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54 Cards in this Set

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Choriocarcinoma & Mole
SS
Dx
Tx
Diagnosed as a B-hcg that does not come down after delivery or
D&C. U/S shows snowstorm appearance.

Dx: U/S & B-Hcg

Tx: D&C if non-invasive.
Methotrexate & Dactinomyacin Chemo if invasive and/or metastasized
Differential dx for female genital ulcer
Painful
1)Herpes:Tzanck +ve, multiple ulcers that come in waves

2) Behcets AI disease: Painful oral & genital tzanck -ve ulcers seen w/ uveitis

3)H.Ducreyi: chancre that presents w/ inguinal lyphadenopathy & school of fish smear

4)Squamous cell cx: Painful, itching & bleeding in older woman

Painless:
1)Syphillus(lata): chancre is punched out w/ rolled margins

2)HPV(Accuminata): exophytic, pedunculated with koilocytosis & dysparenunia
High PA pressure(PAWP)
-Mitral disease(sten/regurg)

-Cardiogenic shock(PE,Tension pneumo,heart failure,MI)

-Renal failure(hypervolemia)
Right vs. Left heart failure
Both: Dyspnea, fatigue, cardiomegaly, S3-S4

Right
-Hepatomegaly w/ ascites, edema & JVD

Left
-Paroxysomal nocturnal dyspnea c/ orthopnea
-Pulmonary rales, b/l pleural effusion, pulmonary vascular congestion, Kerly B-lines.
-Pulsus alternans

Tx:

Ace
-Beta blockers
-Aldosterone Antagonists
-Digoxin(Not if AV block or hypertrophic)
-Low Na+
Recurrent UTI in child
S/S
Dx
Tx
either Vesiculoureteral reflux(male & female) or posterior urethral valve(male only w/ b/l hydronephrosis)

dx: U/S & voiding cystourethrogram

Tx: Abx prophylaxis & surgery if that fails.
Clubbed foot DDX
Metatarsus adductus

Club foot that needs bracing and casting. Cannot passively dorsiflex foot(fixed in plantar flexion) and both heel and metatarsals are adducted

Metatarsus adductus needs no tx and feet are passively dorsiflexed and only metatarsals are adducted
Femur fracture in kid
Get skeletal survey b/c 80% secondary to child abuse
clavicular fracture in kid
SS
Tx
Crepitus/Asymmetric moro in macrosomic or forceps delivery. do not treat just let heal.
Child bone Tumor DDX
All are in kids 10-20 years of age. all cause pain and swelling and all are located at distal femur & proximal tibia. all are diagnosed by x-ray w/ biopsy to confirm.

1) Ewing: systemic symptoms(fever,wt loss,high ESR, High WBC) onion skinning

2) Oseosarcoma: no systemic signs: Bone sclerosis on X-ray.
SCID
No B or T-cells.
No LN's or tonsils and absent thymic shadow on x-ray
Eczema and candida infections
LAD
Failure of umbilical cord to seperate
Necrotic tooth infections
Alot of bacterial diseases
Job syndrome
Coarse facial features
Itching secondary to eosinophilia(high IgE)
Wiskott Aldrich
XLR
Low platelets
Eczema
Immunodeficient(high IgE & IgA but low IgM)
Delirium Tremens
2-3 days after no drink get anxiety, & delirium(usually post-op)
Vitamin B deficiencies
**All but thiamine can cause cheilosis**


B1(thiamine)
1) Wet beri beri: HO cardiac failure w/ edema

2) Wernicke(reversible w/ admin of thiamine): Nyastigmus,opthalmyoplegia,delirium

3) Korsakoff(irreversible): anterograde amnesia(no new memories) & confabulations

B2(riboflavin): Red tongue and cheilosis

B3(Niacin): Pellagra: dementia, dermatitis, diarrhea

B6(pyridoxine): Usually INH induced peripheral neuropathy

B12(cyanocobalmin): Megalo anemia w/ peripheral neuropathy 7 dementia
Treatment of an erythematous episeotomy w/o exudate or breakdown
Sitz bath
Scabies
SS
Dx
Tx
A contagious infection(1 roommate has it then the patient gets it). Itching all over body especially b/w finger webs and wrist flexors.

Dx: Microscopy of skin scrapings

Tx: Permethrin cream to pt & contacts. decontamination of bedsheeets
Testicular cancer
SS
Tx
A scrotal mass usually seen at the superior pole of the testes that is non-painful and does not TI.

Tx: Orchipexy
Hydrocoele
SS
Tx
Painless scrotal mass(processes vaginalis remnant) that TI.

No tx
Variococoele
Dilated pampinaform venous plexus (bag of worms) that is painful and does not TI.

Dx: Dissappears in supine position & no TI
Tx: Remove if painful or causes infertility.
Anaerobic Pneumonia
SS
Those susceptible
Infiltrtaes in the upper lobe and the sputum is foul smelling.

Seen in alcoholics or seizure patients who aspirate gastric contents.
Workup for hirsuitism
Get test & DHEA levels
Orbital vs. Periorbital cellulitis
Orbital has pain on EOM
woman in labor w/ organisms in amniotic fluid
Give ampicillin & gentamicin
TB
SS
Foreigner or aids patient w/ upper lobe cavitations and long term fever w/ chills, hemoptysis & wt loss.

Caseating granulomas
Vaginal candidiasis
SS
Tx
Itching, burning, 7 erythematous vagina w/ cottage cheese D/C that has hyphae and spores on wetmount.

Tx: -Azole
ALL
SS
Pancytopenia in a kid 3-5 years old with a high prevalence in Down's.
Exudate vs transudate
Exudate: Purulent Bacterial infection
-Low glucose,turbid, high neut
-Fluid:serum LDH >.6
-Fluid:serum Protein >.5

Transudate is the opposite
Hepatitis types and ways to acquire
A&E: Fecal to oral & most common(Water or food)

BC&D: Parenteral(ie fluids)
-C is most common from transfusions.
Rh antigens and transfusion
Rh- can get only Rh- blood.
Rh+ can get Rh- or Rh+ blood.

O Universal Donor
AB Universal Acceptor
BMI calculation & what is under,norm,overweight,obese,morbid obese
KG/m^2

<18=under
18-25=norm
>25=over
>27=obese
>30=morbid obese
sleep apnea
SS
Risks
dx
Tx
Obese or alcoholic that snore and stop breathing then wake up tired.

High risk of Pulm HTN and arrythmia

High risk of car accidents 7 depression

Tx: CPAP & Oral airway.
IUD
-USE
-Risk
Only use in non-promoscuous women who do not want children.
-High risk PID, ectopic, infertility
Risk factors for CAD cholesterol screening
Age: Male>45, Female>55
Family: Male<55, Female <65
DM
HTN or on HTN meds
LDL<35
SMOKE
Priaprasm
Causes
Tx
ways to prevent
Sickle cell, trazodone, chlorpromazine

Need surgical decompression or will be impotent

estrogen therapy to prevent in sickle cell
transitional cell Bladder Cx causes
Aromatic amine
Cyclophosphamide long term
Smoking
squamous cell bladder cx RF
smoking or schistosoma haematiobium
Epididymitis Tx
Doxycycline b/c usually chlamydia
Marfan
SS
DDx
Long, tall, skinny, hyperextensible skin and hypermobile joints.

AD defect in fibrillin

Lens upward dislocation & aortic root dilatation

DDX:
1) ED(collagen defect and bruise easily w/ poor wound healing)

2)Homocystinuria(AR deficient cystathione synthase):
-Thromboembolic strokes in kid
-Osteoporosis
-Fair skin
-Lens downward
Marasmus vs Kwashikawator
SS
Marasmus: Not enough calories so wasting of extremities, normal liver, hanging skin and active

Kwash: cal ok but no protein so get edema and lethary w/ fatty liver
Trisomy 13
Patau: Cleft lip/palate and extra fingers
trisomy 18
Edward: fist w. fingers overlapping thumb and rockerbottom feet.
How the body reacts to starvation
Lose weight
Diarrhea(atrophy villi)
slow metabolic rate
lower gucogenesis=low insulin
High glycogenolysis=high glucagon
#1 pancreatic cancer RF
#1 complaint
smoking
postprandial epigastric pain relieved by leaning forward
Microscopic vs macroscopic hematuria worrkup
Repeat UA b/c may be contaminated(menstral blood or urethral injury)

If still + do smear to r/o myoglobinuria

Macro just do radiograph or microscopy study
Fetal circulation & O2 sat distribution
****Highest O2 sat***
U-Vein
heart
carotid
Femoral A/Umbilical A
Femoral Vein ****Lowest O2 Sat****
Huntington disease
SS
DX
Tx
**Autosomal dominant***

Caudate nucleus(BG) hypodense on MRI

Chorea
Dementia
Delirium

No tx
Bipolar tx
Lithium-Valproic acid (1st)
carbamazepine (2nd)
Lamotrigene
ECT (last)
Felty syndrome
RA
Large spleen
Neutropenia
Azotrenam use
Gram -ve "PPEKS"
-Proteus
-Pseudomonas
-e.coli
-klebsiella
-serratia
Most common types of skin cx
Basal cell>SCC>Melanoma
When are teratogens most dangerous
weeks 3-8 during organogenesis
Middleschmitz Tx
Give NSAID or COX selective inhibitor
Breast cancer Tx if it has estrogen and progesterone receptors
Est ant: Fulvestrant

Est mods: Tamoxifen/Raloxifen

GnRH Agonist: Leuprolide, gosarelin

Aromatase inhibitors(no est-test): Anastrozole, letrozole