Med Test Ii

Front 1

hypersegmented neutrophils, gastritis, parasthesias/numbness, low Hct, palor, icteric... is most likely what deficiency?

Back 1

Vitamin B12-peripheral nerves are usually affected first, posterior columns become impaired and p complain of balance problems.

Front 2

what is the hallmark symptom of B12 deficiency?

Back 2

megaloblastic anemia

Front 3

a type of autoimmune anemia. Antibodies are directed against intrinsic factor or parietal cells which produce intrinsic factor

Back 3

pernicious anemia

Front 4

what is the MC dietary deficiency that leads to anemia?

Back 4

occult blood loss

Front 5

what are some examples of bleeding disorders?

Back 5

occult blood loss
inadequate PLT's
ITP

Front 6

what are some manifestations of ITP?

Back 6

isolated thrombocytopenia, purpura, epistaxis

Front 7

an autoimmune disorder in which an IgG autoantibody is formed that binds to platelets. Destruction of pLT takes place in spleen. Common in childhood, precipitated by viurs.

Back 7

Idiopathic (autoimmune) Thrombocytopenic Purpura

Front 8

what are some examples of some infectious processes that lead to ITP?

Back 8

viral: varicella,
sequele: GI, URI

Front 9

what is the primary tx for ITP?

Back 9

corticosteroids; IVIG= intravenous Immunoglobulins

Front 10

Factor VIII deficiency: aka?

Back 10

Hemophilia A

Front 11

VonWillebrand's deficiency: aka?

Back 11

Co-Factor VIII deficiency

Front 12

Hemophilia B: aka?

Back 12

Factor IX deficiency

Front 13

if p is dx c ITP, and is unresponsive to corticosteroid treatment, what is the most aggressive tx and last resort?

Back 13

spleenectomy

Front 14

which blood test is timing the extrinsic cascade?

Back 14

PT

Front 15

which blood test times the intrinsic cascade?

Back 15

PTT

Front 16

what is the hallmark of the ITP disease?

Back 16

thrombocytopenia: <10,000

Front 17

what is the name of the co-existant autoimmune hemolytic anemia usually seen in ITP?

Back 17

Evan's Syndrome: + anemia, reticulocytosis, spherocytes on peripheral smear

Front 18

what is the MC type of drug-induced thrombocytopenia?

Back 18

HIT

Front 19

IgG autoantibody that reacts with platelet factor 4 (PF4) that is usually in a complex with heparin causes what reaction?

Back 19

HIT

Front 20

after you confirm your dx of HIT, what is the first thing you do?

Back 20

stop heparin

Front 21

virchow's triad?

Back 21

damage to vessel wall
stasis of blood
hypercoaguable state

Front 22

thrombocytopenia, elevated serum LDH, microangiopathic hemolytic anemia, neurologic and renal abnormalities... are usually indicitive of what disorder?

Back 22

thrombotic thrombocytopnic purpura

Front 23

what is the hallmark of TTP: thrombotic thrombocytopenic purpura

Back 23

microangiopathic blood picture with shistocytes, etc.

Front 24

definitive tx for TTP?

Back 24

large-volume plasmapheresis: fresh-frozen plasma!

Front 25

what are some examples of microangiopathic hemolytic anemias?

Back 25

TTP, ITP, DIC, HELLP, HIT, HUS

Front 26

MAHA, thrombocytopenia, renal failure, elevated LDH, is indicitive of what disorder?

Back 26

Hemolytic Uremia Syndrome

Front 27

a form of severe preeclampsia, (very elevated BP, thrombocytopenia) may progress to DIC is called?

Back 27

HELLP syndrome: hemolysis, elevated liver enzymes, low plt

Front 28

a direct antibody test that is given to a patient with hemolysis to identify which antiobdy IgG or IgM is involved?

Back 28

COOMBS test

Front 29

most often measured to evaluate the presence of tissue damage. This enzyme is in many body tissues, especially the heart, liver, kidney, skeletal muscle, brain, blood cells, and lungs

Back 29

LDH: Lactate dehydrogenase; Lactic acid dehydrogenase

Front 30

what does the BUN reflect?

Back 30

proteins in liver that get converted to urea

Front 31

a medical condition characterized by abnormal levels of urea, creatinine, various body waste compounds, and other nitrogen-rich compounds in the blood as a result of insufficient filtering of the blood by the kidneys.

Back 31

azotemia

Front 32

a toxic condition resulting from renal failure, when kidney function is compromised and urea, a waste product normally excreted in the urine, is retained in the blood. it can lead to disturbances in the platelets and hypersomnia, among other effects.

Back 32

uremia

Front 33

this condition is MC in children, presents like renal failure; hemolysis of RBC's and decreased plt's. Petechiae, purpura, SOB, fatigue, epistaxis?

Back 33

HUS: hemolytic uremic syndrome

Front 34

more common in adults, presents with HA, seizures, altered mental status, bleeding, thrombosis, is most likely what disorder?

Back 34

TTP

Front 35

It is the most common type of pituitary tumor. S/S are caused by too much prolactin in the blood (hyperprolactinemia) or by pressure of the tumor on surrounding tissues.

Back 35

prolactinoma

Front 36

how do you treat prolactinomas?

Back 36

with drugs that inhibit the production of prolactin= dopamine antagonists aka Bromocriptine or cabergoline

Front 37

cold nodule=?

Back 37

a hypoactive nodule. it does not absorb contrast on CT scan. usually malignant.

Front 38

some systemic symptoms, such as low-grade fever, night sweats, weight loss, pruritus, or fatigue. painless lymphadenopathy

Back 38

Hodgkin's lymphoma

Front 39

membrane defects, spherocytosis , hereditary elliptocytosis, hemoglobinopathies are examples of what types of anemias?

Back 39

intrinsic hemolytic anemias

Front 40

immune, microangiopathic, lymphoproliferative diseases, TTP, HUS, DIC are examples of what type of anemia?

Back 40

extrinsic hemolytic anemias

Front 41

a tumor of the adrenal gland causes severe HTN, palpitations, flushing, irriatibilty is known as what rare disease?

Back 41

pheochromocytoma

Front 42

what is the best way to differentiate between Hyperthyroid and pheochromocytoma?

Back 42

pheo has more severe and paroxsymsmal HTN

Front 43

what is the most definitive way to confirm Pheo?

Back 43

MIBG scintiscan

Front 44

syndromes of these tumors are inherited as autosomal dominant traits and cause a predisposition to the development of tumors in different tissues, particularly involving endocrine glands

Back 44

MEN 1: multiple endocrine neoplasia

Front 45

what is the main risk factor for multiple endocrine neoplasia?

Back 45

familial history

Front 46

what is the first clinical manifestation of MEN-1?

Back 46

hyperparathyroidism: hypercalcemia

Front 47

what is the normal range for calcium?

Back 47

8.5-10.5

Front 48

an enlargement of one parathyroid gland is called?? and it accounts for 96% of all patients with primary hyperparathyroidism?

Back 48

parathyroid adenoma

Front 49

what is the term for an enlargement of all 4 parathyroid glands

Back 49

hyperplasia

Front 50

what is the definitive treatment of hyperparathyroidism?

Back 50

surgery

Front 51

an uncommon disorder caused by destruction or dysfunction of the adrenal cortices. characterized by chronic deficiency of cortisol, aldosterone and adrenal androgens and causes skin pigmentations

Back 51

addison's disease= chronic adrenocortical insufficiency

Front 52

what is the most common cause of addison's disease in the U.S?

Back 52

autoimmune destruction of the adrenal cortex

Front 53

what two hormones are lacking in addison's disease?

Back 53

glucocorticoid (cortisol)
mineralcorticoid (aldosterone)

Front 54

what is the sole purpose of the parathyroid glands?

Back 54

to regulate calcium

Front 55

what are some of the side effects of hypercalcemia?

Back 55

feeling of being "run down" poor sleep habits, irritability, memory decrese

Front 56

what is the MC cause of excess hormone production?

Back 56

the development of a benign tumor in one of the parathyroid glands

Front 57

what test is used to identify adenomas or hyperplastic parathyroids?

Back 57

MIBI: methoxyisobutyl isonitrile

Front 58

what is the name of the disease that affects multiple endocrine glands; is classified into two types?

Back 58

Polyendocrine Deficiency syndrome

Front 59

schmidt's syndrome?

Back 59

type II Polyendocrine Def.
adults
underactive thyroid
slow sexual develop.
diabetes
vitiligo

Front 60

what infection accounts for 20 % of cases of primary adrenal insuff in developed countries?

Back 60

TB

Front 61

what are the main clinical features of addison's disease?

Back 61

fatigue
weight loss
GI disturbances
hypoglycemia
depression
pigmentation (if elevated ACTH production)

Front 62

what is the most specific test for diagnosing Addison's ?

Back 62

ACTH stimulation test

Front 63

what is the acute tx for addison's (crisis)

Back 63

IV hydrocortisone and 0.9% saline
(add dextrose if hypoglycemia present)

Front 64

what is lifelong tx for patient dx with addison's

Back 64

hydrocortisone and fludrocortisone

Front 65

the excess secretion of aldosterone into the blood is from an abnormal adrenal gland/s, usually seen with HTN.

Back 65

Conn's aka primary hyperaldosteronism

Front 66

what is the most rigorous method of diagnosis to test for Conn's

Back 66

test aldosterone and renin

Front 67

what are the 3 hallmark findings in conn's syndrome?

Back 67

HTN
elevated aldosterone
decreased RENIN

Front 68

what is the definitive tx for CONN's?

Back 68

adrenalectomy.
in the meantime; treat with spironolactone (blocks aldosterone)

Front 69

if a patient has hypotension or hyperkalemia what disease should be a part of your diff?

Back 69

addison's

Front 70

a steroid hormone (mineralocorticoid family) produced by the outer-section (zona glomerulosa) of the adrenal cortex in the adrenal gland to regulate sodium and potassium balance in the blood.

Back 70

aldosterone

Front 71

excess production of cortisol by the adrenal glands causes what syndrome?

Back 71

cushings

Front 72

what is the most common cause of excess steroids in the blood and its side effects?

Back 72

long term use of steroid medication for other disorders

Front 73

how do you determine excess cortisol from a pituitary tumor or an adrenal tumor?

Back 73

pituitary tumor secretes too much ACTH, increase cortisol and increase ACTH serum levels.

Adrenal tumor: composed of adrenal producing cells, and normal pituitary will sense excess cortisol and stop making ACTH!

Front 74

what is the major cause of ACTH dependent cushings syndrome?

Back 74

pituitary tumors 60%

lung cancers 5%

Front 75

what is the cause of ACTH independent cushings syndrome?

Back 75

benign adrenal tumors (adenoma) 25%

malignant 10%

Front 76

what is the most sensitive test for cushings?

Back 76

24 hour cortisol serum

Front 77

this disease of the adrenal medula causes "attacks" of HA, perspiration, palpitations, HTN, Nausea, abdominal pain

Back 77

pheochromocytoma

Front 78

elevated urine metanephrine (VMA) and elevated urine catecholamines is indicitive of what disorder?

Back 78

pheochromocytoma

Front 79

what are the 3 main categories of anemias?

Back 79

Impaired production
Bleeding
Hemolytic

Front 80

acquired anemia caused by IgG autoantibody, spherocytes and reticulocytes on peripheral, + Coombs is indicitive of ?

Back 80

autoimmune hemolytic anemia

Front 81

a liver-derived protein that participates in response or with IgG/IgM, it binds to RBC and participates in immune-mediated hemolysis

Back 81

complement

Front 82

what is CREST ?

Back 82

the limited form of scleroderma:
Calcinosis
Raynaud's syndrome
Esophageal Dysmotility
Sclerodactyl
Telangiectasia

Front 83

what are some examples of microcytic processes?

Back 83

MCV <80: "sits"
Sideroblastic anemia
Iron Def
Thalassemia Minor
Sideroblastic

Front 84

what are some representative examples of the macrocytic anemias?

Back 84

MCV > 100:
megaloblastic:
folate def
B12 def.
drug induced
Nonmegaloblastic:
liver disease, hypothyroid

Front 85

differential with normocytic anemia?

Back 85

MCV 80-100:
aplastic anemia
myelophthsic diorders
anemia of chronic disease
uremia

Front 86

what are some of the enteric organisms that reside in GI normally?

Back 86

e.coli, proteus, klebsiella

Front 87

macrophages in tissues aka?

Back 87

histocytes

Front 88

macrophages in brain

Back 88

microglial

Front 89

macrophages in liver aka?

Back 89

kupfer cells

Front 90

patients labs return with an elevated RENIN and elevated Aldosterone...where does this indicate the problem?

Back 90

within the kidneys:
caused by pressure loss, kidnes will raise renin

Front 91

labs return with decreased RENIN and INCREASED ALD? what can you suspect?

Back 91

hyperaldosteronism

Front 92

you perform a 24 hour urine on patient you suspect has PHEO. what will you see?

Back 92

increased VMA which are the byproducts of catecholamines

Front 93

what test allows us to see pheo BEST?

Back 93

MIBI scan