Med-Surg Comprehensive Exam

Front 1

Cardinal Symptoms of Cardiovascular Disease

Back 1

•Chest pain or discomfort
•Dyspnea, orthopnea, paroxysmal nocturnal dyspnea, wheezing
•Palpitations, dizziness, syncope
•Cough, hemoptysis
•Fatigue, weakness
•Pain in extremities with exertion (claudication)

Front 2

Components for differential diagnosis of palpitations

Back 2

•Atrial or ventricular extrasystoles (extra beats)
•Ventricular or supraventricular tachyarrhythmias
•Anatomic abnormalities such as mitral valve prolapse

Front 3

NYHA Class I

Back 3

No limitation of physical activity; no symptoms with ordinary exertion

Front 4

NYHA Class II

Back 4

Slight limitation of physical activity; ordinary activity causes symptoms

Front 5

NYHA Class III

Back 5

Marked limitation of physical activity; less than ordinary activity causes symptoms; ASYMPTOMATIC at rest

Front 6

NYHA Class IV

Back 6

Inability to carry out any physical activity without discomfort; SYMPTOMATIC at rest

Front 7

Acyanotic congential heart disease with a Left-to-Right shunt

Back 7

•Atrial Septal defect
•Ventricular septal defect
•Patent ductus arteriosus

Front 8

Acyanotic congenital heart disease without a shunt

Back 8

•valvular defects (can be valvular, subvalvular, or supravalvular)
•Coarctation (narrowing) of the aorta

Front 9

Cyanotic congential heart disease

Back 9

•Causes decreased pulmonary blood flow
•Tetrology of Fallot

Front 10

Coarctation of the aorta

Back 10

•Fibrotic narrowing of the aortic lumen
•Produces obstruction to LV outflow → LV hypertrophy develops to maintain SV in the face of increased afterload

Front 11

Most common extracardiac abnormality with coarctation of aorta

Back 11

aneurysm of Circle of Willis

Front 12

Pulmonic Valve Stenosis results in:

Back 12

Results in RV hypertrophy

Front 13

Physical exam findings in pulmonic valve stenosis

Back 13

•Physical Exam may reflect right ventricular lift, normal S1, opening click, systolic murmur best heard at left upper sternal border

Front 14

Most common cyanotic congenital heart lesion in adults

Back 14

Tetrology of Fallot

Front 15

Components of Tetrology of Fallot

Back 15

Pulmonic valve stenosis which causes right ventricular outflow obstruction
Ventricular septal defect (VSD) – allowing blood to pass between left and right ventricles; right to left shunt results from right ventricular hypertrophy
Overriding aorta across the VSD -- this aorta is between the left and right ventricles, directly over the VSD; As a result, oxygen poor blood from the right ventricle can flow directly into the aorta instead of into the pulmonary artery to the lungs
Right ventricular hypertrophy -- the right ventricle thickens because the heart has to pump harder than it should to move blood through the narrowed pulmonary valve

Front 16

Atrial Septal Defect

Back 16

Hole or defect in the atrial septum
Symptoms usually secondary to RV dysfunction (fatigue, dyspnea)

Front 17

Ventricular septal defect

Back 17

•Oxygenated blood from LV is shunted through the VSD into the RV
•If defect is large, RV dilates and pulmonary blood flow increases; if uncorrected, pulmonary vascular obstruction could ensue, causing right-to-left shunting and cyanosis (Eisenmenger’s complex)

Front 18

Patent Ductus Arteriosus

Back 18

This opening allows blood to flow directly from the aorta into the pulmonary artery, which can put a strain on the heart and increase the blood pressure in the lung arteries
•Physical exam reflects loud, continuous machinery-like murmur in left infraclavicular region

Front 19

Most reliable enzymes reflecting heart damage

Back 19

•Troponin I and T

Front 20

Cardiac Enzymes

Back 20

Creatine Kinase (MB)
Troponin I and T
Myoglobin
Lactic Dehydrogenase

Front 21

Onset, Peak, Return to normal of Creatine Kinase (MB)

Back 21

Onset: 6-12h
Peak: 24h
Normal: 3-4days

Front 22

Onset, Peak, Return to normal of Troponin I and T

Back 22

Onset: 1-3h
Peak: 24h
Normal: 14-15days

Front 23

Onset, Peak, Return to normal of Myoglobin

Back 23

Onset: 2h
Peak: 6-8h
Normal: 20-36h

Front 24

Onset, Peak, Return to normal of Lactic Dehydrogenase

Back 24

Onset: 24h
Peak: 3days
Normal: 8-9days

Front 25

Echocardiogram

Back 25

•Noninvasive technique to determine heart size, position, chambers, and velocity of blood flow

Front 26

Indications for Echocardiogram

Back 26

suspected valve, chamber disturbances, evaluation of pericardial effusion

Front 27

Indications for cardiac MRI

Back 27

examine size and thickness of heart chambers, determine extent of damage caused by MI or progressive heart disease

Front 28

Contraindications for cardiac MRI

Back 28

implanted metal devices pacemaker
pregnancy

Front 29

Gold Standard for NONINVASIVE cardiac assessment

Back 29

Echocardiogram

Front 30

Indications for Cardiac catheterization

Back 30

suspected myocardial ischemia and/or valvular abnormalities

Front 31

Conditions associated w/ Mitral Valve Prolapse

Back 31

o Marfan Syndrome
o Ehlers-Danlos Syndrome – Types I, II, and IV collagen disorders
o Rheumatic endocarditis
o Acquired collagen-vascular disorders

Front 32

physiolgic consequences of Mitral Regurgitation

Back 32

•Places volume overload on LV; LV responds with hypertrophy and dilation to increase SV; eventually LV dysfunction develops if volume overload is uncorrected

Front 33

Symptoms of Mitral Regurgitation

Back 33

o Dyspnea
o Orthopnea
o PND

Front 34

Physiologic consequences of Mitral Stenosis

Back 34

• Obstruction to LV inflow increases LA pressure and limits cardiac output; mitral valve obstruction increases the pressure work of RV, which is also adversely affected by the pulmonary hypertension that develops

Front 35

Common cause of mitral stenosis

Back 35

rheumatic fever

Front 36

Physiologic consequences of Aortic Stenosis

Back 36

• Pressure overload on the LV with compensation by LV hypertrophy; as disease advances, reduced coronary flow causes angina; hypertrophy and afterload excess lead to systolic and diastolic LV dysfunction

Front 37

Physical exam findings in Aortic Regurgitation

Back 37

o Quinke’s pulse = visible pulse in nail beds
o Corrigan’s pulse = bounding pulse
o Musset’s sign = head nodding with each heartbeat
o Hill’s sign = extremely elevated BP in lower extremities
o Austin Flint Murmur = diastolic “blowing” murmur

Front 38

Quinke’s pulse

Back 38

visible pulse in nail beds

Front 39

Corrigan’s pulse

Back 39

bounding pulse

Front 40

Musset’s sign

Back 40

head nodding with each heartbeat

Front 41

Hill’s sign

Back 41

extremely elevated BP in lower extremities

Front 42

Austin Flint Murmur

Back 42

diastolic “blowing” murmur

Front 43

Physical exam findings in Pulmonic Valve Stenosis

Back 43

o Palpable lift due to RVH
o Loud, harsh systolic murmur
o Murmur increases with inspiration

Front 44

What are the three acyanotic congential heart diseases?

Back 44

Atrial Septal Defect
Ventricular Septal Defect
Patent Ductus Arteriosus

Front 45

What is the most serious complication of statin drugs?

Back 45

Rhabdomyolysis

Front 46

Action of Statins

Back 46

o Inhibit synthesis of cholesterol by cells
o Lower LDL cholesterol
o Promotes LDL clearance

Front 47

What are the 9 valvular diseases?

Back 47

MVP
aortic stenosis
mitral valve stensosis
Mitral regurg
aortic regurg
tricuspid stenosis
pulmonary stenosis

Front 48

What are the three signs and symptoms associated with Printz metals angina

Back 48

Elevated ST,
Symptoms in the morning, Female less than 50

Front 49

What are the three main coronary arterties assoc. with MI?

Back 49

LAD, RCA, and circumflex

Front 50

According to ATPIII (2002) a high risk pt. is what and what is your LDL goal?

Back 50

2 or more risk factors and diabetes, CAD, peripheral disease
LDL goal is under 70

Front 51

What are 4 EKG findings assoc. with MI?

Back 51

Elevated ST
peaked T wave
Q wave development
then t wave inversion.

Front 52

Hallmarks of acute bacterial endocarditis?

Back 52

osler’s nodules
janeway lesions
roth spots on eyes

Front 53

What are 7 lifestyle risk factors in hyperlipidemia?

Back 53

Smoking , diet, sedentary lifestyle, alcohol, elevated Trig., low HDL, metabolic syndrome, HTN (130/85), waist circumference (35 for female, 40 for male), high blood sugar (over 110)

Front 54

First line therapy for MI?

Back 54

MONA= morphine, oxygen, nitroglycerine, aspirin

Front 55

List Duke’s criteria for positive bacterial endocarditis.

Back 55

2 majors
1 major and 3 minors
5 minors

Front 56

Describe Duke's Major and Minor criteria for positive bacterial endocarditis

Back 56

Major: 2 positive blood cultures and evidence of vegetation on prosthetic valve
Minor: predisposing condition, fever, immunologic signs (Osler's nodes, Roth spots, Janeway lesions), positive echo not meeting major criteria

Front 57

What are 7 of the secondary causes of HTN?

Back 57

Pheochromocytoma, kidney dz, diabetic nephropathy, thyroid dz (myxedema), drug reaction, stress, oral contraceptives.

Front 58

What are three uncontrollable risk factors for ischemic heart disease?

Back 58

Age, gender, family history

Front 59

What are the 12 initial labs you are going to order to evaluate HTN?

Back 59

TG’s, LDL, HDL (lipid panel), kidney function, liver function, thyroid test, echo, chest xray, UA, glucose, electrolytes, CBC

Front 60

Whats the drug of choice for acute anginal attack?

Back 60

Sublingual nitroglycerin

Front 61

What antihypertensive medication would you avoid in a pt. with past history of asthma?

Back 61

Beta-blockers

Front 62

According to JNC 7 what are the four bp classifications and what are the systolic and diastolic readings for each?

Back 62

Optimal (<120/80)
Pre HTN (120-139/80-89)
Stage I (140-159/ 90-99) Stage II (>160/100)

Front 63

What are the 9 risk factors for thrombis or embolis?

Back 63

Birth control, sedentary, blunt trauma, Afib, previous DVT or PE, post op lower extremity sx, hyercoaguable state, obesity

Front 64

What are the 8 most common causes of acute pericarditis?

Back 64

Infection (viral, TB, bacteria, fungal)
autoimmune
drug reaction
trauma
post MI
uremia

Front 65

Which AV block is a gradual progression of the PR with at least one non conducted P wave?

Back 65

Mobitz Type I (Weinkebach’s)

Front 66

Describe the electrical conduction of the heart?

Back 66

SA node, propogates to the atrium, AV node, Bundle of his, left and right bundle branches, perkinje fibers

Front 67

What is the most common cause of acute bacterial endocarditis?

Back 67

Staph. Aureus

Front 68

What are the four systems to evaluate for end organ damage for HTN?

Back 68

Kidneys (kidney failure, proteniur, hematuria)
Heart (cardiomegaly (LVH), ischemia, EKG changes)
Brain (stroke, hemorrhage, encephalopathy)
Eyes (copper wire, hemorrhages)

Front 69

Drug of choice for HTN pt. with diabetes?

Back 69

ACE Inhibitor

Front 70

What is the intrinsic rate for SA node, atrial tissue, bundle of His and ventricles?

Back 70

SA is 60 or greater,
atrial is 60 or greater
AV node is 50-60,
Bundle of His is 30-40 Ventricles are less than 30

Front 71

Correlate the electrical components of the heart with the EKG

Back 71

P wave is atrial depol.
QRS is ventricle depol.
T is ventricle repol.
PR interval is conduction through AV node

Front 72

What is the classic EKG finding in most anginas?

Back 72

ST depression (Printzmetals is the only one with elevation)

Front 73

What are the 10 factors associated with the worst prognosis of HTN?

Back 73

Obesity, hyperlipidema, end organ damage, smoking, diastolic blood pressure that is over 115, diabetes, African American, young, male, excess of alcohol intake

Front 74

What is the most common cause of subacute bacterial endocarditis?

Back 74

Strep. Viridans

Front 75

What are the 5 general treatments for CHF?

Back 75

Diuretics, Beta blockers, ACE-I, intrinsic agents, Vasodilators

Front 76

What are the 3 types of cardiomyopathies and what is the most common?

Back 76

Dilated, restrictive, obstructed hypertrophic and non obstructed hypertrophic. Most common is dilated.

Front 77

Which arrythmia is classic for a saw tooth pattern?

Back 77

Atrial Flutter

Front 78

Describe four of the signs & symptoms of Raynaud’s?

Back 78

Vasoconstriction in the hands, aggrevated by cold and stress, gangrene, tingling, white red and blue changes, clubbing of fingers, 2nd-4th decade, females greater than men, worse with smoking and beta
blockers

Front 79

What is the tx. of choice for cardiac tamponade?

Back 79

Pericardiocentesis

Front 80

What are the best post MI management options?

Back 80

Beta blockers, CCB, ACE I, identify the risk factors and control the risk factors, and anti platlet agents (aspirin)

Front 81

What’s the primary organism in acute rheumatic fever?

Back 81

Beta hemolytic Strep

Front 82

In order to diagnosis PE what is the most noninvasive test?

Back 82

Doppler Echo

Front 83

Which AV block has every other P wave non conducted?

Back 83

Mobitz Type II (2nd degree AV block)

Front 84

What's Virchow’s triad?

Back 84

Trauma to vessel, blood stasis and hypercoaguable state

Front 85

Which AV block has every P wave conducted?

Back 85

1st degree AV block

Front 86

AV block where no P waves conducted and requires a pacer?

Back 86

3rd degree

Front 87

What antihypertensive med do u avoid in a pt. with hx. Of gout?

Back 87

Thiazide diuretics

Front 88

On Phys.Exam how would you differentiate ASD,VSD and PDA?

Back 88

ASD is wide fixed
VSD is holosystolic left sternal murmur
PDA is loud continuous machinery murmur on left upper back

Front 89

Gold standard for Pulmonary Embolism

Back 89

Pulmonary Angiography

Front 90

Gold standard for DVT?

Back 90

venogram

Front 91

Criteria of Metabolic Syndrome

Back 91

Any 3 of:
Waist Circumf. (Men > 40in. Women >35 inches)
Triglycerides >/= 150
HDL (Men <40, Women <50)
BP >/= 130/85
Fasting glucose >/= 110

Front 92

ATP III classification of triglycerides

Back 92

Normal <150
Borderline High 150-199
High 200-499
Very High >/= 500

Front 93

Pericarditis: physical findings

Back 93

• Pericardial friction rub
– Scratchy, like creaking leather
– Best heard while patient sitting up, leaning forward, & in full expiration

Front 94

Use of Jones Criteria

Back 94

Diagnosis of Acute Rheumatic fever; Need 2 major or 1 major and 2 minor for diagnosis

Front 95

Major and minor Jones Criteria for Acute Rheumatic Fever

Back 95

Major criteria:
Carditis
Erythema marginatum and subcutaneous nodules Sygenham’s chorea
Polyarthritis
Minor:
Fever, polyarthralgias, reversible prolongation of the PR interval, rapid ESR rate, positive throat culture or rising streptococcal antibody titers

Front 96

most common pathologic condition associated with aortic aneurysm

Back 96

atherosclerosis

Front 97

Cardiac causes of A. Fib

Back 97

Sick Sinus syndrome
HTN
Valvular dz
Ischemic dz

Front 98

Non-cardiac causes of A. Fib

Back 98

Thyroid dz
Alcohol
COPD

Front 99

3 problems caused by A. Fib

Back 99

Thromboembolic events (clots and stroke)
Loss of atrial – ventricular synchrony (atrial kick)
Rapid Irregular Ventricular Rate

Front 100

Mechanism of Atrial Flutter

Back 100

A single reentrant wave of activity circles in the right atrium at ~ 300bpm
the AV node filters the atrial activity resulting in 2:1 or even 3:1 or 4:1 conduction

Front 101

Most common arrhythmia in ASD pts

Back 101

A. fib

Front 102

2nd degree, Mobitz Type 2 AV block

Back 102

At least one non-conducted P wave
No prior PR prolongation preceding block

Front 103

3rd degree AV block

Back 103

No conducted P waves
More P waves than QRS’s
Permanent pacemaker required if chronic

Front 104

Etiology of Cardiac Tamponade

Back 104

MEDICAL EMERGENCY!!compression of heart due to accumulation of fluid in pericardial sac which may lead to hemodynamic compromise

Front 105

Signs & symptoms of Acute Cardiac Tamponade

Back 105

Tachycardia
JVD
Distant heart sounds-also present in subacute
Pulsus paradoxus=Fall in systolic BP by >10mmHg with inspiration

Front 106

Treatment for Cardiac Tamponade

Back 106

pericardiocentesis

Front 107

Physical exam findings of Dilated Cardiomyopathy

Back 107

Enlargement of all cardiac chambers; hypocontractile heart
S3 gallop
Mitral regurgitation may be present due to LV dilation

Front 108

2 common causes of dilated cardiomyopathy

Back 108

Alcoholism
Peri-partum

Front 109

Physical exam findings of Hypertrophic Cardiomyopathy

Back 109

S4 gallop
Heart murmur:
Systolic
Increases with valsalva, standing, post-PVC
Decreases with squatting, beta-blockers
May be confused with aortic stenosis

Front 110

General Principles of CHF Treatment

Back 110

1. Diuretics
2. ACEI/ARB
3. B-Blockers
4. Spironolactone
5. Vasodilators
6. Inotropic agents

Front 111

What drug improves survival rates for pt's post-MI?

Back 111

Beta-Blockers

Front 112

Most important test in diagnosing pericardial effusion

Back 112

Echocardiogram

Front 113

Treatment of pericardial effusion

Back 113

percardiocentesis

Front 114

Etiology of pericardial effusion

Back 114

any cause of pericarditis can lead to pericardial effusion (abnormal amt. of fluid in pericardial space)

Front 115

Describe Osler's nodes and Janeway lesions; What disease are they present in?

Back 115

Osler's nodes = small tender nodules on the finger and toes
Janeway Lesions = small hemorrhages on the palms and soles
Seen in Bacterial endocarditis (acute and subacute)

Front 116

Gold standard for diagnosing myocarditis

Back 116

Biopsy of myocardium

Front 117

Pt. complains of pain, erythema, swelling, swelling is inferior & Medial to the right lower lid, and sup. Lat. to the nose, what is the most likely diagnosis?

Back 117

Dacryocystitis

Front 118

What are the diseases that cause cotton wool spots?

Back 118

Trauma, HIV, Diabetes, HTN

Front 119

What are the four hallmarks for acute glaucoma?

Back 119

Pain, steamy cornea, fixed dialated pupil, red eye

Front 120

Lifeguard who does not wear sunscreen, has a yellow wedge shape growth on the lateral aspect of his eye, affects his cornea, but not the vision?

Back 120

Pterygium

Front 121

What are the six causes of vitreous hemorrhage?

Back 121

Trauma, diabetes, HTN, detached retina, CRVO, bleeding disorders

Front 122

A pt. presents with c/o red eyes, purulent discharge for three days, preauricular lymph nodes enlarged, what is diagnosis?

Back 122

Bacterial Conjunctivitis

Front 123

Open angle glaucoma is usually asymptomatic what is the primary signs you are looking for on physical exam?

Back 123

Cup:disc ratio

Front 124

What are the three most common organisms assoc. with bacterial conjunctivitis?

Back 124

Staph Aureus, Strep. Pneumo, H. Flu

Front 125

Acid burns to the eye have a better outcome than alkaline burns, what sign is a poor prognosis of an acid burn?

Back 125

Blanching of vessels (white); the redder, the better

Front 126

What are the 9 causes of red eye?

Back 126

Conjuctivitis, corneal disease second. to trauma, allergic conjunctivitis, episcleritis, subconjuctivial hemorrhage, scleritis, dry eyes, ant. uveitis, acute glaucoma and blepharitis

Front 127

Pt. presents with severe photophobia, pain and decreased vision in right eye, right pupil is injected and cells in ant. chamber on slit lamp exam what is the diagnosis?

Back 127

Anterior uveitis

Front 128

describe the pathway of the aqueous humor?

Back 128

produced in ciliary body, travels to posterior chamber, thru pupil to anterior chamber thru trabecular meshwork to Canal of Schlemm

Front 129

Which photoreceptor are responsible for differentiating colors?

Back 129

Cones

Front 130

Pt. complains of bloody appearance in sclera only after giving birth to baby two days ago?

Back 130

Subconjuctival hemorrahage (anything that causes increased pressure)

Front 131

What is the most common ocular complication of systemic steroids?

Back 131

Posterior Subcapsular cataract

Front 132

What is the systemic dz associated w/ dry eyes?

Back 132

Sjogren’s syndrome

Front 133

What is one of the major complications assoc. w/ hyphema?

Back 133

Secondary glaucoma

Front 134

What is the primary dz assoc. w/ Argyll Robertson pupil?

Back 134

Tertiary syphilis

Front 135

Drusen’s are assoc. with what disease?

Back 135

AMD (age related macular degeneration)

Front 136

What are the 7 causes of double vision?

Back 136

Head injuries, cataracts, strabismus, lesions that affect CN 2, 4 and 6, amblyopia, misalignment of the eyes, masses or tumors

Front 137

Define hyperopia and kind of lens do you use to correct it?

Back 137

Far-sighted, use convex (plus)

Front 138

What is the medical term for wall eyes?

Back 138

Exotropia

Front 139

What is the normal range for IOP?

Back 139

13 +/- 3 mmHg

Front 140

AMD (age related macular degeneration) is the leading cause of permanent blindness in the elderly what are two of the five risk factors assoc. with AMD?

Back 140

Age over 50, smoking, female gender, family hx

Front 141

What disease is the “cherry red spots” associated with?

Back 141

Central retinal artery occlusion (CRAO)

Front 142

Pt complains of nonpainful nodule on upper eyelid for 6 weeks?

Back 142

Chalazion

Front 143

What organism is most commonly assoc. hordeolum?

Back 143

Staph. Aureus

Front 144

What is the triad of Horner’s syndrome?

Back 144

Myosis, ptosis, and ipsilateral anhydrosis

Front 145

what is the cause of Horner's syndrome

Back 145

Tumor in apex of lung compressing sympathetic chain

Front 146

What are the eleven ocular conditions that are a result of blunt trauma?

Back 146

Retinal detachement, hyphema, and vitreous hemorrahage, acute angle glaucoma, blow out fracture, subconjuctivial hemorrhage, diplopia, ruptured globe, blurred vision, lens dislocation and eye muscle swelling (myoedema)

Front 147

What is the medical term for cross eyes?

Back 147

Esotropia

Front 148

Glaucoma is the leading cause of irreversible blindness in the world, what are the 4 risk factors?

Back 148

Family history, age, elevated IOP, race

Front 149

Which cranial nerve or nerves is responsible for ptosis?

Back 149

CN III-Oculomotor

Front 150

What are the 7 systemic dz’s assoc. w/ optic neuritis?

Back 150

Multiple Sclerosis, Lyme Dz, Syphilis, Sarcoidosis, Wegner’s Granulomatous, SLE, Vit B12 Def

Front 151

A lesion in the optic chiasm results in which visual field defect?

Back 151

bilat temporal vision loss

Front 152

Which CN is responsible for pupil reaction?

Back 152

CN III- Oculomotor

Front 153

A disease that gives you Beriberi is caused by a def. in what?

Back 153

Vit. B1- thiamine

Front 154

What are the 4 main signs and symptoms of a detached retina?

Back 154

Flashing lights, curtain over vision, floaters, decrease in visual fields

Front 155

Which CN is responsible for lid lag (closing of the upper eye lid)?

Back 155

CN VII- Facial

Front 156

Common child hood disease is varicella zoster, name the 5 ocular complications?

Back 156

Conjunctivitis, swollen lids, vesicular lesions, uveitis, optic neuritis

Front 157

What are the 7 conditions that predispose a pt. to corneal infection?

Back 157

Corneal abrasion, contact lens wearer (no.1), trauma, structural eyelid abnormality, exotropia, esotropia, dry eyes, chronic epithelial disease, topical medication toxicity, immunosupression

Front 158

Pt. presents with c/o painful red nodule on right upper lid for three days, no change of vision, what is most likely diagnosis?

Back 158

Hordeolum

Front 159

What are three of five symptoms for keratoconjuctivitis sicca?

Back 159

Irritation, redness, dryness (this is dry, scratchy eyes)

Front 160

What are the 3 CN responsible for eye movements?

Back 160

CN III, IV, VI

Front 161

What are the 2 most common organisms found in orbital cellulitis?

Back 161

Step. Pneumonia, H. Flu

Front 162

What are the 8 causes of papillodema?

Back 162

HTN, cerebral tumor, abscesses, subdural hematoma, AV malformation, meningitis, encephalitis, subarachnoid hemorrhage

Front 163

A pt. presents with red eyes, watery discharge for 2 days, no allergy symptoms, what is the most likely diagnosis?

Back 163

Viral conjunctivitis

Front 164

Which pathogen is a zanck smear used to detect?

Back 164

Herpes

Front 165

What is the most worrisome side effect of isotreniton (accutane)?

Back 165

Birth defects- also want to test liver and lipids

Front 166

Name the two pathogenic types of contact derm

Back 166

Irritant and allergic (irritant will be more localized to where the thing touched the person)

Front 167

Molluscum contagiosum- is it a wart?

Back 167

No- it is a viral infection caused by the pox virus

Front 168

Which bacteria is the most common cause of skin infection?

Back 168

Staph. Aureus

Front 169

Which skin lesion is associated with a pos. dimple sign?

Back 169

Dermatofibroma

Front 170

What is the most common cause of acute urticaria?

Back 170

Allergic reaction

Front 171

Hanson’s disease is also known as?

Back 171

Leprosy

Front 172

What disease process is characterized by skin that is smooth, ivory colored and tight along the fingers with violaceous streaks?

Back 172

Scleroderma

Front 173

What drug is usually associated with erythema nodosum?

Back 173

Birth control pills- most commonly seen in young women- it is tiny red nodules on the tibia

Front 174

What is the most common pustular skin eruption?

Back 174

Acne vulgaris

Front 175

Name a medical condition that is associated with really bad seb. Derm.?

Back 175

HIV, Parkinson’s disease

Front 176

Name the disease associated with the term spaghetti and meatballs

Back 176

Tinea (any type) and it represents the budding hyphae

Front 177

What is the name of the skin condition that will fluoresce coral red under the lamp?

Back 177

Erythrasma

Front 178

MOHS surgery is used to treat what?

Back 178

Basal Cell Carcinoma

Front 179

What is the proper medical term for a skin tag?

Back 179

Acrochordon

Front 180

What is the pathological condition of pulling all your hair out?

Back 180

Trichlilomania

Front 181

What is the rash of lyme disease called?

Back 181

Erythema migrans

Front 182

Name the disease characterized by superficial, stuck on honey colored crust?

Back 182

Impetigo

Front 183

What is alopecia totalis?

Back 183

Loss of hair over the entire body

Front 184

In dealing with topical steroids, category 1 is in low potency or super potency?

Back 184

Super Potency

Front 185

What is the most common cause of green nails?

Back 185

Pseudomonas infection

Front 186

What is the official dermatological terminology for slapped cheeks disease?

Back 186

Fifth’s disease, erythema infectiosum, parvovirus (B19)

Front 187

Which virus causes purpura of the hands and feet in children?

Back 187

Parvovirus B19

Front 188

In little kids, blisters on palm and soles of feet and sometimes in mouth (hand, foot and mouth disease) is caused by what virus?

Back 188

Coxsackie virus

Front 189

Broken shafts of hair are pathopneumonic for what condition?

Back 189

Tinea capitis

Front 190

What class of drugs is the most common cause of anaphylaxis?

Back 190

Penicillins

Front 191

Which class of drugs commonly causes angioedema?

Back 191

ACE-I

Front 192

What compound causes the most cases of contact derm?

Back 192

Nickel

Front 193

In atopic derm. which comes first, the rash or the itch?

Back 193

The itch (it’s called the itch that rashes)

Front 194

What derm. condition has either the Kevner’s phenomenon or the Auspitz’s sign?

Back 194

Psoriasis- Auspitz’s is when you scrape it and underneath they have little tiny specks of bleeding. Kevner’s phenomenon is the predilection to lichenification

Front 195

What is the diagnostic test of choice for a pt. presenting with a suspected syphilis chancre on his penis?

Back 195

Dark field microscopy- look for spirochetes under the microscope

Front 196

This lesion is flat, circumscribed skin discoloration that lacks elevation or depression?

Back 196

Macule

Front 197

In what stage of syphilis do you see neurologic symptoms?

Back 197

Tertiary

Front 198

Treatment for leprosy (Hansen’s Disease)?

Back 198

Rifampin, Dapsone

Front 199

What is the vector for leichmeniasis?

Back 199

Sand fly

Front 200

Give three cutaneous side effects from topical steroids?

Back 200

Atrophy of skin, hypopigmentation, striae, increased incidence of infection

Front 201

What are the 4 charc. Noted on a Tympanic Membrane exam?

Back 201

Pearly grey tympanic membrane, landmarks (cone of light, malleus, umbo), intact Pars flaccida and Pars Tensa, make sure the tympanic membrane is mobile

Front 202

What are the 12 systems you examine in a head and neck exam?

Back 202

ears, nose, throat, thyroid, lymph nodes, sinuses, oral pharynx, nasal pharynx, larynx, face, neck scalp, skin, and neuro

Front 203

Whats the frequency of the tuning fork you use for weber and renee?

Back 203

512 mHz

Front 204

Name 5 drugs that leads to ototoxic hearing loss?

Back 204

Salicylates, asa, loop diuretics, erythromycin

Front 205

What is bell’s palsy?

Back 205

Idiopathic, unilateral facial droop. It’s sudden onset, usually after viral syndrome

Front 206

What is the most common cause of conductive hearing loss in adults?

Back 206

Cerumun impaction

Front 207

Five indications of bilateral PE tubes?

Back 207

Chronic OM lasting over 3 months, hearing loss over 30 decibles, 3 infections in 6 months, poor response to antibiotics, complications

Front 208

5 complications to untreated OM?

Back 208

sensiorneural Hearing loss, mastoidis, parotitis, labrynthitis, tympanic perforation, cholesteoma, meningitis, brain abcess

Front 209

5 symptoms for cholesteoma?

Back 209

Progressive conductive hearing loss, crusting form tympanic perforation, TM perforation, chronic ear infections

Front 210

What are the 9 major causes of sensiorneural hearing loss?

Back 210

Presbycupia, hereditary, occ. Noise exposure, oto toxicity of drugs, immune related, idiopathic, Menieres, infections

Front 211

What is otomycosis and how is it treated

Back 211

Fungal infection of the ears and treat with antifungals (topical)

Front 212

What are the 5 ENT differential diagnosis for dizziness?

Back 212

Meiniere’s, aucostic neroma, viral labryntthisi, benign parxosysml postional vertigo, migraines

Front 213

What are the three most common causes of traumatic tympanic perforation?

Back 213

Trauma (head slap), foreign body, gun fire

Front 214

What is dix hall- pike maneuver used for?

Back 214

This is testing for benign paroxysmal positional vertigo

Front 215

What is the most common site for ant. Epistaxis and what is the most common cause?

Back 215

Kesselbachs and trauma (digital)

Front 216

What are salute signs and allergic shiners and first step for TX

Back 216

Allergic Rhinitis and removing allergic agent (environment)

Front 217

Why are younger children predisposed to Otitis Media

Back 217

Their Eustachian tube is more horizontal and adult becomes wider and more angled.

Front 218

What three organisms are most common cause of OM?

Back 218

Strep Pneumo, H. flu, Moraxella Catarrhalis

Front 219

Whats the first line of treatment for AOM

Back 219

Amoxicillin or Augmentin

Front 220

What is the Meinere’s triad?

Back 220

Vertigo, tinnitus, progressive permanent hearing loss

Front 221

What is the treatment for motion sickness

Back 221

Scopolamine patch

Front 222

What are three oral cancers of the oropharynx

Back 222

Squamous cell carcinoma, leukoplakia, erythroplakia

Front 223

What are the nine common causes of salivary gland enlargement?

Back 223

Silothiasis, paromyxovirus (mumps), morten’s duct stones, tumors, TB, lead toxicity, alcoholism

Front 224

What is Sampter’s triad?

Back 224

Aspirin allergy, rhinitis (polyposis), asthma. Also watch these people for urticaria

Front 225

What is thrush? Whats the most common cause in children? And how is it diagnosed?

Back 225

It’s a yeast infection (oral candidiasis) and usually caused in children from overuse of antibiotics and diagnosed b/c you can scrape off with tongue depressor and do KOH stain

Front 226

Whats the most common sinusitis and whats the three most common bacterial causes and whats the drug of choice?

Back 226

Maxillary sinus. Strep. Pneumo, H. flu, Moraxella Catarrhalis, drug of choice is Augmentin or Amoxicillin

Front 227

Pt. presents with trismus, uvular deviation, dysphonia, hot potato voice, drooling and fever, what is diagnosis?

Back 227

peritonsillar abcess
tx is I&D

Front 228

What are the 10 most common causes of hoarseness?

Back 228

Laryngyl cancer, tonsillitis, vocal fold mucocele, nodule, polyp, cyst, hypothyroidism, sinusitis with Post nasal drip, GERD, recent intubation

Front 229

What are the 6 signs and symptoms of Croup and whats the most common cause?

Back 229

Barking cough, inspiratory stridor, fever, steeple sign, n/v, child b/w 3-6 yo, occurs in fall and winter Most common cause is parainfluenza.

Front 230

S&S of epiglottis?

Back 230

Drooling, tripod, appears ill. Most common organism is H. influenza. This is a medical emergency. Have to keep quiet

Front 231

Which type of leukemia is identified by a smudge cell?

Back 231

CLL

Front 232

Which leukemia has the philidelphia chromosome?

Back 232

CML

Front 233

Which of the leukemias has the best cure rate?

Back 233

ALL

Front 234

What is the life span of the RBC in a patient with sickle cell?

Back 234

14 days

Front 235

What is the definitive test to diagnose sickle cell?

Back 235

Hemoglobin electrophoresis

Front 236

In the diagnosis of multiple myeloma what is the definitive abnormal protein that defines MM?

Back 236

Bence Jones proteins in urine

Front 237

What is the most common presenting symptom in patients with MM?

Back 237

Bone pain

Front 238

Name a drug that has received FDA approval to reduce breast cancer risks that are at increased risk for breast cancer?

Back 238

Tamoxifen

Front 239

What is the most common malignancy of the oral pharynx?

Back 239

Squamous Cell Carcinoma

Front 240

How is cervical cancer diagnosed?

Back 240

Tissue biopsy

Front 241

Women w/ Sickle cell anemia who use Oral contraceptives are at higher risk for?

Back 241

thromboembolism and MI

Front 242

What cell is pathopneumonic for hodkin’s disease?

Back 242

Reed Sternberg cell ("eye" cell)

Front 243

In what bone is osteosarcoma most commonly found in?

Back 243

Femur

Front 244

lay term for nephroblastoma?

Back 244

Kidney tumor (Wilm’s tumor)

Front 245

What is the single best test to discriminate b/w iron def. anemia and anemia of chronic disease?

Back 245

Ferritin

Front 246

What does the MCV have to be to be a megaloblastic anemia?

Back 246

Greater than 100

Front 247

What are seven cancer screening tests as the pop. ages for people that are at average risk

Back 247

Colonoscopy, pap smear, mammogram, PSA, DRE, fecal occult blood test and a clinical breast exam

Front 248

What is the most common presentation for esophageal cancer?

Back 248

Dysphagia

Front 249

What is the primary treatment for tumors of the colon and rectum?

Back 249

Excision

Front 250

3 pop. susceptible to Iron def. anemia

Back 250

Women of child bearing age, toddlers, adolescent females (also vegetarians)

Front 251

Clinical signs of Iron def. anemia:

Back 251

Pica (eating clay,paper,coal), glottitis, angular chelitis (corner of mouth irritation), kolionychia(spoon shaped nails), pallor, fatigue, decrease exercise tolerability

Front 252

Side Effects of oral iron supplement

Back 252

Consitipation, abdo. Pain, diarrhea

Front 253

Megaloblastic anemia is def. of what? Found in whom?

Back 253

B12 and Folate: Found in alcoholics and pernicious anemia

Front 254

What is Schilling test used to diagnose?

Back 254

Pernicious Anemia

Front 255

What is G6PD deficiency?

Back 255

genetic disorder common in African Americans
Medications like antimalarial drugs (primaquine) and sulfonamides will cause hemolysis (jaundice, pallor, back pain, and dark urine); G6PD is an enzyme for red cell integrity; deficiency results in acute hemolytic anemia with hemoglobinuria

Front 256

Patient with sickle cell will have what type of anemia symptoms?

Back 256

Mild until crisis

Front 257

What is polycythemia?

Back 257

Increase in cells, increase in hematocrit and platlets

Front 258

What is Wilson’s disease

Back 258

Copper accumulation in tissues

Front 259

Patient pop. suspect for Hodgkin’s disease:

Back 259

bimodal: 15-40 and greater than 55

Front 260

Area of oral cavity most associated with malignancy

Back 260

Lips

Front 261

Most common causes of esophageal cancer

Back 261

smoking and alcohol

Front 262

Most common virus implicated in aplastic crisis of sickle cell anemia?

Back 262

Parvovirus (B19- fifth’s disease)

Front 263

Treatment for sickle cell crisis

Back 263

oxygen, hydration and pain control

Front 264

Most common cause of sudden death in MI

Back 264

V.Fib

Front 265

photoreceptor most sensitive to light

Back 265

Rods

Front 266

Area of eye with highest concentration of cones

Back 266

macula

Front 267

What is myopia and what kind of lens corrects it?

Back 267

Near sighted; Minus lens (concave lens)

Front 268

Eye condition containing drusens

Back 268

AMD (Age related macular degeneration)

Front 269

S&S of AMD

Back 269

Loss of central vision
Assoc. w/ aging

Front 270

leading cause of blindness in patients >65 y/o

Back 270

AMD

Front 271

Differentiate between "wet" and "dry" drusen

Back 271

Wet = white and exudative
Dry = yellow and non-exudative

Front 272

Crucial test for wet drusens in AMD

Back 272

Fluorescein Angiography

Front 273

What is amblyopia?

Back 273

Lazy Eye

Front 274

Differentiate between anterior and posterior uveitis

Back 274

Anterior= Inflammation of the iris and ciliary body
Posterior= inflammation of the choroid

Front 275

2 diseases assoc. w/ anterior uveitis

Back 275

Herpes Zoster and Sarcoidosis

Front 276

Most common cause of anterior uveitis

Back 276

Trauma

Front 277

Used to measure gas diffusion in lungs

Back 277

Carbon Monoxide (CO)

Front 278

Total lung capacity

Back 278

Vol. in lungs at end of maximum inspiration (IRV + TV + ERV + RV)

Front 279

Tidal Volume

Back 279

Air inspired or expired during normal respiration

Front 280

Inspiratory Reserve Volume

Back 280

Add'l air that can be inhaled after tidal breath in

Front 281

Functional Residual Capacity

Back 281

Amount of air left in lung at end of normal breathing exhalation (ERV + RV)

Front 282

Vital Capacity

Back 282

Amount of air that can be forced out after maximum inspiration (IRV + TV + ERV)

Front 283

Residual Volume

Back 283

Amount of air left in lung after maximum exhalation

Front 284

Inspiratory capacity

Back 284

volume that can be inhaled after a tidal breath out (TV + IRV)

Front 285

Expiratory Reserve Volume

Back 285

Amount of additional air that can be breathed out after normal expiration

Front 286

Oxygen is transported in the blood by

Back 286

Either dissoved in plasma or bound to hemoglobin

Front 287

Oxygen content in the blood depends on:

Back 287

Arterial PO2 and hemoglobin level

Front 288

Tissue oxygen delivery depends on:

Back 288

Oxygen content in the arterial blood and cardiac output

Front 289

CO2 is carried in blood as:

Back 289

HCO3- or CO2 dissolved in plasma

Front 290

True or False: Disorders that affect the airway reduce the diffusing capacity of Oxygen

Back 290

False; only disorders that affect the lung tissue (parenchyma) will reduce the oxygen diffusion capacity

Front 291

What are the normal values for arterial blood gases - pH, PaO2, PaCO2, HCO3

Back 291

pH 7.35-7.45
PaO2 >80 mmHg
PaCO2 35-45 mmHg
HCO3 24-28 mEq/L

Front 292

Describe the relationship between pH and PaCO2

Back 292

They are INVERSELY related; when PaCO2 increases, then pH decreases (acidic)

Front 293

Describe the relationship between pH and HCO3-

Back 293

They are DIRECTLY related; when HCO3- increases, then pH increases (Basic)

Front 294

Describe the level of pH, CO2, and HCO3- in Respiratory Acidosis

Back 294

pH is decreased
CO2 is increased
HCO3- is increased

Front 295

Describe the level of pH, CO2, and HCO3- in Respiratory Alkalosis

Back 295

pH is increased
CO2 is decreased
HCO3- is decreased

Front 296

Describe the level of pH, CO2, and HCO3- in Metabolic Acidosis

Back 296

pH is decreased
CO2 is decreased
HCO3- is decreased

Front 297

Describe the level of pH, CO2, and HCO3- in Metabolic Alkalosis

Back 297

pH is increased
CO2 is increased
HCO3- is increased

Front 298

Condition that is assoc. with an elevated anion gap

Back 298

Metabolic acidosis (anion gap >12; normal is 10-12 mEq/L)

Front 299

How do you calculate anion gap

Back 299

Na - (Cl + HCO3)

Front 300

MUDPIES

Back 300

pneumonic for causes of anion gap indicating metabolic acidosis:
Methanol
Uremia (renal failure)
Diabetic Ketoacidosis
Paraldehyde
Infarction (MI) or Isoniazid (TB tx)
Ethylene glycol
Salicylate

Front 301

Valuable tool in characterizing diseases of the chest wall, pleura, hilum, and mediastinum

Back 301

Computed tomography (CT)

Front 302

Use for bronchoscopy

Back 302

visualization of airways - foreign body
mucous plug visualization

Front 303

Use of Thoracocentesis

Back 303

Used to remove air or fluid from pleural space
Frequently used in pleural effusion

Front 304

Name 3 categories of info given by Pulmonary function tests

Back 304

Lung volumes
Flow rates
diffusing capacity

Front 305

What is FEV1/FVC and what does it indicate?

Back 305

The ratio of forced expiratory volume in 1 second and forced vital capacity;
Indicates OBSTRUCTION to airflow

Front 306

What happens to FEV1, FEV1/FVC, and RV in obstructive dz's such as COPD or Asthma

Back 306

FEV1 decreases
FEV1/FVC decreases
RV increases (due to increased lung volume)
Flow rate decreases

Front 307

What happens to FEV1/FVC and TLC in restrictive dz's such as Cystic fibrosis

Back 307

FEV1/FVC remains normal
TLC decreases
Diffusion capacity decreases

Front 308

Clinical features of pulmonary effusion

Back 308

dyspnea
pleuritic chest pain
dullness to percussion
decreased tactile fremitus
decreased breath sounds
pleural friction rub

Front 309

Clinical features of pneumothorax

Back 309

acute onset of chest pain
dyspnea
decreased breath sounds over affected area
Hyperresonant to percussion

Front 310

Physiolgic conditions that cause Metabolic Acidosis

Back 310

This is assoc. w/ an accumulation of acids and/or a loss of a buffer
Diarrhea—loss of bicarbonate
• Renal failure—inadequate formation and reabsorption of bicarbonate and the inability to excrete acids
• Accumulation of organic acids
• Certain drugs—salicylates, methanol

Front 311

Physiolgic conditions that cause Metabolic Alkalosis

Back 311

This is associated with an accumulation of bicarbonate and/or a decrease in acid
• Vomiting—loss of stomach acid
• Nasogastric suctioning—again, loss of stomach acid
• Loss of potassium
• Exogenous alkali—use of NaCO3 (baking soda), antacids
• Drugs—diuretics, corticosteroids

Front 312

Acute bronchitis is usually caused by

Back 312

Virus (95% of the time)

Front 313

S&S of acute bronchitis

Back 313

Productive Cough (worse lying down & at night)
• Malaise
• Variable crackle, rhonchi & wheezing up to 6 weeks
• Fever absent or mild
• Fever may be prominent with H. flu

Front 314

Describe sputum production in acute bronchitis

Back 314

Initially, dry & nonproductive, small amount sputum
After a few hrs or days, sputum more abundant & mucoid

Front 315

Most common type of lung cancer

Back 315

adenocarcinoma

Front 316

Most aggressive and easily metastasizing lung cancer

Back 316

small cell (oat cell) carcinoma

Front 317

Describe exudative pleural effusion

Back 317

occurs when LOCAL factors change the formation and absorption of pleural fluid
Examples: TB, hemorrhage, malignant neoplasm

Front 318

Describe transudative pleural effusion

Back 318

occurs when SYSTEMIC factors change formation & absorptio of pleural fluid
Examples: CHF, Cirrhosis, nephrotic syndrome

Front 319

clinical sign of tension pneumothorax

Back 319

Trachea deviated to unaffected side due to positive pressure from pneumothorax

Front 320

Hyaline Membrane Disease

Back 320

Disease of infants that do not have enough surfactant;
also called respiratory distress syndrome

Front 321

Tumor that causes Horner's syndrome

Back 321

Pancoast Tumor (apical lung tumor)

Front 322

What causes Mesothelioma

Back 322

Asbestosis exposure

Front 323

What is Hamartoma

Back 323

Benign mass in lung composed of normal tissue

Front 324

What is characterized by "popcorn calcification" in the lung on CXR

Back 324

Hamartoma

Front 325

Empyema

Back 325

pus in the pleural space

Front 326

What is a chronic multisystem dz where abnormal collections of inflamm. cells (granulomas) form in many organs of the body?

Back 326

Sarcoidosis

Front 327

Hampton's Hump and Westermark's Sign on CXR are hallmarks for what condition

Back 327

Pulmonary Embolism

Front 328

What is a laboratory test used to detect DVT/PE

Back 328

d-dimer

Front 329

Hallmark of Sarcoidosis

Back 329

Lofgrens Syndrome (Erythema Nodosum on lower extremities and Bilateral hilar adenopathy)
Noncaseating epitheloid granulomas
Polyarthritis

Front 330

Nodular opacities and eggshell calcifications of hilar lymph nodes on CXR is indicative of?

Back 330

Silicosis

Front 331

Lung condition caused by exposure to silica thru mining, stone cutting, and sand blasting that is rapidly fatal?

Back 331

Silicosis

Front 332

S&S of Foreign body aspiration

Back 332

wheezing
non-productive cough
decreased breath sounds
stridor
dyspnea
cyanosis

Front 333

Hereditary dz that causes certain glands to produce abnormal secretions resulting in tissue and organ damage

Back 333

Cystic Fibrosis

Front 334

GI problems in Cystic Fibrosis

Back 334

Pancreatic insufficiency
Protein & Fat malabsorption
Frequent bulky, foul-smelling stools
Vit. E & K deficiency

Front 335

Diagnostic test for CF

Back 335

Sweat Test to analyze Na & Cl levels

Front 336

Most common cause of Pulmonary HTN

Back 336

Left Heart Failure

Front 337

Controller of choice for asthma

Back 337

Inhaled corticosteroid

Front 338

Hallmarks of COPD

Back 338

EXPIRATORY FLOW LIMITATION
• Compromises ability of pt to expel air
• Hyperinflation and air trapping occurs
• Rib cage reconfigures over time
• Ventilatory muscles adapt temporarily

Front 339

Tx's of COPD based on stages of FEV1

Back 339

Stage I (>50%) Short acting B2 agonist PRN
• Stage II (35-49%) Add Anticholinergic
• Stage III (<35%) Add long acting B2 agonist and/or SR theophyline – consider oral glucocorticoid

Front 340

Cor Pulmonale

Back 340

Right ventricular hypertrophy caused by any factor that increases pulmonary artery pressure e.g. PE, COPD

Front 341

2 conditions that make up COPD

Back 341

Ephysema
Chronic Bronchitis

Front 342

pathogen that causes Croup

Back 342

Parainfluenza Virus type 1

Front 343

"Hour glass" and "Steeple Sign" are indicative of?

Back 343

Croup

Front 344

barking, spasmodic cough followed by horseness usually seen at night accompanied by stridor, rhonchi, and wheezes

Back 344

Croup

Front 345

Disease with airway narrowing (which increases airway resistance), Barrel-chest,and Decrease in elastic recoil and collapse of airways during exhalation

Back 345

Emphysema

Front 346

"pink puffers"

Back 346

Emphysema

Front 347

"Blue bloaters"

Back 347

Chronic Bronchitis

Front 348

Infant w/ Cyanosis,Flaring nostrils, Tachypnea, Grunting sounds with breathing, Chest retractions

Back 348

Hyaline Membrane Dz (Resp. Distress Syndrome)

Front 349

S&S of Influenza

Back 349

Sudden chills & fever, malaise & myalgias, sore throat, severe headaches, weakness, coughing

Front 350

Cough producing foul-smelling sputum (feculent)

Back 350

Lung abcess

Front 351

Bronchiectasis

Back 351

Chronic dilatation of bronchi or bronchioles as a sequel of inflammatory disease or obstruction.

Front 352

hallmarks of Asthma

Back 352

decrease in airway diameter
• increased airway resistance
• airway obstruction

Front 353

Clinical features of asthma

Back 353

Cough
• Dyspnea
• Chest tightness
• Wheezing

Front 354

Common causes of fungal pneumonias

Back 354

histoplasmosis, cryptococcosis, aspergillosis

Front 355

Coal Miner's Lung

Back 355

Pneumoconiosis/Silicosis

Front 356

Pneumonia

Back 356

An acute infection of lung parenchyma including alveolar spaces & interstitial tissue

Front 357

Cough (sounds like a whooping sound),Sneezing, Low grade fever, Rhinorrhea, Conjunctivitis and increased lacrimation are indicative of what condition?

Back 357

Whooping cough (Pertussis)

Front 358

An infectious atypical pneumonia transmitted to humans by birds thru inhalation of dried excrement

Back 358

Chlamydia psittaci

Front 359

Most common cause of Community Acquired Pneumonia

Back 359

Streptococcus Pneumoniae

Front 360

3 typical organisms implicated in community acquired pneumonia

Back 360

1. Streptococcus pneumoniae 40-60%
2. Haemophilus influenzae
3. Staphyloccus aureus

Front 361

S&S of Comm. Acq. Pneumonia

Back 361

Abrupt onset
–Fever / chills
–Cough with purulent sputum
–Pleuritic chest pain
–Tachycardia / tachypnea

Front 362

Organism of ATYPICAL CAP

Back 362

Mycoplasma pneumoniae

Front 363

most common respiratory infection in 5 - 35 y.o., students and military

Back 363

Atypical CAP (walking pneumonia)

Front 364

Most common fungal infection in AIDS pts

Back 364

Pneumocystis carinii pneumonia(PCP)

Front 365

Most common organisms of HAP (hospital acquired pneumo)

Back 365

Pseudomonas aeruginosa and Staph. Aureus

Front 366

Red Currant Jelly sputum indicates what organism?

Back 366

Klebsiella Pneumoniae

Front 367

Severe pneumonia seen in older men from the air conditioning, in patients > 50 y/o and smokers

Back 367

Legionella pneumophila

Front 368

Most common cause of bronchiolitis and pneumonia among infants and children under 1 year of age

Back 368

Respiratory syncytial virus (RSV)

Front 369

Tx for CAP

Back 369

Cephalosporins (Rocephin)
• Fluoroquinolones (Cipro)
•Macrolide/Azalides/Ketolides (Zithromax)
• Aminopenicillins (Augmentin)
• Tetracyclines (Doxycycline)
• TMP/SMX (Bactrim

Front 370

Useful screening tool to R/O PE

Back 370

V/Q scan (ventilation/perfusion scan)

Front 371

Gold Standard for detecting Pulm. Embolism

Back 371

Pulmonary angiography

Front 372

Organism that causes TB

Back 372

Mycobacterium tuberculosis

Front 373

S&S of TB

Back 373

• weight loss
• Fever
• Cough
• night sweats
• Hemoptysis

Front 374

Interpretation of positive PPD test for HIV, high risk settings, no risk factors

Back 374

Must be indurated to be positive
• 5 mm or greater if HIV positive or immunosuppressed
• 10 mm or greater in high risk setting
• 15 mm or greater if no known risk factors

Front 375

Trench Mouth, Vincent’s angina is?

Back 375

Acute Necrotizing Ulcerative Gingivitis

Front 376

“Punched out” ulcerations on interdental papillae, Spontaneous bleeding,Odor, and Pain are indiciative of?

Back 376

Acute Necrotizing Ulcerative Gingivitis

Front 377

Most common pathogens causing acute otitis media

Back 377

Strep Pneumonia
H. Influenza
Moraxella catarrhalis

Front 378

S&S of Acute OM

Back 378

•Otalgia
•Otorrhea
•Hearing loss

Front 379

Condition that lasts up to 4 weeks with complete resolution of symptoms characterized by Facial pain/pressure, Nasal congestion/discharge and Cough

Back 379

Acute Sinusitis

Front 380

Allergic shiners, Allergic salute (salute sign), Allergic crease (nose), Adenoid facies, and Denie’s line are hallmarks of?

Back 380

Allergic Rhinitis

Front 381

Ulcers located on lip and gingival mucosa with raised yellow borders with surrounding erythema

Back 381

Apthous Ulcer (Canker sore)

Front 382

Small, red, pink dome shaped lump with pearly borders

Back 382

Basal Cell Carcinoma

Front 383

Facial Drooping due to damage of facial nerve (VII)

Back 383

Bell's Palsy

Front 384

Ear condition that starts after latency period, Crescendo-decrescendo manner, Lasts 20-30 seconds, Nystagmus, but No hearing Loss

Back 384

BPPV (benign paroxysmal positional vertigo)

Front 385

Cancer Risk Factors

Back 385

Tobacco
Alcohol
Sunlight Exposure
Age
Gender
Race

Front 386

White plaques easily removed
Can be seen after treatment with antibiotic
Can be seen after chronic treatment with steroids
Common in pts with diabetes or HIV
Common in infants

Back 386

Oral Candidiasis (thrush)

Front 387

Often first sign of HIV infection

Back 387

Oral candidiasis (thrush)

Front 388

S&S of chronic OM

Back 388

Perforation
Discharge
Mastoiditis
Hearing Loss

Front 389

Unilateral facial swelling lateral to nose with redness & typical loss of the nasolabial fold

Back 389

Dental abcess

Front 390

Organism that causes membranous pharyngitis

Back 390

Diphtheria (Corynebacterium diphtheriae)

Front 391

"thumb sign" is hallmark of

Back 391

Epiglottitis

Front 392

Procedure to remove insect from ear

Back 392

apply lidocaine before irrigation

Front 393

Child presents with a purulent unilateral nasal discharge

Back 393

Foreign body

Front 394

Organism that causes Herpangina

Back 394

Group A coxsackieviruses

Front 395

Painful vesiculoulcerative mucosal lesions most commonly in infants & children on soft palate or tonsils

Back 395

Herpangina

Front 396

Most common neck space infection life-threatening, bilateral, cellulitis of the sublingual & submandibular spaces that usually starts in an infected lower molar and may cause airway compromise

Back 396

Ludwig's Angina

Front 397

History of increasing ear fullness, Roaring tinnitus followed by a sensation of blocked hearing, nausea, vomiting, and lasting more than 20 min

Back 397

Meniere's dz

Front 398

The eardrum becomes inflamed, and small, fluid-filled blisters (vesicles) form on its surface & caused by mycoplasma

Back 398

Myringitis

Front 399

Painful blisters & vesicular lesions along the vermilion border

Back 399

Oral herpes simplex (HSV-1)

Front 400

Any white lesion that cannot be removed by scraping the mucosal surface (unlike candidiasis)

Back 400

Oral Leukoplakia (can be pre-cancerous)

Front 401

Similar to leukoplakia except has a definite erythematous component and often becomes cancerous

Back 401

Oral Erythroplakia

Front 402

Most common pathogen of Otitis Externa

Back 402

Pseudomonas Aeruginosa

Front 403

Acute or chronic, aggressive, invasive, & destructive inflammatory process of the ear canal commonly caused by Pseudomonas Aeruginosa

Back 403

Malignant (Necrotizing) OE

Front 404

Organism that causes Mumps (parotitis)

Back 404

Paramyxovirus

Front 405

painful enlargement of salivary glands, most commonly the parotids, with pain on chewing or swallowing acidic liquids such as vinegar or lemon juice

Back 405

Parotitis (Mumps)

Front 406

Long term complication of Mumps

Back 406

Sterility

Front 407

Severe sore throat, Uvula deviation, and “hot-potato” voice are characteristic of?

Back 407

Peritonsillar Abcess (Quinsy's Abcess)

Front 408

Organisms implicated in Pharyngitis & Tonsillitis

Back 408

Group A Beta Hemolytic Strep

Front 409

Criteria to determine presence of Group A Beta Hemolytic Strep in Pharyngitis

Back 409

1. Fever
2. Adenopathy
3. Exudate
4. No cough or rhinorrhea

Front 410

associated with Varicella-zoster virus (VZV), Painful red rash with fluid filled blisters on the eardrum, external ear canal, roof of the mouth or tongue, Facial palsy on the same side as the affected ear, Difficulty closing one eye, Hearing loss, Tinnitus, Vertigo, Loss of taste are symptoms of?

Back 410

Ramsey-Hunt Syndrome

Front 411

an infection with group A streptococcus bacteria that can cause the scarlet-colored rash with classic red streaks that turn white when you press on them

Back 411

Scarlet Fever

Front 412

Most common pathogens in acute sinusitis

Back 412

Streptococcus Pneumoniae
Haemophilus influenza
Moraxella Catarrhalis

Front 413

Swelling in submandibular area that starts after a meal
Purulent D/C from Sialolith in salivary duct
Pain & swelling eating tart foods

Back 413

Sialadenitis

Front 414

This virus is assoc. w/ Oral Hairy Leukoplakia

Back 414

Epstein-Barr Virus

Front 415

most common malignancy of the endocrine system

Back 415

Thyroid cancer

Front 416

S&S of Thyroid cancer

Back 416

Hoarseness
– Neck Pain
– Enlarged thyroid nodules
– Swollen lymph nodes

Front 417

Neuropathic disorder of Trigeminal nerve (CN V)
characterized by Intense pain of the eyes, lips, nose, scalp, forehead and jaw

Back 417

Tic Douloureux (trigeminal neuralgia)

Front 418

Schwann Cell Tumor (Tumor of CN VIII)

Back 418

Acoustic Neuroma

Front 419

Most common type of thyroid cancer and tends to grow very slowly

Back 419

papillary thyroid cancer

Front 420

Blood & Thunder, tortuous veins, flame-shaped hemorrhage and cotton wool spots characterize this condition

Back 420

Central Retinal Vein Occlusion

Front 421

Condition involves the maxillary bone and posterior medial floor ethmoid bone, Eye appears sunken in, and best seen on Water's view x-ray

Back 421

Blow Out Fracture

Front 422

Snowflake” cataract is Hallmark for?

Back 422

Diabetes

Front 423

"box-carring" and "cherry-red spots" seen in the eyes are indicative of?

Back 423

Central Retinal Artery Occlusion -- Ophthalmic Emergency!

Front 424

A chronic inflammation of the meibomian gland in the eyelid

Back 424

Chalazion

Front 425

Abnormal development of blood vessels (telangiectasia) behind the retina, leaving cholesterol deposits and damaging the retina

Back 425

Coat's Disease

Front 426

Leading cause of visual loss in AIDS pts

Back 426

Cytomegalovirus retinopathy

Front 427

Key finding in Proliferative Diabetic Retinopathy

Back 427

Neovascularization of the disc

Front 428

3 findings in pre-proliferative diabetic retinopathy

Back 428

Hemorrhages, hard exudates, Cotton Wool Spots

Front 429

Tool used to measure intraocular pressure to detect glaucoma

Back 429

tonometer

Front 430

Condition characterized by painless, insidious raise in IOP, normal acuity until late stages

Back 430

Open angle glaucoma

Front 431

Condition with sudden rise in IOP, painful, Nausea/Vomiting, Steamy cornea, fixed, mid-dilated pupil, EMERGENCY

Back 431

Closed angle glaucoma

Front 432

Tx for open angle glaucoma

Back 432

decrease aqueous production

Front 433

Tx for closed angle glaucoma

Back 433

Miotics increase trabecular meshwork outflow e.g. Pilocarpine

Front 434

- A special contact lens on the topically anesthetized cornea to examine a patient with suspected glaucoma that can examine the anterior chamber angle structures

Back 434

Goinoscopy

Front 435

Dendritic staining pattern in the eye

Back 435

Herpes Simplex Keratitis

Front 436

CWS, flame shaped hemorrhages, macular edema (rare), disc edema, macular star/ring of exudates are findings in this condition

Back 436

Hypertensive Retinopathy

Front 437

Differentiate between Diabetic retinopathy and HTN retinopathy

Back 437

HTN retinopathy is mostly a dry eye condition ( multiple CWS, rare hemorrhage, edema, and exudates) whereas diabetic retinopathy is a wet eye condition, rare CWS, extensive hemorrhages, edema, and exudates)

Front 438

classic “ketchup” and “pizza” retina is found in?

Back 438

AIDS pts

Front 439

Infection/ inflammation of the cornea accompanied by pain, red eye

Back 439

Keratitis

Front 440

White reflex that is an emergency in children
and may signify retinoblastoma or cataract

Back 440

Leukocoria

Front 441

Most common intraocular tumor in adults and demonstrates metastasis to liver

Back 441

Melanoma

Front 442

finding during the swinging-flashlight test whereupon the patient's pupils appear to dilate instead of constrict when the light swings from the unaffected "good" eye to the affected "bad" eye

Back 442

Marcus Gunn Pupil

Front 443

This is an acute infection of the tissues immediately surrounding the eye, including the eyelids, eyebrow, and cheek and needs immediate attention to prevent blindness

Back 443

Orbital Cellulitis

Front 444

inflammation of the optic disc only with a
central field defect

Back 444

Papillitis

Front 445

disc swelling due to increased intracranial pressure where both optic discs are equally affected

Back 445

Papilledema

Front 446

yellow-white deposit on the conjunctiva adjacent to the limbus often due to aging

Back 446

Pinguecula

Front 447

Loss of accommodation reflex due to age

Back 447

presbyopia

Front 448

inherited disorders where individuals first experience defective dark adaptation or nyctalopia (night blindness), followed by constriction of the peripheral visual field and, eventually, loss of central vision late in the course of the disease

Back 448

Retinitis Pigementosa

Front 449

defined as a fleeting loss of vision caused by transient
occlusion of the retinal circulation. This symptom should prompt investigation
of the ipsilateral carotid circulation for atheroma which may be the source of the
retinal emboli.

Back 449

Retinal Vascular Occlusion or
Amaurosis Fugax

Front 450

Most common INTRAOCULAR malignancy in children characterized by Leukocoria (white reflex)

Back 450

Retinoblastoma

Front 451

Most common primary pediatric ORBITAL malignancy with very rapid onset of unilateral proptosis

Back 451

Rhabdomyosarcoma

Front 452

These are retinal hemorrhages with white or pale centers composed of coagulated fibrin observed in leukemia, diabetes, subacute bacterial endocarditis, pernicious anemia, ischemic events associated with elevated venous pressure and systemic vascular conditions with capillary fragility.

Back 452

Roth Spots

Front 453

Misalignment of eyes sometimes caused by lesion on CN III or lack of innervation to orbital muscles; also may be a sign of increased intracranial pressure

Back 453

strabismus

Front 454

bleeding in the vitreous cavity that may occur in response to direct trauma or those conditions
causing retinal neovascularization (diabetes, retinal vein
occlusion)

Back 454

Vitreous Hemorrhage

Front 455

transparent, colorless, gelatinous mass that fills the space between the lens of the eye and the retina lining the back of the eye.

Back 455

Vitreous Humor

Front 456

This leukemia has a variation called "Hairy Cell Leukemia"

Back 456

CLL

Front 457

Areas of metastasis for lung cancer?

Back 457

adrenal glands and brain

Front 458

Areas of metastasis for breast cancer?

Back 458

bone, liver and lung

Front 459

Areas of metastasis for Colon Cancer?

Back 459

liver and lung

Front 460

Areas of metastasis for prostate cancer

Back 460

bone

Front 461

Areas of metastasis for cancers of connective tissue (sarcomas), and testicular cancer

Back 461

lung

Front 462

Organism that causes Burkitt's Lymphoma

Back 462

Epstein-Barr Virus

Front 463

Organism that causes cervical cancer

Back 463

Human Papilloma Virus

Front 464

Condition that causes hepatocellular carcinoma

Back 464

Hepatitis B and C

Front 465

This virus causes Adult T-Cell Leukemia

Back 465

HTLV-I (assoc. w/ ALL)

Front 466

Organism that causes genital cancers

Back 466

Human Papillomavirus

Front 467

Dz where Auer rods are seen on blood smear

Back 467

AML

Front 468

In this condition, chronic renal failure causes defective platelet function and/or decreased platelets

Back 468

Uremia

Front 469

is a destruction of leukemic WBC’s leading to acute rises in uric acid (hyperuricemia) which may cause renal failure; is a side effect of chemotherapy

Back 469

Tumor Lysis Syndrome

Front 470

is a disorder caused by an inherited mutation in the beta-globins component of hemoglobin molecule

Back 470

Sickle Cell Syndrome

Front 471

Complications of Sickle Cell disease

Back 471

Renal defects (Renal insufficiency)
Chronic skin ulcers of leg and ankle
Sepsis (most common cause of death in children)
Pneumonia
Bone infarctions

Front 472

Condition where X-ray shows "punched out" bone lesions due to osteoclasts

Back 472

Multiple Myeloma

Front 473

Condition with proliferation of monoclonal IgM protein with symptoms of anemia, hypercalcemia, and BONE PAIN primarily in back and chest

Back 473

Multiple Myeloma

Front 474

Condition of over-production of RBC

Back 474

Polycythemia Vera

Front 475

Anemia where key clinical feature is a normocytic anemia with increased reticulocyte count

Back 475

Hemolytic Anemia (Cells are being destroyed & bone marrow responds by increased production of reticulocytes)

Front 476

Kayser-Fleischer rings and “sunflower” cataracts are ophthalmic findings in what condition?

Back 476

Wilson's dz

Front 477

"Target Cells" are seen in these 2 conditions

Back 477

Sickle cell anemia and Thalassemia

Front 478

Howell-Jolly Bodies

Back 478

Nuclear remnants in RBC

Front 479

Basophilic stippling is seen in this condition

Back 479

Lead poisoning

Front 480

TAILS is a pneumonic for what condition

Back 480

Microcytic Anemia:
Thalassemia
Anemia of Chronic dz
Iron Deficiency
Lead poisoning
Sideroblastic Anemia

Front 481

Thalassemia defects that are incompatible with life

Back 481

defect in 3 of 4 alpha chains
or defect in both beta chains

Front 482

Procedure to diagnose sideroblastic anemia

Back 482

bone marrow biopsy

Front 483

Condition caused by defect in binding of iron onto heme molecule

Back 483

Sideroblastic anemia

Front 484

sore tongue is indicative of this deficiency

Back 484

Vitamin B12 and/or Folic acid deficiency

Front 485

Conditions that lead to Macrocytic anemias

Back 485

B12 and Folic acid deficiency
Hypothyroidism
Chronic liver disease
Alcoholism

Front 486

Pernicious Anemia is due to:

Back 486

Lack of intrinsic factor which is needed for B12 absorption; this results in B12 deficiency

Front 487

Burr cells and spur cells are due to:

Back 487

Decreased erythropoietin production due to renal failure

Front 488

painful, red, tender nodules on lower legs

Back 488

Erythema Nodosum

Front 489

any eruption of the skin accompanied by inflammation, such as measles, scarlatina, or erysipelas

Back 489

Exanthems

Front 490

Derm. condition w/ increased serum IgE levels

Back 490

Atopic Derm (Eczema)

Front 491

Papule or pustule surrounded by an erythematous halo caused by shaving hairy regions such as the beard area, axillae, or legs facilitates Staph. infection

Back 491

Folliculitis

Front 492

Grouped vesicles on an erythematous base; Once infected it persists in sensory ganglia for life

Back 492

Herpes Simplex Virus

Front 493

Unilateral pain and vesicular or bullous eruption limited to dermatomes innervated by corresponding sensory ganglion

Back 493

Herpes Zoster (Varicella Zoster) AKA “shingles"

Front 494

chronic disease of axilla, anogenital region and scalp can be associated with severe nodulocystic acne; “bridge” scars and "double comedomes" present

Back 494

Hidradenitis Suppurativa

Front 495

2 Organisms that commonly cause Impetigo

Back 495

Staph aureus and strep pyogenes

Front 496

violaceous lesions and lymphedema of the lower extremeties often seen in immunocompromised/HIV pts

Back 496

Kaposi's Sarcoma

Front 497

dome-shaped nodule with a central keratotic plug mimics basal cell carcinoma; usually found on face and has rapid growth rate

Back 497

Keratoacanthoma

Front 498

Head lice

Back 498

Pediculosis Capitis

Front 499

Pubic lice

Back 499

Pediculosis Pubis

Front 500

Flat-topped violaceous, shiny, pruritic papules on skin with white lines (Wickhams striae) on mouth, wrists, and sun-exposed sites

Back 500

Lichen Planus

Front 501

Area of cutaneous thickening and hardening from continued irritation/itching; area is like an erogenous zone

Back 501

Lichen Simplex Chronicus

Front 502

the simplest dermatological lesion; It is flat and can only be seen and not felt

Back 502

Macule

Front 503

Precursors of Cutaneous Melanoma

Back 503

1. Congenital nevomelanocytic nevus (giant or small)
2. Clark’s (dysplastic) melanocytic nevus
3. Lentigo maligna

Front 504

tumor from the beginning is in the “vertical growth” phase
"blueberry-like” nodule

Back 504

Nodular Melanoma

Front 505

mask of pregnancy

Back 505

Melasma

Front 506

Skin colored papules, often umbilicated with central keratotic plug caused by MC virus (poxvirus); severe in HIV pts

Back 506

Molluscum contagiosum

Front 507

Localized cutaneous sclerosis where hair follicle and sweat duct holes disappear; considered to be localized scleroderma

Back 507

Morphea

Front 508

Coin shaped plaques with small grouped papules and vesicles on erythematous base
Common in lower legs of older males during winter

Back 508

Nummular eczema

Front 509

Infection of finger or toenail caused by fungi, yeasts and molds

Back 509

Onycomycosis

Front 510

Superficial solid lesions less than 1 cm in diameter
Palpable
May invade epidermis and upper dermis but not sub Q

Back 510

Papule

Front 511

Fungal infection of nails with pus

Back 511

Paronychia

Front 512

Most common photodermatosis characterized by abnormal reactions to UV radiation,
pruritus and parasthesia

Back 512

Photo Light eruption

Front 513

Begins w/ “herald plaque”
Lesions cleavage in “Christmas tree” pattern

Back 513

Pityriasis rosea

Front 514

Inflammatory reaction caused by an antigen (allergen)
Elicits type IV hypersensitivity reaction
Confined to the site of exposure to allergen

Back 514

Allergic contact dermatitis

Front 515

 Can be life threatening
 Starts with burning erythema that spreads in hours
 Fiery red skin
 “Lakes” filled with purulent fluid

Back 515

Psoriasis Erythroderma

Front 516

o Infestation by mite
o "7 year itch"

Back 516

Scabies

Front 517

o Yellow, greasy scaling where sebaceous glands are
o Scalp: dandruff or cradle cap in infants
o High incidence in HIV and Parkinson’s

Back 517

Seborrhic Dermatitis

Front 518

o Lesion has stuck on appearance, with “warty” surface
o “horn cysts”

Back 518

Seborrheic keratosis

Front 519

Malignant tumor of epithelial keratinocytes

Back 519

Squamous cell carcinoma (SCC)

Front 520

Drug induced or idiopathic skin tenderness and erythema of skin and mucosa
o Variant of erythema multiforme
o Target like lesions
Can be life threatening

Back 520

Steven-Johnson syndrome

Front 521

Painless Chancre indicates this disease

Back 521

Primary Syphilis

Front 522

GUMMA lesions indicate what disease

Back 522

Tertiary Syphilis

Front 523

Mutlisystem disease of connective tissue and blood vessels that mostly occurs in black females w/ symptoms of Skin lesions and Arthritis

Back 523

Systemic Lupus Erythematous (SLE)

Front 524

Fungal infection of scalp resulting in scarring and alopecia

Back 524

Tinea capitis

Front 525

Ringworm; Fungal infection of the trunk, legs and arms

Back 525

Tinea corporis

Front 526

Jock Itch; Fungal infection of inguinal folds

Back 526

Tinea cruris

Front 527

Athlete’s Foot

Back 527

Tinea Pedis

Front 528

Tinea ungium

Back 528

Also known as Onychomycosis; Fungal infection of finger

Front 529

Lesions on the palms and soles that appear 2-6 months after initial painless chancre is indicative of what disease

Back 529

Secondary syphilis

Front 530

"oil spot" and "pitting" on nails is indicative of?

Back 530

Psoriasis Vulgaris

Front 531

Systemic disease caused by Staph characterized by
o Fever
o Malaise
o N/V/D
o Red rash that looks like sunburn

Back 531

Toxic Shock Syndrome

Front 532

Wheals that develop upon dermographism; can be detected with "ice cube" test

Back 532

Urticaria

Front 533

Dew drops on a rose petal

Back 533

Varicella (Chicken pox)

Front 534

Common Warts

Back 534

Verruca Vulgaris

Front 535

diffuse, velvety thickening and hyperpigmentation of the skin, chiefly in axillae, around the neck, and other body folds

Back 535

Acanthosis nigricans

Front 536

o Development of chalk white macules, round, elongated with convex margins
Absence of melanocytes (hypopigmentation)

Back 536

Vitiligo

Front 537

Condition of the face characterized by rhinophyma, that is exacerbated by hot liquids, spicy foods, and sun exposure

Back 537

Acne Rosacea

Front 538

most common type of skin cancer

Back 538

Basal cell carcinoma (BCC)

Front 539

This malignant tumor is locally invasive, aggressive, and destructive, but there is a limited capacity to metastasize.

Back 539

Basal cell carcinoma (BCC)

Front 540

Ulcerated nodule or papule with rolled "pearly" border

Back 540

Basal cell carcinoma (BCC)

Front 541

eruption is an adverse hypersensitivity reaction to an ingested or parenterally administered drug characterized by a cutaneous eruption that mimics measles

Back 541

Exanthematous Drug
Eruption

Front 542

This lesion is derived from epidermis or the epithelium of the hair follicle, and is formed by cystic enclosure of epithelium within the dermis that becomes filled with keratin and lipid-rich debris.

Back 542

Epidermal Cysts

Front 543

Button-like dermal nodule usually occuring on extremities and has "dimple" sign

Back 543

Dermatofibroma

Front 544

Dermal condtion characterized by "spaghetti and meatballs" on KOH prep

Back 544

Tinea Versicolor

Front 545

Blue/green fluorescence of scales under Wood's Lamp

Back 545

Tinea Versicolor (Pityriasis versicolor)

Front 546

Iris or target lesions are typical on the dorsa of hands, palms, and soles; forearms; feet; face; elbows and knees

Back 546

Erythema Multiforme

Front 547

potential precursor of superficial spreading melanoma and also a marker of persons at risk for developing primary malignant melanoma of the skin

Back 547

Clark’s (dysplastic) melanocytic nevus

Front 548

Tapioca-like vesicles on fingers, palms, and soles

Back 548

Dyshidrotic Eczematous Dermatitis

Front 549

Papulopustules, comedomes, or nodulocystic lesions on the face that can lead to pitted or hypertrophic scars

Back 549

Acne Vulgaris

Front 550

Positive Nikolsky sign (blister formation from slight pressure) is seen in these 2 conditions

Back 550

Erythema Multiforme Major (Severe form)
Pemphigus Vulgaris

Front 551

Destructive ulcers of the genital region that have beefy-red granulated tissue base with sharply defined edges; late sequela is SCC of genital skin

Back 551

Donovanosis

Front 552

Congenital gray-blue macular lesion of lumbosacral area that disappears in early childhood

Back 552

Mongolian Spot

Front 553

Single or multiple benign subcutaneous tumors composed of fat cells that are movable against overlying skin

Back 553

Lipoma

Front 554

This dermal tumor is in the "vertical growth" phase from the beginning

Back 554

Nodular Melanoma

Front 555

excessive hair growth in androgen dependent hair patterns; women w/ excessive facial hair

Back 555

Hirsutism

Front 556

hickey

Back 556

Annular Erythematus Erogeniosum

Front 557

ANA test is used to diagnose this condition

Back 557

Systemic Lupus Erythematosus

Front 558

Sexually transmitted painful ulcer at inoculation site caused by Hemophilus Ducreyi

Back 558

Chancroid

Front 559

This condition develops from precancerous lesions often found on the lips and other sun-exposed sites and has great capacity to metastasize

Back 559

Squamous Cell Carcinoma

Front 560

These lesions show initial radial growth followed by vertical growth and can become cancerous

Back 560

Melanoma

Front 561

Condition where loss of scalp hair is in an "M" shaped recession

Back 561

Androgenetic Alopecia

Front 562

Describe phases of hair growth: telogen, anagen, catagen

Back 562

Telogen = resting phase
Anagen = active growth
Catagen = transition phase

Front 563

Hair loss caused by crash dieting, giving birth, or cessation of oral contraceptives; pt will bring in "bags of shed hair"

Back 563

Telogen Effluvium

Front 564

Cafe au lait spots are indicative of what condition?

Back 564

Neurofibromatosis

Front 565

This condition causes fine, downy hair to cover the body and is usually a harbinger of malignancy

Back 565

Hypertrichosis

Front 566

Disease w/ factor VIII deficiency and how it affects PT and PTT

Back 566

Hemophilia A
PT is normal
PTT is prolonged (reflecting that Factor VIII is in the intrinsic pathway)

Front 567

Disease w/ factor IX deficiency and how it affects PT and PTT

Back 567

Hemophilia B
PT is normal
PTT is prolonged ((reflecting that Factor IX is in the intrinsic pathway)

Front 568

Deficiency in this vitamin causes decreased production of factors II, VII, IX, X in the liver

Back 568

Vitamin K

Front 569

assesses integrity of extrinsic coagulation pathway (extrinsic requires Factor VII and X)

Back 569

Prothrombin time (PT)
PT is prolonged (increased) if there are deficiencies of clotting factors in extrinsic pathway and the common pathway

Front 570

this test assesses integrity of intrinsic coagulation pathway (intrinsic pathway requires Factors VIII, IX, X)

Back 570

Partial Thromboplastin Time (PTT)

Front 571

This factor is required for adhesion of platelets to injured endothelium (formation of platelet plug)

Back 571

VonWillebrand Factor

Front 572

A condition characterized by massive, uncontrolled intravascular coagulation eventually leading to depletion of blood clotting components; usually due to massive trauma or sepsis

Back 572

Disseminated Intravascular Coagulation (DIC)

Front 573

Christmas Dz

Back 573

Hemophilia B

Front 574

Primary Hemostasis

Back 574

Inability to form a platelet plug due to platelet defects or decreased number of platelets

Front 575

Secondary Hemostasis

Back 575

Inability to form an adequate fibrin clot due to decrease or absence of plasma coagulation factors

Front 576

An autoimmune dz where body produces antibodies against own platelets; condition is improved w/ splenectomy

Back 576

Idiopathic Thrombocytopenia Purpura

Front 577

Zoster Sine Zoster

Back 577

Nerve involvement that occurs without cutaneous involvement

Front 578

melanoma can be recognized by these 3 physical characteristics

Back 578

color, contour, and size of the lesion

Front 579

4 predisposing risk factors for Melanoma

Back 579

1. Presence of precursor lesions (Clark’s dysplastic melanocytic nevus, congenital melanocytic nevus)
2. Family history of melanoma in parents, children, or siblings
3. Light skin color with inability to tan with ease (skin phototypes I and II)
4. Excessive sun exposure, especially during preadolescence

Front 580

pigmented lesions of the skin usually present at birth, may be any size from very small to very large and are benign neoplasms but may be precursors of malignant melanoma

Back 580

Congenital Nevomelanocytic Nevus

Front 581

Precursor of malignancy, this is a dermal lesion with variations in hues of brown and black, appears like a “stain,” haphazard network of black on a background of brown; has irregular borders, often with a notch, “geographic” shape with inlets and peninsulas

Back 581

Lentigo Maligna

Front 582

an acute, chronic, or recurrent dermatosis of the fingers, palms, and soles, characterized by a sudden onset of many deep-seated pruritic, clear vesicles; later, scaling, fissures and lichenification occur

Back 582

Dyshidrosis

Front 583

an acute beta-hemolytic group A streptococcal infection of the skin involving the
superficial dermal lymphatics that causes marked swelling, high fevers, shaking, chills, fatigue, headaches, vomiting, and general illness within 48 hours of the initial infection

Back 583

Erysipelas

Front 584

Hallmarks of Asthma

Back 584

decrease in airway diameter
• increased airway resistance
• airway obstruction

Front 585

Definition of Chronic Bronchitis

Back 585

• Chronic/recurrent cough with excess mucus production (for most days at least 3 months during 2 consecutive years) in absence of other illness
• Airway narrowing from inflammation / hyperplasia and hypertrophy of mucous glands edema which increases airway resistance
• Loss of ciliary transport
• V/Q mismatch from bronchial narrowing and mucous plugging

Front 586

describe the physiology of Cystic Fibrosis

Back 586

↑ Na absorption and ↓ CL secretion → thick, sticky mucus→ impaired lung defense against infection

Front 587

Cystic Fibrosis pt's get chronic infections from these 2 organisms

Back 587

Staph. Aureus and Pseudomonas aeruginosa

Front 588

CXR findings in pt's w/ Emphysema

Back 588

Hyperinflated lung field (hyperlucency)
• Bullae – local radiolucencies
• Vertically elongated lung field
• Low flattend diaghrams
• Increased retrosteral airspace

Front 589

Most virulent type of Influenza

Back 589

Influenza A

Front 590

Describe Reye's Syndrome

Back 590

acute fatty deterioration of liver, encephalopathy, hypoglycemia, lipidemia in children treated with Aspirin or Salicylates

Front 591

Risk factors for Pulm. Embolism

Back 591

• Immobilization
• Post-operative states
• Chronic venous insufficiency
• Use of oral contraceptives
• Obesity
• Cancer or chemotherapy
• Post-partum state
• Indwelling central venous catheter
• Deficiency of proteins of antithrombotic activity
– Antithrombin III
– Protein C
– Protein S
• Presence of Factor V Leiden

Front 592

S&S of Pulm. HTN

Back 592

shortness of breath
dizziness
fainting
fatigue
nonproductive cough peripheral edema
hemoptysis

Front 593

"helmet" cells are seen in?

Back 593

Poikilocytosis (abnormally shaped blood cells)

Front 594

Acute bacterial infection causes an increase of this cell type in circulation

Back 594

neutrophils

Front 595

Most common Thalassemia type

Back 595

Thalassemia Minor = less severe form; has 2 alpha globin and 1 beta globin

Front 596

Most common presenting sign in CML

Back 596

Splenomegaly

Front 597

Leukemia characterized by splenomegaly, hepatomegaly, lymphadenopathy, and pancytopenia

Back 597

ALL

Front 598

Leukemia assoc. with HTLV-1 (human T lymphocyte virus 1)

Back 598

ALL

Front 599

What is the most aggressive malignant disease of humans?

Back 599

AML

Front 600

2 leukemia types characterized by increased blast (immature) cells

Back 600

ALL and AML

Front 601

Leukemia characterized by a chronic stable phase followed by "blast crisis" when disease becomes very aggressive

Back 601

CML

Front 602

Leukemia w/ onset at age >50

Back 602

CLL

Front 603

"B symptoms" carry an unfavorable prognosis in this disease

Back 603

Hodgkin's Disease

Front 604

Organism that causes infectious mononucleosis

Back 604

Epstein-Barr virus

Front 605

Virus assoc. with Hodgkin's disease

Back 605

Epstein-Barr virus

Front 606

2 aggressive variations of Non-Hodgkins Lymphoma

Back 606

Burkitt's Lymphoma
Lymphoblastic lymphomas

Front 607

What are the components of "B symptoms"?

Back 607

Intermittent fever >100.5
Night sweats
Weight loss >10% of normal body weight

Front 608

Describe stages of assessing Hodgkin's diseases

Back 608

Stage I= involves single lymph node region
Stage II= involves 2 or more lymph node chains on same side of diaphragm (above or below)
Stage III= involves lymph node chains on both sides of diaphragm (above and below)
Stage IV= Diffuse or disseminated dz involving lung, liver, or bone marrow

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What condition is characterized by "fragile blood"

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Spherocytosis: RBCs lack spectrin, a cytoskeletal membrane protein, making RBC's fragile and osmotic forces cause cells to break

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Priapism (persistent painful erections) is assoc. w/ crisis of what disease?

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Sickle cell