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94 Cards in this Set
- Front
- Back
The four "-OR"s of inflammation?
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Dolor, Calor, Rubor, Tumor
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Cell type most associated with acute inflammation?
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Leukocyte
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Cell types most associated with cronic inflammation?
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Macrocyte, lymphocyte, plasma
Destroy tissue, leading to repair and neo |
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Granulomatous inflammation involves collections of what type of cell?
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Macrophages.
Occurs in TB, histo, sarcoid |
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TB skin test (PPD) criteria:
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>15mm healthy
>5 healthcare, immunocompromised |
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What is a sign of TB (happens at night)
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*Night sweats
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The 4 types of immune responses are: (ACID)
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Anaphylactic
Cytotoxic Immune-Complex Delayed |
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Describe Type 1 immune response
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Allergen activates B-lymphocyte and IgE antibodies produced. IgE degranulate mast cells and release histamine. Happens fast.
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Describe Type 2 immune response:
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Antibodies (IgM and IgG) bind intrinsic or extrinsic (in or out of cell) antigen and destroy it. Example: Rh disease, Pn allergy
2 things: Ab,Ag |
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Describe Type 3 immune response:
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Ag/Ab complexes and call in complement which starts tearing up surrounding tissue. Ex: Lupus, RA.
3 things:Ab,Ag,complement |
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Describe Type 4 immune response:
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Sensitized T-cells encounter antigen and release leukokinin, which activates macrophages.
Exp: TB skin test, contact dermatitis, corneal transplant, phylectenulosis (staph-bleph) 4 things: T-cell, antigen, leukokinin, macrophage |
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Normal level of neutrophil and primary indication?
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<7800, bacteria
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Normal level of Eosinophil and primary indication?
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<500, parasite, allergy
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Normal level of Basophil and primary indication?
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<200, shock, acute inflammation
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Normal level of lymphocyte and primary indication?
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<3900, virus
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Normal level of monocyte and primary indication?
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<950, autoimmune
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Cholesterol:
Total LDL HDL Triglyceride |
Total 200
LDL<100 HDL>40 Triglyceride:<150 |
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Normal WBC?
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4000-10,000
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AUTOIMMUNE diseases
gender eye sign type of hypersensitivity rxn |
women>men
dry eye type 3 |
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Lupus
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Any organ
10:1 Female to male Butterfly rash (+)ANA Disc edema, papilledema |
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Rheumatoid Arthritis
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-Joint pain worse in morning
-40-50 yo -Most common cause of scleritis -Necrotizing scler=scleratomalacia perforans |
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JRA
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*Most common cause of uveitis in kids*
Cronic bilateral non-granulomatous uveitis 1 joint = pauciarticular-affects eye |
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Sjogren's triad
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Triad: Dry mouth, dry eye, arthritis
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Gout
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More common in men
Band K from Ca crystals Formation of urate crystals in joints b/c of increased uric acid. |
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Sarcoid
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Black females
(+)ACE (lung) 1-Anterior Granulomatous Uveitis 2-Vasculitis (candle wax) 3-Vitritis 4-Optic nerve disease 5-Bell's palsy |
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Ankylosing Spondylitis
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-Young male
-Bamboo spine(straight), uveitis, aortic regurgitation *HLA B27 (CRAP=autoimmune dz) |
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Reiter's Syndrome
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-Triad:can't See, Pee, Climb a tree
-Males>Females -HLA B27* |
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MUSCULOSKELETAL disorders are low yield for boards.
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Low
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Osteoarthritis
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Not autoimmune
Worsens throughout day Big joints |
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Osteoporosis
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-Demineralization of bone
-decreased estrogen -DEXA test (bone density) |
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Fibromyalgia
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-woman 20-50yo
-Trigger points |
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IMMUNODEFICIENCY
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Develop due to:
-Inherited defect -disease that affect immune system |
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Immunoglobulin A deficiency
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-Inherited loss of IgA (in tear film)
-Decreased mucosal defense -Keratinization of cornea, recurrent URI |
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AIDS
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-RNA infects then makes DNA
-loss of CD4 t-cells (helper) -CD4 count <200 = AIDS -ELISA for HIV Dd -Western Blot to confirm ELISA |
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AIDS opportunistic infections
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*Most common oc infection: Cytomegaloviris
-Pneumonia -Histo -TB -Kaposi's Sarcoma (caused by herpes) |
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Describe the 4 types of necrosis:
Coagulative Liquefactive Caseous Fat |
-Coagulative: structure of cell remains, integral structural proteins denatured (myocardial infarction)
-LiqueFactive: Cell remains but turns gray (LLung, FFungal) -Caseous: white and cheesy (ex TB) -Fat: adipose tissue; white lesions |
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GENETIC disorders
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happens to the genes :-)
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Down's syndrome
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-Most common chromosomal disorder 1/700
-Extra 21 chromosome (Trisomy 21) -Glaucoma, Strabismus, cong cataracts, simian crease(hand), epicanthal folds, Keratoconus (TDOME) |
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Edward's Syndrome(Trisomy 18)
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-extra 18 chromosome
-Microphthalmos -Death within 1 yr |
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Klinefelter's Syndrome
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-XXY (xtra X chromosome)
-Calvin Kline is femmy (gynecomastia, hypogonadism) |
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Turner's Syndrome
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-X0 (female missing 1 X)
-25% have ocular findings:strab, amblyopia, accomodative, CI -Amenorrhea (no menstrual cycle) -Keratoconus (TDOME) |
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AUTOSOMAL DOMINANT:
facts and diseases |
Equally male:femal
Several generations AFTER puberty "Marfan Dominates at hunting because his familial polyposed gardner gives him neurofiber" Marfan's Huntington's Familial Adenomatous polyposis Gardner's Neurofibromatosis |
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Neurofibromatosis (triad)
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Tumor-forming nerve cells
*Triad: 1-Cafe au Lait spots(brown spots in skin) 2-Neurofibromas 3-Lisch nodules |
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Marfan's Syndrome
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-Connective Tissue disorder
-Subluxation of lens (up, out), retinal D. -Cardiovascular defects |
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Huntington's Chorea
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-Dementia and muscle movements
*Slows saccades Trick: dominant hunter needs good muscles |
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Familial Adenomatous Polyposis (FAP)
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-Deletion on Chromosome 5 results in hundreds of polyps on colon post puberty
-100% get colon cancer -Gardner's syndrome is a variant of FAP that has 4 or more CHRPE's |
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AUTOSOMAL RECESSIVE:
facts and diseases |
-One generation
-25% of offspring from 2 carrier parents -Often more severe than dominant -often Presents in childhood "Recessive SICKle Cysts hide in ketonuria" Sickle cell Cystic Fibrosis Phenylketonuria |
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Sickle Cell Anemia
-what substitution causes it? |
Single base-pair mutation where Valine is substituted for Glutamic Acid.
-retinal ischemia, Neo (seafan) Trick: V over G = victory for sickle cell |
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Cystic Fibrosis
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-Disfuntional Cl pumps
-Pulmonary infections, fat vitamin deficiency -Most common lethal genetic disease among caucasians (1/2000) -ddx using cloride sweat test |
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Phenylketonuria (PKU)
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-Mutation to enzyme Phenylalanine Hydroxylase
-leads to buildup of phenylalanine and mental retardation |
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X-LINKED:
facts and diseases |
-If recessive, can't be passed from dad to son
-Sons of heterozygous mothers have 50% chance of infection "Ten(X) fragile duchmen" Fragile X Duchenne's Muscular Dystrophy |
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Fragile X
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-2nd most common genetic mental retardation (2nd to Down's)
-Large testes, long face/jaw/ears, autism |
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Duchenne's Muscular Dystrophy
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-Deletion of gene encoding Dystrophin
-Weakness of muscle and breakdown; begins in pelvic girdle |
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Osteogenesis Imperfecta
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-Multiple fractures; affects collagen synthesis
-Blue sclera, keratoconus (TDOME), megalocornea |
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Leber's hereditary optic Neuropathy
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-Mitochondrial disorder (maternal inheritance)
-Loss of central vision -Men in late 20's, early 30's |
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ANEMIA:
facts and test |
Decreased Hgb
CBC: normal WBC 6-10k |
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Iron Deficiency anemia
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-Most common anemia (50%)
-Often results from GI blood loss |
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Aplastic Anemia
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-Worse kind of anemia
-Bone marrow malfunctions -Can be caused by chloramphenicol, ACETAZOLAMIDE, chemo drugs |
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vitamin b12 deficency
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-Often cause by pernicious anemia(autoantibodies against stomach lining result in malabsorbsion)
-B12 shots for elderly |
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Folic Acid deficiency
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-Common in alcholics.
-Deficiencies in pregnancy can lead to neural tube defects (spina bifida) |
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Multiple Mylenoma
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Malignant Plasma cells take over bone marrow.
-Bone pain |
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Lymphoma (lymph tumor)
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-Proliferation of lymph tissue in solid tissues such as nodes, spleen
-2 types: Hodgkins/non-hodgkins |
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Hodgkin's Lymphoma
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-40% of lymphomas
-15-30 yo -Reed-Sternberg cells (owl eyes) -50% association w/ Epstein Barr |
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Non-hodgkin's Lymphoma
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60% of lymphomas
No reed-sternberg cells Abdominal predilection |
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Acute Myeloblastic Leukemia
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-Excessive MyeloBLASTS (immature cells)
-AML MMore serious, ALL (Acute Lymphoblastic Leukemia) LLess serious *ROTH SPOT = leukemia |
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Chronic Myelocytic Leukemia
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"See Me Later in Philly"
-25-60yo -90% have Philadelpia chromosome |
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Chronic Lymphocytic Leukemia
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-Older ~50
-Better survival rate |
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Leukopenia
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Decrease in number of WBC (4,000-10,000 is normal)
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Leukocytosis
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Increase in number of WBC
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Neutrophilia
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Increase in neutrophils (1500-7800 normal)
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Thrombcytosis
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Elevated platelet count (normal 150,000-450,000)
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Pancytopenia
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Decrease in (PAN=all) red, white, platlets
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Thrombocytopenia
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Decrease in platelets
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Benign tumors:
Adenomas Cystadenomas |
Adenomas: epith tumor from gland
Papilloma: epith tumor, finger-like projections |
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Carcinoma (general term)
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Malignant Tumor derived from epithelium
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Sarcoma (general term)
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Malignant Tumor derived from mesenchymal (connective) tissue (ie bone)
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Rhabdomyosarcoma
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-CT cancer
**most common PRIMARY orbital malignancy |
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Metaplasia
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change from one mature cell type to another
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Dysplasia
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Abnormal growth of epith cells due to disruption of cell maturation
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Malignant Melanoma
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Most common skin cancer in young women
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Basal Cell Carcinoma
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-Central ulceration, telangiectasia
-Most common around eye |
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Squamous Cell carcinoma
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-Stratum spinosum layer of epidermis
-Often arises from Actinic Keratosis -No telangiectasia; 2nd most common around eye |
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Non-cancerous lesions
Eczema: Psoriasis: Tinea Corporis: Impetigo: |
Eczema: itch (pruritis)
Psoriasis: itch and scales Tinea Corporis: Ring worm, KOH test Impetigo: Gram +, yellow crusted lesions |
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Where is the tuning fork located?
1-Weber Test 2-Rinne Test |
1-Tuning fork on forehead
2-In air by ear or mastoid process -They test for conduction vs sensory defects -Normal ear = air better than bone -Plugged ear = reduced conduction = hears Weber better |
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Transient Ischemic Attack
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-Less than 24hr, usually less that 15 min.
-Common cause is embolism -Carotid artery TIA will result in contralateral limb numbness and ipsilateral vision symptoms (amaurosis fugax) |
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Hollenhorst plaque
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Embolism found in retinal vasculature
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Strokes: risks, types
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-HTN*, DB, hyperlipidemia
-Ischemic(80%) & Hemorrhagic |
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Internal carotid stroke symptoms:
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Ipsilateral blindness, contralateral paresis
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Middle cerebral symptoms:
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Homonymous hemianopsia, hemiplegia, Broka's (broken speech) or Wernicke's (wordyspeech) aphasia
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Cluster Headaches
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-Men 30-50yo
-orbital or temporal in location -smokers or alcoholics -*red eyes, nasal stuffiness, induced horners syndrome. |
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Tension headaches
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-All ages, more female
-Stress -*Band-like distribution |
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Migranes
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-More women
-Triggering factors -Aura, nausea, photophobia -*4-72hrs |
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Temporal Arteritis HA
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-Older than 55
-Jaw claudation, scalp tenderness -Polymyalgia Rheumatica (fatigue, morning stiffness) -CRP, ESR, WBC, biopsy |
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Brain tumor
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**Interrupt sleep
-More than just HA |