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GI, Surg,Peds

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resexuwe's version from 2017-07-25 02:46

Gastrointestinal

Question Answer
What are the signs of alcoholic cirrhosis?Spider angioma, palmar erythema, dupuytrens contractions
What is hepatorenal syndrome?Pts w/ liver dx build up liver toxins that cause renal failure
What is Cholangitis?Inflammation of bile duct -> Charcots triad, reynolds pentad
What is Cholecystitis?Inflammation of gall bladder -> murphys signpain with deep inspiration
What is Cholelithiasis?Formation of gallstones -> RUQ colic
What is Choledocholithiasis?Gallstone obstructs bile duct
What is Cholestasis?Obstruction of bile duct -> pruritis -> Increase alkaline phosphatase, jaundice
What is Conjugated bilirubin?Water soluble "Direct"
What is Unconjugated bilirubin?Fat soluble "indirect"
What is the MCC type of gallstone?Cholesterol cant see on x-ray
What is a Xanthelesma?Triglyceride buildup (under eye)
What is Xanthoma?Cholestrol buildup (Elbow or achilles)
What does high cholestrol cause?Atherosclerosis
What does high triglycerides causes?Pancreatitis
What is Type 1 Hyperlipidemia?Bad liver LL (CM)
What is Type 2a hyperlipidemia?Bad LDL or B-100 receptors -> trapped in ER LDL only
What is Type 2b hyperlipidemia?Obesity -> Less LDL/VLDL receptors (LDL/VLDL)
What is Type 3 Hyperlipidemia?Bad Apo E (IDL/VLDL)
What is Type 4 Hyperlipidemia?Bad adipose LL(VLDL only)
What is Type 5 Hyperlipidemia?Bad C2 (VLDL/CM) b/c C2 stimulate LL
What is Crigler-Najjar?Unconjugated bilirubin, usually in infants
What is Gilbert Syndrome?Glucoronyl transferase is saturated -> stress unconjugated bilirubin
What is Rotors?Bad bililrubin storage -> conjugated bilirubin
What is Dubin Johnson?Bad bilirubin excretion -> black liver
What is Cullens sign?Bleed around umblicus -> hemorrhagic pancreatitis
What is Turners sign?Bleed into flank -> Hemorrhagic pancreatitis
What tests are used for following pancreatitis?Amylase- sensitive, breaks down carbs
What does Ransons criteria tell you?Poor prognosis for pancreatitis pts
What is Ransons criteria at presentation?WAGLA Wbc- >16K/ul(infection) / Age- >55 (usually multiple illnesses) / Glucose- >200mg/dL(islets cells are fried), LDH- >350IU/L (Cell death) / AST- 250IU/L (Cell death)
What is Ransons criteria at 48hr?"BuCH was a SOB" Bun- >5MG/Dl (decrease renal blood flow) / Ca- <8 mg/dl (saponification) / Hct- drops >10% (bleed into pancreas) / Sequester >6 L fluid -> 3rd spacing / pO2 <60mm Hg(fluid/protein leak ->ARDS) / Base Deficit >4mEq/L (diarrhea -> pancreatic enzymes are dead)
What is Carcinoid Syndrome?Diarrhea, Flushing, wheezing
What produces currant jelly sputum?Klebsiella
What produces currant jelly stool?Intussuception
What is Gardeners syndrome?Familial polyposis w/ bone tumors
What is Turcots syndrome?Familial polyposis w/ brain tumors
What is familial polyposis?100% risk of colon cancer, APC defect -> annual colonscopy at 5 y/o
What is Peutz-Jegher syndrome?Hyperpigmented mucosa -> Dark gums/vagina w/hyperplastic polyps
What is Crohns dx?IBD w/ cobblestones, melena, creeping fat, fistulas
What is Ulcerative colitis?IBD w/ pseudopolyps, hematochezia, lead pipe colon, toxic megacolon
What is Intusseuception?Currant jelly stool, stacked coin appearance on enema, sx come and go.. alleviated with bending down and coming up
How does diverticulosis present?Bleeds
How does Diverticulitis present?Hurts
How does spastic colon present?Intermittent severe cramps
How does IBS present?Alternating diarrhea/constipation
How do External Hemorrhoids present?Pain
How do internal hemorrhoids present?No Pain
What is pseudomembranous Colitis?Overgrowth of C.difficile due to normal flora being killed off, usually by Clindamycin use
What is Whipples dx?T.whipplei destroy Gi tract, then spread causing malabsorption
What color is an upper Gi bleed?Black
What color is a lower Gi bleed?Red
What adds color to stool?Bilirubin
What is the default color of stool?Clay-colored
What is the default color of urine?Tea-colored
Celiac diseaseLoss of vili and increased number of intraepithelial lymphocytes
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Surgery

Question Answer
What causes fever post-op Day 1Wind-Pneumonia, Atelectasis
What causes fever post op Day 3Water- UTIs
What causes fever post op Day 5Wound-Staph Aureus
What causes fever post op Day 7Walk- DVT
What causes fever post op Day 10Abdominal abscesses
What causes fever anytime?H2 blockers, Antibiotics
What do you check for in an unresponsive patient?ABC Airway- call, listen for noise -> can pt talk? / Breathing- Listen to chest ->intubate / Circulation- Color and capillary refill
What is an indirect Inguinal hernia?Goes through the iguinal canal into scrotum
What is a direct inguinal hernia?Goes directly through abdominal wall in Hesselbachs triangle
What is potency?How long a drug will keep the patient knocked out
What is minimum Alveolar concentration?Concentration needed to push the drug into brain
memorize

Pediatrics

Question Answer
What are the newborn screening tests?Please Check BBefore Going HHome PKU, Congenital adrenal hyperplasia, Biotinidase, B-thalassemia, Galactosemia, Hypothyroidism, Homocystinuria
What is VATER syndrome?Vertebral abnormality, Anal, TE fistula, Renal
What is an average IQ?85-100
What are the MC causes of mental retardation in the US?`) eTOH, 2) Fragile X 3) Downs
What is Rubeola also known as?Measles
What is Rubella also known as?German measles
What is the APGAR?Test at 1 and 5min - Appearance, Pulse, Grimace, Activity, Respiration
What is the MC eye infection the first day of life?Clear discharge due to silver nitrate
What is the MC eye infection the first week of life?Gonorrhea -> Purulent discharge
What is the MC eye infection the second week of life?Chlamydia
What is the MC eye infection the third week of life?Herpes
What are the causes of Hyperbilirubinemia?Sepsis, ABO incomptatibility, hypothyroidism, breastfeeding
What is cause of symmetrically small babies?Chromosomal abnormality or TORCHS
What is the cause of asymmetrically small babies?Poor blood supply spares brain -> small body, normal head
What is the cause of large babies?DM or twin-twin transfusions
What is Milia?Neonatal whiteheads on malar area
What is Nevus Flammeus?"Stork bites" on back of neck, look like flames
What is Seborrheic dermatitisred rash w/oily skin and dry flaky hairline
What are hemangiomas?Flat blood vessels
What are Mongolian spots?Melanocytes on lower back
What is erythema toxicum?White vesicle on red area has eosinophils
What is subgaleal hemorrhage?Prolonged jaundice in newborns due to birthing trauma
What is caput succedaneuma?Bleeding under scalp (edema crosses suture lines)
What is cephalohematoma?Bleeding under bone (blood not cross suture lines)
What is an Epstein pearl?White pearls on hard palate
What is persistent eye drainage since birth due to?Blocked duct
What are wide sutures due to?Hypothyroidism, Downs
What causes cleft lip?Medial nasal prominence did not fuse
What causes cleft palate?Maxillary shelves did not fuse
What is MCC cause of no red reflex?Cataracts
What is MCC cause of a white reflex?Retinblastoma
What is a sign of a clavicle fracture?Asymmetric Moro reflex
What is an ompalocele?Intestines protrude out of umblicus covered by peritoneum
What is Gastrochesis?Abdominal wall defect, off center
What is nephroblastoma?Kidney wilms tumor, hemihypertrophy, aniridia
What is Neuroblastoma?Adrenal medulla tumor, hypsarrthymia, opsoclonus, Increase VMA
What is polyhydraminos?Too much amniotic fluid, baby cant swallow?
What are the MCC of polyhydraminos?NM problem- Werdnig-Hoffman / GI problem- Duodenal atresia
What is Oligohydraminos?Too little aminotic fluid, baby cant pee
What are the MCC of Oiligohydraminos?Abd muscle problem- Prune belly / Renal agenesis- Potter syndrome
What is fifth dx?Erythema infectiosum "slapped cheeks". arthritis in mom, aplastic anemia
What is Sixth dx?Roseola, exanthema subitum(fever disappears then rash appears)
What is the Hand Foot mouth dx?Mouth ulcers -> wont eat or drink, palm/sole rash, Coxsacki A virus
What is Measles ->: Rubeola?1)Cough, Coryza, Conjunctivitis / 2.Koplik Spot / 3. Morbilliform blotchy rash
What is Molloscum Contagiosum?Flesh colored papules w/ central dimple
What is Mumps?Parotiditis -> red stensons duct
What is otitis media?Middle ear infection
What is potyriasis Rosea?Herald patch-> migrates along skin lines "C-mass tree" appearance
What is Rubella-> German 3-DAY measles?Trunk rash, lymphadenopathy behind ears, dont look sick
What is small pox different from chickenpox?Small pox is on face, same stages of development, fever
What i Varicella-> Chickenpox?1)Red macule / 2)Clear vesicle on red dot / 3) Pustule / 4)Scab
What is ZellwegersNeonatal seizures
What is the most common cause of delayed speech development?Hearing loss
What are the signs of child abuse?Multiple ecchymoses, Retinal hemorrhage, Epidural/subdural hemorrhage, Spiral fractures(twisted), Multiple fractures in different healing stages
What should you rule out when child abuse is suspected?Osteogenesis imperfecta, Bleeding disorders, Fifth dx, Mongolian spots
memorize

Immune

Question Answer
Which cytokine do macrophages produce?IL-1
Which cytokines do Th cells stimulate?Everything other than IL-1
Which enlarged lymph nodes are most likely malignant?Supraclavicular / Epitrochlear (ebove elbow) / Inguinal
Who are the CD 8 cells?Tk(killer) or Ts(suppressor) cell, responds to MHC-1(self)
Which of your cells express MHC-1?All except RBCs and platelets
Who are the CD 4 cells?Th(helper) cell, responds to MHC-2(non-self)
What type of immunity does TH1 provide?Cell mediated
What do the Th1 cells secrete?IFN-gamma
What do the TH2 cells secrete?IL-4,IL-5,IL-6,IL-13
What type of immunity does TH2 provide?Humoral
What do B cell deficiency patients die of?Bacterial infection
What is Common variable Hypogammaglobulinemia?Kids w/B cells dont differentiate into plasma cells -> low Ab
What is Brutons Agammaglobulinemia?Young adults w/ defective Tye kinase -> no Ab, X-linked
What is Jobs syndrome?Redheaded females, stuck in IgE stage
What is multiple myeloma?Multiple osteolytic lesions, IgG, k light chains, rouleaux formation
What is Heavy chain dx ?IgA and mulitple myeloma of GI tract
What is Selective IgG2 deficiency?Recurrent encapsulated infections
What is selective IgA deficiency?Transfusion anaphylaxis, mucous membrane defects
What is Hairy cell leukemia?Fried egg/sunburst appearance, TRAP+
What is Ataxia Telangiectasia?Low IgA, neuro problems
What is Hyper IgM syndrome?High Igm, low all other Ab
What do T cell deficiency patients die of?Viral infection, CMV, EBV
What is digeorge syndrome?No thymus/inferior parathyroids, low Ca2
What is Chronic mucocutaneous Candidiasis?T cell defect agianst candida albicans, chronic fatigue
What is SCID?No thymus, frayed long bones, baby dies by 18mo, adenosine deaminase deficient
What is Wiscott Aldrich?Low Igm, low platelets, High IgA, eczema, petechaie
What does the Cd4 count tell you?Status of HIV (normal ->1000)
What does the viral load tell you?Progression of HIV
What organs have the most CD4 receptors?Blood vessels, brain, testicles, cervix, rectum
What are the 3 tests used to screen for HIV?Elisa-> detects IgG Ab to p24 Ag / Western blot -> see >2 proteins / PCR-> detects virus (use in babies >18 mos)
What is the definition of AidsCD4<200/UL OR clinical symptoms
What are the live vaccines?Bring Your Own Very Small Virus MMR -> Bcg, Yellow fever, Opv(Sabin)-> oral polio, Varicella, Small pox, Rota virus, Measles -> Rubeola, Mumps, Rubella -German 3 day measles
What is primary billiary Cirrhosis?Anti-mitochondrial Ab, pruritius, females
What primary sclerosing Cholangitis?p-anca ab, bile duct inflammation, onion skinning, IBD
What is Type I Autoimmune hepatitis?Anti-SM ab, young women
What is Type II autoimmune Hepatitis?Anti-LKM ab, Kids
What is bullous penphigoid?Anti-hemidesmosome Ab, skin bullae
What is celiac sprue?Anti-gliaden Ab, eating wheat -> steatorrhea, gluten
What is CREST syndrome?Anti-centromere Ab
What is dermatitis herpetiformis?Anti-BMZ Ab, Anti-endomysial Ab. vesicles on anteriior thigh
What is Dermatomyositis?Anti-jo1 Ab, myositis+ rash
What is DM type 1?Anti-islet cell, anti-GAD Ab glutamic acid decarboxylase, poluria, polydipsia, weight loss
What is drug induced lupus?Anti-histone Ab, HIPPPE causes it
What is Gastritis Type A?Anti-parietal cell ab, atrophic gastritis, adenoCA
What is Goodpastures?Anti-GBM Ab, attacks lunng and kidney, RPGN, cresents in kidney
What is Graves dx?Anti-TSHr Ab, hyperthyroid, bug eyes, pretibial myxedema
What is Guilliane-Barre?Anti-ganglioside Ab, ascending paralysis, 2 wk after URI
What is Hashimotos?Anti-microsomal Ab->TPO, Anti microsomal, Hypothyroid
What is ITP?Anti-platelet Ab, Anti-gp2b3a Ab, thrombocytopenia
What is Mixed CT dx?Anti-RNP Ab
What is Mononucleosis?Heterophile Ab, teenager w/ sore throat
What is MPGN type IIAnti-C3 convertase Ab -> C3 nephritic factor
What is Multiple sclerosis?Anti-myelin Ab, female w/ ptosis, weaker as day goes by
What is Paroxysmal hemolysis?Donath Landsteiner Ab, bleeds when
What is Pemphigus Vulgaris?Anti-desmosome Ab, skin sloughs off when touched, oral ulcers
What is Pernicious anemia? Anti-IF Ab, Vitb12 def -> megaloblastic anemia
What is Polyarteritis Nodosa? p-ANCA Ab, attacks gut and kidney
What is Post-Strep GN?ASO Ab,nephritic w/ complement deposition
What is Rheumatoid Arthritis?Rheumatoid Factor, pain worse in the morning
What is Scleroderma?Anti-Scl70-> anti-topol, fibrosis, tight
What is Sjogrens?Anti-SSA Ab, dry "sand in" eyes, dry mouth arthritis
What is SLE?Anti-ds DNA/ Sm/ Cardiolipin, rash, photosensitivity, oral ulcers
What is SLE Cerebritis?Anti-neuronal Abb, Anti-ribosomal Ab
What is Vitilligo?Anti-melanocyte Ab, white patches
What is warm hemolysis?Anti-Rh Ab, bleeds at body temeprature
What is Wegeners?c-ANCA Ab, attacks ENT, lungs, kidney
What is HSP?IgA dx 2 weeks after gastroenteritis
What is Bergers?IgA dx 2 weeks after URI
What is Alports?IgA dx associated with deafness & cataracts
What dx are associated with HLA-A3Hemochromatosis
What dx are associated with HLA-B27?Psoriatic Arthritis. Ankylosing Spondylitis, Inflammatory Bowel dx , Reactive arthritis Reiters Syndrome
What dx are associated with HLA-DQ2/DQ8?Celiac dx
What dx are associated with HLA-DR2?Multiple Sclerosis, Hay fever, SLE, Good pasture Syndrome
What dx are with HLA-DR3?Rheumatoid Arthritis, DM1
What dx are with HLA-DR5?Pernicious Anemia, Hashimotos
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