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Clinical diagnosis
FA review
| Question | Answer |
|---|---|
| What is the common name for Primary adrenal insufficiency? | Addison disease |
| What are key signs of Addison disease? | Vomiting, diarrhea, and hyperpigmentation |
| How are the levels of cortisol and aldosterone altered in Addison disease? | Unchanged |
| What is the lab finding of Hyperemesis gravidarum? | Ketonuria |
| What is Hyperemesis gravidarum? | Condition with persistent vomiting, weight loss, and no evidence of another cause |
| What deficits are presented in lesions to the Cerebellum (cerebellar hemisphere)? | Appendicular ataxia, which presents as dysmetria, or lack of coordination. |
| A person's lack of coordination may be due to damage to which brain area? | Cerebellar hemisphere |
| What is dysmetria? | Lack of coordination |
| A lesion to the cerebellar hemisphere will cause ipsilateral or contralateral dysmetria? | Ipsilateral |
| What part of the brain is often affected in a person with ipsilateral undershoot or overshoot of the limb? | Cerebellar hemisphere |
| What is the most common cause of loss of consciousness in a person with SAH? | Hydrocephalus |
| What is a Berry aneurysm? | Thin-walled outpouching at the cerebral artery branch point that can rupture, leading to SAH. |
| What is an important ocular consequence of the rupture of a Berry aneurysm? | CN III palsy |
| What is a common cause of CN III palsy? | Rupture of a Berry aneurysm |
| What condition is associated with the development of SAH? | Rupture of a Berry aneurysm |
| Description of urine of a patient with Central DI? | Kidneys make large amount of DILUTE urine due to a lack of ADH |
| What are common associations of Central DI? | 1. Low urine osmolarity 2. Hypernatremia (when patients cannot drink water) 3. Positive free water clearance |
| Which type of DI is suspected in a person with a positive free water clearance level? | Central DI |
| Is urine osmolarity high or low in Central DI? | Low |
| Is central DI associated with hyponatremia or hypernatremia? | Hypernatremia |
| Which type of diabetes is associated with hypernatremia? | Central DI |
| Common expressive aphasia: | Broca aphasia |
| How is the speech and comprehension of a person with Broca aphasia? | 1. Comprehend noral speech, 2. Speech is not fluent |
| Patient frustrated with no able to speak desired words, but understanding everything told by the doctor. Dx? | Broca aphasia |
| Where is Broca area located? | Posterior inferior frontal gyrus |
| Which area is located at the posterior inferior frontal gyrus? | Broca area |
| What marker is positive in a Hep B vaccinated person? | Anti-HBs antibody |
| What is the approximate or average timeframe for a Lateral Free wall LV rupture after MI? | 2 weeks |
| What MI complication can be expected after 2 weeks approximatelY? | Lateral free wall LV rupture |
| What clinical sign is associated with Lateral free wall LV rupture 2 weeks after MI? | Cardiac tamponade |
| Is Cardiac tamponade associated with Lateral Free wall LV rupture or with Papillary muscle rupture? | Lateral free wall LV rupture |
| What condition is often seen as result of CN VII lesion? | Bell's palsy |
| What are the clinical consequences of Unilateral CN VII lesion? | Ipsilateral dry eye, dry mouth, decreased taste sensation on the anterior tongue, retroauricular pain, sensitivity to noise and facial paralysis |
| Which part of the tongue sensation is affected by Bell's palsy? | Anterior tongue |
| How is the ear pain described in Bell's palsy? | Retroauricular |
| Is Small Cell lung cancer associated with low or high levels of serum sodium? | Low levels |
| A patient with SCC of the lung, has indications to not take HCTZ. Why? | Thiazide diuretics can cause severe hyponatremia, espiecillah in setting of high have an poor solute intake. |
| What are the distinctive physical features of Down syndrome? | Small low set of ears, Flat facial profile Upslanting palpebral fissures Protruding tongue, and, Abnormal space between the first and second toes. |
| What trisomy is seen with a distingute gap between the first and second toes? | Down syndrome |
| What malignancies are highly associated with Down syndrome? | Acute Lymphocytic leukemias |
| What condition is highly associated with ALL? | Down syndrome |
| What are clinical symptoms of ALL? | Fever, easy bruising, fatigue, and hepatosplenomegaly. |
| What is the most common adult leukemia? | CLL/ SLL |
| What is the most distinctive marker of CLL or SLL? | CD5+ |
| If CLL is symtptomatic, what are some clinical and lab clues? | (+) CD5+, Lymphocytosis Splenomegaly Lymphadenopathy |
| What does, in ECG terms, MAT stand for? | Multifocal atrial tachycardia |
| What are the distinctive features for MAT on EKG? | Varying P-wave morphologies and R-R intervals |
| What type of patients commonly develop MAT (multifocal atrial tachycardia)? | Patients with COPD |
| What is Waldenstrom Macroglobulinemia? | B-cell neoplasm associated with overproduction of IgM |
| Which immunoglobulin is overproduced in Waldenstrom Macroglobulinemia? | IgM |
| What is the key characteristic of blood in Waldenstrom Macroglobulinemia? | Increased blood viscosity |
| Description of an person with an avoidant personality disorder? | Social inhibition with oversensitivity to criticism, fear of being disliked, self-consciousness, and feelings of inadequacy |
| Does an avoidant person is interested in forming relation with other people or indifferent? | Interested; avoidant person, wants to have personal relationships but the fear of rejection is bigger. |
| What is the translocation associated with Burkitt Lymphoma? | t(8;14) |
| What is the most common form of SPORADIC Burkitt lymphoma? | Abdominal obstruction or other abdominal symptoms in children and young adults |
| What is often seen in rare forms of Burkitt lymphoma? | Abdominal obstruction or other abdominal symptoms in children and young adults |
| What type of hearing loss is Noise-induced hearing loss? | Sensorineural hearing loss |
| What type of frequencies are the fist to decline in Noise-induced deafness? | High-frequency sounds |
| What kind of hearing loss is expected in a retired construction worker? | Noise-induced hearing loss, which is a sensorineural hearing loss type. |
| What is the difference between bone and air conduction in sensorineural hearing loss? | Air conduction greater than bone conduction |
| Sensorineural hearing loss will show sound lateralization to unaffected ear, in which test? | Weber test |
| If during RInne testing, air conduction is greater than bone conduction bilaterally, it means conductive or sensorineural hearing loss? | Sensorineural hearing loss |
| What is a lifetime condition or characteristic of a person with prior MI on ECG? | Pathologic Q-waves |
| The presence of pathologic Q-waves on ECG indicate what ? | History of prior MI |
| How is normal anion metabolic acidosis levels of pH, bicarbonate, and pCO2? | All three are low |
| Is diarrhea a cause of normal anion gap metabolic acidosis or anion gap metabolic acidosis? | Normal anion gap metabolic acidosis |
| NAGMA is it produced by DKA or diarrhea? | Diarrhea |
| How does diarrhea cause NAGMA? | Diarrhea can cause NAGMA and hypokalemia via GI GIHC and potassium ions loss. |
| What are some common risk factors of Duodenal ulcers due to PUD or H. pylori infection? | NSAIDs, tobacco use, alcohol abuse, and genetic predisposition |
| What is a common and higl form of non-Hodgkin lymphoma? | Burkitt lymphoma |
| What are the findings of a biopsy of Burkitt lymphoma? | Highly mitotic, basophilic lymphocytes surrounding clear zones of macrophages. |
| Is sublimation a mature or immature defense mechanism? | Mature |
| Definition of Sublimation as defense mechanism: | Socially unacceptable impulses or actions are replaced with socially acceptable |
| A person replaces assaulting his wife, by becoming a professional boxer. What type of defense mechanism is expressed in this scenario? | Sublimation |
| What are the 3 main categories of symptoms in AIP? | Abdominal pain, red urine, and psychiatric symptoms |
| What enzyme is deficient or absent in AIP? | Porphobilinogen deaminase |
| Porphobilinogen deaminase deficiency. Dx? | Acute Intermittent Porphyria |
| What is the most common presenting of a patient with IPH (intraparenchymal hemorrhage)? | Headache, vomiting, decreased level of consciousness, and elevated ICP. |
| What is the MCC of IPH in adults? | Systemic hypertension |
| What do benign or innocent flow murmurs often reflect? | Turbulent blood flow in the pulmonary outflow tract of the right ventricle |
| Which heart chamber is most often associated with development of benign heart murmurs? | Right ventricle |
| What is caused by turbulent blood flow in the pulmonary outflow of the RV? | Benign murmur |
| What action often causes a diminish in benign RV tumors? | Standing |
| What is Charcot triad? | Fever, jaundice, and RUQ pain |
| What condition is associated with Charcot triad? | Bacterial Cholangitis |
| What fatal condition is associated with severe indirect hyperbilirubinemia in an infant? | Crigler-Najjar syndrome |
| What type of hyperbilirubinemia is present in Crigler-Najjar syndrome? | Indirect hyperbilirubinemia |
| Is type 1 or type 2, Crigler-Najjar syndrome presentation more severe? | Type 1 is more severe |
| What is the most classic histologic finding of AML? | Auer rods |
| Description of CBC of AML patients? | High WBC count with low hematocrit and platelets |
| How is the bone marrow affected by AML? | AML causes bone marrow infiltration by abnormal leukemic blast cells |
| What cells cause BM infiltration in AML? | Abnormal leukemic blast cells |
| In which condition is often and common for patient to develop Uremic platelet dysfunction? | End-stage Renal disease |
| Which condition is seen with unfiltered uremic toxins leading to poor platelet function? | Uremic platelet dysfunction |
| What are the effects on Bleeding time and PT/aPTT in Uremic Platelet dysfunction? | Increased BT, but normal PT/aPTT |
| Are fistulas in the intestine present in UC or Crohn disease? | Crohn disease |
| What are the MC microscopic findings of Crohn disease? | Transmural inflammation and non-caseating granulomas |
| What is a very common cause of Anemia in the elderly? | Chronic GI bleeding leading to Iron-deficient anemia |
| Which enzyme is seen with decreased activity in Iron-deficiency anemia? | Ferrochelatase |
| Which biliary condition is HIGHLY associated with Ulcerative colitis? | Primary Sclerosing Cholangitis |
| How is the classical clinical presentation of PSC? | Elevated Alkaline Phosphatase, jaundice, fatigue, and pruritus. |
| Is ALP elevated or decreased in PSC? | Elevated ALP |
| What condition is due to fibrosis of intrahepatic and extrahepatic bile ducts? | Primary Sclerosing Cholangitis |
| What levels is commonly elevated in PSC? | Elevated ALP |
| What are some common causes of Hypopituitarism? | Pituitary surgery, radiation, head trauma, or non functioning pituitary adenomas |
| Are Pituitary or Hypothalamic hormones decreased in hypopituitarism? | Pituitary hormones |
| What is the effect of Bernand-Souler disease in BT, PT, and PTT? | Increased BT, and normal PT/aPTT |
| Which hematologic measure is the only affected in Bernard-Soulier syndrome? | Increased BT |
| What causes Bernard-Soulier disease? | Deficiency of platelet membrane protein complex GPIb |
| Which platelet membrane protein is deficient or missing in Bernard-Soulier disease? | GpIb |
| Deficiency in GpIb. Dx? | Bernard-Soulier syndrome |
| How is a prion disease commonly presented in a patient? | Rapid progression of dementia, mood change, impaired concentration, and UMN lesion signs |
| What is the typical finding on EEG of a patient with a Prion disease? | Triphasic periodic sharp wave complexes |
| EEG findings: Triphasic periodic sharp wave complexes. Dx? | Prion disease |
| What are the CT imaging findings of Pancreatitis? | Edematous pancreas with fat stranding |
| What are histologic findings of Pancreatitis? | Inflammation, necrosis, hemorrhage, an areas of focal fat necrosis in pancreatic tissue |
| What is the common way to describe the physical state of the liver in a person with Alcoholic liver disease? | Nodular and shrunken liver |
| What are the effects of hypersplenism in alcoholic (cirrhotic) patient? | Thrombocytopenia |
| What is the Cushing's triad? | 1. Bradycardia 2. Irregular respirations 3. Widened pulse pressure |
| What type of intracranial hematoma is associated with Cushing triad? | Epidural hematoma |
| What palsy is often seen with Uncal herniation? | CN III palsy |
| How is the affected pupil in a person with CN III palsy due to Uncal herniation? | Fixed and dilated pupil |
| What is an Uncal herniation? | Condition associated with epidural hematoma due to pressure on the medial temporal lobe through the tentorial notch |
| Which lobe is affected by a Uncal herniation? | Medial temporal lobe |
| Which notch or foramen paves the path for the uncal herniation to reach the medial temporal lobe? | Tentorial notch |
| What is Trichotillomania? | Obsessive-compulsive disorder in which a person pulls hair, often preceded by tension. |
| What is the MC supratentorial tumor in childhood? | Craniopharyngioma |
| What is the most common neoplasm arising in the pituitary region? | Craniopharyngioma |
| What is the main clinical presentation caused by a Craniopharyngioma? | 1. Increased ICP 2. Endocrine dysfunction 3. Visual disturbances |
Created by:
rakomi
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