firecracker feb 12 Flashcards
1
Q
erythema multiforme infectious causes
A
HSV
Mycoplasma pneumoniae
2
Q
what is erythema multiforme
A
acute cutaneous hypersensitivity condition
immune mediated
target like lesions
3
Q
erythema multiforme most common among
A
males
20-40
4
Q
erythema multiforme other findings besides target lesions
A
malaise, mylagias
macules
plaques, vesicles
5
Q
erythema multiforme lesions
A
red center
pale inner ring
red outer ring
6
Q
meds linked to erythema multiforme
A
penicillins
7
Q
erythema multiforme diagnosis
A
skin biopsy
increased lymphocytes
necrotic keratinocytes
8
Q
erythema multiforme treatment
A
stop offending agent
corticosteroid
analgesics
9
Q
how does membranous nephropathy present
A
edema
dyspnea
10
Q
risk factors for autoimmune hepatitis
A
caucasian/northern europe
female
acute hep a and b infections
DR3,4
11
Q
membranous nephropathy treatment
A
corticosteroids, cytotoxic agents, statins, ACEI
12
Q
lab findings in membranous nephropathy
A
hyperlipidemia
hypoalbuminemia
proteinuria
13
Q
What is the role of anticoagulation in the management of membranous nephropathy?
A
increase in coagulopathies
severe proteinura >5g/day
14
Q
autoimmune hepatitis serological
A
Anti smooth muscle
anti live rkidney microsomal
15
Q
autoimmune hepatitis treatment
A
prednisone
azathioprine
16
Q
membranous nephropathy - immunoflourescnce
A
granular deposits of IgG and C3
17
Q
What is found on electron microscopy in patients with membranous nephropathy?
A
sub-epithelial immune complex deposits
18
Q
secondary membranous nephropathy
A
hep b, c
autoimmune - lupus
drugs - gold, penicillaine
malignancies
19
Q
autoimmune hepatitis
A
circulating antibodies
hepatocellular inflamm
fibrosis
20
Q
follicular carcinoma %
A
15%
21
Q
what is the first and second step in working up someone with a thyroid nodule?
A
- ultrasound (FNA)
- radionucleotide scan if suspicious
- biopsy
22
Q
What percentage of thyroid CA’s are from a medullary carcinoma?
A
5%
23
Q
medullary carcinoma - cells
A
parafollicular/C cells
produce calcitonin
24
Q
How does follicular thyroid CA commonly spread?
A
hematogenous spread –> present with mets
25
thyroid CA treatment
surgical removal
radioactive iodine ablation
lobectomy if less than 1cm
total thyroidectomy if greater than 1 cm
26
What medication is started post-operatively for patients who have undergone surgery for thyroid cancer?
levothyroxine
27
What is the most common sub-type of thyroid CA?
papillary
28
What is a common history in patients who develop papillary thyroid CA? How does it spread?
exposure to ionizing radiation
| spreads thru lymphatics
29
prolactinoma signs & symptoms
F: galactorrhea, amenorrhea
M: loss of libido, erectile dysfxn, gyecomastia
30
prolactinoma =
hyperfunctioning adenoma of anterior pituitary
31
hormones secreted from anterior pituitary
My FLAT PiG
| MSH, FSH, LH, ACTH, TSH, Prolactin, GH
32
prolactinoma treatment
bromocriptine or cabergoline ---> dopamine agonists
| dopamine inhibits prolactin release
33
other causes of hyperprolactinemia
pregnancy
drugs
hypothyroid/hypothalamic damage
34
causes of central DI
idiopathic
trauma
tumors
anorexia
35
diabetes insipidus
can't retain water
| water normally retained by reabsorbing it from urine
36
DI symptoms
polyuria, polydipsia, new onset nocturia
37
First Step Of workup for DI
urinarlysis
dilute urine, urine osm less than serum osm (290)
urine specific grav less than 1.06
38
causes of nephrogenic DI
hereidtary renal diseases
lithitum toxicity
hypokalemia
hypercalcemia
39
second step of DI workup
water deprivation test
| no change in urine osm after water deprivation
40
DDAVP test
increased urine osm in central
| no change in nephrogenic (renal resistance to ADH)
41
central DI treatment
desmopressin
42
nephrogenic DI treatment
underlying disorder
| symptoms with hctz, indomethacin, amiloride
43
secondary adrenal insufficiency most commonly caused by
glucocorticoids
44
What infective infiltrative disorders may affect the adrenal glands?
TB
Histo
HIV
45
secondary adrenal insufficiency
failure of HPAxis
| decreased ACTH
46
What pituitary neoplasms commonly suppress ACTH production?
pituitary adenoma
47
What are some causes of adrenal insufficiency?
- autoimmune destruction
- Tb, Hiv
- infarction of adrenal gland
- Waterhouse-Friderichsen
- DIC
48
what is low in adrenal insuffieiency
low morning cortisol, less than 5
49
What is a common cause of adrenal insufficiency in patients in a hypercoagulable state or in sepsis?
hemorrhagic adrenal infarction
50
What hormones are secreted by the adrenal cortex?
aldosterone
cortisol
androgen
51
What is “stress dosing” of steroids and when is it indicated in adrenal insufficiency?
increased doses given in cases of stress like infection or surgery
52
What may precipitate adrenal crisis?
stress - surgery, sepsis
| look for hypotension, hyponatremia, hyperkalemia
53
What replacement therapy is needed in patients with primary adrenal failure in addition to prednisone?
aldosterone with fludrocortisone
54
What is the cosyntropin test and what would be considered an abnormal result?
differentiate 1 vs 2 ACTH def
ACTH analog
cortisol > 20 normal result
lower indicates non response, primary adrenal failure
55
What is a common life-threatening complication of adrenal insufficiency?
shock (adrenal crisis)
56
treatment for adrenal crisis
IV glucose and corticosteroids
57
What test is used to confirm acromegaly if IGF-1 are found to be elevated?
ORAL glucose tolerance test
58
What are two important metabolic complications of acromegaly?
DM
| HLD
59
What can be used to treat persistent elevations in insulin growth factor 1 after transphenoidal resection of the growth hormone secreting pituitary adenoma?
radiation therapy
60
What constitutes an abnormal oral glucose tolerance test in patients with acromegaly?
GH remains greater than 2 within two hours after ingestion of 75g glucose
61
Patients who have been diagnosed with acromegaly based on elevated IGF-1 levels and positive glucose tolerance test require what further testing?
MRI of brain
62
What is the cause of obstructive sleep apnea in acromegaly?
GH causing macroglossia
63
acromegaly rx
somatostatin and dopamine analogues such as ocretotide and bromocriptine
64
CNS symptoms of acromegaly
bitemporal hemianopsia
| headaches
65
body parts affected by acromegaly
hands, skull, jaw
66
cause of primary hyperPTH
single benign adenoma
| hyperplasia of parathyroid glands
67
triad of primary hyper PTH
hypercalcemia
elevated PTH
elevated 24 hr urinary calcium
68
secondary hyperPTH
parathyroid glands chronically stimulated by hypocalcemia to release PTH
69
how does primary hyperPTH present
hypercalcemia
| bones, stones, moans, groans, polyuria
70
causes of secondary hyperPTH
CKD
Malabsorption
Rickets
PseudohyperPTH
71
indications for surgical intervention in primary hyperPTH
elevated cr
hypercalcemia
kidney stones
osteoporosis
72
secondary hyperPTH labs
low calcium, high phosphorus
| high PTH
73
cortisol production
hypothalamus produces CRH
pituitary produces ACTH
ZF of adrenal gland produces cortisol
74
what test to determine ACTH-independent vs ACTH-dependent cushing's
plasma ACTH
75
what causes glucose intolerance in Cushing's?
cortisol-stimulated gluconeogenesis
| obesity-induced peripehral insulin resistance
76
How does a low-dose dexamethasone suppression test help diagnose Cushing’s syndrome?
normal morning cortisol following dexa should be s
77
Complications of cushing's
diabetes
CVD
opportunistic infections
78
imaging in cushings
look for source
79
infections in Cushing's syndrome
Nocardia
PCP
fungal
80
skin in Cushing's
thinning
bruising
striae
hyperpigmentation
81
acne in Cushings?
imablance in adnrogens, estogren, GnRH
82
osteoporosis in Cushings?
reduced calcium absorption in intestines and kidneys
83
lab abnormalities in Cushings
hypokalemia
hypercalciuria
metabolic alkalosis
84
Cushings work up
24 urinary free cortisol test (3x)
| low dose dexamethasone suppresion test
85
Cardiogenic Shock
decrease CO
increase SVR
increase PCWP
86
Hypovolemic Shock
decrease CO
increase SVR
decrease PCWP
87
Neurogenic Shock
decrease CO
decrease SVR
decrease PCWP
88
Septic Shock
increase CO
decrease SVR
decrease PCWP
89
Pharmacologic Agents in Cardiogenic Shock
Dopamine - vasopressor
| Dobutamine - inotrope
90
Shock =
circulatory collapse
| inadequate blood delivery resulting in hypoperfusion of tissues
91
How is anaphylactic shock managed?
airway maintenace
epinephrine
diphenhydramine
IV fluids
92
cardiogenic shock defined as
hypotension below 80-90 or 30mmhg below baseline
| urine output less than 20 ml/hr
93
causes of cardiogenic shock
```
acute mi
arrhythmias
tension PTX
cardiac tamponade
massive PE
```
94
neurogenic shock =
SNS failure causing widespread peripheral vasodilation and bradycardia
95
anaphylactic shock =
type I hypersenisitivty rxn
96
etiology of neurogenic shock
CNS or spinal cord injury
97
cardiogenic shock =
heart fails to generate sufficient CO to perfuse tissues
98
causes of hypovolemic shock
hemorrhage
| excess fluid loss
99
cause of anaphylactic shock
massive degranulation of mast cells and basophils in response to allergic rxn
100
management of neurogenic shock
IV fluids, vasoconstrictors to treat vasodilation
| atropine for braycardia
101
management of hypovolemic shock
IV fluids or transfusions
surgery
dressing if due to burns
102
hemodynamic effects of cardiogenic shock
decrease in SV
| increase in EDP and ESV
103
cardiogenic shock - PE findings
JVD, pulm edma
AMS
cool, clammy skin
weak thready pulse
104
management of shock related to MI
revascularization
| use of aspirin and heparin
105
clinical features of neurogenic shock
warm, well perfused skin
| low-normal urine output
106
symptoms of ARDS - focus on breath sounds
wheezing
rales
rhonchi
107
ARDS
acute lung inury
complement activation --> lung damage
refractory hypoxemia
108
PaO2/FiO2 ratio for ARDS
<200
109
ARDS lab findings
resp alkalosis
decrease o2
decrease co2
110
causes of ARDS, A
aspiration
acute pancreatitis
air or amniotic embolism
111
causes of ARDS, R
radiation
112
causes of ARDS, D
drug over dose
DIC
drowning
113
causes of ARDS, s
shock
sepsis
smoke inhalation
114
CXR for ARDS
bilateral pulmonary edema with infiltrates
115
BCC risk factors
p53, HPV
116
BCC
most common
| sun exposed areas
117
BCC lesion
pearly, waxy apperance
| telangiectases throughout lesion
118
BCC diagnosis
skin biopsy
119
BCC treatment
```
electrodessication and curettage
surgical excision
cryotherapy
topical meds
radiation therapy
```
120
BCC - meds
5FU
imiquimod
tazarotene
121
BCC -radiation
extensive dz
| can't undergo surgery
122
SCC risk factors
HPV
| actinic keratosis
123
SCC lesion
scaly, ulercated skin lesion
| shallow ulceration with healed up borders
124
gold standard for diagnosing melanoma
excisional skin biopsy with a 1-2mmof normal appearing skin
125
melanoma complications
scarring, keloid formation, metastasis, death
126
cause of dehydration in HHNK
increased blood glucose --> increased insulin demand --> increased plasma osm --> osmotic diuresis --> dehydration
127
HHNK lab values
elevated glucose, 600+
elevated plasma osmolality, +350
no ketones
128
potassium levels in HHNK
normal despite low total-body stores
129
what prevents ketoacidosis in HHNK
some circulating insulin which prevents lipolysis
130
HHNK ABG
normal ph, normal bicarb
131
HHNK presentation
polydipsia, polyuria, AMS, dehydration
132
Cr in HHNK
prerenal azotemia
133
HHNK treatment
NS
Insulin
glucose
potassium
134
when glucose reaches 250-300 in HHNK
given 5% dextrose
135
Hemophilia A
Factor 8 def
136
Hemopihilia A&B inheritance patterns
x linked recessive
137
hemophilia lab values
prolonged PTT
138
hemophilia symtpoms
hemarthroses (bleeding into joints)
| intramuscular hematomas
139
Hemophilia B
def of Factors 9
140
Hemophilia A treatment
Factor 8 during acute bleeding episodes
| minor dz, DDAVP
141
Hemophilia B treatment
factor 9 concentrates
| not DDAVP
142
coccidiomycosis treatment
self resolving
143
coccidiomycosis skin findings
genearlized macular erthematus eruption of eryhthema nodosum
144
coccidiomycosis symptoms
fevers/chills/night sweats
| chest pain
145
coccidiomycosis symptom constellation
erythema nodusum, fever, chest pain, arthrlagias
146
extrapulmonary sites of TB
meningitis
| potts - bones of spine
147
Tb treatment
RIPE for 2 months
| 4 months of isoniazid & rifampin
148
asymptomatic TB treatment
isoniazid for 9 months
149
Tb test - 5mm induration
HIV positive
close contact
CXR changes
immunosuppression
150
gastritis triggers (3)
alcohol
nsaid
h pylori
151
gastritis - best diagnostic study
upper endoscopy with mucosal biopsy
152
gastritis - determining extent of erosions
double contrast barium study
153
gastritis - lab tests
CBC
stool guiac
stool antigen and urea breath test
154
CKD most common causes
HTN
DMT2
Glomerulonephritis
155
stage III CKD
30-59
156
5 absolute indications for emergent dialysis in CKD
```
acidosis
electrolyte abnormalities
ingestion of toxins
overload of fluid
uremia
```
157
stage V CKD
less than 15
158
CKD sodium and water retention
HTN, accelerated atherosclerosis
peripheral edema
CHF
159
Renal Osteodystrophy in CKD
hyperphosphatemia stimulates PTH
decreased alpha1vit D causes increased PTH
low calcium
osteitis fibrosis cystica
160
treatment of CKD anemia
EPO stimulating agents (can increase BP & thrombotic risk)
161
Stage IV CKD
15-29
162
CKD anemia
decreased EPO
| normochromic, normocytic anemia
163
CKD labs
```
elevated Bun, CR
increase K, phosphate
decreased Na, Ca
anemia
metabolic acidosis
```
164
volume managemnt in CKD
loop diuretics
165
CKD anion-gapped metabolic acidosis
decreased excretion of H ions in ammonium
| decreased renal excretion of organic anions
166
hyperkalemia in CKD
inability to excrete potassium
167
platelet dysfunction in CKD
uremia-induced
| increased bleeding risk
168
CKD increased infection risk
uremia-induced neutrophil dysfunction
169
CKD metabolic acidosis treatment
sodium bicarb
170
CKD stage 1
90+
171
CKD dietary modifications
low phosphate diet, phosphate binders
vit d analogues
low potassium diet
protein restriction
172
CKD stage II
60-89
173
treatment of AIN
- supportive
| - corticosteroids
174
AIN presentation
ARF w/
| fever, rash, N/V, malaise
175
AIN lab values
increase in Cr
| eosinophilia
176
AIN caused by what toxins?
```
cadmium
lead
copper
mercury
mushrooms
```
177
AIN caused by what drugs?
Pencillin, NSAID, Allopurinol, Diuretics, Cephalosporins, PPI, Sulfonamide/Sulfasalazine, Rifampin
178
AIN caused by systemic diseases?
Strept, Legionella
Sarcoidosis, Amyloidosis,
SLE
Myoglobinuria, high uric acid levels
179
AIN urinalysis
granual and epithelial casts
180
AIN kidney biopsy
inflamm cells in interstitium
| tubular cell necrosis
181
AIN complications
ATN
ARF, CRF
RPN
182
septic arthritis PE findings
warm, red, tender joint
| skin lesions
183
septic arthritis cause in young male
N. gonorrhea
184
septic arthritis- most common pathogen
s. aureus
185
septic arthritis in immunocompromised
fungal, candida
186
treatment for S. aureus septic arthritis
nafcillin/oxacillin/dicloxacillin
187
treatment for N. gonorrhoeae septic arthritis
ceftriaxone + axithro/doxy
| surrigical irrigation and drainage usually not necessary
188
septic arthritis in sickle cell pts and IV drug users
Salmonella
| Pseudomonas
189
gram negative septic arthritis treatment
aminoglycoside
190
MRI in septic arthritis
confirm joint effusion
191
joint aspirate in septic arthritis
wbc 50000+
high neutrophil count
low glucose
192
septic arthritis treatment
surgical irrigation and drainage
193
septic arthritis - what to monitor for treatment efficacy
CRP
194
septic arthritis lab findings
WBC 10K+
ESR 30+
CRP 5+
195
septic arthritis symptoms
pain in joint
fever
pain with passive ROM
196
Malaria affects which RBCs
vivax/ovale: reticulocytes
malariae: mature RBC
falciparum: reticulocytes & RBC
197
malaria vector
Anopheles mosquito
198
malaria symptoms
chills, myalgia, HA
NVD
splenomegaly
199
hypnozoites associated with
vivax/ovale
200
fever & malaria
falciparum constant
ovale and vivax - q48hr
marlariae - q72h
201
most severe form of malaria with cerebral, renal & pulm symptoms
falciparum
202
primaquine as treatment and prophylaxis for malaria in
Mexico and Argentina
203
treatment of malaria in chloroquine resistant areas
quinine sulfate + tetracycline
atovaquone-proguanil
artemether-lumefantrine
204
med for Pvivax and Povale malaria
primaquine phosphate, two weeks
205
malaria prophylaxis
chloroquine
| mefloquine
206
malaria diagnosed with
perpheral blood smear with giemsa-staining
207
primary syphilis
painless chancre (ulcerated penile lesion)
208
4 causes of false positives with VDRL
viruses (mono, hepatitis)
drugs
rheumatic fever
lupus and leprosy
209
tertiary syphilis
gumma formation
aortitis
neurosyphilis
210
congenital syphilis initial symptoms
rhinitis
lesions on palms/soles
HSM, jaundice
hemolytic anemia, thrombocytopenia
211
neurologic symptoms of tertiary syphilis
tabes dorsalis
argyll-roberston pupils
broad based ataxia
stroke
212
condyloma lata
smooth, flat, lessions in most areas
213
screening test and confirmatory test for syphilis
VDRL or RPR
| FTA-ABS
214
negative VDRL with positive FTA
sucessfully treated syphilis
215
treatment for primary syphilis
benzanthine penicillin IM
| doxy or tetracycline for 2 weeks
216
treatment of secondary and tertiary syphilis
benzathine pencilline g IM for 3 wks
| doxy for 28 d
217
three general causes of acquired long QT syndrome
drugs
electrolyte imbalance
MI
218
long qt =
delayed in repolarization of myocardium
219
What effect does every drug that causes prolongation of the QT interval have?
block cardiac Ikr current mediated postassium channels
220
diagnosis of Qt prolong on ECG?
qt/sqrt(RR)
| less than 440
221
electrolyte imbalances that can cause long qt
hypokalemia
hypomagnesium
hypocalcemia
222
drugs that cause long qt
```
quinidine, amiodarone
haloperiodal, methadone
cisapride
erythromycen
aresenic trioxide
```
223
prolonged QT life threatening complication
torsades de pointes
224
long qt treatments
stop drug, correct electrolytes, IV mag sulfate
225
lactase absorbed ...
brush border of enterocytes
226
borborygmi
rumbling noises made by gas and fluid in intestines
227
tests for lactose intolerance
lactose absorption test (minimal increase in serum glucose)
| lactose breath hydrogen test
228
lactose intolerance stool
bulky, frothy, watery
229
lactase deficiecny pathophysiology
lactase production decreases over time
| injury to small intestine
230
etiologies of DIC
1) sepsis
2) trauma
3) malignancy
4) ob complications
5) severe intravascular hemolysis (malaria, AHTR)
231
pathogenesis of DIC
1) exposure of excess tissue factor
2) coagulation
3) thrombosis & fibrinolysis
4) hemorrhage
232
chronic DIC clinical manifestations
asymptomatic
| predilection for thrombosis
233
factors that determine whether DIC will be acute or chronic
- etiology
| - rate
234
DIC lab findings
1) thrombocytopenia
2) shistocytes
3) decreased fibrinogen, elevated PTT, PT
4) elevated
FDP, D-dimer
235
lab findings in chronic DIC
elevated FDPs, D-dimer, schistocytes
| no coagulopathies
236
DIC supporative care
transfuse platelets if less than 50K
| increased INR/decrease in fibrinogen: FFP or cryoprecipate
237
purpura fulminans
rate but fatal complication of DIC
extensive tissue thrombosis and skin necrosis
treat with proctein c
238
what predisposes to myxedema coma?
longstanding uncontrolled hypothyroidism (usually primary)
239
supportive measures in myxedema coma?
intubation with mechanical ventilation
passive rewarming
non-dilute fluids with electrolytes and glucose
240
myxedema coma =
severe hypothyroidism
with
decreased MS, hypothermia, hyponatremia
241
What makes airway management challenging in a patient with myxedema coma?
nonpitting edema - enlarged tongue, edematous pharynx
242
4 complications of myxedema coma
cardiac abnormalities
lipid abnormalities
anemia
depression
243
myxedema coma labs
TSH, free T4, cortisol
244
myexedma coma clinical presentation
decreased MS
hypothermia
hyponatremia
hypercapnia
245
myxedema cardiac abnormalities
low cardiac output, hypotension, CHF
| reverse with correction of thyroid hormones
246
drug given during myxedema coma
IV levothyroxine (T4)
247
hereditary elliptocytosis genetic mutations
eryhtrocye membrane proteins: alpha spectrin, beta spectrin
248
hereditary elliptocytosis more prevalent in africa...
protection against malaria
249
primary cause of symptoms in hereditary elliptocytosis
hemolytic anemia/chronic hemolysis
250
treatment of hereditary elliptocytosis with severe symptoms
splenectomy
| blood transfusion
251
most severe type of hereditary elliptocytosis
hereditary pyropoikilocytosis
252
best initial treatment for hereditary elliptocytosis
no treatment
| folic acid
253
6 states that worsen hemolytic anemia in hereditary elliptocytosis?
```
neonates (high 2,3BPG)
renal allograft rejection
TTP/HUS
infection
pregnancy
b12 def
```
254
roles of vWF in hemostasis
adheres to platelets and subendothelial components
| binds favtor VIII
255
vWD diagnostic tests
plasma vwf antigen
plasma vwf activity (ristocetin cofactor assay)
factor VIII activity
256
wVD clincial scenarios
difficult to control epistaxis
excessive bleeding following invasive procedures
menorrhagia
excessive peripartum bleeding
257
vWD pts before surgery should be given
vWF concentrate
258
presenting symptoms of FSGS
edema
foamy urine
HTN
dyspnea
259
FSGS risk factors
IV drug use
| HIV
260
FSGS biopsy
sclerotic changes in glomeruli
261
FSGS treatment
steroids, cytotoxic agents, ACEI, statins
262
FSGS lab findings
HLD, hematuria, high levels of proteinuria, hypoalbuminemia
263
wegner's biopsy
granulomatous inflamm of blood vessels
264
MPGN etiologies
Hep B,C
Lupus
bacterial endocarditis
autoimmune, idiopathic
265
MPGN lab findings
hematuria
| hypocomplementemia
266
osmotic diuresis leading to hypernatremia
mannitol
| glucosuria
267
renal cell CA triad
hematuria
palpable flank masses
flank pain
268
renal cell CA paraneoplastic syndromes
PTHrp, EPO, ACTH, Renin
269
causes of hypervolemic hypernatremia
cushings
exogenous steroids
primary hyperaldosteronism
270
hypercalcemia ekg findings
av block, shortened qt
271
renal sodium loss -- hypovolemic hypernatremia
diuretics
osmotic diuresis
renal failure
272
extra renal sodium loss -- hypovolemic hypernatremia
diarrhea, diaphoresis, respiratory
273
good pastures triad
anti GBM antibodies
rapidly progressive GN
pulmonary hemorrhage
274
MPGN treatment
steroids with aspirin or dipyridamole
275
polyarteritis nodosa risk factors
hep B, C, older age, male
276
polyarteritis nodosa - alternative to tissue biopsy
mesenteric or renal arteriography emonstrating multiple aneurysms and irregular constrictions
277
polyarteritis nodosa =
vasculitis of medium sized muscular arteries
| segmental transmural inflamm leads to fibrinoid necrosis
278
polyarteritisi nodosa, rule out
ANCA
279
polyarteritis nodosa presentation
systemic symptoms
| multisystem organ damage
280
polyarteritis nodosa - organ most commonly involved
kidney
281
PAN transmural inflamm leads to
aneurysm of arterial wall
282
PAN labs
increase WBC, ESR
decreased hgb, hct
proteinuria, hematuria
283
polyarteritis nodosa - body parts affected
kidneys, heart, gi tract
| muscle, nerves, joints
284
PAN treatment
steroids
| cyclophosphamide
285
PAN skin manifestations
erythema nodosum like
| palpable purpura similar to HSP
286
PAN gi symptoms
ischemic abd pain (after meals, leads to wt loss)
287
PAN CNS symptoms
named nerve s- both motor and sensory deficits
288
PAN diagnosis
biopsy of tissue
289
HSP pathophysiology
small vessel vascuilitis characterized by IgA
290
HSP joint manifestations
transient non-migratory arthralgia
291
HSP renal
iga immune complex deposition
292
HSP treatment
mainly self limiting/supportive
| otherwise, prednisone and acei and diuretics
293
HSP GI symptoms
colicky abd pain
| increased risk of intussusception
294
HSP urinalysis
blood and protein in ruine
| rBC casts
295
HSP tetrad
palpable purpura
polyarticular arthritis
abd pain
renal failure
