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Clinical Lectures Flashcards

1
Q

Pathophysiology of SIADH. What agent causes this?

A

1) Retain free H2O and dilutes serum –> mental status change
2) Antidiuretic Hormone/Arginine Vasopressin (AVP)

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2
Q

____ is a velvety or warty surface with stuck on appearance. Typically occurs in older adults

A

Seborrheic Keratosis

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3
Q

Typical ___ rash begins on the face and then becomes confluent.

A

Measles

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4
Q

Ovarian Carcinoma can lead to Malignant ___

A

Ascites

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5
Q

___ i facial redness in central part of the face and can be characterized via swollen red bumps and enlarged nose/eye problems.

A

Rosacea

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6
Q

What are some of the clinical consequences of HIV therapy

A

1) Cardiovascular Risk (MI and Stroke)

2) Cervical Cancer Risk

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7
Q

scarlet fever is associated with what microbe

A

Group A B-hemolytic Strep

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8
Q

Sister Mary Joseph Nodule is indicative of ___ metz normally via ___ carcinoma

A

1) Umbilical

2) Ovarian

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9
Q

List the 3 recognizable groups of congenital malformations that increase risk of Wilms Tumor

A

1) Beckwith-Wedemann Syndrome
2) WAGR syndrome
3) Denys-Drash Syndrome

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10
Q

Virchow Node is associated with ____ esp. in older adults.

A

Carcinoma - any thoracic or abdominal carcinoma may be responsible

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11
Q

If a physician was stuck with a used needle from a pt with unknown status what is the next step?

A

PEP

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12
Q

Proximal muscle weakness that improves with repetitive motion/stimulation is indicative of ____

A

Lambert Eaton Myasthenia Syndrome

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13
Q

Common Etiologies for Humoral Hypercalcemia of Malignancy

A

1) Squamous Carcinoma
2) Lung
3) Breast
4) GI/GU

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14
Q

Actinic Keratosis is ___malignant for ___

A

Pre

SCC

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15
Q

Tumors can be irritate the ___ and ___ space leading to fluid accumulation and inflammation.

A

1) Peritoneum

2) Pleural

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16
Q

If breast lump has skin invasion you should be afraid of ___

A

Metz until proven otherwise

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17
Q

It is important to check the ___ reflex in sus. pts of retinoblastoma

A

red

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18
Q

___ tingling pain, eruption of vesicles in a dermatomal distribution
- Pustules –> crusting

A

Zoster Rash

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19
Q

Any child presenting with LAD and shorness of breath need to have a ____. because Lymphoma loves teh ___.

A

CXR

Mediastinum

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20
Q

Fibrosarcoma is a ____ neoplasm

A

malignant

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21
Q

Laboratory Testing can detect:

A

1) Hemorrhage

2) Effusion

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22
Q

___ is a concern in a pt who has Zoster Rash

A

Post-herpetic Neuralgia

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23
Q

___: High protein, High cellular count

A

Exudative

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24
Q

A pt with a positive Kernig and Brudizinskis sign is at risk for what disorder caused by DIC

A

1) Purpura Fulminans

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25
Q

Before the Cushing Syndrome is diagnosed, the pt may present with ____, __, ___.

A

New onset hypertension, buffalo hump, or moon facies depending on the cause.

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26
Q

Endobronchial Lung Cancer Tumor can lead to what clinical manifestations that may be present in the physical exam?

A

1) Stridor

2) Downstream Lung Tissue collapse - SOB

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27
Q

____: Lesions appear at all stages at once; “Dew drop on a rose petal”; Pruritic

A

Varicella Rash

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28
Q

Why are African Americans the demographic that made up the most HIV diagnoses

A

Social Determinants of Health

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29
Q

Radiography can detect: CT = gold standard

A

1) Mass
2) Indications of invasion
3) Obstructive sings/symtptoms
4) Compression
5) Hemorrhage
6) Effusions

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30
Q

What is Pemberton’s Sign?

What is it used for>

A

1) Exaggeration of findings when arms are raised above the head
2) SVC Syndrome

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31
Q

Cushing Syndrome is the 2nd most common paraneoplastic syndrome in ___

A

Small Cell Neuroendocrine Carcinoma

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32
Q

Post-menopausal female menstruates again. What type of cancer do you suspect. This is an example of ____ in tumors.

A

Uterine

Hemorrhage

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33
Q

Irritation of the pleura by tumor can lead to the formation of a ____

A

Malignant pleural effusion

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34
Q

1) How do you diagnose Lambert Eaton Myasthenia Syndrome

A

1) Antibody analysis

2) Nerve Stimulation Testing

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35
Q

Cat-scratch disease is caused by ____

A

Bartonella Heselae

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36
Q

___ are an erythematous rash consisting of macules and papules that is symmetrical and diffuse in terms of distribution

A

Measles

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37
Q

Tumor obstructs ureters may lead to

A

Hydronephrosis

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38
Q

Lung Cancer Tumor growing ___ can cause Stridor and lung tissue collapse

A

Endobronchially

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39
Q

Centor Clinical Criteria is for ____

A

Strep. Pharyngitis

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40
Q

What is the prevalence of HIV in the US?

A

1.2 million

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41
Q

When will a acute HIV infection normally present

A

2-4wks

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42
Q

___ is the most common primary renal tumor of childhood

A

Wilms Tumor

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43
Q

Labs that indicate Humoral Hypercalcemia of Malignancy

A

1) Elevated Ca2+
2) Low PTH
3) Elevated PTH-rP

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44
Q

____ syndrome is when a tumor secretes substances or tumor cytokines cause other factors to be released by the body like autoantibodies or cytokines

A

1) Paraneoplastic

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45
Q

List two diseases that cause vesicular rashes.

A

1) Herpes Simplex

2) Herpes Zosters

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46
Q

Pts with multiple SCC have an increase rate of ____ and nodal ___

A

1) Local recurrence

2) Nodal Metz

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47
Q

Sx of Measles

A

1) Fever
2) Conjunctivitis
3) Koplik Spots
4) Maculopapular rash (blanching)

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48
Q

___, ___, ___ cavities provide an abundant room for tumors to grow with out detection. What is the clinical key to sus. these types of tumors?

A

1) Thoracic
2) Abdominal
3) Pelvic
4) Obstruction

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49
Q

What is the incidence of HIV in the uS

A

37,968

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50
Q

Population that is consistent with Seborrheic Dermatitis

A

1) Parkinson Dz
2) HIV + pts
3) Acute Ill

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51
Q

____ is tender to palpation with sand paper like feel; sun exposed parts of body

A

Actinic Keratosis

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52
Q

____: Painful loose bullae, oral mucosa is common

A

Pumphigus Vulgaris

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53
Q

List LN to check for in Lung Carcinoma. This is done by the means of _____

A

1) Hilar
2) Mediastinal
3) Radiographic Evaluation

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54
Q

___ is the peak incidence of wilms tumor

A

2-5yrs

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55
Q

What is key for the differential of pleural effusion and ascites?

A

HISTORY

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56
Q

Cutaneous Sx in SLE are diffuse and ___

A

nonswelling

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57
Q

Pathogenomic findings in Dermatomytosis

A

1) Periorbital Erythema (Heliotrope)

2) Violaceous Papules over joints of dorsal hands (Gottons Papules)

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58
Q

Pts with meningitiswill have neck stiff ness, fever, back stiffness, and a ___ rash on skin and mucous membranes.

A

Petechial

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59
Q

Male child pt presents with gonadal dysgenesis and nephropathy. Dx

A

Denys Drash Syndrome

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60
Q

_____ is indicated by a nonhealing ulcer or warty nodule

A

SCC

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61
Q

Tumor obstructs GI tract –>

A

SBO

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62
Q

Koplik Spots occur ___ hrs before characteristic measles exanthem

A

48

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63
Q

Advance ____ can manifest through Hematogenous metz as well via the ____ –> ___.

A

1) Carcinomas
2) Thoracic Duct
3) Left Subclavian

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64
Q

___: blueberry muffin baby appearance

A

Neuroblastoma - Cutaneous dissemination

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65
Q

List LN to check for Breast Cancer

A

1) Internal and External Mammary Group

2) Axillary Vein Group

66
Q

Which HIV test may be negative during acute phase?

A

HIV antibody

67
Q

Syndrome of inappropriate ADH secretion (SIADH) is the most common paraneoplastic syndrome in ____

A

1) Small cell neuroendocrine carcinoma

68
Q

Social Determiants of health for African Americans –> Lack of Access to Care –> Lack of Access to HIV PrEP

A

Social Determiants of Health for African Americans –> Lack of Access to Care –> Lack of Access to HIV PrEP

69
Q

What is the first HIV to be positive?

A

HIV RNA PCR ( HIV NAAT) (Viral Load)

70
Q

____ are dry scales (dandruff) or oily yellowish scruff

A

Seborrheic Dermatitis

71
Q

Mass Effect can lead to …. (4x)

A

1) Airway Obstruction
2) Invasion and rupture of vessels –> hemorrhage
3) SVC syndrome
4) Spinal cord compression

72
Q

Pathophysiology of Lambert Eaton Myasthenic Syndrome

A

Anti-VGCC antibodies (voltage gated Ca2+ channels) at neuromuscular junction

73
Q

List all of the HIV tests

A

1) HIV RNA PCR/NAAT/Viral Load
2) HIV p24 antigen
3) HIV Antibody

74
Q

Pt presents with severe pharyngitis, cervical LAD, spleen enlargement, and fatigue. Dx

A

Mononucleosis caused by EBV

75
Q

___ is a pink waxy plaque on lower leg that is associated with Graves and Hyperthroidism

A

Pretibial Myxedema

76
Q

List the Centor Clinical Criteria for Strep Pharyngitis (4X)

A

1) Fever >38
2) Tender anterior cervical adenopathy
3) Lack of cough
4) Pharyngotonsillar Exudate

77
Q

Clinical symptoms of Hemorrhage tumors (3X)

A

1) Blood in body fluid
2) Rapid enlargement of tumor or compartment –> PAIN
3) Iron Deficiency Anemia

78
Q

After detecting a Lymph node that has sus. cancer, the next the to do is a ___. NOTE this is more helpful for specific cancers like ___ and ___. Want to weigh the benefit and risk.

A

1) Biopsy/dissection
2) Breast Carcinoma
3) Melanoma

79
Q

____: psoriasis on the scalp, palms, feet

A

Palmoplantar Psoriasis

80
Q

Breast Cancer may present with ____

A

Breast Lump and LN involvement if metz

81
Q

Common presentation for Lambert Eaton Myasthenia Syndrome

A

1) Weak Legs/muscles that improves with repetitive motion/stimulation
2) Mouth DRY

82
Q

____ is lateral pressure on skin causes sloughing of epidermis

A

Nikolsky Sign

83
Q

What causes the labs of SIADH

A

1) Antidiuretic Hormone/Arginine Vasopressin (AVP)

84
Q

Physical Examination can detect:

A

1) Palpable and/or visible mass
2) Indications of invasion
3) Compression
4) Effusions

85
Q

Tumor that obstructs biliary system –>

A

Jaundice

86
Q

Carcinomas normally will metz through the___

A

Lymph System

87
Q

Sarcomas will normally mez through ___

A

Hematogenous

88
Q

____ is a bright red tounge with enlarged papillae and white patches. This is indicative of ___

A

Strawberry tongue

Scarlet Fever

89
Q

When can mother transmitt HIV to child

A

1) During Birth
2) During Pregnancy
3) During Breastfeeding

90
Q

Seborrheic Keratosis can either be ___ or ___.

A

Papules or Plaques

91
Q

Which demographic made up the most HIV diagnoses

A

African American

92
Q

___ is the most common malignancy in kids < 10yrs old

A

Leukemia

93
Q

Symptoms of Herpes Simplex 1 and 2

A

1) Stomatitis
2) Urogenital Lesions
3) Bells Palsy
4) Encephalitis

94
Q

Pt has trouble climbing stairs or raising arms above head and presents with violaceous papules over joints of dorsal hands.

A

Dermatomytosis

95
Q

child pt presents with wasting and diffuse LAD. Dx

A

HIV

96
Q

Sister Mary Joseph Nodule can be a ____ exam finding

A

Physical

97
Q

Cushing Disease and Primary Adrenal Dz present with

A

1) Centripetal Obesity
2) Mood Facies
3) Buffalo Hump

98
Q

You can perform a ____ for Ascites to provide therapeutic and diagnostic advantages

A

Paracentesis

99
Q

Pt with strep throat, cervical LAD w/ headache, stomach ache, and sore throat. Dx

A

Strep Pyogenes

100
Q

A Blanching rash is adequate enough to make a tentative diagnosis of

A

Measles

101
Q

You can perform a ___ for pleural effusion to provide therapeutic and diagnostic advantages.

A

Thoracentesis

102
Q

Pt. presents with facial port wine stain, leptomeningeal angiomas, and developmental delay. Dx

A

Sturge Weber Syndrome

103
Q

What is incidence

A

New Diagnoses

104
Q

Pt comes in with severe back pain and diminished strength. You suspect Spinal Cord compression. This is a true oncologic emergency because this may cause permanent ____

A

Paralysis

105
Q

What is the window period?

A

Early HIV infection before HIV antibody test becomes +

106
Q

Pt presents with fever, malaise, conjunctivitis, coryza, and cough. He also has a maculopapular Rash that blanches under pressure. what is the Dx

A

Measles

107
Q

Pathophysiology of Rosacea

A

Small BVs that swell often and become visible

108
Q

When do Koplik Spots appear?

A

Prodrome Phase

109
Q

Dermatomytosis is associated with ___ dz and increased risk of maliganancy

A

Celiac

110
Q

____ is a chronic inflammatory papulosqumous and immune-mediated disorder

A

Psoriasis

111
Q

Port wine stain is a Hemangioma that is fairly ___

A

Permanent

112
Q

____ is a congenital malformation that presents with Wilms tumor, aniridia, genital anomalies, and mental retardation

A

WAGR Syndrome

113
Q

In carcinomas on physical examination you will want to check ___. NOTE not all lymph nodes can be checked via physical exam but will have to use ___ evaluation

A

1) Lymph Nodes

2) Radiographic

114
Q

___: Low protein, Low cellular count

A

Transudative

115
Q

Clinical Manifestations of Humoral Hypercalcemia of Malignancy

A

1) Drowsy and Confused (Mental Status Changes)

116
Q

Triggers for Psoriasis (5x)

A

1) Koebner Phenomenon
2) cold
3) sun or hot
4) Infection
5) Meds

117
Q

Lambert Eaton Myasthenic Syndrome is often associated with malignancy esp ___

A

Small Cell

118
Q

Psoriasis of the nails and flexural areas are known as ____

A

Inverse Psoriasis

119
Q

____ evolves from exudative pharyngitis

A

Scarlet Fever

120
Q

What are some of the social challenges in HIV treatment (3x)

A

1) Late Diagnosis
2) Difficulty Engaging in care
3) Stigma/Discrimination

121
Q

What is the halmark of Sturge Weber Syndrome

A

Facial Port wine stain

122
Q

What is prevalence

A

Total amount of people (new + old) living with dz

123
Q

Pt presents with axillary LAD on the ipsilateral side of a cat scratch. Dx

A

Cat-Scratch Dz caused by Bartonella Henselae

124
Q

Polyarteritis Nodosa is not associated with _____.

A

ANCA autoantibodies

125
Q

Any growth or deep dimple over a babys lumbar/sacral area, do a __ or __ to check for spinal cord or vertebral abnormality

A

1) MRI

2) US

126
Q

What you sense a mass does this tell you if it is benign or malignant?

A

NO - local mass doesn’t tell you this information but need to look at adjacent structures for invasion

127
Q

History taking can determine __, __, ___ when wanting to detect a tumor

A

1) Palpable and/or visible mass
2) Obstructive signs/symptoms
3) Hemorrhage

128
Q

Actinic Keratosis can either be ___ or ___

A

Macules or Papules

129
Q

_____ is a chronic inflammatory papulosquamous dz that is associated with ___ and ___ comorbidities

A

1) Psoriasis
2) Joint
3) Cardiovascular

130
Q

Even benign tumors can be fatal when they hemorrhage. An example is ____ adenoma. This can cause __ bleeding and formation of a ____ hematoma.

A

1) Hepatic
2) Extensive
3) Subscapular

131
Q

True or False: In a varicella rash you will see papules, vesicles, pustular and crusted lesions all at the same time.

A

True - lesions appear at all stages at once

132
Q

Rosacea pts may develop a enlarged nose called ___

A

Rhinophyma

133
Q

Pt. presents with bacterial lymphadenitis caused by a lesion that drains to near by lymph node. Dx

A

Staph/Strep

134
Q

Breast Cancers and Soft Tissue Sarcomas can be detected by ____ of a Mass. What are some direct ways you can detect the masses in primary care clinic or at home?

A

1) Physical Examination

2) pt self examination

135
Q

Pt with acute HIV symptoms (flu like symptoms) comes in to the office. If the pt was HIV positive what would be the test to use to receive dx

A

HIV RNA PCR (HIV NAAT) (Viral Load)

136
Q

Labs of SIADH

A

1) Decreased Na+
2) Decreased serum osmolality
3) Increased urine osmolality

137
Q

Nikolsky sign will be positive for ____ and negative for ____

A

1) Pempphigus Vulgaris

2) Bullous Pemphigoid

138
Q

What is the chance of developing a Wilms Tumor in Denys Drash Syndrome

A

90%

139
Q

Carcinomas will need ____ staging

A

Lymph Node

140
Q

How do you decrease the likelihood of transmitting HIV from mother to child

A

1) ART therapy

141
Q

Types of manifestations of Herpes Zoster

A

1) Varicella Rash

2) Zoster Rash

142
Q

Which HIV test may be positive during acute phase

A

1) HIV p24 antigen

2) HIV RNA PCR/NAAT/Viral Load

143
Q

___ is a congenital malformation that presents with gonadal dygenesis in males, early onset of nephropathy and a 90% chance of developing wilms tumor

A

Denys-Drash syndrome

144
Q

Psoriasis normally presents on ___ surfaces like on the ___ or ___.

A

1) Extensor
2) Knees
3) Elbows

145
Q

Classical Symptoms of Ectopic ACTH secretion

A

1) HTN
2) Hypokalemia
3) Metabolic Alkalosis
4) Muscle Wasting

146
Q

Pt. recieves illness from rabbit and has LAD. Dx

A

Tularemia

147
Q

What is the most common tumor-like lesion of infancy

A

Hemangioma

148
Q

____ is the most common malignancy in adolescent 15-19yo

A

Hodgkin Lymphoma

149
Q

Pts with scarlet fever with have a strawberry tongue but describe the rash

A

1) Diffuse erythematous rash with sand paper consistency in the groin and axillae
2) Also flushed face

150
Q

In terms of sensation how is Varicella different than Zoster rash?

A

1) Itchy v. Painful

151
Q

Gottons Papules are characteristic of ____

A

Dermatomyositis

152
Q

Etiology of Bullous Pemphigoid(3x)

A

1) UV light
2) Radiation
3) Drugs: Furosernide, Ibuprofen, and Captopril

153
Q

Lab abnormalities of Cushing Syndrome caused by Ectopic ACTH secretion (3x)

A

1) Hypokalemia
3) Elevated Cortisol
4) Increased ACTH

154
Q

Pt has painless Hematuria. what are some causes of this interms of cancer

A

1) Urinary Bladder

2) Kidney

155
Q

What does WAGR stand for in WAGR syndrome

A

1) W: Wilms Tumor
2) A: Aniridia
3) G: Genital Anomalies
4) R: Mental Retardation

156
Q

___: Type 2 hypersensitivity and is intensly puritic bullous and not in oral mucosa

A

Bullous Pemphigoid

157
Q

Sx of Strep Pharyngitis: (2x)

A

1) Red pharynx, soft palate, and tonsils

2) Possible Exudate

158
Q

Ewing Sarcoma causes _____

A

Chronic bone pain in area of tumor

159
Q

Pretibial Myxedema is associated with what diseases

A

1) Graves

2) Hyperthyroidism

160
Q

____ are pearly papules, Erythematous or nonhealing ulcer in sun exposed areas. They also have a history of bleeding.

A

Basal Cell Carcinoma

161
Q

Invasion of the Mediastinal LN can cause ______ Syndrome. List the Characteristics of this syndrome.

A

Superior Vena Cava Syndrome

1) Venous distension of neck
2) Venous distension of chest wall
3) Facial Edema and Plethora
4) Upper arm edema

162
Q

___ is a congenital malformation that presents with: Macroglossia, organ enlargement, hemi-hypertrophy, omphalocele

A

Beckwith-Wiedemann Syndrome

sbl (8 decks)

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