Clinical Medicine Final Flashcards
BP Ratings
Hypertensive Emergency Symptoms vs Hypertensive Urgency Symptoms
Emergency:
- Chest pain
- Dyspnea (Difficulty breathing)
Urgency:
- Headache
- Epistaxis (Nose bleeds)
Marfan Syndrome genetic defect
Fibrillin 1
In what condition do you find lisch nodules?
Neurofibromatosis
Angle Closure Symptoms
- Nausea
- Vomiting
- Eye pain
- High IOP
- Halos around lights
Cellulitis: What is suggestive of orbital involvement?
- Proptosis
- Chemosis
- Pain with eye movements
- Ophthalmoplegia
- ON involvement
- Fever
- Leukocytosis (75% of cases)
- Lethargy
Orbital Cellulitis Signs and Symptoms
- Rhinorrhea (Runny nose)
- Headache
- Tenderness on palpation
- Eyelid Edema
- Elevated IOP (if ↑ venous congestion)
Sudden discontinuation of oral prednisone may cause what?
Adrenal crisis (Addisonian crisis)
Elevated Growth Hormone Signs/Symptoms
- ↑ skeletal and soft tissue growth
- Hypertension
- DM
Most likely cause of a diabetic feeling cold and clammy?
Hypoglycemia
What should you test if your patient has Superior Limbic Keratoconjunctivitis (SLK)?
You should test for thyroid problems
What causes polyuria in a diabetic?
Elevated serum glucose
What causes the microvascular complications of patients with DM?
- Capillary basement membrane thickens
- Endothelial cell hypoplasia
What causes Graves disease?
Immune stimulation of TSH receptor
Most common symptom reported in IIH (Pseudotumor)?
Headache
Apoptosis
- Programmed cell death
- Irreversible process
- Removes:
- Embryonic cells
- Aged cells from normal tissue
Fat Necrosis
Enzymatic necrosis of pancreas and peripancreatic adipose tissue
Most common cause of cell injury?
Hypoxia
(4) Situations where free radicals are generated?
- Normal metabolism
- Reperfusion after ischemia
- Oxygen therapy in premature infants
- Pharmacotherapy
Main transport affected in cystic fibrosis?
Outflow of chloride
Trisomy 21 Presentation
- Epicanthic eyelid fold
- Growth delay
- Congenital heart disease
- Palm crease
Trisomy 18 (Edwards Syndrome) Presentation
- Cardiopathy
- Mental retardation
- Clenched fists
- Unusual or absent finger prints
- Small mouth and face
Turner Syndrome presentation
- Growth delay
- Webbed neck
- Coarctation of the aorta
What is the most likely cause of aura during a migraine episode?
Vasoconstriction of cerebral vessels
How long do visual phenomena of migraine with aura typically last?
20 minutes
What headache type is associated with postganglionic Horner’s syndrome?
Cluster headache
Cluster Headache Symptoms
- Severe pain around one eye or on one side of the head
- Tearing, nasal stuffiness, and runny nostril on affected side
In which gender are cluster headaches more common?
Males
Giant Cell Arteritis
- Autoimmune disease
- Causes headache, scalp tenderness, jaw pain, and visual symptoms
What do Omega 3 supplements affect?
Clotting time
Conclusions of AREDS studies?
- Smokers are at a very high risk of developing advanced AMD
- Older pts with poor nutrition may be at highest risk of advanced AMD
- Aging can be associated with deficiencies in micronutrients (including zinc/cartenoids)
- Results supported replacement of beta carotene with lutein and zeaxanthin in original AREDS formula
- Addition of omega-3 fatty acids in original AREDS formula did not further decrease risk of progression from intermediate → advanced AMD
What do omega-3 fatty acids do?
Decrease inflammatory cytokines
Hashimoto’s disease lab testing results
- Elevated TSH
- Decreased TH
- Elevated thryoglobulin antibodies
What might cause Addison’s crisis?
Abruptly stopping corticosteroids after long-term use
What is a more sensitive measure of thryoid function?
TSH levels
Pathological change associated with Graves disease?
High levels of circulating thyroid stimulating immunoglobulins
Retinal detachment symptoms
- Lots of new floaters
- Flashes of light in one or both eyes
- Dark shadow or “curtain” on sides or middle of visual field
Most common visual efficiency skills problem after TBI?
OMD
Why isn’t a concussion typically visible on traditional MRI?
Because the shearing of neurons that occurs in concussion causes only microscopic damage along axons
(Damage is too small and scattered to be detected)
What type of occulsion is helpful for patients with TBI and why?
- Binasal occlusion (BNO)
Because:
- It improves ambient visual processing by stimulating/emphasizing peripheral awareness
- Reduces need to process redundant/overlapping info from each eye
What is the ambient (“where”/peripheral) visual system most important to?
Providing input to superior colliculus to be integrated with vestibular and proprioceptive systems
What is the focal (“what”/central) visual most important to?
Providing details for what we’re looking at
Main purpose of BI microprism in TBI patients?
- Treating post traumatic visual syndrome
Progressive lenses are not the best option for what patients?
TBI patients with accommodative insufficiency
Grounding technique that can be used to improve comfort in patients who become nauseous, dizzy, or unstable while you’re working on them?
- Dim lights
- Stimulate peripheral awareness
- Chalkboard circles
- Harmon circles
- Sit in a stable, stationary chair
- Pinch thumbs and index fingers together
- Use a weighted blancket
What do individuals with complete hemiplegia or muscle weakness on one side of the body often demonstrate?
Visual Midline Shift Syndrome (VMSS)
Visual Midline Shift Syndrome (VMSS)
- Sense of center shifted up, down, left, or right
- Poor balance
- Poor motor planning
