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General Diagnosis Flashcards

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1
Q

Where’s the best place to get headache information from you patient during case history?

A) CC
B) present illness
C) ROS
D) HPI

A

B) present illness (siqorra / opqrst)

You get majority of your ddx info here

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2
Q

How many vital signs do you have?

A) 2
B) 4
C) 6
D) 8

What are they?

A

C) 6

T
Pulse
BP
Heart rate
Height
Weight
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3
Q

Where do you find unrelated problems to the cc during history?

It’s mandatory to do if you are a portal of entry physician

A

ROS

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4
Q

What’s most accurate location for temperature?

What’s most common used locations? (2 options)

A

1) Anal

2) Otic & Oral

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5
Q

Unpredictable spikes of fever -> chills helps ddx what type of infection?

Sustained fever helps ddx what?

A

1) Viral infection

2) Bacterial infection

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6
Q

Blood pressure of 110/90 would be called _______, and pt is at risk of _______ due to standing up fast / poor diet

A

Orthostatic hypotension

Fainting / syncope

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7
Q

How do you find true systolic bp?

True diastolic bp?

A

palpating pulse disappearance

Listening all the way to 0

Auscultatory gaps may be present in hypertension and give false readings if you don’t go full range when doing bp

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8
Q

Icterus = ?

A

Jaundice

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9
Q

Absent red light reflex that’s appearing green ddx? (2)

1: cloudy appearance
2: Falling curtain / flashing lights

White reflex in babies eye ddx?

A

1: Cataracts
2: Retinal detachment
3: retinoblastoma

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10
Q

Enlarged disc cup due to intracranial pressure ddx? Pt usuall complains of HA

Intraoccular pressure ddx?

A

1: Papilledema
2: Glaucoma

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11
Q

developing cholesterol deposits around cornea/iris as a greyish/white ring + pupillary dialation under 30 yo ddx?

Over 30 yo?

Which one is significant?

A

1) corneal arcus (significant)

2) arcus senilis

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12
Q

Copper wire / cotton wool spots / flame hemorrhages are indicative of what over systemic issue occurring?

A

Hypertension

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13
Q

Scintillating scotomas identify a __________ problem. 2 Exs?

A

1) Neurovascular problem

Ex/ Ms or Migraines

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14
Q

Which way do you pull ear to straighten the tympanic canal in kids?

A

1) down & back

Adults = up & back

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15
Q

What causes a visibly retracted tympanum?

A

Blocked eustachian tube

Due to serous bubbly infections / high altitude

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16
Q

What causes a visibly bulged tympanic membrane?

A

Otitis media

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17
Q

Weber rest uses a _____ hz tuning fork?

Rhine is done on which ear?

A

512 hz tuning fork = screen

The ear sound lateralized to (hear louder)

“Rhine on the ear that can hear better”

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18
Q

When doing Rhinne test, you place tuninning fork ______ 1st, then move it to ______ 2nd.

Normal is _________________.

ddx of (conduction/sensorineural) on (tested/opposite) ear.

A

When doing Rhinne test, you place tuninning fork MASTOID 1st, then move it IN FRONT OF EAR 2nd.

Normal is AIR conduction TWICE as long as BONE conduction

ddx of SENSORINEURAL on OPPOSITE ear due to nerve problem (cn 8 - vestibule cochlear)

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19
Q

Pt comes in with ear infection in R ear. Weber would lateralize to which ear?

Rhinne would be (normal / abnormal)?

Pt has menieres in R ear. Weber would lateralize to which ear?

Rhinne would be (normal / abnormal)?

A

1) R

Abnormal

2) L

Normal

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20
Q

Cn 1-12 full names?

A

1) olfactory
2) optic
3) oculomotor
4) trochlear
5) trigeminal
6) abducens
7) facial
8) vestibulocochlear
9) glossopharyngeal
10) vagus
11) accessory
12) hypoglossal

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21
Q

Watery unilateral discharge from the nose ddx?

A

Cribriform plate fx

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22
Q

Epistaxis = ?

A

Nose bleed

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23
Q

Discharge:

Pale / blue / grey = ?

Green = ?

Foul = ?

A

1) allergies / chronic “itis”
2) infection
3) foreign object (usually in kids that don’t have any other signs/symptoms [ex fever] but have discharge for weeks)

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24
Q

Majority of your bodies lymphatic system drains to the ________ side of your body?

A

Left side

Right side is everything above diaphragm on r half of body

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25
Palpating a firm hard enlarged nodule on the supraclavicular / sentinel lymph node known as a ______ is more dangerous on the (Right / Left) side of the body?
Virchows Node Left
26
X-ray presents with a widening of the mediastinum. Ddx?
Lymphoma
27
When palpating a patients lymph nodes and you find a mobile, tender lump. What do you do?
Continue exam, it’s a normal finding.
28
Warning signs for Soft Tissue Cancers when palpating lymph nodes are ________ & _________ nodules when palpated
Non-mobile | Non-tender
29
4 signs of soft tissue cancers due to chronic irritation How to dx it?
``` 1) Proliferating cells (greedy) Firm / Rigid soft tissue (stubborn) Painless mass (heartless) Painless bleeding (bleeds you dry) ``` [Soft tissue Cancer = big business ceo] 2) biopsy
30
Where is the head of the pancreas located? Tail?
Epigastric region (retroperitoneal) (below xyphoid with deudenum) 2)
31
Patient presents in slight postural flexion with epigastric pain below xyphoid straight back to T10 like a knife with posterior flank ecchymosis (painless), what’s your ddx? What test do you order?
Pancreatitis / cancer (HEAD of pancreas) (bruising from bleeding leaking into flanks due to pancreas head located retroperitoneal) 2) amylase lipase Distractor: kidneys / UA (Kidneys = PAINFUL FLANKS) (Pancreas = PAINLESS BRUISING OVER FLANKS, pain straight through like knife xyphoid -> t10)
32
Diabetes mellitus type ____ is insulin dependent
Type 1
33
Diabetes mellitus type ______ is a insulin receptor / insulin manufacturer malfunction due to excess consumption of _______ ________ sugars TX: ?
Type 2 High glycemic sugars ``` Tx: Chromium Protein Essential fats Exercise Probiotics ```
34
Obese patient that is fatigued / short tempered / cranky always after eating. Potentially heading towards what ddx?
Hypoglycemia aka hyperinsulinemia (Diabetes mellitus type 2) [non obese pt = not diabetes related]
35
Why does diabetes mellitus type 2 lead to “crud in the blood” (short answer) What does this cause in patients? What is the main test for dx?
1) Sugar can’t be stored in muscles, they begin to starve. Liver pulls out fat to make ketones to compensate. Causes ketoacidosis, fruity breathe & fat storage depletion which increases hunger drive (body thinks it’s starving) Sugar attracts bacteria/fungus to blood. Blood becomes full of sugar, bacteria, fungus, fat, ketones Glycosylation: Sugar is sticky & coats everything leading to increase thirst. classic triad: Polydipsia / polyuria / polyphasia 2) hypertension / arteria disease / infections (more so lower extremities) 3) A1C
36
Sugar combining with protein in the blood causing inflammation/ free radicals is known as _______?
Glycation
37
Classic triad due to glycosylation in Diabetes mellitus type 2 is?
Polydyspia Polyuria Polyphasia
38
What is the main test to dx type 2 diabetes mellitus?
A1C
39
Diabetes mellitus affects which part of the pancreas? Is there pain present with this?
Tail No
40
What are the 4 f’s that relate to the gallbladder and what do they dx?
Female Forty Fat Flatulence Cholecystitis (infection) / Cholelithiasis (stones)
41
Patient presents with RUQ pain is known as ______ sign and identify problem of what organ?
Murphy’s sign Gallbladder
42
Pt presents with RLQ pain, and has a rapid (acute: 2-3 days) increase of WBC (~17,500). Ddx? What is this rapid increase of wbc called? What is the point midway between umbilicus & ASIS known as.
Appendicitis Schilling shift (medical emergency: er immediately) McBurney’s point
43
Orthopedic tests to dx appendicitis? | 5 options
Psoas test Obturator test Blumbergs rebound test (quick pressure test to each of 4 Quadrants) - pain in all 4 = peritonitis Rovsing llq pressure Markle (pt goes on ball of foot and slams down on heels) - pain location = infection at that location
44
Gastric / stomach cancer would present with a virchows node on (left/right) side
Left | Since stomach is in epigastric area below hemidiaphragm
45
Which peptic ulcer is more common from excess acid. Which peptic ulcer is caused by h. Pylori?
1) Duodenal ulcers (duodenum = basic area, gastric is more acidic so acid doesn’t cause ulcers there commonly) 2) Gastric ulcers
46
Chronic gastritis leads to __________ deficiencies. What is the 3 layers of combined systems disease associated with this deficiency?
B12 Combined system disease: Step 1) Chronic gastritis from diet / proton pump inhibitors / medications (nexus) - causes parietal cell degradation, preventing b12 absorption Step 2) pernicious anemia occurs causing fatigue/ pale skin Step 3)posterolateral sclerosis occurs causing stocking/glove paresthesia
47
What vitamin does RBCs need to mature from a reticulocyte? What type of anemia is this known as? RBCs are born as (tiny/huge) reticulocytes and _______ vitamin helps them (grow/shrink) to mature
B12 Megaloblastic / pernicious anemia RBCs are born as HUGE reticulocytes and B12 vitamin helps them SHRINK to mature
48
Cobalamin is responsible for what two things in the body?
RBC maturation Nerve mylenation (Cobalt = b12)
49
Glove / sock paraesthesia is common with b12 deficiencies because it affects __________ columns & _________ tracts. How to test for this?
Posterior columns Lateral tracts (Aka posterolateral sclerosis) 2) Schilling test
50
How and where is cobalamin absorbed?
B12 is absorbed in small intestine (ilium) HCL & intrinsic factor from parietal cells combines with extrinsic factor from animal products (cyanocobalamin)
51
What test do you use to make sure the patient is absorbing b12? Is it good to find b12 in the urine? How to treat this?
Shilling test: chronic gastritis (Not shilling sign: appendicitis) 2) yes! B12 in urine means it was absorbed and unused is being excreted appropriately B12 in stool means it isn’t being absorbed and just passing through 3) B12 injections
52
How long do RBCs live for? What organ recycles them? What portion of the RBC is saved when recycled?
120 days Spleen Heme
53
Outpouching of the colon due to weakening of the wall with age, mc in the descending portion.
Diverticulosis | Diverticulitis is inflammation when seeds/etc get stuck and body flushed with diarrhea
54
Bloody diarrhea + skip lesions/string sign = dx? Stress induced Bloody diarrhea + megacolon = dx?
Crohns Ulcerative colitis
55
You listen for | bowel sounds known as _______ for at least _______ minutes
Aborborygmi 5 minutes
56
Increased GGT = dx?
Liver Corrhosis “GGT = gotta get tipsy” (Gamma glutamine transaminase)
57
Pt comes in with caput medusa or varicose veins. What ddx and organ are we considering?
Portal hypertension Liver “Vein problem = liver”
58
Transmission method of: Hep a? Hep b? Hep c?
A) Oral/fecal B) blood / needle / sex C) blood / needle / sex / pregnancy
59
Strep infections begin in the mouth, spread to the ________(dx______), and eventually reach the _________ (dx_________)
Mouth -> kidney (Glomerulonephritis) -> heart (Carditis / SBE)
60
Upper tract infections (descend/ascend)
Descend
61
H.E.P. Stands for _____, ______, _______ What organ/tract is being affected by this?
Hypertension Edema Proteinuria Upper tract descending kidney infections of the nephrons (ex: Proteinuria / casts / stones / FEVER) (always has “neph-“ in its name)
62
Pt with sedentary lifestyle, Colicky painful urination, not relieved in any position. Dx?
Kidney stones
63
F.U.B. Stands for ? What organ/tract does this relate to?
Frequency Urgency Burning Lower tract ascending kidney infection (Ex: std / e-coli / nitrates / NO fever)
64
Pt has increased fremitus because of (air/fluid) filled lungs. Percussion would be (hyperresonant / dull)? 3 potential ddx?
Fluid “Fremitus feels fluids” Dull percussion Bacterial pneumonia / CHF / pulmonary edema (L ventricle failing)
65
Pt comes in with air filled lungs. fremitus would be (increased/decreased)? Percussion would be (dull/hyperresonant)? 3 potential ddx?
Decreased fremitus Hyperresonant percussion COPD / emphysema / pneumothorax
66
What is it called when the lung is surrounded by fluid but none inside? Would fremitus be increased or decreased?
Pleural effusion (massive amounts: minor won’t affect fremitus) Decreased fremitus
67
What does “stridor” sound like?
Pt coughs, followed by a high pitch inspiratory noise/crowing.
68
Prolonged expiration is associated with what lung disease? Percussion / fremitus would be?
COPD Dull percussion Decreased fremitus (Air filled)
69
What causes a friction rub being heard in the abdomen?
Enlarged viscera due to infection
70
What are the 3 adventitious sounds and what does it mean if you hear them?
Bronchophony (clearer sounding) Egophony (ee sounds like aa) Whisper pectoriloquy (heard louder) = fluid filled lungs (ex/ lobar pneumonia)
71
“Pink puffer” = ?
Emphysema
72
“Blue bloater” = ?
Chronic bronchitis
73
A deep breathing pt in diabetic coma has what type of irregular breathe sound?
Kussmaul (air hunger)
74
What type of irregular breathe sound is present if the pt has rhythmical apnea due to a brain lesions?
Cheyne stokes
75
“Biot’s” breathe sound is present if _______ ________ affects the _________ causing irregular apnea
Intracranial pressure Medulla
76
Red current jelly sputum represents what specific type of pneumonia infection?
Klebsiella | friedlanders pneumonia?
77
Which lung has 3 lobes? You cannot see the (R/L) middle lobe of the lung on the (anterior / posterior) view.
R lung has 3 lobes RML not seen on posterior view
78
Which thoracic spinous process is located at the division between R & L upper / lower lobes of the lungs on the posterior side?
T3
79
What is the inspiration:expiration ratio for: Bronchial
1:3
80
What is the inspiration:expiration ratio for: Vesicular
3:1
81
What is the inspiration:expiration ratio for: Bronchovesicular
1:1 | Tracheal = same
82
Green sputum , night sweats, general chest pain - bacterial pneumonia - viral pneumonia - emphysema
Bacterial pneumonia | Green sputum = bacteria
83
20 years of smoking, prolonged expiration - bacteria pneumonia - viral pneumonia - emphysema
Emphysema | Prolonged expiration = COPD
84
20 year old male, rapid onset pinpoint chest pain after shoveling - MI - angina pectoris - pleurisy
Pleurisy | Pinpoint pain = Friction rub
85
60 YoM has chest pain after shoveling - MI - pleurisy - emphysema
MI
86
Dyspnea at night, swelling, & crackles suggest - MI - CHF - cor polmonale
CHF | Crackles = fluid
87
Proteinuria, pyrexia, WBC Cast, & fat oval bodies - cystitis - glomerulonephritis - nephrosis
Nephrosis (Pylonephritis=better since wbc cast but not option) Nephrosis = both casts present
88
Proteinuria, pyrexia, RBC Casts - cystitis - glomerulonephritis - nephrosis
Glomerulonephritis (RBC casts = strep) Strep: mouth -> Glomerulonephritis -> carditis)
89
Proteinuria, edema, hypertension, & no convulsions - nephrotic syndromes - nephrotic syndromes - eclampsia
Nephrotic syndromes | No convulsions = pre eclampsia
90
Elevated IgM, tenderness RUQ, & leukopenia - acute hepatitis - chronic hepatitis - cirrhosis
Acute hepatitis IgM = acute / IgG = chronic RUQ = liver
91
Jaundice, boggy liver, & leukopenia - acute hepatitis - chronic hepatitis - cirrhosis
Chronic hepatitis
92
Elevated GGT, alcoholism, & jaundice - acute hepatitis - chronic hepatitis - cirrhosis
Cirrhosis
93
18,000 WBC doesn’t indicate - appendicitis - pancreatitis - nephritis - peritonitis
Nephritis Other 3 are classic triad of rapid WBC INCREASE to ~18,000
94
Numbness of hands/feet, excessive drinking - diabetes mellitus + pls - alcoholism + pls
Diabetes mellitus + posterolateral sclerosis
95
20 yom with anxiety, diarrhea, excessive abdominal bloating - cholecystitis - gastritis - ulcerative colitis - peptic ulcer
Ulcerative colitis ``` Hla-b27 stress induced (anxiety) ```
96
Which doesn’t cause PLS - diabetes mellitus - alcoholism - gastritis - cholecystitis
Cholecystitis Pls = posterolateral sclerosis
97
foreskin trapped behind glands of penis (turtle neck)
Paraphimosis
98
Congenital defect on the ventral surface of penis causing dribbling on the floor
Hypospadius | Epispadias = dorsal surface
99
HCG present in a male would cause concern for what? palpate for what? Palpate where?
Seminoma Painless nodule Testicles
100
Crooked penis
Peyronnies
101
Sustained erection 4+ hrs What is the causes?
Priapism - CNS trauma / intracranial pressure - ED drugs
102
Reddened, tender testicles with trans illumination posterior-superior - hydrocele - seminoma - epididymitis - scrotal hernia
Epididymitis
103
“Bag of worms” testes What organ are you concerned about?
Varicocele Liver
104
Painless nodule in testes that doesn’t trans illuminate - hydrocele - seminoma - epididymitis - scrotal hernia
Seminoma
105
Non-tender mass that trans illuminates - hydrocele - seminoma - epididymitis - scrotal hernia
Hydrocele
106
Borborygmi possible, no trans illumination and no palpable mass - hydrocele - seminoma - epididymitis - scrotal hernia
Scrotal hernia
107
The median sulcus of the prostate is obliterated by? - chronic prostatitis - acute prostatitis - bph - cancer
BPH (benign prostatic hypertrophy) | Cancer = only OBSCURES median sulcus
108
Painful ejaculation - chronic prostatitis - acute prostatitis - bph - cancer
Chronic prostatitis
109
What dx do you find firm nontender nodules on Posterior lobes of prostate - chronic prostatitis - acute prostatitis - bph - cancer
Prostate cancer
110
What dx do you find smooth nontender nodules on the lateral lobes of the prostate? - chronic prostatitis - acute prostatitis - bph - cancer
BPH
111
_______ score has a score of 1-5 for severity of prostate cancer
Gleason
112
________ test is a screening test for the prostate. ________ is a specific test for prostate cancer, but a _________ exam must be done first before this test.
PSA Biopsy Digital rectal exam
113
M/c location for hernias to occur in Females - femoral - direct - indirect
Femoral “Female Femoral” (Can occur in males as well)
114
M/c location for hernias to occur in Young males - femoral - direct - indirect
Indirect
115
The (hiatal/inguinal) hernia is alleviated when laying down?
Inguinal (Hiatal located above stomach, feels better when standing up since gravity helps pull it back down where it’s supposed to be)
116
What chambers work harder? - ventricles - atrium
Ventricles
117
S1 heart sound occurs on (systole/diastole) and is because of: - av valves relaxing - av valves shutting - semilunar valves relaxing - semilunar valves shutting
Ventricles contracting AV valves SHUTTING Semilunar OPEN
118
ARMS & PRTS = ? In reference to murmurs heard at (S1/S2) (systole/diastole) when ventricles are (relaxing/contracting)
Aortic regurgitation Mitral Stenosis Pulmonic Regurgitation Tricuspid Stenosis “She die in my arms & prts” “Stenosis = stenosis” “everything else = regurgitation” (Ex/ insufficient - prolapse - incompetent) S2 diastole Ventricles relax
119
Av valves consist of: - aortic - pulmonic - mitral - tricuspid
Mitral | tricuspid
120
Semilunar valves consist of: - aortic - pulmonic - mitral - tricuspid
Aortic | Pulmonic
121
Systolic murmur heard over apex - mitral stenosis - aortic regurgitation - mitral prolapse - pulmonic incompetence
Mitral prolapse (regurgitation) Apex of heart = mitral valve
122
Low pitched murmur on right side of sternum - aortic stenosis - aortic regurgitation - pulmonic insufficiency - pulmonic stenosis
Aortic stenosis Low pitch = listening with bell = stenosis
123
Left peristernal diastolic murmur - mitral regurgitation - tricuspid stenosis - mitral stenosis - pulmonic stenosis
Tricuspid stenosis Left peristernal = tricuspid or pulmonic
124
Click in late systolic in squatting position - mitral regurgitation - tricuspid stenosis - mitral stenosis - pulmonic stenosis
Mitral regurgitation Remove diastolic murmurs M/c murmur locations = mitral & aortic
125
A split difficult to hear, heard over tricuspid
S1 (lub)
126
Aortic valves shutting early ``` Heard durring (s1-4)? Due to what? ```
Pathological S2 split (dub-dub) (Always present) Hypertension
127
Where & when do you listen for a physiological s2 split? M/c in who?
Pulmonic during inspiration only Athletes/children
128
This is always pathological - s1 split - s2 split - s3 - s4
S4 | Atrial gallop
129
Hear low pitched AV regurgitation at apex on a 47 yo pt. - atrial gallop - s2 split - ventricle gallop - pan-systolic murmur Is this pathological or not?
Ventricle gallop = pathological 40+ | Under 40 = physiological
130
Very early diastolic high pitched murmur heard over pulmonic valve. Caused by mitral (regurgitation/stenosis/prolapse/insufficiency)
Opening snap Mitral stenosis (Misdiagnosed as pulmonic valve abnormality)
131
Stills murmur is heard in who?
Children
132
What murmur is associated with PDA
Machinery murmur | Patent ductus arteriosis= opening between heart
133
Fatigue is the 1st sign of what major problem?
Heart failure “Failing to pump enough blood as needed”
134
Cor pulmonale = ? Caused by?
Right sided heart failure Pulmonary hypertension Right ventricular hypertrophy/failure
135
Which side of Heart most commonly fails first? - R->L - L->R
L->R
136
Left sided heart failure is known as? Caused by? Results in?
CHF Systemic hypertension Left ventricular hypertrophic / failure
137
What is the first enzyme present in a MI? 1st hour? 2-3hours? 2-3 days?
Troponin Ck-MB (cpk) SGOT / AST LDH
138
_______ = feeling turbulence _______ = hearing turbulence (Blood flow)
Thrills Bruits
139
What do you use to evaluate heart chamber size / fluid? Heart rythms?
Echocardiogram EKG/ ECG
140
Left ventricular failure causing amplitude to vary - bigeminal - paradoxical - Pulsus alterans - water hammer
Pulsus alterans - bigeminal: 2 beats -> pause (aortic stenosis) - paradoxical: amplitude decrease in inspiration (COPD) - water hammer: aortic regurgitation (jerky?)
141
Bradycardia = ?
<60 (Athletes / hypothyroid) >100 = tachycardia (Fever/shock)
142
Pt comes in with bronze skin, what dx & organ are you considering? Increase or decreased production?
Addisons Kidneys: Adrenal cortex Decreased adrenocorticoids
143
Female comes in complaining about weight gain, you notice abnormal hair growth present on chin and a hump back. What dx? What organ is affected? Increased/decreased secretion? Primary or secondary more common? (Syndrome/disease)
Cushing (Buffalo hump / moon facies / hirstuism) Kidneys: Adrenal cortex / increased adrenocorticoids Cushing disease m/c (secondary) “Sweet salt sex”
144
Sympathetic storm/crisis occurring post CMT at t10-11. Dx? T12-L1?
1) Pheochromocytoma Aka neuroblastoma (Kidneys) 2) Nephroblastoma (Wilms tumor)
145
Decreased t3/t4 Increased tsh Name if it is: Primary? Autoimmune? Children?
Hypothyroidism 2) Myxedema / thyroiditis 3) Hashimoto 4) Cretinism
146
Female pt weight gain, edema/swelling, dry skin, brittle hair Dx?
Myxedema | Cushing s has moon facies swelling, myxedema has swelling around eye
147
Pt with trouble gaining weight, anxiety, soft hair, moist skin. What would you most likely find on lab work? Dx?
Increased t3/t4 Graves’ disease / hyperthyroidism
148
What 2 deficiencies can cause macrocytic normochromic anemia? What does each one lead to?
B12 -> PLS (posterolateral sclerosis) B9 -> neural tube defects
149
Which of the following would result in decreased ferritin levels? - b12 uptake deficiency - thalassemia - sickle cell - chronic hemorrhage What type of anemia is this called?
Chronic hemorrhage: gi/bone disorders/period (iron deficiency or aplastic causes as well) Microcytic hypochromic anemia
150
M/c cause of anemia in: USA? World? Neonates?
Iron deficiency Thalassemia Physiological
151
What anemia causes jaundice
Hemolytic | Normocytic normochromic
152
What anemia can cause AVN of femoral head?
Sickle cell Aka poikylocytosis
153
Multiple myeloma has what type of protein in urine?
Bence Jones (Proteinuria)
154
What organ do you consider malfunctioning if protein is present in urine? What are two pathological exceptions that cause Proteinuria?
Kidneys (nephrons disease) Multiple myeloma (MM) Muscular dystrophy (MD)
155
What are you concerned about if pt has painless hematuria?
Cancer
156
What immunoglobulin is present in acute infections? Chronic?
IgM - acute IgG - chronic
157
Which is not a ddx for Black color urine? - ochronosis - liver disorder - lead poisoning - end stage malaria
Liver disorder = yellow urine
158
Which immunoglobulin is only found in trace amounts?
IgD
159
Which immunoglobulin is found in breast milk? Which protects baby in utero?
IgA IgG
160
Immunoglobulin that is present from allergies?
IgE
161
GUAIAC is a stool test testing for what type of bleed?
Occult / upper gi
162
Biliary obstruction would result in what color stool?
Clay / grey / pale
163
What organs are you considering if pt presents with floating stool?
GB / pancreas / malabsorption of fat Steatorrhea
164
Would be elevated with blastic bone metastasis - alkaline phosphatase - acid phosphatase - A/G ratio - APA
Acid phosphatase | Increased with any bone growth good or bad
165
What type of special study is used to identify the agent of infection?
Cultures = confirm agent Ex/ stool - sputum - blood cultures
166
Ultrasound is used to see what?
“Belly & vessels” Abdominal organs / blood vessels / baby etc
167
Fat soluble vitamins? Most toxic one? Secreted the fastest?
A (most toxic) D E K (secreted the fastest)
168
What vitamins are Antioxidants?
``` A C E Selenium Zinc ``` “Acesz”
169
2nd m/c reason for vitamin deficiency
Malabsorption
170
Why vitamin is for cns? Pns?
B1 - thiamine = cns B6 - pyridoxine = pns
171
Beri beri / wernicke-kaskoff is a deficiency of what? Commonly do to what?
Thiamine (b1) Alcoholics
172
What vitamin is a diuretic that helps with pms?
Pyridoxine (b6)
173
What Vitamin deficiency causes pallegra? What are symptoms?
``` B3 niacin (pruritic/itchy when deficient/excess/taken) ``` 4 D’s: dementia / diarrhea / dermatitis / death
174
What deficiency is common with vegans?
B12 - cyanocobalamin
175
Difference between vitamin k1 / k2
K1: clotting cascade (Don’t give on blood thinner) K2: bone mineralization (Pt osteoporotic? Can give on blood thinner)
176
What are the two most useful vitamins for everything?
Zinc EPA (omega 3)
177
What post viral symptoms are present after: Guillian barre / pityrasis roseacea / Reye’s syndrome / west Nile
Chronic fatigue Fibromyalgia HA

T: Part 2 Boards (2 decks)

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