Important test review Flashcards
Cushing’s Disease
High cortisol levels for a long time.
The most common cause is the use of steroid drugs, -Can occur from overproduction of cortisol by the adrenal glands.
Sx- Fatty hump between the shoulders, rounded face, heavy midsection, skinny limbs.
Treatment options include reducing steroid use, surgery, radiation, and medication.
Diabetic Retinopathy
1 cause of blindness in US adults: Diabetic retinopathy is caused by damage to the blood vessels in the tissue at the back of the eye (retina). Poorly controlled blood sugar is a risk factor.
Macular Degeneration
Macular degeneration involves the deterioration of the center of the retina or Macula. It controls our ability to read, recognize faces and colors, drive a car, and see objects in fine detail.
Risk Factors: Fam history, White, Smoking
Dry - 90%
Wet 10% (accounts for 90% of blindness)
Glaucoma
Glaucoma causes damage to the optic nerve, which carries information from your eyes to your brain. Globally, it’s the second leading cause of vision loss. This disease can’t be cured, and any vision lost to the disorder can’t be restored. Higher-than-normal pressure in the eye usually causes the disease.
Risks: +60yrs, Black, fam history, diabetes, severely nearsided
Urticaria
Hives are red, itchy welts that result from a skin reaction. May be triggered by substances or situations.
measles vs Chicken pox
Measles has a higher fever (up to 105) and chicken pox has milder (102). Measles rash is more dense.
Psoriasis
dysfunction of the immune system that causes inflammation in the body. Silvery, scaly plaques on yang side (elbows, knees)
The Auspitz sign refers to pinpoint bleeding that can occur when you scrape off psoriasis patch.
Can have discolored pitted fingernails.
Tinea corporus
Tinea is a fungal infection of the skin, also known as ringworm. This is because it can cause red patches on the skin in the shape of rings. It’s not caused by worms. It’s caused by different types of fungi.
Round circular rings around patch of scaly, red, itchy skin. V. Contagious
tx: Anti-fungal
Cellulitis
A common and potentially serious bacterial skin infection.
The bacteria enters the opening in skin and may spread rapidly. Affected skin appears swollen and red and may be hot and tender. Without treatment with an antibiotic, cellulitis can be life-threatening
Most common: Group A ß - hemolytic streptococcus (Strep) Streptococcus pneumoniae (Strep)
Closed angle Glaucoma
Fluid drainage of eye becomes suddenly blocked leading to sudden sx of severe eye pain and headache on same side. Blurry vision, rainbow around lights.
Different from thunderclap, which recedes after about hour in that its continuous.
Atopic Dermatitis
Eczema, yin side of body, usually develops in early childhood & is more common in people who have a family hx.
Often an allergy that is inherited and comes with asthma, hay fever and allergies. eczema opens skin to allergies.
Rash typically appears on the arms and behind the knees - can also appear anywhere.
Treatment includes avoiding soap and other irritants.
Diagnosed with skin prick testing
rubeola
Measles is a viral infection that’s serious for small children preventable by a vaccine.
Spreads through the air by respiratory droplets
Sx don’t appear until 10 to 14 days after exposure: They include cough, runny nose, inflamed eyes, sore throat, fever, and a red, blotchy skin rash
No treatment to get rid of measles infection
Koplik spot looks like a small, bluish-white spot with a red background on the inside of the cheek. These spots are early oral signs of the measles virus, and they appear two or three days after measles symptoms begin, before rash.
varicella
Chickenpox is a very contagious disease caused by the varicella-zoster virus (VZV). Causes a blister-like rash, itching, tiredness, and fever. Chickenpox used to be very common in the United States.
DVT, Deep Vein Thrombosis
Anything that prevents your blood from flowing or clotting normally can cause a blood clot.
main causes: damage to a vein from surgery or trauma & inflammation due to infection or injury.
Throbbing, cramping pain, swelling in 1 leg (rarely both legs), usually in the calf or thigh.
warm skin, red, dark around the painful area.
swollen veins that are hard or sore when you touch them.
most commonly treated with anticoagulants, also called blood thinners.
Polycystic ovary syndrome (PCOS)
Numerous small cysts (fluid-filled sacs) that form in the ovaries.
LH:FSH @ leasat 2:1. HAIR AN snydrome
Hyper Androgenism - Androgen excess (facial hair)
Insulin Resistance -→ check glucose levels (diabetes)
Acanthosis Nigricans (dark skin around folds)
&
-Abnormal menstruation -obesity/overweight
Premature Ovarian Failure
Menopause before age 40.
In early menopause, the ovaries don’t produce normal amounts of the hormone estrogen or release eggs regularly. Infertility is common.
Endometriosis
Tissue that normally lines the uterus, grow outside the uterus on the ovaries, fallopian tubes or the intestines.
SX: pain and menstrual irregularities.
TX: hormones and excision via laparoscopic surgery
Munchausen
psychological disorder where someone pretends to be ill or deliberately produces symptoms of illness in themselves. Their main intention is to assume the “sick role” so that people care for them and they are the center of attention.
Guillain Barre syndromes
a rare disorder in which your body’s immune system attacks your nerves. Symptoms start as weakness and tingling in the feet and legs that spread to the upper body.
These sensations can quickly spread, eventually paralyzing your whole body
The condition may be triggered by an acute bacterial or viral infection.
two-thirds of patients report symptoms of an infection in the 6 weeks preceding including respiratory or a gastrointestinal infection or Zika virus.
Crohns
A chronic inflammatory bowel disease that affects the whole lining of the digestive tract. Discontinuous throughout the whole GI.
Can cause abdominal pain, diarrhea, weight loss, anemia, and fatigue.
“Cobble stone intestines”
Ulcerative Colitis
Usually only in the innermost lining of the large intestine (colon) and rectum. Increased risk of developing colon cancer.
SX: rectal bleeding, bloody diarrhea, abdominal cramps, and pain. Continuous.
Treatment includes medications and surgery.
Irritable Bowel Syndrome
Causes pain in the belly, gas, diarrhea, and constipation. Cause isn’t well understood.
SX: abdominal pain, bloating, diarrhea, and constipation.
Some people can control their symptoms by managing diet, lifestyle, and stress. Others will need medication and counseling.
colitis
An inflammatory reaction in the colon, often autoimmune or infectious.
Most common: 1. Ulcerative colitis
- Crohns 3. C Diff
cholecystitis
Inflammation of the gallbladder, a small, digestive organ beneath the liver.
Cholecystitis is often caused by stones that block the tube leading from the gallbladder to the small intestine.
Pain in RUQ
subarachnoid homhorrhage
Bleeding in the space between the brain and the tissue covering the brain.
A medical emergency, is usually from a bulging blood vessel that bursts in the brain (aneurysm). It may lead to permanent brain damage or death if not treated promptly.
The main SX is a sudden, severe headache.
TX: surgery or catheter-based therapy
Ischemic stroke
Ischemic strokes occur when blood supply is cut off to part of the brain. Accounts for the majority of all strokes. May be caused by a blood clot or by atherosclerosis, a disease which causes narrowing of the arteries over time.
Hemorrhagic Stroke
the less common type. It happens when a blood vessel breaks and bleeds into the brain. Within minutes, brain cells begin to die. Causes include a bleeding aneurysm, an arteriovenous malformation (AVM), or an artery wall that breaks open. High blood pressure and trauma are two leading causes. Taking blood-thinning drugs may also increase a person’s risk.
CHF pedal edema
foot and ankle swelling is one of the cardinal signs of congestive heart failure on the Right side, because it is systemic. Left side is related to lungs.
Herpes Zoster conagion
Shingles, contagious until scabs form
Interstitial cystitis
irritating/painful bladder associated with pain during sex, pain in lower abdomen/back or pelvis. Feels similar to UTI but no infection, persistent urge to urinate.
No cure, but can help with lifestyle (sometimes antibiotics can help)
Basal Cell Carcinoma
A V common type of skin cancer that begins in the basal cells.
This cancer typically appears as a white waxy lump or a brown scaly patch on sun-exposed areas, such as the face and neck.
Treatments include prescription creams or surgery to remove the cancer.
metastasis is extremely rare
pre-eclampsia
Usually after 20 weeks of pregnancy:
-High BP - Swelling hands &feet - protein inurine (no seizure)
Meds: Medications to lower bp, corticosteroid medications can temporarily improve liver and platelet function to help prolong your pregnancy, anticonvulsant medication, such as magnesium sulfate, to prevent a first seizure.
Eclampsia
Seizures that occur during a woman’s pregnancy or shortly after giving birth.
SX that signal an increasing risk include RUQ pain, severe headache, and vision and mental status changes.
Medication can treat and prevent seizures and reduce high blood pressure. The baby may need to be delivered early.
Cachexia
Wasting condition - a condition that causes extreme weight loss and muscle wasting (a symptom of many chronic conditions, such as cancer, chronic renal failure, HIV, and multiple sclerosis).
rubella (know specifics)
known by its distinctive red rash.
The disease can spread through direct contact with the saliva or mucus of an infected person, or through the air by respiratory droplets
appearance of a rash (exanthem) on the face which spreads to the trunk and limbs and usually fades after three days
Symptoms often appear two to three weeks after exposure, and also include mild fever and headache, enlarged neck lymph nodes, eye redness, headache, red rashes, or runny nose
MMR vaccine
Know what to look for lab tests for a heart attack
Troponin blood test - troponin is a protein which is released into the blood stream when the heart muscle is damaged. The troponin level provides a quick and accurate measure of any heart muscle damage.
Creatine kinase-MB (CK-MB)- Shows if the msucle of heart have been broken down (non specific), but best test for testinnng for second MI aftter a couple days.
Know what to look for lab tests for a heart attack
Troponin blood test - troponin is a protein which is released into the blood stream when the heart muscle is damaged. The troponin level provides a quick and accurate measure of any heart muscle damage.
CK-MB levels
CK-MB is normally undetectable or very low in the blood. Chest pain and increased CK levels plus elevated CK-MB indicate that it is likely that a person has recently had a heart attack. Levels that drop, then rise again after about 3 days may indicate a second heart attack and/or ongoing heart damage.
lab tests for Thyroiditis
Test TSH, T3, T4, thyroid antibody test
ESR blood test
An erythrocyte sedimentation rate (ESR) is a type of blood test that measures how quickly erythrocytes (red blood cells) settle at the bottom of a test tube that contains a blood sample. Normally, red blood cells settle relatively slowly. A faster-than-normal rate may indicate inflammation in the body.
Echocardiogram
checks how your heart’s chambers and valves are pumping blood through your heart. uses (standard or doppler) ultrasound technology to see how blood moves through your heart.
- An enlarged heart or thick ventricles (the lower chambers)
- Weakened heart muscles.
- Problems with your heart valves.
- Heart defects that you’ve had since birth.
- Blood clots or tumors.
Electrocardiogram (EKG)
Records the electrical signal from your heart to check for different heart conditions. Electrodes are placed on your chest to record your heart’s electrical signals -It is a graph of voltage versus time of the electrical activity of the heart- which cause your heart to beat. The signals are shown as waves on an attached computer monitor or printer.
P, QRS, T
Ventricular depolarization QRS
- To look for the cause of chest pain.
- To evaluate problems which may be heart-related, such as severe tiredness, shortness of breath, dizziness, or fainting.
- To identify irregular heartbeats.
Holter’s Monitor
A type of portable electrocardiogram (ECG/EKG). It records the electrical activity of the heart continuously over 24 hours or longer while you are away from the doctor’s office.
Can Dx irregular heartbeat or heart palpitations
TB
Mycobacterium (like fungus) - Cough, blood in sputum, night sweats, swollen lymph, Weak, weight loss.
When latent - asymptomatic.
Pnemonia
Cough, phlegm, chest pain, fever, trouble breathing, fast breathing, shallow breathing, shortness of breath, or wheezing, blood in sputum
Oscultattion - crackles and pops
Percussion - dull
Levine Scale
Measures Heart murmor
- very faint
- Faint ** (most important)
- Moderately loud
- Loud
- Very loud
- loudest
PET scan
The scan uses a special dye containing radioactive tracers. These tracers are either swallowed, inhaled, or injected into a vein in your arm depending on what part of the body is being examined
identify a variety of conditions, including cancer (and metastesis), heart disease and brain disorders
Hiatal hernias:
Sliding
Para-esophogeal
Sliding - slides above diaphragm
Para-esophogeal - slides to the side
Shows evidence of Peptic ulcer
FOBT - Fecal Occult Blood Test - can show peptic ulcer or colon cancer.
Also can use endoscopy.
Benign Prostatic Hyperplasia Diagnosis
- Prostate Specific Antigen (PSA)
- Trans-rectal Ultrasonography
- Digital Rectal Exam
- Cytoscopy for prostate lobe visual
Type 1 & Type 4 hypersensitivity
Type 1 - (histamine -→ antibody 1gE) Asthma, Hay fever, food, eczema, anaphylaxis
Type 4 → Delayed - poison Ivy
Type IV hypersensitivity is often called delayed type hypersensitivity as the reaction takes several days to develop.[1] Unlike the other types, it is not antibody-mediated but rather is a type of cell-mediated response. This response involves the interaction of T cells, monocytes, and macrophages.
Immunoglobin FX
1gE - Allergic (Extra allergic)
1gG - Crosses the placenta (Girls make placenta)
1gA - Protects Mucus membrane (A vit strengthens mucus membrane)
1gM - First antibody with primary immune response (Men are more reactive)
Types of Hernias
Direct Hernia - ++ older men - due to weakened abdominal wall
Indirect Hernia - congenital, in infants because the inguinal ring fails to close up while a baby is in the mother’s womb
Femoral Hernia - ++ Women - Femoral canal lies just below the inguinal ligament and lateral to the pubic tubercle.
Kline Felter Syndrome
Male with female Characteristics, 47 XXY
Turner Syndrome
Female, short, Heart disease
Female 45 XO
Turner syndrome is a chromosomal condition that affects development in females. The most common feature of Turner syndrome is short stature, which becomes evident by about age 5. An early loss of ovarian function (ovarian hypofunction or premature ovarian failure) is also very common.
Marfan Syndrome
Long Arms and legs, HT Defects
An inherited disorder that affects connective tissue.
Marfan syndrome affects the heart, eyes, blood vessels, and bones.
People with Marfan syndrome are tall and thin with long arms, legs, fingers, and toes.
Treatment includes medications to keep blood pressure low, eyeglasses or contact lenses, and surgery.
Fragile X Syndrome
Broad forehead, long face, indented chest
Fragile X syndrome causes mild to severe intellectual disability. It affects both males and females, but females usually have milder symptoms.
Symptoms include delays in talking, anxiety, and hyperactive behavior. Some people have seizures. Physical features might include large ears, a long face, a prominent jaw and forehead, and flat feet.
Genetic Disorder Syndromes
Trisomy - 21 - Downs Syndrome (Drink) Down syndrome causes a distinct facial appearance, intellectual disability, developmental delays, and may be associated with thyroid or heart disease.
Trisomy - 18 - Edwards Syndrome (Election) A condition that causes severe developmental delays due to an extra chromosome 18. Symptoms include low birth weight, small abnormally shaped head, and birth defects in organs that are often life threatening. Deadly before birth or 1 yr
Trisomy 13 - Patau’s Synrome (puberty) Patau syndrome causes severe intellectual disability and physical defects.Most infants with this condition don’t live past their first week of life. bnormally small head, birth defect with intestinal organs outside of body, failure to thrive, or low birth weight, cleft lip etc
- -olol
Beta blockers - decrease heart rate (Side effect, bradychardia)
-Pril
ACE inhibitors (help relax the veins and arteries to lower blood pressure.)
-Pine
Calcium channel blocker
medications used to lower blood pressure. They work by preventing calcium from entering the cells of the heart and arteries. Calcium causes the heart and arteries to squeeze (contract) more strongly. By blocking calcium, calcium channel blockers allow blood vessels to relax and open.
Statin
antilipemic
Hypolipidemic agents, cholesterol-lowering drugs or antihyperlipidemic agents
-Hitr ??
Nitrates are medications used for treating or preventing heart pain (angina, chest pain) caused by heart disease, usually of the arteries in the heart.
Vasodilatros. Contraindicaated with viagra.
-Zosin/osin
Alpha Blocker
blood pressure medication. They lower blood pressure by preventing a hormone called norepinephrine from tightening the muscles in the walls of smaller arteries and veins. As a result, the blood vessels remain open and relaxed.
Kidney Stone types
80% - calcium oxalate (xray)
15% ammonium magnesium phosphate (xray)
5% uric acid (radiolucent - not xray)
1% cystine (radiolucent - not xray)
Lambert-Eaton Myasthenic Syndrome (LEMS)
the immune system attacks the calcium channels on nerve endings that are required to trigger the release of chemicals (acetylcholine). With fewer calcium channels, the nerve ending releases less acetylcholine, a chemical messenger that triggers muscle contraction. In people with LEMS, the lowered levels of acetylcholine are not sufficient to cause normal muscle contractions, causing muscle weakness.
Nephrology
Cystoscopy - Bladder (urologist)
Intersitial Cystitis - can be pain with intercourse
PSA levels - prostate specific antigent
DRE - Digital rectal exam
Biopsy - definitive
Elevated Creatine/BUN levels indicates KD disease
Menenges Layers
IPAD (inside → outside)
I- Brain
P- Pia
A- Arachanoid
D- Dura
Treating Types of Headaches
Migraine - Triptans (shrink blood vessels after migraine begins)
Cluster - 02
Tension Headache - Relax, bath, massage, acetaminaphin, NSAID, Triptan
Neurotransmitter that lowers alzheimers and Huntington’s disease and increases Parkinsons
Acetylcholine
Huntington’s Disease
Choreiform Movements (involuntary, random, brief), aggression, depression, dementia
Broca’s Aphasia
Non -fluent, with intact comprehension (broken)
Results from damage to a part of the brain called Broca’s area, which is located in the frontal lobe, usually on the left side
Wernicke’s Aphasia
Fluent, wordy, but makes no sense. Comprehension is impaired. (fluent, but makes no sense)
Global Aphasia
Both Wernicke’s and Brocas. Non fluent and impaired comprehension.
Aphasia most impacted by Cerbrovasculara accident
Middle Cerebral Artery (MCA) infarction:
Contralateral paralysis
Contralateral loss of sensation
Motor aphasia
Embolism
VS
Thrombus
Embolism (everywhere) - blood clot that travels via body and goes elsewhere
Thrombus - Unbroken blood clot in the blood vessel
Megoblastic Anemia
a condition in which the bone marrow produces unusually large, structurally abnormal, immature red blood cells (megaloblasts).
Folic acid/B9 and vitamin B12 deficiencies are the leading causes
HIV Measurements for DX
CD4 - below 200 → AIDS
Opportunistic illnesses indicates AIDS
Chronic Gastritis (type A)
characterized by progressive parietal cells destruction leading to hypochlorhydria and intrinsic factor deficiency. These alterations may result in vitamin B12 deficiency and iron malabsorption.
TB
Cough, fever, chills, night sweats*
cough lasts 3+ weeks, unintentional weight loss, loss of appetite
Lung cancer
cough, wheezing, SOB, uninntentional weight loss
Pulmonary edema
Cough, pink frothy sputum, SOB, noisy bubbly breathing (fluid accumulation in airspace)
orthostatic BP
Postural hyportension (head rush) drop inn systolic 20 and diastolic 10 after 3 mins = positive
PSA testing for cancer at age
50yrs. If high risk - 40yrs
Normal is 4ng/ml
Intermediate is 4-10ng/ml
High is 10ng/ml
Medial Scapular Winging
(Sports injury)
Serratus anterior and long Thoracic nerve becomes weakened or is destroyed
Lateral Scapular winging
due to damage to the trapezius or rhomboid muscles.
(Surgery/iatrogenic injury)
Grade II ankle sprain
Partial tear
Grade 1: stretching or small tear
Grade 3: Complete tear
TMain complication of Type 1 Diabetes
DKA ADiabetes Ketose Acidosis. Fruity smell. Ketones in blood in urine. Glucose higher than 150. Normally 500-800.
Sign of breast cancer via nipple
Thickening of nipple and loss of elasticity
Hypoglycemia symptoms
He IS TIRED He - Headache IS - Irritabale/Sweating T- Tachycardia I- irritabaility R - restless E - excessive hunger D - Dizzy
Most common side effects of Ergotamine in treating migraine
Nausea and cold fingers and toes Ergotamine works by constricting blood vessels to reduce pain
Side effects of drugs
Myalgia (pain in muscle/s) - Statins, which lower LDL
GI Bleeding, tinnitus - NSAIDs (decrease inflammation, pain, and fever.)
Tinnitus, Reyes syndrome (brain damage and liver function problems), asthma, GI bleeding - Aspirin (salicylate and NSAID), prevents blood clotting, lower fever, pain and inflammation.
Flush - Niacin/Vitamin B3 - lowers LDL and increases HDL
Nausea, cold fingers and toes - Ergotamine - treats migraines
Acetaminophine (metabolized by liver works by changing the way the body senses pain and by cooling the body) - GI issues (safest for peptic ulcers), clay colored stool, rash
Buerger’s (small - medium vasculitis) disease is strongly associated with
Smoking tobacco Vasculitis is divided by the size of the vessel giant cell arthritis can cause same side blindeness
Risk for breast Cancer
longer exposure to estrogen increases rx: Early Menarche (mestruation) Late meopause Pregnancy after 35 - late pregnancy increase rx Nulliparity - never pregnant
Paget Disease of nipple
Red, scaling, flaking, bloody discharge, itching <1% of breast cancer Requires needle biopsy
NSAIDS inhibit formation of
Statins
Allopurinal
Viagra
Prostaglandins
HMG CoA reductase - Statin, lower cholesterol
Xanthine oxidase production - allopurinal (chronic gout) enzyme converts Purines to Uric acid
PDE5 - an enzyme in the walls of blood vessels. It affects blood flow and how cells signal within the body. ) - viagra
screening exam for female over 50
general checkup every year mammogram every other year pap smear every 3 years
Diabetes Insipidus
pituitary gland sends ADH to KD - So there is a lot of urine (diluted urine) Central DI - deficiency of ADH (vasaopressin) Nephrogenic DI - KD or nephron dysfunction Vasopressin - contracts blood vessel , retain water in body (ADH - antidiuretic hormone)
differences between Crohn’s and Ulcerative colitis
Crohn’s disease has discontinuous lesions, anywhere in GI Ulcerative Colitis - continuous and always in rectum
hormone produced by placenta that develops during pregnancy to hepl feed the baby.
Human chorionic somatotropin (hCS)
AKA Human placental lactogen (hPl)
Menstrual cramps are due to
Prostaglandins
Uterus contracts to help expel lining.P Prostaglandin is involved in pain and inflammation trigger the uterine muscle contractions
Cox-2 inhibitor reduces
Cox 1 - protects
2- inflammation
1- GI
Drugs that are Cox-2 inhibitors: -oxib
Which drug is associated with miosis (constriction of pupil)
Heroin, oxycodone → opioids (life threatening → respiratory depression)
Amphetamines - (yang) psychomotor agitation, tachycardia, high BP, pupillary dilation
Cocaine - cocaine bug (feel like bugs crawling under skin), chest pain, pupillary dilation, psychomotor agitation, impaired judgement
LSD - pupillary dilation, visual hallucination
PCP - psychosis/violent/impulsive/agitated/ tachycardia,
Pertussis
and symptoms
Whooping cough
a highly contagious respiratory tract infection. In many people, it’s marked by a severe hacking cough followed by a high-pitched intake of breath that sounds like “whoop.” There’s a vaccine. Can be treated with antibiotic.
Sx:
Cough: can be chronic or severe
Nasal: congestion, runny nose, or sneezing
Whole body: fatigue or fever
Also common: paroxysmal cough, episodes of no breathing, vomiting, or watery eyes
Tx: Antibiotics
Laparoscopy is used for
Endometriosis (tissue is supposed to be in lining of endometrium) but the tissue is elsewhere, like ovaries, outside uterus (endometrioma/chocolate cyst) , abdomen, fallopian tubes
Most common site of Ectopic pregnancy
Tubular, ampular area
Can do an ultrasound to see
Which of the following is not a key in identifying Hashimoto Thyroiditis
- Anti - thyroid peroxidase antibodies
- TSH
- T4
*T3 is not a crucial to test
Hoshimotos ( teenagers usually had hyperthyroidism as a teenager
Hypo - TSH is high and T4 is low
Hyper- TSH is low and T4 is high
Forms of estrogen hormones
E2 - Estradiol (most common type in women in childbearing age) - (Dios willing, I’ll get pregnant)
E3- Estriol - (main during pregnancy) - (ol baby is in my belly)
E1 - Estrone (only one/estrogen produced after menopause)
How to listen to lung sounds
Step ladder approacah: Left, right, right left, left right etc
Avoid scapula
Signs of UTI
Upper UTI
Upper back and flank pain, high fever, - Kidney infection - pyelonephritis
Lower UTI
lower ab discomfort , pelvic pressure, painful urination Bladder infection - Cystitis
Pain or difficult urination, burning urination, discharge - urethritis
Murphey’s punch sign is used to diagnose infection of
Kidneys
Upper and lower rerspirratory
upper - nasal, pharynx (air+food), larynx (Air)
Lower- Trachea (air), bronchi, lungs
Hemolytic Anemia
a disorder in which red blood cells are destroyed faster than they’re made.
Sickle cell anemia can cause (abnormal hemoglobin) - Pain -→ ER for morphine and IV fluid. 10% of blacks have sickle cell traits- causes pain, slight tachycardia, -→ fluid and morphine for pain
Hiatal hernina
Stomach-
Sliding- stomach slides up into the chest area b/c of weak diaphragm 90%
Para-esophogeal - Stomach slides up adjacent to esophagus
Incisional hernia - incision doesn’t heal properly and organs push through.
Drugs that lead to osteoperosis
Prednisone - steroids (can also increase blood sugar, BP, make ligaments weak, Cushing syndrome_
PPI (Omeprazole)
Examples of opportunistic infections (OIs)
Oral candidiasis (thrush)
Pneumocystic jirovecii pneumonia
Cryptococcal meningitis
Disseminated myobacterium avium complex (MAC)
Sporotrichosis
Rose pickers disease- fungal infection that are introduced into skin from thorn
Pain while chewing food - jaw claudication - and pain pain while brushing hair, right above temple
Temporal arteritis (giant cell arteritis)
ESR test - inflammation- non specific
Confirm with biopsy
treat with high dose corticosteroids
For Cluster headache - 100% O2
Antagonist drug used for opioid intoxication
Naloxone - rapidly reversed effects of opioid toxicity
Naltrexone - opioid antagonist used for long term treatment and is available in oral forms
Contact Dermatitis
A form of eczema (itchy, swollen, rough skin) where skin comes in contact with chemical (dyes, laundry detergent, poison oak etc) and reacts with eczema
Patch test use to Dx.
Closed angle Glaucoma
Fluid drainage of eye becomes suddenly blocked leading to sudden sx of severe eye pain and headache on same side. Blurry vision, rainbow around lights.
Different from thunderclap, which recedes after about hour in that its continuous.
Eye disorders effect which parts of the eye
Glaucoma - optic nerve
Macular degeneration- retina
Cataracts - lens
Retinal detachment
- painless
- sudden appearance of floaters
- blurred vision
- reduced peripheral vision
Retinitis Pigmentosa
Defective night vision from impacted retinal rods
Cataracts is a build up of what on the lens?
Protein
Dry vs Wet macular degeneration
Macular degeneration causes loss in the center of the field of vision.
Dry - majority of cases - the center of the retina deteriorates. Druids (small white/yellow deposits on retina)
With wet macular degeneration, leaky blood vessels grow under the retina. - causes majority of blindness- neurovascularization that pulls retina away causing blindness
In age related MD, its always bilateral
Open vs closed glaucoma
Optic nerve is affected- damaged by intraocular pressure and fluid buildup
Open angle - more common, iris and move away from eachother. This condition is gradual and chronic. Sx not noticed.
Closed angle - move toward each other, acute, fast, causes blurred vision, headache, nausea, eye pain, build up of fluid is fast
Elevated pressure - over 21mmHG
Corneal Abrasion
A corneal abrasion is a scratch, scrape on the surface of your cornea.
Corneal Abrasion Symptoms
- The feeling that something is stuck in your eye
- Red, painful, watery eyes
- Blurry or hazy vision
- Being extra sensitive to light
Dx
Your ophthalmologist will put dye called fluorescein on your eye’s surface. Then they will look at your cornea with an instrument called a slit lamp. The dye will highlight a cut or scratch on the cornea.
Diabetic Retinopathy
Retinopathy occurs when blood vessels in the back of the eye, the retina, become damaged. When the blood vessels become damaged they can leak and these leaks can cause dark spots on our vision. The main causes of retinopathy tend to be sustained high blood glucose levels and high blood pressure as well.
