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Update Disease Find

Updated Disease and Findings

QuestionAnswer
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