Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
87 Cards in this Set
- Front
- Back
Oral manifestations of HIV
|
Candidiasis, aphthous ulcers (stomatitis), hairy leukoplakia (EBV), Kaposi's sarcoma
|
|
Noninfectious ulceration in oral cavity
|
Pemphigus, membrane pemphigoid, eryhema multiforme or SJS (drugs or infection)
|
|
Behcet Syndrome
|
immune complex small vessel vasculitits, causes recurrent mouth and genitalulerations, erythema nodusum
HLA-B27 and B51 |
|
Macroglossia causes
|
Myxedmea, Down's, acromegaly, amyloidosis, mucosal neuromas
|
|
Glossitis causes
|
deficency of iron, B12, folate, vit C, niacin, scarlet fever, hairy leukoplakia
|
|
Ameloblastoma
|
benign tumor of ename organ epithelium, located in mandible, spreads locally but no metastases
|
|
Lower esophageal dysphagia
|
SMC dismotility associated with systemic sclerosis, CREST syndrome
|
|
Plummer Vinson Syndrome
|
d/t iron deficiency, leukoplakia in oral mucosa and esophagus, intermittent dysphagia for solids (obstructive lesion), d/t esophageal web or stricture
|
|
Infectious esophagitis
|
Complication of AIDS
- HSV- multinucleated squamous cell with inclusions - CMV- basophillic intranuclear incluiosn Candida- yeasts and pseudohyphae |
|
Octreotide
|
somatostatin analog used in pancreatitis and esophageal varices, decreased GI blood flow and release of hormones
|
|
Esophageal motor disorders
|
Chagas, CREST, systemic sclerosis, diagnosed by barium swallow
|
|
Esophageal Squamous cell carcinoma risk factors
|
Smoking, alcohol, achalsia, more common in developng countries
|
|
Paraneoplastic Syndrome
|
Hormonal alterations and stuff d/t distal tumors, SIADH or hypercalcemia d/t PTH
|
|
Gastroperesis
|
Frcreased motility form autonomic neurppathy (DM) or vagotomy
|
|
Chronic atrophic gastiritis
|
Type A- pernicious anemia
Type B antrum and pylorus, H pylori usually Menerier disease- hypertrophic giat rugal folds, atrophy of parietal cells |
|
Zollinger Ellison Syndrome
|
malgnat pancreatic islt cell tumors, secrete gastrin -> acidity
elevated serum gastrin > 1000pg/mL |
|
Intestinal type gastric carcinoma
|
most common, inestinal metaplasia d/t H pylori
|
|
Gastric adenocarcinoma clinical findings
|
weitght loss, epigastric pain, Virchow's node, paraneoplastic skin lesions, metastasis to umbilicus
|
|
diarrhea ddx
|
infection, malabsorption, ostmotic diarrhea
If bloody, dysentery, infarction, volvulus Large bowel- infection laxatives, IBD |
|
Campylobacter Jejuni sequelae
|
Guillan Barre d/t cross reactive antigen with neurons, HUS, HLA-B27 sponydloarthropathy
|
|
Shiga toxin
|
Inhibits protein synthesis by binding to ribosomes, leads to cell death
|
|
Trichuris trichrum
|
rectal prolapse in kids
|
|
Ascaris lumbricoides
|
larval phase passes through lones casuing cough and pneumonitis
|
|
Strongyloides
|
from feet to larval phase in lungs, eggs can hatch and larvae can migrate to lungs resulting in autoinfection
|
|
Diphyllobothium latum
|
from fish, diarrhea, preferentially uptake B12
|
|
Pancreatic insufficiency
|
d/t chronic pancreatitis, maldigestion of fat and proteins
|
|
Serum immunoreactive trypsin
|
Specific for the pancreas, decreased with chronic pancreatitis and increased in early CF
|
|
Celiac Dz pathogeneisis
|
transglutaminase in lamina propria deaminates gluten, and enhances immune response producing a T-cell and cytokine response
|
|
Whipple's Dz
|
caused by tropheryma whippelli, blunting of villi, PAS + macrophages in lamina propria -> fat malabsorption, fever, polyarthritis, hyperpigmentation
|
|
Causes of small and large bowel obstruction
|
adhesions, Crohn;s, duodenal atesia, gallstone ileus, Hirsprungs, Indirect and femoral hernia, intussuseption, meconium ileus, volvulus
|
|
Small bowel infarction etiology
|
transmural d/t occlusion of SMA (from left side of heart usually a fib)
or mesenteric vein thrombosis from hypercoagulable state Mural- d/t hypoperfusion state |
|
Direct hernia
|
hernia bulges through Hesselbach's triangele (medial rectus sheath, lateral inferior epigastric, inferior inguinal ligament), diappears with reclining
|
|
Indirect Hernia
|
Most common, into inguinal canal, may enter scrotum
|
|
Femoral Hernia
|
More common in women, bulge below inguinal ligament
|
|
bowel infarction findings
|
diffuse abd pain and distension, bloody diarrhea, no bowel sounds, no rebound tenderness early, Thumbprint sign on radiograph
|
|
Ischemic colitis
|
atherosclerotic narrowing of SMA causes mesenteric angina -> pain at splenic flexure, thumb printing on splenic flexure
|
|
Angiodysplasia
|
Dilatiion of mucosal venules in ascending colon, d/t increased wall stress ->hematochezia, assoicated with vWF and aortic stneosis
|
|
Meckel Diverticulum
|
Remnant vitelline duct, true diverticulum, bleeeding , fecsal material in vitelline duct, Contain pancreatic rests and hetertropic gastric mucosa (increase bleeding risk)
|
|
Diverticulitis findings
|
feverm diarrhea, LLQ pain, tender mass can be palpated sometimes, diagnosis via CT or water soluble barium study
|
|
Ulcerative colitis
|
chronic relapsing ulceroinflammatory diseases, continusous ulcerations limited to the mucosa and submucosa
|
|
Crohn's Disease
|
Chronic granulamtous disease, transmural inflammation, noncaseating granulomas and discontiiiounous spread
|
|
small bowel tumors
|
most common is neuroendocrine tumor, produce bioactive compounds -> portal vein -> usually metabolized unless metastasis, causes flushing, diarrhea, bronchospasm etc.
*urine 5-HIAA* |
|
Juvenile retention polyps
|
most common polyp of kids, in rectum, sometimes prolapse, solitary polyp ot juvenile polyposis (AD)
|
|
Cronkhite-Canada syndrome
|
Nonhereditary polyposis syndrome, polyps plus ectodermal abnormalites of nails
|
|
Peutz-Jeghers Polypois
|
AD, hamartomatous polyps in small bowel, mucosal pigmentation, increased risk of some CA
|
|
Tubular adenoma
|
most common poylp, sgiomid coln is most common site, stalked polyps, less likely to be common
|
|
Villlous adenoma
|
may cause hypoproteiniemia and hypokalemia (secrete protein and potassium rich mucns), greatest risk of colon CA
|
|
Familial polyposis
|
APC gene, AD, all develop CA, prophylactic colectomy
|
|
gardner syndrome
|
FP, AD, colon cancer, osteomas and desmoid tumors
|
|
Turcot's syndrome
|
FP, AR, colon cancer and CNS tumrs
|
|
Carcinogenesis of colon cancer
|
APC -> RAS -> TP53, could also be DNA mismatch repair disease, colonoscopy is gold standard for detection
|
|
Findings in colon cancers
|
left sided- obstructs, get diarrhea or constipation strep bovis
right sided- tend to bleed, iron deficiency |
|
Findings in appedniciitis (in sequence)
|
colicky periumbilical pain, fever, nausea, vomiting and fever AFTER pain, RLQ pain
|
|
Rectal prolapse
|
intussceoptoion of the retum through anus, in kids pertusisis, trichuriasis, and CF casue, in elderly straining with stool
|
|
Pilonidal sinus/abscess
|
painful mass in deep gluteal fold, incise and drain
|
|
Causes of jaundice
|
hemolytic anemias, Gilbert's syndrome, Crigler Nijar syndrome, physioligic jaundice of newborwn, breast milk jaundice, obstructive
|
|
Dubin Johnson syndrome
|
AR dsiorder in secretion into intrahepatic bile ducts, black pigment in hepatocytes
|
|
Rotor's syndrome
|
AR disorder similar to Dubin-Johnson, no black bigment
|
|
Hyperbilrubinemias
|
extravsacular hemolsyis increased UCB, viral hepatiits miced hyperbilrubinemia, obstructive diseae incrrease in conjugated bilirubin
|
|
Liver cell necrosis tests
|
ALT elevated in viral hepatitis, AST elevated in alcholic hepatitis, alk phos- cholestasis, GGYintra or extrahepatic obstruction to bile flow
|
|
Ascending cholangitis
|
Usually d/t E coli, inflammaiton of bile ducts leads to lifethreatening infection, fever, jaundice and RUQ pain
|
|
Autoimmune hepatitis
|
HLADR3 and DR4, young women, m fever, jaundice, hepatosplenomegaly, + ANA, anti-smooth muscle antibodies
|
|
Reye syndrome
|
Encephalapothy, microvesicular fatty change, transaminase elevation, associated with ASA, chickenpox and influeenza, mitochondria damage and accumulation of ammonia decrease in transaminases, and glucose
|
|
Most common cause of heptic vein thromboisis
|
Polycythemia vera, signs are enlarged painful liver, portal HTN, ascites, splenomegaly, high mortality rate
|
|
Venoocclusive disease
|
cause onbstruction of pportal blood flow, complication of bone marrow transplant, collagen develops around central veins
|
|
Mallory bodies
|
damaged cytokeratin intermediate filaments in hepatocytes, associated with alcoholic liver disease, also fatty chjange and neutrophil infiltration
|
|
Primary sclerosing cholangitis
|
onliterative fibrosis of intrahepatic and extrahepatic ducts, HLA-DR52 in 1005, males associated with IBD, can cause cholangfiocarcinoma, jaundice, pruritis, hepatosplenomegaly
|
|
Cirrhosis
|
irreversible diffuse fibrosis of the liver with formation of regenerative nodules, hepatocyte, lack of portal triads, surrounded by bands of finbrosis
|
|
Pathogenesis of ascites
|
Portal HTN, hypoalbuminiae and secondary hyperaldosterone d/t decreased CO and decreased liver metabolism of aldosterone
|
|
Hepatorenal syndrome
|
eversible renal failure without parenchymal disease, d/t decreased RBF
|
|
Primary biliary cirrhosis pathogenesis
|
environmetnal insult insult affecting mitochondrial proteins ttirggering CD* T cell destruction of intralobular bile duct epithlium, antimitochondirla antioides
|
|
Hereditary hemochromatosis
|
AR, HLA-A3 assoicated, unrestricted reabsorption of iron in the small intestine, excess iron stimulates production of free radiaclas leading to damage and cirrhosis
|
|
Hereditary Hemochromatosis
|
AR, HLA-A3 6q chromsome, Northern European, inrestricted reabosrption of iron in the small intestine
leads to cirrhosis, Bronze diabetes (destruction of B-islet cells) hyperpigmentation |
|
Wilson's disease
|
AR, variable onset, liver diseasse from acute hepatitis to cirrhossis, gene mutation leads to defective transport of copper into bile for excretion, defective incorporation fo copper, increased copper in blood
|
|
Wilson's disease CNS affects
|
in over half of patients
deposits in putamen leading to parkinsonian type disorder Subtha,mic nucleus leading to hemiballismus Copper is toxic to neurons in the cerebral cortex -> dementia |
|
alpha1-antitrypsin defici ency
|
AD, codominant inheritance, most severe in homzygous, leads to panacinar emphsema and cirhosis of liver from accumulation of AAT
|
|
Lab tests in cirrhosis
|
decreased serum BUN, increased ammonia, fasting hypoglycemia (defective gluconeogenesis), chronic resp alkalosis, lactic acidosis (not converting lactic acid to pyruvate), hyponatremia, hypoalbunemia
|
|
Cavernous hemangioma
|
most common benigng tumor of liver, best seen on CT, rarely bleeds
|
|
Liver cell adenoma
|
seen with OCPs, and anabolic roids, Von Gierke's glygogenosis. highly vascular dtendency to rupture
|
|
Hepatocellular
|
most common primary liver cancer, finding of bile in neoplastic cells, gross finding focal, multifocal or diffusely infiltrating CA, portal and hepatic vein invasion is common
|
|
Caroli disease
|
AD, segmental dilatation of bile ducts -> portal tract fibrosis, associated with polycystic kidney dissease, increased risk of cholaangiocarcinoma and cholelithaiasis
|
|
Pathogenesisi of cholesterol stones in gall bladder
|
supersaturation of bile with cholesterol with decreased bile salts, seen in women over 40, OTC use, obesity
|
|
Lab findings in acute cholecystitis
|
leukocytosis with left shift, increaset AST/ALP, best test is ultrasound
|
|
Chronic cholecysitis
|
repeated attacks of minor inflammation, clincial findings of severe persistent pain 12 hours post pradially in the evenings
|
|
Gallbladder carcinoma
|
porcelain callbladder from calcification, complication of cholelithiasis
|
|
DIC in acute pancreatitis
|
from activation of prothrombin by trypsin
|
|
Sentinel Loop
|
Plain x-ray in subadjacent duodenum or transverese colon, localized ileus where bowel does not edmonstrate peristalsis
|