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Risk factor: Diabetes. Services? Eye, foot exams; urine tests
Risk factor: Drug use. Services? Hep immunizations; HIV, TB tests.
Risk factor: Alcoholism. Services? Pneumococcal, Influenza immunizations; TB test
Risk factor: Overweight. Services? Blood sugar tests for diabetes.
Risk factor: Homeless, recent immigrant, inmate. Services? TB test
Risk factor: High-risk sexual behavior. Services? HIV, hep B, syphilis, gonorrhea, chlamydia tests.
Reportable diseases? Hep, Hep, Hep, Hooray, the SSSMMART Chick is Gone! Hep A/B/C, HIV, Salmonella, Shigella, Syphilis, Measles, Mumps, AIDS, Rubella, TB, Chickenpox, Gonorrhea
Leading causes of death in the US for infants congenital anomalies, sort gestation/low birth weight, sudden infant death syndrome, maternal complications of pregnancy, respiratory distress syndrome
Leading causes of death in the US for ages 1-14 injuries, cancer, congenital anomalies, homicide, heart dz
Leading causes of death in the US for ages 15-24 injuries, homicide, suicide, cancer, heart disease.
Leading causes of death in the US for ages 25-64 cancer, heart dz, injuries, suicide, stroke.
Leading causes of death in the US for ages 65+ heart dz, cancer, stroke, COPD, PNA, influenza
Stress affects Induce production of free fatty acids, 17-OH corticosteroids, lipids, cholesterol, catecholamines; Affects water absorption, muscular tonicity, gastrocolic reflex, mucosal circulation.
Differential diagnosis of sexual dysfunction Drugs (antihypertensives, neuroleptics, SSRIs, ethanol), Diseases (depression, diabetes), Psychological (performance anxiety)
5 heart block Lyme dz, salmonella typhi (=typhoid), chagas dz (whipple's), legionella, diphtheria
reiter's syndrome chlamydia, shigella, yersinia, crohns, irrit.bowel dz
low complement cryoglob. (bugs) "I AM HE": influenza, adenovirus, mycoplasma, hep c, EBV . (=5 vasculitides assoc with Subacute Bacterial Endocarditis)
drug induced SLE "HIPPE": hydralazine, isoniazid, procainamide, penicillamine, phenytoin, ethosuximide
drugs that blast BM "ABCV": AZT, benzene, chloramphenicol, vinblastine
comma shaped bugs vibrio, campylobacter, listeria, H. pylori
corynebacter chinese letters
giardia lamblia crescent shaped protozoa
TB Rx's "RESPIre": Pyrazinamide, rifampin, ethambutol, isoniazid, streptomycin
6 low complement associated nephrotic syndromes (vascultides) Serum sickness, PSGN, SLE, SBE, Cryoglobulinemia, MPGN II (membranoproliferative GN)
Induce P450 "Really Quiet Bats Go Camping": Rifampin, Quinidine, Barbiturate, Alcohol (chronic), Tetracycline, Sulfa drugs, Griseofulvin, Carbamazepine
Inhibit P450 "I'd SMACK Q": INH, Dapsone, Spironolactones, Macrolides, Amiodarone, Cimetidine, Ketoconazole, Quinolones
P450 dependant "WEPTD": Warfarin, Estrogen, Phenytoin, Theophyline, Digoxin
Neutrophil deficiency CGD (chronic granulomatous dz)= NADPH-oxidase deficiency (X linked recesive)
Side efects of Statins Myositis, hepatitis, elevated liver enzymes
Painful genital lesions herpes, chancroid (hemophilus ducreyi), lymphogranuloma inguinale (venereum, chlamydia), granulom inuinale associated with Donovini
4 hormones with disulfide bonds "PIIG": prolactin, inhibin, insulin, growth hormone
Hookworms "NEATAS": necatur americanis, enterobius vermicularis, anklostoma duodenale, trichuris trichurium, ascaris lumbricoides, strongyloides
x-linked enzyme deficiencies G6PD (=MC), CGD (NADPH oxidase defic.), Pyruvate DH deficiency, Fabry's, Hunter's, Lesh-Nyhan. (are usualy AR)
Screen newborns "Please Check B4 Going Home": PKU, CAH (Congenital Adrenal Hyperplasia), Biotidinase defic., Galactosemia, Hypothyroidism
Actions of Steroids "KIIISS": kils Th cels and eosinophils, inhibit macrophage migration, ingibits phospholipase A2, inhibits mast cel degranulation, stabilizes (tighten) endothelium, stimulate cell protein synthesis
cause monocytosis salmonella (typhoid), TB, EBV (MC), listeria, syphilis, CMV
Ecoli is the most common cause of ? "AAASUC": abdominal absces, ascending cholangitis, apendicitis, spontaneous bacterial peritonitis, UTI, cholecystitis
one dose trx for chlamydia azithromycin
"Big Mama" Anaerobes Strep Bovis, Clostridium melanogosepticus, Baceroides Fragilis
"Big Mama" Trx for anaerobes clindamycin, metronidazole, cefoxitin
low volume state (serum) low K/Na/Cl, hi pH/BP
one dose Trx for gonorhea "CCCCOG": ceftriaxone, cefixime, cefoxitin, ceprofloxacin, ofloxacin, gatifloxacin
Psammoma bodies "PSaMMoma" =calcified cancers: Papilary CA of thyroid, Serous cystadenoma of ovary, Meningioma, Mesothelioma
Urease positive bacteria "PPUNCH": proteus (struvite stones=90%, swarming motility), pseudomonas, ureaplasma urealyticum, nocardia spp., cryptococus neoformans, helicobacter pylori
4 indications for PUD surgery "IHOP": intractable pain, hemorage, obstruction (fr scarring), perforation
cardiac fibrosis adriamycin, phen-fen
MCC of any ...penia viral, drugs (ABCV-C: azt, vincblastine, chemo, benzene, chloramphenical)
salmonela typhi triad hi fever, intestinal fire, rose spots (rash)
drugs that cause myositis "RIPS": rifampin, inh, prednisone, statins
7 encapsulated bacteria (gram negative) "Some Strange Kilrs Have Prety Nice Capsules": salmonela, strep PNA, klebsiela, h. influenza, pseudomonas, neiseria, citrobacter
jones criteria (rheumatic fever) "PECCS": polyarthritis, erythema marginatum, carditis, chorea, Subcutaneous nodules
eosinophilia "CAPAN": neoplasms, alergies/asthma, adison's dz, colagen vasc. dz, parasites
risk factor for primary liver ca (hepatoma) "HAVE CASH BS": hep B/C, aflatoxin, vinyl chloride, EtOH, carbon tetrachloride, anyline dyes, smoking hemochromatosis, benzene, schistosomiasis mansoni
9 live vacines "MR OR Smal Blistery Yelow Vesicles": Measles, Mumps, Rubela, Oral Polio (Sabin), Rotavirus, Small Pox, BCG Yelow Fever, Varicella
IgA Nephropathies henoch-schonlein purpura, berger's, alport's
autoimune hemolytic anemia "PACS PAD": PTU, alpha-methyldopa, cephalosporins, sulfa, PNC, antimalarial , dapsone
autoimune thrombocytopenia ASA, heparin, quinidine
drugs containing sulfa sulfonamides, sulfonylurea, celbrex-celecoxib =COX2 specific (viox-rofecoxib=COX2 spec has NO sulfa)
inhibit dihydrofolate reductase pyremethamine/sulfadiazine, trimethoprim/sulfamethoxasole
MI enzymes TPI= appears in 2h, peaks in 2 d, gone in 7 d; CKMB= appears in 6h, peaks in 12 h, gone in 24h; LDH1=appears in 1d, peaks in 2 d, gone in 3d
siver stains "BC Lawyers Charge Hourly": bartonela henselae (Lymph nodes), candida (yeast), legionela, pneumocystis Carinii, H. pylori
drugs that cause pulm fibrosis "BBAT": bleomycin, busulfan, amiodarone, tocainide
macrophage deficiency chediak-higashi, NADPH-oxidase deficiency
Side efect of loops and thiazides "OHHHH": ototoxic, hyperglycemia, hyperuricemia, hypokalemia, hypovolemia
the only 3 pansystolic M's inc on expir, decr on inspir: MR, VSD; incr on inspir: TR
7 palms and soles rashes "TRACKSSS": TSS, RMSF (rocky mtn spotted fever), coxsackie A (hand/foot/mouth dz), kawasaki, scarlet fever, syphilis, sSSS(staph scald skin syndrome= exfolitin)
every restrictive lung dz and low volume state tachypnea, low pCO2, low pO2, hi pH
2nd messengers: cAMP, cGMP 2nd messengers: cAMP=symp., CRH. cGMP=parasymp.
2nd messengers: IP3/DAG NeuroTransmiter, GHRH, all hypothal. horm. xc CRH, smooth muscle by contraction
2nd messengers: cAlcium/calmodulin smooth musc. contr by distention
2nd messengers: calcium gastrin
2nd messengers: tyrosine kinase insulin, al GF's
2nd messengers: NO nitrates, viagra, ANP, LPS (endotoxin)
T and B cel deficiency WAS (wiskot Aldrich), SCID, CVID, HIV, HTLV1
WAS (wiskot Aldrich) thrombocytopenia, IL4 infx, eczema, decr IgM (IgE?)
SCID framshift/nonsense mutation, adenosine deaminase defic; T>B; bact. and fungal infxns
CVID late onset, frameshift/misense mutation; tyrosine kinase defic
HIV, HTLV1 T>B, CD4 rich; brain testicles, cervix, blod vesels
ETC poisons: complex I=amytal, rotenone; complex II= malonate ; complex III=antimycin D; complex IV= CN-, CO, chloramphenical; complex V=oligomycin
ETC chemical uncouplers dnp, free fatty acids, aspirin (a physical uncoupler)
4 sources of acid (Renal) plasma, urea cycle, collecting ducts, gutaminase
ETC poisons:complex I= amytal, rotenone;
ETC poisons:complex II= malonate ;
ETC poisons:complex III= antimycin D;
ETC poisons:complex IV= CN-, CO, chloramphenical;
ETC poisons:complex V= oligomycin
one dose trx hemophilus ducreyi azithromycin 1 gr po, ceftriaxone 250 mg im,
one dose trx candidiasis ketoconazole 150 mg
one dose trx vaginal candidiasis 1 pill of diflucan
one dose trx trichomonas metronidazole 2 gr
one dose trx gardnerella metronidazole 2 gr
to break down glycogen, 4 enz. phosphorylase (Pi), debranching enz, alpha-1,6-glucosidase, phosphatase, alpha 1,4-glucosidase
to make glycogen, 2 enz glycogen synthase, branching enz (=glycogen alpha-1,4;alpha-1,6 glycosyl transferase)
obstructive vs restrictive pulmonary dz obstructive= hi pO2/N, or hi pCO2, low pH. (leads to resp. acidosis) restrictive = low pO2, low pCO2, hi pH
6 places of TCA where aa's feed in/out pyruvate- gly, ala,ser; acetyl coA- Mr.PITT (phe, iso, thr,tyr) + lys, leu; alpha-KG - glu, gln; succinyl coA- phe, tryp, tyr; fumarate-pro; oxaloacetate- asp,asn
4 steps of beta oxidation 1. oxidation (7 NADH/21 ATP). 2. Hydration. 3. oxidatio(7 FADH/14 ATP). 4. thiolysis (8 AcCoA/ 96 ATP). ***total 131 ATP-2 to bring it in.
4 H's produced by small cell CA ACTH, ADH, PTH, TSH, (ANP)
viruses directly cause CA PAPILLOMA, EBV, HBV,HCV, HIV
tPA 20mg iv push, 40mg drip. give inhibitors. aminocaproic acid
streptokinase 750K iv push, then 750K drip. give inhibitors. aminocaproic acid
warfarin. give inhibitors. vitK
heparin. give inhibitors. protamin sulfate
urokinase. used only for feeding tubes, fistulas, etc.
anticardiolipin SLE
anti-topoisomerase PSS (Progressive Systemic Sclerosis)
anti-TSH receptors Graves
anti-hair follicle allopecia areata
anti-myelin receptor MS
anti-melanocyte viteligo
anti-ACH MG
anti-ribonuclear protein Mixed CT dz (MCTD)
anti-parietal cell receptor pernicious anemia (ab's to intrinsic factor)
anti-epidermal anchoring protein receptors pemphigus vulgaris (positive Nikolsky, ab's to intercellular jntn of epidermal cells)
anti-epidermal BM protein bullous pemphigoid,(IgG subepidermal blisters, oral etc.)
anti-thyroglobulin hashimoto's
anti-microsomal hashimoto's
anti-smooth muscle scleroderma
anti-scl70 scleroderma
anti-rho (SS-A) sjogren's
anti-la sjogren's
anti-proteinase wegener's
clot in front of renal artery renal artery stenosis
clot off whole renal artery renal failure
clot in renal papilla papillary necrosis
clot off renal medulla interstitial nephritis
clot off pieces of nephron focal segmental GN, HIV, drug use assoc.
clot off lots of nephrons RPGN
MC nephrotic dz in adults membranous GN
MC renal dz in blacks/hispanics focal segmental GN
MC renal mass a cyst
MC malignant renal tumor in adults adenocarcinoma
MC malignant renal tumor in children wilm's tumor
MCC leading to RPGN goodpasteurs
alopecia areata patch of hair
alopecia totalis entire head bald
alopecia universalis entire body hairless
pulmonary infiltrate eosinophilia (PIE) syndrome "NASSA": necator americanus, ascaris lumbricoides, schistosomiasis, strongyloides, ankylostoma duodenale
2 enzymes used by B12 homocystine methyl transferase, methyl malonyl mutase
mitochondrial inheritance NO male transmission, ALL
increased susceptibility to pseudomonas and staph infxs burn pts, CF pts, DM pts, neutropenic pts (cover 1x for S. aureus during 1st wk, cover 2x for pseudomonas after 2nd wk)
cause of widened S2 (incr pO2, incr vol in R ventricle). 1. blood transfusion. 2. giving O2. 3. R side failure. 4. pregnancy (incr vol). 5. iv fluids. 6. ASD. 7. deep breathing.
8 cavities of blood loss "PIMP TRAP": pericardium, intracranial, mediastinum, pleural cavity, thighs, retroperitoneum, abdominal (=big), pelvis (=deep)
penicillin gram positive, bone marrow suppression; simple anaerobes; #1 cause of anaphylax; interstitial nephritis; nonspecific rashes; as haptens->hemolytic anemia.
negative-stranded RNA prodromal period b4 sxs=1-3 wks b/c must switch to positive stranded before replication
positive-stranded RNA sxs within 1 wk or less (xc these negative stranded: hanta, ebola, yellow fever)
5 cofactors for dehydrogenase complex "Tender Loving Care For Nancy": TPP (thiamin-B1), lipoic acid (B4), CoA (pantothenic acid- B5), FAD (Riboflavin-B2), NAD (Niacin-B3).
x-linked inheritance (all are x-recessive, xc one) bruton's agammglobulinemia, CGD (NADPH defic.), duchenne, color blindness, G6PD, hemophilia, lesch-nyhan, vitamin resistant rickets (x-linked dominant)
B-cell deficiency bruton's agammaglobulinemia (tyrosine kinase deficiency), SCID (T-cell overlap), WAS (T-cell overlap), CVID (common variable immune defic., tyrosine kinase defic), leukemias, lymphomas, job-buckley syndrome (T-cell overlap)
4 itchiest rash "SLUD": scabies, lichen planus, urticaria, dermatitis herpetiformis
I-myc small cell lung CA, promyelocytic leukemia (Burkitt's lymphoma)
c-myc small cell lung CA, promyelocytic leukemia (Burkitt's lymphoma)
N-myc neuroblastoma, small cell lung CA
c-abl CML, ALL
c-myb colon CA, AML
c-sis osteosarcoma, glioma, fibrosarcoma
c-erb B2 epidermal growth factors receptors
CSF-1 breast
erb-B2 breast CA, ovarian, gastric
ret medullary CA of thyroid, MEN II/III, papillary CA
Ki-ras lung CA, colon CA
bcl-2 Burkitts, follicular lymphoma
erb retinoblastoma
ranson's criteria of acute pancreatitis at admission "GALAW": glu>200, age>55, LDH>350, AST>250, WBC>16,000. at less than 48 hrs "CHOBBS": calcium<8mg/dl, hct drop of>10%, O2<60 (PaO2), base deficit>4, BUN>5, sequestration>6L
hormones produced by placenta "HI HOPE": hCG, inhibin, human placental lactogen (HPL), oxytocin, progesterone, estrogen
pilocarpine CF, glaucoma (painful, red, teary eye)
causing dysgeusias (taste disorders) metronidazole, clarithromycin, Zn deficiency
Rashes associated with cancer: seborrheic keratosis (waxy warts) colon ca or HIV if sudden increase in #. nL with aging.
Rashes associated with cancer: dermatomyositis (violacious, heliotropic rash, malar area) colon ca
Rashes associated with cancer: akanthosis nigricans (dark lines in skin folds) any visceral ca, end organ damage
carcinoid syndrome (triad), measure what, flushing, wheezing diarrhea (measure serotonin 5-HIAA; comes from pancreas, ileum)
AVMs "HEAL": heart (PDA), elbow (fistula from dialysis in renal dz), abd/brain (von hippel lindau, clot off with coils, increased incidence of renal cell CA--chr3), lungs (osler-weber-rendu syndrome).
HDL carries "CEAL": L-CAT, E, C-II, Apo-A
VLDL carries B-100, E, C-II, ApoA
IDL carries B-100, E, CII
LDL carries B-100
chylomicrons take TGs from GI to liver (25%), endothelium (75%)
erythema marginatum little red spots with bright red margins, sandpapery, RF - Jones criteria ->strep pyogenes
Measles morbiliform rash, preceded by cough, conjuctivitis
roseola fever 2 days, sop, rash pops up= rash after fever (=HHV6)
erythema nodosum anterior aspect of leg, redness, teder nodules
erythema multiforme red macules, target lesions, allergy, viruses, severe = Toxic Epidermal Necrolsis (skin peels off); mild = stevens johnson syndrome; mild= virus (MCC), drugs (Sulfa)
seborrheic dermatitis scaly skin with oily shine on hairline
seborrheic keratosis stuck on "warts"
psoriasis HLA B27, extensor surfaces, silvery white plaques, scaly skin, pitted nails
varicella zoster stages- red macules, papules, vesicles, pustules, then scabs; different stages at same time (=HHV3)
dermatitis herpetiformis rash/blisters on ant. thigh, assoc. with diarrhea 2/2 celiac sprue flare up
typhoid fever (salmonella) rose spots assoc. with "intestinal fire"
dermatomyositis heliotropic rash
erysipelas reddened area on skin with raised borders; does not blanch
tinea cruris redness, itchy groin
pityriasis rosea herald patch; dr skin patches that follow skin lines, (HHV7)
Tinea versicolor hypopigmented macules on upper back in "V" pattern (upside-down Christmass tree); Trx=griseofulvin
Scabies linear excoriations on belt line and finger webs, etc. Trx: Lindane, or Permethrin.
T-cell deficiency DeGeorge's (hypokalemia, 3 & 4 pharyngeal pouch, deletion of chr22), HIV (also B-cell, but less so)
Lipoprotein transports: chylomicron takes TGs from GI to liver and endothelium
Lipoprotein transports: VLDL takes TGs from liver to adipose
Lipoprotein transports: IDL takes TGs from adipose to tissue
Lipoprotein transports: LDL only one to carry cholesterol
Lipoprotein transports: excessive TGs xanthelasma- eyelids/-brows
Lipoprotein transports: excess cholesterol xanthoma-elbows
Lipoprotein transports: VLDL is the only one made in the liver
Lipoprotein transports: IDL and LDL are break down products of VLDL
hemophilus influenza "pleomorphic" gram negative rod; "school of fish"; (Type A=80%, non-encapsulated, noninvasive, 2nd MCC of sinusitis/otitis/bronchitis). (Type B=20%, encapsulated-polyribosyl phosphate in capsule, IgA Protease, invasive dz, #1 cause of eiglotitis, stridor
meningitis (wrong in AID): 0-2 months GBS (agalactiae), Ecoli, listeria
meningitis (wrong in AID): 2mo-10yrs S. PNA, N. meningitides (adolescent yrs only)
meningitis (wrong in AID): 10yrs-21yrs N. meningitides
meningitis (wrong in AID): >21yrs S. PNA
Strep pneumo vaccine given at 2,4,6 months. covers 23 strains (98% of cases). indications include: anyone +65yo, splenectomized (sickle cell), end-organ damage (CF, RF, nephrotic syndrome)
strep pyogenes MCC of all throat infections. 2nd MCC of all skin infxns
staphylococcus differentiation S.aureus-gold pigment, S.epi-white pigment, S.saprophyticus-no pigment.
rusty colored sputum Strep pneumonia (pneumococcus)
Created by: hazelett on 2008-11-13



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