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75 Cards in this Set
- Front
- Back
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What is a swan neck deformity?
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-PIP hyperextension and DIP flexion
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What is a Boutonniere deformity
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-PIP flexion, DIP extension
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Which way do the fingers deviate when someone has RA?
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-Ulna deviation
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What are the Rheumatic nodules and where are they located
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1. Heberdens - DIP
2. Bouchard's PIP |
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When is MTX contraindicated?
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-pts w/ liver disease
-pregos -adjust down in pts w/ low GFR |
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What is the least potent DMARD that is sometimes used for RA that is not a TNF inhibitor?
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-Anakinra --> interleukin 1 receptor antagonist
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What is the name of the medication that can be combined w/ MTX for which it is recommended that pts have dilated eye exams every 6 months?
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-Hydroxychloroquine
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If you were to examine the serum iron levels of a pt with ACD would the levesl be high, low or normal?
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-Low because iron is stuck in the macros of the RES
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Where is ferritin stored?
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-Macros of the RES
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What are the ferritin levels in anemia of chronic disease?
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-High because it's locked in the macrophages
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What is TIBC?
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-the actual measure of blood's capacity to bind iron w/ transferrin
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Why is TIBC low in ACD?
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-because ferritin is high!
-always an inverse relationship between TIBC and ferritin |
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What is the reticulocyte count in ACD?
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-Low (high is usually a/w hemolysis) because the body lacks building blocks such as iron to make RBCs
-hence: hypoproliferative anemia |
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What is the most important thing to remember to do when treating someone with ACD?
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-treat the underlying condition
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When treating a pt with temporal arteritis, what is the treatment choice and why must it be done if there is suspicion?
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-Prednisone at a high dose (60mg/day) and must be done immediately b/c the pt could go blind
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A family hx of what is typically a/w atopic dermatitis?
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-Asthma
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What is a major criteria for the diagnosis of atopic dermatitis?
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-Pruritis
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What is a common feature of the infantile phase of atopic dermatitis?
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-it appears on the cheeks
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What is implicated in the etiology of atopic dermatitis?
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-Defective CMI
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What is the appropriate therapy for inflamed skin for atopic dermatitis?
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-Topical corticosteroids
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What is the MC location for keratosis pilaris?
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-on the posterior lateral aspect of the arms
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What is a minor feature for the diagnosis of atopic dermatitis?
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on the hands and feet
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Most pts w/ atopic dermatitis have an elevated level of what?
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immunoglobin E levels
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Atopic dermatitis in young children typically spares the ?
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paranasal areas
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What is a common location of adults presenting w/ atopic dermatitis?
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-back of the hands
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Where would you find Dennie Morgan lines?
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lower eyelid
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People w/ atopic dermatitis should not receive which current vaccine?
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smallpox
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People w/ atopic dermatitis have low levels of _____ in their skin?
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-fatty acids
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It is estimated that how much of the population suffers from Iron-deficiency anemia (IDA)?
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-30%
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What are the MCC of IDA broken down by age group and sex?***
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1. Newborns/kids = inadequate diet
2. F < 50 = menorrhagia 3. M < 50 = PUD 4. M/F > 50 = colon cancer |
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What are the 3 findings in Plummer Vinson Syndrome?
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1. IDA
2. Dysphagia esophageal webs 3. Glossitis |
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What is the MCC of Sideroblastic anemia (type of microcytic anemia)
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-Alcohol --> cure by stop drinking!
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When does one see blue granules?
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-when the mitochondria is encrusted w/ iron
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Where is iron best absorbed?
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-Duodenum and proximal jejunum
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Where is B12 best absorbed?
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-terminal ileum
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Where is folate best absorbed?
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-jejunum
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When treating Fe deficiency what is the first lab finding noted?***
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-Reticulocyte count increases
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What is the term used for craving non-nutritional substances that may be seen w/ IDA?
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-PICA
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What is the condition called when nails curve upward due to Fe deficiency?
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-Koilonchias
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Free iron is ____ to cells
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-toxic
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What is a DDx for IDA?
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-thalassemias
-NOT B12 or Folate bc they are macrocytic |
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The appearance of IDA in an adult male means ____ until proven otherwise?
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-GI blood loss (peptic ulcers)
-maybe colon cancer |
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What helps the absorption of iron?
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-ascorbic acid
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What is the Hb pattern in IDA?
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-pattern is A
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What cells have the highest number of transferring receptors on their surface compared to any other cell in the body?
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-Erythroid
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Females of childbearing age will need to absorb how much iron on average?
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-1.4 mg/dl
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How much do males need to absorb?
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0.8 - 1 mg/dl
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What is the best folate deficiency test?
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-homocysteine levels
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What is Schilling Test used for?
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pernicious anemia
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What is the intestinal parasite that has a high affinity for B12?
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-Diphylobothrium Latum
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What is the tx of Raynaud's phenomenon?
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-Nifedipine - a Ca++ channel blocker
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How is phymatous rosacea usually tx?
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-Surgical intervention
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What types of cosmetics should be used by a person w/ acne?
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-Water based
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Closed comedones are known as?
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-whiteheads
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One of the best tx for G- folliculitis that is unresponsive to Abx is to use?
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-Isotretinoin (Accutane)
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What is the cause of rosacea?
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-unknown
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What agent possesses antibacterial properties has NOT been linked to bacterial resistance?
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Benzoyl peroxide
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What is a finding seen in rosacea that is NOT a/w the skin?
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conjunctivitis
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What is an approximate amount of papules seen in rosacea?
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<10
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What is seen in acne but not in rosacea?
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-comedones
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vWF is required for?
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-normal platelet adhesion
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Type I von Willebrand disease is inherited as?
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-Autosomal dominant
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Henoch-Schonlien purpura has elevated levels of?
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-Serum IgA
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Henoch - Schonlein pupura affects the?
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kidneys
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Arthritis of Henoch Schonlein purpura MC involves the?
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-ankles
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What catalyzes protein C?
Where is Protein C synthesized? |
1. Thrombin
2. Liver |
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Where is the gene for protein C located?
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-Long arm of chromosome 2
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Protein C deficiency is a/w?
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-Warfarin induced skin necrosis
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The MC site of venous thromboembolism in protein C deficiency is?
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-deep veins of the LE
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Antitrhombin III inhibits coagulation by?
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-lysing thrombin and factor Xa
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What is the name of the disorder in which platelet glycoprotein IIb/IIIa complex is deficient or dysfunctional?
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-Glanzmann thrombasthenia
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What is the inheritance pattern and on what chromosome are the genes for glycoprotein IIb/IIIa found?
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-Auto recessive
-chromosome 17 |
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What best describes platelets in Glanzmann thrombasthenia
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-Normal morphology w/ nL number or platelets
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Which best describes platelets in Wiskott-Aldrich syndrome?
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-Thrombocytopenia and small platelets
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What immunoglobulin is deficien and which skin condition is a/w Wiskott-Aldrich syndrome?
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-IgM
-Eczema` |
