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115 Cards in this Set
- Front
- Back
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caused by antibodies against phopholipids on RBC
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Antiphospholipid syndrome
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an acquired cause of hypercoagulability
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antiphopholipid syndrome
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pts that need to remain on coumadin their whole life
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antiphospholipid syndrome
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what are the MC joint involvement of OA
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hips and knees
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List the findings of OA
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crepitus
effusion heberdens nodes (distal) bouchards nodes (middle) sclerosis on xray osteophytes |
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what is the tx for OA
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NSAIDS, steroid, joint replacement, glucosamine
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OA has pain with repetitive use, how does RA differ
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RA has morning stiffness of greater then 1 hour, DOESNT affect the back like OA and is more symmetrical then OA
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what is the genetic component of RA
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HLA DR4
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list some xray findings of RA
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ulnar deviation, schwanna neck deformaties, boutineere deformity
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what test should you run on a young MALE pt with sacroiliac pain, eye pain, photophobia, mouth ulcers
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HLA-B27; test for anklylosing spondylitis
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describe psoriatic arthritis and lab test for it
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joint pain, nail pitting, silvery scale on a red base that is B/L and symmetric, HLA B27
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scleroderma is an immune problem of the CT; describe CREST syndrome
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C- calcium deposits
R - raynauds E- esophagus swallowing problems S - sclerodactyly T - telangiectasias |
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Lupus is an autoimmune disease causing immune complexes to build up and cause TISSUE DAMAGE; list the diagnostic criteria (SOAP BRAIN MD)
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S- serositis
O- oral ulcers A - arthritis P - photosensitive B - blood changes (anemia, low platlets, WBC) R - renal involvement (protein in urine) A - ANA positive I - immunological changes N - neuro signs (seizures and psychosis) M- malar rash D - discoid rash |
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list the causes of osteoporosis
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early menopause, over age 50, reduced Ca intake, thin-small framed people, drugs such as cortisone, endocrine tx for prostate cancer, smokers, celiac pts
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how do you diagnose osteoporosis
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T score of -2.5 as compared to young white women (the greater the negative number the higher the risk)
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Gout is caused by the uric acid buildup from purine metabolism; what can cause this
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sleep apnea or HCTZ
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what joint does pseudogout most commonly affect
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the knee joint
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what is pseudogout
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calcium pyrophosphate deposits (crystals can be seen on aspiration of synovial fluid)
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list the two types of migraines
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with an aura or w/o an aura (without an aura is more common)
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what symptoms are common in both aura and non aura migraines
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they have early symptoms of depression, euphoria, food cravings, lethargy and yawning, both have 4-72 hours of unilateral throbbing
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what is different between aura and non aura migraines
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aura migraines have more neurologic symptoms such as visual disturbances, weakness and dysphagia
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inflammatory vasculitis associated with branches of the temporal arteries
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Giant Cell arteritis (Temporal arteritis)
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what are the long term complications of temporal arteritis
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blindness (this condition is seen in older people with temple headaches
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how long does it take for TIA symptoms to disappear
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30 minutes, but usually less then 24 hours
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black curtain, slurred speech, blurred vision
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TIA
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RIND
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reversible ischemic neurological deficits that lasts greater then 24 hours, but completely resolves
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stroke
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greater then 24 hours and more permanent problems
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worst headache of your life, whose rupture can cause death
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cerebral aneurysm (MC in anterior portion of the circle of willis)
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triggers of vasovagal response
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-standing, heat exposure, sight of blood, fear of bodily injury, toilet exertion
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what is lost in parkinsons
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loss of pigment in substantia nigra
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what are the symptoms of parkinsons
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resting tremor, rigidity, mask face
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what are the tx for parkinsons
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levodopa, carbidopa, dopamine agonist, anticholinergics, amantadine, COMT inhibitors
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how is normal pressure hydrocephalus treated
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-it is reversible and treated with a shunt from the ventricles to the abdomen
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what are the symptoms of normal pressure hydrocephalus
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gait disturbance, ataxia, dementia, urinary incontinence
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weakness of eye skeletal muscles
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Myasthenia gravis
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how is MG diagnosed?
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diagnose with Edrophonium bc it increases ACh levels
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when does MG occur in women
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20-30
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when does MG occur in men
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70
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acute autoimmune polyneuropathy
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Guillan Barre
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what causes Guillan Barre
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commonly after a viral illness or vaccine
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achilles reflex
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S1
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patellar reflex
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L4
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biceps reflex
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C5, C6
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brachioradialis reflex
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C6
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triceps reflex
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C7 (1st two fingers)
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hemophilia is what type of genetic disorder
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X linked (occurs more in males bc they only have one X)
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Hemophilia A is a gene mutation of ?
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F8, this is classic hemophilia
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Hemophilia B is a gene mutation of ?
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F9, Christmas disease
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which type of hemophilia is more common
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Type A
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turners syndrome
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females with only one X
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what are the symptoms of Turners syndrome
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short stature, failure to get puberty, infertility, heart defects, learning disabilities
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Kleinfelters
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males with an extra X (XXY)
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do Kleinfelters males have infertility problems
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no
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what type of genetic disease is CF
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autosomal recessive (25% chance of kid getting it if both parents have it)
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atrophy and stork legs due to muscle loss
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CMT
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give an example of a delayed hypersensitivity
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poison ivy
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give an example of an immediate hypersensitivity
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bee sting
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osteogenesis imperfecta, what is it and what type of genetic disease
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-brittle bone disease
-autosomal dominant |
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how does Growth hormone work
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it goes to the liver and makes the liver produce somatomedins, then somatomedins cause bone and tissue to grow
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what can cause GH hypersecretion
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pituitary adenoma
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Acromegaly
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GH hypersecretion in kids causes epiphyseal plates to close and bones to widen
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Gigantism
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GH hypersecretion in kids before closure of epiphysis
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too little GH when you are growing
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Dwarfism
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what does ADH do
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stimulates water retention
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what is Diabetes Inspidus
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no ADH, so you have dilute urine, but no sugar in it
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what can cause Diabetes Insipidus
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tumor, surgery, lithium, head trauma
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enhances absorption of Ca from the small intestine and blood
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PTH
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mobilizes Ca from the bone by stimulating osteoclasts to resorb bone adn liberate Ca into blood
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PTH
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Calcitonin
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reduces Ca levels by opposing the effects of PTH
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what are the levels of Thyroid hormone and TSH in Hasimotos
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low Thyroid hormone, so high TSH
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what are the effects of aldosterone
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retains water and Na in the body and gets rid of (secretes) K
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what is primary aldosteronism and what is it associated with
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-low K and hypertension
- can occur when pts are on diueretics (low K) or with Conn's Disease (aldosterone secreting tumor) |
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where is the adrenal gland is cortisol produced
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cortex (zona fasciculata)
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what glucocorticoid plays a key role in adaptation to stress
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cortisol
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what causes cushings disease
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cortisol hypersecretion
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what are the symptoms of cushings disease
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hyperglycemia, hump and moon face
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primary adrenocortical insifficency
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addisons disease - caused by undersecretion of all zones of the adrenal gland
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symptoms of addisons disease
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hyperpigmented skin
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pheochromocytoma
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rare tumor that develops in the core of the adrenal gland or a tumor somewhere else that produces catecholamines
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what are the symptoms of pheochromcytoma
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anxiety, increased HR, pale skin
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what is pernicous anemia
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B12 deficiency due to loss of IF
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what do the RBC look like in pernicous anemia
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macrocytic
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what cant be formed in iron deficiency anemia
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HgB cant be formed
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who is Fe deficient anemia most common in
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menstruating females
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what does the lab of fe deficient anemics look like
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reticulocyte count is low, low hgB, hypopigmented, low MCV, low MCHb
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if you have an older pt with Fe deficiency, what should be your first instinct
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-they have colon cancer and are loosing small amounts of blood (hemolytic anemia)
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what is polycythemia vera
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increased RBC and high Hb of 18 (normal is 12-130
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what hematology pts are more prone to blood clots
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Polycythemia vera
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what is hemolytic anemia
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anemia secondary to RBC breakdown
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what are the symptoms of hemolytic anemia
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breakdown of RBC causes release of bilirubin, jaundice, dark urine, increase in LDH
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what is the diagnostic test for hemolytic anemia
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Coombs test (look for antibodies to RBC)
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leukemia with excess lymphoblasts (immature WBC)
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acute lymphoblastic leukemia
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what is the MC form of leukemia
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Chronic lymphocytic leukemia (accumulation of mature B cells)
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blast crisis leukemia whose hallmark is Philadelphia Chromosome
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Chronic myelogenous leukemia (elevated WBC and splenomegaly)
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MC bone cancer in adults
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Multiple Myeloma
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characteristics of multiple myeloma (bone cancer)
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punched out lesions in skull (pepper pot), bone pain in skull and sternum, gamma spike, bence jones proteins in urine
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what is a common symptom of bone cancer
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night pain
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bone cancer in developing bones (before the 2nd decade)
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osteosarcoma
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where is osteosarcoma common
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in long bones (knee area, distal femur, proximal tibia)
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bone cancer that occurs after age 50
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chondrosarcoma
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bone cancer that begins in the nerve tissue in bone marrow of kids after treatmetn of antoher condition with radiation or chemo
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ewings sarcoma
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ITP symtoms and labs
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bruises on skin, low platelets
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MC cause of osteomyelitis
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staph aureus
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most common cause of gas gangrene (necrotizing fascitis)
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strep pyogenes, group A strep
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what does gas gangrene spare
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muscle and skin, but destroys the deep subcut and fascia
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what causes tinea versicolor
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malassezia furfur
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what are the symptoms of tinea versicolor
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hypopigmented
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occlusion of the eustachian tube
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otitis media
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in what age is otitis media most common
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6 months to 3 yo
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what are the MC bacterial causes of otitis media
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strep pneumonia, H influenza, M catarrhalis
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how do you tx otitis media
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abx such as amoxicillan
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what bacteria causes pseudomebranous colitis
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c diff; usually associated with antibiotic use
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what are the symptoms of infectious mono
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fever, sore throat, lymphadenopathy, big spleen, big liver and at risk for splenic rupture
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what is diagnostic for an acute mono infection
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positive IgM test
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what does the CBC of a mono patient show
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lymphocytosis and atypical lymphs
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