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Western Clinical Medicine Winter 2013 Exam I

What is the purpose of palpation during a respiratory exam? To feel for vibrations caused by consolidation (i.e. - pneumonia)
What is an ABG? Arterial Blood Gas - checks oxygenation of pulmonary artery blood
What does spirometry measure? The amount and rate of air that a patient breathes
What is respiratory distress syndrome? Alveolar collapse and lack of surfactant in premature infants
What causes SIDS? Abnormal ventilation allowing for CO2 buildup, periods of apnea and cardiac arrhythmias
What is croup? Severe inflammation and obstruction of the upper airway
What causes acute respiratory distress syndrome? A non-cardiac cause that increases the permeability of the alveolocapillary membrane
What is pulmonary edema? accumulation of fluid in the extravascular spaces of the lungs
What typically causes pulmonary edema? Left sided heart failure
What is atelactesis? Collapsed lung
What is a pneumothorax? The accumulation of air/gas between the parietal and visceral pleura
What are the two types of pneumothorax? Spontaneous (occurs in healthy person) and secondary (occurs as a complication of underlying LU disease)
What are signs/symptoms of a pneumothorax? Sharp chest pain, asymmetrical chest motion, dyspnea, decreased breath sounds on affected side
What is a pulmonary embolism? An embolism that has lodged in the lungs, typically originating from a distal location in the body
What are the three types of sounds heard on percussion? Tympanic - heard over a hollow organ; Resonant - heard over an organ with some air; Dullness - heard over "solid" tissue
What is acute bronchitis? Inflammation of the middle airways
What are some signs/symptoms of acute bronchitis? Productive cough, possibly fever, some wheezing or rhonchi (indicating fluid)
What is pneumonia defined as? An acute infection of lung tissue that commonly impairs gas exchange
Do vaccines exist for pneumonia? Yes
What is aspiration pneumonia? Pneumonia secondary to inhaling gastric contents
Which type of organism is part of the criteria when diagnosing AIDS (in relation to pneumonia)? Pneumocystis carinii
What is pleurisy? An inflammation of the visceral and parietal pleura
What is secondary to what types of conditions? Pneumonia, TB, viruses, SLE, RA, PE
What are signs and symptoms of pleurisy? Sharp, stabbing pain that increases with deep breaths, dyspnea, pleural friction rub during late inspiration/early expiration, increased tactile fremetis
What is a granuloma? A collection of macrophages that form to wall off substances perceived as foreign but unable to be eliminated by the body
What is the primary disease associated with the formation of granulomas? Infectious TB
What bacteria causes tuberculosis? Mycobacterium tuberculosis
Is TB an acute or chronic infection? It can be either
What are signs and symptoms of TB? Non-specific fatigue, weight loss, night sweats, low grade fever, cough
How is TB identified in a patient? With a + TB test (skin test) and/or a chest x-ray
What are the three types of fungal mycoses? Blastomycosis, Histoplasmosis and Coccidiomycosis
Where is blastomycosis found, and who does it normally affect? South-central, south-eastern and midwestern USA; Affects farmers, hunters campers
Where is histoplasmosis found and how is it transmitted? Eastern and central USA; transmitted from bird/bat droppings when soil spores are disturbed
Where is coccidiomycosis found? What is an alternate name for it? Under what conditions is it spread? Western and Southwestern USA; Valley Fever; droughts, farming, even earthquakes can stir up spores
What is sarcoidosis? A multisystem, granulomatous disorder producing lymphadenopathy, pulmonary infiltration and skeletal, liver, eye or skin lesions.
What are some signs of sarcoidosis? If respiratory: cough, dyspnea, substernal pain, cutaneous nodules
What type of cancer does asbestosis/silicosis cause? Mesothelioma
What is COPD? What is it defined as? Chronic Obstructive Pulmonary Disorder; Progressive loss of lung function
What is asthma? An intermittent attack of dyspnea and wheezing, chest tightness, and productive cough
Is asthma marked by decreased inspiration or decrease expiration? Decreased expiration
What is the most common cause of respiratory death in the US? Emphysema
What is the cause of congenital emphysema? Deficiency of alpha-antitrypsin
What are signs and symptoms of emphysema? Dyspnea, weight loss, barrel chest, pursed lip breathing and tachypnea
To what part of the body does LU cancer often metastasize? The spine
What is a Pancost tumor? How does it present? Cancer in the apices of the lung; As pain in the neck and shoulder regions.
What are the three common types of abdominal pain? Inflammatory (steady, acute onset pain), obstructive (colicky pain) and vascular (constant continuous ache)
What is cholecystitis? Inflammation of or stones in the gall bladder
What do LV/GB and duodenal pain refer to? The right shoulder/inferior scapula
Where do pancreatic, stomach, and duodenal pains refer to? Midback region
What type of diagnostic tests are used to determine GI issues? Barium swallow, barium enema, Upper/Lower GI endoscopes, Endoscopic Retrograde Cholangiopancreatography(ERCP), Laparoscopy, labs
Which test is used to examine the biliary and pancreatic ducts ERCP
What chemicals are often looked for on a chem screen? Bilirubin and cholesterol
What type of anemia can intestinal bleeding cause? Iron anemia
To what long term condition can esophageal spasms lead? Achalasia - esophageal sphincter fails to relax
What is GERD? Gastroesophageal reflux disease
Which type of infection can cause GERD? Heliobacter pylori
What is Barrett's esophagus? The lining of the esophagus is damaged d/t long term exposure to stomach acid
To which type of cancer is Barrett's esophagus a precursor? Adenocarcinoma
What are the two types of hiatal hernia? Sliding and paraesophageal
What is a sliding hernia? When the stomach and gastroesophageal junction both slip up above the hiatus
What is a paraesophageal hernia? When the greater curvature of the stomach rolls through the diaphragmatic defect
What is Mallory-Weiss syndrome? When there is a non-penetrating tear that occurs in the distal esophagus
What is gastritis? Inflammation of the gastric mucosa
What type of anemia can chronic gastritis cause? Pernicious (B12 deficiency) anemia
What tests are used to check for Heliobacter pylori? Blood tests (looking for antibodies), fecal test (looking for H. pylori proteins) and urea breath test
What is a cardinal sign for a stomach ulcer? Slight pain that is relieved by eating
What is a peptic ulcer? Circumscribed lesions of the mucosal membrane
What percentage of peptic ulcers are duodenal? 80%
What are the three major causes of peptic ulcers? 1. Heliobacter pylori 2. Excess use of NSAIDs 3. Hypersecretory disorders (such as Zollinger-Ellison syndrome)
What is Zollinger-Ellison syndrome? Condition caused by tumors that produce excess gastrin, increasing stomach acid production
If a patient has a bleeding peptic ulcer, what color will their stool be? Dark in color
What is celiac disease? Poor absorption of food, gluten intolerance
What type of children specifically often present with GI disorders? Children on the autism spectrum
How is celiac disease diagnosed? Biopsy revealing mosaic pattern that is the result of an abscence of villi
What is steatorrhea? Fatty stool
What is diverticulitis? Bulging pouches in the GI wall that push mucousal lining through surrounding muscle which are inflammed
What can cause diverticulitis? Insufficient fiber, old age
What is appendicitis? Inflammation, infection or obstruction of the appendix
What is a cardinal sign for appendicitis? + rebound tenderness
What type of pain does appendicitis initially present with? General periumbilical pain
When appendicitis pain localizes, where does it localize to? The lower right quadrant
What is pancreatitis? Acute OR chronic inflammation of the pancreas
What are the two most common conditions that cause pancreatitis? Alcoholism and biliary tract disease
Where does the pain of pancreatitis typically manifest? Epigastric pain radiating between the tenth thoracic and lumbar vertebrae, unrelieved by vomit
What two enzymes are elevated in serum levels in cases of acute pancreatitis? Amylase and lipase
What is often a condition of chronic pancreatitis? Malabsorption
What is peritonitis? Acute or chronic inflammation of the peritoneum, may extend through or be localized as an abscess
What are signs and symptoms of peritonitis? Sudden, severe, diffuse abdominal pain that tends to intensify and localize in the area of inflammation; weakness, pallor, SHOCK
What is cholelithiasis? Calculi that occur as a result of changes in bile components
What is cholecystitis? Acute or chronic inflammation of the gall bladder
Which type of viral hepatitis may self resolve? Hepatitis C
What symptoms does hepatitis initially present with? Significant fatigue, anorexia, general malaise
Why is urine often dark in cases of hepatitis? Because of the increased concentration of bilirubin
What is one of the most important markers to be familiar with when looking for hepatitis? The Hep B surface antigen
What is a caput medusa? A pattern of veins that manifests over the surface of a distended abdomen
How can you tell the difference between Hepatitis A and cirrhosis of the liver? In Hep A, liver enzymes are very high. In a cirrhotic liver, liver enzymes are very low
What can cause non-viral hepatitis? Carbon tetrachloride, trichloroethylene, mushrooms, certain medications, autoimmune disorders
What is asterixis? Involuntary motion, sometimes seen as a CNS complication of liver disease
Issues with which three systems are typically what kill people with liver disease? Respiratory, CNS and hematology
What are some endocrine issues commonly seen with cirrhosis? Testicular atrophy, gynecomastia, loss of body hair
What color is the stool in cases of cholelithiasis? Clay colored, because it lacks bile
What is the most common GI cancer? Colon cancer
What are some signs/symptoms of colon cancer? Local obstruction, hematochezia (bright red blood in the stool), anemia (pernicious and Fe deficient), abdominal aching
In which populations is ulcerative cholitis common? Young people, people of Jewish origin
What symptoms are often seen with ulcerative cholitis? Weight loss, abdominal pain, anemia, and rectal abscesses
What are the treatments for ulcerative cholitis? Supportive care, colon resection, cholostomy bag
What percentage of kidney function must be lost before signs of kidney failure appear? 75%
What is BUN? Blood Urea Nitrogen (a waste product)
What is a urinary cast? A mold of the kidney tubules formed by precipitation of mucoproteins
Which type of polycystic kidney disease is fatal? Infantile
What is the treatment for polycystic kidney disease? Dialysis and transplant
What is acute pyelonephritis? A bacterial infection of the interstitial tissues of the kidney
What is vesicoureteral reflux? Retrograde flow of urine from the urinary bladder
What are some cardinal signs of acute pyelonephritis? Urgency, frequency, burning upon urination, fever, shaking chills and flank pain
What is acute post-streptococcal glomerulonephritis (APSGN) Bilateral inflammation of the glomeruli following an upper respiratory strep infection
What are some signs/stymptoms of APSGN? Oliguria (reduced urination), + anti-streptolysin O antibody titers
What is acute tubular necrosis? Damage to the kidney tubules from toxins or ischemia
What are some red flags of acute tubular necrosis? Decreased output, symptoms of uremia, elevated BUN, creatinine
What are renal caliculi? Kidney stones
What is lithotripsy? A delivery of shock waves to break up large kidney stones
Created by: eippolito



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