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BIOMED - KIM VIDEOS > DAY4 > Flashcards

DAY4 Flashcards

1
Q

asymptomatic or complain of epigastric pain, nv, hematemesis or melena.. inflammation

A

gastritis

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2
Q

rapidly developing, superficial lesions often due to NSAIDS, alcohol, h-pylori infection, and stress from severe illness

A

acute gastritis

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3
Q

autoantibodies to parietal cells… causes pernicious anemia due to lack of intrinsic factor which aids absorption of Vit B12, assoicated with other autoimmune disorders like thyroiditis

A

Type A Chronic gastritis

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4
Q

occurs in the antrum and may be caused by NSAID use or H pylori infection.. associated with increased risk of PUD and Gastric cancer

A

Type B Chronic gastritis (90 %)

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5
Q

causes of gastritis

A

nsaid use, alcohol, h.pylori infection

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6
Q

meds that block gastric acid secretions by blocking histamine receptors in parietal cells exceptions…

  1. Ranitidine (zantac)
  2. Famotidine (pepcid)
  3. Nizatidine (axid)
  4. Cetirizine (zyrtec)
A
  1. zyrtec is H1 blocker for allergies
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7
Q

pain: duodenal ulcer vs gastric ulcer

A

decrease with meals vs greater with meals

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8
Q

causes of Peptic Ulcer Disease (PUD)

A

h pylori, corticosteroid, nsaid, alcohol, tobacco

Duodenal: hpylori is 90%
Gastric: h pylori is 70%

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9
Q

dx: PUD

A

upper endoscopy with biopsy

h pylori testing - urea breath test

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10
Q

complications of PUD

A

hemorrhage, obstruction, perforation, intractable pain HOPI

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11
Q

56 year old women recently diagnosied with RA. 2 months later has abdominal pain worse with food.

  1. Gastric ulcer
  2. duodenal ulcer
  3. crohn
  4. ulcerative colitis
A

greater pain with meals is Gastric ulcer…

crohns and ulcerative are IBD…

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12
Q

over secretion of Gastrin from tumors in duodenum and pancrease resulting in unresponsive, recurrent gnawing, burning abdomnal pain as well as with diarrhea, nausea, vomiting, fatigue, weakness, weight loss and GI bleeding

A

Zollinger-Ellison Syndrome

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13
Q

hormones for digestion..(source to target)

  1. Gastrin:
  2. Secretin:
  3. Cholecystokinin
  4. Gastric inhibitory peptide:
A
  1. stomach to stomach
  2. duodenum to pancreas, liver
  3. duodenum to pancreas, GB
  4. duodenum to stomach
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14
Q

hormone that stimulates bile secretion in the liver

A

secretin

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15
Q

hormone that stimulates emptying of bile in the GB

A

cholecystokinin

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16
Q

functional disorder that is characterized by changes in bowel habits that increase with stress as well as by abdominal pain that improves with bowel movements:

chronic abdominal pain, discomfort, bloating, alteration of bowel habits, diarrhea or constipation or both

A

irritable bowel syndrome

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17
Q

Inflammatory bowel disease: crohns disease vs ulcerative colitis

A

anywhere from mouth to anus (skip lesions) vs

large intestines and anus (continuous lesions with bleeding)

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18
Q

heartburn 30 to 90 minutes after a meal, worsens with reclining, and often improves with antacids, sitting or standing.. sour taste, globus, unexplained cough, morning hoarseness

A

Gastroesophageal reflux disease (GERD)

symptomatic reflux of gastric contents into the esophagus (transient LES relaxation)

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19
Q

test for GERD

A

barium swallow: hiatal hernia
upper endoscopy with biopsy: rule out barretts esophagus
24 hr ph monitoring

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20
Q

abnormal change of the cells (metaplasia) in the lower portion of the esophagus

  1. pheochromocytoma
  2. zollinger-ellison syndrome
  3. barrett esophagus
  4. hiatal hernia
A

Barretts esophagus

  1. pheochromocytoma - tumor of adrenal medulla
  2. sollinger ellison syndrome - gastrin producing tumor
  3. hiatal hernia ST
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21
Q

unilateral, 4 to 72 hrs, pain with nausea, photophobia or phonophobia, may have aura; more common in women, triggered by food, light or sound

A

migraine headache

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22
Q

treatment for migraines

A

Triptan, nsaids; propranolol, topiramate)

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23
Q

diagnosis for migraines

A

POUND; pulsatile, oneday, unilateral, nausea, disabling

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24
Q

unilateral, 15mins to 3 hrs, repetitive brief headache, excruciating periorbital pain with lacrimation and rhinorrhea; more common in men

A

Cluster headaches

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25
Q

treatment for cluster headaches

A

100% O2, sumatriptan

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26
Q

bilateral, >30mins, 4 to 6 hours, constant, steady pain, most common

A

tension headaches

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27
Q

treatment for tension headaches

A

analgesics, nsaids, acetaminophen

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28
Q

classic vs common migraines

A

unilateral w/aura vs bilateral w/o aura

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29
Q

unilateral chest pain, dyspnea, unilateral chest expansion, decrease tactile fremitus, hyperresonance, diminished breath sounds, all on affected side; commonly in tall, thin, young males

A 
pneumothorax
P_THORAX
pleuritic pain
tracheal deviation
hyperressonancee
onset sudden
reduced breath sounds
absent fremitus
xray shows collapse
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30
Q

subtypes of pneumothorax

A
  1. primary (tall thin young males)
  2. secondary ( to COPD, TB, trauma, iatrogenic)
  3. tension (shock or death)
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31
Q

treatment of tension pneumothorax - emergency

A

immediate needle decompression followed by chest tube placement

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32
Q 
RESULT OF Virchow's triad:
venous stasis (plane flights, bed rest, incompetent venous valves)
endothelial trauma (surgery, injury to LE)
hypercoagulability state (malignancy, pregnancy, OCP use)
A

deep vein throbosis

clot formation in the large veins of the extremities or pelvis

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33
Q

unilateral lower extremity pain and swelling; Homan’s sign (dorsiflex foot causes pain in calf)

A

DVT

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34
Q

test choice for DVT

A

doppler ultrasound

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35
Q

most commonly occurs in young adults, acute EBV infection, infection through exchange of body fluids
FEVER+PHARYNGITIS+LYMPHADENOPATHY

A

infections mononucleosis

36
Q

treatment of mononucleosis

and DX

A

no effective treatment

Dx: heterophil antibody text, EBV specific antiboides

37
Q

red flag complication for Mono

A

splenomegaly… patients should avoid contact sports

38
Q

diagnostic test for Systemic Lupus

A

sensitive test ANA, more specific test is Anti-dsDNA or Anti-Sm or Anti-histone (drug induces SLE) antibodies

39
Q

high BP, BMI>30 (obese), insulin resistance (hirsutism, obesity, acne, androgenic alopecia, acanthosis nigricans)

A

polycistic ovarian syndrome

40
Q

women in reproductive age.. with PCOS have high risk for….

A

type 2 diabetes, insulin resistance, infertility, metabolic syndrome (insulin resistance, obesity, atherogenic dyslipidemia, hypertension)

41
Q

diuretic that treats hirsutism..

  1. acetazolamide
  2. mannitol
  3. furosemide
  4. hydrochlorothiazide
  5. spironolactone
A
  1. spironolactone
42
Q

productive cough for >3months for 2 consecutive years
plus
terminal airway destruction and dilation

A

COPD

Chronic bronchitis plus Emphysema

43
Q

dyspnea, pursed lips, minimal cough, decreased breath sounds, late hypercarbia/hypoxia, pink skin due to rapid breathing

A

Emphysema “pink puffer”

44
Q

cyanosis with mild dyspnea, productive cough, overweight with peripheral edema, rhonchi, early signs of hypercarbia/hypoxia, classic barrel chest, use of accessory chest muscles, muffled breath sounds

A

Chronic bronchitis (blue bloater)

45
Q

most important risk factor for COPD

A

smoking

46
Q

flank pain, fever/chills, nausea/vomiting, dysuria, frequency, and urgency - ecoli

A

pyelonephritis (kidney inflammation)

similar to s/s of cystitis but upper UTI

47
Q

dx: UA, culture, CBC, ultrasound, CT scan

A

pyelonephritis

48
Q

upper UTI

A

ureter, kidneys

49
Q

lower UTI

A

bladder, urethra

50
Q

costovertebral tenderness…

  1. pyelonephritis
  2. cholecystitis
  3. appendicitis
  4. diverticulitis
A

1.pyelonephritis

cholecystitis RUQ
appendicitis RLQ
Diverticulitis LLQ

51
Q

side effects of fluoroquinolone (antibiotics)…

  1. muscle pain
  2. GI bleeding
  3. hepatotoxicity
  4. tendon rupture
A
  1. tendon rupture..
ex: ciprofloxacin (CIPRO, CILOXAN)
levofloxacin (LEVAQUIN)
enoxacin (PLENETREX)
moxifloxacin (AVELOX)
norfloxacin (NOROXIN, CHIBROXIN)
ofloxacin (CLOXIN, OCUFLOX)
52
Q

multiple neurologic complaints that are SEPARATED IN TIME AND SPACE and are not explained by a single lesion
scanning speech + intrnuclear ophthalmoplegia + nystagmus (eyes, ears, mouth)
F>M
between 20 to 40 onset
sensitive to heat

A

Multiple Sclerosis (autoimmune disease)

key: sensitive to hot showers, hot weather

53
Q

remitting, relapsing patient presents with multiple nuerologic complaints that are separate in time and space?

  1. RA
  2. SLE
  3. ALS
  4. MS
A

MS.. myelin sheath damaged and axon exposed

54
Q

types:
- lives on the scalp and lays its eggs as nits attached to the hair
- lives in clothing and bites only the body
- lives on pubic hair
spread through body contact or by sharing bedclothes and garments, secrete local toxin and create pruritus

A

lice
head (classroom epidemics)
body
pubic (crabs)

55
Q

intense pruritus, especially at night and after HOT SHOWERS… most common areas are hands, axillae, genitals, tracks can be seen along with erythematous excoriate papules

A

Scabies - itching increases as an allergy is developed to the mite and its products

56
Q

tx: 1 to 2 applications overnight of 5% permethrin ..neck down

A

scabies

57
Q

disorder of RECURRENT SEIZURES

A

epilepsy.. (febrile seizures are not epilepsy)

58
Q

effect one area (focal) of the brain - PARTIAL

A

simple paritel (<15mins) and complex partial (>15mins)

59
Q

effect a diffuse area - GENERALIZED

A

absence, myoclonic, tonic-clonic, tonic, atonic

60
Q

simple partial vs complex partial seizures

A

consciousness intact vs impaired consciousness

61
Q

petit mal, 3Hz, spike and wave EEG, no postictal confusion, blank stare

A

ABSENCE seizure (diffuse type, generalized)

62
Q

quick repetitive jerks

A

MYOCLONIC seizure (diffuse type, generalized)

63
Q

grand mal, alternating stiffengin and movement

A

TONIC-CLONIC seizure (diffuse type, generalized)

64
Q

stiffening

A

TONIC seizure (diffuse type, generalized)

65
Q

“drop” seizures (falls to floor), commonly mistaken for fainting

A

ATONIC seizure (diffuse type, generalized)

66
Q

dx procedure for seizures

  1. EEG
  2. EKG
  3. EMG
  4. Electo accu
A
  1. EEG electroencephalogram
67
Q

continuous seizure more than 30 mins, recurrent without regaining consciousness between seizures

A

Status Epilepticus.. medical emergency

treated with lorazepam, benzo

68
Q

subtype of dizziness… spinning while stationary (not lightheaded)

A

VERTIGO

69
Q

peripheral vertigo vs central vertigo

A

inner ear etiology vs brain stem or cerebellar lesion

inner ear: canalithiasis(Benign Paroxysmal positional vertigo), neuritis vestibularis, menieres disease, trauma, ototoxic drugs

brain stem or cerebellar lesion: stroke(50%), demyelinating (MS), drugs (anticonvulsant, alcohol, hypnotic)

70
Q

sense of spinning that starts when turning or reaching overhead, sudden <1min, recurrent resulting from a dislodged otolith

A

BPPV (benign paroxysmal postiional vertigo)

71
Q

effects one ear, causing vertigo, tinnitus and hearing loss.. profuse sweating, nystagmus

A

Meniere’s disease

72
Q

most common cause of dementia in elderly

A

ALZHEIMER disease

73
Q

75 year old female, paranoia, loss of memory, CT scan: cortical atrophy, enlarged ventricle, nuerofibrillary tangles, senile plaques, general cerebral atrophy

A

Alzheimers.. tx: donepezil - ARICEPT…(increase acetyl choline)

74
Q

second most common type of dementia…. age, hypertension, diabetes, history of stroke

A

Vascular dementia (stroke) CVA

75
Q

rare, progressive form of dementia characterized by atrophy of the FRONTAL and TEMPORAL lobes
Patients present with significant changes in behavior and personality EARLY in the disease

A

PICK DISEASE

76
Q

dementia, parkinsonism, recurrent VISUAL HALLUCINATIONS

A

lowy body dementia

77
Q

creutzfeldt-jakob disease (prion disease) - rare form of dementia

A

MAD COW DISEASE

78
Q

obsessive compulsive disorder vs obsessive compulsive personality disorder

A

OCD: patients recognize the obsessive/compulsive behavior as products of their own mind and want to get better

OCPD: they do not recognize the behavior

79
Q

key differential for OCD

A

patient will present to a non-pychiatrist for a problem e. skin complain to a dermatologist

80
Q

meds for OCD

A

SSRI’s

81
Q 
fluoxetine = Prozac
Sertraline = Zoloft
Paroxetine = Paxil
Citalopram = Celexa
Escitalopram = Lexapro
A

SSRI’s for OCD

82
Q

side effects of SSRI’s

A

upset stomack, sexual DYSFUNCTION, serotonin syndrome (happens when mixing SSRI’s)

83
Q

PAINFUL (posterpetic nueralgia), vesicles evolving into crusted lesions in a dermatomal distribution?

  1. Herpes Zoster
  2. Acne Vulgaris
  3. Pemphigus vulgaris
  4. Bullous pemphigoid
A

herpes zoster.. shingles.. Varicella Zoster virus

84
Q

diagnostic to find metastasizing cancer?

A

PET scan

85
Q

patient has nocturnal penile tumescence but complains of erectile dysfunction… etiology?

  1. psychological
  2. endocrine
  3. vascular
  4. neurologic
  5. exogenous
A
  1. psychological because of noctural tumescence

endocrine.. from diabetes
vascular .. arthrosclerosis
neurologic.. stroke
exogenous… SSRI, BBlockers

86
Q

urological emergency that requires immediate attention

  1. benign prostatic hyperplasia
  2. epididymitis
  3. orchitis
  4. testicular torsion
A
  1. testicular torsion Prehn’s sign ( pain does not go away when lifted)
  2. epididymitis.. acute infection that results in posterior/superior testicular tenderness. Prehn’s sign is postitive.. pain is relieved

BIOMED - KIM VIDEOS (10 decks)

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