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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...

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 PSGN occurs ***-*** weeks after a streptococcal infection (strep throat or \_\_\_\_\_ infection) Clinical features include \_\_\_\_\_\_\_, \_\_\_\_\_\_, \_\_\_\_\_\_, and \_\_\_\_\_\_ urine output Diagnosis is confirmed by elevated \_\_\_\_\_ titers and \_\_\_\_\_ complement levels (\_\_\_\_\_\_\_\_) 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: Mild = PEFR \>\_\_\_\_% predicted or personal best, SpO2 \>\_\_\_\_% - Tx w/ albuterol Mod = PEFR \_\_\_\_-\_\_\_\_% predicted, SpO2 \_\_\_\_-\_\_\_\_% - Tx w/ albuterol + \_\_\_\_\_ 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 ≥ \_\_\_\_ 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) Demographics: Most common in men over 65, smokers, and those with a family history. Classic Presentation: Often asymptomatic; may have \_\_\_\_\_ pain, pulsatile abdominal mass, or abdominal pain. Treatment: First-Line: Surgical repair for aneurysms \>\_\_\_\_cm or symptomatic. Alternatives: Watchful waiting with regular imaging for smaller aneurysms. Diagnostic Criteria: Diameter \>\_\_\_cm on imaging. 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 Demographics: Risk factors include IV drug use, high-risk sexual behavior, blood transfusion before 1992. Classic Presentation: Often asymptomatic, may have fatigue, jaundice. Diagnostics: Labs: HCV \_\_\_\_\_\_ quantitative \_\_\_\_\_\_ to measure viral load. Imaging: Not applicable for virus quantification. Treatment: First-Line: Direct-acting antivirals (DAAs): \_\_\_\_\_\_\_, \_\_\_\_\_\_, \_\_\_\_\_\_ Alternatives: Different combinations of DAAs based on genotype. 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 Demographics: Common in \_\_\_\_\_\_\_\_\_ women, patients with \_\_\_\_\_\_. Classic Presentation: Bones, \_\_\_\_\_\_, \_\_\_\_\_\_ groans, psychic \_\_\_\_\_\_\_. Diagnostics: Labs: Elevated serum calcium and \_\_\_\_\_\_\_\_-; low \_\_\_\_\_\_\_. Treatment: First-Line: Surgical removal of parathyroid adenoma if present. Alternatives: Bisphosphonates or \_\_\_\_\_\_\_ if surgery not possible. Important Notes: Hypercalcemia of malignancy treated differently than primary hyperparathyroidism. Red Flags: Severe hypercalcemia (\>\_\_\_\_ mg/dL) can be life-threatening. 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 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-Barré 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, \_\_\_\_\_) Used for: Hypertension, heart failure, and edema Alternative: \_\_\_\_\_\_ or \_\_\_\_\_\_ 2. ------------------------------------------------------------------------ Used for: Heart failure, edema, and hypertension Alternative: Torsemide (a loop diuretic less likely to cause gout) 3. Low-dose \_\_\_\_\_ (used for cardiovascular protection) Used for: Prevention of heart attacks and strokes Alternative: \_\_\_\_\_ (an antiplatelet agent) 4. ------------------------------------------------------------------------ Used for: Dyslipidemia (high cholesterol and triglycerides) 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): Prodrome of \_\_\_\_\_\_\_ fever, cough, coryza, and conjunctivitis (the "3 Cs") Koplik spots (small white spots on buccal mucosa) appear \_\_\_\_\_ days before \_\_\_\_\_\_ onset Maculopapular rash begins on the face and spreads downward, becoming \_\_\_\_\_\_ Rash appears around day \_\_\_\_\_ of illness 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 Тype III allergic reaction \_\_\_\_\_\_\_ \_\_\_\_\_\_\_-mediated Timing of Reaction \_\_\_\_-\_\_\_ hours Common Symptom ------------------------------------------------------------------------ Cause: Medications (e.g., \_\_\_\_\_\_\_\_) antibody, 6-24, low plates, transfusions, Rh incompat(ibility) Тype 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 ≥\_\_\_ 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: \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 \\_\_\_\_\_ 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 ≥\_\_\_\_ months and ≥\_\_\_\_/\_\_\_\_\_ 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% ≈ PaO2 \_\_\_\_-\_\_\_\_\_ mmHg - SpO2 \_\_\_\_-\_\_\_\_\_%: Mild hypoxemia ≈ PaO2 \_\_\_\_-\_\_\_\_\_ mmHg - SpO2 \_\_\_\_-\_\_\_\_\_%: Moderate hypoxemia ≈ PaO2 \_\_\_\_-\_\_\_\_ mmHg, consider \_\_\_\_\_\_\_ - SpO2 \< \_\_\_\_\_%: Severe hypoxemia ≈ 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 ≤\_\_\_\_\_\_% 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 \_\_\_\_\_\_, \_\_\_\_\_\_ (for possible adrenal insufficiency), supportive care (mechanical ventilation, warming, IV fluids, vasopressors PRN) Additional key associations to remember: \_\_\_\_\_\_\_\_, \_\_\_\_\_\_\_ edema, dry skin, coarse hair Hyponatremia due to impaired free water excretion PCR test for herpes sigmoid, peritoneal, bean, comma, young, 30-60, whirl, surgery, perf, necrosis Cecal Volvulus Second most common site of volvulus (after \_\_\_\_\_\_\_\_\_) Congenital defect in \_\_\_\_\_\_\_ resulting in twisting of mobile cecum Classic imaging findings: \_\_\_\_\_\_ appearance \_\_\_\_\_\_ appearance Risk factors: \_\_\_\_\_\_ age (\_\_\_\_\_-\_\_\_\_\_) compared to sigmoid volvulus Increased GI malignancy Diagnosis: Plain film (low specificity) Abdominal CT (90% of patients) - look for "\_\_\_\_\_\_ sign" Surgical exploration (10% of patients) Management: \_\_\_\_\_\_\_\_\_ required Detorsion alone has high recurrence rate Avoid nonsurgical treatment due to risk of \_\_\_\_\_\_\_ or missed \_\_\_\_\_\_ mesentery, old, 60, constipation, parkinsons, MS, dilated, bean, gas, whirl, beak, decompress, tube Sigmoid Volvulus Most common site of volvulus in the gastrointestinal tract Occurs when sigmoid colon twists on its \_\_\_\_\_\_\_\_, causing obstruction Risk factors: \_\_\_\_\_\_ patients (\>\_\_\_\_\_yo) Chronic \_\_\_\_\_\_\_ Neurological disorders (\_\_\_\_\_\_\_, \_\_\_\_\_) Institutionalized patients Clinical presentation: Abdominal pain, distension, and constipation Nausea and vomiting Peritoneal signs suggest bowel ischemia or perforation Diagnosis: Plain abdominal radiographs: \_\_\_\_\_ sigmoid colon, \_\_\_\_\_\_ sign, absent rectal \_\_\_\_\_\_ Abdominal CT: \_\_\_\_\_ sign, \_\_\_\_\_ appearance, transition point Management: Initial treatment: endoscopic \_\_\_\_\_\_\_ and rectal \_\_\_\_\_\_\_ placement Elective surgery for recurrent cases: sigmoid resection with primary anastomosis congenital peritoneal, 30, 50, comma, surgery Cecal Volvulus \_\_\_\_\_\_\_ \_\_\_\_\_\_\_ defect Patients in \_\_\_\_s to \_\_\_\_\_s Plain film: coffee bean or \_\_\_\_\_ appearance CT: whirl sign Tx: \_\_\_\_\_\_\_ acquired, bed-bound, coffee, endoscopic, colectomy, gangrene Sigmoid Volvulus \_\_\_\_\_\_ condition Elderly patients, \_\_\_\_-\_\_\_\_\_\_\_ Dx: Plain film: \_\_\_\_\_ bean sign, absent rectal gas CT: whirl sign, bird beak appearance Tx: \_\_\_\_\_\_\_\_ decompression Recurrence: sigmoid \_\_\_\_\_\_\_ Complications: Bowel ischemia, \_\_\_\_\_\_\_, perforation contrast, 24, 2.5 Esophageal Foreign Body in Pediatrics Most common in children \< 5 years old Coins most frequent culprit Dx: X-ray: radiopaque object in esophagus \_\_\_\_\_\_\_ study if radiolucent object suspected Tx: Endoscopic removal if symptomatic or object present \> \_\_\_\_ hrs Asymptomatic & blunt objects \< \_\_\_\_\_ cm may pass spontaneously 24, cerebral, ASA, clop, ABCD2, NIHSS, 60, 140/90, unilat weakness, voice, 10-60, 60, DM, 7, 4-5, 6 TIA Neurologic deficit lasting \< \_\_\_\_ hrs Caused by temporary \_\_\_\_\_\_\_\_ ischemia Risk factors: HTN, smoking, DM, dyslipidemia Dx: Clinical diagnosis Rule out stroke with CT/MRI Tx: Antiplatelet therapy (\_\_\_\_\_, \_\_\_\_\_\_) Address risk factors Carotid endarterectomy or stenting if indicated Admission: \_\_\_\_\_ and \_\_\_\_\_\_\_ scores determine admission The easier of the two: Age ≥\_\_\_\_\_: 1 point Blood pressure ≥\_\_\_\_/\_\_\_\_\_: 1 point Clinical features (\_\_\_\_\_\_\_ \_\_\_\_\_\_: 2 points, \_\_\_\_\_ impairment without weakness: 1 point) Duration (\_\_\_\_-\_\_\_\_ min: 1 point, ≥\_\_\_\_\_ min: 2 points) \_\_\_\_\_\_\_\_\_: 1 point Max score of \_\_\_\_\_\_\_. ***-*** scores get admission to normal floor. \_\_\_\_+ get ICU 0-3 1, 1.5, 3 Stroke Risk % for TIA IF LOW ABCD2 risk = \_\_\_\_\_-\_\_\_\_\_ @ Day 2 = \_\_\_\_% risk of stroke Day 7 = \_\_\_\_% Day 90 = \_\_\_\_% 4-5, 5, 7.5, 10 Stroke Risk % for TIA IF MED ABCD2 risk = \_\_\_\_\_-\_\_\_\_\_ @ Day 2 = \_\_\_\_% risk of stroke Day 7 = \_\_\_\_% Day 90 = \_\_\_\_% 6-7, 10, 12.5, 17.5 Stroke Risk % for TIA IF HIGH ABCD2 risk = \_\_\_\_\_-\_\_\_\_\_ @ Day 2 = \_\_\_\_% risk of stroke Day 7 = \_\_\_\_% Day 90 = \_\_\_\_% 500, HHV8, hairy, EBV AIDS with Common Pathogens CD4 \< \_\_\_\_\_\_: Oral thrush (Candida) White plaques, easily scraped off Kaposi sarcoma (\_\_\_\_\_) Vascular nodules Oral \_\_\_\_\_ leukoplakia (\_\_\_\_) White plaques, cannot be scraped off 200, jirovecii, dry, groundglass, tmpsmx, multifocal, demy(elination) CD4 \< \_\_\_\_\_\_: Pneumocystis pneumonia (Pneumocystis \_\_\_\_\_\_\_) Dyspnea, \_\_\_\_\_\_\_ cough, \_\_\_\_\_\_\_ opacities on CXR Dx: Bronchoalveolar lavage or induced sputum Tx: \_\_\_\_\_\_\_ Progressive \_\_\_\_\_\_\_ leukoencephalopathy (JC virus) Neurological deficits, \_\_\_\_\_\_\_\_\_ on MRI Dx: PCR of CSF Tx: No specific treatment, ART toxo, ring, pyrimeth, sulfa, crypto, HA, fever, CSF, india, ampB, flucytosine CD4 \< 100: ------------------------------------------------------------------------ Encephalitis, multiple \_\_\_\_\_\_\_\_\_ lesions on MRI Dx: Serology, brain biopsy if needed Tx: \_\_\_\_\_\_\_amine + \_\_\_\_\_\_diazine ------------------------------------------------------------------------ \_\_\_\_\_\_\_\_\_, \_\_\_\_\_\_\_\_\_, neck stiffness, increased ICP Dx: \_\_\_\_\_\_\_\_\_ analysis (\_\_\_\_\_\_\_\_\_ ink stain, cryptococcal antigen) Tx: \_\_\_\_\_\_\_\_\_ + \_\_\_\_\_\_\_\_\_, then fluconazole 50, B (night sweats, fever, weight loss), lymph(adenopathy), clarith, azith, etham(butol), CMV, visual, ganciclovir CD4 \< \_\_\_\_: Mycobacterium avium complex (MAC) \_\_\_\_\_\_ sxs, \_\_\_\_\_\_\_\_\_\_ Dx: Blood culture, biopsy Tx: \_\_\_\_\_\_\_ or \_\_\_\_\_\_ + \_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_ retinitis \_\_\_\_\_\_\_ disturbances, retinal hemorrhages, cotton wool spots Dx: Fundoscopy Tx: \_\_\_\_\_\_\_\_\_\_ or valganciclovir tmpsmx, PJP, tmpsmx, toxo, clarith, azith, MAC Abx Prophylaxis in AIDS: CD4 \< 200: \_\_\_\_\_\_\_ for \_\_\_\_\_\_\_ CD4 \< 100: \_\_\_\_\_\_\_\_ for \_\_\_\_\_\_\_ CD4 \< 50: \_\_\_\_\_\_\_ OR \_\_\_\_\_\_\_ for \_\_\_\_\_\_\_ ACE, ARB Try to avoid \_\_\_\_\_\_ and \_\_\_\_\_\_\_ in blacks for HTN meds HCTZ, CCBs Use \_\_\_\_\_\_\_ and \_\_\_\_\_\_\_\_\_ in blacks for HTN meds 150, CKD, DM, 140, CCB, HCTZ, 1 HTN Patient Subgroups: Age ≥ 60 years: SBP: \< \_\_\_ mmHg DBP: \< 90 mmHg Age \< 60 years, Age \> 18 years with \_\_\_\_\_, Age \> 18 years with \_\_\_\_\_: SBP: \< \_\_\_\_ mmHg DBP: \< 90 mmHg General Non-Black Population: Thiazide diuretics Calcium channel blockers (CCBs) Angiotensin-converting enzyme (ACE) inhibitors Angiotensin II receptor blockers (ARBs) General Black Population: ------------------------------------------------------------------------ ------------------------------------------------------------------------ Chronic Kidney Disease: Include ACE inhibitor or ARB Management Notes: Adjust or add therapy after \_\_\_\_m if BP targets are not met. Avoid concurrent use of ACE inhibitors and ARBs. Refer to a hypertension specialist if more than 3 medications are required. 7.0-7.3 Nitrazine blue paper test with a pH between \_\_\_\_-\_\_\_\_\_ would suggest the presence of amniotic fluid. 7.35-7.45, 35-45, 22-26 Acute Respiratory and Metabolic Acidosis and Alkalosis Normal ABG values pH \_\_\_\_-\_\_\_\_\_; PaCO2 \_\_\_\_\_-\_\_\_\_ mm Hg; bicarbonate \_\_\_\_-\_\_\_\_ mEq/L Bronchiectasis, platelike, thick(ened) \_\_\_\_\_\_\_\_\_\_ typically presents as recurrent episodes of acute bronchitis. \_\_\_\_\_\_\_\_\_\_\_ atelectasis and dilated and \_\_\_\_\_\_\_\_\_ airways, sometimes described as tram lines, are common radiographic findings. thyroxine, iodine Amiodarone is structurally related to \_\_\_\_\_\_\_\_ and contains \_\_\_\_\_\_\_, which can induce a hyper- or hypothyroid state. methylpred, pred Acute relapses of MS are treated with a short course of IV \_\_\_\_\_\_\_\_\_ followed by oral \_\_\_\_\_\_\_. This regimen reduces the severity and shortens the duration of attacks. HTN Cotton-wool patches are fluffy white or grayish ovoid lesions with irregular borders. They are typically moderate in size and seen in patients with \_\_\_\_\_\_\_\_. PTU \_\_\_\_\_\_\_\_\_\_\_ is the preferred initial drug in patients with thyroid storm. B12 which anemia is associated with parathesias of hands and feet? young (kids and young adults), patchy, bilat, azith, doxy, slow, dry Mycoplasma pneumoniae PNA Atypical pneumonia Common in \_\_\_\_\_\_ Dx: Chest X-ray: \_\_\_\_\_\_ infiltrates, often \_\_\_\_\_\_\_\_ PCR: most sensitive and specific Tx: ------------------------------------------------------------------------ ------------------------------------------------------------------------ Fluoroquinolones (alternative) Additional: \_\_\_\_\_\_\_ onset of symptoms: \_\_\_\_\_\_ cough, fever, malaise Often associated with extrapulmonary manifestations (e.g., rash, hemolytic anemia) BNP, CHF \_\_\_\_\_\_\_ is a hormone released from the myocardium when stretched such as with high ventricular filling pressures from \_\_\_\_\_\_. slow, pain, itching, scaly, firm, karatin(ization), pigment(ation), sun Squamous Cell Carcinoma (SCC) on Face \_\_\_\_\_\_ developing facial lesion No \_\_\_\_\_\_ and no \_\_\_\_\_\_\_\_ Extremely \_\_\_\_\_\_ \_\_\_\_\_\_\_ nodule Heavy \_\_\_\_\_\_\_\_\_\_ No fluctuance or skin \_\_\_\_\_\_\_\_\_\_ Common in \_\_\_\_\_\_-exposed areas Dx: Biopsy: confirms diagnosis Tx: Surgical excision Mohs micrographic surgery for high-risk areas young, 2, thermia, rigid(ity), labile, AMS, CK, myoglobin, dantrolene, bromo(criptine) Neuroleptic Malignant Syndrome (NMS) Life-threatening reaction to antipsychotic medications, common in \_\_\_\_ adults, often within \_\_\_\_\_ weeks of starting medication. Symptoms: Hyper\_\_\_\_\_\_\_ Muscle \_\_\_\_\_\_\_ Autonomic instability (e.g., tachycardia, \_\_\_\_\_\_\_ blood pressure) ------------------------------------------------------------------------ Dx: Clinical diagnosis Elevated \_\_\_\_\_\_\_\_ Leukocytosis \_\_\_\_\_\_\_\_\_uria Tx: Discontinue antipsychotic Supportive care (hydration, cooling) Medications: \_\_\_\_\_\_\_\_, \_\_\_\_\_\_\_\_\_ Mnemonic: FEVER (Fever, Encephalopathy, Vitals unstable, Elevated enzymes, Rigidity of muscles) nodular Diffuse \_\_\_\_\_\_\_ densities are seen in hypersensitivity pneumonitis organic, farmers, bird, groundglass, nodular, mosaic, pred Hypersensitivity Pneumonitis Inflammatory response to inhaled \_\_\_\_\_\_ antigens Common in \_\_\_\_\_\_\_, \_\_\_\_\_\_ handlers Dx: CXR: \_\_\_\_\_\_\_\_ opacities HRCT: centrilobular \_\_\_\_\_\_\_, \_\_\_\_\_\_\_ attenuation Tx: Avoidance of antigen exposure \_\_\_\_\_\_\_ for severe cases sarcoid Granulomatous inflammation of lungs, think brady-tachy, pacemaker Sick Sinus Syndrome Dysfunction of the sinoatrial (SA) node Common in elderly patients Dx: ECG: \_\_\_\_\_\_\_-\_\_\_\_\_\_\_ syndrome, sinus pauses, or arrest Holter monitor: Correlates symptoms with arrhythmias Tx: ------------------------------------------------------------------------ Address underlying causes (e.g., medications, ischemia) wax, (A)OM, otosclerosis, BC, bad, stapedectomy Conductive Hearing Loss Causes: ------------------------------------------------------------------------ ------------------------------------------------------------------------ ------------------------------------------------------------------------ Dx: Rinne test: Which one is greater? \_\_\_\_\_\_\_ Weber test: Sound lateralizes to \_\_\_\_\_\_ ear Tx: Cerumen removal Antibiotics for otitis media Surgery for otosclerosis (\_\_\_\_\_\_\_\_\_\_) Additional Notes: Common in children and elderly Often reversible with treatment inner, auditory, meds (ototoxins), chemo, loops, AGs, good, AC, aids Sensorineural Hearing Loss Damage to \_\_\_\_\_\_ ear or \_\_\_\_\_\_ nerve Common in older adults, exposure to loud noise, or \_\_\_\_\_\_\_\_\_\_ (\_\_\_\_\_\_, \_\_\_\_\_\_, \_\_\_\_\_\_) Dx: Audiometry: decreased hearing sensitivity Weber test: sound lateralizes to \_\_\_\_\_\_\_ ear Rinne test: Which one is greater? \_\_\_\_\_\_\_ Tx: Hearing \_\_\_\_\_\_ Cochlear implants (severe cases) 20 At \_\_\_\_\_\_\_\_ weeks, fundal height is at the umbilicus. AGs, FQs Topical \_\_\_\_\_\_\_\_ or \_\_\_\_\_\_\_\_ are indicated in contact lens wearers with conjunctivitis to cover for Pseudomonas infection. 50, lymphocytosis, lymphocytes, small, mature CLL typically occurs after age \_\_\_\_\_\_\_ presenting with \_\_\_\_\_\_\_\_ with \_\_\_\_\_\_\_\_ that appear \_\_\_\_\_\_\_ and \_\_\_\_\_. collagen, proliferation Fibroblasts produce \_\_\_\_\_\_\_\_ during the \_\_\_\_\_\_\_\_ stage of healing. hemostasis, inflammation, neutros, heat, 3, proliferation, 3-21, fibroblasts, collagen, granulation, remodeling, 21, collagen Stages of Wound Healing ------------------------------------------------------------------------ Immediate response Vasoconstriction, platelet aggregation, clot formation ------------------------------------------------------------------------ 0-\_\_ days \_\_\_\_\_\_\_\_\_, macrophages Signs: redness, \_\_\_\_\_\_, swelling, pain ------------------------------------------------------------------------ ***-***\_\_\_\_ days \_\_\_\_\_\_\_, \_\_\_\_\_\_\_ deposition, angiogenesis \_\_\_\_\_\_\_\_ tissue formation, wound contraction Maturation (\_\_\_\_\_\_\_) \_\_\_\_\_\_ days to 1 year \_\_\_\_\_\_\_ remodeling, tensile strength increases Scar formation right, congestion, lungs \_\_\_\_\_\_\_ vent failure is manifested by dependent edema and \_\_\_\_\_\_\_ in the \_\_\_\_\_. SOB, conversation, mild Left Ventricular Heart Failure First sign: \_\_\_\_\_\_ with \_\_\_\_\_\_\_ or \_\_\_\_\_\_ exertion Comfortable at rest ADH, low, hyperNa, desmo(pressin), desmo(pressin) Diabetes Insipidus (DI) s/p Trans-sphenoidal Resection Etiology: Post-surgical complication, often after pituitary surgery Pathophysiology: Deficiency of \_\_\_\_ leading to excessive urination and thirst Dx: Clinical Presentation: Polyuria, polydipsia, dehydration Labs: \_\_\_\_\_\_ urine osmolality High serum osmolality ------------------------------------------------------------------------ Water Deprivation Test: Failure to concentrate urine \_\_\_\_\_\_\_ Test: Improvement in symptoms and urine concentration Tx: Acute Management: IV fluids to correct dehydration and electrolyte imbalances Chronic Management: \_\_\_\_\_\_\_ administration Monitoring: Regular follow-up for electrolyte levels and urine output Additional Notes: Complications: Severe dehydration, hypernatremia Patient Education: Importance of medication adherence and monitoring fluid intake/output mesangium, glomnephritis, kids, coke, blood, protein, GI, ACE, pred IgA Nephropathy Pathophysiology: IgA deposition in glomerular \_\_\_\_\_\_\_\_\_ Epidemiology: Most common \_\_\_\_\_\_\_\_ worldwide Often affects \_\_\_\_\_ Clinical Presentation: \_\_\_\_\_\_\_ urine with \_\_\_\_\_\_\_ and \_\_\_\_\_\_\_\_\_ Gross hematuria following upper respiratory or \_\_\_\_\_\_ infection Recurrent episodes of hematuria Diagnosis: Renal biopsy: IgA deposits in mesangium (immunofluorescence) Serum IgA levels may be elevated Treatment: \_\_\_\_\_\_\_\_\_ for proteinuria \_\_\_\_\_\_\_\_\_ for severe cases Fish oil (omega-3 fatty acids) may be beneficial 10, 15 cluster headache (migrainous neuralgia), these headaches respond to oxygen by mask \_\_\_\_\_\_ L/min for \_\_\_\_\_ minutes. 5-15, sand(paper), neck, straw(berry), Pastias, folds, hands, feet Scarlatina Rash Cause: \_\_\_\_\_\_\_\_ Age: Mainly children \_\_\_\_\_-\_\_\_\_\_ years Symptoms: Rash: Fine, \_\_\_\_\_\_\_-like, starts on \_\_\_\_\_\_, spreads to body \_\_\_\_\_\_\_ Tongue: Red, bumpy tongue \_\_\_\_\_\_ Lines: Red lines in skin \_\_\_\_\_\_\_ Desquamation: Peeling skin, especially \_\_\_\_\_ and \_\_\_\_\_ circumoral, folds, cephalexin Scarlet Fever Group A strep infection, usually after strep pharyngitis Sandpaper-like rash, strawberry tongue, \_\_\_\_\_\_\_\_ pallor Pastia's lines (skin \_\_\_\_\_\_\_), desquamation Dx: Clinical, rapid strep test, throat culture Tx: Antibiotics (penicillin, amoxicillin, \_\_\_\_\_\_\_\_) Complications: Rheumatic fever, glomerulonephritis 2, edema, HTN, oliguria, C3, 8, restrict, loops, ACE Poststreptococcal Glomerulonephritis Follows Group A strep infection (pharyngitis, impetigo) by \_\_\_\_\_ weeks Ages 5-12 most commonly affected Presents with hematuria, \_\_\_\_\_\_\_, \_\_\_\_\_\_, \_\_\_\_\_\_\_ ↑ ASO titer, ↓ \_\_\_\_\_\_ (returns to normal in \_\_\_\_\_ weeks) Tx: Supportive (fluid \_\_\_\_\_\_\_\_, \_\_\_\_\_\_\_, \_\_\_\_\_\_) Prognosis: Excellent in children, full recovery in 3-4 weeks hyperK, intrinsic, pressure, K, filtration ACE inhibitors are recognized as valuable agents in the management of hypertension but they may result in \_\_\_\_\_\_\_\_\_ in patients with \_\_\_\_\_\_ renal disease. These agents reduce glomerular filtration \_\_\_\_\_\_ resulting in retention of \_\_\_\_\_\_\_ since less \_\_\_\_\_\_\_\_ occurs in the kidney. K, angio, Terato(genic) ACE inhibitor side effects: Cough Hyper\_\_\_\_\_\_\_ \_\_\_\_\_\_edema ------------------------------------------------------------------------ MALT, adeno(carcinoma), PPI, clarith, amox, metro, 14, pepto, PPI, tetra, metro, 4 H. Pylori Causes peptic ulcers, gastritis, \_\_\_\_\_\_\_ lymphoma, gastric \_\_\_\_\_\_\_\_\_\_ Fecal-oral transmission; more common in developing countries Dx: Urea breath test Stool antigen test Endoscopic biopsy with histology, culture, rapid urease test Tx: \_\_\_\_\_ + \_\_\_\_\_ + \_\_\_\_\_ or \_\_\_\_\_ x \_\_\_\_\_ days or \_\_\_\_\_\_\_\_ + \_\_\_\_\_ + \_\_\_\_\_\_\_\_ + \_\_\_\_\_\_\_\_\_ (quad therapy) Confirm eradication \_\_\_\_\_ weeks after Tx Reinfection common in endemic areas marginal, B, slow, nodules, dense, lympho, lugano, radiation, ritux, chemo MALT Lymphoma Extranodal \_\_\_\_\_\_\_ zone \_\_\_\_\_-cell lymphoma Associated with \_\_\_\_\_\_ infection Median age 60 years \_\_\_\_\_\_ course Dx: Endoscopy: Mucosal \_\_\_\_\_\_\_\_, ulceration Biopsy: \_\_\_\_\_\_\_ lymphoid infiltrate, \_\_\_\_\_epithelial lesions Staging: \_\_\_\_\_\_ system (I-IV) Bone marrow biopsy, CT, PET/CT Tx: H. pylori eradication therapy \_\_\_\_\_\_\_\_ for localized disease \_\_\_\_\_\_, \_\_\_\_\_\_ for advanced stages 1.5, 32, vasc, O2, dilation, detachment, VEGF, vitrectomy Retinopathy of Prematurity Premature infants \\_\_\_\_\_ months Rule out medical causes, substance use Tx: CBT, relaxation techniques SSRIs, SNRIs Buspirone unexpected, more, palps, shaking, losing control, 4, 4, 1, 1, benzos Panic Disorder Recurrent, \_\_\_\_\_\_\_\_\_ panic attacks Worry about \_\_\_\_\_\_\_ Typically develops in 20s-30s More common in women Sx: \_\_\_\_\_\_\_, sweating, \_\_\_\_\_\_\_ Chest pain, nausea, dizziness Depersonalization, fear of \_\_\_\_\_\_ \_\_\_\_\_\_\_ Dx: DSM-5 criteria: ≥\_\_\_\_\_ panic attacks in \_\_\_\_\_ weeks, or \_\_\_\_\_ attack with ≥\_\_\_ month of worry about more attacks Attacks not due to substance use or medical condition Symptoms cause significant distress or impairment Rule out medical causes (thyroid, substance use, etc.) Tx: CBT, exposure therapy SSRIs, SNRIs \_\_\_\_\_\_\_\_ for acute attacks Comorbidities: Depression, substance abuse, other anxiety disorders salicylate, 35, 7.45, K, Cl, parathesias, tetany Hyperventilation Respiratory \_\_\_\_\_\_\_\_ Causes: Anxiety, pain, fear CNS disorders Hypoxemia \_\_\_\_\_\_\_\_\_ toxicity Pregnancy Dx: ↓ PaCO2 \< \_\_\_\_\_ mmHg ↑ pH \> \_\_\_\_\_\_ ↓ Serum \_\_\_\_ and \_\_\_\_\_\_ Sx: Lightheadedness, dizziness ------------------------------------------------------------------------ Chest tightness \_\_\_\_\_\_ if severe LMCA, 3 CABG is indicated in patients with stenosis of the \_\_\_\_\_\_\_ and those with \_\_\_\_\_\_-vessel coronary artery disease. GH, pit adenoma, macroglossia, hyperhidrosis, carpal tunnel, DM, polyps, IGF1, OGTT, somato(statin), ocreotide, GH, pegviso, caber, bromo Acromegaly Excess \_\_\_\_\_\_\_, usually from \_\_\_\_\_\_ \_\_\_\_\_. \_\_\_\_\_ onset, often diagnosed late. Signs/Symptoms: Enlarged hands, feet, jaw, brow, nose; \_\_\_\_\_\_\_\_; \_\_\_\_\_\_\_\_; \_\_\_\_\_\_ \_\_\_\_\_; hypertension; sleep apnea; joint pain; \_\_\_\_\_\_\_; colon \_\_\_\_\_\_\_\_. Dx: High \_\_\_\_\_\_\_, abnormal \_\_\_\_\_\_\_, MRI shows adenoma. Tx: Surgery, meds \_\_\_\_\_\_\_\_ analogs (\_\_\_\_\_\_\_), \_\_\_\_\_ receptor antagonist (\_\_\_\_\_\_\_mant) dopamine agonists - ------------------------------------------------------------------------ - ------------------------------------------------------------------------ BPPV \_\_\_\_\_\_\_\_\_\_ Brief episodes (\ than legs, think \_\_\_\_\_\_\_ stroke MCA, temp(oral) Aphasia (dominant hemisphere), neglect (non-dominant), think \_\_\_\_\_\_\_ stroke, \_\_\_\_\_ lobe ACA, frontal Contralateral leg weakness \> arm, think stroke in Artery: \_\_\_\_\_ (most likely) Lobe: \_\_\_\_\_ (most likely) (vertebro)basilar, stem weakness on same-side-of-face as stroke, but opposite side in rest of body, think \_\_\_\_\_\_\_ stroke, lobe \_\_\_\_\_\_\_\_\_ (vertebro)basilar, stem Stroke: Double vision and problems swallowing: Artery: \_\_\_\_\_ (most likely) Lobe: \_\_\_\_\_ (most likely) MCA, temporal Can't say object names or recognize people, think \_\_\_\_\_\_\_ stroke PCA, occipital color-blindness, think \_\_\_\_\_\_\_ stroke, \_\_\_\_\_\_ lobe PCA, occipital can't read but can write, think \_\_\_\_\_\_\_ stroke, \_\_\_\_\_\_ lobe MCA, parietal Can't write but can read, think \_\_\_\_\_\_\_\_ stroke, \_\_\_\_\_\_\_ lobe Colles, volar, palm, radius, flexed, long arm Smith's Fracture Reverse \_\_\_\_\_\_\_ fracture \_\_\_\_\_ (\_\_\_\_\_\_\_ of wrist) displacement of distal fragment of \_\_\_\_\_\_\_ Fall on \_\_\_\_\_\_ wrist Treatment: closed reduction and immobilization in a \_\_\_\_\_\_ \_\_\_\_\_ cast or splint Smiths, dorsal, back, radius, extended, short arm Colles Fracture Reverse \_\_\_\_\_\_\_ fracture \_\_\_\_\_ (\_\_\_\_\_\_\_ of wrist) displacement of distal fragment of \_\_\_\_\_\_\_ Fall on \_\_\_\_\_\_ wrist "\_\_\_\_\_\_\_" deformity Treatment: closed reduction and immobilization in a \_\_\_\_\_\_ \_\_\_\_\_ cast or splint radius, radioulnar, dislocation, wrist, (fore)arm, ORIF, reduction (of dislocation) Galeazzi's Fracture Distal \_\_\_\_\_\_\_\_\_ fracture Associated DRUJ (distal \_\_\_\_\_\_\_ joint) \_\_\_\_\_\_\_\_\_ - pathognomonic finding Surgical emergency Pain located at the \_\_\_\_\_\_\_\_ and \_\_\_\_\_\_\_\_\_\_ Treatment: \_\_\_\_\_\_ and \_\_\_\_\_\_\_ stasis, bile salt, night, palms, soles, cholestyramine Cirrhosis Pruritus Chole\_\_\_\_\_\_ → \_\_\_\_\_ \_\_\_\_\_\_ accumulation in skin Worse at \_\_\_\_\_\_, affects \_\_\_\_\_\_ and \_\_\_\_\_\_ Dx: Exclude other causes (e.g., renal disease, malignancy) Elevated serum \[above\] Tx: \_\_\_\_\_\_\_\_\_\_\_\_ (a sequestrant of the above) HCC, 6, US Screen for \_\_\_\_\_\_\_\_ every \_\_\_\_\_\_mos with \_\_\_\_\_\_\_ in cirrhosis hematochrom, wilsons, SBP, renal, pulm, INR, PT, albumin, plates, nodular, loops, lactulose, BBs, 6, HAV, HBV Cirrhosis Causes: \_\_\_\_\_\_\_\_\_atosis \_\_\_\_\_\_\_\_ disease PBC, PSC Complications: Portal hypertension Ascites ------------------------------------------------------------------------ Hepatic encephalopathy Hepato\_\_\_\_\_\_\_ syndrome Hepato\_\_\_\_\_\_\_\_ syndrome Varices HCC Dx: Liver biopsy (gold standard) Labs: ↑AST, ALT, bilirubin, \_\_\_\_\_/\_\_\_\_\_; ↓\_\_\_\_\_\_\_, \_\_\_\_\_\_\_ Imaging: \_\_\_\_\_\_ liver, splenomegaly, ascites Tx: Manage complications: \_\_\_\_\_\_\_\_, antibiotics, \_\_\_\_\_\_\_\_ (for enceph), \_\_\_\_\_\_\_\_ (for varices) HCC screening: ultrasound q\_\_\_\_mo Vaccinations: \_\_\_\_\_\_, \_\_\_\_\_\_\_\_, pneumococcal, influenza inflammatory, fibrosis, bile, IBD, men, alkphos, GGT, beading, onion, ERCP Primary Sclerosing Cholangitis (PSC) Chronic \_\_\_\_\_\_\_\_ condition causing \_\_\_\_\_\_ and stricturing of intra- and extrahepatic \_\_\_\_\_\_ ducts Associated with \_\_\_\_\_\_\_ Young to middle-aged \_\_\_\_\_\_ Dx: Elevated \_\_\_\_\_, \_\_\_\_\_\_\_ Magnetic resonance cholangiopancreatography (MRCP): \_\_\_\_\_\_, strictures Liver biopsy: periductal fibrosis, "\_\_\_\_\_\_-skinning" Tx: \_\_\_\_\_\_\_\_ for strictures Liver transplant for end-stage disease Increased risk of cholangiocarcinoma autoimmune, bile, women, mito(chondrial), alkphos, florid, granulomas, Ursodeoxy(cholic) Primary Biliary Cholangitis (PBC) \_\_\_\_\_\_\_\_ disease causing destruction of small \_\_\_\_\_\_ ducts in the liver Middle-aged \_\_\_\_\_\_ Anti-\_\_\_\_\_\_\_\_\_\_ antibodies (AMA) Dx: Elevated \_\_\_\_\_\_ Cholestatic pattern liver function tests (LFTs) Liver biopsy: \_\_\_\_\_\_\_ duct lesions, \_\_\_\_\_\_\_ Tx: \_\_\_\_\_\_\_\_\_\_ acid (UDCA) neurop(athy), IOP, rapid, halos, blacks, myopia, 21, cupping, scotoma, steps, lanaprost, tim(olol), brimon(idine), dorzo(lamide), filter Chronic Glaucoma Progressive optic \_\_\_\_\_\_ with characteristic visual field defects and \_\_\_\_\_\_\_ leading to irreversible blindness if untreated. Types: - Open-angle (POAG): most common, insidious onset - Angle-closure (PACG): \_\_\_\_\_\_\_ onset, acute pain, nausea/vomiting, \_\_\_\_\_ around lights Risk factors: age \>60, \_\_\_\_\_\_\_, family history, diabetes, \_\_\_\_\_, steroids Dx: - Tonometry: elevated IOP (\>\_\_\_\_ mmHg) - Fundoscopy: optic disc \_\_\_\_\_\_\_, nerve fiber layer defects - Visual field blindnesses: characteristic defects (arcuate \_\_\_\_\_\_\_, nasal \_\_\_\_\_\_) - Gonioscopy: assess angle (open vs. closed) Tx: - Medications: prostaglandin analogs (\_\_\_\_\_\_\_\_), beta-blockers (\_\_\_\_\_\_\_), alpha-agonists (\_\_\_\_\_\_\_), carbonic anhydrase inhibitors (\_\_\_\_\_\_\_\_) - Laser trabeculoplasty (\_\_\_\_\_\_\_\_) - Incisional surgery (trabeculectomy, drainage devices) cyanotic, displaced, septum, pulm stenosis, VSD, RVH, clubbing, cyanotic, squatting, boot, r(ight), prosta(glandin) E1, arteriosus, 6 Tetralogy of Fallot (ToF) Most common \_\_\_\_\_\_\_\_\_\_ congenital heart defect Caused by anterosuperiorally \_\_\_\_\_\_\_ infundibular \_\_\_\_\_\_\_\_\_ 4 components: 1. ------------------------------------------------------------------------ 2. Overriding aorta 3. ------------------------------------------------------------------------ 4. ------------------------------------------------------------------------ Presentation: Cyanosis, hypoxia, \_\_\_\_\_\_\_\_\_ "Tet spells" - hyper\_\_\_\_\_\_ episodes \_\_\_\_\_\_ improves symptoms Dx: CXR: \_\_\_\_\_-shaped heart ECG: Right ventricular hypertrophy, \_\_\_\_\_\_\_ axis deviation Echo: Confirms diagnosis Tx: \_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_ to maintain ductus \_\_\_\_\_\_\_\_ Complete surgical repair by \_\_\_\_ months Rotterdam, anovulation, androgen, insulin, test(osterone), DHEAS, 17, prolactin, OGTT clomiphene PCOS (Polycystic Ovary Syndrome) Dx Criteria (\_\_\_\_\_\_\_ criteria): 2 out of 3 1. ------------------------------------------------------------------------ 2. Hyper\_\_\_\_\_\_\_\_\_\_ (clinical or biochemical) 3. Polycystic ovaries on ultrasound Associated Conditions: - \_\_\_\_\_\_ resistance (50-70%) - Metabolic syndrome - Infertility - Endometrial hyperplasia/cancer Workup: - Free/total \_\_\_\_\_\_\_\_, \_\_\_\_\_\_\_\_ - \_\_\_\_\_-hydroxyprogesterone - TSH, \_\_\_\_\_ - 2-hour \_\_\_\_\_ - Lipid panel Treatment: - OCPs for cycle regulation, hirsutism - Metformin for insulin resistance - \_\_\_\_\_\_\_\_ for ovulation induction - Lifestyle modifications Buzzwords: hyperandrogenism, anovulation, hirsutism, virilization, insulin resistance, infertility methotrex RA med that is contraindicated pt's with liver problemas? mumps, hyperemic, FQs, Phrens Epididymitis Inflammation of the epididymis, usually due to retrograde bacterial infection. Presents with acute scrotal pain and swelling. More common in young men. Etiologies: - STIs (chlamydia, gonorrhea) in \35 yo - \_\_\_\_\_\_ epididymitis Dx: - Urinalysis, urine culture - STI testing - Scrotal ultrasound: enlarged, \_\_\_\_\_\_\_\_ epididymis Tx: - NSAIDs, scrotal elevation - Ceftriaxone + doxycycline if STI suspected - \_\_\_\_\_\_\_\_\_ if E. coli suspected Complications: - Abscess - Infertility if untreated Buzzwords: acute scrotal pain, swollen epididymis, STI, mumps, \_\_\_\_\_\_\_ sign (relief of pain with testicular elevation) 7, parotitis, M, orchitis, paramyxo Mumps Epididymitis Viral infection of the epididymis caused by the mumps virus, typically occurring \_\_\_\_\_\_ days after \_\_\_\_\_\_\_\_ in post-pubertal males. Unvaccinated or under-vaccinated Occurs in 15-30% of post-pubertal males with mumps Presentation: Unilateral testicular swelling and pain Fever, malaise, headache Dx: Clinical diagnosis Mumps Ig\_\_\_ antibodies RT-PCR of buccal swab or urine Tx: Supportive care (rest, scrotal elevation, NSAIDs) Avoid strenuous activity for 1 week Rarely requires hospitalization Complications: Testicular atrophy (rare) Infertility (rare) \_\_\_\_\_\_\_ (20-30%) Buzzwords: \_\_\_\_\_\_\_\_virus, parotitis, orchitis, unvaccinated, supportive care notched, P, 1, 120 Left Atrial Enlargement \_\_\_\_\_\_\_, biphasic P waves in leads I and II Negative terminal deflection of \_\_\_\_\_ wave in V\_\_\_ P wave duration \>\_\_\_\_\_ms peaked, II, pos, 1 Right Atrial Enlargement \_\_\_\_\_\_ P waves in lead \_\_\_\_ Large \_\_\_\_\_\_\_ deflection on initial P wave in V\_\_\_ Inflammatory, itchy, palms, soles, moist, clobetasol, tacrolimus Dyshidrotic Eczema \_\_\_\_\_\_ skin condition causing intensely \_\_\_\_\_ vesicles on \_\_\_\_\_\_, \_\_\_\_\_, and lateral fingers. May become large bullae, then dry and fissure. Etiology unknown. Triggers: stress, seasonal allergies, \_\_\_\_\_\_ hands/feet. Dx: Clinical Tx: Topical corticosteroids (e.g., \_\_\_\_\_\_\_\_) Oral corticosteroids for severe cases (e.g., prednisone 40-60 mg daily for 1-2 weeks, then taper over 2-4 weeks) Topical calcineurin inhibitors (e.g., \_\_\_\_\_\_\_\_ 0.1% ointment BID) Oral antihistamines for pruritus (e.g., diphenhydramine 25-50 mg QID PRN) Treat 2° infection VPA, klonopin Ethosuximide, \_\_\_\_\_\_\_\_, \_\_\_\_\_\_\_ are recommended treatments for absence seizures. penG, metro, clinda Tx for peritonsilar abcess: drainage then \_\_\_\_\_\_\_\_\_\_ + \_\_\_\_\_\_\_ or \_\_\_\_\_\_\_\_\_ pars, arch, L5, Scotty, oblique, stress, hyperextension Spondylolysis Defect in \_\_\_\_\_\_ interarticularis of vertebral \_\_\_\_\_, often \_\_\_\_\_. Common cause of low back pain in adolescent athletes. "\_\_\_\_\_\_ dog" sign on \_\_\_\_\_\_\_ X-ray. Congenital or acquired \_\_\_\_\_\_ fracture Adolescents and young adults Repetitive \_\_\_\_\_\_\_\_\_\_/rotation Tx: Rest and activity modification Bracing for acute fractures 4, nv, cramps, cream, custards, preformed Food poisoning: Staphylococcus aureus Onset: \ survives \_\_\_\_\_\_ 6-48, fever, cipro, azithro, eggs, milk, mucosa Food poisoning: Salmonella Onset: \_\_\_\_-\_\_\_\_ hrs Sxs: Diarrhea, \_\_\_\_\_, abdominal cramps Tx: Supportive, consider antibiotics (\_\_\_\_\_\_\_, \_\_\_\_\_\_\_\_) if severe Food: \_\_\_\_\_\_, poultry, unpasteurized \_\_\_\_\_\_ Tests: Stool culture Notes: Invades intestinal \_\_\_\_\_\_\_ 2-5, bloody, fever, cipro, azithro, chicken, comma, S Food poisoning: Campylobacter Onset: ***-*** days Sxs: \_\_\_\_\_\_\_ diarrhea, \_\_\_\_\_\_, abdominal pain Tx: Supportive, consider antibiotics (\_\_\_\_\_, \_\_\_\_\_\_) if severe Food: Undercooked \_\_\_\_\_\_\_, unpasteurized milk Tests: Stool culture Notes: \_\_\_\_\_\_ or \_\_\_\_\_-shaped 1-3