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56 Cards in this Set
- Front
- Back
lab tests for primary liver cancer
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alpha-fetoprotein
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lab test for hepatitis (liver cell injury)
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ALT
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lab test for acute pancreatitis
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amylase and lipase
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BMI for overweight
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25-30
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BMI for obesity
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30.0+
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kidney stone can be seen in 25% of patients with what disease?
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gout
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which disease shows an acute onset of monoarthritis in a joint of the lower extremity, especially in first metatarsophalangeal joint, accompanied with painful erythema and swelling; other joints like foot, ankle, knee, wrist, and hand may also be involved.
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gout
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these patients often feel nervousness, increased sweating, hypersensitivity to heat, palpitation, weakness or fatigue, increased appetite and weight loss, tachycardia, diffuse or nodular enlargement of thyroid, tremor of hands, oxophthalmos, periorbital edema, lid lag, conjunctive congestion and swelling, some patients have diarrhea, or pretibial myxedema
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Graves Disease (Hyperthyroidism)
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Graves Disease (hyperthyroidism) shows high levels of ___ and ____ and low levels of ____
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high levels of T3 and T4, low levels of serum TSH
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a type of hypothyroidism in infants, which causes a disturbance of growth and development and may result in permanent physical and mental retardation
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cretinism
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a type of hypothyroidism in adults, which causes a syndrome of low metabolic rate
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myxedema
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clinical manifestations include impaired development of the skeletal system and central nerve system, manifested by severe mental retardation, short stature, coarse facial features, a protruding tongue, hypotonia, inactivity, an open posterior fontanelle, umbilical hernia, and delayed puberty occur if treatment is delayed
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cretinism (hypothyroidism in infants)
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clinical manifestations include slowing of physical and mental activity, initial symptoms usually start from fatigue, lethargy, cold intolerance, constipation, and gradually gain weight, the skin is dry, coarse, cold, and orange in color, with hair loss. non-pitting edema results in puffy appearance, bradycardia, low blood pressure, slow reaction and delayed reflxes
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myxedema (hypothyroidism in adults or older children)
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lab exam of hypothyroidism results show low levels of __ and ___ and high level of ______
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low levels of T3 and T4 and high level of serum TSH
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the most common pathogen of a urinary tract infection
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E. Coli
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-lower tract infections that involve the bladder
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cystitis
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upper tract infections that involve primarily the kidneys
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pyelonephritis
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these patients usually present with a history of dysuria, frequency and urgency of urination or suprapubic pain
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cystitis
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usually characterized by signs of low tract infection in association with back pain, flank pain, fever and chills, and other systemic symptoms
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pyelonephritis
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physical findings may include suprapubic tenderness
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cystitis
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physical findings may include costovertebral angle tenderness
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pyelonephritis
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clinical manifestations include severe heart burn
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gastroesophageal reflux disease (GERD)
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clinical manifestations: may have no pain (asymptomatic), or may have chronic epigastric pain or discomfort usually occurring after a meal but with no regularity
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chronic gastritis
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clinical manifestations: pain in epigastrium 1-3 hours after a meal
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gastric ulcer (25% of ulcers)
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clinical manifestations: pain in epigastrium when the stomach is empty, with patient usually being awakened by pain around midnight
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duodenal ulcer (70% of ulcers)
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clinical manifestations: chronic and recurrent abdoominal pain in lower right quadrate or around umbilicus
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Crohn's Disease
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clinical manifestations: chronic relapsing abdominal pain in lower left quadrate or both lower quadrates, blood and mucus in diarrhea
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ulcerative colitis
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clinical manifestations: severe right epigastric pain, often referred to right shoulder/interscapular region, lasting 30 min to several hours
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cholelithiasis (gallstones)
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clinical manifestations: abrupt onset of nausea, vomiting, fever, right epigastric discomfort
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Hepatitis A
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clinical manifestations: abrupt onset of severe right epigastric pain with anorexia, fever and chills, fatigue
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Hepatitis B
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disorder in which the lining of the esophagus is damaged by stomach acid and changed (metaplasia) into a lining similar to that of the stomach (columnar gastric type mucosa)
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Barrett's Esophagus
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Helicobacter pylori (HP) infection is related to what types of stomach diseases?
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chronic gastritis (70-95% of CG patients have it)
peptic ulcer disease (related to 90-100% of duodenal ulcers, and 70% of gastric ulcers) |
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What differentiates chronic gastritis type A versus type B?
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type A does NOT have sour regurgitation
(both have epigastric pain, stomach fullness, belching, nausea, and vomiting) |
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Chronic gastritis and peptic ulcer disease can both be caused by ______ and __________
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HP infection and NSAIDs
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...but chronic gastritis differs in cause from peptic ulcer disease in that chronic gastritis can be caused by ______________, and peptic ulcer disease can be caused by ____________.
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gastritis = stress-related gastric mucosal damage;
peptic ulcer = increased acid secretion |
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occurs globally, incidence in US ~ 50/100,000; occurs at any age, most commonly between 20-40yo, with a small peak between 50s-60s.
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Crohn's Disease
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occurs globally, incidence in US is slightly >50/100,000; more common among whites than blacks; more common in women than men; onset of disease peaks ~ age 20-25.
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Ulcerative Colitis
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Composition of gallstones in Western countries versus African/Asian countries
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Western = majority are cholesterol stones
Africa/Asia = majority are pigmented (calcium bilirubinate) stones |
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Cholesterol stones form when there is a disturbance in...
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the process of cholesterol secretion in bile.
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Pigmented stones form when there is an accumulation of...
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bilirubin in the gallbladder.
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transmission of Hep A
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fecal-oral route
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transmission of Hep B
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parenteral, sexual, or vertical (maternal-infant) routes
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transmission of Hep C
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5-10% = blood transfusions
40% = IV drug abuse 5% = health care occupational exposure 10% = heterosexual activity w/ multiple partners 40% = no identifiable source of infection |
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transmission of Hep D
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sexual or blood contact, or mother-to-child;
Hep D cannot exist without also being infected with Hep B |
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prognosis of Hep A
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good; there is no chronic or carrier state
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prognosis of Hep B
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most acute cases have good prognosis;
5-10% turn into chronic states, and even cirrhosis or primary carcinoma of liver; even higher for those infected with Hep D also |
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prognosis of Hep C
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45% of people who get Hep C are at risk to develop chronic liver disease (chronic active hepatitis, cirrhosis, carcinoma of liver, etc.);
90% mortality rate of those who develop into fulminant course |
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prevention of Hep A
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passive immunization ( with ISG) within 2 weeks of exposure;
active immunization by Hep A vaccination |
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prevention of Hep B
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passive immunization (with serum globulin + HBIG) within 14 days of exposure;
active immunization: HBV vaccine (3 doses at 0, 1 and 6 months), effects last 3-5 years. |
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prevention of Hep C
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there is currently no vaccine;
avoid unprotected sex, blood contact, sharing needles, etc. |
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Hep B patients versus HBV carriers
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Hep B patients often have acute symptoms, while chronic Hep B carriers often appear healthy with no symptoms for many years
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commonly seen in children/young people; incidence higher in males than females; edema on eyelids/face usually appears; 80% have mild-moderate HTN
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Acute Glomerulonephritis (nephritis)
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edema, anemia, and renal function impairment, plus persistent HTN
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Chronic Glomerulonephritis (nephritis)
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obvious systemic edema may be accompanied by pleural infusion and ascites; proteinuria > 3.5g/day; hyperlipidemia, hypoalbuminemia
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Nephrotic Syndrome
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same features as acute nephritic syndrome, plus renal function rapidly deteriorating, progressing to renal failure in weeks/months, oliguria/anuria, anemia, increased BUN and serum creatinine
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Rapidly Progressive Glomerulonephritis (RPGN)
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main pathogens in urinary tract infections
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most pathogens responsible for UTI's are part of the patient's normal bowel flora:
Escherichia coli (most common), Klebsiella, Enterobacter, Enterococci |