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Internal medicoine > Medicine 6th > Flashcards

Medicine 6th Flashcards

1
Q

Infective endocarditis 1

A

are non-tender, small erythematous or haemorrhagic macular or nodular lesions on the palms or soles only a few millimeters in diameter that are pathognomonic of infective endocarditis.

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2
Q

Infective endocarditis 2

A

IV drug abuse
Infective endocarditis
Structural heart disease
Heart valve injury/replacement
Family history of autoimmune disorders
HIV status
Mucosal bleeding
Head/neck or lung infection
Tick exposure
Constitutional symptoms

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3
Q

Infective endocarditis 3

A

Infective endocarditis
Cutaneous vasculitis
Disseminated Intravascular Coagulation (DIC)
Erythema multiforme
Idiopathic thrombocytopenia purpura
Polyarteritis Nodosa
Secondary syphilis
Thrombotic thrombocytopenic purpura
Typhoid Fever

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4
Q

Dupuytren’s contracture

A

Alcoholic
Diabetes
Epilepsy
Hand trauma
Hiv
Smokers
Vascular disease

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5
Q

Peripheral cyanosis

A

Peripheral vascular circulation

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6
Q

Palmar erythema

A

Liver cirrhosis
Polycythemia
Pregnancy

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7
Q

Differential diagnosis of hypothermia

A
  • Alcohol Toxicity
  • Benzodiazepine Toxicity
  • Carbon Monoxide Toxicity
    Ethylene Glycol Toxicity
    Gamma-Hydroxybutyrate Toxicity
  • Hemorrhagic Stroke
  • Ischemic Stroke
  • Opioid Toxicity
    Sedative-Hypnotic Toxicity
    Targeted Temperature Management (Therapeutic Hypothermia)
  • Ventricular Fibrillation in Emergency Medicine
  • Ventricular Tachycardia
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8
Q

Differential diagnosis in hyperthermia

A

Infection: malaria, sepsis, meningitis, encephalitis, brain abscess, typhoid fever
Drug/toxin: malignant hyperthermia, withdrawal syndrome from alcohol, cocaine
Endocrine: thyroid storm, diabetic ketoacidosis
Oncology: lymphoma, leukemia

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9
Q

Warm, moist or sweaty palms

A

Thyrotoxicosis

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10
Q

Pigmentation of palmar creases

A
  • Addison’s disease but may be normal
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11
Q

Dry puffy hands

A

Myxoedema

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12
Q

Xanthomata

A

Hyperlipidemia

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13
Q

Infective endocarditis stigma

A
  • Janeway lesions
  • Osler’s nodes
  • Splinter haemorrhage
  • Roth’s spot
  • petechiae
  • clubbing
  • heart murmur
  • embolic phenomenon
  • fever
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14
Q

Leukonychia

A

Seen in hypoalbuminemia states such as
- nephrotic syndrome
- chronic liver disease

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15
Q

Pitting nails

A

Psoriasis
Eczema

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16
Q

Terry’s nails

A
  • liver cirrhosis
  • chronic kidney disease
    Congenital heart failure
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17
Q

Lindsay’s nails

A
  • chronic kidney disease
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18
Q

Capillary refill time

A
  • to check for peripheral perfusion
19
Q

Tremors

A

Pill rolling tremors seen in Parkinson’s disease, Parkinsonism
Fine tremors seen in anxiety, alcohol withdrawal, thyrotoxicosis
Flapping tremors/ Axterixis seen in CO2 retention, hepatic encephalopathy, uremic encephalopathy

20
Q

Xanthelesma

A

Hyperlipidemia

21
Q

Chynes stokes breathing

A

Regular, alternating periods of apnea and hyper apnea
Seen in stroke, congestive heart failure

22
Q

Increased respiratory depth

A
  • brings out metabolic acidosis as seen in Diabetic ketoacidosis
23
Q

Decreased respiratory depth

A
  • pleurisy
  • fractured ribs
  • acute abdomen
  • depression of the respiratory centre by drugs
  • injury to the medulla
24
Q

Stridor

A
  • indicates upper respiratory tract obstruction
25
Q

Wheezing

A
  • seen in:
    Asthma
    Chronic bronchitis
    Tuberculosis (unilateral)
26
Q

Uneven movement of the chest

A
  • pleural effusion
  • lobar pneumonia
  • pleural thickening
    Affected side moves less than the normal side
27
Q

Paradoxical movement of the chest

A

Follows multiple rib fractures which cause the affected flail segment of the chest wall to retract instead of expand during inspiration

28
Q

Clubbing Stage V

A
  • hyperthrophic pulmonary osteoarthropathy
29
Q

Chronic obstructive pulmonary disease

A
  • pursed lip breathing
  • trachea tugging
  • barrel shaped chest as seen in patients with sever airflow obstruction
  • decreased tactile fremitus
  • added sounds: rhonchi- copd
30
Q

Tracheal tugging

A

Visible descent of the trachea during inspiration

31
Q

Trachea pulled to the side of the lesion

A
  • lung collapse
  • interstitial pulmonary fibrosis
32
Q

Trachea pulled away from the site of the lesion as a result of mediation Al shift

A
  • massive pleural effusion
  • tension pneumothorax
33
Q

Cricosternal distance

A

Refers to the distance between the cricoid cartilage and suprasternal notch.
Admits three fingerbreaths

34
Q

Reduced cricosternal distance

A
  • suggests hyperinflated lungs seen in emphysema
35
Q

Pulsatile JVP
Means there is a right sided problem

A
  • corpulmonale
  • tricuspid regurgitation
36
Q

Pulseless JVP

A

-superior vena cava obstruction

37
Q

Barrel shaped chest

A

Seen in patients with increased anterioposterior diameter. As they have severe air flow obstruction.
Copd
Severe asthma

38
Q

Pectus carinatum ( pigeon shaped chest)

A

Seen in secondary to chronic respiratory disease in childhood

39
Q

Pectus excavatum ( funnel shaped chest)

A

Developmental defect that arises due to connective tissue disease

40
Q

Thoracotomy scar or breast surgery

A
  • could suggest malignant pleural effusion
41
Q

Radiotherapy tattoo

A
  • suggests presence of malignancy
  • may be associated with well dermacatee inflammation of the skin in the acute stage (pulmonary fibrosis, potentially detectable on auscultation in the longer term)
42
Q

In respiratory examination of chest

A

Chest movement
Chest expansion
Tactile fremitus
Percussion note
Air entry
Breath sounds
Added or adventitious sounds
Vocal resonance

43
Q

Raised troponin levels signify

A
  • Coronary artery disease
  • chronic kidney disease
  • sepsis
  • myocarditis
  • aortic dissection
  • pulmonary embolism

Internal medicoine (10 decks)

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