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Family Practice

Board Review

What causes Beriberi? Vitamin B1 (Thiamine) deficiency
What is Achelasia? Dysphagia for solids and liquids, absent peristalsis and tight lower esophageal sphincter, and Beak-like esophagus on x-ray
Direct inguinal hernia more common in adults weakness in Hesselbach's triangle
Indirect inguinal hernia more common in infants persistant processus vaginalis
Crohn's disease Can effect entire GI tract, terminal ilium more common, Transmural, Skip lesions, and "Cobblestonnong"
Ulcerative colitis Colon and rectum without skip lesions, and "lead pipe" appearance on x-ray
Viral enteritis Norwalk, Rotavirus in young children
Staphylococcal enteritis "Church picnic" epidemic, onset in 3-6 hours
Shigella dysentary very small bacterial dose, blood and mucus in stool
Vibrio parahaemolyticus Oysters
Cholelithiasis "Female, fertile, forty fat"
Cholangitis Charcot's triad: biliary colic, jaundice, fever
Hepatitis B hep BsAg in early infection and carrier, hep BcAb for life
Secondary hypertension Estrogen, renal dz, hyperaldosteronism, pheo, coarctation
Innocent murmur medium pitch, systolic ejection, L lower/mid sternal border
Osler's nodes nodules on digits secondary to BE
Roth's spots retinal hemprrhages secondary to BE
Raynaud's Pallor, cyanosis, erythema of fingers
Mitral stenosis rheumatic fever, loud S1 and opening snap after S2, low-pitched diastolic rumble
Mitral regurg Midsystolic click, harsh blowing holosystolic
Aortic Stenosis Angina, syncope, left-sided heart failure, crescendo-decrescendo murmur radiating to carotids
Aortic regurg Decrescendo, widened pulse pressure, "water hammer", "pistol-shot" over femoral A
Post-op fever Wind, Water, Walk, Wound, Weird meds
MEN 1 parathyroid, pit, pancreatic
MEN 2a parathyroid, thyroid (medullary), pheo
MEN 2b Neuromas, thyroid (med), pheo, Marfanoid habitus
threatened abortion Abdominal cramps with or without vaginal bleeding or Vaginal bleeding during the first 20 weeks of pregnancy
missed abortion the embryo or fetus has died, but a miscarriage has not yet occurred
incomplete abortion when tissue has been passed, but some remains in utero
SVT re-entrant rhythm, p-waves hidden in T waves
A flutter saw tooth
VT 3 or more consecutive PVCs, independent p-waves
V Fib no definable wave, no pulse
Familial hypercholestrolemia auto dom, xanthomas, xanthelasma, MI in 40s
Familial hypertrigyceridemia auto dom, pancreatitis, milky serum
Familial hyperlipidemia auto dom, increased chol or triG, no xanthomas (eyelid)
MI ST elevation, T wave inversion, CPK peak 12-40 hrs, LDH peak 3-6 days
Left-sided heart failure DOE, Orthopnea, PND
Right-sided heart failure Edema, Hepatomegaly, JVD
Viral pneumonia patchy infiltrates, most common in children
S. pneumoniae pneumonia rust sputum, lobar, gram pos diplococci
H. inf pneumonia COPD, small gram neg rods
Kleb pneumonia EtOH, current jelly, encapsulated gram neg rods
Staph pneumonia salmon sputum, nosocomial, gram pos cocci in clusters
Mycoplasma pneumonia young adults, xray worse than symptoms
symogi effect nocturnal hypoglycemia that leads to morning hyperglycemia
Heberden's nodes DIP - OA
holiday heart inc Etoh consumption and withdrawal - afib
Pyridoxine def B6, neropathy, isoniazid
Niacin def Pellegra - Diarrhea, dementia, dermatitis(stomatitis)
Cobolamin B12
lung cancer squamous (40-50%), adeno (35%), small cell (25%)
Small cell Ca smoking, paraneoplastic, Horner's, superior vena cava syndrome
Sarcoidosis increased calcium, "ground glass" xray
Pulm HTN accentuated P2 of S2, cyanosis and clubbing
Pleural effusion exudate >3g/dl prt, pleural/serum prt >0.5, pleural/serum LDH > 0.6, neoplasm and infection
Pleural effusion transudate <3g/dl prt, pleural/serum prt <0.5, pleural/serum LDH < 0.6, CHF, cirrhosis, nephrotic syndrom
Thyroid nodule previous neck radiation, hoarse voice, "cold" nodule on thyroid scan
Thyroid Ca Papillary (most common, best prog), Follicular, Medullary, Anaplastic (worse)
hypoparathyroidism tingling, tetany, Chovstek's sign
Chovstek's sign tapping of ear causes facial twitching
hyperparathyroidism Bones, stones, abdominal groan and psychic moans
SIADH tumor, trauma, pulm dz, drugs, hypoNa, concentrated urine, tx restrict water
diabetes insipidus lack of ADH leads to polyuria and polydipsia
Addison's dz dec. cortisol, wt loss and fatigue, skin pigmentation, eosinophilia, inc. IV glucocorticoids when stressed
Cushing's syndrome inc cortisol, easy bruising, osteoporosis,
pheochromocytoma HA, palpitation, anxiety, HTN, dx by urinary catecholamines
Wilson's dz auto rec, Copper accum, Kayser-Fleischer
Glomerulonephritis hematuria, proteinuria, RBC casts
Nephrotic syndrome pronteinuria, edema, hypoalbuniuria
renal artery stenosis fibromuscular displasia (young women), atheroscerolsis
Bladder Ca risks smoking, schistosomiasis, aniline dyes
acute tubular necrosis ischemia or toxins, resolves in weeks, may need dialysis
uremic syndrome CNS changes, asterixis, pericarditis, N/V, yellow-brown skin
polycystic kidney dz auto dom, hematuria, HTN, UTIs
central pontine myelinolysis correcting hypoNa to fast
epididymitis support relieves pain
testicular torsion adolescent boys, elevation does not relieve pain
hydrocele can be transilluminated
vericocele "bag of worms"
seminoma painless lump, does not transilluminate,
prostate CA firm, nodular, irregular
Head and neck T1-4
Heart T1-5
Respiratory system T2-7
Esophagus T2-8
Upper GI T5-9, stom - duod
Middle GI T10-11, duod - right colon
Lower GI T12-L2, left colon
Appendix T12
Kidneys T10-11
Ureters T10-11,12-L1
Bladder T11-L2
Trich yellow, green bubbly, strawberry, metro
BV copious fishy d/c
venereal warts HPV 6,11
Vulvar Ca squam, after menopause, pruritis
Cervical ca HPV 16,18,31, postcoital bleeding
Endometrial ca unopposed estro, obesity, nulliparity, early menarche, late menopause
breast ca nuliparity, early menarche, 1st delivery after 30, fixed, irregular painless, 90% invasive ductal
DDx breast mass Ca, cyst, fibroadenoma, fat necrosis
Endometriosis dysmenorrhea, dyspareunia, infertility
PCOS high LH, low/n FSH, hirsutism, obesity
Incontinence DIAPERS - Dementia, Infection, Atroph vag, Pharm, Endocrine, Restricted motility, Stool impaction
first stage of labor from regular painful contractions to complete cervical dilation
second stage of labor from cervical dilation to delivery
third stage of labor birth to placenta
early decelerations normal, occur with contraction
late decelerations begin, peak and end after contraction, fetal hypoxia
variable decelerations cord compression, reposition
Created by: messary