untitled text 21.docx

blanching, viral, dengue, rocky mountain (spotted) Petechiae: \- Tiny, red, non-\_\_\_\_\_\_\_\_ spots, commonly found in dependent areas \- Causes: thrombocytopenia, capillaritis, \_\_\_\_\_ infections (e.g., \_\_\_\_\_\_\_, \_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_ fever) BBs \_\_\_\_\_\_\_- are the initial drug of choice in a symptomatic patient with hypertrophic cardiomyopathy. hypoTN, hypoNa, hyperK, double hydro(cortisone), hydro, 5-10, surgery, ACTH, cortisol, hydro, fludro, Na, BP Adrenal Insufficiency Primary (Addison\'s disease) vs. Secondary (pituitary dysfunction) Monitor for adrenal crisis: \_\_\_\_\_\_, \_\_\_\_\_\_, \_\_\_\_\_ \_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_ dose for minor illness (e.g., cold) Increase \_\_\_\_\_\_\_\_\_ dose \_\_\_\_-\_\_\_\_x for major stress (e.g., \_\_\_\_\_\_\_) Dx: \_\_\_\_\_\_\_ stimulation test Serum \_\_\_\_\_\_\_ levels Electrolyte panel Tx: Glucocorticoid replacement (e.g., \_\_\_\_\_\_\_\_) Mineralocorticoid replacement (e.g., \_\_\_\_\_\_\_\_) for primary adrenal insufficiency to maintain \_\_\_\_\_\_ and \_\_\_\_\_\_\_\_ Educate on stress dosing and emergency injection kit Make, Downs, 48, entero, contrast, constricted, proximal, suction, pullthru 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, \_\_\_\_\_\_ predominance (4:1), \_\_\_\_\_ association Clinical presentation: \- Delayed meconium passage (\>\_\_\_\_\_ hours), progressive constipation, abdominal distension, failure to thrive, \_\_\_\_\_\_\_colitis (life-threatening) Diagnosis: \- \_\_\_\_\_\_ enema: \_\_\_\_\_\_ rectum, dilated \_\_\_\_\_\_\_ colon \- Rectal \_\_\_\_\_\_ biopsy: absent ganglion cells \- Anorectal manometry: absent rectoanal inhibitory reflex Treatment: \- Rectal irrigations, stool softeners \- Definitive surgery: \_\_\_\_\_\_\_\_\_\_ procedure \- Enterocolitis: IV antibiotics, rectal irrigations, decompression virchows, boobs, lungs, balls Metastatic cancer node \_\_\_\_\_\_\_\_ node (left supraclavicular) Types: Gastrointestinal, \_\_\_\_\_\_\_, \_\_\_\_\_\_\_, \_\_\_\_\_\_ cancers preauric Viral conjunctivitis is associated with copious watery discharge and \_\_\_\_\_\_\_\_ adenopathy. estrogen, uterus, progestin HRT for Menopausal sxs: \_\_\_\_\_\_\_-only HRT if no \_\_\_\_\_\_\_, estrogen + \_\_\_\_\_\_ HRT if intact T10 The dermatome \_\_\_\_\_ is at the level of the umbilicus ulcerations, linear, transverse \_\_\_\_\_\_\_ tend to be \_\_\_\_\_\_ with \_\_\_\_\_\_ fissures in Crohn\'s disease. These skip lesions are common with Crohn\'s disease. Not studied (756) You haven\'t studied these terms yet! Select these 756 nonradiating, emesis, lipase, amylase, hypertri(glyceridemia), CT, necrosis Acute pancreatitis Acute pancreatitis presents with severe, \_\_\_\_\_\_\_\_\_\_ abdominal pain and \_\_\_\_\_\_\_\_\_ Elevated \_\_\_\_\_\_\_\_ and \_\_\_\_\_\_\_ levels are key diagnostic markers Alcoholism and \_\_\_\_\_\_\_\_\_\_\_\_\_ are risk factors for acute pancreatitis \_\_\_\_\_\_\_\_\_ can reveal pancreatic inflammation and \_\_\_\_\_\_\_\_\_\_\_\_ Treatment involves supportive care, pain management, and addressing the underlying cause recessive, heterozygous, 25, malaria Sickle cell anemia is an autosomal \_\_\_\_\_\_\_\_ disorder If both parents are carriers (\_\_\_\_\_\_\_\_\_), there is a \_\_\_\_\_\_% chance of having a child with sickle cell anemia Sickle cell trait is the carrier state, where the individual has one normal and one sickle cell gene Sickle cell trait provides some protection against \_\_\_\_\_\_\_\_ Genetic counseling is essential for couples with sickle cell trait levo, tmpsmx, ceft Pyelonephritis is a bacterial infection of the kidney \_\_\_\_\_\_\_\_\_\_, a fluoroquinolone antibiotic, is the most appropriate choice for outpatient treatment Other antibiotics used for pyelonephritis include \_\_\_\_\_\_\_\_ and \_\_\_\_\_\_\_ Urine culture and sensitivity should guide antibiotic selection Hospitalization may be necessary for severe cases or immunocompromised patients Measles, cough, runny nose, Klopik, buccal, cheek, 3-5, PNA, sclerosing panenceph(alitis) \_\_\_\_\_\_\_\_\_ presents with fever, \_\_\_\_\_\_\_\_\_, coryza (\_\_\_\_\_\_ \_\_\_\_\_\_\_), and conjunctivitis \_\_\_\_\_\_\_\_\_ spots (small white spots on the \_\_\_\_\_\_\_\_ \[\_\_\_\_\_\_\] mucosa) are pathognomonic for measles The rash appears \_\_\_\_-\_\_\_\_ days after the onset of symptoms and spreads from the head to the trunk and extremities Complications include \_\_\_\_\_\_\_\_, encephalitis, and subacute \_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_ (SSPE) brain, measles, inflammation, memory loss, myoclonic, antibody, MRI, 1-3 Subacute Sclerosing Panencephalitis (SSPE) Definition: SSPE is a progressive, fatal \_\_\_\_\_\_ disorder caused by persistent infection with the \_\_\_\_\_\_\_\_\_ virus. Pathogenesis: The virus persists in the brain and leads to chronic \_\_\_\_\_\_\_\_\_, which causes progressive damage to the central nervous system. Symptoms: The disease presents with behavioral changes, \_\_\_\_\_\_ \_\_\_\_\_\_, \_\_\_\_\_\_\_\_ jerks (sudden, involuntary muscle spasms), and eventually leads to severe neurological deterioration. Diagnosis: Diagnosis is based on clinical history of infection, characteristic EEG findings, elevated \_\_\_\_\_\_\_\_\_ titers in the cerebrospinal fluid (CSF), and typical \_\_\_\_\_ brain findings. Incidence: It is a rare complication Prognosis: The disease is usually fatal within \_\_\_\_-\_\_\_ years after symptoms begin. Prevention: Vaccination is the most effective way to prevent SSPE. 1-3, skin, hematuria, edema, HTN, dec, ASO, low, C3 Post-streptococcal glomerulonephritis (PSGN) is a common cause of acute glomerulonephritis in children ‚Ä¢ PSGN occurs \_\_\_-\_\_\_ weeks after a streptococcal infection (strep throat or \_\_\_\_\_ infection) ‚Ä¢ Clinical features include \_\_\_\_\_\_\_, \_\_\_\_\_\_, \_\_\_\_\_\_, and \_\_\_\_\_\_ urine output ‚Ä¢ Diagnosis is confirmed by elevated \_\_\_\_\_ titers and \_\_\_\_\_ complement levels (\_\_\_\_\_\_\_\_) ‚Ä¢ Treatment is supportive, and the condition usually resolves spontaneously within weeks to months 30, fullness, nausea, flushing, palps, lightheaded(ness), 1-3, hypogly, simple sugars, somato(statin), ocreotide Dumping syndrome is a common complication after gastric surgery Early dumping syndrome occurs within \_\_\_\_\_\_\_ minutes of eating and is caused by rapid gastric emptying Symptoms include abdominal \_\_\_\_\_\_\_\_, \_\_\_\_\_\_\_, diarrhea, and vasomotor symptoms (\_\_\_\_\_\_\_\_, \_\_\_\_\_\_\_\_, \_\_\_\_\_\_\_) Late dumping syndrome occurs \_\_\_-\_\_\_ hours after eating and is caused by reactive \_\_\_\_\_\_\_ Treatment involves dietary modifications (small, frequent meals; avoiding \_\_\_\_\_\_ \_\_\_\_\_\_) and, in severe cases, \_\_\_\_\_\_\_\_ analogs (\_\_\_\_\_\_\_\_) amen(horrea), infertility, bromo(criptine), caber(goline), MRI Hyperprolactinemia can cause \_\_\_\_\_\_\_\_, galactorrhea, and \_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_\_\_, a dopamine agonist, is the first-line treatment for hyperprolactinemia Other dopamine agonists, such as \_\_\_\_\_\_\_\_, can also be used Pituitary \_\_\_\_\_\_\_\_ should be performed to rule out a prolactinoma Regular monitoring of prolactin levels and symptoms is necessary during treatment granulomatous, meibomian, duct, painless, triam(cinolone), bacitracin, doxy, azith, ID, visual, hygiene A chalazion is chronic \_\_\_\_\_\_\_\_\_ lesion of the \_\_\_\_\_\_\_\_\_ gland in the eyelid due to \_\_\_\_\_\_\_ blockage. Symptoms: A \_\_\_\_\_\_\_ eyelid lump, potentially red and swollen if inflamed. Diagnosis: Typically clinical, based on the appearance of a slow-growing eyelid mass; may use slit lamp or ultrasound for uncertain cases. Treatment: Warm Compresses: Primary treatment to promote resolution. Intralesional Steroids: \_\_\_\_\_\_\_\_\_ injections for persistent inflammation. Antibiotics: Topical erythromycin or \_\_\_\_\_\_\_\_ for infection; oral \_\_\_\_\_\_\_ or \_\_\_\_\_\_\_\_ for severe cases. \_\_\_\_\_\_\_\_: Recommended for chalazia unresponsive to treatment after several weeks, causing significant cosmetic or \_\_\_\_\_ issues, or when malignancy is suspected. Prognosis: Typically resolves within weeks to months; persistent cases require intervention. Prevention: Good \_\_\_\_\_\_\_\_ to prevent gland blockage. ext(ernal), pseudo(monas), StrepPNA, media, DM, prolong(ed), media, kids, not, ear, 7-11, face, swallow(ing), voice, postauric, IV, cipro, ceftazadime, ceft, clinda, myringo Malignant Otitis Externa: Invasive infection of the \_\_\_\_\_ auditory canal, typically caused by \_\_\_\_\_\_\_\_\_\_\_. Mastoiditis: Infection resulting from \_\_\_\_\_\_\_\_, H. influenzae, or Moraxella catarrhalis, secondary to otitis \_\_\_\_\_\_\_\_\_. Risks: Malignant: \_\_\_\_\_\_\_\_, \_\_\_\_\_\_\_ antibiotic use. Mastoiditis: Mostly follows untreated or inadequately treated otitis \_\_\_, common in \_\_\_\_\_, \_\_\_\_\_ directly linked to prolonged abx. Sxs: Malignant: Severe \_\_\_\_\_\_ pain, purulent discharge, & cranial nerve palsies (CN\_\_\_-\_\_\_ \[\_\_\_\_\_\_, \_\_\_\_\_, \_\_\_\_\_\]), indicating deeper & more extensive tissue involvement. Mastoiditis: Symptoms include \_\_\_\_\_\_ pain, swelling, tenderness, fever, & discharge. Tx: Malignant: Requires \_\_\_\_ abx like \_\_\_\_\_ or \_\_\_\_\_\_ for \_\_\_-\_\_\_ weeks, surgical debridement, and strict glucose control for diabetics. Mastoiditis: Generally treated with IV antibiotics such as \_\_\_\_\_ or \_\_\_\_\_, with potential need for \_\_\_\_\_\_\_otomy beta, uptake, muscles Type 2 diabetes is characterized by insulin resistance and progressive \_\_\_\_\_\_-cell dysfunction Insulin resistance leads to impaired \_\_\_\_\_\_ of glucose by the \_\_\_\_\_ and other tissues Compensatory hyperinsulinemia occurs initially, but over time, beta-cells fail to keep up with the increased demand Long-term complications include cardiovascular disease, neuropathy, nephropathy, and retinopathy HA, papilledema, dry(ness), liver Vitamin A toxicity can occur due to excessive intake of vitamin A supplements or megavitamins Symptoms include \_\_\_\_\_\_\_\_, blurred vision, \_\_\_\_\_\_\_\_, nausea, and skin changes (\_\_\_\_\_\_\_\_, peeling) Chronic toxicity can lead to \_\_\_\_\_\_\_ damage, bone pain, and increased intracranial pressure Diagnosis is based on clinical presentation and elevated serum vitamin A levels Treatment involves discontinuation of vitamin A supplements and supportive care cortex, loss, hypoTN, hyperpig, hypoNa, hyperK, hydro(cortisone), fludro(cortisone), salt Addison\'s disease is a primary adrenal insufficiency caused by destruction of the adrenal \_\_\_\_\_\_ It results in deficiencies of glucocorticoids, mineralocorticoids, and androgens Symptoms include fatigue, weight \_\_\_\_\_, \_\_\_\_\_\_, \_\_\_\_\_\_, and electrolyte imbalances (\_\_\_\_\_\_, \_\_\_\_\_\_\_) Treatment involves lifelong replacement of glucocorticoids (\_\_\_\_\_\_\_\_\_) and mineralocorticoids (\_\_\_\_\_\_\_\_) Patients should be advised to maintain a liberal \_\_\_\_\_\_\_\_ intake to help maintain blood pressure and electrolyte balance monosodium urate, colchicine, allopurinol, febux(ostat) Gout is a form of inflammatory arthritis caused by the deposition of \_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_ crystals in the joints Acute gout attacks present with severe pain, erythema, and swelling of the affected joint (often the first MTP joint) Management of acute gout includes NSAIDs, \_\_\_\_\_\_\_\_\_, or corticosteroids Patients should be advised to limit physical activity and rest the affected joint during an acute attack Long-term management involves urate-lowering therapy (\_\_\_\_\_\_\_\_, \_\_\_\_\_\_\_), dietary modifications, and lifestyle changes tim(olol), 2, propan(olol), aten(olol) Beta-blockers, including \_\_\_\_\_\_\_\_\_ ophthalmic solution, can trigger bronchospasm in patients with asthma This is due to the blockade of beta-\_\_\_ receptors in the airways, which normally promote bronchodilation Nonselective beta-blockers (e.g., \_\_\_\_\_\_\_\_) have a higher risk of bronchospasm than cardioselective agents (e.g., \_\_\_\_\_\_\_\_\_) Patients with asthma should be cautious when using any beta-blocker, including topical formulations Alternative medications should be considered for patients with asthma requiring beta-blocker therapy for other conditions cholecystitis, inflamm(ation), stones, weight loss, constant, fever, Murphys, ceft, metro, US, 6-8 Acute \_\_\_\_\_\_\_\_ is an \_\_\_\_\_\_\_\_\_\_ of the gallbladder, usually caused by obstruction of the cystic duct by \_\_\_\_\_\_\_\_\_ Risk factors include obesity, female sex, age over 40, and rapid \_\_\_\_\_\_ \_\_\_\_\_\_ Symptoms include severe, \_\_\_\_\_\_\_\_ right upper quadrant pain, nausea, vomiting, and \_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_\_ sign (abrupt cessation of inspiration during palpation of the right upper quadrant) is a classic finding Treatment involves antibiotics (e.g., \_\_\_\_\_\_ & \_\_\_\_\_\_, pain management, and cholecystectomy Acute cholecystitis is caused by gallstones in 90% of cases Other causes include acalculous cholecystitis and gallbladder cancer Complications include gallbladder perforation, empyema, and sepsis \_\_\_\_\_\_\_\_\_ is the imaging modality of choice for diagnosis Delayed cholecystectomy (\_\_\_\_-\_\_\_\_ weeks after initial presentation) may be considered in high-risk patients Hgb, early, anemia, hepatospleno, electropheresis, transfus(ions), iron, defer(asirox), marrow Thalassemia: A 2-year-old child of Mediterranean descent presents with pallor, failure to thrive, and abdominal distension. High-yield points: Thalassemia is an inherited blood disorder characterized by reduced \_\_\_\_\_\_\_\_\_ production Thalassemia major presents in \_\_\_\_\_\_ childhood with severe \_\_\_\_\_\_\_ and \_\_\_\_\_\_\_\_\_megaly Diagnosis is based on CBC, hemoglobin \_\_\_\_\_\_\_\_\_\_, and genetic testing Treatment for thalassemia major includes regular \_\_\_\_\_\_\_\_\_\_\_ and \_\_\_\_\_\_\_\_ chelation therapy (e.g., deferoxamine, \_\_\_\_\_\_\_\_\_\_\_) \_\_\_\_\_\_\_\_ transplant is the only curative treatment beta, transfuse(ions), iron chelation, asxs Thalassemia major (\_\_\_\_\_\_\_\_-thalassemia) presents in early childhood with severe anemia, failure to thrive, and hepatosplenomegaly Txs: \_\_\_\_\_\_ and \_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_\_ Thalassemia minor is typically \_\_\_\_\_\_\_\_ autoimmune, tachy, lid lag, pretibial, scaly, swelling, inc, toxic multinodular, meth, PTU, ablation, osteoporosis, afib Hyperthyroidism is a condition characterized by excessive production of thyroid hormones The most common cause is Graves\' disease, an \_\_\_\_\_\_\_ disorder Other causes include toxic multinodular goiter, thyroiditis, and exogenous thyroid hormone intake Symptoms include \_\_\_\_\_\_\_\_\_, weight loss, heat intolerance, anxiety, and tremors Diagnosis is based on TSH, free T4, and free T3 levels Physical findings in Graves\' disease include diffuse goiter, ophthalmopathy (proptosis, \_\_\_\_\_\_ \_\_\_\_\_\_), and \_\_\_\_\_\_\_\_ myxedema (thick, \_\_\_\_\_ plaques or \_\_\_\_\_ on the LLs) Radioactive iodine uptake is \_\_\_\_\_ in Graves\' disease and \_\_\_\_\_ \_\_\_\_\_\_ goiter Treatment options include antithyroid drugs (\_\_\_\_, \_\_\_\_\_), radioactive iodine \_\_\_\_\_\_, and thyroidectomy Beta-blockers can be used to control symptomatic tachycardia Regular monitoring of thyroid function and assessment for complications (\_\_\_\_\_\_\_\_\_, \_\_\_\_\_\_\_) is necessary maxillary, allergic, 10, amox, augmentin, strepPNA, hflu, moraxella Bacterial sinusitis is an infection of the paranasal sinuses, often following a viral upper respiratory infection Symptoms include facial pain, purulent nasal discharge, fever, and dental pain (\_\_\_\_\_\_\_\_\_\_ sinusitis) Risk factors include \_\_\_\_\_\_\_\_ rhinitis, nasal polyps, and immunodeficiency Diagnosis is based on clinical presentation and duration of symptoms (\>\_\_\_ days) Treatment involves antibiotics (\_\_\_\_\_\_\_, \_\_\_\_\_\_\_), nasal corticosteroids, and decongestants The most common pathogens in bacterial sinusitis are \_\_\_\_\_\_\_, \_\_\_\_\_\_, and \_\_\_\_\_\_\_\_ CT scan or MRI may be necessary for patients with severe symptoms or suspected complications 25, weakness, osteomalacia, rickets, Ca, cholecalc, ergocalc, 800-1000, 25 Vitamin D deficiency is a common condition characterized by low levels of serum \_\_\_\_\_\_-hydroxyvitamin D Risk factors include limited sun exposure, dark skin pigmentation, malabsorption disorders, and obesity Symptoms include bone pain, \_\_\_\_\_\_\_\_, and increased risk of fractures Severe deficiency can lead to \_\_\_\_\_\_\_ in adults and \_\_\_\_\_\_\_ in children Diagnosis is based on serum D levels Vitamin D is essential for \_\_\_\_\_\_ absorption and bone health Sources of vitamin D include sunlight exposure, fatty fish, egg yolks, and fortified foods Treatment involves oral vitamin D supplementation (\_\_\_\_\_\_\_\_iferol or \_\_\_\_\_\_\_iferol) Maintenance dosing is typically \_\_\_\_\_-\_\_\_\_\_\_ IU/day for adults Regular monitoring of serum \_\_\_\_-hydroxyvitamin D levels is necessary to ensure adequate supplementation gluco, steroid abuse, adenoma, ACTH, purple, proximal, dexameth(asone), ACTH, high, low, DM, HTN, osteoporosis, ketocon(azole), metyrapone Cushing\'s syndrome is a condition characterized by excess \_\_\_\_\_\_corticoid levels The most common cause is \_\_\_\_\_\_ \_\_\_\_\_\_. Endogenous causes include pituitary \_\_\_\_\_\_\_ (Cushing\'s disease), adrenal tumors, and ectopic \_\_\_\_\_\_\_ secretion Symptoms include central obesity, moon facies, buffalo hump, \_\_\_\_\_ striae, easy bruising, and \_\_\_\_\_\_\_ muscle weakness Diagnosis is based on 24-hour urinary free cortisol, late-night salivary cortisol, and low-dose \_\_\_\_\_\_\_\_ suppression test. On the suppression test, \_\_\_\_\_ levels can help differentiate between pituitary (\_\_\_\_\_\_ ACTH) and adrenal (\_\_\_\_\_ ACTH) causes. Cushing\'s syndrome is associated with an increased risk of \_\_\_\_\_\_, \_\_\_\_\_\_\_, and \_\_\_\_\_\_\_ Imaging studies (MRI, CT) are used to localize the source of excess cortisol production Treatment depends on the underlying cause and may include surgery, radiation, or medication (\_\_\_\_\_\_\_, \_\_\_\_\_\_\_\_) viral, peak expiratory, 70, 95, 40-70, 90-95, pred 40, 90, pred, O2, SABA, pred, 2, ipra(tropium) bromide, mag sulf, pred, action plan An asthma exacerbation is an acute worsening of asthma symptoms, often triggered by \_\_\_\_\_ infections, allergens, or irritants Severity is assessed based on \_\_\_\_ \_\_\_\_ flow rate (PEFR), oxygen saturation, and degree of respiratory distress: ‚Ä¢ Mild = PEFR \>\_\_\_\_% predicted or personal best, SpO2 \>\_\_\_\_% \- Tx w/ albuterol ‚Ä¢ Mod = PEFR \_\_\_\_-\_\_\_\_% predicted, SpO2 \_\_\_\_-\_\_\_\_% \- Tx w/ albuterol + \_\_\_\_\_ ‚Ä¢ Severe = PEFR \ \_\_\_\_\_ 3\) \_\_\_\_ \< \_\_\_\_ Also, add \_\_\_\_\_\_ \_\_\_\_\_\_\_ for Blacks severe, any, no, loops, BB, ACE(/ARB), spirono, digoxin, ivabradine, 70, ARNI, sac val, resync, ICD NYHA Class IV (\_\_\_\_\_\_\_\_): Unable to carry out \_\_\_\_\_\_\_ physical activity without discomfort Comfortable at rest? \_\_\_\_\_\_\_\_\_ Tx: \_\_\_\_\_ + \_\_\_\_\_ + \_\_\_\_\_\_\_ + \_\_\_\_\_\_ + \_\_\_\_\_\_\_\_ (for symptomatic relief) + \_\_\_\_\_\_\_\_ (if HR ‚â \_\_\_\_ bpm despite optimal therapy) Consider the following additional therapies: \_\_\_\_\_\_\_ (\_\_\_\_\_ \_\_\_\_\_) for persistent symptoms despite optimal therapy Cardiac \_\_\_\_\_\_\_\_ therapy (CRT) or \_\_\_\_\_\_\_ for select patients Heart transplantation or mechanical circulatory support for end-stage disease surgery consult, CT, intubat(ion) aortic abdominal aneurysm (AAA). \_\_\_\_\_\_\_ \_\_\_\_\_\_\_ is the most appropriate immediate step for a suspected AAA \_\_\_\_\_\_\_ can confirm the diagnosis \_\_\_\_\_\_\_, heparin therapy, dopamine, and Swan-Ganz catheter are not the initial management for AAA chylothorax, thoracic duct rupture, blebs milky pleural effusion (\_\_\_\_\_\_\_\_) after a motor vehicle collision. \_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_ is the most common cause \_\_\_\_\_\_\_ are associated with spontaneous pneumothorax, not chylothorax Bronchus, diaphragm, and esophagus ruptures do not typically cause chylothorax ice, diving, carotid massage, adenosine, sync cardioversion supraventricular tachycardia (SVT) in PEDS. Vagal maneuvers, such as applying \_\_\_\_\_\_ to the face or eliciting the \_\_\_\_\_\_\_ reflex, are first-line treatments for SVT in stable patients \_\_\_\_\_\_\_ \_\_\_\_\_\_ is contraindicated in children due to the risk of artery injury and stroke If vagal maneuvers fail, \_\_\_\_\_\_\_\_ or \_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_ may be necessary vertigo, ischemia, aphasia, unilat, carotid transient ischemic attack (TIA) of the vertebrobasilar arterial system. \_\_\_\_\_\_\_\_ is a common symptom of vertebrobasilar TIAs due to the involvement of vestibular pathways Amaurosis fugax is a symptom of retinal or ophthalmic artery \_\_\_\_\_\_\_\_, not vertebrobasilar ischemia \_\_\_\_\_\_\_\_\_, hemiparesis, and \_\_\_\_\_\_\_\_ sensory deficits are more common in anterior circulation (\_\_\_\_\_\_\_\_) TIAs CCBs, nifedipine, BBs, periph Raynaud\'s phenomenon. \_\_\_\_\_\_\_\_\_\_, such as \_\_\_\_\_\_\_\_\_, are the first-line treatment for Raynaud\'s phenomenon \_\_\_\_\_\_\_\_\_\_ may worsen Raynaud\'s symptoms by reducing \_\_\_\_\_\_ blood flow VSD, holosys, PDA, PFO, no \_\_\_\_\_\_ is the most common congenital heart defect and can cause a \_\_\_\_\_\_\_\_\_ murmur in neonates \_\_\_\_\_\_ typically presents with a continuous or machinery-like murmur, not a holosystolic murmur \_\_\_\_\_\_ is a normal finding in neonates and typically causes \_\_\_\_\_\_\_\_ murmur back, 5.5, 3 Abdominal Aortic Aneurysm (AAA) ‚Ä¢ Demographics: Most common in men over 65, smokers, and those with a family history. ‚Ä¢ Classic Presentation: Often asymptomatic; may have \_\_\_\_\_ pain, pulsatile abdominal mass, or abdominal pain. ‚Ä¢ Treatment: ‚Ä¢ First-Line: Surgical repair for aneurysms \>\_\_\_\_cm or symptomatic. ‚Ä¢ Alternatives: Watchful waiting with regular imaging for smaller aneurysms. ‚Ä¢ Diagnostic Criteria: Diameter \>\_\_\_cm on imaging. ‚Ä¢ Red Flags: Sudden severe back or abdominal pain (may indicate impending rupture). RNA, PCR, ribavirin, sofo(sbuvir), ledip(asvir), sustained Hepatitis C Virus (HCV) Management ‚Ä¢ Demographics: Risk factors include IV drug use, high-risk sexual behavior, blood transfusion before 1992. ‚Ä¢ Classic Presentation: Often asymptomatic, may have fatigue, jaundice. ‚Ä¢ Diagnostics: ‚Ä¢ Labs: HCV \_\_\_\_\_\_ quantitative \_\_\_\_\_\_ to measure viral load. ‚Ä¢ Imaging: Not applicable for virus quantification. ‚Ä¢ Treatment: ‚Ä¢ First-Line: Direct-acting antivirals (DAAs): \_\_\_\_\_\_\_, \_\_\_\_\_\_, \_\_\_\_\_\_ ‚Ä¢ Alternatives: Different combinations of DAAs based on genotype. ‚Ä¢ Important Notes: Goal is to achieve a \_\_\_\_\_\_\_\_ virologic response (SVR), which is indicative of cure. postmeno, CA, stones, abd, moans, PTH, phos, calcitonin, 14, IVF, loops Hypercalcemia Management ‚Ä¢ Demographics: Common in \_\_\_\_\_\_\_\_\_ women, patients with \_\_\_\_\_\_. ‚Ä¢ Classic Presentation: Bones, \_\_\_\_\_\_, \_\_\_\_\_\_ groans, psychic \_\_\_\_\_\_\_. ‚Ä¢ Diagnostics: ‚Ä¢ Labs: Elevated serum calcium and \_\_\_\_\_\_\_\_-; low \_\_\_\_\_\_\_. ‚Ä¢ Treatment: ‚Ä¢ First-Line: Surgical removal of parathyroid adenoma if present. ‚Ä¢ Alternatives: Bisphosphonates or \_\_\_\_\_\_\_ if surgery not possible. ‚Ä¢ Important Notes: Hypercalcemia of malignancy treated differently than primary hyperparathyroidism. ‚Ä¢ Red Flags: Severe hypercalcemia (\>\_\_\_\_ mg/dL) can be life-threatening. ‚Ä¢ Treatment Cornerstone: Address underlying cause; For severe: \_\_\_\_\_\_ followed by \_\_\_\_\_\_\_ painless, unilat, whitening, cherry red, refer Central Retinal Vascular Occlusion Demographics: More common in the elderly and those with vascular risk factors (hypertension, diabetes). Classic Presentation: Sudden \_\_\_\_\_\_ visual loss, often \_\_\_\_\_\_. Imaging: Funduscopic exam shows retinal \_\_\_\_\_\_\_ and \_\_\_\_\_ \_\_\_\_\_ spot. Treatment: First-Line: \_\_\_\_\_\_\_\_\_ autoimmune, junction, acetylcholine, kinase, 20-40, women, men, intermittent, fatigable, ptosis, diplopia, smile, proximal, bulbar, rest, edro(phonium), EMG, MuSK, ice, ptosis, bx, pyrido(stigmine), pred, azath, mofetil, IVIG, thymectomy Myasthenia Gravis chronic \_\_\_\_\_ disorder affecting the neuromuscular \_\_\_\_\_ antibodies against \_\_\_\_\_ receptor (AChR) or muscle-specific \_\_\_\_\_ impair contraction ‚Ä¢ Peak incidence: \_\_\_\_\_-\_\_\_\_\_ years old, \_\_\_\_\_ \> \_\_\_\_ (2:1 ratio) Clinical Presentation: \_\_\_\_\_, \_\_\_\_\_ weakness of muscles: \+ Extraocular (\_\_\_\_\_, \_\_\_\_\_) \+ Facial (\_\_\_\_\_) \+ \_\_\_\_\_ (arms \> legs) \+ \_\_\_\_\_ (swallowing, speech) Sxs worsen with repetition and improve with \_\_\_\_\_ Diagnostic Evaluation: \_\_\_\_\_ test: rapid improvement in strength \_\_\_\_\_: decrementing response to repetitive nerve stimulation Serum: AChR or \_\_\_\_\_\_\_\_ (not 100% sens) \_\_\_\_\_\_ pack test: improves strength (e.g. \_\_\_\_\_\_\_\_) Muscle \_\_\_\_\_\_\_: rules out other conditions Treatment: Acetylcholinesterase inhibs: \_\_\_\_\_, neostigmine Immunosuppressants: \_\_\_\_\_ \_\_\_\_\_, mycophenolate \_\_\_\_\_ (steroid-sparing) \_\_\_\_\_, plasmapheresis (severe cases) \_\_\_\_\_: for thymoma or refractory PT, speech therapy, resp support Ca, acetylcholine, proximal, legs, hips, improves, MG, SCLC, EMG, improvement, legs, arms, improves, 34-DAP Lambert-Eaton myasthenic syndrome (LEMS) Autoimmune disorder affecting the presynaptic neuromuscular junction Antibodies against voltage-gated \_\_\_\_\_\_\_\_ channels impair \_\_\_\_\_\_\_ release Presents with \_\_\_\_\_\_\_ muscle weakness, especially in the \_\_\_\_\_\_ and \_\_\_\_\_ Weakness \_\_\_\_\_\_\_ with repeated muscle use (opposite of \_\_\_\_\_) Associated with \_\_\_\_\_\_\_ in \~50% of cases Diagnosed with \_\_\_\_\_\_\_ showing incremental \_\_\_\_\_\_\_ to repetitive stimulation Treated with 3,4-diaminopyridine, immunosuppressants, and cancer screening It\'s important to differentiate LEMS from MG because: The pattern of weakness is different (\_\_\_\_\_ \> \_\_\_\_\_, \_\_\_\_\_\_ with use) LEMS is often paraneoplastic and requires cancer screening Treatment involves \_\_\_\_\_-\_\_\_\_\_\_ instead of acetylcholinesterase inhibitors myelin, campy, CMV, EBV, acute, areflexia, symmetric, labile, ileus, protein, WBC, albumin, EMG, resp, IVIG, pre, months, vent Guillain-Barr√© syndrome Acute inflammatory demyelinating synd Autoimmune attack on peripheral nerve \_\_\_\_ sheaths Often triggered by preceding infection (e.g., \_\_\_\_, \_\_\_\_, \_\_\_\_) Presentation: \_\_\_\_ ascending muscle weakness and \_\_\_\_ \_\_\_\_, starts in legs and spreads upwards Paresthesias and neuropathic pain common Autonomic dysfunction: \_\_\_\_ BP, urinary retention, \_\_\_\_ May progress to respiratory failure requiring intubation Dx: based on presentation and exam CSF: elevated \_\_\_\_ with normal \_\_\_\_ count (\_\_\_\_ocytologic dissociation) \_\_\_\_: prolonged distal latencies, conduction block Tx: Supportive care: close monitoring of \_\_\_\_ function \_\_\_\_\_ or plasmapheresis in acute phase to hasten recovery Pain control, PT/OT, prevention of secondary complications No role for \_\_\_\_ (may worsen outcomes) Prognosis and Recovery: Most patients recover w/i \_\_\_\_ with tx \~25% require \_\_\_\_ \~5-10% have residual weakness or other deficits chlorthal(idone), CCB, ARB, loops, ASA, clop, niacin, statin, fibrate, BBs, CCB, ARB Meds that worsen GOUT 1\. Thiazide diuretics (e.g., hydrochlorothiazide, \_\_\_\_\_) ‚Ä¢ Used for: Hypertension, heart failure, and edema ‚Ä¢ Alternative: \_\_\_\_\_\_ or \_\_\_\_\_\_ 2\. \_\_\_\_\_ ‚Ä¢ Used for: Heart failure, edema, and hypertension ‚Ä¢ Alternative: Torsemide (a loop diuretic less likely to cause gout) 3\. Low-dose \_\_\_\_\_ (used for cardiovascular protection) ‚Ä¢ Used for: Prevention of heart attacks and strokes ‚Ä¢ Alternative: \_\_\_\_\_ (an antiplatelet agent) 4\. \_\_\_\_\_ ‚Ä¢ Used for: Dyslipidemia (high cholesterol and triglycerides) ‚Ä¢ Alternative: \_\_\_\_\_ or \_\_\_\_\_\_ 5\. \_\_\_\_\_\_ (e.g., atenolol, metoprolol) Used for: Hypertension, angina, and heart failure Alternative: \_\_\_\_\_\_ or \_\_\_\_\_\_\_ 13-14, 3-4, 2, 17, estrogen, nuts Gynecomastia is a common finding in males during early puberty (ages \_\_-\_\_, Tanner stage \_\_-\_\_) Occurs in 50% of males at some point during adolescence Results from relative imbalance between estrogen and testosterone levels Males reach adult testosterone levels after estrogen rises, causing temporary imbalance Gynecomastia in males and asymmetric breasts in females are normal aspects of puberty Reassurance is all that is required in these cases Further evaluation is indicated if gynecomastia persists \>\_\_ years or past age \_\_ Serum \_\_\_\_\_ is not elevated in physiologic gynecomastia 24-hour testosterone and estradiol can be abnormal but are not needed for diagnosis Ultrasound is not indicated unless malignancy or infection is suspected Thorough \_\_\_\_\_\_ exam should accompany evaluation of suspicious breast masses BRCA gene is not associated with physiologic or pathologic gynecomastia smoking, fat, asbestos, renal cell carcinoma, cortex, abd, vena cava, edema, lungs, bones, liver, CT, nephrectomy, pembro Risk Factors for Renal Cell Carcinoma (in order from greatest to least risk): 1\. \_\_\_\_ 2\. \_\_\_\_ 3\. Hypertension 4\. End-stage kidney disease 5\. Strong family history of renal cell carcinoma 6\. Prior kidney irradiation 7\. Occupational exposure to \_\_\_\_ and other toxic compounds Key Points: \- \_\_\_\_ \_\_\_\_ \_\_\_\_ makes up 85% of malignancies, originating in kidney \_\_\_\_ \- Early-stage disease is often sxs \- Classic triad of later symptoms: flank pain, hematuria, palpable \_\_\_\_ kidney mass \- Inferior \_\_\_\_ \_\_\_\_ involvement can cause lower extremity \_\_\_\_, ascites, hepatic dysfunction, pulmonary emboli \- Metastatic commonly involves \_\_\_\_, lymph nodes, \_\_\_\_, \_\_\_\_, brain \- Abd \_\_\_\_ used for diagnostic evaluation; preliminary ultrasound can help distinguish benign vs malignant \- Definitive diagnosis made by tissue analysis after \_\_\_\_ \- Adjuvant \_\_\_\_lizumab for intermediate-high/high-risk after nephrectomy koil(onychia), IDA, hypoalbumin, lung CA, CF, onycholysis, paron(ychia), biting \_\_\_\_ is a spoon-shaping of the nail itself. It is usually a result of\_\_\_\_ Leukonychia is often associated with \_\_\_\_ that causes partial or complete \_\_\_\_ discoloration of the nails. Clubbing of the nails is an actual \_\_\_\_ or elevation of the nail bed - it is a sign of a release of TNF associated with pulmonary disorders (tissue necrosis factor) typically found in bronchiectasis, \_\_\_\_ \_\_\_\_, and \_\_\_\_ (the nails are NOT necessarily cyanotic.) \_\_\_\_ is a painless separation of the nail from the nail bed. Several or all nails are usually affected - there are many causes. \_\_\_\_ is an infection of the nail bed and nail margin, usually from trauma or more commonly, \_\_\_\_. nephritic, edema, HTN, azo(temia), BUN, Cr, poststrep, IgA, lupus, GP Hematuria is present in \_\_\_\_ syndromes. In those syndromes, the following are also typically seen: 1\) \_\_\_\_ 2\) \_\_\_\_ 3\) \_\_\_\_ which is dx\'d with elevated \_\_\_\_\_\_ and \_\_\_\_\_ Common causes of nephritic syndrome include: Acute \_\_\_\_\_\_\_ glomerulonephritis \_\_\_\_\_ nephropathy \_\_\_\_\_ nephritis Vasculitis (e.g., granulomatosis with polyangiitis, microscopic polyangiitis) \_\_\_\_\_\_ syndrome I, O, 3.5, I, O, I, I, low, C3, I, O Key differences between nephrItic and nephrOtic syndromes: Onset: \_\_\_\_\_ is rapid (days to weeks), the other is gradual (weeks to months) Proteinuria: \_\_\_\_\_\_ has heavy proteinuria (\>\_\_\_\_\_ g/day), the other has less Hematuria: More common in \_\_\_\_\_\_\_\_\_ Edema: Severe, generalized in \_\_\_\_\_\_\_; less prominent in the other Hypertension: More common and severe in \_\_\_\_\_\_ syndrome Renal function: \_\_\_\_\_\_\_ often causes acute kidney injury Complement levels: \_\_\_\_\_ (especially \_\_\_\_\_) in \_\_\_\_\_\_; normal in the other Lipid abnormalities: Hyperlipidemia in \_\_\_\_\_\_; not significantly affected in the other poststrep, IgA, lupus, GP, minimal change, focal, diabetic Nephritic Syndrome Nephritic syndrome involves glomerular inflammation, causing hematuria, proteinuria, hypertension, and edema. Diseases that can cause nephritic syndrome include: \_\_\_\_\_\_\_glomerulonephritis \_\_\_\_\_ nephropathy (Berger\'s disease) \_\_\_\_\_\_ nephritis \_\_\_\_\_\_ syndrome ANCA-associated vasculitis Membranoproliferative glomerulonephritis (MPGN) Nephrotic Syndrome Nephrotic syndrome is characterized by heavy proteinuria, hypoalbuminemia, hyperlipidemia, and edema. Diseases that can cause nephrotic syndrome include: \_\_\_\_\_\_ \_\_\_\_\_\_ disease \_\_\_\_\_\_ segmental glomerulosclerosis (FSGS) Membranous nephropathy \_\_\_\_\_\_\_\_ nephropathy Amyloidosis hilar, noncase(ating), eye, uveitis, Ca, uric Sarcoid typically presents with \_\_\_\_\_\_ lymphadenopathy and \_\_\_\_\_\_\_\_ granulomas of the lungs (and other organs). In addition, patients may get \_\_\_\_\_ involvement (\_\_\_\_\_\_\_). Elevations of ACE, \_\_\_\_\_\_\_ and \_\_\_\_\_ acid are frequently seen. potts, osteopenia, cortical \_\_\_\_\_ disease is TB of the spine. Seen on xray as \_\_\_\_\_\_\_ and \_\_\_\_\_\_ breakdown of vertebral bodies epi, duration Lidocaine with \_\_\_\_\_\_ both increases the \_\_\_\_\_\_ of anesthesia and decreases blood flow to the area of injection-i.e. penis, nose, fingers, toes. NSTEMI, o2, heparin, BB, ASA, tPA, morphine, ACE, nitro OH BATMAN for \_\_\_\_\_\_ Treatment: O = \_\_\_\_\_ H = \_\_\_\_\_ B = \_\_\_\_\_ A = \_\_\_\_\_ T = \_\_\_\_\_ M = \_\_\_\_\_ A = \_\_\_\_\_ N = \_\_\_\_\_ 8, 8 Hemophilia A: A = Factor \_\_\_ deficiency (remember \"A\" for \"\_\_\_\") CHF, BB, ACE, spirono, hydral, Entresto (sac/val ARNI), diuretics \_\_\_\_\_\_ Treatment - B.A.S.H.E.D: B = \_\_\_\_\_ A = \_\_\_\_\_ S = \_\_\_\_\_ H = \_\_\_\_\_ E = \_\_\_\_\_ D = \_\_\_\_\_ BIOMES, ipra(tropium), mag (sulf), epi, steroids \_\_\_\_\_\_\_ for Acute Asthma Exacerbation Treatment: B = Beta-agonists I = \_\_\_\_\_\_\_ O = Oxygen M = \_\_\_\_\_\_\_ E = \_\_\_\_\_\_\_ S = \_\_\_\_\_\_\_ MS, locomotor, gait, memory, nystagmus, optic, paresthesia LMNOP for \_\_\_\_\_ Symptoms: L = \_\_\_\_\_ (\_\_\_\_\_ difficulties) M = \_\_\_\_\_ issues N = \_\_\_\_\_ O = \_\_\_\_\_ Neuritis P = \_\_\_\_\_ Sinus arrhythmia, inspiration, dec vagal \_\_\_\_\_\_\_ \_\_\_\_\_\_\_ is a normal variation in heart rate that occurs with breathing Heart rate increases slightly during \_\_\_\_\_\_\_. This is due to \_\_\_\_\_ \_\_\_\_\_\_ tone. autoimmune, parietal, IF, B12, periph, ataxia Pernicious anemia is an \_\_\_\_\_\_\_\_ destruction of the gastric \_\_\_\_\_\_ cells that make \_\_\_\_\_\_\_r. Signs & symptoms are not present until \_\_\_\_\_\_ levels are very low (and include \_\_\_\_\_\_ neuropathies and \_\_\_\_\_\_\_). lebeta(lol), nifed(ipine) XR HTN meds during pregnancy (2) torus, buckle, proximal, long, bends \_\_\_\_\_ or \_\_\_\_\_\_ fracture is most common in a child. This is \_\_\_\_\_\_ to the epiphyseal plate and so is not a Salter-Harris issue. Greenstick fracture is also common in children in \_\_\_\_\_\_ bones and is a fracture which \"\_\_\_\_\_\_\" the bone without fracturing it. hyperreflex(ia), reflexes, Ca Pre-eclampsia causes \_\_\_\_\_\_\_\_\_. Magnesium is the treatment. The sign of Mg toxicity is a loss of \_\_\_\_\_\_. This is treated with \_\_\_\_\_\_. serositis, pericarditis, abortions, ANA 40-60% of patients with SLE have \_\_\_\_\_\_\_\_ (pleuritis and \_\_\_\_\_\_\_\_). That, combined with joint pains, habitual \_\_\_\_\_\_\_\_ - should cause you to order an \_\_\_\_\_\_\_. toxoplasmosis, ring(-enhancing) brain, retinitis \_\_\_\_\_\_\_\_ occurs commonly in AIDS and is a parasitic infection causing \_\_\_\_\_ \_\_\_\_\_\_ lesions. CMV is common as well and typically causes \_\_\_\_\_\_\_\_. PJP, AIDS diffuse infiltrate on a CXR in a young adult, think \_\_\_\_\_\_ with \_\_\_\_\_\_\_ internal amoureux fugax is associate with a TIA in the \_\_\_\_\_\_\_\_ carotid a. roseola kid with high fever that suddenly stopped the a widespread, fine maculopapular rash developed measles, toxic, conjunc(tivitis), koplik Rubeola (\_\_\_\_\_\_\_) is an acute illness, the child is \_\_\_\_\_\_, has \_\_\_\_\_\_ and \_\_\_\_\_ spots. C (cough, coryza, conjunct), koplik, confluent, sudden stop, rash, 5th Dz, slapped cheek, lacy, mild, post, congenital, preggo Rubeola: 3 \_\_\_\_\_\_s prodrome, \_\_\_\_\_\_ spots, \_\_\_\_\_\_ rash Roseola: High fever followed by \_\_\_\_\_\_ \_\_\_\_\_ followed by \_\_\_\_\_\_ onset Erythema infectiosum (\_\_\_\_\_ \_\_\_\_\_): \_\_\_\_\_\_ \_\_\_\_\_\_\_\_ appearance, \_\_\_\_\_\_ rash, aplastic crisis risk Rubella: \_\_\_\_\_\_ prodrome, \_\_\_\_\_\_\_ cervical lymphadenopathy, \_\_\_\_\_\_\_\_ rubella syndrome possibility if \_\_\_\_\_\_\_\_ Rubeola, high, 2, rash, confluent, 4, 4, 4 \_\_\_\_\_\_\_\_ (Measles): ‚Ä¢ Prodrome of \_\_\_\_\_\_\_ fever, cough, coryza, and conjunctivitis (the \"3 Cs\") ‚Ä¢ Koplik spots (small white spots on buccal mucosa) appear \_\_\_\_\_ days before \_\_\_\_\_\_ onset ‚Ä¢ Maculopapular rash begins on the face and spreads downward, becoming \_\_\_\_\_\_ ‚Ä¢ Rash appears around day \_\_\_\_\_ of illness ‚Ä¢ Contagious from \_\_\_\_\_\_ days before to \_\_\_\_\_ days after rash onset 6, 2, 39.5, 103, 3-5, rash, rose, trunk, 2, HHV6 Roseola (Exanthem subitum): \- Primarily affects infants and young children (\_\_\_ months to \_\_\_ years old) \- High fever (\>\_\_\_\_\_¬∞C or \_\_\_\_\_¬∞F) for \_\_\_\_-\_\_\_\_\_ days, followed by \_\_\_\_\_\_\_ defervescence \- \_\_\_\_\_\_\_-pink maculopapular rash appears as fever subsides, starting on the \_\_\_\_\_ and spreading to the extremities \- Rash typically lasts \_\_\_\_\_ days \- Caused by human \_\_\_\_\_\_\_ parvo(virus) B19, slapped, red, retic(ular), trunk, light, mild, 7-10 Erythema infectiosum (Fifth disease): \- Caused by \_\_\_\_\_ \_\_\_\_\_ \- \"\_\_\_\_\_\_ cheek\" appearance: bright \_\_\_\_\_, well-demarcated rash on cheeks \- Lacy, \_\_\_\_\_\_\_ rash on \_\_\_\_\_ and extremities follows the facial rash \- Rash may wax and wane for several weeks, exacerbated by \_\_\_\_\_, heat, or stress \- \_\_\_\_\_ prodromal symptoms (low-grade fever, malaise) may occur \_\_\_-\_\_\_\_ days before rash onset rubeola (measles), roseola These two childhood viruses cause high fever 5th dz (erythema infectiosum), rubella These two childhood viruses cause low-grade fever mild, rash, pink, 2, confluent, fades Rubella (German measles): \- \_\_\_\_\_ prodromal symptoms (low-grade fever, malaise, lymphadenopathy) 1-5 days before \_\_\_\_\_\_ onset \- \_\_\_\_\_\_\_ maculopapular rash begins on the face and spreads downward, lasting \_\_\_\_\_\_ days \- Rash is less \_\_\_\_\_\_\_ and \_\_\_\_\_ more quickly than measles rash \- \_\_\_\_\_\_ cervical and suboccipital lymphadenopathy is a characteristic finding \- Congenital rubella syndrome can occur if infection during pregnancy US, PSA Prostate cancer: isolated nodule, order \_\_\_\_\_\_ and \_\_\_\_\_ spoon, IDA Koilonychia: \_\_\_\_\_-shaped nails in \_\_\_\_\_\_\_ proteinuria, albumin, lipid(emia), hemat(uria) Nephrotic syndrome: \_\_\_\_\_\_\_\_, low \_\_\_\_\_\_, hyper\_\_\_\_\_\_, edema; no \_\_\_\_\_\_ hilar, uveitis, Ca, uric Sarcoidosis: \_\_\_\_\_\_ adenopathy, \_\_\_\_\_\_\_\_, elevated ACE/\_\_\_\_\_/\_\_\_\_\_ acid small, ESR, RF Rheumatoid arthritis: symmetric \_\_\_\_\_\_ joint arthritis, elevated \_\_\_\_\_, 20% \_\_\_\_\_ negative hysterosalpingogram, PID, appendicitis Female Infertility: consider \_\_\_\_\_\_\_\_ to evaluate tubal scarring/adhesions if hx of \_\_\_\_\_\_ or \_\_\_\_\_\_\_ erythromycin The drug of choice for Mycoplasma pneumonia during pregnancy is: congenital syph(ilis) A patient with notching of the maxillary incisors most likely had\.... 115, 30, 145 An A1c of 6.0 equates to an average blood glucose level over the past 2-3 months of \_\_\_\_\_\_mg/dL. For every A1c point above that add \_\_\_\_\_\_\_mg/dL, e.g. A1c of 7.0 = \_\_\_\_\_mg/dL chadwicks The vaginal mucosa may appear cyanotic in early pregnancy. This bluish discoloration is referred to as \_\_\_\_\_\_\_ Sign 2, sodium, protein, 600-800 For recurrent kidney stones, make these dietary changes: Fluid increase to \_\_\_\_+L/day Low \_\_\_\_\_\_\_\_ intake Low \_\_\_\_\_\_\_\_ intake Calcium intake should be \_\_\_\_\_-\_\_\_\_mg/day mucous, severe, DIC, TTP \- Wet purpura: - Blood blisters on \_\_\_\_\_\_\_ membranes, indicating \_\_\_\_\_\_\_\_ thrombocytopenia and high bleeding risk \- Causes: \_\_\_\_\_\_, \_\_\_\_\_\_\_\_\_ tender, plates, vW Thrombocytopenic ecchymoses: \- Small, scattered, non-\_\_\_\_\_\_\_ superficial bruises \- Causes: thrombocytopenia, \_\_\_\_\_\_\_ function disorders (e.g., \_\_\_\_\_\_ disease, medication-induced) B, C, liver, 30, 50 Thrombocytopenia: platelet count below 100,000/uL \- Causes: pregnancy, hepatitis \_\_\_\_\_ & \_\_\_\_, HIV, chronic \_\_\_\_\_ disease, medications, malignancies \- Spontaneous bleeding: usually occurs when platelets are below \_\_\_,000/uL \- Surgical bleeding: typically happens when platelets are below 50,000/uL \- Treatment: address the underlying cause and maintain platelets above \_\_\_\_\_,000/uL parkinsonian, mask, cogwheel, benz(tropine), Benadryl, tetraben, dopa(mine) D2 Antipsychotic-induced Extrapyramidal Symptoms (EPS) and Tardive Dyskinesia (TD) Key Demographics: All ages, typically seen in patients on typical antipsychotics, especially elderly Classic Presentation: \- EPS: \_\_\_\_\_\_-like Akinesia, bradykinesia, \_\_\_\_\_-like facial expression, tremor, \_\_\_\_\_\_ rigidity, postural abnormalities \- TD: Involuntary, repetitive movements of the face and body (e.g., lip smacking, tongue protrusion, choreiform movements) Treatment: First-Line: Reduce antipsychotic dose or switch to atypical antipsychotics For severe: Anticholinergic medications (e.g., \_\_\_\_\_\_\_, \_\_\_\_\_\_\_\_) for EPS; \_\_\_\_\_\_\_ inhibitors (e.g., \_\_\_\_\_\_\_azine) for TD \- EPS typically occurs early in treatment, while TD may develop after prolonged exposure to antipsychotics BUZZWORDS: EPS, TD, typical antipsychotics, \_\_\_\_\_\_\_ \_\_\_\_\_\_ receptor blockade, akinesia, bradykinesia, cogwheel rigidity, tardive dyskinesia, involuntary movements 21, XO, 45X, mosaic, karyotyping, up, single, heart, webbed, nips(ples), cubital, amen(norrhea), infertile, CoA, GH, estrogen \- Down Syndrome: Trisomy \_\_\_\_\_\_ confirmed by karyotyping \- Turner Syndrome: \_\_\_\_\_ karyotype (\_\_\_\_\_\_) or \_\_\_\_\_\_\_\_ pattern confirmed by \_\_\_\_\_\_\_ Down Syndrome: \- Physical: \_\_\_\_\_\_-slanting eyes, flat facial profile, \_\_\_\_\_ palmar crease, hypotonia, congenital \_\_\_\_\_\_\_ defects \- Cognitive: Intellectual disability, developmental delay, characteristic facial features Turner Syndrome: - Physical: Short stature, \_\_\_\_\_\_ neck, wide-spaced \_\_\_\_\_, \_\_\_\_\_\_\_ valgus, ovarian dysgenesis leading to \_\_\_\_\_\_\_ and \_\_\_\_\_\_\_\_ \- Other: Lymphedema, cardiac abnormalities (e.g., \_\_\_\_\_\_\_), renal anomalies Treatment Cornerstone: \- Down Syndrome: Supportive care, early intervention, management of associated medical conditions \- Turner Syndrome: \_\_\_\_\_\_ therapy for short stature, \_\_\_\_\_\_\_ replacement for pubertal development echo, low volt, alternans, bottle, dec, 10, inspiration, hypothy, renal, vanco, ceft, IBU, colchicine, tamponade Pericardial Effusion \- \_\_\_\_\_\_\_\_\_\_\_: Gold standard for diagnosis, evaluates fluid accumulation around the heart \- ECG: May show \_\_\_\_\_\_ \_\_\_\_\_\_\_ QRS complexes, electrical \_\_\_\_\_\_\_\_ \- Chest X-ray: Enlarged cardiac silhouette, water \_\_\_\_\_\_ heart shape \- pulsus paradoxus: exaggerated \_\_\_\_\_\_\_ in systolic blood pressure (more than \_\_\_\_\_ mmHg) during \_\_\_\_\_\_\_\_ Differential Diagnosis: \- Cardiac: Acute myocardial infarction, pericarditis, myocarditis \- Non-cardiac: \_\_\_\_\_\_\_\_, malignancy, \_\_\_\_\_\_\_ failure, trauma Treatment: \- Based on underlying cause and severity: \- Small, asymptomatic effusions: Observation \- Large effusions causing hemodynamic compromise: Pericardiocentesis Empirical Drug Names: \- Antibiotics: \_\_\_\_\_\_, \_\_\_\_\_ \- Anti-inflammatory agents: \_\_\_\_\_, \_\_\_\_\_\_ Important Notes: \- Large pericardial effusions can lead to \_\_\_\_\_\_\_\_\_, a life-threatening condition requiring immediate intervention. jak2, splenomegaly Essential Thrombocytosis Elevated platelet count \_\_\_\_\_\_\_\_ mutation Increased risk of thrombosis Hemorrhagic complications \_\_\_\_\_\_\_\_ marrow, jak2, teardrop Myelofibrosis \_\_\_\_\_\_ fibrosis \_\_\_\_\_\_ mutation Splenomegaly Anemia \_\_\_\_\_\_ cells M, viscosity, neuro Waldenstrom\'s Macroglobulinemia Ig\_\_\_\_ monoclonal gammopathy Hyper\_\_\_\_\_\_ syndrome Lymphoplasmacytic lymphoma Anemia \_\_\_\_\_\_pathy mass, jak2, itching, shower, thrombo Polycythemia Vera Elevated red blood cell \_\_\_\_\_\_ \_\_\_\_\_\_\_ mutation \_\_\_\_\_\_ after \_\_\_\_\_\_\_ (aquagenic pruritus) Splenomegaly \_\_\_\_\_\_\_\_sis (myelo)blasts, auer, 53, 8;21, marrow Acute Myeloid Leukemia (AML) \_\_\_\_\_\_\_ on peripheral blood smear \_\_\_\_\_ rods p\_\_\_\_ mutation Cytogenetic abnormalities (e.g., t(\_\_\_\_\_), inv(16)) \_\_\_\_\_\_ failure acute, fever, bone, bleeding, splenomegaly, TdT, BCR-ABL, TKIs ALL vs CML Age: ALL is more common in children, while CML is more common in adults. Onset: ALL has an \_\_\_\_\_\_ onset, whereas CML has a chronic, insidious onset. Symptoms: ALL presents with \_\_\_\_\_, \_\_\_\_\_\_ pain, and \_\_\_\_\_\_, while CML presents with fatigue, \_\_\_\_\_\_\_\_, and weight loss. Peripheral Blood Smear: ALL shows lymphoblasts, while CML shows a full spectrum of myeloid cells. Cytogenetics: Both can have the Philadelphia chromosome, but it is more common in CML. Markers: ALL is \_\_\_\_\_\_ positive, while CML is \_\_\_\_\_\_\_\_-\_\_\_\_\_ positive. Treatment: ALL primarily uses chemotherapy, while CML treatment focuses on \_\_\_\_\_\_\_\_. TdT, WBCs Acute Lymphoblastic Leukemia (ALL) Lymphoblasts on peripheral blood smear \_\_\_\_\_ (terminal deoxynucleotidyl transferase) expression High levels of \_\_\_\_\_\_\_\_ Lymphadenopathy BCR-ABL, WBCs, left Chronic Myeloid Leukemia (CML) Philadelphia chromosome (Ph+) \_\_\_\_\_\_-\_\_\_\_ fusion gene Chronic phase, accelerated phase, blast crisis Splenomegaly Low \_\_\_\_\_\_\_ with \_\_\_\_\_\_ shift smudge, 19, 20, hypogamma, painless Chronic Lymphocytic Leukemia (CLL) \_\_\_\_\_\_\_\_ cells (basket cells) on peripheral blood smear CD5+, CD\_\_\_\_\_+, CD\_\_\_\_\_+ \_\_\_\_-cell lymphoproliferative disorder Lymphocytosis \_\_\_\_\_\_\_\_\_globulinemia \_\_\_\_\_\_\_ lymphadenopathy thal, lead, ACD (anemia of chronic dz) Microcytic Decreased mean corpuscular volume (MCV) Iron deficiency anemia \_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_ poisoning \_\_\_\_\_\_\_ fever, renal Thrombotic Thrombocytopenic Purpura (TTP) Microangiopathic hemolytic anemia (MAHA) Thrombocytopenia Neurological symptoms \_\_\_\_\_\_\_\_ \_\_\_\_\_\_ failure 4, thrombosis, necrosis Heparin-induced Thrombocytopenia (HIT) Platelet count decrease after heparin exposure Anti-heparin/platelet factor \_\_\_\_ antibodies \_\_\_\_\_\_\_\_\_ Skin \_\_\_\_\_\_\_ at injection site Disseminated intravascular coagulation (DIC) 8;14, starry-sky, EBV, jaw, face Burkitt Lymphoma c-myc translocation (t(\_\_\_\_\_)) \_\_\_\_\_\_-\_\_\_\_\_ appearance on histology \_\_\_\_\_\_ association (endemic form) \_\_\_\_\_\_ & \_\_\_\_\_\_ bone involvement (endemic form) High proliferation rate monoclonal, bone, back, ribs, Ca, renal Multiple Myeloma \_\_\_\_\_\_\_\_ gammopathy \_\_\_\_\_\_\_ pain, especially in the \_\_\_\_\_\_ or \_\_\_\_\_\_ Hyper\_\_\_\_ \_\_\_\_\_\_ failure Lytic bone lesions reedstern, 15, 30, B, fever, mediastinal, bimodal Hodgkin Lymphoma \_\_\_\_\_\_\_ cells CD\_\_\_+, CD\_\_\_\_+ cells \_\_\_\_ symptoms (\_\_\_\_\_, night sweats, weight loss) \_\_\_\_\_\_\_\_ lymphadenopathy \_\_\_\_\_\_ age distribution more, 8, recessive, hemarthrosis, long, normal Hemophilia A \_\_\_\_\_\_\_ common than hemophilia B Factor \_\_\_\_\_\_ deficiency X-linked \_\_\_\_\_\_ inheritance \_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_ PTT \_\_\_\_\_\_\_\_ PT less, 9, recessive, long, normal Hemophilia B \_\_\_\_\_\_\_ common than hemophilia A Factor \_\_\_\_ deficiency X-linked \_\_\_\_\_ inheritance Hemarthrosis \_\_\_\_\_\_\_\_ PTT \_\_\_\_\_\_\_\_ PT mucosal, bruising, muscle, desmopressin, TXA vWD is caused by a mutation in the VWF gene, while Hemophilia A and B are caused by mutations in the F8 and F9 genes, respectively. Inheritance Pattern: vWD can be autosomal dominant or recessive, while Hemophilia A and B are X-linked recessive disorders. Bleeding Symptoms: vWD primarily causes \_\_\_\_\_\_ bleeding and \_\_\_\_\_\_\_, while Hemophilia more commonly causes joint and \_\_\_\_\_\_ bleeding. Treatment: vWD can be treated with \_\_\_\_\_\_\_ and \_\_\_\_\_\_\_ , in addition to VWF concentrate replacement therapy, while Hemophilia is primarily treated with factor replacement therapy. 50, 50, 50, 25, 25, 50, carriers, unaffected Hemophilias A&B \- Mother carrier, Father unaffected: \_\_\_\_% sons affected, \_\_\_\_\_% daughters carriers \- Both parents carriers: Sons have \_\_\_\_% chance of being affected, daughters have \_\_\_\_\_% chance of being affected, \_\_\_\_\_% normal, \_\_\_\_% carriers \- Mother unaffected, Father affected: All daughters \_\_\_\_\_\_\_, all sons \_\_\_\_\_\_\_ 50, 75 vWD \- One parent affected: \_\_\_\_\_\_% chance each child will inherit the disease, regardless of sex \- Both parents affected: \_\_\_\_\_% chance child will inherit the disease flu, midwest, south, yeast, antifungal, itra(conazole), ampB Blastomycosis \- Often presents with \_\_\_\_\_-like symptoms, which may delay diagnosis. \- Typically found in \_\_\_\_\_\_ and \_\_\_\_\_\_\_ \- Disseminated disease may involve the skin, bones, and CNS. MUST-KNOW Exact/specific Diagnostic Criteria: Identification of Blastomyces dermatitidis in culture or tissue biopsy Pathognomonic: Broad-based budding \_\_\_\_\_\_\_ forms on histopathology Red Flags: Disseminated disease, CNS involvement Treatment Cornerstone: \_\_\_\_\_\_\_\_ therapy with \_\_\_\_\_\_\_ or \_\_\_\_\_\_\_ Immune complex, 3-10, arthralgia, PCN --¢ype III allergic reaction \_\_\_\_\_\_\_ \_\_\_\_\_\_\_-mediated Timing of Reaction \_\_\_\_-\_\_\_ hours Common Symptom \_\_\_\_\_\_\_\_ Cause: Medications (e.g., \_\_\_\_\_\_\_\_) antibody, 6-24, low plates, transfusions, Rh incompat(ibility) --¢ype II allergic reaction \_\_\_\_\_\_\_ -mediated Timing of Reaction \_\_\_\_-\_\_\_ hours Common Symptom \_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_ Cause: \_\_\_\_\_\_\_ & \_\_\_\_\_\_\_ 100, 3, PR MAT: cardiac arrhythmia with multiple competing atrial foci Irregular atrial rate \>\_\_\_\_\_\_ bpm ‚â \_\_\_ distinct P wave morphologies Irregular P-P intervals Isoelectric baseline between P waves Varying \_\_\_\_\_ intervals small, deep, nail, flat, cleft palate, deaf Fetal warfarin syndrome (Dysmorphism due to warfarin, Warfarin embryopathy) Caused by maternal warfarin use during pregnancy Key features: Nasal hypoplasia, \_\_\_\_\_\_ nasal bridge, \_\_\_\_\_\_ nasal groove Stippled epiphyses in infancy Brachydactyly, \_\_\_\_\_ hypoplasia \_\_\_\_\_\_\_ fingers \_\_\_\_\_\_ \_\_\_\_\_\_ Other associated findings: Low birth weight Mental retardation Seizures Hypotonia Widely spaced nipples \_\_\_\_\_\_\_ Feeding difficulties and failure to thrive Argyll Robertson, accomdate, near, light, neurosyph, DM \_\_\_\_\_\_\_ \_\_\_\_\_\_ (AR) pupils, aka \"Prostitute\'s Pupil\" Bilateral small pupils \_\_\_\_\_\_\_\_ (constrict with \_\_\_\_\_\_\_ vision), but do not react to \_\_\_\_\_\_ Highly specific for \_\_\_\_\_\_\_\_ May also indicate \_\_\_\_\_\_ neuropathy 50-125, 150 The therapeutic range for valproic acid (total) is \_\_\_\_-\_\_\_\_ ¬µg/mL. The toxic level is greater than \_\_\_\_\_ ¬µg/mL. 5-10, 15 Carbamazepine: Therapeutic range \_\_\_\_-\_\_\_ ¬µg/mL. Toxic level \>\_\_\_\_ ¬µg/mL. 15-40, 65 Phenobarbital: Therapeutic range \_\_\_-\_\_\_ ¬µg/mL. Toxic level \>\_\_\_\_ ¬µg/mL. 10-20, 30 Phenytoin: Therapeutic range \_\_\_-\_\_\_ ¬µg/mL. Toxic level \>\_\_\_\_ ¬µg/mL. gaba(pentin), trileptal (oxcarb) 2 antiepileptics that are only used for partial seizures liver, Carb(amazepine), SIADH, pheny(toin), gingival, osteomalacia Tonic-Clonic Seizures - Top 3 Maintenance Drugs: Valproic acid (Depakote) ADEs: \_\_\_\_\_\_ toxicity, thrombocytopenia \_\_\_\_\_\_\_\_\_ (Tegretol) ADEs: Agranulocytosis, \_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_ (Dilantin) ADEs: \_\_\_\_\_\_\_ hyperplasia, \_\_\_\_\_\_\_\_ keppra, SJS Partial Seizures - Top 2 Maintenance Drugs: Levetiracetam (\_\_\_\_\_\_\_\_) ADEs: Behavioral changes, somnolence Lamotrigine (Lamictal) ADEs: \_\_\_\_\_\_\_\_\_, dizziness thal(assemia), high, TIBC, RBC, 13 Microcytic anemia (MCV \< 80): Consider iron deficiency anemia or \_\_\_\_\_\_\_\_ or anemia of chronic dz For that missing one above: All are iron studies are \_\_\_\_\_\_\_\_\_\_\_; \_\_\_\_\_\_\_\_ is not MCV/\_\_\_\_\_ \< \_\_\_\_\_ IDA if microcytic anemia and TIBC is high, then think \_\_\_\_\_\_\_\_- ACD (anemia of chronic dz) if microcytic anemia and both iron and TIBC are low, then think \_\_\_\_\_\_\_\_- retic, 2, AML, CLL, drug, parvo, 2, GI, hemolytic Normocytic anemia (MCV 80-100) with \_\_\_\_\_\_\_\_ count: \\_\_\_\_% (hyperproliferative): Hemorrhage (e.g., \_\_\_\_\_\_\_ bleeding, trauma) \_\_\_\_\_\_\_\_ anemias (e.g., autoimmune, microangiopathic) seg(mented) neutro(phils), methotrex, phenytoin, seg(mented) neutro(phils), alchy, liver, Fanconi Macrocytic anemia (MCV \>100): Megaloblastic causes (these have \_\_\_\_\_\_\_ \_\_\_\_\_\_ on smear): Vitamin B12 and/or folate deficiency Drug-induced (e.g., \_\_\_\_\_\_\_\_, trimethoprim, \_\_\_\_\_\_\_\_\_) Non-megaloblastic causes (these DO NOT have \_\_\_\_\_\_\_ \_\_\_\_\_\_ on smear): \_\_\_\_\_\_\_\_ Myelodysplastic syndrome (e.g., refractory anemia) \_\_\_\_\_\_ disease (e.g., cirrhosis) Congenital bone marrow failure syndromes (e.g., \_\_\_\_\_\_\_ anemia, Diamond-Blackfan anemia) cath, normal, spasm, hypervent, Ergonovine Prinzmetal\'s angina: suspect when severe chest pain + dramatic ECG changes, but cardiac \_\_\_\_\_\_ shows \_\_\_\_\_\_\_ coronaries Diagnosis confirmed via provocative testing to induce coronary artery \_\_\_\_\_\_ Two provocative tests commonly used: \_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_ administration If spasm induced, definitively diagnoses Prinzmetal\'s angina INR, PT, synthesis PTT, indirect, urine Alcoholism and cirrhosis commonly cause: Elevated \_\_\_\_\_\_ and \_\_\_\_\_\_ due to impaired liver \_\_\_\_\_\_\_ of clotting factors Normal \_\_\_\_\_\_ Elevated \_\_\_\_\_\_\_ bilirubin due to impaired liver conjugation Bilirubin spills into \_\_\_\_\_\_\_ synthetic, PT, INR, indirect, unconjug, urine Cirrhosis impairs liver\'s \_\_\_\_\_\_\_\_\_ function Impaired clotting factor synthesis prolongs \_\_\_\_\_ and \_\_\_\_\_\_\_ \_\_\_\_\_\_\_ (\_\_\_\_\_\_\_\_) bilirubin accumulates Bilirubin in \_\_\_\_\_\_\_ indicates liver dysfunction bile, obstructive, stones, tumors Direct bilirubin is conjugated in the liver and excreted into \_\_\_\_\_\_\_ Accumulation of direct bilirubin leads to jaundice and dark urine Common cause is usually \_\_\_\_\_\_\_\_ in nature, (e.g., \_\_\_\_\_\_\_, \_\_\_\_\_\_, strictures) IUDs, ligation, vasectomy, 95, non-IUD, 75, fertility Most effective contraceptives (\>99% effectiveness with actual use): \_\_\_\_\_\_ (Copper T, Levonorgestrel/Mirena) \_\_\_\_\_\_ \_\_\_\_\_\_ Highly effective contraceptives (\~\_\_\_\_\_% effectiveness with actual use): \_\_\_\_\_\_\_-\_\_\_\_\_\_\_ drugs in any form Least effective contraceptives (\ 4 indicates \_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_ AST:ALT \< 1 more common in \_\_\_\_\_\_\_\_ and \_\_\_\_\_\_ hepatitis Equal elevation of AST and ALT can occur in \_\_\_\_\_\_-induced liver injury, autoimmune hepatitis, and \_\_\_\_\_\_\_\_ disease \>2 Whats the AST:ALT ratio in alch liver dz? \>4 Whats the AST:ALT ratio in alch hepatitis? \ \_\_\_ years: Observe mild-moderate, treat severe, follow up in \_\_\_ days Unreliable follow-up: Consider \_\_\_ dose then oral antibiotics Recurrent AOM (‚â \_\_\_ in 6 months or ‚â \_\_\_ in 12 months): Consider \_\_\_\_\_\_, \_\_\_\_\_\_\_, ENT referral recessive, DM, bronze, iron, letting Hemochromatosis is an autosomal \_\_\_\_\_\_\_\_ inherited disorder that causes cirrhosis, \_\_\_\_\_\_\_, and \_\_\_\_\_\_ pigmentation to the skin due to the abnormal accumulation of \_\_\_\_\_\_\_\_ in tissues. Intensive \_\_\_\_\_\_\_ is the treatment of choice until the overload is corrected. stress, cold, triptans, elevation, CAS (coronary artery spasm), rest, night, morning, cyclical, elevation, CCBs, nidfed(ipine), nitro, BBs Coronary Artery Spasm: Transient, focal constriction of coronary arteries Can occur in normal or atherosclerotic vessels Triggered by smoking, \_\_\_\_\_\_, \_\_\_\_\_\_, and medications (e.g., \_\_\_\_\_\_, cocaine) ECG: Transient ST-segment \_\_\_\_\_\_ during episodes Prinzmetal Angina (Variant Angina): Caused by \_\_\_\_\_\_\_\_\_\_\_ Occurs at \_\_\_\_\_, often at \_\_\_\_\_\_ or early \_\_\_\_\_\_, \_\_\_\_\_\_\_\_ Not typically triggered by exertion ECG: Transient ST-segment \_\_\_\_\_\_ during episodes FOR BOTH: Tx with \_\_\_\_\_\_\_\_ (\_\_\_\_\_\_\_ etc) and \_\_\_\_\_\_\_ FOR BOTH: Avoid \_\_\_\_\_\_\_\_\_\_ 400, adeno(carcinoma), SCC, SCLC, 400, granuloma, 50 Typical doubling times for lung lesions: Malignant (\\_\_\_\_\_\_\_d): Hamartoma \_\_\_\_\_\_\_\_\_ Inflammatory (Infectious): \_\_\_\_\_\_ days outer, pit adenoma, meningioma Bitemporal hemianopia: Loss of vision in the \_\_\_\_\_\_\_ half of both visual fields Lesion: Optic chiasm Common causes: \_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_, craniopharyngioma, \_\_\_\_\_\_\_\_\_ bilat, nerve, gliomas Binasal hemianopia (rare): Loss of vision in the inner half of both visual fields Lesion: \_\_\_\_\_\_ lesions at junction of optic \_\_\_\_\_ and chiasm Common causes: Bilateral optic nerve \_\_\_\_\_\_\_, meningiomas same, left, occipital lobe, stroke, tumor, occipital, TBI, ischemic, left PCA, young Homonymous hemianopia: Loss of vision in the \_\_\_\_\_\_ half of both visual fields Right homonymous hemianopia: \_\_\_\_\_\_ optic tract or \_\_\_\_\_\_\_ lobe Left homonymous hemianopia: the opposite Common causes: \_\_\_\_\_\_, \_\_\_\_\_\_ of \_\_\_\_\_\_\_ lobe, \_\_\_\_\_\_ For Stroke: if Right homonymous hemianopia, then likely \_\_\_\_\_\_\_ stroke at the \_\_\_\_\_\_\_ \_\_\_\_\_\_\_ tumor more likely in \_\_\_\_\_\_ people closure, LV, dia, bicusp, rheum(atism), SOB, palps, PP, descres, ACE, CCB, loops, nail, bobs, sitting forward Aortic Insufficiency ‚Üì AoV \_\_\_\_\_\_\_ ‚Üí ‚Üë Ao‚Üí\_\_\_\_\_ blood in \_\_\_\_\_\_\_\_ Causes: \_\_\_\_\_\_\_\_, \_\_\_\_\_\_\_, endocarditis, Ao root ‚Üë Sx: \_\_\_\_\_\_\_, fatigue, \_\_\_\_\_\_, angina Signs: wide \_\_\_\_\_\_, \_\_\_\_\_\_\_\_ diast murmur, bounding pulses, displaced PMI Dx: \_\_\_\_\_\_ Rx: meds (vasodil (\_\_\_\_\_\_, \_\_\_\_\_\_), \_\_\_\_\_\_\_) mild-mod; valve replace if severe/Sx Assoc: Austin Flint murmur: low mid-diast at apex Quincke\'s: vis \_\_\_\_\_\_\_ pulse de Musset\'s: head \_\_\_\_\_\_ w/ beats Duroziez\'s: murmurs over compressed fem art LUSB murmur ‚Üë \_\_\_\_\_\_\_ \_\_\_\_\_\_\_.6-1.2, 1.5 NV, tremors, AMS, hypothy, goiter, T4, DI, GFR, Cr, 6 Lithium Toxicity and Thyroid Effects Lithium has a narrow therapeutic index \_\_\_\_-\_\_\_\_; toxicity can occur at levels slightly above therapeutic range (\>=\_\_\_\_\_\_) Signs of toxicity: \_\_\_\_\_\_\_, diarrhea, ataxia, \_\_\_\_\_\_\_, \_\_\_\_\_\_\_\_, seizures, coma Lithium can cause \_\_\_\_\_\_\_ and \_\_\_\_\_\_\_ due to inhibition of \_\_\_\_\_ release Hypothyroidism more common in women, elderly, and those with preexisting thyroid disease Renal effects: nephrogenic \_\_\_\_\_\_, chronic tubulointerstitial nephritis Monitor \_\_\_\_\_, \_\_\_\_\_, TSH and free T4 levels every \_\_\_\_\_ months in patients on lithium therapy If hypothyroidism develops, treat with levothyroxine while continuing lithium Rarely, lithium can cause hyperthyroidism or thyrotoxicosis Lithium-induced thyrotoxicosis may not respond to antithyroid drugs; may require lithium discontinuation tretinoin, adap(alene), mino(cycline), 4, 4, peroxide, abx Acne Vulgaris Treatment, Stepwise by Severity: Mild: Topical retinoids (\_\_\_\_\_\_\_, \_\_\_\_\_\_\_), benzoyl peroxide, or combination products Moderate: Topical retinoids + oral antibiotics (doxycycline, \_\_\_\_\_\_) for \_\_\_\_\_\_ months Severe: Oral isotretinoin (13-cis-retinoic acid) for \_\_\_\_\_ months; monitor for teratogenicity and other side effects Maintenance: Topical retinoids ¬± \_\_\_\_\_\_\_\_ to prevent recurrence Additional PANCE Exam Points: Hormonal therapy (OCPs) can be used in females with moderate-severe acne Avoid topical \_\_\_\_\_\_ due to resistance development dilated, left, LV, EF \_\_\_\_\_\_\_\_ cardiomyopathy is often caused by chronic alcohol use. It is characterized by signs and symptoms of \_\_\_\_\_\_\_-sided heart failure, a dilated \_\_\_\_\_\_ and decreased \_\_\_\_\_\_\_. dilated, myocardium, LV, SOB, edema, JVD, megaly, S3, regurg, ACE, BB, loop Alcoholic cardiomyopathy: \_\_\_\_\_\_ cardiomyopathy caused by chronic heavy alcohol use Pathophysiology: alcohol is directly toxic to \_\_\_\_\_\_, leading to dilation and impaired contractility of \_\_\_\_\_\_ Signs/symptoms: \_\_\_\_\_\_, orthopnea, paroxysmal nocturnal dyspnea Peripheral \_\_\_\_\_\_, \_\_\_\_\_\_ \_\_\_\_\_\_ Auscultation: Distant heart sounds \_\_\_\_\_\_ gallop Murmurs of mitral/tricuspid \_\_\_\_\_\_ may be present Diagnosis: echocardiogram shows dilated left ventricle with decreased ejection fraction Treatment: alcohol cessation, guideline-directed medical therapy for heart failure (\_\_\_\_\_\_\_, \_\_\_\_\_\_\_, \_\_\_\_\_\_) neg, campy Guillaine barre is usually caused by this gram-\_\_\_\_\_\_\_ bact: \_\_\_\_\_\_\_ pale turbins(ates) Which physical examination finding distinguishes allergic rhinitis from other rhinitis etiologies? RV, trapping Lung volume measurements in COPD reveal a marked increase in \_\_\_\_\_\_ indicative of air \_\_\_\_\_\_\_. lupus Antinuclear Antigen (ANA) is most commonly associated with and monitors progress of which disorder? 1000 Cesarean section performed prior to the onset of labor and rupture of membranes significantly reduces the risk of perinatal HIV transmission. Planned cesarean section delivery at 38 weeks of gestation to prevent perinatal transmission of HIV is recommended in women with a viral load of \>\_\_\_\_\_\_ copies/mL. MI, 10, antlat, LV, scarring, sys, ACE, BB Left Ventricular Aneurysm Complication of \_\_\_\_\_\_\_, usually occurs \~\_\_\_\_\_\_ days post Most common location: \_\_\_\_\_\_\_\_\_ wall of \_\_\_\_\_\_\_ Pathophysiology: thinning and \_\_\_\_\_\_\_\_ of infarcted myocardium leads to outward bulging during \_\_\_\_\_\_ Symptoms: heart failure, ventricular arrhythmias, thromboembolic events Management: \_\_\_\_\_, \_\_\_\_\_\_\_, anticoagulation if thrombus present Surgical intervention: aneurysmectomy for refractory heart failure or recurrent ventricular tachycardia longer, 30 Rheumatoid arthritis has an insidious onset, morning stiffness is typically \_\_\_\_\_\_\_ than \_\_\_\_\_\_ minutes, and is typically symmetrical in presentation. split S2, inspiration A \_\_\_\_\_\_ \_\_\_\_\_\_ with \_\_\_\_\_\_ murmur is common in pregnancy due to the increased blood flow across the aortic and pulmonic valves. dia, 140, papilledema, enceph, nephropathy Malignant hypertension is characterized by \_\_\_\_\_ reading greater than \_\_\_\_\_ mm Hg associated with \_\_\_\_\_\_ and either \_\_\_\_\_\_ or \_\_\_\_\_\_\_\_. The treatment for malignant hypertension is hydralazine. interstitial, compliance, RA, scleroderma, asbestos, silica, amiodarone, methotrex, bibasilar crackles, transplant Pulmonary Fibrosis Chronic, progressive \_\_\_\_\_\_ lung disease Characterized by fibrosis (scarring) of lung tissue Leads to impaired gas exchange and decreased lung \_\_\_\_\_\_ Common Causes Idiopathic (unknown cause) Connective tissue diseases (e.g., \_\_\_\_\_, \_\_\_\_\_\_\_) Environmental exposures (e.g., \_\_\_\_\_\_, \_\_\_\_\_ dust) Radiation therapy Chronic hypersensitivity pneumonitis Drug-Induced Pulmonary Fibrosis \_\_\_\_\_\_\_ Bleomycin \_\_\_\_\_\_\_ Nitrofurantoin Key Points Presents with progressive dyspnea, dry cough, and \_\_\_\_\_\_\_ \_\_\_\_\_\_ Diagnosis: High-resolution CT (HRCT) and lung biopsy Treatment: Supportive care, supplemental oxygen, lung \_\_\_\_\_\_\_\_\_ Poor prognosis with median survival of 3-5 years after diagnosis Coxsack B, C, adeno, HIV \_\_\_\_\_\_ \_\_\_\_\_ virus, Hepatitis \_\_\_\_\_, \_\_\_\_\_\_virus, and \_\_\_\_\_\_ are the predominant agents in clinically significant acute viral myocarditis in the US. cipro, azith, levaquin, rifampin, ceft Household contacts of a patient with bacterial meningitis are best treated with which abx? (5) hypoK U waves are associated with which electrolyte abnormality? 3, 3, 30, 2, 3, HIV Women with \_\_\_\_\_ consecutive negative annual Pap smears may be screened every \_\_\_\_\_ years if: Age ‚â \_\_\_\_\_ No history of: CIN \_\_\_\_ or \_\_\_\_\_ Immunosuppression \_\_\_\_\_\_ infection In utero DES exposure withdrawn, avoids, indiff(erent), cold, iso(lation), friends Schizoid personality disorder: \_\_\_\_\_\_, \_\_\_\_\_\_\_ relationships \- \_\_\_\_\_\_\_\_ to praise or criticism from others \- Appear \_\_\_\_\_, unfeeling, and detached \- Key traits to remember: \- Social \_\_\_\_\_\_- and aloofness \- Emotional coldness and \_\_\_\_\_\_\_ affect \- Prefers solitary activities \- Lacks close \_\_\_\_\_\_ or confidants hydroxychloroquine, nitro, ASA, hemolysis, hemolysis, anemia, fatigue G6PD deficiency is more common in African Americans, Middle Easterners, and those of Mediterranean descent Prevalence in African American males in the US is \~10% Oxidative stressors (e.g., \_\_\_\_\_\_\_, primaquine, sulfonamides, \_\_\_\_\_\_\_\_, \_\_\_\_\_\_) can trigger \_\_\_\_\_\_\_\_ Symptoms of drug-induced \_\_\_\_\_\_- typically appear within weeks of starting the offending medication Presents with \_\_\_\_\_\_\_ and \_\_\_\_\_\_ due to hemolysis CBC shows anemia consistent with hemolytic process metro \_\_\_\_\_\_\_\_\_ can be used for initial treatment of nonsevere C. difficile infection. The recommended regimen is 500 mg three times daily or 250 mg four times daily for 10 to 14 days. Carb(amazepine), Tegretol, gamma knife Trigeminal neuralgia is generally responsive to \_\_\_\_\_\_\_\_\_ (\_\_\_\_\_\_\_) however, for those who fail to respond to medicinal therapy surgery is the next valid option. Though there are various procedures, Stereotactic (\_\_\_\_\_\_\_ \_\_\_\_\_\_\_) radiosurgery has provided the best results. brief, 5, electric, chewing, cold, MRI, MS, Tegretol, gamma knife Trigeminal Neuralgia: Severe, \_\_\_\_\_\_\_\_ facial pain in distribution of trigeminal nerve (CN \_\_\_) Brief, \_\_\_\_\_\_ shock-like pain lasting seconds to minutes Triggered by light touch, \_\_\_\_\_\_, brushing teeth, \_\_\_\_\_ air More common in females over 50 \_\_\_\_\_\_ to rule out other causes (tumors, \_\_\_\_\_) Treatment: \_\_\_\_\_\_\_\_ first-line; \_\_\_\_\_\_\_ \_\_\_\_\_ surgery for refractory cases spleen CML patients present with an enlarged \_\_\_\_\_ 2-4 The American Academy of Pediatrics recommends screening of hypothyroid disease between \_\_\_\_-\_\_\_\_ days of birth TLC, VC, FEV1, RV COPD Spirometry findings in obstructive lung disease typically show normal \_\_\_\_\_\_\_, decreased \_\_\_\_\_\_, prolonged \_\_\_\_\_\_, and increased \_\_\_\_\_\_. 3, renal, bruits Renal artery stenosis is characterized by hypertension that is resistant to \_\_\_\_\_\_ or more medications and \_\_\_\_\_ artery \_\_\_\_\_ on examination. small, light, near, neurosyph, DM, midbrain, accom(odation), DTRs, syph, DM Argyll-Robertson pupils: \_\_\_\_\_\_, irregular pupils that constrict poorly to \_\_\_\_\_\_\_ but accommodate normally to \_\_\_\_\_\_ vision Seen in \_\_\_\_\_\_\_\_ (tabes dorsalis), \_\_\_\_\_, and Adie\'s tonic pupil syndrome Caused by lesions in the dorsal \_\_\_\_\_\_\_\_ affecting the light reflex pathway while sparing the \_\_\_\_\_\_\_\_ reflex pathway Associated with loss of \_\_\_\_\_\_\_, ataxia, and positive Romberg sign in tabes dorsalis Important to screen for \_\_\_\_\_ and \_\_\_\_\_\_ in patients with Argyll-Robertson pupils GCA, migraine Amaurosis fugax: Transient monocular vision loss, often due to emboli from carotid artery atherosclerosis or cardiac source Other causes of amaurosis fugax: \_\_\_\_\_\_\_, \_\_\_\_\_\_, retinal detachment, optic neuritis diff(erent), Horners Anisocoria: \_\_\_\_\_\_\_ pupil sizes Causes of anisocoria: \_\_\_\_\_\_\_\_ syndrome, third nerve palsy, pharmacologic dilation, physiologic anisocoria, Adie\'s tonic pupil unilat, optic neuritis, CRVO \_\_\_\_\_\_\_ vision loss in multiple sclerosis: Due to \_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_ Other causes of unilateral vision loss: Retinal detachment, central retinal artery occlusion, vitreous hemorrhage, severe glaucoma, \_\_\_\_\_\_\_\_\_, optic neuropathy symp(athetic), stroke, tumor, dissection, cluster, miosis, ptosis, anhidrosis, stem, hypothal, apex Horner\'s Syndrome Caused by disruption of \_\_\_\_\_\_\_ innervation to the eye and face Etiologies: \_\_\_\_\_\_, \_\_\_\_\_\_, trauma, carotid \_\_\_\_\_\_\_, \_\_\_\_\_\_ headache Classic triad: \_\_\_\_\_\_\_ (constricted ) \_\_\_\_\_\_\_ (drooping) \_\_\_\_\_\_\_ (lack of on affected side of face) Can be caused by lesions anywhere along sympathetic pathway: Central (\_\_\_\_\_\_\_, \_\_\_\_\_\_\_) Preganglionic (spinal cord, lung \_\_\_\_\_, neck) Postganglionic (cavernous sinus, carotid artery) Diagnosis: clinical, plus imaging (CT/MRI) to identify lesion location Treatment: address underlying cause; ptosis can be managed with surgery 10, fat Celiac Dz Greater than \_\_\_\_ grams of fecal \_\_\_\_ in 24 hours is most consistent with a malabsorption syndrome such as celiac sprue. adeno, 3, pools, cool, sys(temic) One of the most common causes of viral conjunctivitis is \_\_\_\_\_virus type \_\_\_\_\_. Contaminated \_\_\_\_\_can be a source of infection. There is no specific antiviral agent for the treatment of viral conjunctivitis. Some patients derive symptomatic relief from topical antihistamine/decongestants. These are available over-the-counter (Naphcon-A, Ocuhist, generics). Warm or \_\_\_\_\_ compresses may provide additional symptomatic relief. \_\_\_\_\_\_\_ agents play no role in viral conjunctivitis. 1-2, LH, estrogen Ovulation occurs within \_\_\_-\_\_\_days of the \_\_\_\_\_ surge and at the time of elevated \_\_\_\_\_\_ factor 5 Leiden In young adults with otherwise unexplained thrombosis, \_\_\_\_\_\_ \_\_\_\_\_\_ \_\_\_\_\_\_ is the most common associated abnormality. spasm, stressful Raynauds phenomenon is caused by vascular \_\_\_\_\_\_\_ when exposed to cold or \_\_\_\_\_\_\_ situations. pulm edema, trauma, pancreatitis, perm(eability), protein, (pulm) edema, bilat crackles, bilat, opacities, white, intubate, low TV, prone, 50 Acute Respiratory Distress Syndrome (ARDS): Severe, acute lung injury causing noncardiogenic \_\_\_\_\_\_\_ \_\_\_\_\_\_\_ Risk factors: sepsis, pneumonia, aspiration, \_\_\_\_\_\_\_, \_\_\_\_\_\_\_ Pathophysiology: alveolar-capillary membrane damage ‚Üí ‚Üë \_\_\_\_\_\_\_ ‚Üí \_\_\_\_\_\_\_-rich \_\_\_\_\_\_\_ Clinical presentation: Acute onset dyspnea, tachypnea, hypoxemia \_\_\_\_\_\_\_ \_\_\_\_\_\_\_ on auscultation Chest X-ray: \_\_\_\_\_\_\_ diffuse \_\_\_\_\_\_\_ (\"\_\_\_\_\_\_\_-out\") Diagnosis: Berlin criteria (timing, chest imaging, origin of edema, oxygenation impairment) Management: \#1 \_\_\_\_\_\_\_\_\_\_ Supportive care, treat underlying cause \_\_\_\_\_ \_\_\_\_\_\_ mechanical ventilation (6 mL/kg ideal body weight) \_\_\_\_\_\_\_ positioning if severe ARDS (PaO2/FiO2 \< 150) Consider neuromuscular blockade, inhaled pulmonary vasodilators, ECMO in refractory cases Complications: pneumothorax, ventilator-associated pneumonia, fibrosis, mortality (\~\_\_\_\_\_%) narrow, farsighted, asian, dilation, dark, rapid, halos, steamy, dilated, hard, acetaz, pilo(carpine), 30, tim(olol), 60, irido(momy), pupil block Acute angle-closure glaucoma (AACG) occurs in those with pre-existing \_\_\_\_\_\_\_ anterior chamber angles Risk factors: older age, hyperopia (\_\_\_\_\_\_), Inuit and \_\_\_\_\_\_\_ ethnicity Can be precipitated by pupillary \_\_\_\_\_\_\_ (sitting in \_\_\_\_\_\_\_ room, stress, pharmacologic mydriasis) Classic presentation: \_\_\_\_\_\_\_ onset of severe eye pain Profound visual loss with \_\_\_\_\_\_\_ around lights Red eye \_\_\_\_\_\_\_ cornea \_\_\_\_\_\_\_ pupil \_\_\_\_\_\_\_ eye on palpation Common treatments: Oral carbonic anhydrase inhibitors (e.g., \_\_\_\_\_\_\_ 500 mg stat) Topical miotic agents (\_\_\_\_\_\_\_\_) \_\_\_\_\_\_\_\_\_ mins later Topical \_\_\_\_\_\_\_ \_\_\_\_\_\_ mins later Laser peripheral \_\_\_\_\_\_\_ to relieve \_\_\_\_\_\_\_ \_\_\_\_\_\_ (same-day) 2nd, 2, 2, 3, syncope, constant, QRS, pacemaker \_\_\_\_\_\_\_ Degree AV Block Mobitz Type \_\_\_\_\_: Characterized by non-conducted P waves with a constant PR interval QRS complexes are dropped in a regular pattern (e.g., \_\_\_:1, \_\_\_\_:1) Indicates disease in the bundle branches or His-Purkinje system More serious than Mobitz Type I; can progress to complete heart block Patients may be asymptomatic or present with \_\_\_\_\_\_\_, dizziness, or fatigue ECG findings: \_\_\_\_\_\_\_ PR interval, missing \_\_\_\_\_\_\_ complexes in a regular pattern Treatment: \_\_\_\_\_\_\_ simple partial The lack of altered consciousness and presence of focal motor symptoms are strongly indicative of a \_\_\_\_\_\_\_ \_\_\_\_\_\_\_ seizure. shock, jerks, juvenile, Keppra, Topamax Myoclonic seizures: Brief, \_\_\_\_\_-like muscle \_\_\_\_\_\_ Often seen in \_\_\_\_\_\_ myoclonic epilepsy (JME) Treatment: Valproic acid, \_\_\_\_\_\_, \_\_\_\_\_\_\_ AMS, smacking, picking, temp(oral), Tegretol, lamictal Complex partial seizures: Sxs: \_\_\_\_\_\_\_ with automatisms (lip \_\_\_\_\_\_, \_\_\_\_\_\_\_) \_\_\_\_\_\_ lobe origin common Treatment: \_\_\_\_\_\_, oxcarbazepine, \_\_\_\_\_\_ AMS, focal motor, pheny(toin), keppra Simple partial seizures: Sxs: No \_\_\_\_\_\_\_, \_\_\_\_\_\_\_ \_\_\_\_\_\_\_/sensory/autonomic symptoms May secondarily generalize Treatment: Carbamazepine, \_\_\_\_\_\_\_\_, \_\_\_\_\_\_\_ delayed, paresis, satiety, scint(igraphy), metoclop, erythro, neuropathy Diabetes mellitus (DM) can cause \_\_\_\_\_\_ gastric emptying (gastro\_\_\_\_\_\_) Gastroparesis symptoms: early \_\_\_\_\_\_, bloating, nausea, vomiting, abdominal pain Diagnosis: gastric emptying study (\_\_\_\_\_\_) Treatment: dietary modifications (small, frequent meals), \_\_\_\_\_\_, \_\_\_\_\_\_ Complications: malnutrition, poor glycemic control, bezoars Autonomic \_\_\_\_\_\_ from long-standing DM is the most common cause of gastroparesis Other causes: post-surgical, medications (anticholinergics, opioids), Parkinson\'s disease annual, 50-80, 20, current, 15, 15 Lung Cancer Screening Recommendations \_\_\_\_\_ low-dose CT (LDCT) for high-risk individuals Ages \_\_\_\_-\_\_\_\_ years ‚â \_\_\_\_\_\_ pack-year smoking history \_\_\_\_\_\_ smoker or quit within past \_\_\_\_ years Discontinue screening if: \>\_\_\_\_\_ years since quitting smoking RV, lift Tetralogy of Fallot is commonly associated with a palpable \_\_\_\_\_\_ \_\_\_\_\_\_. 2, 3, in situ, abnormal, unsatisfactory Cervical Conization: Surgical procedure to remove a cone-shaped portion of the cervix Indications: 1\) Diagnosis and treatment of cervical dysplasia (CIN \_\_\_\_/\_\_\_\_\_) or carcinoma \_\_\_\_ \_\_\_\_\_ 2\) Persistent \_\_\_\_\_ Pap smears with \_\_\_\_\_\_ colposcopy propan(olol), tremor, sweating, anxiety \_\_\_\_\_\_\_\_ is used for symptomatic relief until the hyperthyroidism is resolved. It relieves tachycardia, \_\_\_\_\_\_\_\_, \_\_\_\_\_\_\_\_ and \_\_\_\_\_\_\_\_. heterophile The \_\_\_\_\_\_\_\_ test is used for the diagnosis of infectious mononucleosis in children and adults. forever Patients with mechanical valves require anticoagulation to prevent thrombosis for \_\_\_\_\_\_\_\_ lifelong warfarin, 2.5-3.5, 6, heparin, LMWH, amox, clinda, LMWH Heart Valve Replacement and Anticoagulation: Mechanical valves need \_\_\_\_\_\_ \_\_\_\_\_ (INR \_\_\_\_\_-\_\_\_\_\_) Bioprosthetic valves may only need anticoagulation for \_\_\_\_\_ months post-op Bridge with \_\_\_\_\_ or \_\_\_\_\_\_ when stopping warfarin for procedures \_\_\_\_\_\_ often added to reduce thromboembolism risk Regular INR checks and dose adjustments needed Bleeding is main complication; clots may form if anticoagulation is too low \_\_\_\_\_\_ or \_\_\_\_\_ before dental work to prevent endocarditis Pregnancy is high-risk; switch to \_\_\_\_\_\_\_ layering, psoriasis Nail Pitting: punctate depressions of nail plate Caused by defective \_\_\_\_\_\_ of superficial nail plate by proximal nail matrix Associated with \_\_\_\_\_\_\_ white, brown, cirrhosis Terry\'s nails: Nail plate turns \_\_\_\_\_ with ground glass appearance Distal band of \_\_\_\_\_\_ Obliteration of lunula Seen in \_\_\_\_\_\_\_ swelling, lung, IBS, CA Nail Clubbing: bulbous \_\_\_\_\_\_ of soft tissue at nail base Associated with \_\_\_\_\_\_ problems, \_\_\_\_\_, \_\_\_\_\_ bronchial, egophony, inc, fremitus, rust, strepPNA Lobar pneumonia PE findings: Fever, chills, productive cough Dullness to percussion over affected lobe \_\_\_\_\_\_\_ breath sounds, \_\_\_\_\_\_\_, \_\_\_\_\_\_ vocal \_\_\_\_\_\_\_\_ Tachypnea, tachycardia Chest pain (pleuritic) \_\_\_\_\_\_ colored sputum Leukocytosis Consolidation on CXR Additional high-yield points: \_\_\_\_\_\_ most common cause Abrupt onset of symptoms Occurs more in winter months Can see \"currant jelly\" sputum blue, 12 Chadwick\'s sign is a \_\_\_\_\_\_\_ discoloration of the vagina early in pregnancy; it usually appears by \_\_\_\_\_ weeks of gestation areflexia, fever, sensory, protein, axonal, glucose, WBCs Guillain-Barre syndrome Progressive, symmetric, ascending weakness and \_\_\_\_\_\_\_ No \_\_\_\_\_\_ or \_\_\_\_\_\_ deficits CSF: Elevated \_\_\_\_\_\_ (due to \_\_\_\_\_ demyelination) Normal \_\_\_\_\_\_\_ Normal \_\_\_\_\_\_\_ vert(ical), erythro, bacitracin, patch, 24, rust Eye Foreign Body Most common in males, 20-40 years old Symptoms: pain, tearing, blurred vision, foreign body sensation Exam: check visual acuity, evert eyelids, fluorescein stain, slit lamp exam Corneal abrasion: \_\_\_\_\_\_\_ linear defect with fluorescein uptake Treatment: Topical anesthetic, remove foreign body with cotton swab or irrigation Antibiotic ointment (\_\_\_\_\_\_ or \_\_\_\_\_\_), eye \_\_\_\_\_ for \_\_\_\_\_ hours Oral analgesics for pain Refer to ophthalmology if large, central, or deep foreign body, or if \_\_\_\_\_ ring present Prevention: safety glasses in high-risk occupations compression, herniated, unilat, straight (leg), narrowing, degen, bilat, ext(ension), claud(ication), rest, old Lumbar Radiculopathy vs. Spinal Stenosis Lumbar Radiculopathy: Caused by nerve root \_\_\_\_\_\_\_, often due to \_\_\_\_\_\_\_\_ disc \_\_\_\_\_\_ leg pain, numbness, weakness in specific dermatome/myotome Positive \_\_\_\_\_\_ raise test MRI shows nerve root compression Spinal Stenosis: \_\_\_\_\_\_\_ of spinal canal, often due to \_\_\_\_\_\_\_\_ changes \_\_\_\_\_\_\_\_ leg pain, numbness, weakness; worse with \_\_\_\_\_\_, better with flexion Neurogenic \_\_\_\_\_\_\_\_: leg symptoms with walking/standing, relieved by \_\_\_\_ MRI shows narrowed spinal canal More common in \_\_\_\_\_\_\_ patients fibrosis, radiation, TB, virus, right, JVD, hepato, edema, dec, sys, inc, inspiration, loops Constrictive pericarditis: Chronic inflammation and \_\_\_\_\_\_\_ of the pericardium Leads to restricted filling of the ventricles Causes include idiopathic, post-cardiac surgery, \_\_\_\_\_\_\_, infection (\_\_\_\_\_, \_\_\_\_) Presents with symptoms of \_\_\_\_\_\_-sided heart failure \_\_\_\_\_\_\_\_, \_\_\_\_\_megaly, peripheral \_\_\_\_\_\_\_\_\_ Pulsus paradoxus may be present: Exaggerated \_\_\_\_\_\_ (\>10 mmHg) in \_\_\_\_\_ BP during inspiration Kussmaul\'s sign: JVP \_\_\_\_\_\_ with \_\_\_\_\_\_\_\_ (opposite of what it should do) Diagnosis: Echocardiogram, cardiac catheterization, CT/MRI Treatment: \_\_\_\_\_\_\_, salt restriction, pericardiectomy in severe cases Bordetella, neg coccobacillus, 2, Paroxysmal, vom, inspiration, months, azithro, erythro, shaggy, (peri)hilar \_\_\_\_\_\_\_\_ pertussis: Gram-\_\_\_\_\_ \_\_\_\_\_\_\_\_ Causes pertussis (whooping cough) Highly contagious, spread by respiratory droplets Incubation period: 7-10 days Catarrhal stage: URI symptoms for \_\_\_\_\_ weeks \_\_\_\_\_\_\_\_\_\_ stage: severe coughing fits, post-tussive \_\_\_\_\_, \"whoop\" sound on \_\_\_\_\_ Convalescent stage: gradual recovery over \_\_\_\_\_ Complications: pneumonia, seizures, encephalopathy, death (infants) Diagnosis: clinical presentation, PCR, culture Treatment: macrolides (\_\_\_\_\_, \_\_\_\_\_), supportive care Prevention: DTaP and Tdap vaccines Additional exam-relevant points: Most severe in infants \< 6 months old Leukocytosis with lymphocytosis is common Chest X-ray may show \"\_\_\_\_\_\" \_\_\_\_\_ infiltrates Contact precautions necessary white \_\_\_\_\_\_\_\_ cell casts are indicative of renal infection or inflammation as seen in pyelonephritis or interstitial nephritis. tubular Granular casts: Formed from degenerated cellular casts; may indicate \_\_\_\_\_\_ injury or proteinuria CKD, DM Waxy casts: Suggest \_\_\_\_\_\_\_\_\_ or \_\_\_\_\_\_\_\_\_ nephrotic, DM Fatty casts: Associated with \_\_\_\_\_\_\_\_ syndrome or \_\_\_\_\_\_\_ nephropathy glom, vasculitis, HTN Red cell casts: Indicate \_\_\_\_\_\_\_ injury or bleeding; associated with glomerulonephritis, \_\_\_\_\_\_\_, and severe \_\_\_\_\_\_\_\_\_ protein, dehydration Hyaline casts: Benign, \_\_\_\_\_\_\_-based casts; can be seen in \_\_\_\_\_\_\_\_ or mild renal disorders sulfasal(azine), mesa(lamine), abx \_\_\_\_\_\_\_\_\_\_ and 5-ASA drugs (e.g., \_\_\_\_\_\_\_\_\_) are first-line treatments for mild to moderate inflammatory bowel disease (IBD) These drugs have both anti-inflammatory and \_\_\_\_\_\_\_\_ properties Malarone \_\_\_\_\_\_\_\_ is used for prophylaxis for malaria in areas with chloroquine- or mefloquine-resistant malaria. C4, 5 which nerve roots are associated with diminished biceps reflex? (2) C6, 7 which nerve roots are associated with diminished triceps reflex? (2) C4 which nerve root is associated with weak shoulder? C5 which nerve root is associated with weak biceps muscle? C6 which nerve root is associated with weak wrist? C7 which nerve root is associated with weak triceps muscle? C7 which nerve root is associated with diminished brachioradialis reflex? (2) C6 which nerve root is associated with thumb/index finger paresthesias? C7 which nerve root is associated with middle finger paresthesias? C8 which nerve root is associated with pinky finger paresthesias? propan(olol) only \_\_\_\_\_\_\_\_\_ is indicated for reducing the frequency of migraine headaches. palps, mid, late Patients with mitral valve prolapse will often present with complaint of \_\_\_\_\_\_\_. Auscultation would reveal a \_\_\_\_\_-systolic click with or without a \_\_\_\_\_\_ systolic murmur. AFP Periodic surveillance of \_\_\_\_\_\_\_\_ is a sensitive biomarker for detecting early relapse of testicular cancer. carditis, penG, 4 Recurrences of rheumatic fever are most common in patients who have had \_\_\_\_\_\_\_\_ during their initial episode and in children. The preferred method of prophylaxis is \_\_\_\_\_\_ every \_\_\_\_\_\_ weeks. pseudo(monas) \_\_\_\_\_\_\_\_\_\_is the most predominant pathogen in patients with cystic fibrosis. detrusor, oxybut(ynin) Urge incontinence is caused by \_\_\_\_\_\_\_\_ overactivity that causes urinary leakage. Antimuscarinics, such as \_\_\_\_\_\_\_, are prescribed to relax the pelvic muscles. 11-14, transparency US, hcg, PAPPA, 15-22, AFP, hcg, inhibinA, CVS, 15, nasal, bowel, short Fetal Aneuploidy Screening: First trimester (\_\_\_\_\_-\_\_\_\_ wks): nucal \_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_, \_\_\_\_\_\_\_ & \_\_\_\_\_\_\_\_ cfDNA screening (10+ wks): High accuracy for trisomies 21, 18, 13 Quad screen (\_\_\_\_\_-\_\_\_\_ wks): Serum \_\_\_\_\_, \_\_\_\_\_\_, uE3, \_\_\_\_\_\_\_ High-risk results: \_\_\_\_\_\_ (10-13 wks) or amniocentesis (\_\_\_\_+ wks) Ultrasound markers: ‚Üë NT, absent \_\_\_\_\_\_ bone, echogenic \_\_\_\_\_\_, \_\_\_\_\_\_ bones Integrated screening: 1st & 2nd trimester tests combined progressive, hypereflex(ia), babinski, atrophy, fascics, sensory ALS (amyotrophic lateral sclerosis) Characteristic hallmark: \_\_\_\_\_\_\_\_\_ weakness + UMN signs (\_\_\_\_\_\_\_\_, spasticity, positive \_\_\_\_\_\_\_ sign) and LMN signs (muscle \_\_\_\_\_\_\_, \_\_\_\_\_\_\_ (muscle twitches)) without \_\_\_\_\_\_\_ deficits interstitial, pleura, calc(ified) Asbestos exposure often presents years later with increasing dyspnea and \_\_\_\_\_\_\_\_ fibrosis of the lower lungs, thickened \_\_\_\_\_\_ and \_\_\_\_\_\_\_ pleura plaques. They will have a restrictive pattern on PFT. crackles, interstitial, plaques, vols, FEV1/FVC, dec, monoxide, cor, right, pulm HTN Asbestosis \- Caused by inhalation of asbestos fibers \- Presents with dyspnea, dry cough, inspiratory \_\_\_\_\_\_\_ \- Chest X-ray: bilateral \_\_\_\_\_\_\_ fibrosis, pleural \_\_\_\_\_\_/thickening Pulmonary function tests: restrictive pattern (decreased lung \_\_\_\_\_\_\_, normal \_\_\_\_\_\_-\_\_\_\_\_ ratio), \_\_\_\_\_ DLCO (diffusing capacity of the lung for carbon \_\_\_\_\_\_\_, indicating impaired gas exchange) \- Diagnosis: history of asbestos exposure + imaging + PFTs \- Complications: \_\_\_\_\_\_ pulmonale (\_\_\_\_\_\_-sided heart failure secondary to \_\_\_\_\_\_\_ \_\_\_\_\_), respiratory failure, lung cancer \- No specific treatment; supportive care (oxygen, pulmonary rehab) \- Prevention: avoid asbestos exposure, workplace safety measures DM, pseudo(monas), temporal, 8-12, cipro, ceftazidime, gallium Malignant External Otitis: Severe infection of external auditory canal, typically in elderly pts with \_\_\_\_\_\_\_ or immunocompromised Caused by \_\_\_\_\_\_\_\_\_ (most common) Presents with severe otalgia, otorrhea, granulation tissue in ear canal Can spread to \_\_\_\_\_\_\_\_ bone, cranial nerves (VII, IX, X, XI), brain Diagnosis: clinical exam, culture of ear drainage, CT/MRI to assess extent Treatment: prolonged course \_\_\_-\_\_\_wks of \_\_\_\_\_\_ PO or \_\_\_\_\_\_\_\_ IV. Strict glucose control is essential. Surgical debridement may be necessary for removal of necrotic tissue. To avoid relapse, antibiotics should be continued even in the asymptomatic patient, until \_\_\_\_\_\_\_\_ scanning indicates a marked reduction in the inflammatory process. lispro, aspart, 4, regular, 7, NPH, 16, glargine, detemir, 24, degludec, 42 Common insulins and their approximate duration of action: Rapid-acting (e.g., \_\_\_\_\_, \_\_\_\_\_\_, glulisine): \_\_\_\_\_ hours Short-acting (\_\_\_\_\_\_ insulin): \_\_\_\_\_ hours Intermediate-acting (\_\_\_\_\_\_): \_\_\_\_\_ hours Long-acting (e.g., \_\_\_\_\_\_, \_\_\_\_\_\_): \_\_\_\_ hours Ultra-long-acting (e.g., \_\_\_\_\_\_): \>\_\_\_\_\_ hours ectopics \_\_\_\_\_\_\_\_ will have an abnormally low hCG level because the hCG will not double every 48 hours as a normal pregnancy would. nitro \_\_\_\_\_\_\_\_ is an effective treatment of asymptomatic bacturia in the pregnant woman. salmet(erol), relaxation, bronchial smooth muscle The MOA of SABAs (albuterol & \_\_\_\_\_\_\_\_) is the \_\_\_\_\_\_\_\_\_ of \_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_ flagel(lated) proto(zoan), foamy, smelly, green, saline, motile, inc, 4.5, metro, tinid(azole) Trichomoniasis (Trich) Vaginitis: \- Caused by \*Trichomonas vaginalis\*, a \_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_ \- Most common non-viral STI \- Symptoms: \_\_\_\_\_\_\_, \_\_\_\_\_\_\_, yellow-\_\_\_\_\_\_\_ vaginal discharge; vulvar irritation; dysuria; dyspareunia (painful sexual intercourse) \- Diagnosis: \_\_\_\_\_\_ wet mount microscopy (direct visualization of \_\_\_\_\_\_\_\_ trichomonads), rapid antigen testing (point-of-care immunochromatographic assays), nucleic acid amplification tests (NAAT, highly sensitive and specific molecular diagnostic methods), and vaginal pH testing (\_\_\_\_\_\_ pH \> \_\_\_\_\_\_) \- Treatment: \_\_\_\_\_\_ or \_\_\_\_\_\_\_\_ (\_\_\_\_\_ for both); treat sexual partners scaphoid, splinted, referred Tenderness in the snuffbox should be treated as a suspected \_\_\_\_\_\_\_ fracture. The patient should be treated with \_\_\_\_\_\_\_\_ and \_\_\_\_\_\_\_\_ temporal, frontal, ischemic, MCA Which lobe was probably injured if there is lasting depression after the acute injury? \_\_\_\_\_\_\_/\_\_\_\_\_\_\_\_ It was likely an \_\_\_\_\_\_\_\_ stroke involving the \_\_\_\_\_\_\_\_ zofran, HA Which med is typically given for N/V assoc with chemo? \_\_\_\_\_\_\_. Common SE is \_\_\_\_\_\_\_\_ immune complex, glomneph(ritis), hemat, HTN, edema, cyclo, mycophen(olate) Lupus nephritis: \_\_\_\_\_\_ \_\_\_\_\_\_-mediated \_\_\_\_\_\_\_\_\_ \- Presents with proteinuria, \_\_\_\_\_\_uria, \_\_\_\_\_\_\_\_\_, \_\_\_\_\_\_\_ \- Diagnosed by \_\_\_\_\_\_ \- Treated with corticosteroids and immunosuppressants (e.g., \_\_\_\_\_\_\_phosphamide, \_\_\_\_\_\_\_\_\_) hflu, strepPNA, moraxella, amox, augmentin, 7, doxy, cefixime, FQ, 72 Acute Bacterial Sinusitis: Symptoms: facial pain, purulent nasal discharge, nasal obstruction, fever Diagnosis: clinical presentation, CT or X-ray if uncertain Most common pathogens: \_\_\_\_\_\_\_, \_\_\_\_\_\_\_, \_\_\_\_\_\_ Treatment: \_\_\_\_\_\_\_\_ or \_\_\_\_\_\_\_ for \_\_\_\_\_\_ days (allergic: \_\_\_\_\_\_ or \_\_\_\_\_\_ or \_\_\_\_\_\_\_) Consider referral if no improvement after \_\_\_\_\_\_\_ hours of antibiotics neck, hips, 3, 11, 18, sleep, amitrip, pregabalin Fibromyalgia: \- Chronic widespread musculoskeletal pain disorder, with pain typically occurring in the \_\_\_\_\_\_, shoulders, back, \_\_\_\_\_\_, arms, and legs \- Affects 2-4% of population, more common in women \- Diagnostic criteria: widespread pain for ‚â \_\_\_\_ months and ‚â \_\_\_\_/\_\_\_\_\_ tender points \- Associated with fatigue, \_\_\_\_\_ disturbances, cognitive difficulties, depression, anxiety, suggesting fibromyalgia may be more of a psychological disorder than a physical one \- Pathophysiology involves central sensitization and altered pain processing \- Management: patient education, exercise, CBT, antidepressants (\_\_\_\_\_\_\_\_, duloxetine), anticonvulsants (\_\_\_\_\_\_\_), sleep hygiene Amyloidosis, small thick LV, early, dia \_\_\_\_\_\_\_\_\_ is the most common cause of restrictive cardiomyopathy and is associated with a \_\_\_\_\_ \_\_\_\_\_\_\_ \_\_\_\_\_\_ that has rapid \_\_\_\_\_ filling with \_\_\_\_\_\_\_ dysfunction protein, organs, light-chain, MM, A, RA, IBD, familial, transthy(retin), restrictive, nephrotic, periph(eral), hepatomeg(aly), macroglossia, congo red, chemo Amyloidosis Abnormal deposition of insoluble \_\_\_\_\_\_ fibrils in tissues/\_\_\_\_\_\_\_ Types: AL (Amyloid \_\_\_\_\_\_-\_\_\_\_\_\_): Associated with plasma cell disorders like \_\_\_\_\_ AA (Amyloid \_\_\_\_): Due to chronic inflammatory conditions (\_\_\_\_\_\_, \_\_\_\_\_\_, chronic infections) \_\_\_\_\_\_\_\_\_: Inherited, e.g., \_\_\_\_\_\_\_ amyloidosis Symptoms depend on organ involvement: Cardiac: Heart failure, arrhythmias, \_\_\_\_\_\_\_\_\_ cardiomyopathy Renal: \_\_\_\_\_\_\_ syndrome, renal failure Neurological: \_\_\_\_\_\_ neuropathy, autonomic dysfunction GI: Malabsorption, \_\_\_\_\_\_\_, \_\_\_\_\_\_\_\_ Diagnosis: Tissue biopsy (\_\_\_\_\_ \_\_\_\_\_ stain), serum/urine protein electrophoresis, bone marrow biopsy Treatment: Depends on type; may include \_\_\_\_\_\_\_, stem cell transplant, supportive care central, proximal, hypergly, HTN, ketocon(azole), metyrapone, OP (osteoporosis), DM, infection Cushing\'s Syndrome: \- Caused by chronic excess cortisol (endogenous or exogenous) \- Signs/symptoms: \_\_\_\_\_\_ obesity, moon facies, buffalo hump, purple striae, \_\_\_\_\_\_\_ muscle weakness, \_\_\_\_\_\_\_, \_\_\_\_\_\_\_ \- Diagnosis: elevated 24-hour urinary free cortisol, dexamethasone suppression test \- Treatment: surgery (pituitary adenoma, adrenal tumor), medications (\_\_\_\_\_\_\_, \_\_\_\_\_\_\_\_), gradual tapering of exogenous steroids \- Complications: \_\_\_\_\_\_\_\_, \_\_\_\_\_\_, cardiovascular disease, increased \_\_\_\_\_\_\_\_ risk 80-100, 90-95, 60-80, 85-90, 50-10, ABGs, 85, 50, ABGs, 80-100, 80, 100, 95, CO2 \- Normal SpO2: 95-100% ‚âà PaO2 \_\_\_\_-\_\_\_\_\_ mmHg \- SpO2 \_\_\_\_-\_\_\_\_\_%: Mild hypoxemia ‚âà PaO2 \_\_\_\_-\_\_\_\_\_ mmHg \- SpO2 \_\_\_\_-\_\_\_\_\_%: Moderate hypoxemia ‚âà PaO2 \_\_\_\_-\_\_\_\_ mmHg, consider \_\_\_\_\_\_\_ \- SpO2 \< \_\_\_\_\_%: Severe hypoxemia ‚âà PaO2 \< \_\_\_\_\_ mmHg, \_\_\_\_\_\_ necessary \- Normal PaO2: \_\_\_\_-\_\_\_\_ mmHg \- Low PaO2 (hypoxemia): \< \_\_\_ mmHg \- High PaO2 (hyperoxemia): \> \_\_\_\_ mmHg \- SpO2 monitoring: Continuous for critically ill, intermittent for stable patients \- SpO2 goal: \> 90% for most patients, \> \_\_\_\_\_% for pregnant or \_\_\_\_\_\_ retainer patients angina, syncope, EF, meto(prolol), carvedilol, lisinopril, ramipril, ASA, statin, pacemaker-ICD, 35 Comorbids of H/o Ischemic cardiomyopathy \- Presenting symptoms: \- Transient \_\_\_\_\_\_ \- \_\_\_\_\_\_ often due to arrhythmia or reduced cardiac output \- Chronic low \_\_\_\_\_\_ \- Management: optimize medical therapy with beta-blockers (e.g., \_\_\_\_\_\_\_ 25-100 mg twice daily or \_\_\_\_\_\_\_\_ 3.125-25 mg twice daily), ACE inhibitors (e.g., \_\_\_\_\_\_\_ 2.5-40 mg daily or \_\_\_\_\_\_\_ 1.25-10 mg daily), antiplatelets (e.g., \_\_\_\_\_ 81-325 mg daily), and \_\_\_\_\_\_\_\_. Consider \_\_\_\_\_\_-\_\_\_\_\_\_ combo if EF ‚â§\_\_\_\_\_\_% with syncope metastatic carcinoid 5-HIAA levels are elevated in \_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_\_ tumors Zollinger-Ellison, panc(reas), duodenum, ulcers, beta islet, tumor, MEN1, fasting \_\_\_\_\_\_\_\_-\_\_\_\_\_\_\_ 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 Diagnostic tests: 1\) \_\_\_\_\_\_\_ serum \_\_\_\_\_\_\_ level \>\_\_\_\_\_\_ pg/mL is diagnostic. 2\) \_\_\_\_\_\_\_ \_\_\_\_\_\_ test: a hormone that normally inhibits gastrin secretion. The test involves IV administration of the hormone and measurement of serum gastrin at baseline and 2, 5, 10, 15, and 30 minutes after. A rise in serum gastrin \>\_\_\_\_\_ pg/mL after secretin is diagnostic. \- Treatment: \_\_\_\_\_\_ therapy, surgical resection of tumor colicky, Menorrhagia, OCPs, myomectomy Uterine leiomyomata (fibroids): \- Severe dysmenorrhea (painful menstruation) with agonizing, \_\_\_\_\_\_\_, spasmodic pelvic pain \- \_\_\_\_\_\_\_\_ (abnormally heavy or prolonged menstrual bleeding) \- Enlarged, irregular uterus on exam \- Additional key points: \- Most common benign uterine tumor \- Can cause infertility, pelvic pain, pressure symptoms \- Diagnosis: pelvic exam, ultrasound \- Treatment: NSAIDs, \_\_\_\_\_\_\_, \_\_\_\_\_\_\_, hysterectomy viral, EBV, adeno(virus), supportive Cobblestoning of the posterior pharynx: Appearance: Irregular, bumpy mucosa resembling cobblestones Etiology: Typically \_\_\_\_\_\_\_\_ (e.g., \_\_\_\_\_\_, \_\_\_\_\_\_\_) Treatment: \_\_\_\_\_\_\_\_\_\_ hypothy, hypotherm, hypoTN, brady, hypovent, AMS, hypoNa, hypogly, levo, hydrocort(isone), macroglossia, periorbital Myxedema Coma Severe \_\_\_\_\_\_\_ leading to \_\_\_\_\_\_\_, \_\_\_\_\_\_, \_\_\_\_\_, \_\_\_\_\_\_\_\_, \_\_\_\_\_\_\_\_ Usually seen in elderly females with long-standing, untreated hypothyroidism Precipitated by \_\_\_\_\_\_, cold exposure, sedatives, or other metabolic stressors Presents with lethargy progressing to stupor/coma, hypoventilation, hypothermia, \_\_\_\_\_, \_\_\_\_\_\_ Diagnosis: clinical presentation, very low free T4, elevated TSH Treatment: IV \_\_\_\_\_\_, \

untitled text 21.docx

Document Details

Tags

Related

Full Transcript

Upgrade to continue