Random Diseases I've never heard of Flashcards Preview

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Flashcards in Random Diseases I've never heard of Deck (17):
1

Aspirin sensitive asthma

Asthma with nasal polyps

Avoid aspirin or NSAIDs because they can cause systemic reaction

2

Histiocytosis X

Chronic interstitial pneumonia caused by abnormal proliferation of histiocytes

90% are cigarette smokers

Symptoms: dyspnea and nonproductive cough
Can also have spontaneous pneumothorax, lytic bone lesions, and diabetes insipidus

CXR: honeycomb appearance, Ct scan shows cystic lesions

Treatment: corticosteroids and lung transplantation

3

Pulmonary alveolar protenosis

Accumulation of surfactant lke protein and phospholipids in alveoli

Symptoms: dry cough, dyspnea, hypoxia, and rales

CXR: ground glass appearance with bilateral alveolar infiltrates that resemble a bat shape

Diagnosis: lung biopsy required for definitive diagnosis

Treatment: lung lavage or Granulocyte-colony-stimulating factor
Do not give steroids due to increased risk of infection

4

Cryptogenic organizing pneumonitis

Inflammatory lung disease with similar features to pneumonia

Features: cough, dyspnea, flu-like symptoms

CXR: bilateral patchy infiltrates

Treatment: spontaneous recovery or corticosteroids

5

Radiation pneumonitis

Interstitial pulmonary inflammation

Acute: 1-6 months after irradiation
Chronic: 1-2 years after

Features: low-grade fever, cough, chest fullness, dyspnea, pleuritic chest pain, hemoptysis, ARDS

CXR: normal

CT scan: best study-diffuse infiltrates, ground glass density, consolidation, pleural/pericardial effusions

Treatment: corticosteroids

6

Complications of Ventilators

Anxiety, agitation and discomfort-use benzos for sedation
opiods for analgesia

Tracheal secretions: suction on the reg

Nosocomial pneumonia: if >3 days

Barotrauma-high airway pressures

O2 toxicity: if FiO2 greater than .6 for 2-3 days

Hypotension: increased intrathoracic pressure decreases venous return

Tracheomalacia: softening of tracheal cartilage if greater than 2 weeks

Stress ulcers and cholestasis

7

Gardner's syndrome

Colon Polyps plus osteomas, dental abnormalities, benign soft tissues tumors, desmoid tumors, sebaceous cysts

Risk of Colorectal cancer is 100% by 40

8

Turcot's syndrome

AR

Polyps plus cerebellar medulloblastoma or gliobalstoma multiforme

9

Angiodysplasia of the colon

Tortuous, dilated veins in submucosa of he colon-usually proximal wall
Common cause of lower GI bleeding

Diagnosed by colonscopy

90% bleeding stops spontaneously

Treated with: colonscopic coagulation
persists-right hemicolectomy

10

Ogilvies Syndrome

Signs, symptoms and radiological evidence of large bowel obstruction are present but there is no mechanical obstruction

Causes: recent surgery or trauma, serious medical illnesses and medications (narcotics, psychotropic drugs, anticholinergics)

Treatment: stop offending agent
IV fluids, electrolyte repletion
Decompression with enemas or nasogastric suction
Colonoscopic decompression
Surgical decompression is last resort

11

hepatorenal syndrome

indicates end stage liver disease
Progressive renal failure in advanced liver disease, secondary to renal hypoperfusion from vasoconstriction of renal vessels

Precipitated by infection or diuretics

Clinical: azotemia, oliguria, hyponatremia,, hypotension, low urine sodium (

12

Spontaneous bacterial periotnitis

Infected ascitic fluid-occurs in 20% of patients hospitalized for ascites
High mortality rate (associated with ESLD)

Etiologic agents: E. Coli (most common), Klebsiella, Strep. pneumo

Clinical: abdominal pain, fever, vomiting, rebound tenderness, SBP may lead to sepsis

Diagnosis: established by paracentesis
WBbs >500 PMN>250
Culture fluid

Treatment: broad sprectrum antibiotics
Repeat paracentesis in 2-3 days to decrease ascitic fluid PMN to less than 250

13

Hepatic Hydrothorax

Tansudative pleural effusion more common on right side

Treatment: liver transplantation
Therapeutic thorancentesis
salt restriction and diuretics

Refractory: transjugular intrhepatic portosystemic shunt

14

Hemobilia

Blood draining into duodenum via common bile duct

Causes: trauma, papillary thyroid carcinoma, surgery, tumors, infection

Clinical: GI bleeding, jaundice, and RUQ pain

Diagnosis: arteriogram
Upper GI endoscopy shows blood coming out of the ampulla of Vater

Treatment: resuscitation
Severe bleeding: surgery-ligation of hepatic arteries or embolization of vessel

15

Aortoenteric fistula

Rare but lethal cause of GI bleed

history of aortic graft surgery who has a small GI bleed involving the duodenum before massive fatal hemorhage hours to weeks later

Endoscopy or surgery during small window to prevent death

16

Schatzki's ring (distal esphogeal webs)

Cricumferetnial ring in lower esophagus acompanied by a sliding hiatal hernia

usually asymptomatic but can have dysphagia

Symptomatic but no reflux=esophageal dilatation
Reflux=antireflux surgery

Due to ingestion of alkali, acids, bleach or detergents (alkali most dangerous due to full thickness necrosis)

Complications: strictures leading to esophageal cancer

Treatment: esophagectomy if full thickness necrosis has occurred
Patient should avoid vomiting, gastric lavage, and all oral intake
Give patient steroids and antibiotics as well
Perform bougienage for stricture

17

Myxedema coma

Depressed state of consciousness, profound hypothermia, and respiratory depression

Develops after years of severe untreated hypothyroidism

Trauma, infection, cold exposure and narcotics may precipitate coma

high mortality event with treatment

Supportive therapy to maintain BP and respiration
IV thyroxine and hydrocortisone while maintaining hemodynamic state