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| Causes of non-proliferative GN? | Minimal change; Focal segmental glomerulosclerosis; Membranous glomerulonephritis |
| Causes of proliferative GN? | IgA nephropathy; HSP (systemic variant of IgA nephropathy); Post infectious; Membranoproliferative mesengiocapillary; Rapidly progressive (Crescentic: Goodpasteur and Wegener)) |
| Wilms tumor is associted with? | WAGR (Wilms, Aniridia, Genital abnormalities, mental Retardation); hemihypertrophy; Beckwith-Wiedemann Sx; |
| Congenital conditions and GU anomalies? | Turner and horseshoe kidney; microcephaly and Posterior Urethral Valve in boys |
| Association of neonatal respirtory distress, pneumothorax and abdominal mass? | High occurance of significant urinary obstruction (posterior urethral valve or urethral agenesis) |
| Psychotherapies? | Psychodynamic therapies; Behavioral therapies; cognitive therapy; Group therapy; Familial therapy; Hypnosis; Dialectical behavioral therapy |
| Psychodynamic therapies? | Psychoanalysis; Supportive psychotherapy; Short term brief psychotherapy; Interpersonal psychotherapy |
| Behavioral therapies? | Systematic desensitization; Flooding; Positive and negative reinforcement; Extinction; Punishment (causing a behavior to diminish by applying a noxious stimulus; in negative reinforcement: causing behavior to occur more by removing a noxious stimulus) |
| LBBB ECG changes? | In both RBBB and LBBB: supraventricular rhythem + wide (> 0.12 sec) QRS; then LBBB: QS or RS pattern in V1 + monophasic R in I and V6 |
| RBBB ECG changes? | In both RBBB and LBBB: supraventricular rhythem + wide (> 0.12 sec) QRS; then RBBB: terminal R pattern in V1 + slurred S in I and V6 |
| Heart sounds S4 (atrial gallop) implications? | late in diastole; always abnormal (CHF and HOCM) |
| Heart sounds S3 implications? | Early in diastole; Normal in children and athletics; left heart failure; R/o MI |
| Heart sounds: S2; origin and implications in splitting | A-P; Splitting by inspiration, RBBB and RV infarct; paradoxical in LBBB and anterolateral MI |
| Precordial knock? | Constrictive pericarditis |
| Openning snap? | Mitral and tricuspid stenosis (look for atrial fibrilation) |
| Most common causes of AS and AR? | AS: Bicuspid valve, atherosclerosis with age, Rheumatic; AR: 50% supra-valvular: aortic root dilatation (idiopathic: 80%; also with aging and hypertension, Marfan syndrome, aortic dissection, and syphilis) |
| Most common causes of TR? | TR: Infective endocarditis (IVDUs) |
| Most common causes of MS and MR? | MS: almost always rheumatic; MR: myxomatous degeneration of chorda tendinea leading to MVP Rheumatic dis., ruptured chorda tendinea following MI |
| Cardiac manifestations of SLE? | endocarditis then Libman-Sacks endocarditis (a form of nonbacterial endocarditis) |
| Association of congenital heart diseases: Turner? | CoA; HTN |
| Association of congenital heart diseases: Down? | Endocardial cushion defects |
| Association of congenital heart diseases: Cartagener? | Dextrocardia |
| Association of congenital heart diseases: Noonan? | Right sided cardiac defects; pulmonary stenosis |
| Association of congenital heart diseases: Prematurity? | PDA |
| Association of congenital heart diseases: TORCH? | PDA |
| Association of congenital heart diseases: CHARGE? | TOF and septal defects |
| Association of congenital heart diseases: Digeorge? | conotruncal abnormalities, such as truncus arteriosus or total anomalous pulmonary venous return |
| Association of congenital heart diseases: Marfan? | MVP, aortic dissection or insufficiency |
| Association of congenital heart diseases: William Sx? | aortic and pulmonic stenosis |
| Association of congenital heart diseases: Mothers with SLE? | Congenital heart blocks |
| Association of congenital heart diseases: Mothers with alcohole abuse? | ASD; VSD |
| Association of congenital heart diseases: Mothers with DM? | TGA, CoA |
| Association of congenital heart diseases: Phenytoin and valporic acid? | Phenytoin: ASD, VSD, PS, AS; valporic acid: CoA, Hypoplastic Left Heart Sx |
| Association of congenital heart diseases: lithium and benzo? | Epstein anomaly |
| CXR in CHDs? | Boot shaped (RVH) in TF and egg shaped in TGA; enlarged right heart: ASD; Rib notching: CoA; Prominetnt Pulmonary artery: PDA; |
| TF clinical presentation | Exertional states (crying, activity) increases shunt and so cyanosis; paroxysm of rapid and deep breathing; CXR: boot shape heart (RVH) |
| Epstein anomaly features? | Low set tricuspid valve so Malfunctioning RV, TR and TS; usually patent foramen ovale exists. WPW is usually present; Associated with maternal lithium and benzo use in 1st trimester |
| Typical atrial rates in MAT, A-Flutter, A-fib, V-Tach? | MAT: 100-200, A-Flutter: 250-300, A-fib: 400-800, V-Tach rate: 140-200 |
| A-fib risk assessment for Warfarin therapy? | CHADS2: CHF, HTN, Age>75, DM, Stroke (2 points): 0-1: ASA; for moderate to high risk (valvular disease): warfarin |
| TIMI score? | ARCA PST; History: Age >65yrs, >3 risk factors for CAD, Known CAD (stenosis >50%), Aspirin use in past 7days; Presentation: Recent (24 hr) severe angina, ST-segment deviation ≥0.5 mm, cardiac markers (Troponins); high risk: > 2 points |
| Management of STEMI? | PCI for symptoms < 3 hr, PCI available immediately OR symptoms > 3 hr, PCI available in 90 minutes OR Hypotension; Otherwise thrombolysis if symptoms < 12 hr |
| Lipids level goal in pts with CAD | LDL < 100 mg/dL, HDL 40 mg/dL or higher, TGs: < 150 mg/dL |
| Long QT: | 50% familial syndrome; also in hypokalemia, hypocalcemia, hypomagnesemia, and many drugs; associated Syndromes: Jervell and Lange-Nielsen and Romano-Ward syndromes |
| Management in DVT? | minimum of 3 months (6 months if idiopathic and not provoked) to indefinite oral anticoagulation; if malignancy: 6 months of LMWH |
| Major autosomal dominant disorders? | {Fam. colonic polyposis, Adult polycystic kidney dis., Acute int. porphyria}{Type ii fam. hypercholesterolemia, MEN II}{Osteogenesis imperfecta, Achondroplasia}{Waardenburg, Noonan}{Neuro-cut. Sx, , Amyloidosis, vWD}{HOCM, ASD}{malignant hyperthermia} |
| Major X-linked disorders? | Recessive: Hemophilia A and B, G6PD, Fragile X, Testicular feminization, Nephrogenic DI, Duchenne and androgenic alopecia; Dominant: Rett, X-linked hypophosphatemic rickets |
| Porphyrias; types and presentations: | Porphyria cutanea tarda (Mc; chronic blistering and crusting lesions on sun-exposed skin); Acute intermittent porphyria (severe abd pain, Avoid barbiturates); Erythropoietic porphyria (acute photosensitivity with pain and swelling after sun exposure) |
| Arnold-Chiari malformation | a malformation of the brain. It consists of a downward displacement of the cerebellar tonsils and the medulla through the foramen magnum, sometimes causing hydrocephalus |
| cerebral palsy pathophysiology? | Germinal matrix hemorrhage, ulegyria (early neonatal hypoxia), and periventricular leukomalacia |
| Thrombasthenia: | lack of the platelet membrane glycoprotein GPIIb- IIIa; failure of clot retraction; AR genetic disorder that presents with epistaxis early in childhood |
| Bernard-Soulier syndrome | large platelets; deficiency of glycoprotein Ib (GpIb), the receptor for vWF |
| Bruton disease | pan hypogammaglobulinemia but intact T cell function |
| Nezelof syndrome | Thymic dysplasia with normal immunoglobulins that function poorly (absent T cell function, deficient B cell function, fairly normal immunoglobulin levels) |
| Friedreich ataxia | Onset 5-20 y/o; Hereditary sclerosis of the dorsal and lateral columns of the spinal cord with cerebellar involvement; ataxia, speech impairment, scoliosis, and peculiar swaying, with paralysis of the muscles |
| Continuous machinery murmur throughout cardiac cycle | PDA |
| Decrescendo diastolic murmur heard best at mid precordium | AR |
| Faint murmur that increases in intensity with inspiration | TR |
| Holosystolic murmur with radiation of murmur to the axilla | MR |
| Opening snap and mid-diastolic rumbling murmur | MS |
| Murmur best heard while Pt sitting and leaning forward | AR |
| Murmur best heard in left lateral decubitus | MS |
| renal failure, anemia, thrombocytopenia in a child | HUS; Rx: supportive; no indication for steroids; platelets are contraindicated |
| Hair Loss: "TOP HAT" | Telogen effluvium, Tinea capitis; Out of Fe, Zn; Physical: trichotillomania; "corn-row" braiding; Hormonal: hypothyroidism; androgenic; Autoimmune: SLE, alopecia areata; Toxins: heavy metals, anticoagulants, chemotherapy, Vit. A, SSRIs |
| Toxins and drugs that may cause allopecia | heavy metals, anticoagulants, chemotherapy, Vit. A, SSRIs |
| Non-scarring causes of alopecia: (3 As, 3 Ts, and S): | Androgenic Alopecia; Alopecia Areata; Anagen effluvium; Telogen Effluvium; Trichotillomania; Traction Alopecia; Secondary Syphilis |
| Scarring allopecia: | Trauma (burns, radiation); inflammation (discoid lupus, sarcoidosis, lichen planus), infection (Tinea capitis), neoplasms (basal cell ca, squamous ca, lymphoma) |
| Marjolin ulcers: | Sq cell ca on scars with repeated ulceration and healing |
| Bowens disease and Erythroplasia of Queyrat | Sq cell ca in situ (Erythroplasia of Queyrat on glans penis) |
| Keratoacanthoma: | Sq. cell ca., erupts abruptly, grows to its max size within weeks or months and then most commonly undergoes spontaneous resolution |
| Usher Sx | Genetic disorder with hereditary deafness (inner ear) and blindness (retinitis pigmentosa) |
| Skin lesions with association with malignancies | Xeroderma pigmentosa (very large congenital nevi and basa cell nevus); Actinic keratosis; Lentigo maligna melanoma; Leukoplaques; nevus sebaceous; (Note: Juvenile Melanoma is always benign (Spitz nevus) |
| Psoriatic (arthritis) features | Well-demarcated erythematous plaques with silvery scale on the extensor side; Nail involvement; asymmetric oligoarthritis (common), DIP may involve (unlike OA), conjunctivitis, aortic ins. and apical pulmonary fibrosis (late findings) |
| Psoriasis types? | Chronic plaque: the most common form; Guttate: raindrops, associated with strep; high recurrence rates; erytherodermic: involves more than 90% of the body; Inverse: in flexor surfaces and axilla |
| Acanthosis nigricans | benign skin condition; papillomatous hypertrophy of the epidermis with hyperpigmentation; flexural regions of axilla and groin; o Associated with some malignancies (gastric) and also endocrinopathies (DM, polycystic ovarian disease); Test: FBS |
| Koebner phenomenon | development of skin lesions in the line of trauma or inflammation (Molluscum contagiosum, warts, Also: : vitiligo, psoriasis, lichen planus, pityriasis rubra pilaris, and keratosis follicularis) |
| Vesiculo-bullous lesions | Pemphigus vulgaris (Blisters on skin and inside the mouth, steroids); Bullous pemphigoid (Old age, tense bulla, pruritic; not in the mouth); Dermatitis herpetiformis (Small herpetiform bulla on the extensors and back;with PMNs and IgA deposition, Dapson) |
| Papulosquamous lesions | Lichen planus (Ch. Infl. of mucous membrane and skin, violaceous papules on the flexor aspect, polygonal, Wickham's striae); Pityriasis Rosea (Herald patches; Christmas tree on the back, Steroids); Psoriasis (Steroids); |
| Lichen planus association and risk? | Association with Hepatitis C and increased risk of Sq cell carcinoma |
| Phototoxic substances: | tetracyclines, amiodarone, sulfonamides, quinolones |
| Photoallergans | fluoroquinolones, tetracyclines, amiodarone, NSAIDS, pellagra, psoralens, coal tar, PABA, St. John Wort |
| Side effects of isotretinoin | lip fissures (very common), teratogenic, skin dryness, conjunctivitis, hyperlipidemia, reversible alopecia and abnormal LFTs |
| Erythrasma | pink patches, which can turn into brown scales; caused by the Corynebacterium minutissimum; Rx: erythromycin cream; Pathognomic:coral-red fluorescence on Woods light exam |
| Erythema nodosum | Painful lumps on the pretibial area (shins); panniculitis; Causes: infections (TB, leprosy, strep mycoplasma); infl. (sarcoidosis, IBD, Behcet); meds (sulfonamides, OCPs); pregnancy and cancer |
| Lentigo | a uniformly pigmented, brown to black, flat macule with sharp margins. Solar lentigo (aging spots): Caucasians > 40 y/o |
| Miliaria | pruritic sweat gland inflammations |
| Most common cause of hirsutism | Polycytic Ovary disease (+ menstrual irregularities, obesity, insulin resistance) |
| Exeptional Rx; Heparin Induced Thrombocytopenia | hypercoagulability state; replace heparin with heparinoids (hirudin, …) |
| Exeptional Rx; ITP | platelet only if life threatening bleeding; steroids ± IVIg and anti Rh |
| Exeptional Rx; HUS and TTP | platelet is contraindicated; plasmapheresis ± steroids |
| Exeptional Rx; vWD and Hemophilia A | desmopressin |
| Exeptional Rx; Kawasaki | No steroids; ASA and IVIg to prevent aneurysms |
| Relative C/Ind for platelet | HUS and TTP, HIT, post-transfusion purpura (PTP), HELLP |
| Behcet Sx | oral (aphthous lesions); arthritis; skin and genital lesions, eye involvement (iritis, uveitis); Like Herpes but negative for multinucleated giant cells on Tzank smear |
| Naloxone dose? | 2 mg bolus up to 10 mg (peds 0.01 ml/kg) |
| Metabolic acidosis with increased AG? | MUDPILES CAT: methanol, uremia, DKA and SKA, phenformin (oral hypoglycemic) and paraldehyde, INH and iron and ibuprofen, lactic acidosis, ethylene glycol, salicylates, CN and CO, alcoholic ketoacidosis, Toluene |
| Metabolic acidosis with decreased AG? | error, electrolyte imbalance (K, Na, Mg), Li, hypoalbuminemia, para-proteins (multiple myeloma) |
| Metabolic acidosis with normal AG? | High K: pyelonephritis, obstructive nephropathy, RTA type IV, TPN; Low K: small bowel losses, RTA types 1 and II, acetazolamide, |
| Causes of increased osmolar gap? | (MAE DIE): Methanol, acetone, ethanol, osmolar diuretics, isopropanol, ethylene glycol |
| Major indications for DEXA? | Age ≥ 65 years; Early menopause (< 45); Low trauma fracture; FHx of osteoporotic fracture; Steroids; Malabsorption syndrome; Primary hyperparathyroidism; Hypogonadism |
| minor indications for DEXA? | Weight < 60 kg; weight loss > 10% from weight at age 25; Low dietary calcium intake; Medications (anticonvulsants, heparin); Smoking, caffeine (> 4 cups coffee/day), alcohol; RA |
| Polyglandular deficiency Sx, Type I | Characteristic: hypoparathyroidism and candidiasis; also hypothyroidism (in all types) and adrenal insufficiency |
| Polyglandular deficiency Sx, Type II | Characteristic: DM type I and adrenal insufficiency |
| Polyglandular deficiency Sx, Type III | Like Type II but without adrenal insufficiency (i.e. only hypothyroidism + DM type I) |
| Early dementia | HIV, Tumor, Spongioform encephalopathy, Vascular dementia, dementia pugilistica, Medications (anticholinergics, amphethamine, TCAs, lithium, |
| Rx for DIC: | in hemorrhage: replacement of hemostatic elements with platelet transfusion, FFP, cryoprecipitate; in thrombotic phase: LMWH (controversial) |
| Jones major and minor criteria for RF | SPACE: subcutaneous nodule, Pancarditis, Arthritis, Chorea and Erythema Marginatum; Minors: previous Hx, poly-arthralgia, fever, high ESR, prolonge PR interval; 2 major or 1 major and 2 minor for Dx) |
Created by:
Bijan39
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