar crease, hypotonia, congenital heart defects • Cognitive: intellectual disability, developmental delay, characteristic facial features
  • Turner Syndrome: • 45,X karyotype or mosaic pattern confirmed by karyotyping • Physical: short stature, webbed neck, wide-spaced nipples, cubital valgus, ovarian dysgenesis leading to amenorrhea and infertility • Other: lymphedema, cardiac abnormalities, renal anomalies

Hematology

  • Essential Thrombocytosis: • Elevated platelet count • JAK2 mutation • Increased risk of thrombosis • Hemorrhagic complications
  • Myelofibrosis: • Bone marrow fibrosis • JAK2 mutation • Splenomegaly • Anemia • Teardrop cells
  • Polycythemia Vera: • Elevated red blood cell mass • JAK2 mutation • Splenomegaly • Thrombosis • Pruritus after showering
  • Acute Myeloid Leukemia (AML): • Auer rods • p53 mutation • Cytogenetic abnormalities • Bone marrow failure • Acute onset • Fever, bone pain, and bleeding • Splenomegaly
  • Chronic Lymphocytic Leukemia (CLL): • Smudge cells • CD5+, CD23+ • Lymphocytosis • Hypogammaglobulinemia • Painless lymphadenopathy

Infectious Diseases

  • Blastomycosis: • Often presents with flu-like symptoms • Typically found in the Midwest and South • Disseminated disease may involve the skin, bones, and CNS • Exact diagnostic criteria: identification of Blastomyces dermatitidis in culture or tissue biopsy • Pathognomonic: broad-based budding yeast forms on histopathology • Red flags: disseminated disease, CNS involvement • Treatment cornerstone: antifungal therapy with itraconazole or amphotericin B

Immune System

  • Type III allergic reaction: • Immune complex-mediated • Timing of reaction: 3-10 hours • Common symptom: arthralgia • Cause: medications (e.g., PCN)
  • Type II allergic reaction: • Antibody-mediated • Timing of reaction: 6-24 hours • Common symptom: low platelets • Cause: transfusions, Rh incompatibility

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Quiz on medical conditions such as dengue and rocky mountain spotted fever, and their treatment options, including pharmacological and surgical interventions.

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