Path 2 after quiz 3 Flashcards by Bryce Johnson

What are some posterior seg manifestations of AIDS?

HIV retinopathy (cotton wool spots, asymptomatic) CMV retinitis (more common back in the day)

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Risk factors:
Preexisting renal disorders
Dialysis

Renal Cell Carcinoma

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What is “liver breath”? What causes it?

Fetor hepaticus is found in liver failure

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What kidney cancer happens usually at 50-70 years of age

Renal Cell Carcinoma

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What causes sudden depigmentation of skin?

Vitiligo

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Large, Scaly, crusty, erythematous lesion can indicate…

Squamous cell carcinoma

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How Tx RA and Juvenile idiopathic arthritis?

Disease modifying anti-rheumatic drugs (DMARDs)
Biologics
Anti-inflammatories
Exercise makes joints feel better (unlike in osteoarthritis)

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How is life expectancy for HIV wo/ treatment?

Something like 40 years shorter

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What are the effects of alcoholic liver injury?

Inflammation
Increased fat storage
Collagen synthesis
Neutrophil infiltration

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Reactive arthritis is a type __ hypersensitivity.

Type III (Immune complex)

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RF
 Obesity*
 F>M
 Joint injury
 Repetitive motion

Osteoarthritis

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What is the cause of hepatic jaundice?

Defective liver functioning
Viral hepatitis
Drug interference
Cirrhosis

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Which viral hepatitis is bloodborne? Of the two, which is sexually transmitted?

HBV (sex) and HCV

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What’s the difference between osteoarthritis and rheumatoid arthritis?

Osteoarthritis is mechanical and can be localized, Rheumatoid is autoimmune (and can have (epi)scleritis, iritis, and PUK)

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HIV Preferentially attacks _____

CD4+ TH1-cells

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____ is most deadly skin cancer

Malignant melanoma

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___ is the gold standard for measuring glomerular filtration rate because it’s completely filtered

Inulin

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What are some cardiovascular complications from renal failure?

Hypertension
Accelerated atherosclerosis
Arrhythmias
Pericarditis

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Melanocytes Are in the ___ layer of the skin

Basal

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What are the most common causes of cirrhosis?

HCV, alcoholic liver disease, (both together), and cryptogenic cirrhosis make up 80%

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____ can cause acute pancreatitis

50% of gallstones are related to acute pancreatitis

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What is a Type IV hypersensitivity from?

Allergic contact dermatitis

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What is the cause of prehepatic jaundice?

Excess bilirubin

Hemolytic anemia

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When is HIV considered AIDS?

One of the following: CD4+ T-cell count

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How is life expectancy for HIV w/ treatment?

Only 8 years shorter than normal

``` Name liver injury cause: Inflammation Increased fat storage Collagen synthesis Neutrophil infiltration ```

Alcoholic liver injury

S&S: | Dry, elevated, and rounded erythematous plaques

Psoriasis

``` S&S Fever Dysuria Bacteriuria Pyuria ```

UTI

What skin disease is more common in white men than other demographics?

Seborrheic Dermatitis

How dx gout?

See uric acid in urine, blood, and synovial fluid of joint

Neurofibromas are what?

Nerve sheath tumors

``` S&S: Acne Rustules Rhinophyma (thick red nose, rare) Ocular manifestation In 33% of pts ```

Acne Rosacea

Herpes Zoster ophthalmicus affects what dermatome?

1st ophthalmic division of trigeminal ganglion

____ is the most common bladder cancer

Transitional cell carcinoma

S&S | Aniridia

``` Nephroblastoma. (black girl child cancer) Total S&S Palpable abdominal mass* Pain Hypertension Hematuria Aniridia ```

What renal disease is mostly in children?

Minimal change disease (also has facial edema)

_____ can cause increased risk of hepatocellular carcinoma

Hepatitis B and C

Which hepatitis is the cause of half of the chronic liver disease in the US?

HCV

What are some ophthalmic manifestation of renal disease?

Ophthalmic Manifestations of Renal Disease Band keratopathy Posterior subcapsular cataract (from steroid use) Renal Retinopathy Elschnig spots Non-rhegmatogenous Retinal detachment

What can be treated with Tar?

Psoriasis

Kidneys function at 10% normal level

End Stage Renal Disease

What are some Anterior seg manifestations of AIDS?

Molluscum contagiosum, shingles (ophthalmicus) Kaposi sarcoma (cancer via virus)

What is the most common complication of cirrhosis?

Ascites

What can liver failure cause in men?

Gynecomastia Impotence Testicular atrophy Female hair distribution

Which viral hepatitis is found in developing countries (fecal-oral route)?

HAV, HEV

_____ nevi have indistinct borders

Dysplastic nevi

What causes inflamed, fused spine?

Ankylosing spondylitis

What is the umbrella term for Athlete's foot and tinea?

Cutaneous mycoses

``` Palpable abdominal mass* Pain Hypertension Hematuria Aniridia ```

Nephroblastoma. (black girl child cancer)

What are some liver function tests? 6

- Enzymes - Bilirubin - Proteins (esp albumin and plasma proteins) - Coagulation tests - Hepatitis virus antigens and antibodies - Autoimmune antibodies

What is the accumulation of free fluid within the peritoneal cavity?

Ascites. The most common cirrhosis complication

``` S&S Lymphadenopathy Hairy leukoplakia, oral candidiasis Immunologic abnormalities ```

HIV early symptomatic phase

Virus + aspirin in children can cause…

Reye's syndrome

_____ can cause chronic pancreatitis

60% related to alcoholism

Acute liver disease is associated with…

HAV (food) and HBV (blood and sex)

Which hepatitis virus often makes people carriers? Rarely?

Many become carriers with HCV. Few become carriers with HBV

What are the most common causes of death in AIDS?

Cytomegalovirus (cold) Mycobacterium avium complex

What is hepatolenticular degeneration?

"wilson disease" has a toxic accumulation of copper from an autosomal recessive disorder. Can cause Kayser-Fleischer rings

What causes Port-wine stain?

Sturge-weber syndrome

What is associated with Yeast infection, sebum, and autoimmune response?

Seborrheic Dermatitis

S&S: Vesicles, pustules, and yellowish crusts, Fever

Impetigo (it's bacterial)

What contact dermatitis is more common?

Irritant CD from solvents / trauma, no sensitization required

``` Name disease from these symptoms Jaundice Portal hypertension Ascites Fetor hepaticus Hypoalbuminemia Hypoglycemia Hyperammonemia Bleeding disorders ```

Hepatic failure

Hepatitis B and C can cause increased risk of

Hepatocellular carcinoma

Which cancer happens often in children?

Nephroblastoma

What is renal colic?

Pain associated with kidney stones

Ocular man.: | Abnormal EOMs and Dry eye

Fibromyalgia

What can cause splenomegaly?

Portal hypertension

What ocular man. Is super common in Juvenile idiopathic arthritis?

Anterior uveitis

What can liver failure cause in women?

Irregular menses Palmar erythema Spider telangiectasia

S&S Musculoskeletal pain for more than 3 months, Pain, fatigue, lack of sleep, memory defects, no physical damage

Fibromyalgia

What has uremia?

1 Chronic renal failure, which can lead to | 2 End stage renal disease (10% kidney function)

What is the most common hepatitis cause in the world?

HAV

_____ is the final common end stage of many chronic liver diseases

Cirrhosis

2nd most common kidney cancer

Renal Cell Carcinoma

In addition to CD4+ TH1 cells, what other cells does HIV affect?

Dendritic cells in mucosal tissue Intestinal epithelium Monocytes and macrophages in tissue (like lung brain)

``` S&S Proteinuria Low blood protein High blood lipids Edema "foamy urine" ```

Nephrotic syndrome

``` S&S: Fatigue Loss of appetite Headache Nausea Vomiting ```

Diabetic Nephropathy

``` What can cause: Scarring Thinning Neovascularization Vision loss ```

Recurrent Herpes Keratitis

S&S - Stiffness in a joint after a period of immobility - Swelling in one or more joints; joint pain - Crunching feeling or the sound of bone rubbing on bone

Osteoarthritis

___ can cause Verrucae vulgaris

HPV

What is the most common cause of acute renal failure?

Acute Tubular Necrosis

Name disease: Benign and self-limited (supportive treatment) Incubation period of 2–6 weeks Fatalities are very rare Oral-fecal contamination of water or food

HAV

What are the causes of Nephrolithiasis?

Dehydration Low urine volume Abnormal pH Infection

Which medication is the primary cause of liver toxicity?

Tylenol (APAP)

S&S Hematuria* Dysuria Polyuria

Transitional cell carcinoma

What renal disease has Azotemia and edema?

Acute Glomerulonephritis (immune complex in GBM). Acute renal failure only has Azotemia

What are some problems of the pancreas?

Premature activation of protease enzymes Obstruction of the common bile duct Pancreatic malignancies

S&S: Scaling, itching, flaking, erythematous patches

Seborrheic Dermatitis

____ is the leading cause of death in young diabetics

Diabetic Nephropathy

What renal disease is mostly in adults (not children)?

Membranous Glomerulonephritis

What are the different Spondyloarthropathies?

``` CRAP (more like CRAS ha) Crohn's Reactive arthritis (not rheum.) Ankylosing Spondylitis Psoriatic arthritis ```

____ is most common skin cancer

Basal cell carcinoma

S&S - Sudden pain usually in proximal joint of big toe - Edema and erythema

Gout

S&S of this indicates: | Eruption of vesicles / burning at the tip of the nose

Herpes Zoster ophthalmicus

What happens in chronic viral hepatitis?

``` You have Enlarged, tender liver Splenomegaly Palmar erythema (red palm) Spider angiomas (on face) ```

What can cause Acute Tubular Necrosis?

``` Lack of blood (because of Vascular collapse) Toxins like Antibiotics Heavy metals x-ray contrast media ```

CD4 T-count is lower than 200 uL. What HIV phase?

AIDS

What is the difference in pre vs post exposure prophylaxis?

Pre is long-term dual medication | Post-is 28-day Antiretroviral therapy within 72 hours of exposure

What can anterior uveitis indicate?

Rheumatoid arthritis, Juvenile idiopathic arthritis (and Spondyloarthropathy)

_____ nevi have round, well-delineated borders.

Benign acquired nevi

S&S - Inflammatory back pain - Enthesitis - tendon ligament joint capsule inflammation - Anterior uveitis, inflammatory bowel disease

Spondylarthropathies

``` S&S Hematuria Hypertension Azotemia Oliguria Edema ```

Acute Glomerulonephritis (immune complex in GBM)

Palmar erythema and Spider angiomas are from what?

Chronic viral hepatitis

Uremia is associated with what other diseases?

Urine in the blood is asso. With | HTN, Anemia, Edema, Oliguria (no urination)

What some common AIDS diseases?

Kaposi's sarcoma (from Herpes HHV8) Burkitt's lymphoma (EBV) Primary CNS lymphoma (EBV)

What causes Café au lait spots?

Neurofibromatosis (type of Phakomatoses)

Pearly or waxy lesion with an ulcerated center can indicate…

Basal cell carcinoma

Lesion with peripheral scaling, central clearing indicates

Cutaneous mycoses

Ocular symptoms: Nystagmus Lack of pigmentation of the fundi Reduced acuity

Albinism

What non-hepatitis viruses can cause hepatitis?

Cytomegalovirus, epstein-Barr virus

What is Erythema?

Reddening of the skin

___ albinism is x-linked

Ocular albinism

Which hepatitis is very contagious?

HBV

_____ is in 70% of cases of hepatocellular carcinoma

Alpha-fetoprotein

Tx osteoarthritis?

- Low impact exercise - Weight loss - Anti-inflammatories - Joint replacement

How are the blood concentrations in Azotemia?

Increased nitrogen and creatinine

CD4 T-count is higher than 200 uL. What HIV phase?

Clinical latency (or acute phase)

``` S&S Hematuria* Weight loss Dull flank pain Palpable mass ```

Renal Cell Carcinoma

What causes gout?

Uric acid buildup in any joint (because of decreased kidney clearance) causing episodes of painful joint inflammation

Whare are 3 types of antiretroviral therapies?

Reverse transcriptase inhibitor Integrase inhibitor Protease inhibitor

What diseases are associated with Nephrotic syndrome?

``` Minimal change disease (in children) Membranous Glomerulonephritis (in adults) ```

Which arthritis affects Hands*, knees, shoulders? | Which arthritis affects Hands, Spine, *Knees, *Hips

Rheumatoid (autoimmune) esp hands | Osteoarthritis (cartilage break down) esp knees hips

What causes Ash-leaf spots?

Tuberous sclerosis (type of Phakomatoses)

That is the rule of thirds for | Membranous Glomerulonephritis?

Resolve, stabilize, End-stage renal disease

What is angioedema?

rapid swelling of the skin from type I hypersensitivity (IgE)

What can Dx with x ray?

X-ray lower spine for Ankylosing spondylitis

How are bones implicated in renal failure?

There is bone pain from too much phosphate (and deficient blood Ca) causing excess parathyroid hormone that breaks down bone

What renal disease is a type III hypersensitivity?

Acute Glomerulonephritis (immune complex go into GBM)

What is the progression of alcoholic liver disease?

``` 1 Fatty change 2 Acute hepatitis 3 Chronic hepatitis with portal fibrosis 4 Cirrhosis 5 Chronic liver failure ```

``` Tx ___ with : underlying disease management Diuretics Dialysis Transplant ```

Acute renal failure. Diuretics is unique tx

What are some hematologic complications from renal failure?

Anemia from less erythropoietin, Coagulopathies from blood flow problems

____% of US adults over 40 develop cholelithiasis

20% (these are gallstones)

What are rough scaly skin patches (pre-cancerous)?

Actinic keratosis

S&S | Palpable abdominal mass*

``` Nephroblastoma. (black girl child cancer) Total S&S Palpable abdominal mass* Pain Hypertension Hematuria Aniridia ```

Which lab tests can dx Rheumatoid arthritis?

*Rheumatoid factor, Anti-cyclic citrullinated peptide (CCP) antibody Antinuclear antibody (ANA) (also in SLE) HLA-DR1 and HLA-DR4

___ albinism is autosomal recessive

Oculocutaneous albinism

``` (disease) can cause cause Vascular collapse (shock)* Toxic damage to tubules Severe hemolysis Muscle disorders Acute vascular disease Urinary tract obstruction ```

Acute renal failure

Name disease based on S&S Burning/tingling sensation Fluid-filled vesicles Erythema

Herpes simplex virus

Psoriasis, which causes | Dry, elevated, and rounded erythematous plaques, is from a disorder on gene ___

HLA-B27

What are the primary causes of ESRD in US?

Diabetes, HTN

___ can cause Squamous papilloma

HPV

What is associated with | Pernicious anemia, Hyperthyroidism, or Diabetes

Vitiligo

____ clearance rate is easier to measure than inulin

Creatine

S&S: Papules, Pustules, Erythema

Acne Vulgaris

Risk factors: Smoking 50% Occupational (Benzene) Bladder irritation (catheter)

Transitional cell carcinoma

Which HIV is in western africa?

HIV-2

Which HIV is world-wide?

HIV-1

Chronic pain of lower spine and buttocks Morning stiffness Bamboo spine (not flexible starts to curve)

Ankylosing spondylitis

What is the cause of post hepatic jaundice?

Biliary obstruction Gallstones Pancreatic cancer

Who does gout affect more?

Black men > white women

What can HLA-B27 diagnose?

Juvenile idiopathic arthritis and the Spondyloarthropathies 1. Crohn's/ IBD asso spondyloarthropathies 2. Reactive Arthritis (type III hypersensitivity) 3 Ankylosing spondylitis (inflamed fused spine) 4 Psoriatic arthritis (scaly rash arthritis)

What are the levels of albumin, glucose, and ammonia during hepatic failure?

Hypoalbuminemia Hypoglycemia Hyperammonemia

What is the most common kidney stone type?

Calcium

Most common cell in epidermis is ___in the ____ layer

Most common cell in epidermis is Keratinocytes in the basal layer

What are the potential complications of pancreatitis?

Bleeding Tissue damage Infection may Bloodborne distribution of digestive enzymes

What is seronegative for RF and ANA?

Spondylarthropathies