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NBCE Part 3 A

Diagnosis: Related Terms and Definitions

QuestionAnswer
ACROCYANOSIS Idiopathic vasospasm of the arterioles of the skin of the hands resulting in a symmetrical, persistent painless cyanosis.
ERYTHROMELALGIA Proximal, bilateral vasodilation of the lower extremities blood vessels causing burning pain, redness and increased temperature of the feet
RAYNAUD'S PHENOMENON Episodic vasospasm (sympathetic stimulation) Color changes (white – blue – red), ulcerations of the fingers, associated: stress, smokers, cold (crypto therapy is C.I.), SLE or Scleroderma
THROMBOANGIITIS OBLITERANS Inflammatory arteries veins of legs. M/C in Males, smokers, 20-40 yoa, intermittent claudication (P! w exercise, relieved by rest) aka Buerger's
AIDS Immunosuppression due to retrovirus HIV–1, from exchange of body fluids. Infections (pneumocystitis carinii, toxoplasmosis, cytomegalovirus, EBV, candidiasis, histoplasmosis, cryptospordium) Kaposi's Sarcoma. Lab: ELISA CD4 (helper T cells) lymphocytes
ANGINA PECTORIS Temporary myocardial ischemia produced with exertion. P! retrosternal "crushing" may radiate, last <5min. EKG and ESR norm.
DISSECTING ANEURYSM Separation Wall aorta, sudden peak intensity at onset, severe, "torn in half" Shocky normal EKG and BP, associated Marfan syndrome, arachnodactyly, Lens dislocation.
MYOCARDIAL INFARCTION P! "Crushing" or "pressure like" (20 minutes - hours) May occur spontaneously with no relief with rest.
PERICARDIAL EFFUSION Fluid accumulation in sac. Dyspnea, precordial P!, inc cardiac dullness (x-ray shadow), inc pulse pressure, friction rubs, orthopnea, muffled heart sounds, diff from CHF w ECG, listen at Tricuspid, seated lean forward, exhale and hold.
PRINZMETAL'S ANGINA Variant angina from coronary artery spasm. P! at rest. EKG arrhythmia and inc ST.
APPENDICITIS Inflammation from obstruction. P! epigastric/periumbilical migrating to the R.L.Q & groin. Vomit, Fever, constipation, rigidity, rebound tenderness (Blumberg's sign), leukocytosis. Associated "psoas sign" "obutrator sign"
IRRITABLE BOWEL SYNDROME AKA spastic colon. Chronic, G.I. motility (psycho-physiological ass. w stress) S/S chronic intermittent constipation, diarrhea
DIVERTICULITIS Information/perforation of diverticula, LLQ P! Fever, abdominal distention, occult blood, and leukocytosis. Intestinal obstruction, malignancy
REGIONAL ILEITIS (CROHN'S) Nonspecific granulomatous inflammation associated chronic diarrhea, abdominal P!, Vit B12 def & + HLA-B27
ULCERATIVE COLITIS Chronic 15-40 yoa, bloody diarrhea, arthropathies (sacroiliitis) +HLA-B27. Dx w sigmoidoscopy.
APTHOUS ULCER/STOMATITIS "canker sore"
BASAL CELL CARCINOMA AKA rodent ulcer. Small, shiny (pearly gray) nodule on skin w occasional teleangiectasis. Maybe ulcerated, crusted & bleed. Any skin cancer.
CARCINOMA OF THE LIP males 2:1 lower lip. round, indurated lesion becomes crusted and warty. Epidermoid or squamous cell carcinoma.
FORDYCE SPOTS Small yellow papules (blisters) seen on buccal mucosa due to enlarged but normal sebaceous glands
HERPETIC STOMATITIS/LABIALIS "coldsore/feverblister"
MELANOMA ABCD'S Asymmetrical, irregular Borders, Colors, Diameter > 6 mm, M/C fatal skin disease & malignancy of the eye (retina)
TORUS PALATINUS Normal midline bony protuberance of the hard palate.
ALOPECIA ARREATA Stress, patchy areas of hair loss.
ATOPIC DERMATITIS Eczema, Allergic Dermatitis, recurrent, allergic or familial
ERYTHEMA INFECTIOSUM Fifth disease. epidemic low grade fever, a macula-papular rash of extremities, "slapped face" Common in children.
IMPETIGO CONTAGIOSUM local strep/staph infection of skin small vesicles encrusted (gold or "honey-colored" to black) upon rupturing
INTERTRIGO Dermatitis fold/pleasures of skin due to heat, diabetes. Red & denuded. From bacterial or candidial infection
PITYRIASIS ROSEA Inflammatory skin, oval, salmon colored, scaly eruption on trunk. "herald patch", 1-2 weeks later eruption. Last 4 - 10 weeks
SEBORRHEIC DERMATITIS Sebaceous eruption face and scalp, e.g., dandruff, cradle cap.
ROSEOLA INFANTUM Infants 3-4 day high fever followed by 1-3 maculopapular rash on trunk.
BLOMBERG'S SIGN Rebound tenderness assoc w parietal peritonitis.
CULLEN'S SIGN Blue discoloration of the periumbilical area seen in hemoperitoneum.
KEHR'S SIGN Altered skin texture below the level of a spinal cord lesion
MURPHY'S SIGN Deep palpation elicits Inspiratory Arrest tenderness in acute cholecystitis
ROVSING'S SIGN P! in RLQ w L side pressure in appendicitis
ROGOFF'S SIGN P! w deep palpation at the 12th rib, in adrenal disease.
CARCINOID SYNDROME Metastasis argentaffinomas of GI tract w secretion of vasoactive substance (serotonin, histamine) SS: episodic flushing, face, neck, cramps, recurrent diarrhea, inc 5-HIAA.
CARCINOMA OF THE BREAST Retracted nipple, bleeding, distorted contours, and dumpling.
FIBROADENOMA Freely movable nontender masses
FIBROCYSTIC DISEASE Multiple movable tender masses of the breast. Larger/more painful prior to menses.
MASTITTIS Breast tender, swollen, red, warm and hard usually after postpartum.
PAGET'S DISEASE OF THE BREAST Intraductal carcinoma red, scaly erosions and ulcerations of the nipple.
EMPHYSEMA COPD – Type A Chronic, Older, Bilateral. Overinflated lung. Hyperresonant. Radiolucent (black). Mediastinum shifting, flat diaphragm. SS: exertional dyspnea, prolonged expiration .6 sec, barrel chest. Smoking, occupational or environmental exposure.
PNEUMOTHORAX Chronic, Older, Bilateral. Sudden onset of P!, Hyperresonance and radiolucent.
BRONCHIAL ASTHMA Dull/radiodense. Acute, unilateral, old and young. Hyperreactivity to allergens, exertion. Acute dyspnea, wheezing, productive cough. Eosinophilia, Curschmann spiral, and Charcot-Leydens crystals.
BRONCHIECTASIS Dull/radiodense. Unilateral, old and young. Chronic, halitosis, copious, foul-smelling, muco-purulent sputum
BRONCHOGENIC CARCINOMA Dull/radiodense. Acute, unilateral, old and young. Hemoptysis, weight loss, sinus arrhythmia (vagal irritation) and Horner's syndrome (ptosis, miosis, anhidrosis) M/C and right upper lobe. M/C squamous cell.
CHRONIC BRONCHITIS COPD – Type B EDull/radiodense. Acute, unilateral, old and young. excessive mucus, history of productive cough, dyspnea
MIDDLE LOBE SYNDROME Dull/radiodense. Chronic, unilateral, old and young. Pneumonia/atelectastis from bronchus obstruction by enlarged lymph
PLEURAL EFFUSION Dull/radiodense. Excess >250ml fluid accumulation in pleural space due to cardiopulmonary disease. SS: chest pain, dyspnea, orthopnea and a dry, nonproductive cough. Dec fremitus, dec breath sounds near lung base.
PNEUMONIA Dull/radiodense. Pulmonary consolidation from infection. SS: fever, dyspnea, tachypnea, productive cough, displaced breath sounds, inc voice sound (broncophony), inc tactile fremitus. Vignette ***
PULMONARY EDEMA Dull/radiodense. Fluid in lungs from left ventricular failure or mitral stenosis. SS: nocturnal dyspnea, orthopnea, tachypnea, pink frothy sputum. Exam: Rales rhonchi at lung base. "butterfly pattern" on x-ray.
PULMONARY EMBOLISM Dull/radiodense. Sudden onset "nice like" chest P!. cough w hemoptosis. Possible pulmonary infarct. History suggests pre-embolic condition: surgery, fracture, thrombosis, prolonged immobility, postpartum.
CELLULITIS Infection of skin and deep subcutaneous tissues, local tenderness and edema. Skin hot and red borders.
ERYSIPELAS beta-hemolytic strep skin infection, redness of face, tight skin and pitting edema. sudden chills, fever, pain. Considered superficial form of cellulitis.
CIRRHOSIS Hardening of hepatic tissue. S/S: jaundice, hepatic enlargement, portal hypertension, testicular atrophy, bronze diabetes, hemochromatosis. M/C cause of ascites.
COARCTATION OF THE AORTA Narrowing of aortic arch from systolic hypertension of upper extremities, head and neck (dizziness, epistaxis, headaches), decreased blood pressure in the lower extremities.
LERICHE'S SYNDROME "Saddle thrombus" of terminal aorta causing intermittent claudication, impotence, dec femoral and popliteal pulses, and coldness of lower extremities.
CONGESTIVE HEART FAILURE Systemic and/or pulmonary congestion. Coenzyme Q 10 deficiency
LEFT SIDED CONGESTIVE HEART FAILURE Pulmonary changes: nocturnal dyspnea, or orthopnea, rales, edema of the face, neck and upper extremities.
RIGHT-SIDED CONGESTIVE HEART FAILURE Systemic hypertension producing ascites, hepatomegaly, pitting edema of extremities.
CROUP Acute upper respiratory larygotracheobronchitis, barking cough "stridor"
ANEURYSM OF THE AORTIC ARCH Loud brassy, nonproductive dry cough, tracheal tug, dysphagia, hoarseness (due to left recurrent laryngeal nerve)
CYSTIC FIBROSIS A.k.a. mucoviscidosis. Hereditary, exocrine glands, excess mucus production and attraction, results in pancreatic insufficiency, malabsorption with steatorrhea. Lab: sweat test for chloride.
DIABETES INSIPIDUS Worse prognosis, polyuria, dec specific gravity, polydipsia (Increased thirst). Maybe caused by deficiency of vasopressin (ADH)
DIABETES MELLITUS Insulin deficiency and hyperglycemia. Complications: cardiovascular disease, hypertension, arteriosclerosis, obesity, stroke, neuropathies, retinopathy (microaneurysms, neovascularization, deep hemorrhages) and cadidial vaginitis.
TYPE I DIABETES MELLITUS Insulin-dependent diabetes. Usually juvenile onset <25 yoa. Polydipsia, polyurea, polyphagia, weight loss, hyperglycemia and ketosis. Uncontrolled leads to wide swings between hypo and hyperglycemia.
Type II diabetes mellitus Non-insulin-dependent diabetes. Common in obese individuals less than 40 years of age. Type II lack polyphagia and ketosis.
EPIDIDYMITIS Inflammation of epididymis, palpates painful, swollen mass. Fever, inc WBC, polyuria.
HYDROCELE cystic swelling of tunica vaginalis, is smooth, non-tender and transilluminates.
SPERMATOCELE Retention cyst of epididymis. Painless, movable and transilluminate.
TESTICULAR TUMORS Palpates hard, painless smooth solid mass., Between ages 20 – 35, 95% are malignant.
VARICOCELE First custodies of veins of the spermatic cord, palpates soft, a regular "bag of worms", does not transilluminate.
ERYTHEMA NODOSUM Allergic or vascular reaction information with tender painful red indurated subcutaneous nodules. Usually below the knees.
LYMPHANGITIS P! Tender and palpable lymph nodes; warmth and edema on leg; red linear streaks on skin.
POLYARTERITIS (NODOSA) Idiopathic affecting middle aged males. Chronic, necrotizing inflammation of small – medium-sized arteries. SS:
STASIS DERMATITIS Venous pooling causing inflammation of lower leg, edema, brown pigmentation of skin and possible ulceration.
THROMBOPHLEBITIS (DEEP) Inflammation of veins causing thrombosis formation. Painful tender veins; possible muscle cramps: fever, leukocytosis; D–dimer test and + Holman's. Dx: Doppler
FIBROMYALGIA (AUTOIMMUNE) Joint and myofascial pain. (Muscle ache, 11 of 18 triggerpoints and stiffness), morning fatigue, anxiety, disturbed sleep. Lab: (-) TX includes: rest, heat (no cryotherapy), massage, ROM exercises, and psychotherapy.
POLYMYOSITIS (AUTOIMMUNE) Inflammation symmetrical striated mm weakness of prox limbs & trunk. Females 40–60 yoa SS: Motor disability, muscle tenderness, pain, dysphagia, heliotropic rash of the eyelids. Goes in to out. MS works out to in. Lab: inc aldolase, CPK, Sgot, Creatinuria
SCLERODERMA (AUTOIMMUNE) A.k.a. progressive systemic sclerosis. Fibrotic, degenerative inflammation of skin, muscles, cardiovascular system and viscera. SS: poly-arthralgia (hand/feet), calcinosis, Reynards, esophageal dysfunction, sclerodactyly, telangiectasia. CREST syndrome.
SJOGREN'S (AUTOIMMUNE) xerophathalmia (keratoconjunctivitis sicca), rheumatoid arthritis. Affects females 9:1 ages 40 – 60. Lab: rheumatoid factor (sero – positive), leukopenia, eosinophilia, anti-RNA. Assoc: RA, SLE, polymyositis, Felty's syn, Hashimoto's thyroiditis...
STILL'S DISEASE (AUTOIMMUNE) seronegative arthritis before age 17. s/s: intermittent fever, salmon colored macular rash, apophyseal joints of upper cervical spine, Juvenile RA
SYSTEMIC LUPUS ERYTHEMATOSIS (AUTOIMMUNE) chronic inflammation connective tissue. s/s: exacerbations and remissions, migratory joint pain hands and feet, arrhythmia of the face "butterfly/mylar rash", photosensitivity (uv light CI), vasculitis, renal. Lab: ANA, anti-DNA, LE cell.
GLAUCOMA inc intraocular pressure, fixed and dilated pupils, redness of the eye, visual disturbances, copy of the disc, crescent shaped shadow, I pain, headache, possible blindness. TX: immediate referral
PAPILLEDEMA "Choked disk" swelling of optic disc due to increased intracranial pressure. Bilateral with minimal visual impairment or iPad. Exam: hyperemic, edematous disk with blurred margins.
PAPILLITIS (WORSE BUT SIMILAR TO PAPILLEDEMA) Sudden unilateral vision loss and pain with movement bye-bye. Idiopathic or do to demyelination (MS) or viral infections. a.k.a. optic neuritis.
GOODPASTURE'S SYNDROME Pulmonary hemorrhage (hemoptysis and dyspnea), rapid and progressive glomerulonephritis, & renal failure, iron def. anemia. in young adult males. Due to antibody two position and damage of alveolar & glomerular basement membrane.
NEPHROTIC SYNDROME Chronic nephritis, SLE, diabetes mellitus. S/S: edema (puffy face), peripheral neuropathic, increased urinary proteins w hypo-albuminemia, ascites hypokalemia (low potassium) and hypercholesterolemia.
UREMIA Renal failure associated with yellow brown bronze skin, fatigue, mental clouding, uriniferous breath and azotemia.
HASHIMOTO'S THYROIDITIS Hypothyroidism. Autoimmune disorder, insidious, nontender enlargement of Bayreuth. S/S: maybe subclinical or with signs of decreased thyroid function. Usually females 30-50
HEMOPHILIA A Hereditary disorder from lack of blood clotting Factor 8
HEMOPHILIA B From deficiency of Factor 9 (Christmas factor)
HEREDITARY SPHEROCYTOSIS Abnormal cell membranes of RBC's, and sphere shape cells. Diminished abilities of RBCs to flow through and the spleen resulting in hemolytic anemia.
THROMBOCYTOPENIC PURPURA autoimmune platelet count <10,000mm Females 20-50 (2:1). Afebrile. Abnormal marrow function or excess platelet construction needs to epistasis, skin and mucosal petecia, oral bleeding, menorrhagia, melena, splenomegaly.
VON WILLEBRAND'S "pseudohemophilia" hereditary blood congratulation abnormality do to deficiency of Willebrand factor that aids and clumping of platelets.
HEPATITIS patchy necrosis of the liver. fever, jandus, hepatomegaly, cervical lymphadenopathy & leukopenia Type A, B, C.
HEPATITIS HAV infectious, fecal–oral route. anti-HAV, IgM, anti-Hav IgG
HEPATITIS HBV serum hepatitis; blood route. HBsAG, anti-HBs, HBeAg, anti-HBe, anti-HBc
HEPATITIS HCV (NANB) blood/body fluid contact. Chronic infection may be asymptomatic w potential for early cirrhosis or malignancy.
JAUNDICE "ICTERUS" "HYPERBILIRUBINEMIA" Excess bile pigments and tissues due to disturbance in transport, production, excretion or hemoglobin metabolism. Yellowing of the skin sclera, pruritus, light clay colored stool. Conjugated bilirubin produces a dark brown urine with a yellow foam.
PRE-HERPETIC JAUNDICE Unconjugated bilirubin, hemolytic or hepatic anemia, indirect van den Bergh, insolvable and water, decreased urinary urobilinogen.
POST HEPATIC JAUNDICE CODS - Conjugated bilirubin, Obstractive (gallstones, pancreatic enlargement), Direct van den Bergh, Soluble in water, bilirubinuria
HERNIAS A Hernia that cannot be reduced is incarcerated, and it strangulated ischemic necrosis may occur.
DIRECT INGUINAL HERNIAS Uncommon usually males >40 you. Occurs posterior wall of inguinal canal at Hesselback's triangle.
INDIRECT INGUINAL HERNIAS Most common. Through inguinal ring/canal into scrotum.
FEMORAL HERNIAS Rare. Below and when you'll ligament through for moral triangle (femoral ligament, Sartorius and adductor longus) usually females.
HIATAL HERNIA Displacement stomach above diaphragm. Cause dysphasia and post-prandial gastroesophageal reflux with increased intrathecal pressure. e.g.. reclining, belching. May be DX: X-ray.
PYLORIC STENOSIS Pyloric hypertrophy in neonate. SS: projectile vomiting, dehydration, a palpable mass and visible peristaltic waves (from left to right) in the epigastrium.
HODGKIN'S Chronic proliferative disorder lymphoid tissue. S/S: pruritus, fever, cachexia, night sweat, firm non-tender enlarged lymphs. hepato-splenomegaly, achohol sensitivity, ivory vertebrae w ant. scalloping. Normochromic–normocytic anemia. Reed-Sternberg cells
INFECTIOUS MONONUCLEOSIS Young adults, sore throat, periorbital edema, leukopenia Dwoney cells, +Monospots & heterophil agglutination (Paul-Bunnell)
LEUKEMIA Hemopoietic malignancy with elevated lymphoblasts w pancytopenia. SS: Acute illness w bleeding (petechia, purport) secondary infection, septicemia, bone and joint P!
ACUTE LYMPHOBLASTIC LEUKEMIA also ALL. MC age 3-7 (80% of childhood leukemias)
ACUTE MYELOGENOUS LEUKEMIA AML or acute non-lymphocytic leukemia . Age 50 yoa inc w age.
CHRONIC MYELOGENOUS LEUKEMIA CLL. Slowly progressive disorder characterized by lymphocytosis ("mature" appearance) >20,000 SS: fatigue, lymphadenopathy, immunosuppression. Ave 65 yoa.
LYME DISEASE from ticks spirochete. Stage I: fever, myalgia (headache, stiff neck) and skin lesion. Bull's eye rash. Stage II: Cardiac and neurological. Quick phase. Stage III: musculoskeletal, migratory polyarthristis, arthralgia.
MITRAL STENOSIS MC due to rheumatic heart disease. S/S: malar flushing, tachycardia, orthopnea, paroxsymal nocturnal dyspnea, pulmonary hypertension. apical rumbling, diastolic opening snap.
RHEUMATIC FEVER Systemic immune response to hemolytic strep infection. Peak age 5-15. SS: CARDITITS (pericarditis, cardiomegaly, CHF, valvular insufficiency. POLYARTHRITIS. Fever, polyarthralgia, pharyngitis, glomerulonephritis. inc ESR, ASO-titre. Jaccoud's Arthritis.
ORAL THRUSH A.k.a. Candidiasis, moniliasis. White curdy patches in oral mucosa surrounded by areas of erythema. Scraped off may bleed. Seen in Diabetes, pregnancy and immune def (HIV)
PANCREATITIS SS: persistent epigastric/periumbilical P! relieved by sitting, leaning forward or lying in the fetal position. May radiate to lumbars and L shoulder. Shocky, Jaundice, steatorrhea, flank ecchymosis. Grey Turner Sign. Assoc w alcoholism. Lab: inc. amylase
PEPTIC ULCER SS: chrionic, recrrent of "gnawing, burning, or achy" epigastric P!. 3cm tenderness below the xiphoid. Dysphagia, hematemesis, hypochrimic anemia. Lab: RBC's, Guiac Benzim
DUODENAL PEPTIC ULCER P! worse 12-2 am, Eating may relieve symptoms w/in 30 mins. Assoc w heliocobacter pylori.
GASTRIC ULCER P! may be caused by eating.
PHEOCHROMOCYTOMA A.k.a. "proximal hypertension" (sudden inc of BP). Tumor of adreanl. "shot of adrenaline" elevated epinephrine. SS: episodic flushing, sustained or paroxysmal hypertension. Hyperglycemia, headaches, abdominal pain. inc. catecholamines.
POLYCYTHEMIA VERA "too many cells" hang upside down can give this symptom. Idiopathic, chronic hyperplastic of bone marrow. inc blodd viscosity. Impaired blood flow. onset 60 yoa. Hepato/splenomegaly, retinal engorgement, headaches, dizziness, dermal/mucsal discoloration.
PREECLAMPSIA A.k.a. toxemia. During last trimester. HYPERTENSION, EDEMA, PROTEINURIA, headaches, weight gain, visual disturbances. HEP.
PSEUDOTUMOR CEREBRI Headaches, papilledema, visual disturbances (diplopia, optic atrophy, blindness) intracranial hypertension.
PSORIASIS define Chronic, sero-negative inflammatory disease. Pruritits, Arthrotis, bleeding silvery scales (Auspitz sign) on scalp & Extensor surfaces. Knees & elbows. Pitting of nails. inflammation of cervical ligaments. inc ADI. non-marginal syndesmophyte formation.
PSORIASIS SS and Lab Sacro-iliitis, pencil in cup, mouse ear erosions, ray sign, +HLA-B27, ESR, Treatment UV-B (coal tar). Adjust when not acute.
REITER'S SYNDROME "Can't see, pee, dance w me". Asymmetrical, oligarticular ARTHRITIS, (sacra-iliitis, heelp P!) non-bacterial URETHRITIS & CONJUNCTIVITIS. Pssible chlamydial w, HLA-B27 antigen. Males 20-40 yoa.
REYE'S SYNDROME Acute encephalopathy (post-viral infection and aspirin use) sudden change of mental status.
RUBELLA "German measles" Viral exanthem (widespread rash) w malaise, arthralgia, cervical and psotauricular lymphadenopathy. 3 day macula-papular rash moving face to extremities. Early trimester may result in congenitial defects.
RUBEOLA Systemic viral infection with fever, Coryza, cough and Koplik spots. Brick red macula-papular rash starting at face to palms and soles.
SCARLET FEVER beta-hemolytic strep infection with edematous pharyngitis, strawberry tongue. Red papules on chest and neck. Rash blanches on pressure.
SCARCOIDOSIS Granulomatous disease of lung with characterized by bilateral calcific lymph-adenopathy, hilar enlargement, dyspnea, lymphocytosis. More w females around 3rd or 4th decade.
SICKLE CELL ANEMIA Inderited abnormal HgbS. Maybe asymptomatic, or bone abnormalities (infarction, "hair on end", "H" – vertebra) and PN. Enlarged heart, liver and spleen, vaso-occlusion (stroke, AVN, leg ulcers) LAB: dec Hematocrit, crescent shaped RBCs, Howell-Holly body
THALASSEMIA Hereditary disturbed globin chain synthesis (hemoglobin). Seen in Mediterranean, Southeastern Asian and African ancestry.
TOXIC SHOCK SYNDROME Exotoxin producing Staph. Aureus infection with high fever, myalgia, orthostatic hypotension, shock and diffuse sunburn like rash on face.
HYPOTHYROIDISM Cretinism, myxedema, Dry, brittle hair, nails and skin. slow speech, mentation, weight gain; puffy face. Cold, loss of lateral 1/3 eyebrows, dec deep tendon reflexes, dec T3, T4, inc TSH
HYPERTHYROIDISM Thyrotoxicosis, Grave's, fine hair, moist skin, fast speech, irritability, inc appetite w weight loss. heat intolerance, exophthalmos, inc BMR, diarrhea, postural tremors, excess energy.
HYPOADRENALISM (ADDISON'S) Adreno-cortical insufficiency, hypotension, weakness, dizziness, weight loss, hyperpigmentation, bronze "tanned" skin. Hair loss (Nancy the salt creature)
HYPERADRENALISM (CUSHING'S) Hypertension, buffalo hump, moon facies, truncal obesity, weight gain, hirsutism, aldosteronism, hypercortisolism, hypokalemia dec K+, inc glucose.
INSULIN SHOCK WET sudden, moist, pale, drooling,full to bounding blood pressure, shallow respirations, confusion, tremors
DIABETIC COMA DRY gradual, dry skin, dry mouth, weak holes, low blood pressure, Kussmaul's acetone breath, polyuria, anorexia, acidosis.
URETHRAL STONES Back, flank groin P! consistantly moving. Most seen on Xray.
KIDNEY STONES Flank P! radiation to groin, intermittent, excruciating P! not relieved by position. seen on Xray. Blood in urine and often.
CYSTITIS Suprapubic mass, P! during and after pee. blood in urine and often. E. Coli.
DIOPTER 0= red relex, retina/normal vision Black= + convex lens/ outer structures Conrnea and lens Red= - Concave lens/inner structures retina, myopia
ADIE'S PUPIL aka tonic pupil. A large regular pupil with sluggish accommodation and convergence, w diminished or absent light reflex.
ARCUS SENILIS Concentric gray ring around the cornea. Normal aging. Hyperlipidemia.
ARGYLL ROBERTSON with Syphilis and diabetes mellitus. Accommodation preserved, dec/absent direct light and ciliospinal reflexes, irregular mitotic pupils.
KAYSER-FLEISCHER RING Gold brown/gray green pigmentation around the cornea in Wilson's dz. Excessive copper. A.k.a. hepatolenticular degeneration
CONJUNCTIVITIS Dilation blood vessels at periphery of conjunctiva.
IRIDOCYCLITIS Inflammation of Iris and cillary bodies seen in systemic disease. AS, syphilis, gonorrhea, glaucoma. Dilated blood vessels around limbus.
PINGUECULA Yellow plaques on bulbar conjunctiva in aging.
PTERYGUIM Wing–like thickening of scleral conjunctiva into cornea.
CHALAZION Granulomatous nodule on eyelid from chronic inflammation of Meibomian gland
HORDEOLUM Stye. Possible referral
XANTHELASMA Yellow nodules at medial canthus of eyelid in hyperlipidema
HYPERTENSIVE RETINOPATHY "flame" hemorrhages, A-V nicking and tapering, hard ("waxy") and soft ("cotton -wool" patches) exudates.
MICROANEURYSMS Seen in diabetic retinopathy
SENILE MACULAR DEGENERATION MC irreversible loss of central visual acuity in elderly
EARDRUM Normal - pearly gray Amber - acute serous otitis media Bulging - angry red - acute otitis media retracted - blocked Eustachian tube White - Suppurative otitis media (pus)
CHHEMODECTOMA Tumor in the middle ear. red pulsatile mass behind tympanic membrane
RINNE'S TEST (Test for CN 8) Air conduction is 2X's bone conduction is Normal
WEBER'S TEST (Test for CN 8) LETERALIZATION TEST Normal - No lateralization Air conduction loss (blockage) - lateralize to bad ear Sensorinerual loss (nerve damage, Meniere's) - lateralize to good ear
TONGUE CARCINOMA indurated (hard) white ulcer MC seen on lateral aspect or base of tongue.
FISSURED TONGUE sscrotal tongue - Transverse grooves. syphilitic tongue - longitude fissures
GEOGRAPHIC TONGUE
Created by: hughesdc on 2013-07-10



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