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NBEO Part 1 > Systemic > Flashcards

Systemic Flashcards

1
Q

What happens with acute inflammation

A
  1. vasodilation 2. structural changes 3. PMNs
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2
Q

What happens with chronic inflammation

A

Macrophages, lymphocytes, plasma cells, Tissue destruction, repair.

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3
Q

Granulomatous inflammation

A

Marked by a large amount of macrophages.

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4
Q

What affects wound healing

A

decrease blood flow, other infections,

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5
Q

What happens with cell death?

A

Lack of oxygen and increased anerobic respiration results in increase cellular Na. If this prolongs necrosis will occur.

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6
Q

Necrosis

A

The death or one or more cells as a result of irreversible damage.

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7
Q

Coagulative necrosis

A

Occurs with heart attack. The structure is maintained but inside is sad

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8
Q

Liquefactive necrosis

A

Lungs with fungus.

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9
Q

Caseous Necrosis

A

TB.

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10
Q

Hypersensitive Reactions

A

ACID

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11
Q

Type I hypersensitivity

A

analphyactic. IgE mediates and bind to mast cell for degranulation. Ca binds the next time for increased response. Initial is 5-30 and late 4-6 hours.

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12
Q

Type 2 hypersensitivity

A

Cell mediated. Occurs with IgG and IgM. Attacks a foreign body but also hurts the own cell.

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13
Q

Type 3 hypersentivity

A

Immune complex mediated. Antigen/AB complexes. Occurs with lupus. No foreign part.

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14
Q

Type 4 hypersentivity

A

Delayed. T lymphocytes encounter an antigen and release luekokini leading to macrophage activation.

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15
Q

Systemic Lupis Erythromatosis

A

SLE. W>M. 30s. Mallar rash. Type 3. Can have dry eye, disc edema, papilledema, etc. ANA+

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16
Q

Rheumatoid Arthritis

A

W>Ms. 50’s. Synovial shift in morning so pain is worse. Dry eye=aqeuous deficient. ANA and RF+

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17
Q

Scleromalacia perforans

A

common with RA. Necrotizing scleritis without inflammation.

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18
Q

JIA

A

W>M. chronic bilateral non-granulomatous anterior uvieits. Can have a low grade fever. ANA+

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19
Q

Sjogren’s Syndrome

A

Dry mouth, eye, and arthritis. No arthritis in primary.

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20
Q

Sarcoidosis

A

Middle aged african American women. non-caveating granulomous and increased ACE. Order a lung X-ray if suspect.

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21
Q

SE with Sarcoidosis (The big 6)

A
  1. Anterior granulomatous uveitis 2. bells palsy 3. vitritis (cotton balls) 4. vasculitis (candle wax) 5. ON disease 6. Dacroadentitis
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22
Q

Ankylosing spondylitis

A

M>F. Young. Has a bamboo spin, sacroiliitis, uveitis, and aortic regurgitation. HLAB27 and X ray should be ordered.

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23
Q

Reactive arthritis

A

M>F. Urethra, uveitis, joint pain. HLA B27.

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24
Q

Psoriatic Arthritis

A

Sores in synovial fluid so join pain. HLA B27

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25
Q

Which disease are HLA B27 postiive

A

CRAP. Chrns, reactive arthritis, Ankylosing, psoriatic.

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26
Q

Which are ANA positive

A

RA, SLE, JIA,

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27
Q

Giant Cell arteritis

A

AAION. Superior temporal can affect SPCAs. Have scalp and jaw tenderness. Test to order include ESR, CRP, CBC/WBC, and temporal artery biopsy. Has skip lesions.

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28
Q

Granulomatosis with polyangiitis

A

(weaner’s granulomatosis). Vasculitis including the kidney, lungs, and upper respiratory tract. Can cause granulomatous sclerouveitis.

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29
Q

Scleroderma

A

tightening of the skin. Can cause dry eye and shrinkage of areas of the skin and conj.

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30
Q

Gout

A

Uric acid in the MTP (podogra). Painful. Men.

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31
Q

Band keratopathy

A

Calcium in bowman’s

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32
Q

Congenital immunodeficinty disease

A

IgA. Born with less. Can have keratinization of cornea, weight loss, diarrhea, and reccurnt upper respiratory tract infections.

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33
Q

AIDS

A

Caused by HIV an RNA virus that does reverse transcriptase to make DNA.

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34
Q

What CD4 count means you have aids

A

200 or less

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35
Q

Tests to run for Aids

A

ELISA and Western blot

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36
Q

Most common infection with AIDs

A

Cytomegalovirus retinitis, pneumonia, toxo, TB, kaposiosacroma.

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37
Q

Seborrheic Keratosis

A

Benign. Elevated stuck on appearance.

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38
Q

Keratocanthoma

A

Isolated dome shaped nodules. Remission over months.

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39
Q

Papillomas

A

Viral slow growing epithelial tumors that may be caused by HPV. Look like skin tags. HPV can cause cervical cancer.

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40
Q

Xanthelasma

A

Yellow plaque lesions in lid. Associated with high cholesterol.

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41
Q

Molluscum contagiosum

A

Common in kids. Spread by DNA pox virus. Dome shaped waxy nodules. If multiple think HIV.

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42
Q

Acne Rosacea

A

telengectasia and rhinopehyma. Can have hordeolum, chalzia, phlyctenulues, keratitis, and dry eye.

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43
Q

Allergic contact dermatitis

A

Type 4.

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44
Q

Impetigo

A

Grame + infection. Honey colored crusted lesion. Very common in kids.

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45
Q

HSV 1

A

Above the belt. More likely ocular

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46
Q

HSV 2

A

STD. Can have ocular manifestations with birth. Herpetic keratitis in neonates. Dendritic keratitis can also occur.

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47
Q

Herpes zoster virus

A

Chicken pox and shingels. Will have keratitis with pseudo dendrite.

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48
Q

Behcet’s disease

A

Middle east. Must have 2 of the following (skin lesions, mouth lesions, genital lesions, ocular lesions). Have acute recurrent hypopyon.

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49
Q

Superficial spreading melanoma

A

The most common variant of melanoma. It has rapid growth and is found on non-exposed skin

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50
Q

Basal cell carcinom

A

Most common. Telengectasia. Can have a rodent ulcer

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51
Q

Squamous cell carcinoma.

A

No telengectasia. More likely to metastasize. Arises for actinic keratosis.

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52
Q

Sturge Weber syndrome

A

Capillary malformation. Can cause glaucoma due to increase episcleral venous pressure. Can also cause iris heterochromia. Have port wine stain.

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53
Q

Tuberous sclerosis

A

Astrocytic hamartomas. Grows tumors in the brain and other organs. Have hypo pigmented macule, shagreen patches, angiofibromas, and brown plaque on the forehead.

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54
Q

Down syndrome

A

Trisomy 21. Prominent epicanthal folds, congenital cataracts, strabismus, glaucoma, keratoconus.

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55
Q

Klonefelter’s syndrome

A

XXY.

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56
Q

Turner’s syndrome

A

XO. Keratinous. BV issues (CI, strabismus, amblyopia, reduced accommodation)

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57
Q

Von hippie Lindau Disease

A

AD. Benign and malignant tumors. Retinal angiomas can rupture.

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58
Q

Neurofibromatosis Type 1

A

AD. Von recklinghauson’s disease. Tangle of tissue. Optic nerve glioma, litchi nodules, cafe au last spots.

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59
Q

Marfan’s syndrome

A

AD. Connective tissue disorder. Long stature. Keratinous. Sublimation of lens up. Aortic problems. Floppy valves.

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60
Q

Huntington’s chorea

A

AD. Bad movement and eye movemens

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61
Q

Familial adenomatous polyposis

A

AD. Gardner’s is a variant that will have CHRPE lesions (4 or more). Refer for testing as 100% with FAP will get colon cancer.

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62
Q

Sickle Cell

A

AR. glutamic acid on beta goblin to valine. Sickling of cell. African american. Sea fan retinopathy. Can get jaundice. Decrease hemoglobin, MCV normal, increased reticulocyte.

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63
Q

Tay Sach’s

A

AR. Cherry red spot. Atrophy of ON with increased glycolipids.

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64
Q

The only AR conditions we talked about

A

Sickle cell, Tay sach’s, PKU.

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65
Q

The only AD conditions we talked about

A

Huntingtons, Von hippie, Neurofibromatosis, FAP, Marfans.

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66
Q

The only X linked conditions we talked about

A

Fabry’s and Duchenne musclular dystrophy.

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67
Q

Leber’s Hereditäre Optic Neuropathy

A

Mitochondrial. Cause central vision loss. My mother leber lost my eyes.

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68
Q

What tests to order for anemia

A

CBC-Hgb and MCV

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69
Q

Anemias with MCV low

A

All low HGB. Low MCV with iron deficient anemia and aplastic anemia.

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70
Q

Iron deficiency anemia

A

Most common. Pica.

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71
Q

Aplastic Anemia

A

Attack all cells in the bone marrow (pancytopenia). Acetazolamdie and chloramphenicol can cause

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72
Q

Issues with normal MCV

A

Sickle cell and chronic kidney disease (cannot release as much erythropotein)

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73
Q

Anemias with increased MCV

A

Folate acid anemia, and Vitamin B12 deficiency.

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74
Q

Vitamin B12 Deficiency

A

Cobalamin. Often caused by pernicious anemia.

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75
Q

Folic acid deficiency

A

Occurs in pregnancy and alcoholism. Worry about neural tube defects with pregnancy.

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76
Q

Multiple Myeloma

A

Cancer of plasma cells. Affects kidney. Increased Ca in blood.

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77
Q

Hodgkins lymphoma

A

40% lymphoma. Reed-sterner cells. Associated with EBV.

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78
Q

Non-hodgkin’s lymhoma

A

60%.

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79
Q

Acute Lymphoblastic leukemia

A

Better prognosis. Increase lymphoblasts

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80
Q

Acute Myeoblastic Leukemia.

A

Poor prognosis. Increased myeblasts. Auer rods in blood cells.

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81
Q

Chronic Lymphocytic Luekemia

A

Better prognosis.

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82
Q

Chronic Myeocytic Leukemia

A

Worse prognosis. Associated with philidelphia chromosome.

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83
Q

Leukopenia

A

Decreased number of WBC

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84
Q

Lukocytosis

A

Increase in the abolsute number of WBC

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85
Q

Neutrophilia

A

Increase in the absolute number of neutrophils.

86
Q

Thrombocytosis

A

Increased platelets count

87
Q

Pancytopenia

A

Decrease in number of red and white blood cells and plateletes

88
Q

Thrombocytopenia

A

Decrease in platelets.

89
Q

Non-inflammatory causes of edema

A

Protein poor transudate. Increased organ pressure, reduced plasma osmotic pressure, lymphatic obstruction, sodium retention,

90
Q

Inflammatory causes of edema

A

Protein rich exudate. Acute and chronic inflammation and angiogenesis.

91
Q

Purpura

A

Greater than 3mm hemorrhage associated with trauma, vascular disease, or low platelet count

92
Q

Ecchymoses

A

Greater than 1-2 cm and include subcutaneous hematoma or bruises

93
Q

Virchow’s triad of thrombus

A

Stasis, injury, alteration in the constitutes in the blood (Prot C or S or things like birth control)

94
Q

Types of Embolus

A

FATBAT. Fat=fracture. Air. Thrombus, bacterial, Amniotic fluid, tumor.

95
Q

Where does an embolus formed in the vein system go?

A

The lungs

96
Q

Where does an embolus formed in the arterial system go?

A

The brain

97
Q

Shock

A

Decreased blood perfusion from a reduction in cardiac output or circulating blood volume.

98
Q

Cariogenic shock

A

Occurs when heart stops.

99
Q

Hypovolemic shock

A

Occurs when you loos a large amount of fluid or blood

100
Q

Septic

A

Vasodilation causes pooling of blood with infection

101
Q

Atherosclerosis

A

cholesterol plaques build up. Endothelial cell injury can lead to further atherosclerosis. Macrophages try to fix the damage to the endothelium and can cause a blockage of the vessel.

102
Q

Amaurosis Fugax

A

Ipsilateral vision loss in one eye due to carotid arty disease.

103
Q

Roth Spots

A

Leukemia and endocarditis.

104
Q

Left sided heart failure

A

Most common cause is ischemic cardiomyopathy from Coranary artery disease. Fluid backs up in the lungs.

105
Q

Right sided heart fialure

A

Most commonly caused by left sided heart failure. Now blood poos in abdomen and legs.

106
Q

Rheumatic Fever

A

Type II hypersensitivity. Strep causes. The disease can alter the shape of the heart valves.

107
Q

Bacterial Endocarditis

A

Bacterial in the inner lining of the heart (especially the lungs) Get roth spots.

108
Q

Heart palpitation

A

Premature ventricular complexes most common. Most are benign

109
Q

Transient Ischemic Attacks

A

Less than 24 hours. Most common cause is an embolism. There are two types of TIA

110
Q

Carotid artery TIA

A

Contralateral arm/hand weakness or sensory loss and face and legs symptoms. Patients can also have amaurosis fugax (ipsilateral visual symptoms)

111
Q

Vertebrobasilar TIA

A

Diplopia, ataxia, vertigo, dysarthria, and either unilateral or bilateral vision loss.

112
Q

Hollenhurst plaque

A

Embolism found in retinal vasculature. These patients have TIAs and should be referred asap.

113
Q

Stroke

A

Sudden onset of neurological deficits. Like TIA but lasts longer.

114
Q

Macular sparing homonymous hemianopsia

A

Most common. Can affect middle cerebral or posterior cerebral but not both.

115
Q

Ischemic Stroke

A

Most common. Occurs from occlusion with an embolus or other.

116
Q

Hemorrhagic stroke

A

Occur from a hemorrhage that stops oxygen from reaching its destination.

117
Q

Subarachnoid hemorrhages

A

Worst headache that they have. Can have a pupil involving CN III lesion.

118
Q

Where do aneurysm with CN III palsies occur

A

Circle of Willis. Typically at posterior communicating and ICA.

119
Q

Who does anterior cerebral supply?

A

Frontal lobe

120
Q

Who does middle cerebral supply

A

fontal lobe, temporal and parental, and occipital

121
Q

Who does posterior cerebral supply?

A

Temporal and occipital.

122
Q

Syncope

A

Decreased blood to the brain

123
Q

Cluster Headaches

A

M>W. Worse in morning. Associated with corners. Orbital or temporal. Usually unilateral.

124
Q

Tension headaches

A

Band like distribution. More common in females.

125
Q

Migraine Headaches

A

W>M. Lasts a long time. Prodrome. Better after menopause.

126
Q

Meningitis Triad and ocular

A

Stiff neck, Head ache, fever. papilledema.

127
Q

Glioblastoma Multiforme

A

The most common primary malignant brain tumor.

128
Q

Meningioma

A

Being brain tumor.

129
Q

Schwannoma

A

Can cause gradual onset of proptosis.

130
Q

Pituitary adenoma

A

Bitemporal hemianopsia as well as prolactin which causes milk production

131
Q

Multiple Sclerosis

A

F>M around age 40. Diagnosis requires two separate central nervous system lesions on two separate occasions. Most common sign is ON. Can also have pain on eye movement, APD, INO, and diplopia.

132
Q

Uthoff’s phenomena

A

Decreased VA with hot

133
Q

INO

A

Caused by damage to MLF. The eye with the nystagmus means there is contralateral damage to the MLF.

134
Q

Guillain-Barre Syndrome

A

Just like MS but in the periphery. Can have Addies tonic pupil and papilledema.

135
Q

Myasthenia Gravis

A

Associated with thymic tumor, RA, and lupus. Bodies binding to acetylcholine receptors. Ptosis and diplopia with symptoms worse at the end of the day.

136
Q

Alzheimer’s disease

A

Age, Amyloid, Aricept, acetylchinerasterase inhibitor.

137
Q

Parkinson Disease

A

Too little dopamine. TRAP. Tremor, rigidity, akinesia, postural instability.

138
Q

Why do we monitor pupils with head trauma

A

Epidural hematoma can cause brain to go through foramen magnum but will damage pupils first.

139
Q

Epidural hematoma

A

blood above the skull after closed head trauma

140
Q

Subdural hematoma

A

Blood between dura and arachnoid. Can have a blown tumor

141
Q

Horner’s Syndrome

A

Does not always have anhydrous. Pan cost affects preganglionic fibers

142
Q

Bells palsy

A

Diagnosed by exclusion.

143
Q

Type I diabets

A

Do not release insulin like they should. Due to beta cell destruction. Worry about diabetic ketoacidosis (start using other things for energy).

144
Q

Type II Diabets

A

Resistance to insulin. No DKA.

145
Q

Normal A1C

A

Less than 7

146
Q

Normal fasting plasma glucose

A

Less than 126

147
Q

Diabets INsupidus

A

Lack of ADH. ADH pulls water out so reduced ADH=more water loss. Think diabetes but will have normal glucose.

148
Q

What has the greater genetic association?

A

Type II.

149
Q

Hypothyroidism

A

Have increased TSH with decreased T4 and T3.

150
Q

Hashimotis Thyroiditis

A

ANA +. Autoimmune mediated condition that attacks the thyroid gland.

151
Q

Hyperthryoidism

A

Have decreased TSH with increased T4 and T3.

152
Q

Hyperparathyroidism

A

Increased calcium in the blood form the bones. Causes band keratopathy, renal stones, bone pain. etc.

153
Q

Hypoparathyroidism

A

Most commonly seen after a thyroidectomy. Will have decreased calcium in the bones. Can have cataracts and uveitis and difficulty with muscle contraction.

154
Q

Addison’s Disease

A

ANA+. Autoimmune atrophy of the adrenal glands. Decreased corticosteroid.

155
Q

Cushing’s Syndrome

A

Hypercortisolism. Effect of excess steroids on the body. Have a central obesity, a moon face, and a buffalo hump.

156
Q

Pheochromocytoma

A

Tumor secreting excessive amount of norepinephrine and epinephrine. Can be on adrenal glands or anywhere on the SNS chain. Causes increased BP, heart palpitations, pain, pallor, perish, papilledema.

157
Q

Acute Renal Failure

A

Cause with heart attack or shock.

158
Q

Chronic renal failure

A

Caused by HTN or DM

159
Q

Tests for the Renal failure. What would they look like with kidney failure

A

GFR-low. Creatine-1 is normal. Would be high. BUN=increased in disease.

160
Q

Nephrotic syndrome

A

Greater than 3.5 grams protein in the urine.

161
Q

Post streptococcal glomerulonephritis

A

Renal infections caused by streptococci. Occurs after street infections.

162
Q

Renal Cell Carcinoma

A

Flank pain, hamatouria, abdominal renal mass.

163
Q

Chalmydia

A

The most common bacterial STD. Chronic. Treat with Azithromycin and doxycycline.

164
Q

Gonorrhea

A

Hyper acute. Purulent discharge. Often with Chlamydia. Treat with cefrtiaxone (gonorrhea), doxycycline (in case also has chlamydia)

165
Q

Syphilis

A

STD caused by treponema palladium. Primary phase is a chancre. Secondary is eye lesions, kidney, CNS, etc. Third phase is CNS-Argyll Robertson pupil

166
Q

Syphilis Ocular Manifestations

A

Interstitial Keratitis, salt and pepper funds, uveitis.

167
Q

Lab tests to see if currently have Syphills

A

VDRL, RPR, EIA

168
Q

Lab tests to see if every had syphillis

A

FTA-ABS, TPPA, MHA-TP.

169
Q

Benign Prostatic Hypertrophy

A

Prostate grows and makes it difficult to urinate.

170
Q

Prolactin vs. oxytocin

A

Prolactin=milk production. Oxytocin=milk ejection.

171
Q

Most common cancers in women

A

breast, lungs, colon

172
Q

Most common cancers in men

A

prostate, lungs colon

173
Q

Most likely cancers to cause death in women

A

Lung, breast, colon

174
Q

Most likely cancers to cause death in men

A

Lung, prostate, colon.

175
Q

What causes neural tube defects during pregnancy

A

Folic acid deficiency

176
Q

Cerebral Palsy

A

Non progressive varied infections, toxins and congenital malformations in infants.

177
Q

Rubella

A

Mothers transfer this to the features. Microphthalmia, glaucoma, cataracts.

178
Q

What do you think with infant cataract

A

Rubella or galactosemia.

179
Q

Peptic Ulcer Disease

A

Helicobacter pylori, NSAIDS, etc.

180
Q

Barrett’s Esophagus

A

From squamous to columnar. Occurs from continuous acid damage to esophagus.

181
Q

IBD

A

Chron’s and ulcerative collinitis

182
Q

Chron’s Disease

A

Infectious. Fat old crone skipping down a cobblestone road. Rectal sparing. Skip lesions.

183
Q

Ulcerative colitis

A

More common uvieits. Colon–>rectum.

184
Q

Wilson’s disease

A

hepatolenticular degeneration. Collection of copper. Has a kayser fleshier ring and sunflower cataract.

185
Q

Which types of hepatitis have a vaccine

A

A and B.

186
Q

Which is the only DNA hepatitis virus

A

B

187
Q

Which are transmitted by fluid

A

B,C,D

188
Q

Which are transmitted fecal oral

A

A and E

189
Q

Hepatitis A

A

Vaccine. Fecal oral

190
Q

Hepatitis B

A

Vaccine. Fluid. DNA.

191
Q

Hepatitis C

A

No vaccine. Fluid.

192
Q

Hepatitis D

A

No vaccine. Carries with hepatitis B

193
Q

Hepatitis E

A

Fecal oral. no vaccine.

194
Q

Tests for hepatitis

A

AST and ALT.

195
Q

Cholecystitis

A

inflammation of the gall bladder. Most common in overweight females of child breaking age.

196
Q

Pancreatitis labs

A

amylase and lipase

197
Q

Pancreatitis cause

A

Alcohol and gall stones.

198
Q

Meniere’s disease

A

vertigo, hearing loss, tinnitus.

199
Q

Temporomandicular disorder (TMJ)

A

Headaches, facial pain, and jaw pain. It is a join issue.

200
Q

COPD

A

Emphysema and Chronic bronchitis.

201
Q

Emphysema

A

Pink puffers. More air spaces.

202
Q

Blue bloaters

A

Mucus. Stops oxygen exchange. Blue bloaters.

203
Q

Asthma affects

A

Acute reversible bronchoconstirction and chronic inflammation in the air ways

204
Q

Tuberculosis Ocular manifestations

A

Bilateral granulomatous uveitis, CME, keratitis, phlyctenules.

205
Q

Normal TB results

A

15 mm in everyone. 10 mm in healthcare. 5 mm in immunocompromised or living with TB

206
Q

Carcinoma

A

Malignant tumor of epithelial cells

207
Q

Sarcoma

A

Malignant tumor or CT

208
Q

Metaplasia

A

Mature form one mature cell to another mature cell

209
Q

Neoplasia

A

New growth

210
Q

Dysplasia

A

Disorganized growth.

211
Q

Wernicke-Korsakaoff

A

No vitamin B1 (thiamine). Toxic optic neuropathy. Korsakoff is not reversible.

212
Q

What causes schizophrenia

A

Increased levels of dopamine

NBEO Part 1 (17 decks)

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