internal med Flashcards
(253 cards)
1
Q
beriberi
A
vit B1 def, can induce dilated cardiomyopathy
2
Q
Amyloidosis
A
precipitate restrictive infiltrative cardiomyopathy
3
Q
furosemide and chlortalidone
A
provoke gout by reducing uric acid excretion
4
Q
etacrynic acid (and furosemide)
A
can lead to temporary or permanent hearing loss
5
Q
Ivabradine
A
blocking funny Na-K channel, used to decrease resting sinus heart rate in ischemic heart disease
6
Q
ST elevation can be caused by
A
pericarditis
myocarditis
acute pancreatitis
pulmonary embolism
7
Q
hypertrophic cardiomyopathy
A
beta-blockers are recommended as first-line therapy
8
Q
Proarrhythmia
A
anti-arrhythmic drugs in some cases can cause different type, often worse arrhythmia than the arrhythmia which made the use of these types of drugs reasonable
9
Q
congenital long QT syndrome
A
can be associated with deafness
10
Q
suspected intracardiac thrombus
A
transesophageal echocardiography
11
Q
post myocardial infarction, detection of viability
A
cardiac MRI
12
Q
mitral valve prolapse
A
2D, color Dippler-echocardiography
13
Q
systemic use of nitrates
A
causes small vein expansion, their arterial effect develop at intracoronary delivery
14
Q
level of CK
A
elevated 3hrs after MI
troponin T and troponin I level are slightly earlier and more sensitively to myocardial necrosis
15
Q
transesophageal and transthoracic echocardiography
A
TEE is more sensitive and more specific: examines the heart more closely and very little absorption and diffusion medium between the heart and transducer probe
16
Q
fever and “big silent heart”
A
typical for pericarditis
17
Q
vulnerable plaque
A
high lipid content, the exist of inflammatory cells and thin fibrotic “cap”. Content of whitewash of these plaques are typically low and don’t necessarily cause stenosis in the lumen
18
Q
cephalic phase
A
gastric secretion is triggered by stimulation of the taste receptors in the mouth
19
Q
Menetrier disease
A
exsudative gastropathy of unknown origin, characterized by diffuse thickening of the gastric wall caused by excessive proliferation of the mucous membrane
loss of protein through gastric lesions, lead to edema formation
complain of epigastric pain and diarrhea
no multiple ulcers in the stomach, unlike ZES
20
Q
pentagastric test
A
reveals the acidity of the stomach
21
Q
NSAIDs
A
cause gastric mucosal damage by inhibiting the synthesis of protective prostaglandins
chronic NSAID users develop “silent ulcers” and are diagnosed only when complications occur (perforation, bleeding)
22
Q
PPI
A
inhibit H+/K+ ATPase
cause inhibition of HCl acid secretion, which leads to an increase in serum gastrin levels
23
Q
somatostatin
A
inhibits gastric acid secretion and the release of several GI hormones, including gastrin
24
Q
hepatic encephalopathy can be provoked by
A
GI bleeding, aggressive diuretic therapy, spontaneous bacterial peritonitis, after TIPS procedure
25
hepatic encephalopathy
confusion, increased blood ammonia level, foetor, asterixis
26
PBC (primary biliary cholangitis)
remains asymptomatic for a long time, pruritus might be the first symptoms, AMA (anti-mitochondrial antibody), inc IgM level, middle-aged women
27
PSC (primary sclerosing cholangitis)
more frequent in males, can be associated with ulcerative colitis, increase the risk of cholangiocellular carcinoma, ANCA positivity
28
autoimmune hepatitis
inc serum igG, good response to corticosteroid, affects young women
29
hepatitis E virus
can be transmitted with consumption of undercooked pork meat, become chronic infection in immunocompromised patients, can cause CNS symptoms
30
Courvoisier-sign
tactile, not painful enlarged gallbladder
31
Klatskin tumor
extra-hepatic cholangiocarcinoma arising in the junction of the main right or left hepatic ducts to form the common hepatic duct
32
Caroli syndrome
congenital cystic dilatation of the intrahepatic biliary tree
typical symptoms: recurring cholangitis, shaking chills, fever
fusiform dilation of intrahepatic bile ducts and bile duct stenosis
33
Mirizzi's syndrome
characterized by obstructive icterus and dilated hepatic duct
because the stone in the gallbladder fundus presses the common bile duct
34
Juxtapapillary diverticulum
Raises the risk of bile duct stone by a supposed bile flow obstruction
doesn't cause chronic liver disease, endoscopic papillotomy is not contraindicated anymore
35
SPINK1 gene
encodes a protein called pancreatic secretory trypsin inhibitor
36
metformin and contrast agent
administration of metformin should be suspended by 2 days prior to the examination
can be continued after 48hrs from the examination only if the GFR is >30ml/min/1.73m2
IV iodinated contrast agents may be nephrotoxic and the deterioration of renal function may lead to accumulation of metformin to toxic levels and lead to lactic acidosis
37
in severely declined kidney function
thiazide-like diuretics are ineffective, loop diuretics could be used to decrease hypovolemia
38
MEN1
primary hyperparathyroidism, pituitary adenoma, neuroendocrine tumor of the pancreas
39
acromegaly
investigate GH concentration during oral glucose tolerance test
40
Primary aldosteronism and primary hyperparathyroidism cause polyuria
due to prolonged hypercalcemia causes the insensitivity of the vasopressin receptors of the kidney tubules
41
pheochromocytoma
only in MEN2 and not in MEN1
42
glycoprotein hormones
TSH, LH, hCG, FSH
43
chromogranin
protein stored in the secretory granules of neuroendocrine cells
chromogranin A examination is used as a specific serum marker of neuroendocrine tumors, can be found in high concentration in carcinoid tumors, gastrinoma, insulinoma, pheochromocytoma
44
Nelson disease
aggressive ACTH-producing adenoma evolving after bilateral adrenalectomy performed because of Cushing's disease
45
diuretic treatment can cause secondary gout
due to inhibition of the tubular secretion of urate
46
android obesity
waist to hip ratio >1.0 in men or >0.8 in women in obese individuals
47
gynoid obesity
waist to hip ratio <1.0 in men or <0.8 in women in obese individuals
48
exercise in DM
In T2DM: dec blood glucose via decreasing insulin resistance and helps reach the optimal body weight
In T1DM: optimal time to exercise is the afternoon (afternoon down phenomenon), but in case of insulin deficiency, exercise alone doesn't decrease blood glucose levels, but shifts the metabolism towards ketosis
49
Charcot joint
severe joint destruction is caused by the overextension of the joint due to lack of pain sensation and the associated trophic disorder
50
Shilling test
Examine B12 absorption
51
HAM test
traditional screening method paroxysmal nocturnal hemoglobinuria
52
beta2-microglobulin
reflect B cell proliferation and immuno reaction
53
bone marrow PAS stain
traditional bone marrow cytochemistry in ALL
54
antidote for unfractionated heparin
protamin
55
CLL
appearance of 5G/L or more CD19/CD5 co-expressed lymphocytes in peripheral blood is the official diagnostic criterium
56
Alarcon-Segovia diagnostic criteria for mixed connective tissue disorder
serology criterion (positive antibodies to U1 RNP antibodies) + clinical criteria: edema of the hands, synovitis, myositis, Raynaud phenomenon, Sclerodactyly
57
Schirmer test
For Sjogren's syndrome: less than 5mm/5mins
58
Belimumab
The only agent for SLE therapy which inhibits B-cell activating factor
59
HSP (Henoch-Schonlein purpura)
ANCA-negative, palpable purpura, abdominal angina, age <21, neutrophil granulomcytes in the wall of small vessels
60
PAN (polyarteritis nodosa)
not ANCA-associated
61
packed red blood cell transfusion
improve oxygen delivery
62
oxygen dissociation curve
shifted to the right by acidosis, inc PaCO2 and inc temp
63
Succinylcholine
depolarizing muscle relaxant
bind to nicotinic ACh receptors of the end plates results in sustained depolarization
SE: muscle pain, bradycardia, malignant hyperthermia
hyperkalemia, extensive burns, muscle dystrophy can leads to inc potassium levels => contraindications
64
continuous thoracic epidural analgesia
most efficient analgesic method and induces symphaticolysis and improves visceral blood flow
can mask symptoms of acute abdomen, but 24-hourly analgesic breaks can minimize the risks
65
morphine
contraindicated because of its spasmic effect on the Oddi sphincter
66
Nitrate
veno- and coronary dilating effect and improves symptoms of cardiac decompensation in acute coronary syndrome and reduces ischemia
its use however is contraindicated in hypotension, because further reduction in diastolic pressure diminished coronary flow
67
thiopental
barbiturate type IV anesthetic which has a tendency to cumulate: best used for induction or short operation
most common side effects: histamine release => asthma is a contraindication
68
normal arterial blood gas values
pH 7.35-7.45
PaCO2: 35-45mmHg
PaO2: 80-100mmHg
HCO3-: 22-26mEq/L
69
high anion gap metabolic acidosis
AG = (Na+K) - (HCO3 + Cl): normal value 8-16mmol/L
in uremia, diabetic ketoacidosis, intoxication of ethylene glycol, paraldehyde, isoniazide, salicylate
70
mechanical ventilation weaning failure
pulmonary causes: reduction of FRC and dystelectasis
cardiac causes: decompensation, since spontaneous breathing increases right heart preload and left heart afterload
energetic causes: muscle weakness
71
Thrombolysis
indication: in AMI within 12hrs, ischemic stroke within 3 hrs, pulmonary embolism
not contraindicated in ages above 75 or in menstrual bleeding
72
distributive shock
sepsis, toxic shock syndrome, chemical intoxications, anaphylaxia, neurogenic shock, endocrine shock (thyrotoxicosis, diabetic ketoacidosis)
73
aspirin intoxication
causes CNS stimulation, vasoconstriction in the inner ear and decoupling of intracellular oxidative phosphorylation
severe cases: cerebral and pulmonary edema, platelet dysfunction and inc bleeding time
most common symptoms: hyperpnea, tachycardiac, hyperthermia or hypotonia, arrhythmias, N/V, GI bleeding, perforation, pancreatitis, hepatic failure
CNS Sx: tinnitus, dec consciousness, seizure
blood gas values: respiratory alkalosis with high anion gap acidosis
74
Gardner syndrome
predisposes to GI polyposis doesn't predispose to pheochromocytoma
75
compound heterozygosity
two different mutations are present on the two different alleles of the same gene in AR inherited diseases
76
genomic imprinting
in the pathogenesis of Prader-Willi syndrome, Angelman syndrome and Beckwith-Wiedemann syndrome
77
Trinucleotide repeat disorder
fragile X syndrome
myotonic dystrophy
Huntington's disease
Friedreich's ataxia
78
Associated with breast cancer
Li-Fraumeni syndrome (mutation of p53)
Mutation of BRCA1/2 gene
Cowden syndrome (mutations of PTEN)
79
von Hippel-Lindau disease
renal cancer, pancreatic cysts and cancer, retinal and cerebellar hemangioblastomas
80
associated with chromosomal instability arising from deficient DNA repair
ataxia teleangiectasia, Bloom syndrome, xeroderma pigmentosum and Fanconi anemia
81
Fragile X syndrome
moderate mental retardation in affected boys and mild mental retardation in affected girls
caused by mutations of FMR1 gene, belongs to trinucleotide repeat disorders
enlarged testicles is a characteristic of the disease in affected boys
82
tumor growth depends on
time of cell cycle, growth fraction (proliferating tumor cell ratio), time to duplicate tumor volume and tumor cell loss (cell death rate)
83
RECIST-staging system
RECIST (response evaluation criteria in solid tumors) is used for evaluating the therapeutic response in solid tumors
84
Forrest-Classification
evaluate the bleeding activity of the ulcer
85
Bismut-Classification
provide an anatomical description of hilar biliary tract cancer
86
Duke classification
staging of colorectal carcinoma
87
Adalimumab
human monoclonal antibody used to treat IBD and has no indications in treatment of solid tumor
88
targeted therapies
imatinib: GIST (gastrointestinal stromal tumor)
sorafenib: hepatocellular carcinoma, kidney cancer
cetuximab: colorectal carcinoma, NSCLC
sunitinib: kidney cancer, GIST
89
most common primary tumor site in Krukenberg tumor
gastric cancer
90
NPI
```
Nottingham prognostic index
below 3: excellent prognosis
below 3.14: good prognosis
3.14-5.4: moderate long-term prognosis
>5.4: poor prognosis
```
91
breast cancer that typically affects both sides
Lobular carcinoma
92
Colorectal cancer staging
TNM staging
MAC (Modified Astler-Coller) classification
Dukes classification
93
FIGO position
ovarian cancer
94
Imatinib (Glivec)
For GIST and CML
95
DeGramont chemotherapy protocol
used in colorectal cancer, not breast cancer
96
Trastuzumab
in HER-2 positive tumors
97
Gleason-score
for prostate cancer
98
non-seminomas
chemotherapy sensitive and less responsive to radiotherapy
99
isolated ascites
pathological fluid accumulation occurs only in the abdominal cavity without being part of a generalized edema
100
Bernstein test
To confirm that retrosternal pain is caused by reflux disease
serves for the evaluation of the esophageal acid sensitivity
101
ZES (Zollinger-Ellison syndrome)
associated with hyperparathyroidism
102
Repair of an inguinal hernia
Lichtenstein surgery
103
Trendelenburg test
assess the condition of the valves in the greater saphenous vein
104
Perthes test
assess the rate of blood flow towards the deep veins (clinical test for assessing the patency of the deep femoral vein)
After placing a rubber compression band on the leg of the standing patient, ask the patient to walk, and emptying of the superficial beins means a good flow towards the deep veins (negative Perthes test)
105
Homan's sign
Sign of deep-vein thrombosis when dorsalflexion of the foot induces calf pain
106
surgical indication
immediate (vital) indication: medical condition where the life of the patient can only be saved with an immediate surgery
absolute surgical indication: disease is to be treated surgically, although not necessarily immediately
107
Inguinal hernia
Lateral (indirect): prone to incarceration since the hernia has to pass through the long, curvy and relatively narrow inguinal canal => develop in the persisting tunica vaginalis (congenital hernia) and thus the hernia sac can reach the scrotum itself
medial (direct) hernias: only a short hernial sac, orifice is usually wide
intermittent pain or discomfort associated with inguinal hernias is caused by the stretching of the mesentery of the trapped bowel loop
108
Requirements of primary wound healing
Sharp wound edges, non-tight edhes, lack of foreign or contaminated parts in the cavity
109
Classic signs of inflammation
tumor, rubor, calor, dolor, functio laesa
bulge, erythema, warm, pain and loss of function
110
Post-thrombotic syndrome
chronic insufficiency of venous circulation in the lower extremities, which develops years after DVT
111
GEA & EST
GEA: gastroenteroanastomosis
EST: endoscopic sphincterotomy
112
"Resectability" and "Operability"
resectability is related to the tumor: resectable or unresectable (technically cannot be removed by the surgeon)
Operability: refers to the patient
varies from patient to patient, depending on the patient's condition and reserves and the progression of the disease
113
Symptoms of post-thrombotic syndrome
progressive edema, indurations, thickening of the subcutaneous tissue, development of secondary varicosity, crural ulcers due to impaired localized tissue nutrition, brownish pigmentation caused by hemosiderin deposition, eczema and dermatosis
114
treatment of secondary varicosity
crossectomy, stripping, subfascial ligature of perforator veins
115
degloving injury
skin and its underlying tissues are torn off the fascia
significant amount of bleeding can develop into the recessed area and the blood supply to the skin above the injury is severed, therefore skin necrosis is common
116
Bennett fracture
Fracture of the base of the first metacarpal bone which extends into the carpometacarpal joint
intra-articular fracture is the most common type of fracture of the thumb
117
V-shaped phlegmon
the type of pyogenic tenosynovitis extending between the thumb and the little finger
because the tendon sheaths reach the level of the wrist, but on the 2nd-4th fingers, they extend only to the distal palmar crease
118
Triangular fibrocartilage complex
cartilage structure located on the small finger side of the wrist that, cushions and supports the small carpal bones in the wrist
119
Cubital tunnel syndrome
area of sensory innervation and muscles of motor innervation by the ulnar nerve are affected
120
Dupuytren's contracture
One or more fingers become permanently bent in a flexed position
usually begins as small, hard nodules just under the skin of the palm, then worsens over time until the fingers can no longer be straightened
cannot be treated with conservative methods (splinting, cast fixation and redressing bandaging techniques)
121
Periappendicular infiltration
Complicated form of advanced appendicitis, which requires 5-7 days to develop
122
Anus preternaturalis
colostomy
123
UICC
international anti-cancer organization (Union Internationale Contre le Cancer)
124
Blumer's shielf
hard resistance that is palpable in the pouch of Douglas with rectal examination in advanced gastric cancer
it develops as a result of the fact that the tumor has metastasized to the peritoneum => patient already has ascites, which is the consequence of peritoneal cancer
125
PTC: percutaneous transhepatic cholangiography
penetrating an intrahepatic bile duct through the skin
126
complications of GERD
esophagitis
peptic stricture
esophageal ulcer: bleed, penetrate, perforate
Barrett's esophagus: can lead to esophageal adenocarcinoma
lung infections due to aspiration
Schatzki ring: narrowing of the lower esophagus that can cause difficulty swallowing
reglux laryngitis
esophageal motility disorders
reflux stomatitis
127
Terminal ileum resection
anaemia (due to vit B12 def) and loss of biliary acids (absorbed primarily in terminal ileum)
128
Tenesmus
continual or recurrent inclination to evacuate the bowels
129
choledochus
common bile duct
130
Heller operation
an operation for achalasia of the cardia (can try Botox injections or balloon dilatation before)
131
Torek operation
resect the thoracic part of the esophagus, can be used in esophageal perforation
132
Decortication
medical procedure involving the surgical removal of the surface layer, membrane or fibrous cover of an organ
133
Mitral stenosis treatment
mitral commissurotomy and prosthetic heart valve implantation
134
mitral regurgitation treatment
implantation of artificial chordae and the use of annuloplasty rings
135
polyneuropathy
more commonly cause lower limb hypesthesia/paresthesia and rarely manifests in lower limb weakness
136
Parinaud's syndrome
inability (paresis or palsy) of upgaze and it often comes with retraction nystagmus
a sign of compression of the quadrigeminal lamina
137
Strumectomy
surgical removal of all or a portion of a goitrous tumor
138
Suxamethonium (same as succinylcholine)
neuromuscular blocker family of medication and of depolarizing type
depolarization is caused by succinylcholine mimicking the effect of acetylcholine but without being rapidly hydrolysed by acetylcholinesterase
highly potent agonist at the NMJ nicotininc acetylcholine receptors
139
PEEP (positive end expiratory pressure)
decrease venous return due to increased mean intrathoracic pressure
altered left ventricular geometry
circulating, negative inotropic mediators
140
Agoraphobia
fear of being in situations where escape might be difficult or that help wouldn't be available if things go wrong
141
Transcortical aphasia
disables spontaneous speech, but have echolalia
142
TMS and TDCS
TMS: transcranial magnetic stimulation
TDCS: transcranial direct current stimulation
143
WAIS
Wechsler Adult Intelligence Scale
verbal and performance IQ
The level of intelligence measured by it predicts the level of life competence
144
tests
```
Rorschach probe: projective test
MMPI: personality inventory
BPRS: clinical rating scale
Raven matrices: measure intellectual performance
Szodi test: projective personality
```
145
For dementias
MMSE, clock drawing test, WAIS for level of cognitive decline
146
Perceptions without objective stimuli
hallucination
147
Alexithymia
personal trait characterized by the subclinical inability to identify and describe emotions experienced by one's self or others.
The core characteristics of alexithymia are marked dysfunction in emotional awareness, social attachment and interpersonal relating
characterized by difficulties in expressing and verbalizing emotions
148
Delusions of infestation
a condition where an individual has a firmly fixed false belief that they have an infection
aka Ekbom symptom
149
Rumination
focused attention on the symptoms of one's distress, and on its possible causes and consequences
can also be the action of chewing the cud
150
negativism
behaviour that is the opposite of that suggested by others
in active negativism: the individual does the opposite of what is asked for. can be associated in psychosis
In passive negativism: the person fails to cooperate, this occurs in schizophrenia and depression
151
Delusion of the double
Capgras syndrome
152
Pseudologia Fantastica
aka pathological lying, deception syndrome, mythomania
153
Fregoli syndrome
false identification of strangers as familiar people
154
can be seen in a motor disorder in schizophrenia
catatonia, negativism, waxy flexibility, automatic obedience
155
Nihilistic delusions
specific psychopathological entities characterized by the delusional belief of being dead, decomposed or annihilated, having lost one's own internal organs or even not existing entirely as a human being
156
Cotard syndrome
rare condition marked by the false belief that you or your body parts are dead, dying or don't exist
157
Bleuler's 4 A's in schizophrenias
disturbance of affect, association, ambivalence and autism
158
phobia
claustophobia (fear of closed spaces)
acrophobia (fear of heights)
hydrophobia (fear of water)
arachnophobia: fear of spiders
159
delirium tremens
signs of autonomic hyperactivity: hypertension, fever, tachycardia, global confusion, disorientation, perceptual disorders as a result of withdrawal from alcohol
160
Wernicke's encephalopathy
consequence of long-term alcohol abuse
associated with periaqueductal gray hemorrhages at the level of lamina quadrigemina
symptoms: sudden onset, nystagmus and ophthalmoplegia, confusion along with somnolence, lesions of the mammillary bodies
161
polysomnography
sleep study, a test used to diagnose sleep disorders
162
Rapid cycling in bipolar disorder
4 episodes within one year
163
cyclothymia and dysthymia
cyclothymia: mood disorder causes emotional ups and downs that are less extreme than bipolar disorder
164
dysthymia
chronic form of mild depression
165
Narcomania
a pathological craving for or addiction to narcotics or alcohol
166
Hypochondriasis
illness anxiety disorder
167
Ambivalence
inability to make decisions
| a division of all states or operations of mind into contradictory tendencies
168
Pick disease
aka frontotemporal dementia or frontotemporal lobar degeneration (affects parts of the brain that control emotions, behaviour, personality and language)
169
Conversion disorder
resemble a somatic illness
in definite connection with some outside event (psychotrauma)
Freudian primary illness-benefit: the patient can escape from a conflict
Freudian secondary illness-benifit: evoke increased attention and sympathy of others
patient cannot control these symptoms
limb paralyses and sensory deficits don't follow anatomical innervations
170
Dissociative fugue
sudden and unplanned travel away from home
inability to recall past events or important information from the person's life
confusion or loss of memory about his or her identity, possibly assuming a new identity to make up for the loss
171
Adaptation disorder (Adjustment disorder)
symptoms (stress, feeling sad/hopeless, physical symptoms) that can occur after you go through a stressful life event
172
trichotillomania
patients are unable to resist pulling out their own hair
173
pyromania
the person commits arson intentionally for pleasure
174
kleptomania
an irresistible urge to steal worthless objects
175
Akathisia
movement disorder characterized by a feeling of inner restlessness and inability to stay still
early adverse effect of antipsychotic medication
176
tardive dyskinesia
permanent side effect of antipsychotic medications that involve involuntary muscle
rapid blinking, waving of the arms or hands, sticking out the tongue
177
Trancranial megnetic stimulation
Can be used in depression and in the presence of acoustic hallucinations
178
Disengagement
describes the traits of a family or the current type of family interaction or functioning
disengaged families lack intimacy between the members
179
countertransference
occurs when a therapist transfers emotions ot a person in therapy
180
Tranference
process of projecting one's feelings toward an important figure in your life onto someone else
181
Unconditional positive regard
means that the therapist accepts the client totally for who he or she is without evaluating or censoring, and without disapproving of particular feelings, actions, or characteristics
"I'll accept you as you are"
182
Person-Centered therapy
By Carl Rogers
Congruence (Genuineness): the ability for the therapist to be genuine, no façade, require self-awareness, deliberate self-disclosure. Therapist's openness and genuinessness to relate to clients without hiding behind a professional facade
unconditional positive regard
empathy: ability to understand what the client is feeling
183
Oezema
disease of the nose in which the bony ridges and mucous membranes of the nose waste away
it's a form of atrophic rhinitis
involves foul-smelling lesion of the mucosa
unknown etiology
becomes better with aging
184
Osteoma
Most common benign tumor of the nose and paranasal sinuses
| should be surgically removed
185
Pollakiuria
benign idiopathic urinary frequency
refers to frequent daytime urination in children without specific cause
can be caused by urine retention in the bladder and urethritis
186
continent urinary diversion
performed by incorporating segments of both the small and large intestine into the urinary tract to create a urinary reservoir in the suitably selected patient
E.g. Orthotopic bladder formation (bladder replacement from an isolated intestinal tract) and Mainz II pouch
187
urologic procedure
internal urethrotomy: incision of the urethral stenosis
| epicystostomy: percutaneous bladder puncture
188
Nephroptosis
rare condition where a person's kidney drops down into the pelvis when they stand up
189
Verruca vulgaris
common warts, which are caused by infection with HPV
190
Anergy
Describes a lack of reaction by the body's defense mechanisms to foreign substances
191
Condyloma acuminatum
single genital wart, usually due to HPV 6 and 11
192
Promiscuous
having multiple sexual partners
193
White dermographism
blanching response resulting from capillary vasoconstriction after skin stroking and more pronounced in patients with atopic dermatitis
194
pityriasis rosea
exact cause of pityriasis rosea is unknown but most likely due to a viral cause
acute, self-limited, exanthematous skin disease by slightly inflammatory, oval, papulosquamous lesions on the trunk and proximal areas of the extremities
195
Sezary syndrome
aggressive form of cutaneous T-cell lymphoma
| occur when T cells become cancerous, typically affect the skin
196
hidradenitis suppurativa (acne inversa)
inflammatory skin disease that affects apocrine gland-bearing skin in the axillae/groin/under the breasts
recurrent boil-like nodules and abscesses that culminate in pus-like discharge, difficult-to-heal open wounds and scarring
197
Methimazole
treat hyperthyroidism, also used before thyroid surgery or radioactive iodine treatment
Can cause aplasia cutis
198
thelarche
occurs for a low amount of estrogen
present also in testicular feminization
usually this is the first somatic change during puberty
199
Female pseudohermaphroditism
individual with ovaries but with male secondary sexual characteristics or external genitalia
can be caused by androgen-producing tumors, CAH
200
male pseudohermaphroditism
individuals whose gonads are testes but whose secondary sexual characteristics or external genitalia resemble those of a female
usually a AR genetic defects
201
testicular feminization
androgen insensitivity
202
pubertal preaecox
precocious puberty
203
Adenomyosis
endometrial tissue infiltrates the myometrium deeply, causing dysmenorrhea and hypermenorrhea
204
Dysmenorrhea
painful periods or menstrual cramps
205
Menorrhagia
Heavy menstrual bleeding
| Hypermenorrhea : longer menstruation with more bleeding than usual
206
Hypomenorrhea
Regular, but shorter menstruation with light bleeding
207
Oligomenorrhea
more than 35 days between two menstruation
208
Polymenorrhea
less than 21 days between two menstruation
209
Metrorrhagia
irregular bleeding, which can last long
210
Postpartum galactorrhea-amenorrhea syndrome
Chiari-Frommel syndrome
211
Stein-Leventhal syndrome
PCOS: polycystic ovary syndrome
212
POPs
Progesteron-only pill
213
Clomiphene citrate
for ovaluation induction
widely used to treat infertility
SERM: selective estrogen receptor modulator
competitive inhibitors of estrogen binding to estrogen receptors
214
Cyproteron-acetate
Anti-androgen used in hypersexuality in males, as a palliative in prostatic carcinoma and in combination with estrogen, for the therapy of severe acne and hirsutism in females
215
LNG-IUS (Levonorgestrel-releasing Intrauterine system)
effectiveness are almost as high as the effectiveness of tubal ligation
release usually daily 20ug progestin
commonly cause strophic endometrial changes
primarily affects menstrual bleeding patterns and amenorrhea
216
CTG
cardiotocography: monitor fetal heartbeat
217
Spinnbarkeit test
Spinnbarkeit mucus: stretchy, egg white quality of cervical fluids around ovulation
218
Sims Huhner test (postcoital test)
test in the evaluation of infertility
| evaluate the sperm's interaction within cervical mucus postcoitally
219
Parlodel
Aka Bromocriptine
| treat hyperprolactinemia or pituitary gland tumor that produces too much growth hormone
220
Oradexon
Aka Dexamethasone
can treat infertility with increased testosterone and/or DHEAS
221
Pyelectasia
dilatation of the renal pelvis
222
vena cava inferior syndrome
when the pregnant woman lays back the uterus overlies and compresses the vena cava inferior
due to decline in venous backflow, a fast maternal BP drop occurs, dizziness, sweating and tachycardia may lead to collapse
decrease in the placental circulation causes fetal bradycardia
can cause faintness of the pregnant woman
223
IDDM
insulin-dependent diabetes mellitus
224
Menstrual regulation
Menstrual extraction, another type of manual vacuum aspiration
induction of uterine bleeding that has been delayed either to 14 days beyond expected onset or 42 days from the start of the last menstrual period
225
Synclitism
parallelism between the pelvic plane and the plane of the fetal head
in asynclitism, the sagittal suture is in the transverse diameter of the pelvic inlet and not between the symphysis pubis and sacral promontory
226
Naegele obliquity
presentation of the anterior parietal bone to the birth canal during vaginal delivery with the biparietal diameter being oblique to the brim of the pelvis
is a type of asynclitism
227
Litzmann obliquity
posterior asynclitism
can lead to cephalopelvic disproportion and normal vaginal delivery cannot take place
228
Deflexion presentations
When the head is hyperextended: brow presentation and face presentation
229
Apraxia
motor disorder caused by damage to the brain in which the individual has difficulty with the motor planning to perform tasks or movement when asked, provided that the request or command is understood and the individual is willing to perform the task
230
amaurosis fugax
transient monocular blindness
caused by thromboembolisation of the ophthalmic artery (Terminal branch) from the ulcerated plaque of the ipsilateral internal carotid artery
231
Parinaud-syndrome
disturbance of gaze (vertical upwards) with vertical nystagmus
232
Weber syndrome
alternating motor brainstem syndrome: ipsilateral oculomotor nerve lesion, contralateral hemiparesis
233
Ticlopidine
Anti-platelet drug as ADP (adenosine diphosphate) receptor inhibitor
useful for preventing strokes and coronary stent occlusions
234
Diaschisis
sudden change of function in a portion of the brain connected to a distant, but damaged, brain area
235
Thalamic lesions
ventrolateral nucleus: cloely related to the cerebellum, its damage causes hemihypesthesia with hemihyperkinesis (choreoathetosis-like involuntary movements)
thalamic hand: basic joints are in flexion while the interphalangeal joints are in extension
thalamic pain: burning, shooting pain that is difficult to localise and occurs in attacks
236
Gerstmann syndrome
Left-to-right confusion, finger agnosia, agraphia and acalculia
237
abdominal lancinating pain
symptom of syphilis when granulomatous inflammation infiltrate posterior roots of thoracic spine and ganglion coeliacum and cause pain with sharp quality and very short duration
238
Vegetative symptoms
Weight loss and anorexia (loss of appetite), insomnia, fatigue and low energy, inattention
239
Cervicogenic headache
pain that develops in the neck, though a person feels the pain in the head
240
Meralgia paresthetica
numbness or pain in the outer thigh not caused by injury to the thigh, but injury to a nerve that extends from the spinal column to the thigh
241
Prosopalgia
facial or Trigeminal neuralgia
242
Causalgia
severe burning pain in a limb caused by injury to a peripheral nerve
known as complex regional pain syndrome type II
median nerve lesion often causes causalgia
243
Froment's sign
physical examination of the hand to test for palsy of the ulnar nerve which results in reduced functionality and muscle weakness of the pinch grip
it tests the strength of the adductor pollicus of the thumb, which is innervated by the ulnar nerve and is weakened in ulnar nerve palsy
244
Neuromyelitis optica
aka Devic disease
autoimmune disorder in which WBCs and antibodies primarily attack the optic nerves and the spinal cord, but may also attack the brain
the damage to the optic nerves produces swelling and inflammation that cause pain and loss of vision
the damage to the spinal cord causes weakness or paralysis in the legs or arms, loss of sensation and problems with bladder and bowel function
presence of aquaporin-4 antibodies in serum
245
Adrenoleukodystrophy
rare genetic condition that causes the buildup of VLCFAs (very long chain fatty acids) in the brain
When VLCFAs accumulate, they destroy the protective myelin sheath around nerve cells, responsible for brain function
246
Convulsive syncope
Like syncope, can precede by fainting sensation, pallor or sweating
during the unconsciousness, a brief tonic phase, myoclonic or clonic jerking can occur
in contrast to grand mal, convulsive syncope never begins with a tonic phase (starts with a loss of muscle tone)
tongue biting can also occur in convulsive syncope, but it never affects the lateral part of tongue, rather the tip of tongue (apical tongue biting)
247
Disulfiram
support the treatment of chronic alcoholism by producing an acute sensitivity to ethanol
the first medication approved by the FDA to treat chronic alcohol dependence
248
Epilepsy
recurrent unprovoked epileptic seizures
however, epileptic seizures can occur in healthy people (known as the provoked seizure)
249
Eaton-Lambert syndrome
neuromuscular presynaptic disorder with paraneoplastic etiology
production of antibodies against a presynaptic calcium-ion channel protein
plasmapheresis or immunosuppression can be effective in the treatment of this disease
250
Drusen
small yellow deposits of fatty proteins (lipids) that accumulate under the retina
251
Ectropion
condition in which your eyelid turns outward and leaves the inner eyelid exposed and prone to irritation
tearing (epiphora) is the consequence
252
Odds ratio
typically used in case-control studies
the odds of a certain exposure given an event v.s. the odds of exposure in the absence of that event
if odds-ratio is exactly 1, then there is no relationship between the risk factors and the disease
can be calculated from contigency tables
253
Stochastic effects
those affects the frequency and probability of which increases on elevating the doses, more precisely the dose equivalent value
