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76 Cards in this Set
- Front
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Ranson's Criteria
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Acute Pancreatitis
1. Age >55 2. WBC> 16,000 mg/dL 3. Glucose> 200 4. AST >250 5. LDH>350 |
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Jones Criteria
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Rheumatic Heart disease
Major: Carditis, arthritis,syndeham's chorea, erythema marginatum, subsutaneous nodules Minor: Previous history of RF/ RHD, Arthralgias, Elevated ESR, Prolonged PR, and Fever (2 Major or 1 Major/2 Minor) |
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Phimosis
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Unable to retract foreskin (rarely emergent)
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Paraphimosis
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Retracted foreskin -necrosis of glans
Emergent "Call the paramedics" |
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Osler- Weber-Rendu Syndrome
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Hereditary hemorrhagic telangiectasia; Telangiectasias of the skin, mucous membranes, GI tract
recurrent GI episodes of bleeding |
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Hepatitis Markers
1. HBsAg 2. HBsAb 3. HBeAg 4. HBcAb |
1. sAg: (+) early infections
2. sAb: (+) immunity after vaccine 3. eAg: (+) super infection 4. cAb: (+) immunity after previous infection |
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Ulcerative Colitis
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1. Rectum and colon (small bowel not affected)
2. Blood diarrhea 3. Risk of cancer > 30x's |
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Crohn's Disease
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1. Mouth to anus
2. Skip lesions: gross blood is uncomin 3. Increased oxalate absorption leads to calcium oxalate kidney stones |
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Behcet's syndrome
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1. Painful oral/ genital ulcers
2. Arthritis, vasculitis, neurolgic, uveitis/ retinal vasculitis 3. Prednisone for flair ups |
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Guillan Barre Syndrome
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Progressive ascending motor weakness with sensory component (loss of DTRs)
Causes: campylobacter/flu vaccine Respiratory support, plasmapheresis/ immunoglobulin |
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Multiple Sclerosis
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Demylenating in the central nervous system.
1. Optic neuritis (painful visual loss) 2. Bilateral internuclear opthalmoplegia (eyes can't look at nose) 3. Mutiple areas of sensory/ motor issues that make no sense |
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Myasthenia Gravis
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Autoimmune AB's to AcH receptors- muscles weaken with repeative use
Limb weakness proximal> distal Muscle weakness and fatiguability with diplopia and ptosis |
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Dressler's Syndrome
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Pericarditis 2-8 weeks post-MI
Fever, leukocytosis, friction rub, pericardial and pleural effusions Treat: NSAIDs adn steroids |
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Kleihauer-Betke Test
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Test in pregnancy for women who sustained abdominal trauma to detect/quantify the amount of fetomaternal hemorrhage that has occured
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Transient global amnesia
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sudden, transient amnesia - where patient is unable to form new memories (short: hours - a day)
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leptomeningeal cyst
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(skull fx): 'growing fracture' in pediatrics that enlarges overtime aand associated tear of underlying dura - initially have >4mm fragment separation.
-re xray in 2 months for signs of growing fracture |
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Hamman's crunch
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Mediastinal friction rub with heart beat (associated with tracheobronchial injury and diving injuries)
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Low Sodium (3) [Hyponatremia]
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1. Rocky mountain spotted fever
2. Necrotizing fasciitis 3. SIADH |
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Ramsey Hunt Syndrome
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Herpes zoster oticus causes deafness, vertigo, facial palsy; grouped vesicles on an erythematous base inside the ear canal.
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Carbon Monoxide
a. measure it b. symptoms c. treatment |
a. Pulse OX ABG = normal; carboxyhemoglobin
b. family that presents with headache, nausea, confusion, coma, seizures, and not cyanotic - get a delayed neuropsychiatric syndrome c. 100% oxygen and HBO |
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Hydrogen sulfide
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rotten eggs - don't go in you will die
treat: cyanide antidote kit |
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What two drugs are contraindicated in MAOI?
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Meperidine and dextromethorphan - can cause severe hypertermia
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Opisthotonus
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back muscle spasms, body arched (occurs in stychnine toxicity and NMS)
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Neuroleptic Malignant Syndrome
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AMS, severe hyperthermia (106F), rigidity, opisthotonos, hypertension, tachycardia
Treatment: fever control, dantrolene, paralysis, bromocriptine |
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Serotonin Syndrome
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Lower extremity rigidity >> UE rigidity
Rapid onset, myoclonus/hyperkinesia, ⇑BP/TEMP/HR Distinguished from NMS [slow in onset, associated with bradykinesia and lead pipe rigidity] Treatment: cypoheptadine |
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Strychnine Toxicity
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CNS hyperstimulation -muscle twitching, facial grimacing, extensor spasm, opisthtonos
rx: airway, benzodiazepines, may require paralytics |
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Acute Periodic Paralysis
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Rapidly progressive extremity weakness in young males - after exercise
Associated with hypokalemia, thyrotoxicosis |
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Tensilon test
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Increases ACH by blocking break down of AcH by cholinesterase = increases muscle strength (EMG= rapid fatigue)
can cause: AV block and cardiac arrest - atropin at bed side |
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ALS
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degeneration of upper and lower motor neurons
NO SENSORY defects UMN: spasticity, no sensory defects LMN: atrophy and fasciculations |
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Normal pressure hydrocephalus
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Wet Wild Wacky
dementia, ataxia, urinary incontinence Treatment: shunt |
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Jefferson Fracture
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Burst fracture of atlas (C1) Unstable fracture due to axial compression such as diving
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Brown-Sequard Syndrome
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Ipsilateral weakness, loss of position/vibration sense
Contralateral loss of pain and temperature sensation |
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Diagnostic criteria for Kawasaki disease?
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Fever for last 5 days plus at least 4 of the following:
- Bilateral non-exudative conjunctivitis - Changes of lips/oral mucosa (fissured lips; strawberry tongue) - Changes in extremities (erythema of palms/soles, edema, periungal desquamation) - Polymorphous rash -Cervical lymphadenopathy (at least one node >1.5 cm) |
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Treatment of Kawasaki's?
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ASA (80-100mg/kg/day)
Single infusion of IVIG (2g/kg) DO NOT GIVE STEROIDS |
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Henoch-Schonlein Purpura
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The most common acute vasculitis in children
ARENA A= Abdominal pain (bloody stool/intussusception) R= Rash, purpuric in dependant areas (legs and butt) E= Edema N= Nephritis (microscopic hematuria) A= Arthralgias |
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Severe's Disease
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Norweigian Scabeies that is seen in immunocompromised patients
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Rocky Mountain Spotted Fever
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Rickettsia rickettsii; Dermacentor tick
Rash starts on ankle/wrists/palms/soles and then moves centrally becomes palpable and non-blanching Treatment: doxycycline |
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Diptheria
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Cornybacterium diphtheria (Gram + bacillus)
Thick grayish membrane with sharply defined borders; sore throat, dysphagia; can cause myocarditis and airway obstruction Treatment: Respiratory isolation and erythromycin for 14 days |
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Pertussis
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Bordetalla pertussis (Gram neg coccobacilli)
Three phases with barking cough; whoop and post tussive emesis |
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Babesiosis
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Tick (Ioxedis)
Hemolytic anemia (elevated bilirubin and LDH) |
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Ehrlichiosis
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obligate intracellular rickettsia-like coccobacilli
Thrombocytopenis and leukopenia |
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Dengue Fever
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Viral infection in the tropics and subtropics (Aedes mosquito)
Acute, self-limiting fever, myalgias, headaches, rash, lymphadenopathy, leukopenia |
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Rabies
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Acquire from bats, raccoon, fox skunk
Post exposure: 5 doses of vaccination and HRIG 20 IU/kg |
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Tichinosis
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Trichinella spiralis - ingestion of infected pork
Eosinophilia Treatment: mebendazole |
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Tetanus Prophylaxis
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1. Clean wounds
a. primary series completed w/ last booster >10 years ago: Td b. Unknown status: Td 2. All other wounds a. Primary series completed >5 yr: Td b. Unknown: Td and TIG |
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Rubella
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German Measles
Rash spreads from head to feet Prominent lymphadnopathy: posterior auricular, cervical, and occipital |
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Rubeola
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(Measles)
Fever, cough, conjuctivitis, coryza Koplik spots Maculopapular red-brown morbiliform rash spreads from head to feet |
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Roseola Infantum
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HHV 6/7
High fever => rash with defervescence Febrile seizures common Pink macules on trunk that can spread to neck, face, extremities |
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Erythema Nodosum
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Painful, non-ulcerative, violacesous nodules loncate on anterior tibia, arms, and trunk;
Often a marker for systemic disease (drug reaction, infection, sarcoid, IBD, Malignancy) |
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Carcinoid tumor
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circumscribed tumors occuring in small intestines, appendix, stomach,, colon
secretes serotonin: skin flushing, watery stools, hypotension, vasodilation, edema, ascites, and bronchoconstricution |
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Pheochromocytoma
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Tumor of adrenal medulla cells that secrete NE causing elevated HTN
Diagnosis w/ catecholamines and VMA in 24 hr urine |
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Acoustic Neuroma
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Benign tumor of CN VIII
Atacia, deafness, and ipsilateral facial weakness |
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TTP
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⇓⇓platelets, severe microangiopathic hemolytic anemia; transient neuro defects; renal failure; fever
release of vWF and consumption thrombocytopenia Treatment: steroids, plasmapheresis, FFP NO PLATELETS |
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ITP
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Generally no other findings than thrombocytopenia (low platelets) and petechia/purpura
Treatmet: platelets; IVIG |
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Tumor Lysis Syndrome
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Massive lysis of cancer cells from chemotherapy 12-72 hr post treatment
Treatment a elevated PO4/K - hydration/forced diresis b. Decrease uric acid build up by alkalinzation of urine Calcium supplimentation if cv instability |
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Central Retinal Artery Occlusion
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Sudden, painless visual loss (embolic) causing monocular blindness
Pale retina, fixed dilated pupil with cherry-red spot on macula and box-car look to retinal artery |
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Temporal Arteritis
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3 of the 5 criteria
a. age >50 b. New onset headache or localized cephalgia c. Temporal artery tenderness d. Decreased pulsation not related to carotid disease e. ESR>50 mm Ischemic of muscles of mastication cause painful chewing |
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Treatment for temporal arteritis
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Opthalmology consult, high-dose prednisone or IV prednisolone
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Treatment for acute angle glaucoma
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1. Decrease aqueous humor production (topical β-blocker, alpha agonist acetazolamide)
2. Mannitol 4. Topical miotic (pilocarpine) - facilitates aqueous humor drainage |
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Horner's syndrome
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Loss of sympathetic chain
ptosis, miosis (constriction) and anhydrosis |
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CREST syndrome
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Scleroderma
Calcinosis: subcuaneous calcifications (fingers) Raynauds phenomenon Esophagitis (due to LES sclerosis-> reflux) Sclerodactyly (fibrosed skin causes immobile digits and rigid facies Telangiectasis |
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vWF deficiency
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Most common inherited bleeding dz
⇑ bleeding time and ecchymoses, normal PT/PT Treatment DDAVP |
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HELLP syndrome
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Hemolysis
Elevated LFTs Low Platelets |
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Sarcoidosis
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bilateral hilar adenopathy; uveitis (can be bilateral) noncaseating granulomas on biopsy of lungs
Rx: steroids |
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Marfan's
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Genetic collegen defect
Increased risk for aortic dissection, MVP, joint laxity, optic lens dislocation and blue sclera |
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Osteogenesis Imprefecta
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"brittle bone disease" and blue sclera
mutation in defective collegen synthesis |
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Paget's disease
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Increased activity of both osteoblasts and osteoclasts - diffuse fractures and bone pain
HIGH OUTPUT CARDIAC failure (increased alkaline phosphatase) |
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G6PD
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AR X-linked; causing hemolytic anemia with administration of certain drugs (antimalerias, sulfonamides, and nitrofuratoin)
RBCs are unable to produce gluthione that protects hemoglobin from oxidative denaturation |
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Botulism
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Acute DESCENDING flaccid paralysis cause by Clostridium botulinum 0 ingestion of spores in honey
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Lambert Eaton Syndrome
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similar to MG + Cancer
Weakness and fatigue of proximal muscles especially thigh/hips but IMPROVES with use Treatment: remove tumor and plasmaphoresis |
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Subacute Cerebellar Degeneration
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deterioration of the area of the brain concerned with muscle coordination and balance
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Wernicke's encephalopathy
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occulomotor crisis, CN VI palsy (lateral rectus), nystagmus, ataxia, global confusion
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Korsakoff's syndrome
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retrograde amnesia and confabulation
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Trimetaphan
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drug that counteracts cholinergic tranmission bloking both SNS and PNS acting as a non-depolizing antagonis at the nicotinic receptor
use; hypertensive crises, dissecting aortic aneurysm, and treat pulmonary edema |
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Phentolamine
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alpha adrenergic antagonis causes vasodilation
Used in cocaine induced hypertension; hypertensive emergencies and pheochromocytoma |
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Pyridostigmine
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parasympathomimetic and a reversible cholinesterase inhibitor - used to treat MG
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