Especial Flashcards
Whats Charge Syndrome
Mutation in CHD7 gene on 8q12 chromosome.
- COLOBOMA
- Heart disease
- Choanal atresia
- Retardaded growth
- SNC and genital abnormalities
- Ear abnormalities (Deafness)
Symptoms of Fetal Alcohol Syndrome
Short palpebral fissures Epicanthal folds Flat nasal bridge Long philtrum Thin upper lip
Abnormalities in infant of diabetic mother
Sacral agenesis (agenesia) Femoral hypoplasia Cleft palate Microtia Microcephaly/Anencephaly Spina bifida Polydactyly
Whatr VATER association
Abnormalities in:
Vertebral Anal Tracheoesophageal Esophageal Radial/Renal
Phases of Acetaminophen intoxication
1) First 24hrs:
- Nonspecific symptoms
2) 24-72hrs:
- Nonspecific symptoms resolve + Appear right upper quadrant pain + Hepatomegaly + Increase liver function tests
3) 72-96hrs:
- Return of nonspecific symptoms + Liver failure (Jaundice, coagulopathy)
4) 4 days to 2 weeks:
- Recovery of death
Whats prevalence
Number of total cases (new and old) at a specific point in time divided by total population at that time.
Whats incidence
Number of new cases in study population pero total study population at risk per given time period.
Whats Monoclonal Gammapathy
Presence in the beta-gamma region of serum proteins of an abnormal spike (M Protein) consisting of Inmunoglobulins of the same isotype produced by a single clone of abnormally proliferating lymphocyte/plasma cells.
It causes NEUROPATHY with loss of proprioception in the sixth to sevent decade of life
Symptoms of Wound Infection after cesarean delivery
More common in patients with Chorioamnionitis or Obese Women.
- Tenderness
- Erythema
- Discharge
First two days: Streptococcal
After that: Staph. or mixed
Symptoms of Endometritis
Polymicrobial infection caused by normal vaginal flora (Strep. B = Agalactiae and E.Coli)
The bacteria gain access to the upper genital tract due to vaginal examination.
- Fever >38º
- Uterine tenderness
- Purulent lochia
Main patogen of Pyelonephritis
E. Coli
Whats Placental Abruption
Premature separation of a normally implanted placenta
It causes high frequency and low amplitude contractions + bleeding.
Virus family of Hepatitis Viruses and transmission
VHA: Picornaviridae
-Oral-Fecal
VHB: Hepadnaviridae
-Sexually transmitted, vertical
VHC: Flaviviridae
-Blood transmitted
Uses of Calcitonin, mechanism and side effects
Paget disease
Hypercalcaemia
Mechanism: Osteoclast Inhibitor
Side effects: Increase risk of malignancy, dizziness
Uses of RANKL Inhibitors, mechanism and side effects
Osteoporosis
Metastatic bone disease
Antibody which blocks effects of RANKL: Inhibiting osteoclastic bone resorption
It can cause OSTEONECROSIS of the jaw, atypical femoral frectures and Erysipela
Uses of Parathyroid Hormone, mechanism and side effects
Osteoporosis
Mechanism: Stimulates bone formation, increasing bone mass.
Side effects: MUSCLE CRAMPS.
Contraindication: Bone malignancy.
Uses of Biphosphonates mechanism and side effects
Osteoporosis, Paget and metastatic bone disease.
Mechanism: Inhibition of osteoclastic bone resorption.
Side effects: DYSPEPSIA, esophageal ulceration, bone PAIN, atrial fibrillation.
Cause of Cystic Fibrosis
Mutations in the gene that encodes the cystic fibrosis transmembrane conductanse regulator (CFTR) protein.
That regulates ion flux at epithelial surfaces.
Breast tumor formed by glandular and cystic epithelial structures surroundes by cellular stroma.
Fibroadenoma (Benign)
Breast tumor formed by epithelial-lined spaces surroundes by cellular stroma with atypia.
Phyllodes Tumor (benign, intermediate or malignant)
Breast tumor formed by dilated ducts and acini with dense collagenous stroma.
Fibrocystic Mastopathy (Cyclic and benign)
Most common cause of mesenteric ischemia
Ischemic colitis
Characteristics of Nonproliferative diabetic retinopathy
Moderate: Microaneurysms, intraretinal (blot) hemorrhage, soft exudates, venous beading <2 quadrants
Severe: >20 hemorrhages in each of 4 quadrants or venous beading (Arrosariamiento) in 2 quadrants
Characteristics of Hypertensive Retinopathy
Grade 2: Silver wiring (arrowheads), nippin of the venules at arteriovenous crossing. And copper wiring appearance of sclerosed arterioles.
Grade 3: Silver wiring (arrowheads), nipping and flame-shaped retinal hemorrhages with soft “cotton-wool” exudates.
Fetal part that directly overlies the pelvic inlet
Presentation
Longitudinal axis of the ferus relative to the longitudinal axis of the uterus
Lie
Position of the head with regards to the fetal spine (degree of flexion/extension)
Attitude
Relationship of the fetal presenting part to the maternal pelvis
Position
Cause of Molluscum Contagiosum
Poxvirus that is transmitted by direct human to human contact or by infected fomites.
It causes papula with central umbilication.
Disease showing Thumbprinting in RX
Ischemic Colitis: Most common cause of mesentecis ischemia
Forward translation (slip) of one vertebral body on the one below
Spondylolisthesis. Due to repetitive hyperextension or sports
Patognomic sign of Scabies
Burrows (surcos)
Surgical treatment of CACU that preserves fertility
Trachelectomy
Types of Hysterectomy
Type 1 (Simple): Extrafascial
- Removes uterus and cervix
- Does not removes parametrium
Type 2 (Modified Radical Hysterectomy) -Removes uterus, cervix, proximal vagina and pamaetrial tissue
Type 3 (Radical Hysterectomy):
- All of the above + greater resection of parametrial tissue
- Ligation of uterine arteries
Agent of Tinea Capitis
Trichophyton Tonsurans
Most common cause of diffuse hair loss after stressful state (illness, surgery)
Telogen Effluvium: Mature hair follicles switch prematurely to the telogen (resting) state.
It occurs 3 months after stressful event.
Trichotillomania
Alopecia due to compulsive urge to pull out one’s own hair.
Risk factor of cervical pregnancy
History of dilatation and curettage
Most common type of conjunctivitis
Viral: Adenovirus
Usually secondary to upper respiratory tract infection
Most common cause of peripheral precocious puberty
Granulosa cell tumor: Increased estrogen concentrarion
Whats heterosexual precocious puberty
Androgen excess with virilization caused by increased production by the adrenal gland or ovary.
Whats central precocious puberty
Early activation of the hypothalamic-pituitary-ovarian axis with increase in GnRH secretion.
Disease with “boot-shaped heart”
Aortic Stenosis
Study that defines prevalence
Cross-sectional study. Compare proportion of two groups:
A) Disease + Risk factor
B) Healthy + Risk factor
Case-control study
Compares two groups:
A) Disease
B) Healthy
Compare proportion of cases with and without risk factor
Karyotype of Mola
Complete: 46XX
Incomplete: 69XXX, 69XXY
Whats Brown-Sequard Syndrome
Due to hemisection of the cord:
- Ipsilateral motor paralysis
- Contralateral loss of sensation
Types of cord syndromes
Posterior:
- Hyperextension injuries
- Ataxia
- Loss of propioception
Anterior:
- Flexion/rotation injuries
- Paraplegia (legs more affected)
- Loss of sensitivity
Central:
- Motor loss (arms more affected)
- Sacral sparing
- Example: SYRINGOMYELIA
Genetically determined heart muscle disorder with loss of cardiomyocytes and replacement by fibrous tissue in the right ventricular myocardium
Arrhythmogenic Right Ventricle Cardiomyopathy.
Heart muscle disorder with dilatation and impaired systolic function in the absence of coronary disease
Dilated Cardiomyppathy. There’s reduced ejection fraction
Whats Uterine Didelphys
Failed fusion of the paired müllerian ducts. Forming two separed uterine horns each with an endometrial cavity and uterine cervix.
Ectopic rests of endometrium located deep within the myometrium
Adenomyosis
Signs of Carpal Tunnel Syndrome
- Paraesthesia of the median distribution (thumb, index, middle and radial half of the ring finger) more marked at night
- Relieved by shaking the hand
- Phalen test
Signs of Trigger Finger
Can affect any finger. It is caused by fibrotic thickening which results in restricted movement of the flexor tendon.
Digit locked in flexion on attempt at passive extension. Unlocked forcibly by patient.
Signs of Quervain’s Tenosynovitis
Inflamacion y estenosis de las vainas tendinosas del ABDUCTOR largo del pulgar y el EXTENSOR corto del pulgar.
Ocasiona dolor al utilizar la muñeca y el pulgar aveces con crepitacion.
Signs of Dupuytren’s Contracture
Progressive, painless fibrotic thickening of the palmar and digital fascia leading to nodular hypertrophy and contracture of the fascia.
Symptoms of Candidal Breast Infection
Severe pain through the chest.
Symptoms of Breast Abscess
Complication of Mastitis:
- High fever >39º
- Localized erythema, tenderness and induration
- Fluctuant area in the center
- Usually by S. Aureus
Symptoms of Mastitis
High fever Localized erythema and tenderness Flulike symptoms Leucocytes <4000 or >12000 Occurs in the first 2-4 weeks postpartum Caused by S. Aureus
Mechanism of elbow dislocation
Fall with outstretched hand with elbow in flexion
Most common type of elbow dislocation
Posterior displacement of the ulna (cubito)
Most characteristic sign of elbow dislocation
Elbow held in flexion by the other arm
Symptoms of Eosinophilic Esophagitis
Secondary to immune response or alergenic
Children: Dyspepsia
Adults: Solid food dysphagia.
Dx: White exudates,
Effect of Ciclosporin
Inhibits calcineurin (Involved in activation of T-cells, used in Arthitis)
Can cause:
- Gingival hiperplasia
- Hypertension
- Hyperglycemia
Effect of Cyclophosphamide
Used in Lupus. Alkylating agent that halts cell replication by forming cross-links between strands of DNA causing immunosuppression
Effect of Azathioprine
Used in Arthritis. Inhibits DNA synthesis causing immunosuppression
Effect of Methotrexate
Inhibits dihydrofolate reductase
TNM of Vulvar Cancer
IA: Lesions <2cm with invasion <1mm
-Local excision
IB: Lesions >2cm
-Radical resection + Lymphadenectomy
II: Extension to lower structures of the perineum
-Radical resection + Lymphadenectomy
III: Metastases to inguinal nodes
- Radical resection + Lymphadenectomy
- Radiation + Chemotherapy (Platinum)
IVA: Urethra, bladder, rectal mucosa, pelvic metastases.
-Radical surgery + all of the above.
Grades of vesicoureteral reflux
II: No dilatation
III: Mild dilatation
IV: Complete obliteration of sharp angle of fornices (fondos de saco)
V: Gross dilatation and tortuosity
Most common site of metastases of Prostate Cancer
Bone
Most common type of lower urinary dysfunction in elderly
Detrusor overactivity
Cause of Dermatomyositis
Inflammatory myophaty that causes loss of muscle blood vessels
Which condition presents with atrial rate of 250-350bpm and “SAWTOOTH” pattern
Atrial Flutter
Whats Transient Synovitis of the Hip
“Irritable hip” is an inflammatory of the hip joint in prepubescence with history of injury or RECENT VIRAL INFECTION.
Type of stones in obese and DM2 or myeloproliferative patients
Uric Acid Stones
Type of stones more common in women that are more susceptible to urinary tract infections.
Struvite Stones (Infection stones).
They form in the presence of urease-producing bacteria. (PROTEUS)
Mutations of Cystinuria and complication
SLC3A1 cause Cystine Stones
Most common malignancy of the vagina in children
Embryonal Rhabdomiosarcoma (Sarcoma Botryoides) -Girls <5 years
Classic finding of Vitaline Sack Tumor
Schiller-Duval body
Most common type of vaginal sarcoma in adults
Leiomyosarcoma Vitaline Sack Tumor
AB that causes ototoxicity and nephrotoxicity
Aminoglycosides
AB that causes deformity or discoloration of teeth
Tetracyclines
AB that causes anaphylaxis, dizziness, hemolytic anemia or cistitis
Penicilins
Type of endometrial cancer with Psamoma Bodies
Serous. The tumor is exophytic with a papillary appearance emerginc from a small, atrophic uterus.
Most common type of Endometrial Carcinoma
Endometrioid
Type of endometrial cancer similar to cervical adenocarcinoma
Mucinous Carcinoma.
Symptoms of Valvular Paget
Localized on the labia MAJORA as an eczematoid, red area with slow growth.
Clinical manifestations of Hypokalemia
Weakness and arrhythmias
- Flat or absent T
- U waves
Clinical manifestations of Hypocalcemia
TETANY, cramping, seizures, arrhytmias:
- Prolonged QT
- Trousseau sign (carpopedal smasm after arterial occlusion)
- Chvostek sign (muscle twitching with percussion of facial nerve)
Lession in which meniscus will lead to degenerative changes
Lateral.
Medial is the most commonly affected.
What fracture can cause a rapid contraction of the quadriceps
Patella fracture
What structure can be damaged after a fall onto a flexed knee
Extensor mechanism injury (Patellar or Quadriceps tendon rupture)
Lession caused by athletes who “side step” or teenage girls.
Dislocation of the patella
Which lession occur in valgus stress or twisting
Medial collateral ligament (Most common)
Anterior cruciate ligament injury (Males)
Which knee ligament is damaged in car accident (knww flexed, tibia forced posteriorly)
Posterior cruciate ligament
Which lession occur in varus stress
Lateral collateral ligament
Symptoms of Aspergillosis
Conidia (inhalated) reaches the tissue and germinate to form invasive filaments (HYPHAE).
Symptoms (immunosupresed):
- Fever
- Focal PULMONARY infiltrates that may progress to CAVITY.
- Pleuritic pain
- Hemoptisis
TX VORICONAZOL
Which opportunistic disease affects lungs, SKIN, hepatosplenomegaly and CID.
Histoplasmosis
Disease with right heart failure with low ejection fraction
Pericardial constriction due to chronic pericarditis
Sharp retrosternal pain irratiated to the scapula, is worse with inspiration and when supine + pericardial friction rub.
Acute Pericarditis.
Most common cause of malignant pericarditis
Breast CA, lymphoma and leukemia.
First symptom of chronic open-glaucoma
Loss of peripheral visual field with retention of central visual function.
First symptom of Macula degeneration
Loss of central visual field (FOVEA) with retention of peripheral visual function
First symptom of Retinitis Pigmentosa
Night blindness. Starts in early adult life is a genetic disease.
Dislocation caused by a fall backwards with an outstretched hand (abduction and EXTERNAL rotacion)
Anterior glenohumeral dislocation
Dislocation caused by direct blow to the anterior aspect of the shoulder (abduction and INTERNAL rotation)
Posterior glenohumeral dislocation
Which glenohumeral dislocation can lead to a recurrent one
Anterior
Mostly asymptomatic infection that can be chronic and intermittent diarrhea, anorexia and weight loss with bowel dilatation, ulceration and perforation. Can be fulminant in immunocompromised.
Balantidiasis
Sharp pain created by compressing appendix between abdominal wall and iliacus
Bassler sign.
Transient abdominal wall rebound pain.
Blumberg.
Pain at McBurney point when compressing the left lower abdomen.
Rovsing.
Pain or pressure in epigastrium or chest when pressing McBurney.
Aaron sign.
Arthritis associated with Crohn or CUCI
Enteropathic
Most common agent of Reactive Arthritis
Chlamydia
Gold Standard for Urolithiasis
Helicoidal TAC
Inflammation of the eyelid associated with Acne Rosacea
Blepharitis
Multiple seizure type often intractable with intellectual disability (1-8 years).
Lennox-Gastaut
Benign epilepsy of childhood (2-13 years) with centrotemporal spikes
Benign rolandic epilepsy
Sudden flexion or extension in 4-6 months old. EEG shows hypsarrhythmia.
Infantile spasms
