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Systemic Disease > 09. Hepatology, Hematology and Infection > Flashcards

09. Hepatology, Hematology and Infection Flashcards

1
Q

What is hepatitis?

A

Inflammation of the liver

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2
Q

What 3 things cause hepatitis?

A

Viruses
Alcohol
Drugs

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3
Q

What characterizes hepatitis?

A

Diffuse or patchy necrosis

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4
Q

What is the classic finding of viral hepatitis?

A

Jaundice

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5
Q

Anemia is a reduction of circulating what?

A

RBCs

Hemoglobin

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6
Q

What kind of anemia occurs in chronic renal failure?

A

Normocytic

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7
Q

What causes microcytic anemia?

A

Deficient heme or globin synthesis

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8
Q

What causes normocytic anemia?

A

Primary bone marrow failure

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9
Q

What is the cause of macrocytic anemia?

A

Impaired DNA synthesis with B12 or folate deficiency

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10
Q

What is the most common cause of iron deficiency anemia?

A

Blood loss

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11
Q

What is the cause of pernicious anemia?

A

Autoimmune gastritis causes a B12 deficiency - antibodies are directed against parietal cells that produce intrinsic factor

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12
Q

What are the “important” characteristics of pernicious anemia?

A

Lower neuropathy - stocking and glove neuropathy

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13
Q

What causes aplastic anemia?

A

Loss of blood cell precursors, leading to bone marrow hypoplasia

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14
Q

What are the known drug causes of aplastic anemia?

A

Abx: chloramphenicol, trimethoprim
Acetazolamide
Penicillamine
NSAIDS

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15
Q

What are the systemic signs and symptoms of aplastic anemia?

A

Pallor of the skin and mucous membranes
Cheilosis of nail bed, mucous membranes, and palm crease
Koilonychias (spoon nails)

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16
Q

What are the ocular signs of aplastic anemia?

A

Retinopathy of anemia
Palp conj pallor and hemes
Roth spots

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17
Q

What is absent in hemophilia A?

A

Factor VIII

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18
Q

What is absent in hemophilia B?

A

Factor IX

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19
Q

What are the ocular signs/symptoms of hemophilia?

A 
Lid ecchymosis
Sub-conj heme
Retinal hemes
Vit hemes
Choroidal hemes and detachment
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20
Q

What characterizes hyperglobulinemia?

A

Excessive production of immunoglobulin or its derivative polypeptide

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21
Q

What characterizes cryoglobinemia?

A

Immunoglobulins that precipitate when cooled

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22
Q

What retinal findings may be seen in cryoglobinemia?

A

Cherry red spot in the macula

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23
Q

What are the ocular signs of Waldenstrom’s Macroglobinemia?

A

Corneal crystals

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24
Q

What is multiple myeloma?

A

Cancer of plasma cells that produce excessive monoclonal immunoglobulins

25
Q

Multiple myeloma is knowns for osteolytic lesions where?

A

Long bones
Axial skeleton
Skull

26
Q

What is the “important” ocular sign of multiple myeloma?

A

Conj/corneal crystals

27
Q

What lab should be done to investigate multiple myeloma?

A

Urinary Bence-Jones proteins

28
Q

Acute lymphocytic leukemia typically affects who?

A

Children

29
Q

Acute myelocytic leukemia typically affects who?

A

Adults

30
Q

What are the “important” anterior seg findings in leukemia?

A

Spontaneous conj heme

Spontaneous hyphema

31
Q

What is the “important” fundus involvement in leukemia?

A

Hemes and roth spots

32
Q

How are platelet disorders evaluated?

A

Bleeding time

Platelet count

33
Q

What is the effect of platelet dysfunction?

A

Prolonged bleeding time with normal platelet count

34
Q

What is thrombocytopenia?

A

Abnormal decrease in platelets

35
Q

What are the 2 “important” systemic findings in thrombocytopenia?

A

Mucosal bleeding

Intracranial hemorrhage

36
Q

What are the “important” ocular findings in thrombocytopenia?

A

Spontaneous hyphema
Vit heme
Retinal heme
Choroidal heme

37
Q

What characterizes erythrocytosis?

A

Increased red cell count

38
Q

What are the findings of Polycythemia Vera?

A

Increased red cell count

Packed cell volume

39
Q

What are the systemic signs/symptoms of polycythemia vera?

A

Non-specific: HA, dizziness, vertigo, tinnitus, visual disturbance

40
Q

What are the ocular signs/symptoms of polycythemia vera?

A

Hyperviscosity retinopathy

Dilated, engorged retinal vessels

41
Q

What is the substitution in hemoglobin S?

A

Valine for glutamic acid

42
Q

What is the substitution in hemoglobin C?

A

Lysine for glutamic acid

43
Q

What is sickle cell train?

A

Hemoglobin A is normal

44
Q

What are the ocular signs and symptoms of sickle cell?

A 
Conj comma sign
Hyphema - ocular emergency
Sickle cell disc sign
Salmon patch hemes
Black sunburst
Sea fan
Angioid streaks
45
Q

What are the “important” systemic signs of tularemia?

A

Ulcerated skin lesions

Painful lymph adenopathy

46
Q

What are the “important” ocular findings of tularemia?

A

Purulent conj
Granulomas of conj
Sumbandibular lymph node
Necrotic membranes

47
Q

What type of organism is loa loa?

A

Nematode (round worm)

48
Q

How is loa loa released into the blood stream?

A

As microfilariae

49
Q

Where does loa loa prefer to live?

A

Subcutaneous tissue - sub conj area

50
Q

What are the ocular findings of Schistosomiasis?

A

Granulomas with calcified eggs in conj/sclera, retina, choroid, and orbit

51
Q

Cystercercosis on the optic nerve may mimic what?

A

Optic nerve glioma

52
Q

What is the most common location of cystercercosis?

A

Posterior seg - at the macula

53
Q

What is the “important” ocular sign of Ocular Toxocariasis?

A

Fibrous band that may extend to the optic disc, dragging the macula

54
Q

What are the systemic signs of trichinosis?

A

High fever, HA, hyper-eosinophillia, edema…

55
Q

What is the classic triad of trichinosis?

A

Bilateral peri-orbital edema
Fever
Eosinophilia

56
Q

What are the ocular signs of leprosy?

A

Thickened corneal nerves
Superficial stromal keratitis
Pannus
Uveitis

57
Q

What are the common systemic symptoms of TB?

A 
Fever
Chills
Night sweats
Hemoptysis
Weight loss
58
Q

What are the common pulmonary signs in TB?

A

Hilar adenopathy

Infiltrates of the apical posterior segments of the upper lobes

Systemic Disease (12 decks)

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