Syndromes & Signs Flashcards
Horners syndrome
When a group of nerves known as the sympathetic trunk is damaged.
Miosis (a constricted pupil)
Partial ptosis (a weak, droopy eyelid)
Apparent anhidrosis (decreased sweating)
with or without enophthalmos (inset eyeball).
Carcinoid syndrome
Carcinoid tumor producing Bradykinin + Serotonin ------> secondary symptoms: Cyanotic flushing Diarrhea Bronchial spasm Edema, ascites.
PEUTZ-JEGHERS SYNDROME:
Autosomal dominant - Polyposis (hamartomas) of small intestine
Also see melanin pigmentation of buccal mucosa and skin around mouth and lips
CONN’S SYNDROME:
Primary Hyperaldosteronism ——> muscular weakness, hypertension, hypokalemia
FELTY’S SYNDROME:
Rheumatoid Arthritis with splenomegaly, leukopenia, anemia, and thrombocytopenia.
YELLOW-NAIL SYNDROME:
Stop growth of nails ——> increased convexity, thickening, and yellowing of nails.
Found in Lymphedema, bronchitis, chronic bronchiectasis.
TIETZE’S SYNDROME:
Costochondritis. Swelling and tenderness of the costal cartilege.
BUDD-CHIARI SYNDROME:
Hepatic vein obstruction –>ischaemia and hepatocyte damage –> liver failure or insidious cirrhosis
ACUTE: Hepatic Vein Thrombosis ——> Massive ascites (SAAG >1.1) and dramatic death.
CHRONIC: Gradual hepatomegaly, portal hypertension, nausea, vomiting, edema, ulimately death.
ZOLLINGER-ELLISON SYNDROME:
Gastrin-secreting tumor in pancreas ——> Severe peptic ulcers, gastric hyperacidity.
BROWN-SEQUARD SYNDROME:
Damage (injury) to half of spinal cord ——> symptoms:
Loss of pain and temperature sensation on contralateral side of body.
Loss of proprioception and discriminatory touch on ipsilateral side of body.
BEHCET’S SYNDROME:
Vasculitis ——> secondary symptoms:
Oral and genital ulcers
Uveitis
Optic atrophy
MEIGS’ SYNDROME:
Fibroma of ovary with ascites and hydrothorax
REITER’s SYNDROME
Associated with STD or gastroenteritis
Arthritis, urethritis, conjunctivitis
Causes of central cyanosis
- Central nervous system (impairing normal ventilation):
Intracranial hemorrhage
Drug overdose (e.g. heroin)
Tonic–clonic seizure (e.g. grand mal seizure)
2. Respiratory system: Pneumonia Bronchiolitis Bronchospasm (e.g. asthma) Pulmonary hypertension Pulmonary embolism Hypoventilation Chronic obstructive pulmonary disease, or COPD (emphysema)
3. Cardiovascular diseases: Congenital heart disease (e.g. Tetralogy of Fallot, right to left shunts in heart or great vessels) Heart failure Valvular heart disease Myocardial infarction
- Blood:
Methemoglobinemia * Note this causes “spurious” cyanosis, in that, since methemoglobin appears blue,[6] the patient can appear cyanosed even in the presence of a normal arterial oxygen level.
Polycythaemia
Congenital cyanosis (HbM Boston) arises from a mutation in the α-codon which results in a change of primary sequence, H → Y. Tyrosine stabilises the Fe(III) form (oxyhaemoglobin) creating a permanent T-state of Hb. - Others:
High altitude, cyanosis may develop in ascents to altitudes >2400 m.
Hypothermia
Obstructive sleep apnea
Causes peripheral cyanosis
All common causes of central cyanosis
Reduced cardiac output (e.g. heart failure, hypovolaemia)
Cold exposure
Arterial obstruction (e.g. peripheral vascular disease, Raynaud phenomenon)
Venous obstruction (e.g. deep vein thrombosis)
Korotkoff sounds
Phase I—The first appearance of faint, repetitive, clear tapping sounds which gradually increase in intensity for at least two consecutive beats is the systolic blood pressure.
Phase II—A brief period may follow during which the sounds soften and acquire a swishing quality.
Phase III—The return of sharper sounds, which become crisper to regain, or even exceed, the intensity of phase I sounds.
Phase IV—The distinct abrupt muffling of sounds, which become soft and blowing in quality.
Phase V—The point at which all sounds finally disappear completely is the diastolic pressure.
