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Intro to Clinical Medicine > Clinical Manifestations of Disease > Flashcards

Clinical Manifestations of Disease Flashcards

1
Q

Homeostasis

A

The purposeful maintenance of a stable internal environment maintained by coordinated physiological processes that oppose change

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2
Q

Pathophysiology Definition

A

Pathology: study of the structure and functional changes in cells, tissues, and organs caused by disease
Physiology: the branch of biology that deals with the normal functions of living organisms and their parts; study of pathology

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3
Q

Disease State

A

any deviation from or interruption of the normal structure or function of a part, organ, or system of the body manifested by aa characteristic set of symptoms or signs

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4
Q

Disease:

A
  • does not allow body to function normally
  • can affect individual organs or an entire body system
  • acute or chronic
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5
Q

2018 ACC/AHA guidelines for blood pressure

A

normal: <120/<80
elevated: 120-129/<80
Stage 1 HTN: 130-139/80-89
Stage 2 HTN: 140 +/90 +

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6
Q

What is the #1 reason for office visits?

A

Hypertension; 55 yo normotensive person has up to 90% lifetime risk of developing HTN
leading contributor to death (MI, stroke..)

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7
Q

Pathogenesis

A

sequence of cellular events from time of initial contact until presentation of disease

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8
Q

clinical manifestations

A

signs and symptoms

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9
Q

Etiology of disease

A

cause of the disease, can be:

biologic, physical forces, chemical agents, genetics, nutrition

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10
Q

infectious disease transmitted by:

A

microorganism and is contagious; can be bacterial, viral, fungal, parasitic

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11
Q

non infectious disease can be:

A

genetic or hereditary
congenital like cerebral palsy (happened in utero or at birth)
environmental
not contagious, not caused by microorganism

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12
Q

pathogens

A

microorganisms which can cause disease; not all cause disease
yeast-promotes normal bacteria in the colon
microflora on skin is normal

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13
Q

how to pathogens make us sick?

A

bacteria produce toxins that cause cell death
viruses use our cells to reproduce and cause cell death
fungi grow and produce toxins
parasites live and grow in our body destroying tissue

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14
Q

diagnostic process includes:

A

history taking of symptoms and the physical exam of signs

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15
Q

cephalgia

A

headaches

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16
Q

brain tissue itself ___ pain receptors, but meninges are _____ sensitive

A

lacks, pain

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17
Q

primary classification of headaches

A

migraine, tension-type, cluster and chronic daily headache

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18
Q

secondary headaches

based on:

A

tumor, sinus, medication overuse or withdrawal, cerviogenic(whiplash), infection, trauma, bleed
based on etiology not symptoms!

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19
Q

Bilateral headaches include:

A

tension-type headache: non throbbing headache “band around head” can be caused by stress, squinting, sun, clenching jaw

sinus headaches which are secondary headaches

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20
Q

unilateral presenting headaches:

A

migraine: throbbing, with or without aura, nausea and visual changes
cluster: severe headache attacks and typical autonomic symptoms like flushed face, stiffness

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21
Q

chronic daily headache can be diagnosed with what frequency:

A

15 or more days a month for longer than three months

can encompass multiple headache syndromes

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22
Q

ask all patients with headache this question:

A

is this the worst headache of your life?

red flag- worried about subarachnoid hemmorge

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23
Q

other red flags with headaches:

A

fever, sudden onset, absence of similar headaches in past, worsening pattern, change in mental status or LOC

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24
Q

danger signs on exam of headache:

A

neck stiffness and meningismus(resistance to passive neck flexion)
paipillodema
focal neurological signs suggesting intracranial mass lesion, increase in intracranial pressure

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25
Q

subjective fever vs objective fever

A

feel hot and red vs pt took actual temp at home and it is high

26
Q

temp ranges: normal and fever

body temp fluctuation

A

normal is 97-99.5 or 36-37.5
fever indicated at 100.4 or 38

temp normally is higher at night

27
Q

how does a fever affect basal metabolic rate?

A

for every 1C above baseline, BMR increases 7% and oxygen consumption increases 13%

28
Q

exogenous pyrogen

A

derived from outside the host

eg. gram - endotoxins and gram + exotoxins

29
Q

endogenous pyrogen

A

aka pyrogenic cytokines
ex) IL-6, IL-1
these induce prostaglandin release causing an increase in the thermostatic set point
play a role in both infectious and non-infectious cause of fever

30
Q

can see fever in multiple differential diagnoses :

A

infectious disease, skin inflammations, immunological diseases like lupus, Kawasaki disease, inflammatory bowel diseases, tissue destruction as in surgery, infection, rhabdomylosis, incompatible blood products, cancers, metabolic disorders, thrombosis-embolic processes, can also be of unknown origin

31
Q

what to think with kids with fever but no obvious source?

A

urinary tract infection

32
Q

cough can be classified by:

A

duration-acute, subacute, chronic (greater than 8 weeks)
character-productive, wet or dry
quality
timing

33
Q

most common differential diagnosis of cough in infections?

A

common cold

34
Q

can have unexplained cough in ?

A

gastroesophageal reflux

35
Q

8% of pts using this drug develop cough?

A 
ACE inhibitors (angiotensin converting enzyme inhibitors) used to treat HTN
cough is common side effect with increasing doses
36
Q

diagnostic approach to cough:

A

cbc, h pylori if h/o gerd, sed rate for inflammation, cxr, spirometry

37
Q

edema is :

A

palpable swelling produced by expansion of interstitial fluid volume

38
Q

pathophysiology of edema :

A

alteration in capillary hemodynamics that favors the movement of fluid from the vascular space into the interstitum
-retention of dietary or iv administered sodium and water by the kidneys

39
Q

differentail diagnoses of edema:

A

heart failure, cirrhosis, nephrotic syndrome, renal failure, meds like calcium channel blockers, lymphedema, venous stasis disease

40
Q

grading edema levels:

A

1+=2mm
2+=4mm
3+=6mm
4+=8mm

41
Q

what should we be thinking about with acute onset unexplained unilateral leg edema??

A

Deep vein thrombosis
consider hx long drive or flight, tobacco use esp in females over age 35 and birth control use, recent surgery
check with ultrasounf

42
Q

weight loss defined as:

A

loss of 5% body weight over 6-12 months

43
Q

cachexia?

A

weakness and wasting of the body due to severe chronic illness; losing muscle mass

44
Q

differential diagnoses of vague neurological complaints:

A

syncope, dizziness (is the room spinning or are you spinning), numbness or tingling
always ask pt to elaborate on what they mean

45
Q

syncope clinical definiton?

A

clinical syndrome defined as transient loss of consciousness

46
Q

true syncope:

A

results from abrupt drop of systemic bp
typically brief duration
spontaneously self limited

47
Q

differential diagnoses of tru syncope:

A

reflex syncope-see blood/scared
orthostatic syncope
cardiac arrhythmias
structural cardiopulmonary disease

48
Q

causes of transient loc that is not true syncope:

A

seizures -wake up confused?, sleep disturbances, accidental falls, psych conditons

49
Q

dizziness

dizziness is a ____ , not a ______!

A

nonspecific term used by pts to describe symptoms
symptom, not a diagnosis
pts will interchange lightheadedness for dizziness

50
Q

most common diagnosis with dizziness?

A

number 1 cause: peripheral vestibular dysfunction-40%

  1. pre syncope or disequilibrium-25%
  2. psych disorder
  3. central brainstem vestibular lesion
  4. unknown in 10% of pts
51
Q

sensory loss is categorized as:

A

hypoesthesia, anesthesia, hypalgesia, analgesia

52
Q

hypoesthesia:

A

diminished ability to perceive pain, temp, touch or vibration

53
Q

anesthesia:

A

complete inability to perceive pain, temp, touch or vibration

54
Q

hypalgesia:

A

decreased sensitivity to painful stimuli

55
Q

analgesia:

A

complete insensitivity to painful stimuli

56
Q

numbness/tingling differential diagnoses:

A 
mononeuropathy-carpal tunnel
distal sensory polyneuropathy(glove and stocking)-as in diabetes, etoh, vit definciencies, hiv
spinal cord lesions
brain stem lesions
thalamic lesions
sensory cortex lesions
57
Q

goal of sensory exam is to:

A

localize the lesion

58
Q

three main processes of inflammation:

A

arterioles dilate
capillaries become permeable
neutrophils and some macrophages migrate out of the capillaries and venules and move into interstitial spaces

59
Q

5 cardinal signs of inflammation:

A 
pain
redness
immobility
swelling
heat
PRISH
60
Q

what to think with unilateral swelling?

A

long drive, tobacco use and on BC..think DVT

consider cellulitis

61
Q

what to think with bilateral inflammation?

A

rhabdomyolysis

immune disorders

Intro to Clinical Medicine (3 decks)

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