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HS 401 - SU 16 @ OU > Exam 3 > Flashcards

Exam 3 Flashcards

1
Q

Tracheoesophageal Fistula (Atresia)

A

Congenital abnormality where esophagus communicates with trachea. Most common is where the upper end is a blind pouch.

Causes: Congenital
Symptoms: Newborn choking, excessive salivation, respiratory distres
Treatment: Surgery

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2
Q

Barrett Esophagus

A

Lower portion of esophagus squamous epithelium is replaced by columnar epithelium.

Causes: Usually from GERD
Symptoms: Symptoms related to GERD, dysphagia, ulcerations
Treatment: Acid pump reducer drugs (Nexium) reduce the acid. Antacids are only temporary (Tums), H-2 blockers (Zantac) blocks the histamine which slows the acid

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3
Q

Achalasia

A

Esophageal sphincter doesn’t relax during peristalsis so food gets clogged in esophagus and dilates.

Causes: Idiopathic
Symptoms: Progressive dysphagia, regurgitation, bird-beak esophagus (shown from Barium esophageal swallow)
Treatment: Botox, LES dilation

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4
Q

GERD

A

Reflux of gastric juice into esophagus

Causes: Untreated LES. Associated with hiatal hernia, alcohol, and tobacco
Symptoms: Heartburn which worsens after meals, lying down, and bending, but relieved by antacids. Complications can lead to Barrett esophagus
Treatment: H-2 blockers (Zantac) and lifestyle modifications

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5
Q

Esophageal Carcinoma

A

Squamous Cell Carcinoma is in upper esophagus. Lesions and ulcers
Adenocarcinoma is lower esophagus from Barrett esophagus

Causes: Barrett esophagus, achalasia, smoking and alcohol
Symptoms: Dysphagia starting with solid foods then liquid, anorexia, hematemesis
Treatment: Chemo, radiation, surgery. BAD prognosis

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6
Q

Acute Gastritis

A

Acidic damage to the stomach, associated with ulceration and bleeding

Causes: NSAIDs, alochol, smoking
Symptoms: Hemorrhages, neutrophilic infiltration, anorexia, epigastric pain, hematemesis, nausea, vomiting
Treatment: H-2 Blockers (Zantac), acid pump reducer (Prilosec)

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7
Q

Chronic Gastritis

A

Acidic damage to the stomach. Type A is autoimmune and Type B is caused by bacterial infection

Symptoms: Type A - Chronic mucosal infection and atrophy of mucosal glands, thickened folds in fundus, lymphocyte infiltration, fatigue, autobodies to parietal cells, pernicious anemia. Type B - asymptomatic with peptic ulcer
Treatment: Type A - vitamin B12. Type B - triple therapy

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8
Q

Peptic Ulcer

A

Holes in stomach

Causes: H. pylori (95%). In duodenum, arises from increased acid and pepsin secretion. In Gastric, arises from decreased mucosal protection
Symptoms: Punched out margins near lesser curvature. In duodenum, there’s hypertrophy of Brunner glands
Treatment: Gastric - pain intensifies after meals, weight loss. Duodenum - pain lessens after meals, weight gain. H-2 Blockers help (Zantac) and triple therapy. D Ulcers don’t lead to carcinoma, G Ulcers do

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9
Q

Gastric Carcinoma

A

Malignant epithelial cells. Most common in men over 50 and those with blood group A

Causes: Chronic gastritis, peptic ulcers
Symptoms: Weight loss, epigastric pain. Intestinal - lesions with necrotic base and heaped up margins. Diffuse - leather bottle stomach
Treatment: Surgery with or without chemo

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10
Q

Crohn’s Disease

A

Inflammation of distal ileum (right side abdomen). Corn on the cob

Causes: Idiopathic
Symptoms: Ulcers of mucosal layer and scaring of the small intestine. Precense of granuloma, fistula, and stenosis. String sign on X-Ray after barium swallow. Symptoms like IBD.
Treatment: Cortisol, Humira

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11
Q

Celiac Sprue

A

Autoimmune disease against gluten

Causes: Idiopathic/autoimmune
Symptoms: Failure to thrive, malabsorption, steatorrhea (pale, frothy stool), chronic diarrhea, dermatitis herpetiformis (blisters over trunk, scalp, and neck). Lab findings include antigliadin and antiendomysial and anti-TTG antibodies.
Treatment: Gluten-free diet

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12
Q

Acute Appendicitis

A

Inflammation of the appendix

Causes: Obstruction of the appendix by a fecalith, inflammation, foreign body, or neoplasm. Affects mostly 10-30 year olds
Symptoms: Swollen appendix, neutrophilic infiltration. RLQ pain (McBurney’s point), fever, vomiting, pain by hip
Treatment: Appendectomy

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13
Q

Colorectal Adenocarcinoma

A

Carcinoma arising from colonic or rectal mucosa;
3rd most common site of cancer. Peak incidence
is 60-70 years of age.

Causes: Adenomatous polyps, ulcerative colitis, P53 mutation, DNA mismatch repair, low fiber
Symptoms: Pallor, weight loss, intermittent diarrhea, LLQ pain. Positive stool guaiac test, increased serum CEA
Treatment: Surgical resection, chemotherapy

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14
Q

Adenomatous Polyps

A 
Tubular Adenomas (75%): Most common. Appear as peducular mass on the membrane. Malignancy potential is low
Tubulovillous Adenomas (15%): Similar in appearance to tubular adenomas, except their surface has finger-like projections. Malignancy potential is intermediate
Villous Adenomas (10%): Flattened with large finger-like villi. High malignancy potential

Causes: Somewhat genetic
Symptoms: Asymptomatic to rectal bleeding
Treatment: Aspririn, NSAIDs, Colonoscopic removal

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15
Q

Ulcerative Colitis

A

Chronic inflammation and linear ulcerations with megacolon and pseudopolyps. Mucosal layer is red and granular. Meat loaf

Causes: Idiopathic
Symptoms: Tenesmus (urge to defecate ineffectively), diarrhea with blood, toxic megacolon (leads to gangrene), increased risk for colorectal adenocarcinoma. Lead-pipe appearance
Treatment: Antidiarrheals, cortisol, DMARDs

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16
Q

Diverticulosis

A

Presence of multiple diverticula usually in sigmoid colon

Causes: Increased pressure in bowel and bowel wall weakness
Symptoms: Asymptomatic, some abdominal discomfort
Treatment: High-fiber diet, laxatives

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17
Q

Diverticulitis

A

Inflammation of diverticula

Causes: Impacted fecal material causes inflammation
Symptoms: Fever, LLQ abdominal pain, bright red blood in stool
Treatment: Antibiotics, high-fiber diet

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18
Q

Hirschsprung Disease

A

Megacolon proximal to rectum. No ganglion cells of Auerbach and Meissner plexuses

Causes: Failure of neural crest cell migration
Symptoms: Failure to pass meconium, chronic constipation
Treatment: Surgery

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19
Q

Pneumothorax

A

Accumulation of air in the pleural space.

Causes: Rupture of some sort
Symptoms: Trachial deviation, chest pain, dyspnea
Treatment: Needle decompression

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20
Q

Lung Carcinoma

A

Causes: cigarette smoking, air pollution, radiation, asbestos, nickel, chromium

Squamous cell: most common, tumors are centralized
Adenocarcinoma: most common in non-smokers, slow growth rate, peripheral tumors
Small cell (oat cell): highly malignant, small round cells with neuclei resembling oat grains
Large cell: pleomorphic giant cells, peripheral lesions, undifferentiated, poor prognosis

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21
Q

Polymyositis

A

Inflammation of skeletal muscles

Causes: Idiopathic, CD8+ T-cell injury
Symptoms: Necrotic muscle cells, gradual proximal muscle weakness, muscle atrophy, endomysial inflammation (CD8)
Treatment: Corticosteroids, immunosupression

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22
Q

Dermatomyositis

A

Inflammation of skin and skeletal muscles

Causes: Idiopathic, immune complex deposition in blood vessels
Symptoms: Necrotic muscle cells, rash of the upper eyelids (heliotrope), red papules on the elbows, knuckles, and knees (Gottron papules), rash similar to lupus, proximal muscle weakness
Treatment: Corticosteroids, immunosupression

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23
Q

Abrasion

A

Scrapes

24
Q

Avulsion

A

Skin peeling off

25
Q

Myasthenia Gravis

A

Antibodies bind to acetylcholine receptors at NMJs, so muscles don’t work

Causes: Hypersensitivity II, autoimmune
Symptoms: Eye drooping, facial muscles relaxed, speech affected. Diagnosed by tensilon test
Treatment: immunosupression, blood transfusions, anticholinesterase

26
Q

Lambert-Eaton Syndrome

A

Antibodies against presynaptic calcium channels at NMJ

Causes: Small cell carcinoma
Symptoms: Proximal muscle weakness
Treatment: Treating the cancer

27
Q

Myotonic Dystrophy

A

Autosomal dominant disorder. Results in increased CTG repeats

Causes: Genetic
Symptoms: Myotonia (can’t relax muscles), atrophy, facial muscle weakness, cataracts, testicular atrophy, baldness, hatchet face
Treatment: Phenytoin

28
Q

Duchenne Muscular Dystrophy

A

X-linked recessive disorder. No dystrophin means the structural proteins in the membrane aren’t held together. Only affects males

Causes: Genetic
Symptoms: Weakness in proximal muscles of extremities (usually pelvis), eventual immobilization, pseudohypertrophy of calves, Gower’s maneuver. Increased serum CK. Affects respiratory muscles
Treatment: Glucocorticoids, poor prognosis, death at 25

29
Q

Becker Muscular Dystrophy

A

Similar to Duchenne

Causes: Genetic
Symptoms: Similar to Duchenne. Mutated dystrophin
Treatment: Death at around 40

30
Q

Botulism

A

Food poisoning from Clostridium botulinum, mostly from canned foods

Causes: Old canned food
Symptoms: The toxin binds to ACH receptors, resulting in paralysis of skeletal and respiratory muscles
Treatment: Antitoxins

31
Q

Albinism

A

Inability of melanocytes to produce melanin

Causes: Genetic, enzyme deficiency tyrosinase
Symptoms: Hypopigmentation
Treatment: None

32
Q

Vitiligo

A

Autoimmune destruction of melanocytes

Causes: Autoimmune
Symptoms: Flat lesions of pigment loss (MJ)
Treatment: Corticosteroids

33
Q

Melasma

A

Hyperpigmented patches usually on cheeks and forehead

Causes: Pregnancy, oral contraceptives
Symptoms: Mask of pregnancy
Treatment: Sunscreen

34
Q

Ichthyosis Congenita

A

Fish Skin

Causes: Congenital
Symptoms: Hard, thickened skin
Treatment: Salicylic acid

35
Q

Jackson’s Theory

A

Zone of Coagulation: Area in a burn nearest the heat source that suffers the most damage as evidenced by clotted blood and thrombosed blood vessels
Zone of Stasis: Area surrounding zone of coagulation characterized by decreased blood flow
Zone of Hyperemia: Peripheral area around burn that has an increased blood flow

36
Q

Allergic Contact Dermatitis

A

Type IV Hypersensitivity

Causes: Allergens
Symptoms: Edema within epidermis, vesicles, thickening of epidermis
Treatment: Corticosteroids

37
Q

Eczema

A

Dermatitis except cause unknown

38
Q

Scleroderma

A

Thickening and hardening of the skin

Causes: Autoimmune, presence of HLA-DQB1 and autoantibodies
Symptoms: Thickened skin exhibits (a) a
increase in collagen fibers in the dermis; (b) thinning of the epidermis, (c) atrophy of dermal appendages; (d) hyalinization and destruction of arterioles and (e) variable mononuclear infiltrates, consisting primarily of T cells
Treatment: anti-inflammatories, immunosuppresives

39
Q

Psoriasis

A

Red patches with silver scales

Causes: Idiopathic, autoimmune, genetic
Symptoms: No itching, positive Auspitz sign, nail discoloring, psoriatic arthritis (usually fingers)
Treatment: Corticosteroids, UVB light exposure

40
Q

Basal Cell Carcinoma

A

Most common skin cancer

Causes: Chronic exposure to light
Symptoms: Elevated nodule with central dome-shaped papule
Treatment: Surgical excision

41
Q

Squamous Cell Carcinoma

A

Malignant proliferation of squamous cells

Causes: Excessive exposure to UV light, defective DNA repair mechanisms
Symptoms: Small red firm ulcerating nodules on face
Treatment: Metastasis is rare, surgery

42
Q

Malignant Melanoma

A

Malignant neoplasm of melanocytes

Causes: Excessive exposure to UV light, genetic, albinism
Symptoms: a) Radial growth: discolored macule, horizontal growth of nests of atypical cells within epidermis, lymphocytic infiltrate and melanin containing macrophages in dermis, does not metastasize; (2) Vertical growth: nodular appearance, growth into underlying dermis, does metastasize and metastatic probability is directly proportional to depth of invasion
Treatment: Surgical excision, IL-2 treatment

43
Q

Hirsutism

A

Soft, fine hair transformed to coarse, thick hair

Causes: High androgen
Symptoms: deep voice, muscle bulk, clit enlargement
Treatment: Oral contraceptives

44
Q

Alopecia

A

Autoimmune destruction of hair follicles

Causes: Autoimmune
Symptoms: Hair loss
Treatment: Immunosuppresives, topicals

45
Q

Achondroplasia

A

Form of dwarfism

Causes: Mutation of gene FGFR3 (Fibroblast growth factor receptor 3)
Symptoms: Cartilage proliferation in growth plate, dwarfism
Treatment: None

46
Q

Osteogenesis Imperfecta

A

Brittle bone disease

Causes: Deficient synthesis of type 1 collagen, autosomal dominant
Symptoms: Multiple fractures, blue sclerae, hearing loss
Treatment: Pneumatic bracing

47
Q

Osteopetrosis

A

Thick bones

Causes: Defective osteoclasts
Symptoms: Multiple fractures, anemia, cranial nerve palsies
Treatment: Bone marrow transplant

48
Q

Osteomyelitis

A

Infection of bone and bone marrow

Causes: Usually bacterial (S. aureus, gonorrhea, salmonella, TB), needles
Symptoms: Bone pain with systemic signs of infection, abscess of bone on X-ray
Treatment: Antibiotics

49
Q

Osteoporosis

A

Decrease in bone mass/porous bone

Causes: Genetic, diet and exercise, decreased estrogen
Symptoms: Multiple fractures, spine curving/shortening, DEXA shows low bone mass
Treatment: Bisphosphonates, SERM, calcium and vitamin D

50
Q

Rickets and Osteomalacia

A

Softening of bones. Rickets is children, osteomalacia is adults

Causes: Vitamin D deficiency which results in low calcium and phosphate serum levels
Symptoms: Rickets - bowlegged, pigeon breast, shortened stature. Osteomalacia - diffuse back pain, muscle weakness
Treatment: Vitamin D

51
Q

Paget’s Disease

A

Increase in both osteoclasts and osteoblasts

Causes: Idiopathic
Symptoms: Microfractures, bone pain, lion-face, hearing loss, bowleg, kyphosis (hunch back)
Treatment: Calcitonin, bisphosphonates

52
Q

Osteoma

A

Most common benign tumor in bone

Causes: Lateral part of growth plate displacement
Symptoms: Extra cartilage from bone growth covers bone
Treatment: Surgery if symptomatic

53
Q

Chondrosarcoma

A

Malignant tumor of cartilage commonly found in pelvis

Treatment: Surgery, chemo

54
Q

Osteosarcoma

A

Malignant tumor from osteoblasts affecting 10-20 yr old males. 60% of tumors in knee. Codman triangle

Treatment: Surgery, chemo

55
Q

Ewing’s Sarcoma

A

Childhood tumor. Blue due to primitive cells. Affects males

56
Q

Osteoarthritis

A

Most common joint disease

Causes: Mechanical wear and tear
Symptoms: Polishing of bone, joint stiffness that worsens, affects hips knees and fingers and toes
Treatment: NSAIDs, COX-2 inhibitors, Voltaren, surgery

57
Q

Rheumatoid Arthritis

A

Systemic inflammation of joints

Causes: Idiopathic
Symptoms: Cartilage is destroyed and replaced with pannus, joint deformity, rheumatoid nodule, most severe in morning but gets better, swan neck deformity. Lab findings: autoantibodies

HS 401 - SU 16 @ OU (14 decks)

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