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85 Cards in this Set

  • Front
  • Back
Mitral valve prolapse
Asymptomatic mid systolic click usually seen in a woman
Bicuspid Aortic valve
Main cause of Aortic stenosis
Systolic murmur with an opening click
Congenital pulmonary stenosis
Systolic murmur w/ opening click
Tricuspid Regurgitation
Systolic murmur that increases with inspiration
Ruptured papillary muscle
Systolic mitral regurg murmur that radiates to the axilla 5 days post RCA MI or endocarditis.
-Leukemia of kids(0-15)
-Check via tdt
-Low platelets but leukocyte count is normal
-Marrow is hypercellular w/ many blasts and needle shaped Auer rods
-Middle aged leukemia(15-40)
-Low platelets but leukocyte count is normal
-Marrow is hypercellular w/ many blasts and needle shaped Auer rods
-Middle aged leukemia(40-60)
-Platelet count(N to high) but leukocyte count>500K
-Philadelphia chromosome 9q to 22q balanced translocation(abl-bcr)
-Marrow shows mature lymphocytes
Leukemoid reaction
-Leukocytes elevate rapidly in response to infection(up to 50k)
-High leukocyte alkaline phosphatase differentiates this from CML/AML(where it is low)
Herniated disk
-Groin & hip pain
-Poor biceps femoris reflex

-sciatica(pain on straight leg raise)
-Poor achilles reflex
-Poor plantar flexion

Tx: NSAID & bedrest x2days
-If no improvement get MRI spine and do lumbar distectomy
-No B or t-cells due to ADA deficiency
-No LN, tonsils, or thymic shadow
Ataxia telangiectasia
multiple telangiectasias and ataxia
di george
-22q11 microdeletion causes failure of 3rd and 4th pharyngeal pouches to form.

-No thymus so get hypocalcemia(prolonged QT interval)and tetany,low set ears, T-cell deficiency
Selective IgA deficiency
-B-cells do not differentiate so no IgA is made.

-Get anaphylactic transfusion reactions

-Diagnose via serum electrophoresis
Bleomyacin AE
Pulmonary fibrosis
Cisplatin AE
tinnitus,hearing loss, nephrotoxic
Verapamil AE
Headache and dizziness
Mithramycin AE
HUS(thrombocytopenia, ARF, Neuro changes and fever)
Vincristine AE
Peripheral neuropathy
Microcytic anemia
Iron def (TIBC up)
Chronic disesae(Ferritin up)
Sideroblastic(Fe/ferritin up)
-lead: wrist drop, encephalopathy, epiphyseal deposition, serum protoporphyrin>35, basophillic strippling


Actinic Keratosis
-Precursor to SCC
-White scaly plaques at sunexposed areas.

-Biopsy and find dysplasia that does not invade dermis
Squamous cell Cx
Erythematous and crusting/ulcerating lesion.

Excisional Biopsy shows anaplasia invading dermis
Basal cell Cx
Pearly & umbilicated

Excisional biopsy shows palisading cells
Will morph quickly and just excise.

Diagnose via ABCD:
border irregular
color changes
Typical pneumonia in elderly or COPD
Gram negative diplococci (moraxella cattharalis)
Hepatitis types
High Bili(jaundice)

A&E: fecal to oral
BCDEG: Parenteral

A: Daycare vowel that hits the bowel

B: Asia
-Anti-Hbs Ab=vaccinated or had it previously
-Anti Hbc=Acute

C: Chronic, cirrhosis,Cx and dx via RIBA if strong clinical suspicion but ELISA is negative

D: Dependent on HbSAg, Drugs(IV),Defective RNA

E: Vowel hits bowel and expectant mother may die in burma,india,mexico

G: Dialysis or IV drugs
Watery diarrhea
E.coli: Activates cyclic AMP
Staph Aureus: custards or mayo
B. Cereus: Fried rice
V.Cholarae: Rice water stools
When to do further diarrhea workup and what
If bloody, fever or >4 days.

Examine stool for:
-C.dificile toxin
Bloody diarrhea
E.coli/ Yersinia enterolytica
Campylobacter jejeni
Entamoeba Histolytica
EKG & how to tx
High K+= T-waves=Ca gluconate
Low K+= U waves=Oral K+

High Ca: Short QT
Low Ca: Long QT

Ischemia: ST depression, inverted t-wave, st elevation
Cluster headache
-Multiple Periorbital attacks at night.
-Get conjunctival injection and lacrimation.
-Tx w/ oxygen & sumatriptan
Migraine headache
Unilateral with photophobia and last for hours.

Tx: Sumatriptam
Tension headache
Tight band around the head that is most tense at the back of the skull
-20-40 black
-b/l hilar adenopathy w/ non-caseating granulomas
-Erythema nodosum @ shins, arthritis

Tx: Prednisone
Berger disease
IgA Nephropathy

Get micrscopic hematuria after URI.

-Have elevated IgA in body that binds to mesangium.

-HSP is similar but it has arthritis, abd pain and LE rash
Goodpasture syndrome
TYPE II HS(Ab mediated)

Hemoptysis and hematuria with a linear pattern of anti collagen Ab seen on IF of GBM.

-Have IDA and sputum w/ hemosiderin laden macrophages

-Tx is plasmapheresis and steroids
Necrotizing-granulomatous vasculitis

-c-ANCA(anti proteinase 3Ab)

-Like Goodpasture(hematuria & hemoptysis & nosebleeds)

Tx: Give cyclophosphamide or steroids
Post infectious Glomerulonephritis
Post strep sore throat get hematuria(coca cola), edema & htn

C3 Low
ASO high

Lumpy bupy IF pattern

Tx: Supportive
Causes of nephritic syndrome
Post infectious GN
Minimal change disease
Lose -ve charge on GBM and get nephrotic syndrome, edema and high lipids.
Allopecia Arreata
Loss of hair in sporadic areas secondary to AI disease -Hashimoto
-Pernicious anemia,

Get lymphocytic infiltrate around hair shaft.

Treat with topical corticosteroids
Get psych consult and will have unilateral missing hair and it will be trying to grow back
LHS appendicitis

NPO or liquid diet + cephalexin.

Barium or Colonoscopy in 2 weeks to confirm diverticula.

Surgery if necessary.
Visual Pathway defects
hemianopsia: optic glioma or optic neuritis(seen in MS) or Retinal A occlusion.

Bitemporal hemianopsia: pit adenoma or craniopharyngioma

homonomous hemianopsia:

Occipital: Spare macula
Parietal: Lose Lower quarter
Temporal:Lose upper(T for top)quarter
Gram negative that can cause gastritis, PUD, gastric lymphoma, gastric cx

Detect with serum IgG & igA or urease test on gastric mucosal biopsy

eradicate w/ clarithromyacin, metronidazole,omeprazole

Make sure it is gone with urea breath test
Lower motor neuron degeneration of middle ages(40-50)
-muscles waste and fasciculate
-foot drop, wrist clumsiness
-Get dysphagia, dysarthria later

Dx: Biopsy see denervation,renervation

**In kids called werdnig hoffman(spinal muscular atrophy) and can move EOM and sphincter only**
Guillian Barre
AI peripheral nerve demyelination seen 1 week after URI or immunization.

Ascending paralysis & weakness(LE then UE)

CSF norm but has high protein

Tx: plasmaphoresis
Myasthenia gravis
Anti Ach receptor Ab in women 20-40.

Biopsy normal

Get weak at end of day,ptosis and diplopia.

Erdophonium/tensilon test(short acting AchE inhibitor) and should get better.

Pyridostigmine(long acting AchE inhibitor) & removal of thymus(get thymomas).
Charcot marie tooth
LE wasting and distal muscle weakness w/o fasciculations

Kid disease and into 20's
Coartation of Aorta
UE HTN, LE hypo, just proximal to L. Subclavian

rib notching

+ association with turner and cerebral aneurysm later in life if not repaired
3 types all treated w/ heme b/c can't make it:

1) Intermittant: N-V-D & abd pain on and off that mimics acute abdomen.

Dx: Urine porphyrin(high D-ALA)

2) erythropoetic: painful skin & swelling at sun exposed areas

Dx:serum or erythrocyte porphyrin

3) Cutanea tarda: Painful blisters at sun exposed regions

Dx: All porphyrin(urine/feces/serum/erythrocyte)
High D-dimer, High PT & PTT
Low fibrin and all other factors
See schistocytes
Thrombocytopenia after viral infection
Thrombocytopenia, ARF, Microangiopathic hemolytic anemia(Coombs -ve, schistocytes, helmet, high LDH), fever, neuro changes
Evans syndrome
TTP with Coombs +ve hemolytic anemia
Euthyroid sick syndrome
clinically Euthyroid but have abnormal TFT's
Subacute thyroiditis
Goiter that is painful post viral infection.

-female w/ other AI diseases
-anti thyroid peroxidase Ab(anti-microsomal).
Left main coronary artery>80% stenosis
Need CABG b/c angioplasty CI as it cuts off blood to heart when balloon filled
malaise, non-bloody diarrhea, abdominal cramps & low grade fever.

2 types both Dx w/ colonoscopy & biopsy:

Crohn: All over(esp mouth) w/ fissure,fistula,skip lesion, well demarcated & cobblestone.
-Low chance of Colon Cx
-Granulomatous disease
-RLQ pain from terminal illeum involvement
Tx: steroids

UC: Only colon & Rectum, pseudopolyps w/ high chance of colon Cx

Tx: Steroids & sulfadiazine
Pseudomembraneous colitis
C.dificile after antibiotics
-Green and foul smelling
-Green/white patches in colon on scoping

Tx: Metro/vanco
Mesenteric Ischemia
Bloody diarrhea w/ abdominal pain. Can be post angioplasty.
Hematemesis in alcoholic w/ liver disease
Probably varice. Find w/ EGD and do banding, vasopressin & sclerotherapy. If this fails use balloon tamponade. Finally if all else fails do TIPS
Marrow fibrotic so see extramedullary hematapoesis and spleen is very large w/ tear drop cells on smear.
High WC count and lymphadenopathy in patient 65+.

See smear cells on biopsy.
Leukemia age ranges
ALL:0-15(Auer rod)
AML:15-40(Auer rod)
CML:40-65(philly 9q to 22q;bcr-abl)
Budd Chiari Syndrome
-Someone who is hypercoagulatable who gets large clot in IVC so get ascites and LE swelling rapidly(2mo vs cirrhosis= years).

-Liver will be smooth(vs cirrhosis nodular)

-Will not have JVD b/c of clot

Tx: Anticoagulate

Hypercoagulatable states:
-Factor 5 leyden
-Protein C&S def
-AT3 def,
-Antiphospholipid Ab
-Pregnant or BC
Necrotizing fascitis
Get laceration then GAS infection all over and signs of septic shock. Skin will be dusky and will have loss of T.Pain and crepitus.

Tx: I&D surgery
Primary sclerosing cholangitis vs Primary biliary cirrhosis
Primary sclerosing Cholangitis
-Young w/ IBD

Get intra and extrahepatic biliary tree fibrosis seen as dilatation and strictures on ERCP. Do liver biopsy to confirm and you will see periductal fibrosis.

Primary biliary cirrhosis
-Anti Mito Ab
-Only affects INTRA-hepatic ducts.

Tx: Cholystyramine
Psoriasic Arthritis
Seen with psoriasis and is in DIP joint w/ nail piting and onchyosis
Swollen monoarticular joint(usually knee) that will have white speckles @ articular cartilage on x-ray due to Ca pyrophosphate crystal deposition. These crystals are weakly birefringent and widen the joint space.
Systolic murmur at Left sternal border. If pulmonary to systemic flow ratio <1.5 leave alone and just give prophylactic Abx before procedures to prevent infective endocarditis.

If P:S ratio >1.5 then may cause pulm HTN-RVH-RH failure & shunt could reverse so surgically repair.
Gram +ve encapsulated rod

Exposure to sheep/cattle/goats

papule to vessicle to black eschar within 2 days

Pen G
-found in

Hydrophobia & neurological

1)Clean wound w/ soap
2)Catch animal
-wild=kill and look at brains
3) Always give Ig and vaccine unless bitten by domestic animal w/ provocation.
-Found in
Unpasteurized milk,cheese,deli meats.

Miscarriage, premie labor, stillbirth
Diseases of Ticks
RMSF(rickettsiae): East coast -headache,malaise,fever-chills
-Rash on extremities palm &soles that spreads to trunk and face

Tx: doxy or chloramphenicol

Lyme disease(Borrelia)
-Ertythema chronicum migrans and migratory arthritis and bells palsy.

Tx: Doxycycline or amoxicillin if pregnant
Diseases of rabbits
Tularemia from tick on rabbit
Diseases from birds
Chlamydia Psittaci atypical pneumonia
Diseases from uncooked pork
1) Toxoplasmosis(cats too)
-Intracranial calcifications

2) Trinchella spiralis (trichinosis)
-muscle pain
-periorbital edema

3) Cysticercosis(T.solium)
-Seizure w/ ring enhancing lesion on CT
Diseaes from uncooked salmon
diphylabothrium latum(B-12 def)
Disease from canned food
Megaloblastic anemia
Hypersegmented neutrophils

Folate: alcohol-phenytoin-phenobarbitol

-pernicious post gastrectomy
-Malabsorption post terminal illeum recetion
-D.latum=uncooked salmon
Metatarsal stress fracture
Seen in runner. Just gie bedrest b/c x-ray will not pick it up.
Ischemic colitis
Abd pain and bloody diarrhea in 60-80 year old

Dx: Barium enema see narrow lumen from edematous mucosa and air in bowel wall.

Surgical resection
Syndromes that are p-ANCA +ve
(Anti-myeloperoxidase Ab)
1) churg strauss: Asthmatic w/ eosinophilia & lung granulomas that have eosinnophils

2) Polyarteritis Nodosa: Fever, abd pain, wt loss, renal dysfunction, peripheral neuropathy