ismailalmokyad's version from 2018-01-05 13:25


Question Answer
what is barrett's esophagus?complication of chronic GERD which is metaplastic columnar epithelium in the esophagus replacing normal stratified squamous epithelium.
what is the complication of barrett's esophagus?can precede development of adenocarcinoma
how barrett's esophagus present on upper endoscopy Columnar epithelium on endoscopy usually appears reddish with a velvet-like texture (salmon-colored); squamous epithelium has a pale and glossy appearance.
what is most common cause of death 2/2 steering wheel injuries?(car accident)Aortic injury is the most common cause of sudden death due to steering wheel injuries.
what is Periodic breathing in neonate and infantsphysiologic breathing pattern characterized by pauses of 5-10 seconds in breathing followed by rapid, shallow breaths. secondary to recurrent central apnea due to immaturity of the nervous system in infants up to age 6 months.There is no associated cyanosis, change in tone, or abnormal limb/eye movements. In addition, signs of respiratory distress, such as retractions, nasal flaring, and persistent tachypnea, are not present in infants with periodic breathing. assure it is benign
what is Apnea of prematurity?true apnea and pauses in breathing lasting >20 seconds;

it typically resolves by a corrected gestational age of 37 weeks(so if baby is 36 weeks it correct in one week)
what is oculovestibular testing for coma?(caloric stimulation), when it is positive and what does it mean?Caloric stimulation of the vestibular apparatus is performed by irrigation of the external auditory canal with cold water. A  normal response is characterized by a transient, conjugate, slow deviation of gaze to the side of the stimulus (brainstem-mediated), followed by saccadic correction to the midline (cortical correction). A caloric response cannot be voluntarily suppressed; therefore, the normal oculovestibular reaction strongly suggests psychogenic coma. if it is abnormal it can mean brain death
what is blepharospasm and how does it present and what is the treatment ?is a form of focal dystonia. The history of periodic involuntary eye closure that can be provoked by external stimuli (e.g., bright light or irritants)Older women are particularly predisposed to this condition. The potential explanation is that dry eyes in postmenopausal women may serve as a trigger for blepharospasm. Botulinum toxin injections are the mainstay of treatment. They can be used for many years without any loss of efficacy or significant side effects.
how to differentiate between major depression and normal grieving intermittent periods of sadness that revolve around reminders of the deceased. In contrast, depressed individuals are more likely to have continuous sadness and pervasive anhedonia
when GERD pt needs screening for Barrett's esophagus?chronic GERD symptoms and one or more of the following
1-age >50.
2- male sex.
3-white ethnicity.
4-hiatal hernia.
5-increased BMI.
6-intraabdominal body fat distribution.
7-tobacco use.
how to manage intestinal metaplasia finding on upper endoscopy of GERD pt?1-if no dysplasia surveillance endoscopy every 3-5 years
2-if low-grade dysplasia on pathology then surveillance endoscopy every 6-12 months or exndoscopic eradiaction,
3-if high grade dysplasia then endoscopy eradiation therapy.
Acute cholangitis Clinical presentationFever, jaundice, RUQ pain (Charcot triad) ± Hypotension, AMS (Reynolds pentad)
Acute cholangitis DiagnosisCholestatic liver function abnormalities ↑ Direct bilirubin, alkaline phosphatase Mildly ↑ aminotransferases Biliary dilation on abdominal ultrasound or CT scan
Acute cholangitis Treatment1-Antibiotic coverage of enteric bacteria
2-Biliary drainage by ERCP within 24-48 hours
Infection with Escherichia coli O157:H7, cause, c/p , labs1-consumption of contaminated food (eg, undercooked ground beef, lettuce).

2-presents with
-abdominal pain
-bloody diarrhea.
-Hemolytic uremic syndrome can develop and is characterized by microangiopathic hemolytic anemia, thrombocytopenia, and renal insufficiency.
what is rosacea, how it present and who is at risk.A chronic skin lesion, etiology is unknown but it can be triggered by specific diet(eg spice), it present as erythema in the central face and is often associated with flushing, telangiectasias, and pustules (occasionally). occur mainly in age 30-60 and mainly in light skin, hair and eye color. Periods of exacerbation and remission are expected. most sever complication are ocular rosa.
how to treat rosacea ?1-use mild cleansers and sunscreens, avoid med day sun
2-avoidance of factors that trigger as spice food
3-Laser or pulsed light therapy and topical brimonidine can also be considered.
4-For patients with papulopustular rosacea, topical metronidazole is the most commonly prescribed treatment, though azelaic acid, topical clindamycin, and benzoyl peroxide are also useful. Oral antibiotics (eg, metronidazole, tetracyclines) are sometimes required for more severe cases.
which complications is most associated with rosaceaOcular rosacea which may include
1-burning or foreign body sensations
2-blepharitis, keratitis
4-corneal ulcers
5-recurrent chalazion.
if present refer for ophthalmologist
what is chalaziongranulomatous inflammation of a meibomian gland and presents as a painless pea-sized nodule within the eyelid.
what is complication associated with actinomycosis1-Fistulous tracts,
3-sinus tracts
what is the gram stain of Actinomycosis bacteria-filamentous, branching gram-positive bacterium.
-Examination of abscess fluid shows characteristic yellow "sulfur granules."
what is Actinic keratoses and increase risk of what?small scaly lesions found in sun-exposed areas and are caused by excessive ultraviolet (UV) light exposure. They are associated with up to a 20% risk of transformation to squamous cell carcinoma.
what is the complication associated with invasive mucormycosis.Cerebral venous thrombosis
what is manifestaitons of Chlamydia & gonorrhea in women1-Asymptomatic (most common)
5-Perihepatitis (Fitz-Hugh-Curtis syndrome)
how to dx Chlamydia & gonorrhea in womenNucleic acid amplification testing
how to treat Chlamydia & gonorrhea in women1-Treatment Empiric: Azithromycin + ceftriaxone
2-Confirmed chlamydia: Azithromycin
3-Confirmed gonorrhea: Azithromycin + ceftriaxone
what is complication of chlamydia and gonorrhea in womenComplications includes
1-Pelvic inflammatory disease
2-Ectopic pregnancy
when to screen for chlamydia trachomatis during pregnancy-All pregnant patients are routinely screened for chlamydia via nucleic acid amplification testing (NAAT) at the initial prenatal visit.

-High-risk patients (eg, age <25, multiple partners) undergo screening again in the late third trimester.

-In addition, patients with symptoms suggestive of acute cervicitis, such as postcoital spotting and mucopurulent cervical discharge, are tested with NAAT at any time.
what is risk factor for Chlamydia, and how does it affect screening a pregnant woman1-Age <25
2-History of sexually transmitted infection
3-Recent new partner
4-History of multiple partners
5-History of unprotected intercourse.

if present test the patient again for chlamydia at third trimester
Obstetric complications Chlamydia in pregnancy1-Preterm premature rupture of membranes
2-Preterm labor
3-Postpartum endometritis
Fetal complications of chlamydia in pregnancy1-Neonatal conjunctivitis
2-Neonatal pneumonia
Treatment Chlamydia in pregnancyAzithromycin. All sexual partners are also treated to prevent reinfection, then
1-test for cure in 3-4 weeks after treatment
2-retested 3 months after treatment to exclude reinfection.
what cause focal radioiodine uptake (ie, a "hot" nodule in a "cold" thyroid background)hyperfunctioning adenoma.
Patchy radioiodine uptaketoxic multinodular goiter
what cause Diffusely increased radioiodine uptakeGraves disease, which is due to thyrotropin receptor autoantibodies that stimulate iodine uptake and thyroid hormone synthesis.
What is the treatment of subacute thyroiditis (ST)it is a self-limited condition. Treatment is primarily supportive with NSAIDs and beta blocker (eg, propranolol, atenolol) to minimize the hyperadrenergic symptoms of thyrotoxicosis (eg, sweating, palpitations).
what is Suppurative infection of the thyroid gland (infectious thyroiditis)is a rare condition that causes high-grade fever and pain at the thyroid. Patients will often have evidence of a thyroid abscess on examination or ultrasound, but are usually euthyroid as involvement of the thyroid gland is focal. Bacterial thyroid infections are treated with systemic antibiotics, and surgical drainage may be required.
what increase mortality rate in Untreated cases of acromegalythreefold increase of cardiovascular disease, this leading cause of the increased mortality rate
how does upper airway cough syndrome (UACS) (postnasal drip) present1-chronic cough
2-rhinorrhea is expected
3-oropharyngeal cobblestoning on exam
what is Tracheomalaciaweakness of the walls of the trachea leading to expiratory airway collapse. Patients often have coughing and shortness of breath as well as stridor on physical examination.

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