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Update Disease Find
Updated Disease and Findings
| Question | Answer |
|---|---|
| Migraine headache nerve | trigeminal |
| Blow-out fracture at the ER | immediate ophthalmology consult |
| Methanol Metabolic acidosis therapy | ethanol and dialysis |
| Tularemia | infected animal flesh; insect bites; conjunctive inoculation |
| Late decelerations indicates what? | Uteroplacental insufficiency. |
| Colle's fracture (distal radial fx) splint | volar forearm splint |
| AIDS | CD4 < 200 |
| Lung lesion | < 3 cm (> 3cm - mass) |
| Gram negative diplococci | neisseria gonorrhea |
| Epididymitis in men under 40 | chlamydia trachomatis |
| Baterial conjunctavitis | neisseria gonorrhea |
| Virchow's Triad | 1. Hypercoagulable state (CA, etc) 2. Venous stasis (long travel) 3. intimal injury |
| Pulmonary Embolism CXR | 1. Westermark's sign 2. Hampton's hump |
| Worst headache ever had | Subarachnoid hemorrhage; CT is the best modality |
| Primary Sclerosing Cholangitis | diffused dilatation and sclerosing through the bile duct. |
| Prophylaxis for travelers diarrhea | quinolones |
| Clostridial myonecrosis | gram negative anaerobes |
| Renal Cell carcinoma presentation | hematuria, flank pain, mass |
| Lewy Bodies | eosinophilic inclusions in damaged substantia nigra cells |
| Low-set ears | Down; DiGiorge, Trisomy 18 (Edwards) |
| Machine-like murmur | Patent ductus arteriosus |
| Mallory-weiss tear | distal esophageal laceration secondary to alcoholic wretching |
| Marfan's | elstin defect; floppy mitral valve; |
| McBurney's sign | appendicitis; 2/3 distance from umbilicus to right ASIS |
| Meckel's Diverticulum | rules of 2's: 2" long; 2' from the ileocecum; 2% population |
| Mid-systolic click | mitral prolapse |
| Mousy/Musty odor | PKU |
| Mucosal bleeding | platelet disorder |
| Myxedema | hypothyroidism |
| Nutmeg liver | CHF; right sided failure |
| Painless jaundice | pancreatic head cancer |
| Parkinson's | dopamine depletion in nigrostriatal tracts; cogwheel rigidity |
| Peutz-jegher's Syndrome | melanin pigmentation of lips; mouth; hand; genitalia |
| CML | Philadelphia chromosomes |
| Pink foamy lung exudate | Pneumocystis Jeroveci pneumonia |
| Hemangioma | port wine stain |
| Punched-out bone lesions | multiple myeloma |
| Rash on palm and sole | Secondary syphilis |
| Reed-sternberg cells | Hodgkin's Disease |
| Reiter's Syndrome (chlamydia) | Urethritis; conjunctivitis; arthritis non-infectious; HLA-B27 |
| Reye's Syndrome | Ingestion of Aspirin by young children; microvesicular fatty liver change and encephalopathy |
| Rouleaux formation | multiple myeloma RBC's stacked as poker chips |
| S3 Heart sound | mitral regurg; left - right shunt; LV failure |
| S4 heart sound | pulmonary stenosis; pulmonary HTN |
| Scalloped Colloid | Grave's disease |
| Steven Johnson Syndrome | erythema multiforme; fever; malaise; mucosal ulceration (often secondary to infx or sulfa drug) |
| Splinter hemorrhage; splenomegaly; petechiae; murmur | infective endocarditis |
| Spider telangiectasia (angioma) | Hyperestrinism; liver failure; pregnancy |
| Sjogren's Syndrome | triad; dry eyes; dry mouth and arthritis |
| amarousis fugax (transient monocular blindness) | monocular blindness usually from carotid emboli |
| PMS | happens during the second half of the cycle |
| Uterine Leiomyoma | Fibroids; benign smooth muscle neoplasm; not malignant or pre-malignant; No treatment or Lupron |
| FSH Level should be checked to evaluate what? | Menopause |
| Nadir of blood pressure in pregnancy? | Second trimester |
| Myasthenia gravis (edrophonium test) | upper body organ muscle and upper limbs usuallydiplopia; difficulty swallowing; ptosis |
| Threatened abortion | First 20 weeks; cervix is closed |
| thiazide diuretic | hypercuricemia and gout flare up |
| Sycope, dizziness in CAD patient | think heart block |
| Muscular dystrophy | starts usually by age 5; from the pelvic girdle |
| Excessive levothyroxine therapy | risk of osteoporosis due to increased metabolic turn over |
| Onychomycosis | terbinafine (systemic anti-fungal) |
| Erysipelas | Group A Strep |
| Blast cells | non seen in healthy people |
| Elevated Ferritin level | inflammation, liver disease, malignancy, Anemia of chronic diseases (impaired iron usage, not iron deficient) |
| Decreased ferritin level | iron deficiency |
| Pinguecula | Harmless triangular nodule on the bulbar conjuncativa |
| Bacterial meningitis CSF | glucose - decreased protein - increase |
| Viral meningitis CSF | glucose - normal mono - increased |
| Abx of choice for human bite | Augmentin |
| Cryptococcois | Bird droppings; mostly CNS symptoms; risk to farm workers |
| Histoplasmosis | Usually asymptomatic; usually respiratory symptoms; Immuno-compromised patients; Tx: Amphotericin B |
| Botulism | Descending paralysis, no fever |
| Chlamydia pneumoniae | atypical bronchitis & pneumonia (young adults/kids) |
| Chlamydia psittici | from exotic birds |
| Chlamydia trachomatios | Non-Gonococcal-Urethritis (men), proctitis (homosexual anal intercourse), painful epididymitis and swelling; Zithromax (macrolides) or doxycycline |
| Corynebacterium diphtheriae | exotoxin, Gram +; immunization is the key; hospitalization; PCR test |
| Neisseria gonorrheae | unilateral arthritis; urethritis; cervicitis; Ceftriaxone single dose |
| EBV | double-stranded DNA |
| S3 Heart sound | pathognomonic for CHF |
| Polymylgia rheumatica hallmark | Symmetrical proximal muscle pain and stiffness; elevated ESR; Tx: low-dose corticosteroid |
| Holosystolic murmur heard best at left 3rd ICS; EKG shows hypertrophy in both ventricals | VSD |
| Klinefelter syndrome | XXY, male presents with female characteristics |
| fontanelle closing | usually 2 months; 9 - 18 months is still acceptable |
| Indirect bilirubin water soluble? | No; Direct bilirubin is |
| Most common bacteria in neonate sepsis? | GBS; E coli; Listeria |
| Most common bacteria in children over 2 months? | S. pneumoniae; Neiserria meningitidis |
| Hirschprung's diagnosis | Barium enema; then biopsy |
| Pyloric stenosis therapy | erythromycin in even neonate |
| Most common pathogen in pediatric otitis media? | Streptococcus pneumoniae |
| most common pathogens in pediatric otitis externa? | staph and pseudomonas |
| Bacterial sinusitis pathogens? | Strep; H. flu; M. catarallis |
| Pharyngitis | virus: adenovirus; coxsackievirus; EBV Bacteria: Group A strep; mycoplasma; chlamydia and neisseria; |
| Laryngotracheitis (Croup) | Steeple sign on x-ray; barking cough; parvovirus |
| Bronchiolitis | 1. beta agonist and corticosteroids, racemic epinephrine 2. Palivizumab: RSV prophylaxis 3. Ribivirin for severe cases |
| Osgood-schlatter Disease | growth stress in the tibial tuberosity; painful swelling over the tibial tubercle |
| Legg-calve-perthes | Avascular necrosis of the femoral head |
| Uterine fibroids | 1. menometrorrhagia 2. moves with uterus |
| Lithium toxicity | caused by sodium loss; tremor, hyperreflexity, nausea, vomiting, muscle weakness |
| Meniere's disease | episodic vertigo; low frequency hearing loss; horizontal nystagmus |
| Pneumonia with Staph, patchy infiltrates and cavities | IV drug use |
| Recurrent acute bronchitis (purulent); tram line, or plate-like atelectasis on CXR | Bronchiectasis (cystic fibrosis is the usual underlying condition) |
| Thyroid side effect | amiodarone |
| acute pharyngitis in children | rhinovirus |
| Seizure med discontinuation | symptom free for 4 years |
| Legionella pneumonia | erythromycin |
| Herniated disk radiographic | MRI |
| Allergic Contact Dermatitis most common manifestation | vesicles |
| Most effective arterial thromboembolism prophylaxis | Aspirin |
| Transient monocular blindness | carotid artery insufficiency |
| Anemia of chronic disease | normochromic and normocytic; decreased serum iron level |
| Hypothyroidism | cold intolerance, muscle cramps, joint pain |
| alcoholic hepatitis | tender hepatomegaly |
| Chlamydia trachomatis | Os bleeding after cervical swab |
| CREST syndrome (Scleroderma) | calcinosis, reynauds, esophageal dysmotility, sclerodactly, telengiectasia |
| Upper Motor Neuron Injury | contra lateral - above brainstem ipsilateral - below brainstem contralateral loss of temp/pain |
| Essential tremor tx: | beta blocker or Primidone |
| Multiple sclerosis: | autoimmune; Tx: corticosteroidsLimb weakness, optic neuritis, urinary retention;worsens with hot shower |
| TIA Gold standard | arteriogram |
| TIA surgical treatment | carotid endarterectomy |
| Brain tumor | Gliomas (60%) > Meningiomas (20%) |
| Birbeck granules | cell mediated immune function |
| Stasis dermatitis | venous stasis: ulceration, edema, hyperpigmentation |
| Herald patch; HHV 7 | Pityriasis rosea |
| Brown recluse spider bites | skin recrosis |
| Black widow bites | neurologic symptoms |
| Molluscum contagiosum | flesh-color, itchy, umbilicated papules |
| acanthosis nigricans | velvity, hyperpigmented papule on the neck; usually with DMII |
| Vitiligo treatment | topical steroids? |
| Most common cause in adult anemia | occult blood loss |
| Completely obstructed bronchial lumen | atelectasis |
| anemia with elevated retic count | sickle cell anemia |
| low retic count | ususlly indicates RBC production problem, or bone marrow insufficiency |
| Low retic count plus pancytopenia | aplastic anemia |
| rubeola | high fever, maculopapular rash, malaise, coryza |
| Eosihophile on Wright's stain | Asthma |
| treating uncomplicated chlamydia infection | doxycycline |
| Reynaud's treatment | nifedipine |
| Coronary artery spasm | angina at rest |
| Acute Respiratory Distress Syndrome | Severe trauma - car accident |
| Thyroiditis | Pain in the thyroid could happen in subacute patient |
| pneumocystis jiroveci confirmation | gallium scan |
| Most common CNS complication from AIDS is? | Dementia |
| Amphotericin B (anti-fungal) side effects | Fever; Chills; hypotension; nephrotoxicity |
| Sandpaper-like maculopapular rash; high fever; vomiting | Scarlet Fever |
| Folate deficiency is due to | poor dietary intake of fruits and vegetables |
| Cheilosis | Riboflavin (B2) deficiency |
| Cirrhosis | decreased Pro time; jaundice; pitting edema; spider angioma; hepatomegaly |
| CHF Symptoms | S3, S4 murmur; pulmonary rales; hepatomegaly |
| Sickle cell crisis treatment | 1. Hyderation; 2. analgesics; 3. Oxygen administration |
| Interstitial infiltrate on CXR | non-bacterial pneumonia |
| Zollinger-ellison | gastrinoma |
| treating uncomplicated urinary infection | Single dose Bactrim (trimethroprim/sulfamethoxazole |
| COPD Test | FEV1 |
| Initial step in rheumatoid arthritis management | Aspirin |
| Nephrotic syndrome | Edema; hyperlipidemia; hyperalbuminemia; proteinuria |
| GERD Contraindication | anti-cholinergic drug - reduces LES stricture |
| Hyperadrenalism | truncal obesity; abdominal striae; mentation |
| Gardenrella vaginalis (bacterial vaginosis) | clue cells; malodorous, watery vaginal discharge |
| Neiserria gonohhroeae | gram negative diplococci; Tx: IM ceftriaxone or PO cefexime |
| Chlamydia trachomatis | Intracellular obligate; Tx: macrolides or Doxycycline (tetracycline class) |
| L-dopa chronic side effects | on/off oscillation; dyskinesia; |
| aortic dissection | uneven bicipital BP; diastolic murmur |
| Relaxed DTR | Hypothyroidism |
| Satellite Lesions | Intertriginous candidiasis |
| Earliest evidence of diabetic nephropathy? | microalbuminuria |
| Post-op fever most likely from | Atlectasis |
| L4-L5 Nerve root impairs which muscle | Quadriceps |
| Kerley B line on CXR | CHF |
| post-op high fever | Atelectasis |
| Aortic Insufficiency (regurgitation) | Murmur heard over 2 - 4 LICS on the sterner border; systolic and diastolic decrescendo; high-pitched blowing |
| Essential tremor | 1. ETOH improves symptoms; 2. on both hands and the head |
| abnormal pap's next step | excisional biopsy |
| Thalassemia Minor | microcytosis; mild anemia |
| Excruciating facial pain near the nose and mouth | trigeminal = first brnachial |
| Auer Rods | Acute Myeloid Leukemia |
| Hairy cells | subtype of Chronic lymphoid leukemia |
| Para-protein on serum protein electrophoresis | Multiple myeloma |
| isolated lymphocytosis - lymphocytes appear mature and small | Chronic Lymphocytic Leukemia |
| Philadelphia chromosome | Chronic Myeloid Leukemia |
| Esophageal achalasia | dysphagia of liquid and solids; only regurge at night; undigested regurgitation |
| Wernicke's Aphasia | Temporal lobe; comprehending, verbal or written impairment |
| Hepatic Steatosis (fatty liver) | alcohol abuse |
| Delta wave | WPW |
| Viral Meningitis | enterovirus |
| Alcohol tolerance in the liver | endoplasmic reticulum |
| Eye ulceration form contact lenses | acanthamoeba |
| Normal Pressure Hydrocephalus (NPH) | Gait Apraxia - loss of function to use tool for daily living;Triad (DUG): Dementia, urinary incontinence, gait apraxia |
| Nasal polyps assocciated with? | Asthma, aspirin sensitivity, cystic fibrosis |
| Pyelonephritis | WBC casts |
| Glomerulonephritis | RBC casts |
| Cancer cells in the pleural effusion | 1. indicates mets; 2. surgery is not indicated |
| Non-smoker and women lung cancer | bronchogenic adenocarcinoma |
| H. pylori test | urea breath and stool antigen |
| Labor induction | magnesium sulfite |
| Coarctation of the aorta confirmation test | increased renin level due to decreased renal profusion |
| Hot tub folliculitis | pseudomonas aureginosa |
| Fungal infx agents pathogens | Candida; cryptococcus; histoplasmosis; pneumocystis |
| Fungal infx treamtent agents: | fluconozole; itraconozole; amphotericin; TMP/SMX (Bactrin); niastatin |
| Gram + cocci | staph and streps |
| Gram + rods (bacilli) | clostridium batulinum; listeria; corynebacterium; bacillus |
| alcholics hypoglycemia | alcohol interferes with gluconeogenesis |
| hyperaldosteronism | triad of: hypertension, hypokalemia and metabolic alkalosis |
| Addison's Disease (primary adrenal insufficiency) | Cosyntroin test; fatigue, orthostatic hypotention, weight loss, myalgia; hyponatremia/hyperkalemia, hypercalcemia4S: saline, steroids, support, search for underline conditions |
| v-tach | no CCBs |
| C-diff initial diagnosis test? | cytotoxicity testTx: metronidazole, vancomycin |
| Isoniazide may cause | acute pericarditis |
| Lung abscess in alcoholics | bacteroids |
| atypical pneumonia | mycoplasma, legionella; chlamydia |
| malabsorption leads to increase DuPT | due to vitamin K deficiency |
| Causes of A. fib | PIRATES: Pulmonary embolism, ischemia, rheumatoid arthritis, anemia, thyrotoxicosis, ethanol and Sepsis |
| Open-angle glaucoma risk factor | african american |
| Aortic stenosis complications (ASC) | ASC (angina, syncope, CHF) |
| thyroxine overdose | a. fib |
| Causes of secondary hypertension | CHAPS: Cushing's, Hyperaldosteronism, Aortic coarctation, Pheochromocytoma, stenosis of renal artery |
| Posterior and middle cerebral artery occlusion's effect on vision? | homonymous hemianopia |
| acute cervicitis treatment | ceftriaxone |
| Tendinous xanthoma | associated with familial hypercholesterolemia; usually on Achillis tendon |
| B12 deficiency blood smear | hypersegmented neutrophil |
| Labetolol | alpha and beta blocker; has the most pressure lowering strength |
| First-line therapy for cardiogenic shock | dobutamine |
| Pheochromocytoma 5P's | Pressure, Pain, Palpitations, Perspiration, Pallor/diaphoresis |
| Tinea versicolor cause? | Malassezia |
| Varicocele relief? | lying supine decreases the size |
| epiglottitis in adults? | Usually in DM patients |
| Autism | age of onset before 3;mostly with impaired intelligence1/3 associated with seizure disorder |
| Tendinous xanthoma | thickened Achille's tendonusually from hyperlipidemia |
| Cerclage | suture technique on the cervix to keep the pregnancy;for imcompetent cervix |
| Acute Angle-closure glaucoma emergent tx? | IV acetazolamide followed by PO or IV mannitol for severly elevated IOP. |
| A. flutter underlying condition | COPD |
| Rheumatic fever prophylaxis? | Benzathine penicillin monthly for 5 years if symptom freeFirst line Tx: Salicylates |
| Asthma medications? | ASTHMA: Albuterol, Steroids, Theophyllin, Humidified O2, Magnesium, Anticholingergics |
| First line tx for absence seizure | ethosuximide |
| Who requires periodic audiology testing? | people over age 65 |
| Lobar consolidation indicates? | pheumococcal pneumonia |
| Sarcoidosis imaging? | bilateral hilar adenopathy |
| Diabetic folliculitis pathogen | staphHot tub: pseudomonas |
| what to watch for refractory hypokalemia | hypomagnesemia |
| recurrent SVT treatment? | radiofrequency ablation |
| Ulcerative colitis risk for? | malignancy |
| PPI and methotrexate drug interaction | decreased methotrexate excretion |
| Reduce endometrial cancer | oral progesterones |
| Iron deficiency anemia in elderly? | colorectal cancer until proven otherwise |
| Anemia of Chronic Diseases causes? | 1. impaired iron utilization (not iron deficient)2. Incrased ferritin level |
| Causes of microcytic anemia | TICS: thalassemia, iron deficiency, Chronic disease, sideroblastic anemia |
| Hairy cell leukemia (older people) | splenomegaly |
| Hemophilia A | 1. X-linked recessive2. Affected father gives the gene to all daughters |
| ITP First line treatment | 1. steroids2. usually in young girls |
| Pheochromocytoma management | 1. Alpha blocker first to control pressure2. Beta blocker to control tachycardia** Do not give BB first!! |
| Trauma to femur most like will cause | fat embolism |
| Dawn phenomenon | early morning decreased insulin effectiveness and increase growth hormon secretion |
| Brainstem glioma will cause | cranial nerve palsy |
| UMN lesion | 1. muscle spasmstic2. increased DTR3. Babinski's and other CNS signs |
| LMN lesion | 1. flaccid muscle tone2. reduced DTR3. muscle atrophy and fasciculation |
| Testicular cancer marker | AFP and Beta-HCG |
| Huntington's disease | cerebral atrophy on MRI |
| Amytrophic Lateral Sclerosis (Lou Gehrig's) | UMN/LMN lesion; tongue atrophy and fasiculation; eye movement and sphincter tone are spared |
| Horner's syndrome | miosis, ptosis, anhidrosis;posterior, inferior cerebral artery occlusion |
| Guillain Barre Syndrome | Ascending paralysis; autonomic neuropathy; arrhythmias |
| Toxic shock syndrome | Staph; mostly from tampon during child bearing ages |
| Nephrolithiasis most common cause is | idiopathic hypercalciuria; Tx: HCTZ |
| Waxy cast and lipiduria; from: DM, SLE, Amyloidosis | Nephrotic syndrome |
| Danazol side effect | hirsutism |
Created by:
jonyeh
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