U world missed 7/1 Flashcards
Psychogenic non-epileptic seizures explain the findings
this is conversion disorder with findings inconsistent with seizures.
it is characterized by forceful eye movements, side to side head off body movements and memory recall of the event.
there is no abnormal cortical activity and video electroencephalogram monitoring is the gold standard for diagnosis.
can have a history of psychiatric disorders and/or trauma.
*shaking all over, tightly closing her eyes
caffeine intoxication can cause what ?
heart palpitations, anxiety, psychomotor agitation, cardiac arrhythmia, hallucinations in rare cases.
Generalized tonic-clonic seizures explain them
an abrupt loss of consciousness followed by stiffening throughout the body followed by rhythmic jerking of the extremities. - typically the eyes are open during this episode and patients fall asleep after the seizure with confusion when they wakeup
pancreatic cancer typically presents in the head of the pancreas and can what manifestations in the biliary tree on imaging
intra-hepatic and extra hepatic biliary duct dilation
if the tumor also compresses the pancreatic duct it can form a double duct sign
**symptoms painless jaundice, nontender enlarged gallbladder, weight loss
what is functional hypothalamic amenhorrhea
this is when stress, illness, strenuous weight loss, anorexia and other causes cause secondary amenorrhea secondary to decreased GnRH release from the hypothalamus.
this decreases LH and FSH release from the pituitary and subsequent decrease in estrogen (the low estrogen will not allow withdrawal bleeding after medroxyprogesterone is initiated)
outcomes of functional hypothalamic amenorrhea
amenorrhea, low estrogen state, and bone loss (decreased bone mineral density)
In alcoholic associated liver disease early liver cirrhosis can be reversible, the steatosis and steatohepatitis (inflammation) can be reversed if you decreased portal pressure and inflammation of the liver.
what can a patient do to decrease both portal pressures and inflammation?
what can patients take to decrease portal pressures?
complete alcohol cessation will decrease portal pressures and inflammation
b-blockers (nonselective) can decrease portal pressures (varices) and Diuretics
what medications are avoided in cirrhosis
ACE inhibitors because they can cause hypotension (they will decrease the RAS system which typically counteracts the splanchnic vasodilation that occurs in cirrhosis)
causes of meningitis in children <1 from most common to least
group B strep
ECOLI
Listeria
Herpes
most common causes of neonatal sepsis in child > 1 month old
Strep pneumoniae
nsisseria meningiditis
congenital toxoplasmosis signs
chorioretinitis
hydrocephalus
jaundice
hepatosplenomegaly
first line treatment of endometriosis
OCPs and NSAIDS
Thoracic aortic aneurysm repair can cause spinal cord ischemia, especially of the anterior cord. Anterior cord syndrome typically presents with?
With distal, bilateral flaccid paralysis; loss of pain/temperature and crude touch sensation; and urinary retention.
vibratory/light touch is preserved
Pre-eclampsia prophylaxis in high risk patients are typically started on what medication
low dose aspirin around 12-28 weeks gestation (continued until delivery)
Galactosemia is what?
an autosomal recessive deficiency in GALT which metabolizes galactose to glucose. This deficiency presents early in life and causes galactose to accumulate in the liver and eyes.
Presents the 1st week of life with vomiting, jaundice, hepatomegaly, cataracts and increased bilirubin, and hemolytic anemia (galt deficiency in RBC, causes increased galactose in RBC and promotes RBC death)
babies with galactosemia are at increased risk of what infection
Ecoli sepsis
galactose is found in
breast milk, cows milk based formula
Wiskott Aldrich syndrome
immunodeficiency disorder caused by loss of function in the WAS gene that leads to recurrent infections, eczema and thrombocytopenia (low platelets)
First line treatment of ankylosing
spondylitis is NSAIDS and COX2 inhibitors
ischemic stroke in patients with sickle cell is treated with
exchange transfusion which replaces sickles cells with healthy red blood cells to increase oxygen carrying capacity and improve hyper viscosity to limit further occlusion
if exchange tranfusion is unavailable use simple tranfusion
under what instances should a diabetic foot ulcer be imaged for underlying osteomyelitis
any of the following
deep (bone exposed)
long duration >7 days
large >2 cm
ESR or CRP elevated
soft tissue infection
imaging even in the absence of signs/symptoms like erythema, streaking, pain etc.
what is a focal seizure
a seizure that originates in a single hemisphere and can cause a motor, sensory or autonomic activity
*isolated right head tilt and arm twitch
focal seizures can spread to involve both cerebral hemispheres and cause an impaired awareness like a staring episode and automatism (chewing/picking)
postictal confusion and transient paralysis (todd paralysis)
EEG results of focal seizure
during: abdnomral electrical activity arising from specific portion of the brian
interictal EEG is normal
Absence seizures
originate from both hemispheres and present with staring spells +/- automatisms and lasts only 10-20 seconds with no postictal period.
provoked by hyperventilation
juvenili myoclonic epilepsy
myoclonic jerks immediately upon wakening in adolescents
Lennox-Gastaut syndrome
intellectual disability and severe seizures of varying types by age 5
interictal (between seizures) EEG shows slow spike and wave pattern
MCC of death in patients with treated hodkins lymphoma <10 year and >10 years
<10 years - reoccurence
> 10 years - secondary malignancy (breast/lung) or cardiovascular disease
the greatest risk factor for life threatening asthma is a history of?
prior intubation or need for mechanical ventilation
or increased/normal PaCO2 (should be decreased)
what is the differential diagnosis for ulcerative skin lesion and suppurative regional lymphadenopathy
bartonella hensle- papule and lymphadenopathy
Francisella tularensis- ulcer then lymphadenpathy
sporothrix schenckii - ascending lymphagnitis
asymptomatic BV treatment
no further workoup or treatment only workup/treat if there are symptoms
tx: metronidazole
dx: wet mount microscopy and KOH whiff test
beckwith-wiedemann syndrome
macrosomia, macroglossia, hypoglycemia, hemihyperplasia, umbilical hernia, visceromegaly
increased risk of embryonal tumors: wilms tumors and hepatoblastoma
BWS surviellence
serum a fetoprotein
abdominal ultrasound
renal ultrasound
granulosa cell tumors secrete what?
Estradiol and Inhibin
post menopausal subtype will cause (breast tenderness, abnormal uterine bleeding)
juvenile subtype subtype causes precocious puberty
Carpal tunnel syndrome is common in patients with hypothyroidism and is frequently bilateral. Hypothyroidism causes soft tissue thickening and ______ infiltration, which can lead to compression of the median nerve within the carpal tunnel.
mucinous
***amyloid/crystal deposition contributing to CTS is common in people with end stage renal disease on dialysis it affects the site at where the vascular access is placed.
