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54 Cards in this Set
- Front
- Back
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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 |
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Differential dx for female genital ulcer
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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 |
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High PA pressure(PAWP)
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-Mitral disease(sten/regurg)
-Cardiogenic shock(PE,Tension pneumo,heart failure,MI) -Renal failure(hypervolemia) |
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Right vs. Left heart failure
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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+ |
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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. |
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Clubbed foot DDX
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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 |
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Femur fracture in kid
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Get skeletal survey b/c 80% secondary to child abuse
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clavicular fracture in kid
SS Tx |
Crepitus/Asymmetric moro in macrosomic or forceps delivery. do not treat just let heal.
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Child bone Tumor DDX
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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. |
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SCID
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No B or T-cells.
No LN's or tonsils and absent thymic shadow on x-ray Eczema and candida infections |
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LAD
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Failure of umbilical cord to seperate
Necrotic tooth infections Alot of bacterial diseases |
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Job syndrome
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Coarse facial features
Itching secondary to eosinophilia(high IgE) |
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Wiskott Aldrich
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XLR
Low platelets Eczema Immunodeficient(high IgE & IgA but low IgM) |
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Delirium Tremens
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2-3 days after no drink get anxiety, & delirium(usually post-op)
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Vitamin B deficiencies
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**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 |
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Treatment of an erythematous episeotomy w/o exudate or breakdown
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Sitz bath
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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 |
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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 |
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Hydrocoele
SS Tx |
Painless scrotal mass(processes vaginalis remnant) that TI.
No tx |
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Variococoele
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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. |
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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. |
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Workup for hirsuitism
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Get test & DHEA levels
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Orbital vs. Periorbital cellulitis
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Orbital has pain on EOM
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woman in labor w/ organisms in amniotic fluid
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Give ampicillin & gentamicin
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TB
SS |
Foreigner or aids patient w/ upper lobe cavitations and long term fever w/ chills, hemoptysis & wt loss.
Caseating granulomas |
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Vaginal candidiasis
SS Tx |
Itching, burning, 7 erythematous vagina w/ cottage cheese D/C that has hyphae and spores on wetmount.
Tx: -Azole |
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ALL
SS |
Pancytopenia in a kid 3-5 years old with a high prevalence in Down's.
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Exudate vs transudate
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Exudate: Purulent Bacterial infection
-Low glucose,turbid, high neut -Fluid:serum LDH >.6 -Fluid:serum Protein >.5 Transudate is the opposite |
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Hepatitis types and ways to acquire
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A&E: Fecal to oral & most common(Water or food)
BC&D: Parenteral(ie fluids) -C is most common from transfusions. |
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Rh antigens and transfusion
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Rh- can get only Rh- blood.
Rh+ can get Rh- or Rh+ blood. O Universal Donor AB Universal Acceptor |
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BMI calculation & what is under,norm,overweight,obese,morbid obese
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KG/m^2
<18=under 18-25=norm >25=over >27=obese >30=morbid obese |
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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. |
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IUD
-USE -Risk |
Only use in non-promoscuous women who do not want children.
-High risk PID, ectopic, infertility |
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Risk factors for CAD cholesterol screening
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Age: Male>45, Female>55
Family: Male<55, Female <65 DM HTN or on HTN meds LDL<35 SMOKE |
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Priaprasm
Causes Tx ways to prevent |
Sickle cell, trazodone, chlorpromazine
Need surgical decompression or will be impotent estrogen therapy to prevent in sickle cell |
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transitional cell Bladder Cx causes
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Aromatic amine
Cyclophosphamide long term Smoking |
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squamous cell bladder cx RF
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smoking or schistosoma haematiobium
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Epididymitis Tx
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Doxycycline b/c usually chlamydia
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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 |
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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 |
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Trisomy 13
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Patau: Cleft lip/palate and extra fingers
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trisomy 18
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Edward: fist w. fingers overlapping thumb and rockerbottom feet.
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How the body reacts to starvation
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Lose weight
Diarrhea(atrophy villi) slow metabolic rate lower gucogenesis=low insulin High glycogenolysis=high glucagon |
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#1 pancreatic cancer RF
#1 complaint |
smoking
postprandial epigastric pain relieved by leaning forward |
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Microscopic vs macroscopic hematuria worrkup
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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 |
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Fetal circulation & O2 sat distribution
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****Highest O2 sat***
U-Vein heart carotid Femoral A/Umbilical A Femoral Vein ****Lowest O2 Sat**** |
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Huntington disease
SS DX Tx |
**Autosomal dominant***
Caudate nucleus(BG) hypodense on MRI Chorea Dementia Delirium No tx |
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Bipolar tx
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Lithium-Valproic acid (1st)
carbamazepine (2nd) Lamotrigene ECT (last) |
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Felty syndrome
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RA
Large spleen Neutropenia |
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Azotrenam use
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Gram -ve "PPEKS"
-Proteus -Pseudomonas -e.coli -klebsiella -serratia |
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Most common types of skin cx
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Basal cell>SCC>Melanoma
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When are teratogens most dangerous
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weeks 3-8 during organogenesis
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Middleschmitz Tx
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Give NSAID or COX selective inhibitor
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Breast cancer Tx if it has estrogen and progesterone receptors
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Est ant: Fulvestrant
Est mods: Tamoxifen/Raloxifen GnRH Agonist: Leuprolide, gosarelin Aromatase inhibitors(no est-test): Anastrozole, letrozole |
