Midterm Blueprint PDF

# Midterm Blueprint ## Endocrine Disorders 1. **Red flag of endocrine disorders:** * Unexplained weight changes * Fatigue * Changes in skin/hair/nail texture * Polyuria * Polydipsia * Menstrual irregularities. 2. **Common complaint of patients with endocrine disorders:**...

# Midterm Blueprint ## Endocrine Disorders 1. **Red flag of endocrine disorders:** * Unexplained weight changes * Fatigue * Changes in skin/hair/nail texture * Polyuria * Polydipsia * Menstrual irregularities. 2. **Common complaint of patients with endocrine disorders:** * Fatigue * Unexplained weight gain/loss * Increased thirst or urination * Hair changes * Mood swings. 3. **What is gynecomastia:** Enlargement of male breast tissue, 4. **Signs and symptoms of Gynecomastia:** * Often presenting as firm, movable tissue under the nipple. 5. **What is hirsutism:** * Excessive hair growth in areas where men typically grow hair, like the face, chest, and back, often due to hormonal imbalances (e.g., elevated androgens). 6. **Management of hirsutism:** * Address underlying cause (e.g., PCOS, adrenal issues) * Consider hair removal options (laser, electrolysis), and/or medications like oral contraceptives or anti-androgens 7. **Male breast malignancy, how seen in clinic:** * Palpable hard mass * Often painless * May have skin changes (redness, dimpling) * Or nipple discharge. ## Diabetes Mellitus 8. **Definition of DM Type 1:** Type 1 diabetes mellitus is an autoimmune disorder where the pancreas produces little to no insulin, typically diagnosed in childhood or adolescence. 9. **Definition of DM2:** Type 2 diabetes mellitus is a chronic condition where the body becomes resistant to insulin or the pancreas does not produce enough insulin, typically seen in adults. 10. **Microvascular complications of DM:** * Retinopathy * Nephropathy * Neuropathy. 11. **Macrovacular complications of DM:** * Coronary artery disease * Peripheral artery disease * Cerebrovascular disease (stroke). 12. **Triad of diabetic ketoacidosis:** * Hyperglycemia * Metabolic acidosis (low pH) * Ketonuria. 13. **Differential Dx of DM Type 1:** * Diabetic ketoacidosis * Hypoglycemia * Viral illnesses (e.g., flu) * Dehydration. 14. **Clinical recommendation (education) for a diabetic patient:** * Monitor blood glucose levels * Adhere to medication regimen * Eat a balanced diet * Exercise regularly * Manage stress. 15. **Risk factors of DM2:** * Obesity * Family history * Sedentary lifestyle * Age \> 45 * High blood pressure * High cholesterol. 16. **Who gets a DM screening?:** * Adults over 45 * Those with risk factors like obesity * Family history * Hypertension. 17. **Which labs for DM patients?:** * HbA1c * Fasting blood glucose * Lipid profile * Kidney function tests (creatinine, GFR) * Urine microalbumin. ## Thyroid Disorders 18. **Red flags of patient with thyroid disorders:** * Unexplained weight changes * Fatigue * Temperature sensitivity * Mood changes * Hair loss * Neck swelling. 19. **Clinical presentation of hyperthyroidism:** * Weight loss * Heat intolerance * Tremors * Palpitations * Hyperactivity * Increased appetite. 20. **Treatment of patient with hyperthyroidism:** * Antithyroid medications (methimazole) * Radioactive iodine therapy, or * Surgery. 21. **Symptoms of hypothyroidism:** * Weight gain * Fatigue * Cold intolerance * Dry skin * Constipation, * Depression, * Bradycardia. 22. **Definition of myxedema coma:** A severe, life-threatening form of hypothyroidism with: * Altered mental status, * Hypothermia, * Respiratory depression. 23. **Goal of treatment for a patient with Cushing's syndrome:** * Normalize cortisol levels * Treat the underlying cause (e.g., tumor removal, medication adjustments). 24. **Education for a Cushing's syndrome patient:** * Monitor blood sugar * Prevent infection * Avoid trauma * Discuss medication adherence. 25. **Most common cardiac arrhythmia in the US:** * **Atrial fibrillation:** Rapid, irregular heart rate due to disorganized electrical signals in the atria. 26. **Patient with A-fib 42 y/o stable, new onset, what are the treatment options?:** * **Cardioversion** in the first 48 hours: * Rate control (e.g., beta-blockers, calcium channel blockers), * Anticoagulation therapy (e.g., warfarin, DOACs), and * Rhythm control if needed (e.g., cardioversion). 27. **What is pulsus paradoxus:** An exaggerated decrease in systolic blood pressure during inspiration: Often seen in conditions like cardiac tamponade. ## Pulsus Paradoxus Defined as a fall in SBP of more than 10 mmHg during the inspiratory phase. Also known as a paradoxical pulse. It is an important physical sign of cardiac tamponade. Certain pulmonary and cardiac conditions that impair diastolic filling can cause an exaggerated decrease of the intrathoracic pressure during inspiration. **Pulmonary Cause** Asthma, emphysema (increased positive pressure) **Cardiac Cause** Cardiac tamponade, pericarditis, cardiac effusion (decreases movement of left ventricle) 28. **Pulsus paradoxus is more likely to be associated with:** * A. Sarcoidosis * B. Acute bronchitis * C. Status asthmaticus * D. Bacterial pneumonia ## Hypertension 29. **Definition of hypertension:** Blood pressure consistently above 130/80 mmHg. 30. **Instructions for a patient before taking BP** * no smoking, **no drinking coffee...** * Rest for 5 minutes * Avoid caffeine * Avoid tobacco * Avoid exercise 30 minutes before measurement. 31. **Macrovacular complications of HTN:** * Stroke * Myocardial infarction * Heart failure * Peripheral artery disease. 32. **Clinical findings in secondary hypertension:** * Elevated BP with identifiable causes, such as: * Pheochromocytoma * Primary hyperaldosteronism * Renovascular disease. 33. **How to diagnose a patient with HTN:** * BP over 130/90 * Confirm diagnosis with at least two separate readings on two different occasions. 34. **What defines hypertensive urgency:** BP \>180/120 mmHg without acute target organ damage. 35. **What is hypertensive emergency:** BP \>180/120 mmHg with evidence of acute organ damage (e.g., encephalopathy, kidney injury). 36. **Hypertension sistolica aislada en los viejitos, que lo causa?:** Arterial stiffness due to aging, leading to isolated systolic hypertension. 37. **Patient recently diagnosed with grade 1 HTN, initial recommendations:** * **Lifestyle modification:** * Diet changes (e.g., DASH diet) * Weight loss * Increased physical activity * Reduce alcohol * Reduce sodium intake * Stress management. 38. **Factores de precipitación de heart failure:** * Non-compliance with medications * Excessive fluid intake * Infections * Myocardial ischemia. 39. **Signs and symptoms of patient with left ventricular heart failure:** * Dyspnea * Fatigue * Orthopnea * Pulmonary edema (e.g., crackles on auscultation). 40. **Signs and symptoms of heart failure:** * Shortness of breath * Swelling in legs/ankles * Fatigue * Increased weight * Orthopnea. 41. **NYHA (New York Heart Associations) classifies heart failure class 2 as?:** En dependencia de la actividad física de pt * Mild symptoms of heart failure. Individuals in this class experience slight limitations of physical activity. * Comfortable at rest but ordinary activity results in fatigue or dyspnea. 42. **Patient that traveled long distance with painful, edematous, redness lower extremity...?** * **DVT** 43. **Smoker with hyperlipidemia and intermittent claudication – PAD:** * Peripheral artery disease (PAD), commonly associated with smoking and hyperlipidemia. 44. **Treatment of PAD:** * Lifestyle modification (smoking cessation, exercise) * Antiplatelet therapy, and * Possibly surgical intervention (e.g., angioplasty, bypass). 45. **Complications of PAD:** * Ulcers * Gangrene * Infection, * Critical limb ischemia. 46. **Signs and symptoms of bacterial endocarditis:** * Fever * Heart murmur, * Embolic phenomena (e.g., splinter hemorrhages, Janeway lesions), fatigue, weight loss. 47. **Symptoms of mitral valve prolapse:** * Palpitations * Chest pain * Dyspnea * Fatigue. 48. **Best treatment for asymptomatic patient with mitral valve prolapse:** * Reassurance * Monitoring, * Consideration of beta-blockers for palpitations. 49. **Lifestyle modification in patients with hyperlipidemia:** * Heart-healthy diet (low saturated fat, high fiber), * Regular exercise, * Weight loss, * Smoking cessation. 50. **Risk factors for cardiovascular disease:** * Hypertension, * Hyperlipidemia, * Smoking, Diabetes, * Family history, * Obesity, * Physical inactivity.