COMQUEST Flashcards
Symptoms of acute rheumatic fever. Cause of rheumatic fever?
Cause: untreated group A strep pharyngitis
Symptoms: skin findings (erythema marginatum, subcutaneous nodules), central nervous system involvement (Sydenham chorea), arthritis, and pancarditis
Most common causes of drug-induced lupus erythematosus? Symptoms?
Most commonly caused by hydralazine, procainamide, quinidine, and isoniazid (can also be caused by sulfa drugs, methyldopa, minocycline, phenytoin, and TNF-alpha inhibitors).
Symptoms: fatigue, joint pain, skin rash, and flu-like symptoms
What condition has positive anti histone antibodies?
Drug-induced lupus erythematosus
What condition has anti centromere antibodies?
systemic sclerosis
Symptoms of limited sclerosis
CREST syndrome (calcinosis cutis, Raynaud phenomenon, esophageal hypo motility (peristalsis and a hypotonic lower esophageal sphincter), sclerodactyly, and telangiectasias)
What condition has anti-double stranded DNA antibodies?
systemic lupus erythematosus (presence of these antibodies also conveys an increased risk of lupus nephritis in the future)
What condition has positive anti-SSA antibodies?
Sjogren’s syndrome
Symptoms of Sjogren’s syndrome
dry eyes, dry mouth, and parotid gland enlargement
Slipped capital femoral epiphysis (SCFE) - Age, symptoms? Risk factors?
Obese male children age 10-15
Symptoms: dull aching pain in the hip, goin, thigh, or knee with no history of trauma, altered gait/limp
Risk factors: obesity, renal failure, endocrine abnormality (hypothyroidism, growth hormone deficiency), genetic disorders (Down and Rubinstein-Taybi syndromes)
An infant is brought to the offie and can turn his head toward the sound of the door opening, smile directly at the physician and make cooing sounds. When placed prone, he lifts up his head and shoulders and is able to support his upper body with his forearms. He opens and shuts his hands and occasionally swipes at visible objects. He is unable to remain seated without support. What age is the patient?
3 months
A baby that can sit without support, roll both ways, reach with one hand, transfer objects from hand-to-hand, uses a raking grasp, babbles, responds to their name, explores using their hands and mouth, and can distinguish emotion by tone of voice is what age?
6 months
A baby that crawls well, pulls to stand, uses and immature three-finger pincer grasp, holds a bottle, and is able to throw an object is what age? This baby is able to say mama and dada indiscriminately, wave bye-bye, and enjoys peek-a-boo.
9 months
This baby may be shy with strangers, finger-feeds themselves, responds to “no,” can use one to three words, and points in order to get a desired object. Motor skills include standing momentarily without support, moving from sitting to crawling or prone, taking independent steps, and using a two-finger pincer grasp to pick up small objects. What age is this baby?
12 months
This baby creeps up stairs, walks backward independently, builds a tower of two blocks, climbs onto furniture, and walks holding an object. This baby can use 3-5 words, can point to one body part, and follow a one-step command. What age is this baby?
15 months
You see ringed sideroblasts on peripheral blood smear. What causes that?
Sideroblastic anemia - can be caused by isoniazid, chronic alcohol abuse, chloramphenicol, lead poisoning, neoplastic disease, and genetic causes
What lab findings do you expect with sideroblastic anemia?
increased serum iron, increased ferritin, and normal (or slightly decreased/increased) TIBC
What is the treatment for sideroblastic anemia?
removal of the offending agent and treatment based on cause. If isoniazid is the cause, continue isoniazid with pyridoxine (Vitamin B6)
Anisakis simplex - how to get it? Symptoms?
Zoonotic roundworm obtained by ingestion of raw or undercooked fish (most common being salmon, herring, cod, mackerel, squid, and red snapper)
Symptoms: due to direct tissue damage. The worm burrows through the wall of the small intestine where it dies and forms an abscess, leading to bowel obstruction
Ascaris lumbricoides - how do you get it? Symptoms?
parasitic nematode obtained by consumption of infected, undercooked pork or chicken liver or by fecal-oral route
Symptoms: mostly asymptomatic but pulmonary and gastrointestinal symptoms can occur
Dracunculus medinensis - how do you get it? Symptoms? Treatment?
guinea worm ingested in contaminated water
Symptoms: worm migrates under the skin, causing intense pruritus and pain. If the patient soaks his leg in water to soothe the pain, the worm does out of the skin and releases eggs into the water
Treatment: worm physically extracted from skin
Schistosome mansoni - disease, cause, symptoms?
Causes a human disease called bilharziasis
Infection occurs in Africa after swimming in infested freshwater where the larvae penetrate the skin
Symptoms: skin lesion at the site of penetration, allergic reaction, diarrhea, and abdominal pain
Trichinella spiralis - how is it obtained? Symptoms?
obtained from consumption of undercooked meat of mammals, mostly pigs, hoarse, bear, moose, and rodents.
Symptoms: short GI illness followed by severe pain, muscles, tenderness, and swelling when larvae embed themselves in skeletal muscle. Periorbital edema, difficulty breathing, and difficulty moving are seen. Cardiac muscle can be involved and cause myocarditis, which is the most common cause of death
TTP path, cause, findings
thrombosis in small blood vessels and thrombocytopenia
Cause: congenital or acquired deficiency of ADAMTS 13 protease
Peripheral smear: schistocytes
Low levels of ADAMTS 13 protease activity
Hemolytic uremic syndrome path
microagniopathic hemolytic anemia and progressive renal failure
On exams: think of HUS with a child presenting with microangiopathic hemolytic anemia and acute renal failure occurring after infection with Shigella dysenteries or E. coli
