? Flashcards
Temporal arteeiris
- what vessels are involved (+ symptoms)
- diagnostic ( beware of something)
- treatment
- temporal artery (headache), opthalmic artery (vision problems), jaw claudication plus poly myalgia rheumatica (Fever joint and muscle pain
- biopsy the vessel (but if negative still can’t tule out because affects only certain parts of the carotid arteries
Tx: steroids
Takayasu
- vessels affected (+ symptoms)
- treatment
Aortic branches (brachial, radial, ulnar) visual and neurologic disturbances with low upper extremities pulse
- Tx: steroids
Pan
- vessels affected (+symptoms )
- spares what organ
-treatment
Necrotizing vascultiis affecting mesenteric artery ( abdominal pain), renal (HTN) neurological , skin lesions
- abdominal pain and peripheral neuropathy
Spares lungs
Steroids and cyclophosphamide according to pathoma
Churg
- symptoms
- treatment
Heart, asthma , neuropathy
Steroids and cyclophosphamide
Renal disorder in Wegner
Rapidly progressive glomerulonephritis
IGA nephropathy
- pathophysiology
- symptoms
- treatment
Viral URI caused IGA to be deposited in blood vessel and kidney
- gib, IGA nephropathy, swollen scrotum, abdominal pain , purpura on legs and/ or burr
-Tx: self limited
Aortic dissection
- cause
- presentation
- MCCOD
-diagnostic
- treatment
- common complication
- HYPERTENSION weakened the t. Media
- severe sudden onset chest pain, widen mediastinum and left pleural effusion
- MCCOD : pericardial tamponade
- Dx: stable do ct angiogram with contrast and if unstable do TEE
- Tx: Type a (BB and surgery ; it can involve asc and desc) type B (BB)
- complication - hoarseness bc left recurrent laryngeal nerve is right by the aortic arch
Thoracic aneurysm
- pathophysiology (MCC)
- most common complication
Tertiary syphilis weakened the t media
Aortic dilation
Aaa
- cause
- presentation.
Atherosclerois ( thickens the intima therefore blood can’t flow into the vessel causing weakness
- hypotension ? Pulsátiles mass bc blood flowing through , flank pain
Nasopharyngeal carcinoma
- how does it present
- positive for
Cervical lymph node involvement
Keratin
Tb spreads where (+ most common)
Meninges causing meningitis, vertebrae (Potts disease, cervical lump nodes and Mc Is kidney causing sterile pyuria
Homozygote A1AT complications
Emphysema with liver cirrhosis
Sarcoidosis symptoms
Uveitis, sjorgren features, erythema nososun
Lung cancer
- complication
- likes to metastasize where
Recurrent latrngeal nerve (hoarseness) and phrenic (diaphragm paralysis
Adrenals
Common complication of mesothelioma
Recurrent pleural effusions
FAS associated with what CHD
Vsd
Fixed split S2
ASD
Maternal diabetes associated with what CHD
Transposition of great vessels
Acute rheumatic fever
- MCCOD
- which valve is most commonly involved
- treatment
Myocarditis
MITRAL (MR)
Tx: nsaid and penicillin such as macrolide
Chronic rheumatic disease
- complication
- affects what valve
Infectious endocarditis
MS always and maybe AS
Systolic ejection click followed by crescendo descreído murmur
(+complication
AS
Microangiopathic hemolytic anemia bc of the calcifications crushing the RBC
Early blowing diastolic murmur
AR
Bounding pulse, pulsating nail bed and head bobbing
AR
Midsystolic click followed by regurgitation
MVP
Opening snap followed by diastolic rumble
MS
Holosystolic blowing murmur
MR
Behcet presentation
Genital ulcers, apthous ulcer, uveitis after viral infection
Complication of mumps
Sterility if happens on teens
Complication of esophageal web
Esophageal squamous cell cancer
MCCOD in cirrhosis
Rupture esophageal varices
Complication of achalasia
Increased risk of esophageal squamous cancer
GERD
- unique symptoms
- name interesting risk factor
Adult onset asthma
Hiatal hernia
Types of esophageal cancer
Adenocarcinoma ( Barrett’s vs squamous cell ( esophageal web, achalasia , hot drinks
When does pyloric stenosis present
2 weeks old bc that’s how long it takes for stenosis to occur
Causes of acute vs chronic gastritis
Acute - burns / increased intracranial pressure cause ulcers, shock bc Dec blood flow , nsaids
Chronic - autoimmune gastritis (antibody attacks parietal cells in type 4 hypersensitivity so low acid so increase gastrin, pernicious anemia , intestinal metaplasia due to the increased gastrin, increased risk of intestinal gastric adenocarcinoma
Chronic - h pylori induced —ulceration, possible maltoma, gastric adenocarcinoma (intestinal but triple therapy would reduce these symptoms
Peptic ulcer
- types (+ causes
Duodenal vs gastric
- duodenal better with eating; h. Pylori and zollinger
- gastric - h pyloric or NSAIDs ; can lead to gastric adenocarcinoma (intestinal
Gastric carcinoma (+ types
Intestinal - large irregular ulcer due to intestinal metaplasia ( chronic gastritis), gastric ulcer
Diffuse - signet rings, can present with trelat (increased seborrheic keratosis) and Acanthosis nigiri and
Complication of meckles
Intussusception, volvulus, mimics appendicitis when there’s obstruction but most cases are asymptomatic
Volvulus most affected areas
Sigmoid in elderly and Cecum in young adults
Pathophysiology of small bowel infarction
Thrombosis for whatever reason (afib, vasculitis such as PAN ,antiphospholipid syndrome anti cardiolipin, polycytemia Vera ) of SMA or mesenteric vein
Celiac
- affects where
- HLA
- complications
Duodenal
Hal dq2 and dq8
Small bowel carcinoma and enteripathy associated T cell lymphoma
Other one similar to whipples
- pathophysiology
- affects where
- complication
Infectious diarrhea triggers it
Jejunum and ileum therefore b12 and b9 deficiency
Presentation of whipple disease
Synovial fluid of joints (Arthritis) , cardiac valves , lymph nodes and cns
Common complication of appendix
PeriAppendiceal abscess
Hirschsprung affects what organ
Sigmoid Colon and rectum
Uc and chrons complications. And associations
Uc- ulcer heals with pseudopolyp; toxic megacolon; increased risk of Colon cancer; associated with PSC panca
Chrons - heals with fibrosis so cobble stones, pulls fat up so fat stranding
Associated with ankyloisng spondylitis , uveitis, erythema nodosum, sacroilitis
Diverticulosis vs angiosysplasia
- complication of diverticulosis
Wall stress causes rectal bleeding but affects different sides (a on right colp. and d affects sigmoid colon
Diverticulitis , colovesical fistula with air of stool urine
Ischemic colitis
- pathophysiology
-presentation
Atherosclerois of sma so affects splenic flexure, pain with eating
Improve with defecation and fiber
IBS
Peutz jegher
- pathophysiology
- complications
Benign polyps (hamartoma ) in GI and hyperpigmentation of lips
Cancers : breast, gyn and crc
Crc
- differentiate lynch vs adenoma sequence (fap
Lynch occurs sporadically without polyps - occurs on the right side; IDA and occult bleed.
Adenoma sequence occurs on the left side with left lower quadrant pain and obvious blood streaked stool
Pancreatitis
- complications
- poor prognosis
Pancreatic pseudo cyst or abscess both present with persistently elevated amylase - abscess- fever abdominal pain and cyst has abdominal mass
Hypo calcemia
Chronic pancreatitis
- causes
- complications
Alcohol and cf (kids)
Dm , pancreatic cancer , pancreatic insufficiency so malabsorption and steatorrhea, dystrophic calcifications
Pancreatic cancer
- complications (based on if head or body involvement)
- tumor marker
Pancreatitis, palpable gallbladder , (obstructive jaundice with dark urine and pale stool if head), Dm if tail, troaseau sign(migratory thrombophlebitis- red tender swollen extremities .
Ca19-9
Biliary atresia presentation
Jaundice bc inc conjugated bili
Can progress to cirrhosis
Acute cholecystitis
-presentation
- lab: increae of what
RUQ pain radiating to right scapula
Increas alkaline phosphates
Chronic cholecystitis
-pathophysiology
- complications
Long standing gallstones causes chemical irritation leading to calificativo of gallbladder (porcelain gallbladder
Complication; cancer
Ascending cholangitis
- pathophysiology
Choledocholithiasis
Gallbladder carcinoma
- risk factor
- presentation
Gall stones with porcelain gallbladder
- new onset cholecystitis in someone 40-50
HBsAg positive, HBeAg positive , HBcAb IgM positive
Acute
Only HBSAg IGG positive
Vaccinated
Only HBcAB IgM positive
Window period
HBsAg positive, HBeAg positive or maybe negative , HBcAb IGg positive , HBsAb negative
Chronic
HBcAb IgG positive and HBsAB IgG positive.
Resolved
Alcoholic relative liver disease vs NAfatty liver disease
Both can present worth fatty change , or hepatitis or cirrhosis but alcoholic fatty liver has AST>ALT BC AS is in mitochondria. ALT> ALT in NAFLD
Hemochromatosis
- lab
- liver biopsy results
- complication
- treatment according to pathoma
Just like acd
Brown pigment in liver (Prussian blue positive
HCC
Phlebotomy
Wilson
-presentation
- labs
- complications
- treatment
Child has cirrhosis. Párkinson and Huntington symptoms, neurologic behavioral changes
Inc urinary copper inc copper on liver biopsy , decrease serum ceruloplasmin
Complication: HCC
Tx: s penicillamine
HCC
- risk factors
- tumor marker
- complication
Cirrhosis (Wilson , hemochromatosis , Nash A1AT deficiency ) chronic hepatitis ,
Complication. Budd chiari
Alphafetoprotein
Holosystolic murmur at Llsb with Apical diastolic rumble
VSD
Vasalva
Decreases preload
Abrupt standing
Decreases preload
Nitroglycerin
Decreased preload
Sustained handgrip
Increases afterload
Squatting
Increases preload and afterload
Positive leg raise
Increases preload
Gallstone ileus
- pathophysiology
- complications
Due to cholecystitis and can lead to SBO
