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93 Cards in this Set

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  • Back
hypersegmented neutrophils, gastritis, parasthesias/numbness, low Hct, palor, icteric... is most likely what deficiency?
Vitamin B12-peripheral nerves are usually affected first, posterior columns become impaired and p complain of balance problems.
what is the hallmark symptom of B12 deficiency?
megaloblastic anemia
a type of autoimmune anemia. Antibodies are directed against intrinsic factor or parietal cells which produce intrinsic factor
pernicious anemia
what is the MC dietary deficiency that leads to anemia?
occult blood loss
what are some examples of bleeding disorders?
occult blood loss
inadequate PLT's
what are some manifestations of ITP?
isolated thrombocytopenia, purpura, epistaxis
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.
Idiopathic (autoimmune) Thrombocytopenic Purpura
what are some examples of some infectious processes that lead to ITP?
viral: varicella,
sequele: GI, URI
what is the primary tx for ITP?
corticosteroids; IVIG= intravenous Immunoglobulins
Factor VIII deficiency: aka?
Hemophilia A
VonWillebrand's deficiency: aka?
Co-Factor VIII deficiency
Hemophilia B: aka?
Factor IX deficiency
if p is dx c ITP, and is unresponsive to corticosteroid treatment, what is the most aggressive tx and last resort?
which blood test is timing the extrinsic cascade?
which blood test times the intrinsic cascade?
what is the hallmark of the ITP disease?
thrombocytopenia: <10,000
what is the name of the co-existant autoimmune hemolytic anemia usually seen in ITP?
Evan's Syndrome: + anemia, reticulocytosis, spherocytes on peripheral smear
what is the MC type of drug-induced thrombocytopenia?
IgG autoantibody that reacts with platelet factor 4 (PF4) that is usually in a complex with heparin causes what reaction?
after you confirm your dx of HIT, what is the first thing you do?
stop heparin
virchow's triad?
damage to vessel wall
stasis of blood
hypercoaguable state
thrombocytopenia, elevated serum LDH, microangiopathic hemolytic anemia, neurologic and renal abnormalities... are usually indicitive of what disorder?
thrombotic thrombocytopnic purpura
what is the hallmark of TTP: thrombotic thrombocytopenic purpura
microangiopathic blood picture with shistocytes, etc.
definitive tx for TTP?
large-volume plasmapheresis: fresh-frozen plasma!
what are some examples of microangiopathic hemolytic anemias?
MAHA, thrombocytopenia, renal failure, elevated LDH, is indicitive of what disorder?
Hemolytic Uremia Syndrome
a form of severe preeclampsia, (very elevated BP, thrombocytopenia) may progress to DIC is called?
HELLP syndrome: hemolysis, elevated liver enzymes, low plt
a direct antibody test that is given to a patient with hemolysis to identify which antiobdy IgG or IgM is involved?
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
LDH: Lactate dehydrogenase; Lactic acid dehydrogenase
what does the BUN reflect?
proteins in liver that get converted to urea
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.
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.
this condition is MC in children, presents like renal failure; hemolysis of RBC's and decreased plt's. Petechiae, purpura, SOB, fatigue, epistaxis?
HUS: hemolytic uremic syndrome
more common in adults, presents with HA, seizures, altered mental status, bleeding, thrombosis, is most likely what disorder?
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.
how do you treat prolactinomas?
with drugs that inhibit the production of prolactin= dopamine antagonists aka Bromocriptine or cabergoline
cold nodule=?
a hypoactive nodule. it does not absorb contrast on CT scan. usually malignant.
some systemic symptoms, such as low-grade fever, night sweats, weight loss, pruritus, or fatigue. painless lymphadenopathy
Hodgkin's lymphoma
membrane defects, spherocytosis , hereditary elliptocytosis, hemoglobinopathies are examples of what types of anemias?
intrinsic hemolytic anemias
immune, microangiopathic, lymphoproliferative diseases, TTP, HUS, DIC are examples of what type of anemia?
extrinsic hemolytic anemias
a tumor of the adrenal gland causes severe HTN, palpitations, flushing, irriatibilty is known as what rare disease?
what is the best way to differentiate between Hyperthyroid and pheochromocytoma?
pheo has more severe and paroxsymsmal HTN
what is the most definitive way to confirm Pheo?
MIBG scintiscan
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
MEN 1: multiple endocrine neoplasia
what is the main risk factor for multiple endocrine neoplasia?
familial history
what is the first clinical manifestation of MEN-1?
hyperparathyroidism: hypercalcemia
what is the normal range for calcium?
an enlargement of one parathyroid gland is called?? and it accounts for 96% of all patients with primary hyperparathyroidism?
parathyroid adenoma
what is the term for an enlargement of all 4 parathyroid glands
what is the definitive treatment of hyperparathyroidism?
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
addison's disease= chronic adrenocortical insufficiency
what is the most common cause of addison's disease in the U.S?
autoimmune destruction of the adrenal cortex
what two hormones are lacking in addison's disease?
glucocorticoid (cortisol)
mineralcorticoid (aldosterone)
what is the sole purpose of the parathyroid glands?
to regulate calcium
what are some of the side effects of hypercalcemia?
feeling of being "run down" poor sleep habits, irritability, memory decrese
what is the MC cause of excess hormone production?
the development of a benign tumor in one of the parathyroid glands
what test is used to identify adenomas or hyperplastic parathyroids?
MIBI: methoxyisobutyl isonitrile
what is the name of the disease that affects multiple endocrine glands; is classified into two types?
Polyendocrine Deficiency syndrome
schmidt's syndrome?
type II Polyendocrine Def.
underactive thyroid
slow sexual develop.
what infection accounts for 20 % of cases of primary adrenal insuff in developed countries?
what are the main clinical features of addison's disease?
weight loss
GI disturbances
pigmentation (if elevated ACTH production)
what is the most specific test for diagnosing Addison's ?
ACTH stimulation test
what is the acute tx for addison's (crisis)
IV hydrocortisone and 0.9% saline
(add dextrose if hypoglycemia present)
what is lifelong tx for patient dx with addison's
hydrocortisone and fludrocortisone
the excess secretion of aldosterone into the blood is from an abnormal adrenal gland/s, usually seen with HTN.
Conn's aka primary hyperaldosteronism
what is the most rigorous method of diagnosis to test for Conn's
test aldosterone and renin
what are the 3 hallmark findings in conn's syndrome?
elevated aldosterone
decreased RENIN
what is the definitive tx for CONN's?
in the meantime; treat with spironolactone (blocks aldosterone)
if a patient has hypotension or hyperkalemia what disease should be a part of your diff?
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.
excess production of cortisol by the adrenal glands causes what syndrome?
what is the most common cause of excess steroids in the blood and its side effects?
long term use of steroid medication for other disorders
how do you determine excess cortisol from a pituitary tumor or an adrenal tumor?
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!
what is the major cause of ACTH dependent cushings syndrome?
pituitary tumors 60%

lung cancers 5%
what is the cause of ACTH independent cushings syndrome?
benign adrenal tumors (adenoma) 25%

malignant 10%
what is the most sensitive test for cushings?
24 hour cortisol serum
this disease of the adrenal medula causes "attacks" of HA, perspiration, palpitations, HTN, Nausea, abdominal pain
elevated urine metanephrine (VMA) and elevated urine catecholamines is indicitive of what disorder?
what are the 3 main categories of anemias?
Impaired production
acquired anemia caused by IgG autoantibody, spherocytes and reticulocytes on peripheral, + Coombs is indicitive of ?
autoimmune hemolytic anemia
a liver-derived protein that participates in response or with IgG/IgM, it binds to RBC and participates in immune-mediated hemolysis
what is CREST ?
the limited form of scleroderma:
Raynaud's syndrome
Esophageal Dysmotility
what are some examples of microcytic processes?
MCV <80: "sits"
Sideroblastic anemia
Iron Def
Thalassemia Minor
what are some representative examples of the macrocytic anemias?
MCV > 100:
folate def
B12 def.
drug induced
liver disease, hypothyroid
differential with normocytic anemia?
MCV 80-100:
aplastic anemia
myelophthsic diorders
anemia of chronic disease
what are some of the enteric organisms that reside in GI normally?
e.coli, proteus, klebsiella
macrophages in tissues aka?
macrophages in brain
macrophages in liver aka?
kupfer cells
patients labs return with an elevated RENIN and elevated Aldosterone...where does this indicate the problem?
within the kidneys:
caused by pressure loss, kidnes will raise renin
labs return with decreased RENIN and INCREASED ALD? what can you suspect?
you perform a 24 hour urine on patient you suspect has PHEO. what will you see?
increased VMA which are the byproducts of catecholamines
what test allows us to see pheo BEST?
MIBI scan