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223 Cards in this Set
- Front
- Back
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Where is CK-MB found?
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Heart
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Where is CK-MM found?
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Muscle
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Where is CK-BB found?
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Brain
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Why should you wait 30 minutes after a meal before swimming?
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all blood in GI so muscles have low ATP
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How does neurogenic muscle disease present?
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Distal weakness and fasciculations
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How does myopathic muscle disease present?
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Proximal weakness and pain
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What is a light chain composed of?
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Actin
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What is a heavy chain composed of?
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Myosin
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What band of the sarcomere does not change length?
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A Band
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Where are the t-tubules located?
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Cardiac muscle: Z line
Skeletal Muscle: A-I jxn |
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What is duchenne's muscular dystrophy?
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Distrophin frameshift mutation
Gower sign Pseudohypertrophy of Calf |
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What is Becker's muscular dystrophy?
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Dystrophin missense mutation. Symptoms onset AFTER 5 yrs
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What is myotonic dystrophy?
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Bird's beak face
Can't let go when they shake hands |
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What is myastenic syndrome?
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Lambert Eaton
Gets stronger as day goes by Small cell carcinoma of lung |
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What is myastenia gravis?
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Weaker as the day goes by
Stronger with edrophonium Weaker with EMG Rule out Thymoma |
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What is multiple sclerosis?
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Anti Myelin ab
Young woman with vision problems Symptoms wax and wane |
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What is metachromatic leukodystrophy?
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Arylsulfatase deficiency
Kid with MS presentation |
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What is ataxia telangectasia?
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Spider Veins
IgA deficiency |
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What is Friedreich's Ataxia?
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Retinitis pigmentosa
Scoliosis |
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What is adrenal leukodystrophy?
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Carnitine shuttle problem
Adrenal failure |
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What is Guillenne Barre
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Ascending paralysis 2 wks after URI
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What is ALS
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Middle aged male with fasciculations
Descending paralysis No sensory problems |
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What is Werdnig-Hoffman?
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Fasciculations in newborn
No anterior horns |
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What is Polio?
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Asymmetric fasciculations in child
2 wks after gastroenteritis |
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What is choreoathetosis?
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Dance-like movements
Wringing of hands Quivering of voice |
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What is atonic cerebral palsy?
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No muscle tone (floppy)
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What is slipped capital femoral epiphysis?
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Obese boy with dull achy pain
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What is Legg-Calves-Perthes?
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Limp (femoral head)
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What is Osgood-Schlatter?
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Knee Pain (Tibial Tubercle)
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What is septic arthritis?
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Joint pain (S. Aureus)
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What is ankylosing spondylitis?
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LIgament ossification (vertebral body fusion)
decreased lumbar curvature Stiffer in AM Kyphosis Uveitis HLA B27 |
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What is Cauda Equina Syndrome
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"Saddle Anaestesia"
Can't feel butt, thighs, perineum |
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Where do bone cancer mets come from?
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Breast
Prostate Lung Kidney |
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What is costochondritis?
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Painful swelling of chest joint-bone attachments. Worse with deep breath
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What is disk herniation?
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Straight leg raise leads to shooting pain
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What is lumbar stenosis?
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MRI "Hourglass"
Low back pain |
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What is ochronosis (alkaptonuria)?
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Kids with OA
Homogentisic acid oxidase deficiency Black urine |
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What is osteitis Fibrosis cystic?
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Inflammation of bone with holes
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What is osteogenesis imperfecta?
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Blue sclera
Multiple broken bones |
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What is osteomalacia (rickets)?
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Soft bones (waddling gait)
Craniotabes (soft skull) Rachitic rosary (costochondral thickening) Harrison's groove Pigeon breast (sternum protrusion) |
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What is osteomyelitis?
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Infected bones
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What is osteonecrosis (Legg-Calve-Perthes)?
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Wedge shaped necrosis of femoral head
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What is osteopenia?
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Lost bone mass
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What is osteopetrosis?
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Decreased osteoclast activity
Marble bones Obliterate own BM |
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What is osteoperosis?
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Loss of bone matrix
Compression fractures |
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What is osteosclerosis?
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Thick bones
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What is Paget's disease?
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"My hat doesn't fit"
Increased osteoclasts/blasts Increased alkaline phosphatase alone Paramyxovirus Fluffy bone Osteosarcoma CHF Deafness |
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What is gastroschisis?
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AKA paromphalocele
Abdominal viscera develop outside of abdomen Abdominal wall defect off center, no peritoneum cover |
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What is a nephroblastoma?
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Kidney (Wilm's Tumor)
Hemihypertrophy Aniridia |
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What is a neuroblastoma?
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Adrenal medulla tumor
Hypsarrhythmia Opsoclonus Increased VMA |
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What is polyhydramios?
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Too much amniotic fluid (AFI > 20)
Baby can't swallow |
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What are the MCC of polyhydramios?
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Obstruction, i.e. GI problem like duodenal atresia
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What is oligohydramios?
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Too little amniotic fluid (AFI < 5). Baby cannot pee
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What is the MCC of oligohydramios?
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Abdominal muscles problem (prune belly) or Renal agenesis (Potter's syndrome)
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What is fifth disease?
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Erythema Infectiosum (Slapped Cheek)
Arthritis in mom Aplastic Anemia |
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What is sixth disease?
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Roseola
Exanthema subitum (fever disappears, then rash appears) |
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What is hand-foot-mouth disease?
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Mouth ulcers (won't eat or drink)
Rash on Palms/Soles Coxsackie A Virus |
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What is measles? (Rubeola)
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1) Cough, Coryza, Conjunctivitis
2) Koplik Spots 3) Morbiliform botchy rash |
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What is molluscum contagiosum?
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Flesh colored papules with central dimples
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What is mumps/
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Parotitis
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What is Pityriasis Rosea?
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Herald patch migrates along skin lines, "Christmas Tree" appearance
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What is Rubella (German 3 day measles)
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Trunk Rash
Lymphadenopathy behind the ears Don't look sick |
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How is smallpox different from chickenpox?
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Small pox is on face
Same stages of development Fever |
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What is varicella (Chicken Pox)
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1) Red Macule
2) Clear vesicle on red dot 3) Pus 4) Scab |
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What is Zellweger's?
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Neonatal seizures
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What is the MCC of delayed speech development?
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Hearing loss
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What are the signs of child abuse?
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Multiple ecxchymoses
Retinal hemmorhages Epidural/Subdural hemmorhage Spinal fractures (twisted) Multiple fractures in different healing stages |
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What should you rule out when suspected child abuse?
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Osteogenesis Imperfecta
Bleeding Disorder Fifth's disease Mongolian spots |
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What are the newborn screening tests?
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"Please check before going home"
PKU Congenital Adrenal Hyperplasia Biotinidase, Beta Thalassemia Galactossemia Hypothyroidism/Homocysteinurea |
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What is the MCC of mental retardation in the US?
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EtOH
Fragile X Down's |
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What is Rubeola also known as?
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Measles
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What is Rubella also known as?
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German Measles
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What is the MC eye infection of the first day of life?
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Clear discharge d/t silver nitrate
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What is the MC eye infection of the first week of life?
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Gonorrhea (purulent discharge)
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What is the MC eye infection of the second week of life?
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Chlamydia
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What is the MC eye infection of the third week of life?
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Herpes
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What are the causes of hyperbilirubinemia?
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Sepsis
ABO incompatibility Hypothyroidism Breast feeding |
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What is the cause of symmetrically small babies?
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Chromosomal abnormality or TORCHS
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What is the cause of large babies?
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DM or twin-twin transfusion
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What is Milia?
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Neonatal whiteheads on malar area AKA milk spots
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What is Nevus flammeus?
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"Stork bites" on back of neck
Looks like flames |
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What is seborrheic dermatitis?
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Red rash with oily skin and dry, flaky hairline
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What are hemangiomas?
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Flat blood vessels
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What are Mongolian spots?
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Melanocytes on lower back
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What is erythema toxicum?
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White wheal on red area. Has eosinophils
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What is subgaleal hemorrhage?
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Prolonged jaundice in newborns d/t birthing trauma
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What is caput succadaneum?
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Under scalp *edema crosses suture lines)
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What is cepahlohematoma?
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Under bone (blood doesn't cross suture lines)
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What is an Epstein's pearl?
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White pearls on hard palate
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What is persistent eye drainage since birth usually due to?
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Blocked duct
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What are wide sutures due to?
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Hypothyroidism
Down's |
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What causes a cleft lip?
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Medial nasal prominence did not fuse (maxillary sinus)
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What causes a cleft palate?
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Maxillary shelves did not fuse
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What is the MCC of no red reflex?
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Cataracts
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What is the MCC of a white reflex?
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Retinoblastoma
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What is the sign of a clavicle fracture?
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Asymmetric moro reflex
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What is an omphalocele?
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Intestines protrude out of umbilicus
Covered by peritoneum |
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Which cytokines do macrophages stimjulate?
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IL-1
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Which cytokines do T helper cells stimulate
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everything except IL-1
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Which enlarged lymph nodes are most likely malignant?
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Supraclavicular
Epitrochlear Inguinal |
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What is CD8
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T Killer or T Supressor cell. Responds to MCH-I (self)
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What cells express MHC-I
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All except RBCs and Platelets
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What is CD4
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T helper cells
Responds to MHC-II (non-self) |
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What type of immunity does TH1 provide?
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Cell mediated
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What type of immunity does TH2 provide?
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Humoral
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What do B Cell Deficient patients die from?
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Bacterial infection
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What is the common variable hypogammaglobulinemia?
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Kids w/ B cells that don't differentiate into plasma cells. Low ab
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What is Burton's Agammaglobulinemia?
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Young adults with defective Tyrosine Kinase
No Ab X-Linked |
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What is Job's syndrome?
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Stuck in IgE stage
Red head females |
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What is Multiple Myeloma?
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Multiple osteolytic lesions
IgG Kappa light chains Rouleaux formations |
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What is heagvy chain disease?
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IgA and Multiple Myeloma of the GI Tract
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What is selective IgG2 deficiency?
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Recurrent encapsulated infections
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What is selective IgA deficiency?
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Transfusion anaphylaxis
Mucous membrane infections |
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What is hairy cell leukemia?
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Fried egg
TRAP + |
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What is ataxia telangectasia?
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Low IgA
Neuro Problems |
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What is hyper IgM syndrome?
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High IgM
All other Ab low |
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What kind of problems do you see in patients with defects in cell mediated immunity?
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Viral
Fungal Mycobacterial Protozoa Parasite Neoplasm |
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What do T cell deficient patients die from?
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Viral infection
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What is DiGeorge syndrome?
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No Thymus/Inferior Parathyroids
Low Ca2+ Only immunodeficiency with low calcium |
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What is chronic mucocutanous Candidiasis?
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T cell defect against Candida albicans
Chronic fatigue |
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What is SCID?
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No Thymus
Frayed long bones Baby dies by 18 months |
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What is Wiskott-Aldrich?
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Low IgM
Low Platelets High IgA Eczema Petechiae |
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What organs have the most CD4 receptors?
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Blood Vessels
Brain Testicles Cervix Rectum |
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What are the 3 tests used to screen for HIV?
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ELISA --- Detects IgG Ab to P24 Ag
Western Blot---- See >2 proteins PCR----Detects Virus |
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What are the 9 Live Vaccines?
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MMR OR Very Yellow Sick Babies
Measles Mumps Rubella OPV (Sabin oral polio) Rotavirus Varicella Yellow Fever Smallpox BCG |
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What is Primary Biliary Cirrhosis?
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Anti-mitochondrial Ab
Pruritis Females |
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What is primary sclerosing cholangitis?
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p-ANCA
bile duct inflammation onion skinning IBD |
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What is type I autoimmune hepatitis?
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Anti-SM Ab
Young Women |
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What is type II autoimmune hepatitis?
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Anti-LKM Ab
Kids |
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What is bullous pemphigoid?
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Anti-hemidesmosome Ab
Skin bullae |
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What is Celiac Sprue?
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Anti-gliadin/ anti-Gluten Ab (wheat)
Steatorrhea |
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What is CREST syndrome?
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Anti-centromere Ab
Calcinosis Raynaud's Esophageal Dysmotility Sclerodactyly Telangiectasia |
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What is Dermatitis Herpetiformis?
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Anti BMZ Ab
Anti endomysial Ab Vessicles on anterior thigh Assoc w/ Dermatitis Herpetiformis |
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What is dermatomyositis?
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Anti-Jo1 Ab
Myositis + rash |
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What is DM Type I?
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Anti- Islet Cell Ab
Anti GAD Ab Polyuria Polydypsia Weight Loss |
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What is drug-induced lupus?
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Anti-Histone Ab
Hydralazine INH Procainamide Penicillamine Penytoin Ethosuxamide |
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What is gastritis type A?
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Anti-Parietal cell Ab
Atrophic Gastritis Achlorhydria Adenocarcinoma (Increased risk) |
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What is Goodpastures?
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Anti GBM Ab
Attacks lung and kidney MCC RPGN |
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What is Grave's disease?
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Anti-TSHr Ab
Attacks lung and kidney MCC RPGN |
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What is Guillain-Barre?
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Anti-ganglioside Ab
Ascending paralysis 2 wks post URI |
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What is Hashimoto's?
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Anti Microsomal Ab
Anti Thyroid Peroxidase Ab Hypothyroid |
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What is ITP?
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Anti Platelet Ab
Anti GP3b3a Ab Thrombocytopenia |
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What is mixed CT disease?
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Anti RNP Ab
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What is mononucleosis?
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Heterophile Ab
Teen w/ sore throat |
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What is MPGN Type II?
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Anti C3 convertase Ab (C3 nephritic factor)
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What is MS?
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Anti Myelin Ab
Middle Aged Female w/ vision problems |
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What is myastenia gravis?
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Anti-Achr Ab
Female w/ ptosis Weaker as day goes by |
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What is paroxysmal hemolysis?
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Donath Landsteiner Ab
Bleeds when cold |
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What is Pemphigus Vulgaris?
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Anti Desmosome Ab
Skin sloughs off when touched |
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What is pernicious anemia?
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Anti IF Ab
VItamin B12 deficient Megaloblastic anemia |
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What is polyarteritis nodosa?
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p-ANCA
Attacks gut and kidney Hep B |
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What is post-strep GN?
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ASO Ab
Nephritic with complement deposition |
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What is rheumatoid arthritis?
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Rheumatoid factor
Pain worse in AM |
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What is scleroderma?
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Anti Scl70
Anti-Topoisomerase Fibrosis Skin Tightening |
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What is Sjorgrens?
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Anti-SSA
Dry "sand in eye" Dry Mouth Arthritis |
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What is SLE?
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Anti DsDNA/Smith/Cardiolipin
Rash Photosensativity Oral Ulcers RF |
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What is SLE Cerebritis?
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Anti-Neuronal Ab
Anti-Ribosomal Ab |
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What is Vitiligo?
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Anti-Melanocyte Ab
White patches |
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What is warm hemolysis?
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Anti Rh Ab
Bleeds at body temperature |
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What is Wegner's?
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c-ANCA
Attacks ENT, Lungs, Kidney #2 cause of RPGN |
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Drugs that cause autoimmune hemolytic anemia?
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"PAC SAP"
PTU alpha-methyldopa Cephalosporins Sulfas Anti-Malarials Penicillin |
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Drugs that cause autoimmune thrombocytopenia
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Aspirin
Heparin Quinidine |
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T Cytotoxic Cells
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CD8
CD4 Recognize MHC-II Also have CD2 and CD3 markers |
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T-Helper Cells
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CD8
CD4 Recognize MHC II Also have CD2 and CD3 markers |
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Wiskott-Aldrich Syn
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B&T Cell Def
Low IgM Low platelets High IgA Increased IL4 Eczema Petechiae |
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SCID
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Adenosine Deaminase deficiency
T cells more affected than B cells Frameshift/Nonsense Mutation Increased bacterial and fungal infections |
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CVID
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Tyrosine Kinase Deficiency
Late Onset Frameshift/Nonsense Mutation |
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HIV (HTLV-1)
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Effects CD4-Rich tissue
Blood vessels Brain Testes Cervix Rectum T cells more affected than B |
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Job-Buckley (Job's) syndrome
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Tyrosine Kinase deficiency
Stuck in IgE Red Headed Female |
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Burton's agammaglobulinemia
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Tyrosine Kinase Deficiency
B Cell Deficiency |
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Leukemias
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98% B Cell
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Lymphomas
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98% B Cell
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DiGeorge Syndrome
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Hypocalcemia (only immunodeficiency with decreased Ca2+)
Problem w/ 3rd and 4th Pharyngeal pouches Deletion on Ch22 T Cell Deficiency |
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What is the CNS?
|
Brain and Spinal Cord
Oligodendrocytes |
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How does the parasympathetic system behave?
|
"DUMBBELS"
Diarrhea Urination Miosis (constrict) Bradycardia Bronchoconstrict Erection Lactimation Salivation |
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What is the sympathetic system?
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Fight or flight
Speeds stuff up |
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How does the sympathetic system behave?
|
"Opposition of parasympathetics"
Constipation Urinary Retention Mydriasis "eyes wide w/ fright" Tachycardia Bronchodilate Ejaculate Xeropthalmia (dry eyes) Xerostomia (dry mouth) |
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What is Cushing's Triad?
|
HTN
Bradycardia Irregular breathing |
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What is Budd-Chiari?
|
Hepatic Vein Obstruction
|
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What is Arnold-Chiari?
|
Formaen Magnum Obstruction
|
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What is anencephaly?
|
Notochord did not make contact with the brain. Only have medulla
|
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What is encephalocele?
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Brain tissue herniation
|
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What is a dandy-walker malformation?
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No cerebellum
Distended 4th and Lateral Ventricles |
|
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What is an arnold-Chiari malformation types I and II?
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Herniation of the cerebellum through the Foramen Magnum.
Type I: Cerebellar Tonsils (asymptomatic) Type II: Cerebellar Vermis/Medulla, Hydrocephalus, Syringomyelia (loss of pain/temp) |
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What is Spina Bifida Occulta?
|
Covered by skin w/ tuft of hair
|
|
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What is Spina bifida aperta?
|
Has an opening (high AFP)
|
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What is meningocele?
|
Sacral pocket with meninges in it
|
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What is meningomyelocele?
|
Sacral pocket with meninges and nerves in it
|
|
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What is open angle glaucoma?
|
Overproduction of fluid
Painless ipsilateral dilated pupil Gradual tunnel vision Optic disc cupping |
|
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What is closed angle glaucoma?
|
Obstruction of Canal of Schlemm
Sudden onset Pain Emergency |
|
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What are the watershed areas?
|
Hippocampus
Splenic Flexure |
|
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What bug loves the frontal lobe?
|
Rubella
|
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What bug loves the temporal lobe?
|
HSV
|
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What bug loves the parietal lobe?
|
Toxoplasma
|
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What bug loves the hippocampus?
|
Rabies
|
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What bug loves the posterior fossa?
|
TB
|
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What bug loves the DCML tract?
|
Treponema
|
|
|
How do migraines present?
|
Aura
Photophobia Numbness and tingling Throbbing HA Nausea |
|
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How does tension HA present?
|
"Band-like" pain starts in posterior neck
Worse as day progressses Sleep disturbance |
|
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How do cluster HA present?
|
Rhinorrhea
Unilateral orbital pain Suicidal Facial flushing Worse when lying down |
|
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How does temporal arteritis present?
|
Pain with chewing
Blind in one eye (emergency) |
|
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How does trigemial neuralgia present?
|
Sharp, shooting face pain
|
|
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What are the two kinds of parial seizures?
|
Simple (aware)
Complex (unaware) |
|
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What are the three kinds of generalized seizures?
|
Tonic-Clonc (Grand Mal)
Absence: "Petite Mal" Status Epilepticus |
|
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How does an epidural hematoma present?
|
Intermittent consciousness
"lucid interval" |
|
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How does a subdural hematoma present?
|
HA 4 wks after trauma
Elderly (loose brain) |
|
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How does a subarachnoid hemmorhage present?
|
Worst headache of my life
History of Berry Aneurysm |
|
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What is an Astrocytoma?
|
Rosenthal fibers
#1 in kids w/ occipital HA |
|
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What is an Ependymoma?
|
Rosettes
In 4th Ventricle Hydrocephalus |
|
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What is a craniopharyngioma?
|
"Motor Oil Biopsy"
Tooth enamel Rathke's pouch ADH problem Bitemporal Hemianopsia |
|
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What is Glioblastoma Multiforme?
|
Pseudopalisading
Necrosis Worst Prognosis Intralesional hemorrhage |
|
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What is hemangioblastoma?
|
Cerebellum
Von-Hippel-Lindau |
|
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What is medulloblastoma?
|
Pseudorosettes
Compresses brain Early AM vomiting |
|
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What is a meningioma?
|
Parasagital
Psammoma bodies Best pronosis |
|
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What are the most common places to metastasize to the brain?
|
Lung, Brest, Skin
See the tumor at the white-grey jxn |
|
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What is an oligodendroglioma?
|
Fried egg appearance
nodular calcification |
|
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What is a Pinealoma?
|
Loss of upward gaze
Loss of circadiam rythms Precocious puberty |
|
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What is a Schwannoma?
|
CNS Tumor
Unilateral Deafness |
|
|
What is Neurofibromatosis?
|
Cafe Au Lait spots (hyperpigmentation). Peripheral nerve tumors. Axillary freckles.
|
|
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Neurofibromatosis Type I
|
Von Racklinghausen's
Peripheral Chr 17 Optic Glioma Lisch nodules Scoliosis |
|
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Neurofibromatosis Type II
|
Acoustic Neuroma
Cental Chromosome 22 Cataracts Bilateral Deafness |
|
|
What is Sturge-Weber?
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Port wine stain (big purple spot on forehead).
Angioma of the retina |
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What is Tuberous Sclerosis?
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Ashen leaf spots (hypopigmentation)
Primary brain tumors Rhabdomyolysis of the heart Renal Cell CA Shagreen spots (leathery) |
