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68 Cards in this Set
- Front
- Back
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Risk factors for pneumonia
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Alcoholism
Institiutionalism Smoking COPD Immune compromise Extremes of age |
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Bronchopneumonia: Location & PE
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Alveoli around bronchi
Rales +/- rhonchi |
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Etiology of bronchopneumonia
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Hemophilus
Pseudomonas Staph aureus |
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Lobar pneumonia: Location & PE
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Entire lobe
Dull to percussion CXR - consolidation "white out" |
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Etiology of lobar pneumonia
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Strep pneumonia (Pneumococcal pneumonia)
Klebsiella pneumonia (Friedlander's pneumonia) |
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S/S Pneumococcal pneumonia
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Sudden onset dyspnea, cough, fever, rigors (shaking chills)
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S/S Klebsiella pneumonia
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Prolonged onset progressive dyspnea, cough, fever over days
CURRANT-Jelly sputum |
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Atypical pneumonia: location? bil or unilateral?
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Patchy pneumonia lower lobes bilaterally
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Clinical atypical pneumonia
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Rales
CXR - patchy bil pulmonary infiltrate |
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Etiology Atypical pneumonia
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Viral: kid - RSV, adenovirus, influenza; adult - influenza A & B
Mycoplasma pneumonia: 5-35 yo |
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What kind of pneumonia is called "Walking pneumonia"? Triad?
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Atypical pneumonia
Malaise, Sore throat, dry cough |
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Legionnaire's disease: CXR & PE
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CXR - Unilateral patchy segmental or lobar
Rales |
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Clinical legionnaire's disease
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Hi fever w/ relative bradycardia
Diarrhea Productive cough |
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Who does legionnaire's affect
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Middle-age Males
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Etiologic agent legionnaire's disease
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Legionella pneumophilia
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Aspiration pneumonia - 3 types
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Chemical pneumonitis (gastric acid)
Anaerobic bacteria Mechanical obstruction |
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Clinical gastric acid chemical pneumonitis
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Acute onset
SOB Pink frothy sputum Bronchospasm Cyanosis |
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Clinical anaerobic bacteria aspiration pneumonia
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Insidious onset
Cough Fever Purulent foul-smelling sputum |
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Clinical mechanical obstruction causing aspiration pneumonia
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ACUTE
SOB Cyanosis |
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Cause of anaerobic bacteria aspiration pneumonia
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Aspiration gingival organisms in saliva
2nd decreased consciousness or decreased pharyngeal space/airway control (MS, ALS, stroke) |
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Primary lung tumors
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Peak 45-70 yo
Smoking |
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Types of benign lung masses
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Hamartoma
Adenoma - glandular Leiomyoma - sm m |
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Carcinoid lung tumor
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Serotonin & histamine producing tumor from GI mucosa
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Carcinoid syndrome
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Flushing
Diarrhea Bronchospasm R heart valve lesion Hypotension |
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Dx of carcinoid syndrome
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24-hr urinary 5'-HIAA
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1st symptom carcinoma
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New onset cough OR
Change in freq or character pre-existing cough |
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4 kinds of lung carcinoma
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adenocarcinoma
Squamous cell carcinoma Large cell carcinoma Small cell carcinoma |
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Adenocarcinoma
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Pre-existing lung scar (non-smoker)
Peripheral |
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Squamous cell carcinoma
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Smoking
PTH-like peptide --> hypercalcemia Central to mediastinum |
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Large cell carcinoma
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Smoking
Peripheral |
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Small cell carcinoma
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Smoking - worse px
Mediastinum ADH --> fluid overload ACTH --> cushing's syndrome Autoimmune - Eaton Lambert syndrome |
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What is Eaton Lambert syndrome
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Proximal m. weakness
Ab to presynaptic Ca channels on neurons of NMJ |
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What lung tumor is a/w Horner's syndrome
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Pancoast tumor - apex of lung
(compression of cervical sympathetic ganglia) |
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S/S Horner's syndrome
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Sinking of eyeball
Miosis Ptosis VD Anhidrosis of face |
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Nephritic syndrome
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Acute onset & rapid progression
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Cause of nephritic syndrome
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Inflammation of glomerulus
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Clinical of nephritic syndrome
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Hematuria
Red cell casts HTN edema Increased BUN & creatinine (Azotemia) |
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Examples of nephritic syndrome
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Post-strep glomerulonephritis
Goodpasture's syndrome Diffuse proliferative glomerulonephritis |
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Nephrotic syndrome
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Changes in glomerular permeability
(no longer adequately limits filtration of proteins) **Structural change** |
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Clinical nephrotic syndrome
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Severe proteinuria
Frothy urine Hypoalbuminemia Hyperlipidemia Edema |
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Examples of nephrotic syndrome
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Minimal change disease
Membranous GN |
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Acute nephritic syndrome
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Hematuria
Azotemia Variable proteinuria Oliguria Edema HTN |
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Rapidly progressive glomerulonephritis
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Acute nephritis
Proteinuria Acute RF Severe oliguria Severe edema HTN Marked azotemia Crescents |
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Chronic renal failure
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Azotemia w/ uremia progressing for yrs
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Uremia defined
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M. twitching & cramps
Fatigue Decreased mental acuity N/V HTN Pruritis Pericarditis Occ. uremic frost |
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Cause of Type I RPGN
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Idiopathic, Goodpasture's
(Ab-mediated cytotoxicity) |
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Cause type II RPGN
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Idiopathic, SLE, Henoch-Schonlein, post-infectious
(Immune complex disease) |
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Cause type III RPGN
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Idiopathic, Wegener's, microscopic polyangiitis, advanced terminal polyarteritis nodosa
(pseudo-immune --> +ANCA d/o) |
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Purulent discharge (vagina, urethra, rectum, pharynx)
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Gonorrhea
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2 STDs which can ascend causing PID
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Gonorrhea & Chlamydia
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Lymphogranuloma venereum: s/s, etiology, tx
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Lg palpable granulomas in inguinal LNs
Erupt on skin surface Chlamydia trachomatis Doxy |
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Granuloma inguinale: s/s, etiology, tx
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Granuloma develops on genitals then organism blocks lymphatic drainage
Klebsiella granulomatis Tetracycline |
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Chancroid: s/s, etiology, tx
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soft PAINFUL chancre
Hemophilus ducreyi Ceftriaxone |
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Syphilis: s/s, etiology, tx
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1 - PAINLESS hard chancre, 2 - rash palms, condyloma lata genitals, 3 - gummas
Treponema pallidum Pen G |
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Condyloma acuminatum: s/s, etiology, tx
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Painless
HPV 6&11 (16&18 dangerous) Cryotherapy |
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Pathophysiology HPV
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HPV viral genes E6 & E7 interfere w/ p53 & RB (tumor suppressor genes) --> overgrowth epithelial cells
(Koilocytes) |
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Genital herpes: s/s, etiology, tx
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PAINFUL fluid-filled vesicles in grps on erythematous base
HSV 1 or 2 Acyclovir |
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Which non-germ cell testicular tumor produces high testosterone?
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Leydig cell tumor (intersititial cell tumor)
-precocious puberty (occur before puberty) -gynecomastia (occur post-puberty) |
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Differentiate serous & mucinous surface epithelial ovarian tumors
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Serous - fallopian tube epithelium (watery secretion); 1/2 of ovarian CA; bilateral
Mucinous - columnar cells (mucus); pseudomyxoma peritonei |
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What is pseudomyxoma peritonei?
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rupture of mucinous cystandeocarcinoma to produce multiple intraperitoneal tumor implants
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Teratoma
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2 or more germ layers
(more are mature form) |
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Dermoid cyst
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Mature teratoma
cyst lined by skin w/ hair follicles +/- nails, sebaceous glands; bones, teeth, GI, neuro, resp., thyroid tissue |
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Struma ovarii
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unusual variant dermoid cyst
Only 1 tissue element - THYROID (hyperthyroidism) |
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Granulosa-theca cell tumor
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Secretes E
+ Call-Exner bodies (follicle w/eosinophilic material) A/w 2nd endometrial hyperplasia or CA |
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Sertoli-Leydig cell tumor in ovary
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Secretes T
(virilization in female - irreversible) |
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Meig's syndrome
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caused by ovarian fibroma
-ascites -pleural effusion -(+) ovarian tumor |
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Krukenberg tumor
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Tumor in ovary that mets from elsewhere and bilaterally replacement of ovaries w/ mucin-producing signet-ring cell
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Primary source for Krukenberg tumor
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Stomach
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