Medicine Flashcards

Question

Cafe au lait

Answer 1

Café au lait spots are most often harmless, but they may be associated with syndromes such as neurofibromatosis and McCune–Albright syndrome. They're caused by a collection of pigment-producing melanocytes in the epidermis of the skin. Those with McCune-Albright syndrome often develop areas of abnormal scar-like tissue in their bones; polyostotic fibrous dysplasia.

Answer 2

Found in bone, the most abundant collagen in the body

Answer 3

Type II collagen is primarily found in hyaline cartilage

Answer 4

Found in skin, blood vessels, granulation tissue

Answer 5

Type IV collagen is a type of collagen found primarily in the skin within the basement membrane zone.

Answer 6

Target cells are red blood cells that have the generalized appearance of a shooting target with a bullseye. Thalassemia is an inherited-blood disorder, characterized by diminished hemoglobin and fewer red blood cells in the body than normal. Target cells appear in conditions that cause the surface of the red cell to increase disproportionately to its volume.

Answer 7

Resolute purulent discharge is seen most often in chronic osteomyelitis. Chronic osteomyelitis includes involucrum, cloaca and dead bone.

Answer 8

Beriberi is a disease caused by a Thiamine (vitamin B1) deficiency. It is often seen in cases of alcoholism or a poor diet. Beriberi may present with generalized weakness, shortness of breath, lower extremity edema, and limb pain. Vitamin B1 supplementation is initiated for treatment.

Answer 9

- Type 1 forms are typically polymicrobial and occur in the immunocompromised. - The most common form of Type 2 NF is haemolytic group A streptococcus, often resulting in toxic shock syndrome. - Primary cause for microbial Type 2 NF varies in the literature (some sources say staph/strep), but for podiatric board preparation, we recommend: haemolytic group A streptococcus… NF is quickly developing and tissue palpation is POSITIVE for crepitus. CT demonstrates soft-tissue thickening and enhancement, with fluid collections within the deep fascia.

Answer 10

Atrial fibrillation is the most common sustained arrhythmia in the elderly. Serum potassium is associated with ventricular arrhythmias and cardiac arrest. Low serum levels of potassium were associated with a higher risk of atrial fibrillation

Answer 11

An ABI below 0.4 is indicative of severe peripheral arterial disease. After a failed midfoot amputation and multiple attempts for revascularization, an AKA would be the most appropriate level of amputation.

Answer 12

Hypercalcemia is not associated with Ehlers-Danlos syndrome. Ehlers-Danlos syndrome is a group of inherited connective disorders that affects blood vessels, skin, and joints. There is no known cure and symptoms commonly include hyper-elastic skin and joints and delayed wound healing.

Answer 13

Found in hyaline cartilage

Answer 14

Type III collagen is found in the skin, blood vessels and granulation tissue

Answer 15

Type IV collagen is a type of collagen found primarily in the skin within the basement membrane zone

Answer 16

Unlike CRPS type II, there is no known peripheral nerve injury associated with CRPS type I. “CRPS is an uncommon chronic condition that usually affects the extremities. Type, 1 previously known as regional sympathetic dystrophy, occurs after an illness or injury that did not directly damage the nerves in the affected limb. On the other hand, type 2 follows a distinct nerve injury. CRPS was first described during the civil war when soldiers continued to report excessive pain after wounds had healed.

Answer 17

Initial symptoms of frostbite generally involve pale colored skin, cold sensitivity and numbness. Upon warming the skin may become to appear mottled, erythematous and fluid-filled blisters. Hyperhidrosis and hair loss are reported long term findings along with patchy skin lesions and distal tuft necrosis.

Answer 18

Furosemide Bactrim Silvadene

Answer 19

Ewing's sarcoma most commonly arises from the diaphysis. 30% are overtly metastatic at presentation. People usually experience extreme bone pain. Demonstrates onion skin appearance Highly malignant Occurs frequently in the second and third decade of life

Answer 20

Inflammatory, Proliferative, and Maturation

Answer 21

Inflammatory markers to site of wound

Answer 22

Early wound contracture, collagen synthesis, neovascular formation, and re-epithelialization

Answer 23

Maturation/remodeling: the previously synthesized collagen bundles remodel, contracts, and wound increases in tensile through closure.

Answer 24

Nodular melanoma In the polypoid variant of NODULAR MELANOMA, melanoma cells accumulate in large volume above the skin's surface. This increase in tumor volume encourages dislodgment of melanoma cells that are carried to superficial lymphatic vessels without invading the reticular dermis; this feature differentiates polypoid melanoma from the nonpolypoid nodular variant. Polypoid melanoma is considered the most malignant form of melanoma

Answer 25

Buerger's disease (thromboangiitis obliterans) is a progressive inflammatory and clotting disease of small and medium vessels in both hands and feet. It is directly related to tobacco and smoking and often leads to ischemia and amputation. While immediate smoking cessation may not halt progression, it has been shown to slow the advancement of and minimize the severity of the level of amputation

Answer 26

Joint space is preserved until the very late, advanced stages of gout. Periarticular erosions, punched out lytic bone lesions, and increased soft tissue density are all commonly seen in earlier stages of gout.

Answer 27

Superficial spreading melanoma is the most common form of melanoma. This accounts for approximately 70% of all cases. It is common in young people.

Answer 28

X-linked recessive disorders, such as Lesch-Nyhan syndrome, occur much more frequently in males. It occurs due to mutations in the HPRT1 gene located on the X chromosome, and is caused by a deficiency of the enzyme hypoxanthine-guanine phosphoribosyltransferase (HGPRT). The HGPRT deficiency causes a build-up of large volumes of uric acid.

Answer 29

Gram positive, catalase positive, cocci in clusters signifies staphylococcus (chains = streptococcus). Vancomycin would be the drug of choice for a Gram positive, catalase positive, cocci in clusters for a patient with a PCN or penicillin allergy.

Answer 30

While genu valgum is often benign, it is often caused by rickets in children. Rickets results in soft, weak bones in children. Symptoms include vitamin D deficiency, inadequate bone mineralization, bone weakening, and bowing in the lower extremities. The primary cause of congenital rickets is vitamin D deficiency.

Answer 31

Likely a descendant from bat coronavirus Can result in loss of taste Severity of disease is associated with age

Answer 32

A male with a hemoglobin level of of 7.6 g/dL would require anemia treatment prior to undergoing midfoot amputation. Epoetin alpha (PROCRIT) is commonly used to treat anemia in those undergoing cancer treatment (chemotherapy and radiation) and chronic kidney disease (but not on dialysis). For those who require dialysis iron should be given with erythropoietin.

Answer 33

Under polarized light and parallel to the axis of the lens, needle-shaped monosodium urate gout crystals display negative birefringence.

Answer 34

Testing of anti-cyclic citrullinated peptide antibodies (anti-CCP) is commonly used as a marker for the diagnosis and prediction of rheumatoid arthritis (RA).

Answer 35

Kaposi sarcoma is a type of skin cancer that often begins as a purple skin lesion. Human herpesvirus 8 (HHV8) is found in the lesions of all those affected. Risk factors for Kaposi’s sarcoma include: HIV positive individuals and those with poor immune function.

Answer 36

Malignant Anaplastic cells describe cancer cells that divide rapidly with minimal resemblance to normal, healthy cells. Malignant neoplasms that are composed of undifferentiated cells are said to be - anaplastic. Benign cells do not invade surrounding tissues. Metaplastic cells transform from one differentiated cell type to another differentiated cell type. They are cells that change from one cell type to another. Neoplastic cells are cells that grow abnormal, excessive, and autonomously. Neoplasias are often caused by genetic mutations. Neoplasias can be benign or malignant.

Answer 37

Cefepime is a broad-spectrum cephalosporin with pseudomonas coverage. Common antibiotics that cover pseudomonas: aminoglycosides (gentamicin, amikacin, tobramycin; not kanamycin) quinolones (ciprofloxacin, levofloxacin, not moxifloxacin), and cephalosporins (CEFEPIME, and ceftazidime).

Answer 38

Common features of Osteogenesis imperfecta can include blue sclerae of the eyes, bone that easily fractures, short stature, curvature of the spine, joint deformities, hearing loss, respiratory problems, tooth development disorder called dentinogenesis imperfecta.

Answer 39

The Rosenthal classification describes three zones of injury involving nail bed injuries: Zone I: distal to the distal phalanx Zone II, distal to the lunula Zone III, proximal to distal end of the lunula.

Answer 40

Volkmann’s contracture is compartment syndrome of the forearm. Much like the lower leg, symptoms include: 5 P’s of compartment syndrome: pain, pallor, pulselessness, paresthesias, and paralysis. Of these, pain is the earliest sign. Pain is expressed with passive extension.

Answer 41

Sickle cell disease is the most common autosomal recessive disorder in African-Americans. Patients are predisposed to infections with capsulated organisms (S pneumoniae >> H influenzae type b > N meningitidis) dues to functional asplenia from consecutive splenic infarcts. Cardiac complication due to ischemic events typically happen later in life.

Answer 42

A chancre is often the first sign of syphilis. It appears as a sore at the site of inoculation. Alopecia, rash, and fatigue are all common finding of secondary syphilis occurring several weeks following initial inoculation.

Answer 43

Acute hematogenous osteomyelitis occurs in children with open growth plates. Blood flow slows as it passes through metaphyseal bones in growing children predisposing that region to infection.

Answer 44

Adduction, Varus, Equinus (AVE). Talipes equinovarus (club foot) deformity is characterized by: adduction at the midtarsal joint, cavus and internal tibial torsion, and equinus at the ankle.

Answer 45

As serum K+ levels rise, the qrs complex widens eventually becoming abnormal. Hyperkalemia causes widened qrs complexes and tall T waves. The effect of hyperkalaemia on cardiac rhythm devices.

Answer 46

Muscle rigidity, rhythmic tremors at rest and hypomimia (reduced facial expression) are all characteristics that frequently discovered in those with Parkinson’s disease.

Answer 47

A non-healing wound that has failed to respond to routine ulcer therapy is best treated with a punch biopsy and path evaluation. In this case the image represents an individual with malignant melanoma. In cases of non-healing wounds, melanoma must be a consideration.

Answer 48

Sickle cell disease causes a chronic hemolytic anemia. An inherited disorder, the sickle-shaped red blood cells cause vaso-occlusion and are prone to hemolysis, leading to severe pain crises, organ ischemia, and other systemic complications.

Answer 49

Acute green skin and nail discoloration can be caused by Pseudomonas aeruginosa infection of the nail plate and skin. Ciprofloxacin would be the most appropriate antibiotic listed for the safe treatment of this patients bacterial infection.

Answer 50

Volatile inhaled anesthetics such as halothane, isoflurane, sevoflurane, desflurane, and ether may trigger malignant hyperthermia .