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NBCE Part 3 A
Diagnosis: Related Terms and Definitions
| Question | Answer |
|---|---|
| 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 |
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