Medical Terminology and Conditions

• A thorough set of flashcard-style notes covering various medical definitions, conditions, and diagnostic indicators.

Neurological Conditions

• Neuropathy refers to a disease of the peripheral nerves.
• Radiculopathy is a disease affecting the spinal nerve root.
• Myelopathy is a disease of the spinal cord itself.
• Functional B12 deficiency can lead to peripheral neuropathy.

Dermatophyte Infections

• Trichophyton rubrum is the most common pathogenic dermatophyte.
• Terbinafine (Lamisil) is a popular treatment for onychomycosis and dermatophyte skin infections.

Onychomycosis Types

• Four types: Proximal Subungual, Distal Subungual, Superficial white, and Candidal onychomycosis.
• Proximal subungual onychomycosis is difficult to treat due to potential matrix and lunula involvement; common in immunocompromised patients.
• Superficial white onychomycosis involves direct nail plate invasion with randomly dispersed lesions that coalesce.
• Candidal onychomycosis is least common, associated with edema and erythema of proximal and lateral nail folds.

Nail Conditions

• Onychomadesis is the proximal separation of the nail plate, linked to Coxsackie virus infection.
• Onychocryptosis is the curvature of the nail plate's medial or lateral portion, also known as pincer nails.
• The Lovibond angle is used in diagnosing nail clubbing.
• Koilonychia, or spoon-shaped nails, is often associated with anemia.
• Onychopuntata (pitting) can appear on nails affected by psoriasis.
• Staph aureus is the most common pathogen in acute paronychia.

Nail Procedures

• Straight Back procedure for ingrown toenails leaves the matrix intact, making it non-permanent.
• Peripheral artery disease (PAD) patients are contraindicated for P & A or "cold-steel" nail procedures like Winograd, Frost, and Zadik.

Tinea Pedis

• T. metagrophytes is the most common cause of vesicular tinea pedis.
• Erosio Interdigitalis Blastomycetica presents as eroded, erythematous areas surrounded by macerated skin in toe webspaces in severe cases.

Melanoma Subtypes

• The four subtypes of malignant melanoma are: Superficial spreading, Nodular, Acral Lentiginous, and Lentigo Maligna melanoma.
• Superficial spreading melanoma is the most common form, characterized by a slow horizontal growth phase.
• Nodular melanoma has a short horizontal growth phase and rapidly enters vertical growth.
• Acral lentiginous melanoma frequently occurs on palms, soles, or beneath nail plates.
• Lentigo maligna melanoma develops from a benign lesion, more commonly in older individuals.

Skin Conditions

• Bowen's disease is squamous cell carcinoma (SCC) in-situ, appearing as an erythematous, well-demarcated scaly patch/plaque.
• Marjolin's ulcer is a rare SCC that arises from wounds or scars, often associated with non-healing chronic venous ulcers.
• A ganglion cyst is a mass that transilluminates and fluctuates in size.

Vascular Phenomena

• Raynaud's phenomenon color change order: White → Blue → Red.
• Mondor's sign indicates plantar ecchymosis specific to Lisfranc or calcaneal fractures.

Fractures and Tendon Issues

• Zone 2 of the fifth metatarsal is associated with Jones fractures.
• A Dancer's fracture is a shaft fracture of the fifth metatarsal.
• The Lisfranc ligament supports the transverse arch, originating on the lateral aspect of the medial cuneiform and inserting on the medial aspect of the 2nd metatarsal base.
• Posterior tibial (PT) tendon dysfunction is the most common cause of adult-acquired flatfoot.

Ulcers

• Arterial ulcers are sharply demarcated, punched-out, painful lesions usually near the lateral malleolus or dorsal foot, treated with dependency.
• Venous ulcers are superficial, shallow, painless, with exudate and irregular margins, often found over the medial malleolus.

Achilles Rupture

• Simmon's triad involves using the Matles test, Thompson test, and Dell sign to diagnose an Achilles rupture.

Podiatric Emergencies

• Five medical emergencies: Open fracture, gangrene, compartment syndrome, necrotizing fasciitis, and neurovascular compromise.

Foot Compartments

• Nine compartments of the foot: Medial, superficial, lateral, adductor, calcaneal, and 4 interossei.

Watershed Zones

• Four watershed zones: Achilles, Zone 2 of the fifth metatarsal, navicular, and PT tendon.

Achilles Testing and Imaging

• Thompson's Test: Squeeze calf, observe foot response; no movement indicates Achilles rupture (positive).
• Kager's triangle borders: Anterior = Achilles, Posterior = FHL, Inferior = Calcaneus; damage is indicated if not radiolucent.

Charcot Treatment

• Total contact cast is the best treatment for Charcot foot.

Infections

• Necrotizing fasciitis is a painful infection of the fascia that travels proximally fast.
• Gas gangrene is a non-painful, odorous infection of tissue and muscle that spreads deeper.

Deep Vein Thrombosis (DVT)

• Venous ultrasound is the gold standard for diagnosing DVT.
• Elevated D-dimer is necessary for a patient to have a DVT.

Osteoarthritis (OA)

• Osteoarthritis is the most common disorder of the musculoskeletal system, characterized by non-inflammatory destruction of articular cartilage.
• PIPJ nodules in osteoarthritis are called Bouchard's nodes, and DIPJ nodules are Heberden's nodes.
• Osteoarthritis is associated with uneven joint space narrowing.
• Two findings associated with osteoarthritis on X-ray: Osteophytes and subchondral cysts.
• Hallux Rigidus is end-stage osteoarthritis of the first metatarsophalangeal joint (MTPJ).

Pediatric Conditions

• Blount's disease is progressive tibia vara, with potential recurrence and osteoarthritis.
• Chondromalacia patellae (runner's knee) presents as anterior knee pain in young athletes (especially women) due to patellar cartilage changes.
• Osgood-Schlatter disease is traction apophysitis at the tibial tuberosity, common in males during development (9-14 y.o.), self-limiting until growth plate fusion.
• Sever's Disease is traction apophysitis of the Achilles insertion into the posterior calcaneus due to overuse injuries in athletes.
• Slipped Capital Femoral Epiphysis (SCFE) involves the proximal epiphysis of the femur slipping posterior and inferior on the metaphysis in the hip joint.
• Klein's line is used as a reference to diagnose SCFE on X-rays.
• Legg-Calve-Perthes Disease is idiopathic avascular necrosis of the femoral head affecting the hip joint.
• The crescent sign is seen on radiography to help diagnose Legg-Calve-Perthes disease.
• Growing pains are idiopathic pain in the afternoon/nighttime due to overuse in an active child, non-pathogenic.

Inflammatory Myopathies

• Polymyositis is an inflammatory myopathy typically affecting adults (females > males), resulting in painful bilateral proximal weakness.
• Dermatomyositis differs from polymyositis as it affects both children and adults and presents with skin manifestations.
• Heliotrope rash is a facial rash associated with dermatomyositis.
• Calcinosis, telangiectasias, and Gottron's papules are manifestations of dermatomyositis.
• Muscle biopsy is the gold standard diagnostic technique for inflammatory myopathy.

Myositis Infiltrates

• Polymyositis: CD8+ lymphocytes infiltrate the endomysium.
• Dermatomyositis: CD4+ lymphocytes infiltrate the perimysium.
• Corticosteroids are the treatment for myopathies and vasculitis.
• Cancer is often associated dermatomyositis.
• Inclusion body myositis affects older males with asymmetric proximal and distal muscle weakness that responds poorly to corticosteroids.
• Muscle biopsy from a patient with inclusion body myositis would show inclusion bodies and rimmed vacuoles.
• Necrotizing myopathy typically results from statin therapy.

Muscular Dystrophies

• Duchenne Muscular Dystrophy (DMD) is an X-linked non-inflammatory myopathy from deficient dystrophin, typically affecting 5-6 y.o. males with waddling gait and pseudohypertrophy.
• Becker's muscular dystrophy is less severe than Duchenne's because dystrophin is abnormal, not deficient.
• Emery-Dreifuss disease: AD form has defective laminin, X-linked form has defective emerin.

Neuromuscular Disorders

• Guillain-Barré syndrome is an acute demyelinating polyneuropathy from an immune response attacking myelin, often following viral or bacterial infection, causing symmetrical distal limb weakness.
• Myasthenia gravis involves auto-antibodies attacking AChRs at the NMJ, causing weakness that improves with rest and worsens with activity; associated with ptosis, thymoma, and dysphagia.
• The edrophonium test is used to diagnose myasthenia gravis.

Rheumatoid Arthritis (RA)

• Rheumatoid arthritis is a chronic inflammatory systemic disease affecting bilateral joints, with morning stiffness.
• Boutonniere deformity, swan neck deformity, and ulnar deviation are associated with rheumatoid arthritis.
• Serology for RA shows elevated rheumatoid factor and anti-CCP.
• X-rays of RA patients show uniform joint space narrowing and erosions.

Lupus

• Systemic lupus erythematosus (SLE) is a chronic autoimmune disease with multisystem involvement, causing fever, joint pain, and rash.
• Jaccoud's arthropathy and Libman-Sacks endocarditis are associated with lupus.
• Serology for SLE shows elevated ANA, anti-dsDNA, and anti-Smith antibodies.

Scleroderma

• Scleroderma is the thickening of skin typically triggered by Raynaud's phenomenon.
• Serology for scleroderma exhibits Anti-Scl-70 and Anti-centromere antibodies.

Vasculitis Diseases

• Giant cell arteritis is large vessel vasculitis affecting the temporal artery, often causing headache.
• Kawasaki disease is medium-vessel vasculitis affecting children 5-6 y.o., associated with rashes and increased risk of cardiovascular disease.
• Behcet's disease is vasculitis associated with oral/genital ulcers with a negative STD and positive pathergy test.
• ANCA associations: Wegener's (c-ANCA), Microscopic polyangiitis (p-ANCA), Churg-Strauss (p-ANCA); medication-induced can be both.

Sjögren's Syndrome

• Sjögren's syndrome is a systemic autoimmune disease targeting salivary & lacrimal glands.
• Serology for Sjögren's syndrome shows Anti-Ro (SSA) and Anti-La (SSB) antibodies.

Seronegative Spondyloarthropathies

• Positive HLA-B27, asymmetric peripheral involvement, dactylitis, and enthesitis are indicative of seronegative spondyloarthropathies.
• Ankylosing Spondylitis (AS) affects males < 40 y.o. at the axial skeleton, especially the sacroiliac joint.
• Acute, unilateral uveitis is a systemic manifestation associated with ankylosing spondylitis.
• X-ray in ankylosing spondylitis shows bamboo spine, while MRI shows Romanus lesion.
• Diffuse idiopathic skeletal hyperostosis (DISH) is differentiated from ankylosing spondylitis as it exhibits more ossification (especially anterior longitudinal ligament - ALL) and spares the sacroiliac joint.

Psoriatic Arthritis

• Ivory phalanx, acro-osteolysis, and "pencil-in-cup" deformity are associated with psoriatic arthritis.
• DIP predominant psoriatic arthritis manifests as dactylitis; arthritis mutilans presents with telescoping digits.