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83 Cards in this Set
- Front
- Back
achondroplasia
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-falure of longitudinal bone growth==>short limbs
-nl membrane ossification (nl skull, facial bones, axial skeleton) -impaired cartilage maturation in growht plate d/t mutated fibroblast growth factor receptor |
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what is mutated in achondroplasia
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mutated fibroblast growth factor receptor (GFR)
==>impaired cartilage maturation in growth plate |
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subchondral cysts
=>dz? |
Osteoarthritis
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eburnation
==>dz? |
osteoarthritis
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Bouchard's and Heberdon's nodes
==>dz? |
osteoarthritis
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destruction of articular cartilage
==>dz? |
osteoarthritis
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bone and cartilage erosion
==>dz? |
Rheumatoid arthritis
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incr synovial fluid in joint space
==>dz? |
Rheumatoid arthritis
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pannus
==>dz? |
Rheumatoid arthritis
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subluxation of joints
==>dz? |
Rheumatoid arthritis
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Boutonniere deformity
==>dz? |
Rheumatoid arthritis
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swan-neck deformity
==>dz? |
Rheumatoid arthritis
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Z-thumb deformity
==>dz? |
Rheumatoid arthritis
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describe bone mineralization in osteoporosis
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nl bone mineralization
(but incr bone resorption) |
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osteoporosis : Type I vs II
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Type I= post-menopausal
(decr estrogen==>incr bone resorption) Type II= Senile osteoporosis (>70 y/o) |
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distal radius fractures is assoc with what dz
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osteoporosis
(distal radius fractures= Colles fractures) |
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Tx osteoporosis
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for severe osteoporosis, tx wtih bisphosphonates (patrick's mneumonics) or pulsatile PTH
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thickened, dense bones
anemia, thrombocytopenia, infxn dz? et? serum Ca, phosphate, and alk phos levels? |
dz=Osteopetrosis (marble bone dz)
et=osteoclasts do not resorb bone like they should serum Ca, phosphate, and ALK PHOS levels are nl (alk phos ~ osteoBLASTic activity) thickened dense bones ==>decr BM space ==>anemia, thrombocytopenia, decr WBC cause infxn (~aplastic anemia) |
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osteomalacia/rickets
-desc -reversible |
deficient Vit D
==>defective bone mineralization ==>soft bones -Osteomalacia (Vit D deficiency in adults) is reversible -Rickets (Vit D deficiency in kids) ==>decr calcification ==>incr osteoid accumulation ==>incr thcikness of epiphyseal growth plate & other Sk deformities |
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osteitis fibrosa cystica
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von Recklinghausen Dz of bone
-d/t hyper-PTH *brown tumors (cystic spacews lined by osteoclasts, filled with fibrous stroma and blood) hyper-PTH==>high serum Ca, low serum phosphorus -high alk phos (~osteoblastic activity) |
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cystic spaces lined by osteoclasts, filled with fibrous stroma and blood
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=brown tumors
==>osteitis cystica fibrosa (AKA von Recklinghausen Dz of bone) -d/t hyper-PTH hyper-PTH==>high serum Ca, low serum phosphorus -high alk phos (~osteoblastic activity) |
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describe cardiac abnl secondary to Paget's dz of bone
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In Paget's dz of bone, A-V shunts cause incr blood flow
==>high-output CHF |
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polyostitic fibrous dysplasia
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"polyostitic fibrous dysplasia"
-"polyostotic"==>affects multiple bones -"fibrous dysplasia"==>bone replaced by fibroblasts, collagen, and irregular bony trabeculae; QBank: "unmineralized whorls of connective tissue" -Albright's syndrome (imagine Madeleine Albright as a young girl with big boobs (precocious pubery) with these other Sx) is a type of polyostitis fibrous dysplasia in which there are: *multiple unilateral bone lesions *unilateral pigmented skin lesions (i.e. on one side of back) *endocrine abnl (precocious puberty) |
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multiple unilateral bone lesions are associated with what endocrine and skin abormalities?
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-this is Albright's syndrome (imagine Madeleine Albright with these Sx), which is a type of polyostitis fibrous dysplasia in which there are:
*multiple unilateral bone lesions *unilateral pigmented skin lesions *endocrine abnl (precocious puberty) |
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polymyalgia rheumatica is assoc w what vascular problem
how Tx |
temporal (giant cell) arteritis
Tx with prednisone |
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polymyositis
-desc -et -how Dx -lab tests show what |
=progressive symmetric muscle weakness
-et: CD8+ T-cell induced injury to myofibers Dx=muscle biopsy with evidence of inflammation -labs for polymyositis/dermatomyositis show: *incr CK (indicates muscle destruction b/c CK is in muscle) *incr aldolase *positive ANA *anti-Jo-1 |
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dermatomyositis
-desc -et -lab tests show what |
-similar to polymyositis (progressive symmetric muscle weakness d/t CD8+ T-cell induced injury to myofibers)
-but also "shawl and face" skin rash and incr risk of malignancy -labs for polymyositis/dermatomyositis show: *incr CK (indicates muscle destruction b/c CK is in muscle) *incr aldolase *positive ANA *anti-Jo-1 |
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*incr CK
*incr aldolase *positive ANA *anti-Jo-1 suggest what |
polymyositis/dermatomyositis
(incr CK indicates muscle destruction b/c CK is in muscle) |
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anti-Jo-1 suggest
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polymyositis/dermatomyositis
|
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antibodies to U1RNP
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mixed connetive tissue dz:
-Raynaud's -arthralgias/myalgias -esophageal dysmotility |
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SSA & SSB
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Sjogren's Syndrome
(SS=Sjogren's Syndrome) |
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Ro antibodies
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=SSA
(SS=Sjogren's Syndrome) |
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La antibodies
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=SSB
(SS=Sjogren's Syndrome) |
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risks assoc with Sjogren's syndrome
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incr risk of B-cell lymphoma & dental caries
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sicca syndrome
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(~Sjogren's)
dry eyes dry mouth nasal & vaginal dryness ("Vaginal dryness? sicca!") chronitic bronchitis refluex esophagitis |
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wire loop lesions in kidney
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SLE
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what dz can cause false + on syphilis tests (RPR/VDRL)
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SLE
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autoantibodies in lupus
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1. ANA: sensitive but not specific
2. anti-ds DNA: very specific, poor prognosis 3. anti-Smith: very specific, but not prognostic 4. antihistone Ig: drug-induced lupus |
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antihistone Ig
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drug-induced lupus
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anti-dsDNA
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lupus
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anti-Smith antibodies
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lupus
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et of gout
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1. decr excretion of uric acid (i.e. thiazide diuretics competitively inhibit uric acid excretion)
2. Lesch-Nyhan 3. PRPP excess 4. G6PD |
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podagra
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painful MTP joint (big toe) in gout
|
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pseudogout
-type of crystals -MC joint affected |
Ca++ pyrophosphate
MC joint affected=knee |
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sarcoidosis
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"GRAN"uloma
G=Gammaglobulinemia (incr IgG) R=Rheumatoid arthritis (also assoc w/incr IgG) A=ACE increase N=noncaseating granulomas -interstitial lung dz -bilateral enlarged hilar LN -uveitis -parotitis -erythema nodosum of skin (red nodules ~ RA) -high Ca++ (d/t elevated activation of Vit D in epithelioid macrophages) -Bell's palsy |
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anticentromere antibody
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CREST (anti-CENT-romere sounds like of like CREST)
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anti-Scl-70 antibody
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diffuse scleroderma
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pinpoint bleeding if scrape off this skin lesion
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pinpoint bleeding=Auspitz sign
==>Psoriasis |
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atopic dermatitis
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AKA eczema
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allergic contact dermatitis is what type of hypersensitivity
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Type IV
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dermatitis herpetiformis
-pathogenesis -asoc w what dz |
IgA deposits at tips of dermal papillae
==>papules & vesicles -assoc w celiac dz |
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lichen planus
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pruritic papules & vesicles
lymphocytic infiltrate at epidermal-dermal jxn (mneum: "PLANe of lymphocytes at epidermal-dermal PLANE) |
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erythema multiforme
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"multiforme"==>multiple types of lesions:
*target lesions (red papules with pale central area) *macules *papules *vesicles -assoc w/"multiple" causes: *infections--esp Mycoplasma pneumoniae *drugs *cancer *autoimm dz |
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seborrheic keratosis
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=senile keratosis (old ppl get it)
-BENIGN -sharply demarcated plaques/papules with "stuck on" appearance -squamous epithelium proliferation w/keratain-filled cysts |
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Stevens Johnson syndrome
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-assoc w sulfa drugs and anticonvulsant drugs
-severe form of erythema multiforme -high mortality rate -high fever -bulla (fluid filled blister >0.5 cm) formation and necrosis -skin ulceration |
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actinic keratosis
-risk assoc with what |
-precursor to SCC
-risk of CA is proportional to epithelial dysplasia |
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keloid
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-abnl proliferation of dermal connective tissue
==>raised, tumor-like scars -follows trauma to skin (i.e. ear piercing, surgical wounds) -AfAm |
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arsenic exposure is assoc w/what skin cancer
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SCC
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skin SCC is assoc with exposure to what?
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arsenic
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skin lesion with pearly papules
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skin BCC
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skin tumor that shows "palisading nuclei"
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skin BCC
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dysplastic nevus
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precursor to melanoma
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MC malignant skin lesion
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BCC
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sudden outcropping of raised pigmented papules/plaques (look like moles)
-what are they -what does the sudden outcropping of them suggest? |
=seborrheic keratosis
suggest stomach adenoCA |
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acanthosis nigricans suggest what
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stomach adenoCA
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bone tumor:
“double bubble” or “soap bubble appearance on X-ray” -which bone tumor? -site? |
giant cell tumor
Epiphysis of long bones; Distal femur, prox tibia |
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MC benign bone tumor?
site? |
osteochondroma
-mature bone capped by cartilage -♂ <25 y/o site=Metaphysis of long bones |
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MC malignant bone tumor?
-desc site? |
osteosarcoma
*Codman’s triangle ♂ 10-20 y/o site=Metaphysis of long bones |
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cartilage tumors
-benign -malignant |
Enchondroma:
Benign cartilage tumor Site=intramedullary bone (like chondrosarcoma), BUT in hands/feet (vs chondrosarcoma) Chondrosarcoma: Malignant cartilage tumor Site=intramedullary bone (like enchondroma), BUT in pelvis, spine, scapula, humerus, tibia, femur |
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“onion skin appearance” on X-ray
-which bone tumor? -benign or malignant? -site? |
Ewing’s sarcoma
-malignant -“onion skin appearance” on X-ray (mneum: go out for eWINGS and onion rings) -t (11,22) -Site=Diaphysis of long bones, pelvis, scapula, & ribs |
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Buerger's disease
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AKA thrombitis obliterans
(Tip: visualize!) -thrombosing vasculitis of small-medium peripheral vessels ==>claudication (very painful!) ==>cold insensitivity (Raynaud's) ==>superficial nodular phlebitis -seen in heavy smokers |
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MC vasculitis
-name -affects what arteries -Sx -assoc w/what MSK problem -Tx |
temporal arteritis (AKA giant cell arteritis)
-affects medium-small arteries, usu branches of carotid A Sx: -jaw claudication -impaired vision (occlusion of opthalmic artery, can cause blindness) -unilateral H/A -assoc w/polymyalgia rheumatica Tx: steroids (b/c inflammatory) |
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jaw claudication
elevated ESR Dx? |
temporal arteritis (AKA giant cell arteritis)
|
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unilateral H/A
imparied vision elevated ESR |
temporal arteritis (AKA giant cell arteritis)
|
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vasculitis of kidney, lungs/upper airway
-what type of Hypersensitivity |
Wegener’s granulomatosis
Type 3 hypersens |
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vasculitis of kidney, GI
-Dz? -what type hypersensitivity? -assoc w/what dz |
polyarteritis nodosa
P-ANCA + Type 3 hypersens *assoc w/Hep B -Tx: corticosteroids (to reduce inflammation), cyclophosphamide |
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perforation of nasal septum
chronic sinusitis otits media mastoiditis hemoptysis hematuria & red cell casts -Chest X-ray shows large nodular densitis ==>Dx? |
Wegener's granulomatosis
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Wegener's granulomatosis
Sx? Tx? |
perforation of nasal septum
chronic sinusitis otits media mastoiditis hemoptysis hematuria & red cell casts -Chest X-ray shows large nodular densitis Tx: corticosteroids (to reduce inflamm), cyclophosphamide |
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granulomatous vasculitis involving lungs, heart, skin, kidneys, nerves
-what cells do you see? |
Eo's
(this is Churg-Strauss syndrome) |
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-vasculitis in infants/kids
-fever -congested conjunctiva -chaps in lips/oral mucosa -lymphadenitis ==>Dz? ==>prognosis ==>risk? |
Kawasaki dz
-acute, self-limiting but may develop coronary aneurysms |
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Goljan: palpable purpura means what?
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=small vessel vasculitis
=ImCo (Type 3 hypersens) |
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telangiectasia
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A-V malformation in small vessels
|
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hereditary hemorrhagic telangiectasias have what inheritance pattern?
-Sx? |
AD
Sx: nosebleeds skin discolorations |