DAY7 Flashcards by Jacqueline Plachta

infection of the epidermishoney colored crusted lesion, caused by staph aureus

impetigo
erysipelas
cellulitis
necrotizing fascitis

impetigo.. epidermus layer

erysipelas is painful, upper dermis
cellulitis red subcutaneous fat
necrotizing fascitis fascia

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infection of the dermis and subcatenous fat, indentifiable portal of entry (cuts, bites, tinea pedis), warm erythematous, tender skin

cellulitis (tinea pedis is athletes foot)

repeated excoriation of extremities lead to MRSA

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burns that involve epidermis and superficial dermis.. red wet and painful BLISTERS

2nd degree..

first degree - epidermis
3rd degree - epidermis, dermis and fat
4th degree - no pain

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red, itchy, silvery, scaly plaque on outer side ex knees, elbows, gluteal cleft, scalp, pitting nails

psoriasis

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test for psoriasis.. scraping causes pinpoint bleeding

auspitz sign

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irregular areas on complete depigmentation, autoimmune destruction of melanocytes

vitiligo

albinism - normal melanocyte, decreased melanin
melasma - hyperpigmentation (pregnancy)
acanthosis nigricans - diabetes, dark rings usually in neck area

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allergic contact dermatitis…

type 1 hypersensitivity .. Anaphylaxis, allergy
type 2 hypersensitivity .. Cytotoxic
type 3 hypersensitivity….Immune
type 4 hypersensitivity—Delayed TBtest

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associated with asthma or allergic rhinitis, starts on the face in infancy, commonly on skin flexure, atopic dermatitis

eczema

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another name for hives..

Urticara

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Verrucae caused by..

HPV infection.. 2,4 common warts
6,11 genital warts
16,18 cervical cancer

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upper respiratory vs lower respiratory

larynx vs trachea, bronchi, bronchiole lung

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upper endoscopy goes as far as…

duodenum (SI)

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diaphragmatic irritation may refer pain to the….

neck and shoulder…
ex. cholecystitis refers pain to shoulder and neck..
phrenic nerve origniates in the neck at C3 to C5 and passes down between the lung and heart to reach the diaphragm

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right lung has how many lobes..

right has 3, left has 2

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the most common site for and inhaled foregin body..

right lung as the bronchioles are wider and more vertical

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vital capicity of the lungs are…

inspiratory reserve, tidal, and expiratory reserve volume…

total lung capacity .. inspiratory, tidal, expiratory and residual volume

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carbon monoxide poisoning is based in..

CO has 200 times more affinity than O2 for hemoglobin.. CO attaches to hemoglobin rather than O2…

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most significant risk factor of COPD..

cigarette smoking

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obstructive pulmonary disease… reduction of Airflow..

asthma..
chronic bronchitis, emphysema, bronchiectasis

these are restrictive.. interstitial lung disease, sarcoidosis, obesity hypventilation syndrome

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how is COPD diagnosed..

spirometry

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restrictive pulmonary disease..reduction of lung volume

sarcoidosis..difficulty taking air into the lungs

asbestosis, goodpasture syndrome

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chills, high fever, chest pain, cough and mucous..

pneumonia.. acute inflammation of the lungs, smoking, alcohol, hospital patients

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the second most common cause of lung cancer

radon gas..

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meninges and spinal cord herniate through the spinal canal…

myelomeningocele… (myelogram is a pic of the spinal cord)

meningocele - meninges forced through gap
spina bifida occulta - nothing protruding

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part of the cell the receives messages from other cells...d

dendrites.. | axon takes messages away from cell body

what covers the axon of some nuerons and helps speed neural impulses..

myelin sheath

neurotransmitter that is lower in parkinsons/depression and higher in huntington disease..

dopamine... drug for parkinsons (levadopa with carbidopa)

neurotransmitter that is lower in anxiety/depression and increase in parkinsons

5-HT (serotonin).. meds are SSRI also 5HTTP

neurotransmitter that is lower in Alzheimer/huntington and increase in parkinson

acetylcholine (drug for alzheimer is aricept)

genetic cause of abnormal involuntary writhing movements called chorea.. autosomal dominant mutation in either of an indiviudas two copies of a gene called...

huntingtons disease..child of an affected person has a 50% chance of getting it

non fluent aphasia with INTACT comprehension..

Broca aphasia... broca broken boca

fluent but makes no sense.. impaired comprehension and repletion.

Wernicke aphasia.. sensory

poor repetition but fluent speech.. intact comprehension...

conduction aphasia

most commonly affected by Cerebrovascular accident (stroke)

middle cerebral artery.. MCA

contralateral paralysis, upper limbs and face, contralateral loss of sensation, motor aphasia

stroke affecting MCA middle cerebral artery

rupture of berry aneurysm leads to..

Subarachnoid hemorrhage... (rupture/bleed)

worst headache of my life..

subarachnoid hemorrhage... | this term can also be associated with bacterial meningitis... difference is fever, altered mental status

CT shows a crescent shaped concave hyperdensity..headache, changes in mental status, contrlateral hemiparesis, common in elderly and alcoholics

subdural hemotoma

CT shows a lens shaped conves hyperdensity, skull fracture, severe trauma with immediate loss of consciusness followed by lucid interval

epidural hematoma.. emergency neurosurgincal evacuation.. may evolve to brain herniation and death secondary to the arterial source of bleeding

20 year old develops a headache from drinking wine..

migraine

25 year old male wakes up repeatedly during the night with unilateral PERIORBITAL pain associated with IPSILATERAL lacrimation...

cluster headache .. can also have ptosis, miosis

30 year old female has headaches at the end of the day that worsen with stress and improve with relaxation and massage..

tension headaches.. | tx: nsaids, acetominophen, tylenol, triptan(meds for migraine)

most common headache in adults

tension

most important FIRST diagnostic test to order in syncope...

EKG.. to rule out any issue with the heart..

fatigable ptosis, or double vision, proximal muscle weakness, symptoms worsen as the day progresses but fluctuate dramatically..

myasthenia gravis... can present like MS.. except MS has sensitivity to heat.. MS issues separated in time and space

autoimmune disorder antibodies directed towards PRESYNAPTIC calcium channels in the neuromuscular junction

Lambert Eaton myasthenic syndrome... Myaasthenia Gravis is post synaptic disorder caused by autoantibodies

multiple nuerological complaints separated in time and space and are not explained by a single lesion, triad: scanning speech, intranuclear ophthalmoplegia, nystagmus

Multiple Sclerosis.. symptoms worse with hot showers and weather

acute, rapidly progressive acquired demyelinating autoimmune disorder of the peripheral nerves that results in weakness..

Guillain Barre syndrome

55 year old male with slowly progressive weakness in his left upper extremity and later his right, associated with fasciculations and atrophy, no bladder distubrance

Amyotrophic lateral sclerosis.. ALS (Lou Gehrigs disease) UMN and LMN MS has bladder incontinence.. differential

pain during intercourse is found in...

interstitial cystitis and endometriosis..

high creatinine levels are...

problems with kidneys.. also BUN test

upper urinary tract infection ..Kidneys and ureter

pyelonephritis and ureteritis.. lower Urinary tract is bladder and urethra

flank pain and high fever is indicative of...

pyelonephritis (vs. cystitis)

increased urinary frequency, painful urination, WBC and bacteria in urine is indicative of..

cystitis or pyelonepritis but pyelonephritis also has fever and flank pain..

most common cause of UTI...

E. COLI..because of closeness to anus.. higher in women

intracellula fluid is...

40% of body weight... total body water is 60%.. other 20% is extracellular fluid

normal ph of blood...

7.4.. neutral is 7

definition of acidosis...

excess acid in blood... ph of less than 7.35

definition of alkalosis

excess base in blood.. ph > 7.45

ph of 7.25 and rapid shallow respiration..

respiratory acidosis..

ph of 7.55 with vomiting and diarrhea

metabolic alkalosis...

most common type of kidney stones..

calcium oxalate and calcium phosphate.. 80%.. uric acid stones are about 5% and can not be seen with an xray only with CT

best imaging studies for neprolithiasis (kidney stones)

CT scan but has high amount of radiation... xray is lesss but will not see uric acid stones as they are radio lucent

cholesterol lowering drugs end in...

-statin... side effects are myalgia.. muscle aches and pain, because of reduction of CoQ10

HMG CoA reductase inhibitors

cholesterol lowering drugs.. statins..

side effect of Niacin (B3 supplementation)

facial flushing and itching

beta agonist for asthma.. used during acute asthma attack

albuterol..

patient taking acetaminophen should report any bleeding, bruising, nosebleeds, and ....

this tylenol.. also RUQ pain as it can impact the liver NSAIDS affect the stomach

drugs that end in -olol are ...

beta blockers.. used for hypertension.. ex. propranolol inderal side effect is bradychardia..<60 beats..

highly active antiretroviral therapy.. HAART.. is for..

HIV infection..

initiated when patients present with AIDS defining illness, low CD4 cell counts <500, high viral load

HAART.. AIDS is diagnosed when CD4 count is <200 but therapy started before

diarrhea with a history of recent antibiotic use suggests..

clostridium difficile.. a bacterium that can cause symptoms ranging from diarrhea to life threatening inflammation of the colon tx: metronidazole/oral vancomycin

excessive licorice can cause..

hypokalemia.. loss of potassium..

foods rich in folic acid...

asparagus, spinach, lentil.. NOT beef

mode of action of NSAIDS..IBprofen naproxen ketorolac

inhibit prostaglandins.. but also inhibits COX1 which is for the GI mucosa.. this cause GI bleeding

NSAIDS and aspirins block ...

COX1 and COX2 pathways.. COX1 is for GI mucosa.. COX2 is prostaglandins..

NSAIDS are used with caution with people who have..

peptic ulcer because of gastric protection loss...

NSAIDS are commonly used for...

osteoarthritis, RA, tennis elbow

toxicity of aspirin can cause...

gastric ulceration, tinitus (CNVIII), risk of Reye syndrome in children...

chronic gout is medicated with...

allopurinol..

acute gout is treated with..

nsaids, glucocorticoids, colchicine

side effect of ACE inhibitors.. (ends in -pril)

dry non productive cough.. used for hypertension

diuretics can cause ..

gout