Systemic Disease Flashcards

Question

Caseous necrosis

Answer 1

Most often seen in TB infections. The term casesou comes from “cheesy” because the central necrotic tissue appears white and cheesy

Answer 2

Death to adipose tissue. Small white lesions are formed

Answer 3

Well organized self destruction of cells; commonly referred to as programmed cell death. It occurs during embryogenesis, endometrium shedding during the menstrual cycle, or cell depletion in tumors. Apoptosis is critical in fine-tuning the developing retina. Over 70% of ganglion cells die via this process during development

Answer 4

Critical in fine-tuning the developing retina. Over 70% of ganglion cells die this way during development

Answer 5

Anaphylactic cytotoxic Immune complex Delayed

Answer 6

Type 1 IgE Histamine

Answer 7

An allergen activates a B lymphocytes and IgE Abs are produced and bind to the surface of mast cells and basophils. A second exposure to the allergen causes cross linking of IgE, allowing calcium to enter and resulting in degranulation of the cell

Answer 8

Peanuts, shellfish, drugs (PCNs), snake venom, and winged insects

Answer 9

5-30m and resolves in 30-60m. Late phase response (4-6 hours later) can occur, resulting in tissue damage

Answer 10

Primary mediator released from mast cells and basophils during a type I allergic reaction

Answer 11

``` Itching Redness Rhinitis Wheezing Hypotension (vasodilation) Tachycardia Nausea/vomiting HA, syncope, seizures Life threatening anaphylactic shock ```

Answer 12

Type I anaphylactic Requires EpiPen

Answer 13

IgG and IgM Ex. Rheumatic fever Destroy part of the body in attempt to destroy the toxic cells

Answer 14

Abs against antigens absorbed on various tissue components, such as cell surfaces. IgM and IgG Ab bind to antigen or enemy cell, which leads to its destruction - transfusion reaction with the prime example being Rh disease. Maternal IgG ab capable of crossing the placenta attack fetal erythrocyte antigens. - rheumatic fever is another example

Answer 15

Anaphylactic

Answer 16

Ag/Ab complexes | RA/SLE

Answer 17

Type III - mediated by Ag/Ab complexes either in the systemic circulation of those formed at the location of antigen deposition - these Ag/Ab complexes activate the complement response. This triggers the attack on neutrophils, which then release lysosomal enzymes - SLE - serum sickness is also an immune complex disorder in which Ab are formed due to the intake of large amounts of foreign proteins

Answer 18

T cells (memory) 2-3 days TB skin test example

Answer 19

Type IV Sensitized T lymphocytes encounter an antigen and release leukokinin, leading to macrophage activation -examples: TB skin test, contact dermatitis, and cornal transplant rejection, phlyctenules is 2-3 days

Answer 20

AI disease affects multiple systems including the skin, kidneys, joints, and heart. Female to male is 10:1 and often arises in the 2-3rd decades of life. Symptoms include a butterfly (malar rash), discoid lupus, photosensitivity, arthritis, renal disorders, neuro disorders, immunological disorders, and hemolytic anemia. SLE patients will produce ANA and 90% will have joint pain.

Answer 21

Dry eye, recurrent episcleritis, peripheral keratitis, and photophobia

Answer 22

Disc edema and papilledema

Answer 23

The most common systemic inflammatory disease classically causes systemic arthritis in multiple locations that leads to destruction of articular cartilage. Symptoms are often worse in the AM and can include pain in the hands, wrist, feet, and small joints. Women are affected mroe commonly than men, age 40-50. These patients will have a positive RF test. Appx 25% of patients with RA will have ocular manifestations

Answer 24

Keratoconjunctivitis sicca Scleromalacia perforans Choroiditis, retinal vasculitis Papilledema is less common but possible

Answer 25

Necrotizing without inflammation=scleromalacia perforans. No pain

Answer 26

Formerly known as JRA. Predilection for young females and can affect multiple joints, these patients will have a negative RF, but can have a positive ANA. Patients under the age of 6 with recent onset of the disease and positive ANA are at a higher risk of ocular manifestation They usually just have one joint affected

Answer 27

Female with asymptomatic, chronic, bilateral, non-granulomatous, anterior uveitis Often present with a low grade fever

Answer 28

Affects females between 40-60. Classified as primary and secondary

Answer 29

Aqueous deficient dry eye Dry mouth Evidence of reduced salivary secretion, positive focus score on a minor salivary gland biopsy, and the presence of autoAb

Answer 30

Primary Sjogrens AND an autoimmune CT disease (RA) Dry eye, dry mouth, arthritis

Answer 31

Dry eyes Dry mouth RA

Answer 32

Appx 5% of Sjogrens patients develop a malignant B cell lymphoma - primary Sjogrens more likely - mean development of it is 7 years

Answer 33

Refractory dry eye disease | Patients with oncurrent symptoms of dry eye, dry mouth, and/or arthritis

Answer 34

Idiopathic condition that classically affects middle aged AA females. Characterized by non-caseating granulomas and increased levels of serum angiotensin converting enzyme (ACE). Up to 40% of active cases of sarcoidosis can have normal ACE resutls. 90% of patients have lung invovlemt-a chest X ray is indicated if the disease is suspected. Patients are often asymptomatic, but can have complaints of breathing difficulties, dry cough, and unusual rashes. 25% of patients will have ocular manifestation

Answer 35

- chonric dacryadenitits - dry eye disease - 19% of patients will have chronic, bilateral, anterior granulomatous uveitis - CN VII palsy - vasculitis, vitritis - possible ON disease (unilateral disc edema, papilledema)

Answer 36

Chronic inflammatory condition of the spine with large joints that usually affects young males 10-30 years old. 90% of patients with be HLA-B27 positive

Answer 37

- bamboo spine - sacroiliitis causing lower back pain that IMPROVES with exercise and responds well to NSAIDs - Acute anterior, unilateral (or alternating) non-granulomatous uveitis - aortic regurgitation Order a sacroiliac X ray

Answer 38

Ankylosing spondylitis

Answer 39

AKA reiters syndrome - classic triad of urethritis, conjunctivitis, and/or anterior uveitis, and arthritis - urinary symptoms will usually appear first. Low grade fevers, conjunctivis, and arthritis will then develop over the next several weeks - affects young males more than females and is typically HLA-B27 positive Can’t see, cant pee, cant climb a tree

Answer 40

RA Lupus UCRAP

Answer 41

UCRAP JIA Syphilis

Answer 42

TB Sarcoidosis Syphilis

Answer 43

Sarcoidosis | Lupus

Answer 44

Symmetrical, peripheral, small joint pain with accompanying psoriatic lesions found on the knees, elbows, and scalp. 7% of patients with psoriatic arthritis may develop anterior uveitis. These patients will have a positive HLA-B27 test. Treatment includes UV-B light exposure and methotrexate

Answer 45

UCRAP - ulcerative colitis - Crohns disease - reactive arthritis - ankylosing spondylitis - psoriatic arthritis

Answer 46

Systemic vasculitis that affects the medium to large vessels including temporal artery. These patients are typically older than 55 years old and present with complaints of jaw claudication, jabbing neck pain, anorexia, scalp tenderness, temporal HA, and fever. A dialted and nodular temporal artery may also be present. 50% of patients with GCA may also develop polymayalgia rheumatica, which characterized by fatigue and morning stiffness in the hips and shoulders

Answer 47

STAT ESR STAT CRP STAT CBC with differential and platelets Temporal artery biopsy (gold standard) -can have false negatives due to skip lesions

Answer 48

>age/2 for men | >age +10/2 for women

Answer 49

> 2.45 mg/DL

Answer 50

>400,000 cells/uL

Answer 51

90% will have an ESR>50 mm/hr. An elevated ESR and CRP is 97% specific for GCA

Answer 52

AION due to occlusion from the SPCA | Ischemic optic neuropathy may not be present for the first 24-48 hours after the onset of blindness

Answer 53

Begin therapy with prednisone immediately. Low dose aspirin (81mg) should also be considered to reduce the chance of visual loss or stroke

Answer 54

Systemic vasculitis involving the URT, lungs, kidneys. 60% have ocular invovlvement

Answer 55

Granulomatous sclerouveitis, retroorbital mass lesion with proptosis, conjunctivis, episcerlitis, scleritis, and ciliary vessel vasculitis Peripheral sclerokeratitis may also occur and lead to corneal ulceration

Answer 56

Multisystem disorder causing inflammation and vascular changes of the skin and internal organs. Ocular effects: -dry eye and shrinkage of the areas of the skin, including the conjunctiva

Answer 57

- caused by the formation of monosodium urate crystals in joints in response to increased Uris acid levels - occurs most frequently in the MTP joint of the big toe, which is called podagra - more common in men. Presents with sudden onset of red, hot joints

Answer 58

Allopurinol: reduces incidence of gout flare ups by inhibiting xanthine oxidase

Answer 59

``` Ankylosing spondylitis (90%) IBD (85-90%) Reactive arthritis (60%) ``` Since they are all HLA-B27, ordering this test fails to differentiate between them if you suspect uveitits is due to an HLA-B27 disease

Answer 60

May develop due to inherited defects in the development of the immune system or may be secondary to disease that affect the normal immune system. An ex alpine of inherited immunodeficny is immunoglobulin A deficiency

Answer 61

- IgA deficiency is the most common of the primary immunodeficiency diseases - IgA is the prominent immunoglobulin in external secretions, including the tear film; involved in mucosal defenses - patient will show a significant decrease in IgA in both serum and secretions - may be asymptomatic, or may suffer from recurrent respiratory infections, keratinization of the cornea, weight loss, and diarrhea

Answer 62

Caused by HIV, and RNA virus that uses reverse transcriptase to make viral DNA within effected cells. AIDs is marked by severe immunosuppression and resulting opportunistic infections. The smog common way to acquire HIV is through sexual contact. The most common symptoms include fever, lymphadenopathy, sore throat, rash, myalgia/arthralgia, and HA. Prolonged duration of these vague symptoms with the presence of mucocutaneous ulcers is suggestive of the disease

Answer 63

Reverse transcriptase

Answer 64

ELISA test is used as the screening test for HIV. A western blot is then used to confirm the ELISA test. Collectively these tests have a 99.9% specificity rate. Although these tests are still recommended for testing saliva and dried spot blood samples, the CDC recommends new guidelines for testing blood samples for HIV that involves Ag/Ab immunoassay to detect HIV Ab and HIV Ag within the blood

Answer 65

CMV retinitis | -CD4 <200 at risk, <50 at high risk

Answer 66

Gancyclovir | Foscarnet

Answer 67

Pneumocystic pneumonia

Answer 68

Toxoplasmosis - papilledema - CN palsies

Answer 69

Mycobacterium TB

Answer 70

CMV and herpes simplex | Kaposi’s sarcoma is a malignancy caused by HHV-8

Answer 71

Herpes virus 8 HIV Malignant Red/purple lesions on the lids or conj

Answer 72

Crusty, plaque like tan lesions that have a classic elevated “Stuck on” appearance. These are found most commonly in males over 30. Seborrheic keratosis is usually not treated; for smaller lesions, shave excision or curretage is recommended; larger lesions rewuire complete surgical excision

Answer 73

Isolated, dome shaped nodules usually seen on the face and mimics SSC. It has a spontaneous remission over a period of several months

Answer 74

Common slow growing epithelial tumors (viral warts) that may be caused by HPV - characterized by finger like or cauliflower like appearance (skin tag); usually elevated and multilobulated with a central vascular core - treatment for papillomas can range from no intervention, to excision or snipping, chemical cauterization, surgical excision, or cryotherapy

Answer 75

Yellow, elevated, plaque like lesions that are typically bialteral, symmetric, and located within the medial portion of the eyelids - associated with older age, female gender, and high cholesterol, although most patients with xanthelasma have normal cholesterol - treatment includes full thickness surgical excision, carbon dioxide laser treatment, and chemical cauterization; recurrences after treatment are common

Answer 76

- Chronic infection (direct contact) skin condition caused by DNA pox virus. The condition is common in kids and young adults in communities with poor hygiene. - classic presentation is a single or multiple dome shaped waxy umbilicated nodules on the eyelid or eyelid margin. Patients are typically asymptomatic, but nodules can spontaneously open, resulting in a follicular conjunctivitis - if multiple are presently, HIV should be considered - treatment is incision, curretage, shaving excision, cauteriation, or cryotherapy

Answer 77

CHAT - chlamydia - herpes - adenovirus - toxic (molluscum)

Answer 78

Syndrome of undertermined etiology that affects sebaceous glands of the face and eyelids. It is characterized by vascular abnormalities and papulopustular lesion on the cheeks and forehead. Classic signs include superficial telangiectasia, rhinophyma (late stage), and facial flushing. The latter is associated with triggers such as alcohol, spicy foods, caffeine, and increased sun exposure

Answer 79

Due to inflammation of the meibomian and zeiss glands - inspissated meibomian glands - blepharitis - hordeola - chalazia - DED - phlyctenules - staph marginal keratitis - SPK - corneal neo

Answer 80

Delayed type 4 HS response of inflammation to any substance that comes in contact with the skin. Classically results from cosmetics, makeup, shampoo, hairspray, fingernail polish, perfume, jewelry, poison ivy, CL solution. Medications such as aminoglycosides, trifluridine, cyclo/myds, glaucoma meds, and preservatives

Answer 81

Acute periorbital swelling | Conjunctival chemosis, redness, itching, and tearing

Answer 82

Gram + infection with classic honey colored crusted lesion | Very common in kids

Answer 83

HSV I and II. Both can cause ocular infections but type I is significantly more commonly (98%) of cases. Type I HSV usually occurs above the belt and is transmitted by close persons along contact. Type II HSV usually causes infections below the belt and is STD

Answer 84

Primary infection as a child

Answer 85

Virus hides in the trigeminal ganglion and can reoccur at any time

Answer 86

Physical and emotional stress, including sun exposure, hormonal changes, fever, trauma, and immunosupression

Answer 87

Blepharitis with focal vesicular lesion on the eyelids and periorbital skin Acute unilateral follicular conjunctivitis with PAL

Answer 88

- dendritic keratitis - marginal or GA ulcers - neurotrophic Keratopathy - interstitial keratitis - disciform endotheliitis - acute anterior unilateral non-granulomatous uveitits with trabeculitis - acute retinal necrosis

Answer 89

25% The risk increases to 40-45% after a 2nd episode

Answer 90

Initially presents at chicken pox. After the inital infection, the virus lays dormant in the nerve roots. HZV is the reactivation of VZV in the dermatome that was assocaited with the latent virus. 66% of patients are over the age of 50. Consider a medical evaluation in patients younger than 40 to determine if they are immunocompromised

Answer 91

- blepharitis with vesicles on the eyelid margin - acute follicular conjunctivitis on the affected side - episcleritis - pseudodendritic keratitis - acute anterior unilateral non-granulomatous uveitis with trabeculitis - acute retinal necrosis - optic neuritis - EOM palsies - proptosis

Answer 92

Vesicular rash on the tip of the nose. Indicates involvement of V1, which increases the risk of ocular involvement Nasociliary

Answer 93

Inflammtory disease causing multissytem complications. Recurrent oral aphthous ulcers and two of the following features are needed for diagnosis: genital ulcers, eye lesions, or skin lesions. Most commonly seen in Asian and middle eastern young adults. Ocular findings are - acute recurrent hypopyon, - iritis - posterior and anterior uveitis - retinal vasculitis - vitritis - secondary cataracts - glaucoma - neovascular lesions

Answer 94

Behçet’s disease

Answer 95

- most common cancer of young women - depth of invasion is the number one prognostic factor - risk: age, skin color, fam Hx, an repeated irritation and sun exposure - characteristics of suspicious skin lesions for malignant melanoma include ABCDE; asymmetry, border, color, diameter, and enlarging

Answer 96

Malignant melanoma

Answer 97

Depth of invasion

Answer 98

Superficial spreading melanoma | -it has rapid growth and is classically found on non-exposed skin

Answer 99

- malignancy of the basal cell layer of the epidermis. Often appears as a shiny, firm, pearly nodule with superficial telangiectasia. Progression can lead to central ulceration (rodent ulcer) - treatment is 5-FU or biopsy with surgical removal

Answer 100

Malignancy of the stratum spinosum layer of the epidermis. Non-healing ulcer that often appears an an erythematous plaque. It can arise from a pre cancerous lesion called actinic keratosis

Answer 101

Rare congenital vascular disorder characterized by a facial capillary malformation (overabundance) known as a port wine stain. These patietns may have seizures, focal neurological deficits, or mental retardation. Ocular findings - unilateral glaucoma due to increased EVP (obstruct outflow) - vascular malformations of the conjunctiva, episclera, choroid, and retina - iris heterochromia

Answer 102

Multisystem genetic disease that causes benign tumors to grow in the brain and other organs. About 90% of these patietns with TSC have one of the characteristic skin lesions which include hypopigmented macules (ash leaf spots), shagreen patches, angiofibromas, and a distinctive brown fibrous plaque on the forehead. Ocular findings - astrocytic hamartoma s or phakomas which are grey-ish or yellowish-white lesion in the retina. Astrocytic hamartoma calcify and can be seen on a CT scan - choroioretinal depigmentation - coloboma - angiofibromas of the eyelid - papilledmea ( from brain tumors)

Answer 103

Resutls from one abnormal dominant gene. If an affected heterozygous man (Aa) and an affected heterozygous woman (Aa) have kids, the rolling phenotypes are possible - 75% of offspring will have the condition - the remaining 25% will NOT have the condition

Answer 104

Result from two abnormal recessive genes. If a man (aa) and a carrier heterozygous woman (Aa) have kids, the following phenotypes are possible in their offspring - 50% of their kids will have the condition - the remaining 50% of the kids will NOT

Answer 105

Defective recessive genes on the X chromosome. A man is affected i he has an abnormal recessive gene on his X chromosome. A woman is affected i both X chromosomes have the abnormal recessive gene. If an affected nan (XdY) marries a carrier women (XDXd), the following phonetypes are possible - half of their sons will have the condition - half od their daughters will have the condition

Answer 106

``` TDOME Turners Down OI Marfans Ehlers-Danlos ```

Answer 107

- most common chromosomal disorder - caused by an extra 21st chromosome - mental retardation, flat facial profile, prominent epicanthal folds, congenital cataracts, glaucoma, strab, simian crease in hands, congenital heart disease, and early onset of Alzheimer’s, keratoconnus

Answer 108

XXY - girly men - most common cause of male primary hypogonadism - an extra X chromosome (XXY) results in testicular atrophy, long extremities, gynecomastia, female hair distribution, and hypogonadism

Answer 109

X0 - absent X chromosome - manly girls - the only sex chromosome aneuploidy with established ocular findings; common ones include keratoconus, strab, amblyopia, reduced accommodation, and convergence insuffiency (turners=eye turn) - affects 1 in 3000 females and is characterized by short stature, dysgenesis, webbing of the neck, and coarctation of the aorta - most common cause of primary amenorrhea

Answer 110

Turners | -strab and Amblyopia

Answer 111

Abnormal structural genes. They affect many generations and occur equally in males and females. They often present after puberty; one must consider fam Hx in dx. Examples of AD disroders include - VHL - NF1 - marfans - Huntington’s Chorea - FAP

Answer 112

AD Benign and malignant tumors Retinal agiomas that can hemorrhage if left untreated, leading to retina detachment, glaucoma, and loss of vision

Answer 113

``` AD Tumor forming nerve cells 1:3000 50% have no fam Hx Triad -cafe au lait spots, neurofibromas, and lisch nodules on the iris Optic nerve gliomas (can squeeze ON) Congenital glaucoma ```

Answer 114

AD CT disease Tall ,long extremeitis, subluxating joints, and long fingers and toes Causes cardio effects such as aortic incompetence, dissecting aortic aneurysms, and floppy mitral valve Ocular effects -subluxation of the lens (ST), RD, kone

Answer 115

AD Chromosome 4 Gradual onset and progression of chorea and dementia 30-50 years of age, with a 15-20 year survival rate Abnormal eye movements will occur and include a delay in pursuits, voluntary saccades, and refixation (“Hunters pursuit”)

Answer 116

AD Chromosome 5 Hundreds of polyps on the colon post puberty 100% of these patients get colon cancer Gardners syndrome -variant of FAP characterized by multi-focal CHRPE (4 or more) -refer for colonoscopy

Answer 117

Sickle cell Tay-Sachs PKU

Answer 118

Seen in 1 generation, as 25% of offspring from 2 carrier parents are affects. The disease are often more severe than the dominant disorders and will often present in childhood

Answer 119

- patients have painful crises (ischemia) due to sickle CHRPEs RBCs causing blockages within arteriole vessels; ultimately leading to organ failure I - the most common form of sickle cell anemia is caused by a single base pair mutation in the beta globin gener where VALINE is substituted with GLUTAMIC ACID - 1 in 400 AA are afflicted. 8% of AA population are carriers - can occlude retinal arterioles, leading to ischemia and subsequent retinal neo (proliferative). The blood vessels are often called sea fan retinopathy because of their shape.

Answer 120

Decreased hemoglobin Increased bilirubin Increased reticulocytes Blood smear shows sickling

Answer 121

DRVOS - DM - ROP - vein Occlusions - OIS - sickle cell

Answer 122

- AR - mutations in the enzyme phenylalanine hydroxylase; this is used in the AA conversion of phenylalanine’ to tyrosine. If not treated, it will result in mental retardation. All newborns are tested for PKU. If the patient responds as a positive carrier, then treatment with a diet low in phenylalanine is initiated. Phenylalanine is found in milk products, aspartame, meat, and chicken. - occurs in 1/10,000 people

Answer 123

AR Eastern European Jews progressive destruction of the nervous system. Ocular findings - cherry red spot -atrophy of the ON Build up of ganliosides in the ganglion cells (none in the fovea)

Answer 124

CRAO | Taysaches disease

Answer 125

Fabrys | Duchenne muscular dystrophy

Answer 126

X linked Abnormal lipid depositions in blood vessel walls throughout the body. Deficiency of the enzyme alpha galactosidase A allows lipids to build up to harmful levels in the eyes, kidneys, ANS, and cardiovascular system. It affects adolescent boys and is characterized by excruciating pains in the extremeities and abdomen. Areas of telangiectasia on the umbilicus, growing, elbows, and knees are diagnostic Ocular findings -light colored, whorl K

Answer 127

- AR - deletion within the gene coding for dystrophin - 1/3000 male infants afflictedm symtoms by age 5 - condition is characterized by muscle weakness that begins in the pelvic girls and progresses superiority - walking and getting tired

Answer 128

OME of “TDOME”

Answer 129

Brittle bone disease -host of genetic defects giving rise to abnormal collagen synthesis. Characterized by multiple fractures occurring with minimal trauma. Ocular findings are blue sclera, keratoconnus, and megalocornea

Answer 130

Transmitted only through mother’s (maternal inheritance). All offspring of affected females may show the disease. An important mitochondrial disorders with ocualr results manifestations is LHON

Answer 131

rare recessive disorder that resutls in bilateral, asymmetric primary optic neuropathy. 85% of affected patients are males. The average age is late teens or early 20s. The condition may spontaneously improve in 35% of cases ocular findings: -early: optic disc hyperemia, and telangiectatic vessles -late: progressive optic disc pallor with resulting loss of central vision (BCVA 20/200 to CF) My Mother Leber Lost My Eyes

Answer 132

Iron deficiency | More than 50% of anemia’s fit into this category

Answer 133

Iron deficiency Thalassemia All have decreased Hgb

Answer 134

Aplastic CKD Sickle cell All have decreased Hgb

Answer 135

Vit B12 deficiency Folic acid deficiency Alcoholism

Answer 136

- most common anemia - adutls=GI blood loss - may also occur with malabsorption or increased need with decreases intake, such as in childhood or pregnancy - iron defiance impairs cellular function and can cause brittle hair, nail spooning, and pica (eating weird things) - treat with oral iron

Answer 137

Pancytopenia characterized by severer anemia, neutropenia, and thrombocytopenia -destroyed bone marrow

Answer 138

``` Infectious agents (viruses) Radiation (chemo) Drugs -chloramphenicol -acetazolamide -trimethoprim -methotrexate -pyrimethamine ```

Answer 139

Chronically damage kidneys synthesize inadequate amounts of erythropoietin (EPO), a hormone that normally stimulates RBC production in the bone marrow

Answer 140

Can cause proliferative retinopathy due to the crescent or sickle shaped cells occluding the retinal vessels

Answer 141

Due to inadequate intake or malabsorption of vitamin B12; malabsorption is often caused by pernicious anemia

Answer 142

Characterized by autoAB directed against parietal cells of the stomach, causing decreased production of intrinsic factors

Answer 143

Intrinsic factors helps absorb B12. Decreased=decreased B12

Answer 144

- dietary deficiency is the leading cause and use especially common in alcoholics - may also be drug induced (chemo, methotrexate), or from malabsorption syndromes - folic acid deficiency in pregnancy increases the risk of neural tube defects (spina bifida)

Answer 145

Neoplastic disorder of plasma cells Proliferation of a malignant clone of plasma cells in the bone marrow. This often results in extensive skeletal bone destruction, unexplained anemia, hypercalcemia, and acute renal failure

Answer 146

Leukemia and lymphoma are malignant proliferative diseases involving leukocytes. Early cell growth and maturation are inhibited, causing “malignant clones” of these cells to accumulate. Death results because of substantial loss of normal cells, and also due to poor organ function owing to the increase in malignant cells

Answer 147

Proliferation of malignant lymphoid cells in solid tissues such as lymph nodes, spleen, and the GI tract. Initally the tumor is localized, but it may subsequently spread. There are two types of lymphomas 1. Hodgkin 2. Non-Hodgkins

Answer 148

40% of lymphoma - tow peak age groups: 15-30 and then >50 - commonly presents with enlarged lymph nodes, fever, night sweats, and itching - characterized by Reed-Sternberg cells (owl eye nucleus) - prognosis is good is dx early enough - 50% of cases are associated with EBV

Answer 149

- 60% of lymphomas - enlarged lymph nodes and GI tumors (with abdominal pain) - heterogenous group of malignancies with variable prognoses depending on the type - bone marrow biopsy is performed to determine T or B cell ropes

Answer 150

Hodgkin lymphomas

Answer 151

Non-Hodgkin

Answer 152

This disease can affect all ages, but usually occurs in younger patients. The predominate cell type is Blast cells: >30% of marrow cells are blasts (immature cells). There are two major types of acute leukemia 1. Acute myeloblastic leukemia (AML) 2. Acute lymphocytic leukemia (ALL)

Answer 153

- infants and middle aged or older - characterized by normal WBC count with excessive myeloblasts - Auer Rods may be seen within leukemic cells in the blood

Answer 154

- peak age 2-10 - normal WBC count with excessive lymphoblastic - with treament, 75% of kids remain disease free > 5 years ALL kids live long

Answer 155

Roth spot | Characteristic of leukemia and endocarditis

Answer 156

Usually affects older adults. The predominant cells are mature cells of the bone marrow. Patients are often asymptomatic and may have anemia. There are two types 1. Chronic myelocytic leukemia (CML) 2. Chronic lymphocytic Leukemia (CLL)

Answer 157

- age of onset 25-60 years old. Poor prognosis, only 3 year survival rate - characterized by WBC count of 50,000 to 300,000 with increased granulocytes in all states of maturation - 90% have the Philadelphia chromosome “Cut my life”

Answer 158

- onset >50 - male/female 2:1 - WBC count of 20,000-200,000 with a predominance of mature small lymphocytes - 5-10 year survival rate “Could live long”

Answer 159

A decrease in the number of WBC | Due to bone marrow injury, bone marrow inactivation, drugs, or chemical suppression

Answer 160

Increase in the absolute number of WBCs | Can occur after surgery, or result from infections, illness, stress, or pregnancy

Answer 161

Increase in he absolute number of neutrophils | Typically reuslts from stress, exercise, pain, fear, or pathological infections

Answer 162

Elevated platelet count | Causes include inflammation, kidney disease, or spleen removal

Answer 163

Decrease in the number of RBCs and WBCs and platelets

Answer 164

Decrease in platelets | Causes include infection, live failure, and bone marrow disorders

Answer 165

Increased intestinal fluid that can be non-inflammtory (yielding protein poor transudate) and inflammatory (yielding protein rich exudate) in etiology. Edema can be recognized on exam by increased swelling of the length due to subcutaneous edema, or shortness of breath due to pulmonary edema. Treatment includes diuretics and compression stockings

Answer 166

1. Increased organ pressure: seen in CHF, liver cirrhosis, and venous obstruction or compression 2. Reduced plasma osmotic pressure: protein-losing glomerulo-pathologies and malnutrition 3. Lymphatic obstruction-post surgical or neoplastic 4. Sodium retention: excessive salt intake with renal insuffiency

Answer 167

Caused by macroaneurysms with dilation of capillary walls. Pericytes, endothelial foot-plates that surround the vessels, are damaged, allowing leakage of blood and fluid with resulting edema

Answer 168

Acute and chronic inflammation | Angiogenesis (after injury)

Answer 169

Leakage of blood due to a vessel injury that may be uncontained or enclosed within a tissue. Hemorrhage within a tissue are referred to as hematomas. All are grouped according to size

Answer 170

1-2mm hemorrhages on the skin

Answer 171

Greater than 3mm hemorrhagehs associated with trauma, local vascular inflammation, and low platelet count

Answer 172

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

Answer 173

These are large accumulations of blood within body cavities

Answer 174

Resutls from an inappropriate activation of blood clotting in an uninjured vein, or an occlusion of a vessel after a relatively minor injury. These can form anywhere in the circulatory system, may be arterial or venous, and may be non-occlusive. The most common location of thrombus formation is the deep venous system of the legs

Answer 175

A major theory delineating the cause of a venous thromboembolism (VTE). It proposes that VTE occurs as a result of 1. Alterations in blood flow STASIS 2. Vascular endothelial INJURY 3. Alterations in the constituents of the blood through an inherited or acquired HYPERCOAGULABLE STATE

Answer 176

Factor V laden Antothrombin 3 deficiency Protein C and S deficiency Prothrombin gene mutation

Answer 177

BCP Preg Smoking Malignancy

Answer 178

Commonly occurs in either the superficial or deep legs of the veins. Those in the deep leg veins (typically above the knee) are mote likely to embolism to the heart or lungs Leg to lungs=pulmonary embolism

Answer 179

These are commonly formed from atherosclerosis or a MI. They usually travel (embolism) to the brain, kidneys, and spleen

Answer 180

Systemic HTN and DM are associated with an increased risk for the development of central abd branch retinal vein occlusions, conditions that most commonly result from thrombus formation

Answer 181

Inherited state of hypercoagulability

Answer 182

A thrombus is a clot that remains where it was formed. An embolism is a clot that has dislodged from where it was formed

Answer 183

Refers to any intravascular solid, liquid, or gas mass carried by the blood to a distant site from its point of origin: 99% arise from thrombi

Answer 184

FATBAT - fat - air - thrombus - bacterial - amniotic - tumor

Answer 185

Long bone fractures and lipsuction

Answer 186

Result from gas bubbles after a chest wall injury or from an obstetric procedure

Answer 187

Most from DVTs go to the pulmonary system

Answer 188

Cause tissue destruction and pain

Answer 189

Can lead to DIC, especially postpartum

Answer 190

Decreased blood perfusion resulting from a reduction of either cardiac output or circulating blood volume.

Answer 191

Cardiogenic Hypovolemic Septic Anaphylactic

Answer 192

Etiologies include MI, ventricular rupture, arrhythmias, and pulmonary embolism. The heart fails to pump due to cardiac cell damage, extrinsic pressure, or outflow obstruction

Answer 193

Hemorrhage and fluid loss from vomiting, diarrhea, burns, or trauma

Answer 194

Overwhelming microbial infections or toxic shock gram positive septicemia. The main mechanism includes peripheral vasodilation, leading to pooling of blood

Answer 195

Histamine cause cause the following during anaphylactic shock - hypotension and tachycardia - sneezing, itching, hoarseness, and stridor - bronchospasm - nausea, vomiting, abdominal pain, and diarrhea - HA, syncope, and seizure

Answer 196

Localized abnormal dilation of blood vessels. A true aneurysm is enclosed by complete arterial wall components. The most common aneurysms occur in the abdominal aorta, iliac, and other large arteries

Answer 197

Pseudoaneurysm | -form with parts of the arterial wall missing

Answer 198

May result from rupture, pressure upon adjacent structures, occlusion of the proximal vessels, or embolism from mural thrombosis

Answer 199

Most likely a result of an aneurysm

Answer 200

Typically found in men over 50

Answer 201

Increases with the maximal diameter of the aneurysm bulge

Answer 202

Slowly progressing disease of the arteries marked by elevated fibrosis and fatty intimal plaques. Theses A.R. formed by fat deposits, smooth muscle cell proliferation, and synthesis of an extracellular matrix in the intima. Elastic arteries are involved, principally in the abdominal aorta, coronary arteries, popliteal arteries, descending thoracic artery, and ICAs. Patients are asympatomic for decade and can eventually experience shortness of breath and chest pain

Answer 203

These may lead to atherosclerosis. Monocytes and leukocytes circulating in the bloodstream adhere to the injured vessel endothelium. They then transform into macrophages, which attract lipids and become foamy cells. This causes lipoproteins to migrate into the vessel wall at the enter of the endothelial injury. The accumulation of macrophages and the adhesion of platelets to the injured areas cause a mass ICA plaque or clot to form. This can lead to reduced blood glow to the heart, ultimately causing MI

Answer 204

Childhood | Usually appears in middle aged

Answer 205

Older than 50, family Hx, HTN, smoking, hypercholestermia, and diabetes

Answer 206

Increased total cholesterol, decreased HDL, increased LDL, and increased CRP

Answer 207

Low fat diet, exercise, BP monitoring, and smoking cessation

Answer 208

Aggressive lipid lowering therapy (statins), diet and exercise. Stenting of arteries also serves as a secondary treatment for patients who demonstrate symptoms of CAD

Answer 209

Inhibit HMG-CoA reductase, the rate limiting step in cholesterol synthesis

Answer 210

Arcus senilis | It is a sign that the patient has or has had high cholesterol. It does not effect vision

Answer 211

Characterized by atherosclerosis within the coronary arteries supplying blood to the heart. Patients can be asymptomatic or have chest pain (angina) and dyspnea (difficulty breathing). If not treated by diet, exercise, or stenting of the artery, the patient may suffer a MI. If a patient experiences MI, 325mg of aspirin should be given immediately

Answer 212

``` MONA Morphine Oxygen Nitroglycerin 325 mg aspirin ```

Answer 213

325 mg aspirin

Answer 214

No pulse or respiratory efforts Chest compressions are the most important element. Interruptions in CPR Results in declines in coronary and cerebral perfusion pressure 100 compressions/min Compress chest at least 5cm with each down stroke Allow chest to recoil completely between 30 compressions to 2 ventilations Continue compressions with an advanced airway

Answer 215

Atherosclerosis of the carotid arteries. 25% of strokes are due to build up of plaque causing stenosis of the carotid arteries. These patients present with sensory loss, dizziness, amaurosis fugax, or complete loss of vision in the ipsilateral eye. They may have a high pitched bruit over the artery

Answer 216

The most common primary diagnosis in America. More than 50% of people 60-69 years old, and appx 75% of those 70 years of age and older are affected. The rise in systolic pressure continues throughout life, in contrast to diastolic presure which increases until age 50, and then tends to level off. HTN leads to increased risks of heart attack, heart failure, stroke, and kidney disease

Answer 217

120-139/80-89

Answer 218

BP of 140/90 or higher

Answer 219

120-129/<80=elevated BP >130-139/>80-89=HTN stage 1 >140/>90= HTN stage 2 >180/>120= HTN urgency

Answer 220

AHA recommends health lifestyle changes for patietns with elevated BP

Answer 221

Healthy life style changed and 2 BP lowering meds in different classes

Answer 222

Age, family Hx, race, obesity, diabetes, smoking, and excessive Na intake. AA have the highest probability of HTN, with Asians maintaining the lowest risk

Answer 223

Anti hypertensive meds, exercise, weight loss, low Na diet

Answer 224

When taking BP reading, the patient should be seated quietly for at least 5 minutes in a chair, with feet on the floor, and arm supported at heart level. Smoking, caffeine, and excessive should be avoided for 30m prior to BP measurement. Appx the size of the cuff should be used to ensure accuracy. At least two measurements should be made and the average recorded. SBP is the point at which the first of two Kotokoff sounds are heard; and the disappearance of the Korotkoff sound is used to determine the DBP

Answer 225

Narrowing of the retinal arterioles. In acute or advanced HTN, the retinal vasculature may be injured enough to cause occlusion of leakage. These changes may be seen as RNFL infarcts ( soft exudates or CWS), extravascular edema (hard exudates), intraretinal hemorrhages, and retinal arterial macroaneurysms. HTN choroidopathy is often found in younger patients with acute HTN. These findings can include Elschnig spots and Siegrist Streaks. Severe HTN can cause optic neuropathy and may present with flame hemorrhages, venous congestion, and macular exudates. Papilledema is found in stage 4 HTN retinopathy (malignant HTN)

Answer 226

1. Inability to fill with blood (diastolic heart failure) or | 2. Inability to pump efficient amounts of blood through the body (systolic heart failure)

Answer 227

- When the left side of the heart fails, blood backs up into the lungs, causing them to fill with fluid (pulmonary edema) - the most common cause of left sided CHF is Ischemic cardiomyopathy resulting from coronary artery disease (MI) - the primary symptom is shortness ofbreak

Answer 228

- Inability to pump blood into the lungs, causing blood to back up in the abdomen (ascites) and legs (lower extremity edema) - symptoms: edema, chest discomfort, and shortness of breath - the smog common cause of right sided CHF is left sided CHF. Other causes include pulmonary HTN, COPD, and right sided MI

Answer 229

CHD, cigarette smoking, HTN, obesity, DM, and valvular heart disease

Answer 230

Elevated BNP Cardiomegaly on chest X ray Changes on echocardiogram

Answer 231

BBlockers, ACE inhibitors, diuretics, and correction of any underlying causes

Answer 232

Usually ages 5-15; results from untreated pharyngeal infections with group A strep beta hemolytic streptococci (strep pyogenes). This disease can alter the shape of the heart valves. In 75-80% of cases, the mitral valve is attacked, often requiring valve replacement later in life. Common signs and symptoms include fever, elevated ESR, red-hot joints, and endocarditis

Answer 233

Bacteria may infect the inner lignin of the heart, especially the valves. - risk factors: prosthetic heart valves, IV drug use, and age - present with fever and may have symptoms from arterial emboli to heart failure, depending on the severity of valvular damage - the echocaridogram (US of heart) will show “vegetations” on heart valves (mixture of bacteria nad thrombus) or abscesses within the heart tissue

Answer 234

Symptoms a patient experiences when the heart has an atypical rhythm. Most are benign, irregular heartbeats, with the most common being PVCs. These can increased with dehydration, stress, decreased sleep, exercise, or pregnancy

Answer 235

TEMPORARY neurological deficits (always less than 24 hours, usually less than 15m) due to inadequate perfusion; as perfusion is restored, patients are left with no symptoms. The most common cause is an embolism.

Answer 236

1. Carotid artery TIA with contralateral hand/arm weakness or sensory loss and face and leg symptoms. Patients can also have ipsilateral visual symptoms (amaurosis fugax) or aphasia 2. Vertebrobasilar TIA can result in diplopia, ataxia, vertigo, dysarthria, and either unilateral or bilateral visual loss

Answer 237

Embolism found on the retinal vasculature. These patients often have TIAs and should be referred immediately

Answer 238

Characterized by sudden onset of neurological deficits reflecting the arteries involved and the brain structures they supply

Answer 239

``` HTN DM HLD Tobacco use Fam HX ```

Answer 240

Auscultation of the subclavian and carotid arteries for a bruit

Answer 241

Used to detmermine the size and the location of strokes

Answer 242

Depend on the vasculature affected and whether the macula is invovled

Answer 243

Stroke at the occipital lobe that has affected either the MCA or the PCA but not both

Answer 244

Almost never in a stroke | -most commonly occurs from a tumor that has compressed both blood supplies to the macualr cortex

Answer 245

Accounting for 80% of all strokes, they resutls from occlusion of an artery leading to the brain; embolism of an atherosclerotic plaque is the most common cause. Treatment involves modification of stroke risk factors

Answer 246

Occurs as a result of accumulation of blood within the brain due to bleeding from brain tissue, truama, and/or vascular malformations. The smog common type of hemorrhagic stroke is a subarachnoid hemorrhage

Answer 247

- sudden severe HA, pupil involving CN III palsy, and nuchal rigidity - 30% have changes in consciousness - aside from head trauma, the smog common cause of a subarachnoid hemorrhage is rupture of an intracranial aneurysm. Tend to occur at arterial bifurcations and are usually asymptomatic until they rupture, causing a hemorrhage. - those that cause CN III palsies tend to occur in the circle of Willis, between the junction of the posteiror communicaitng and ICA

Answer 248

Junction of ICA and posterior communicating arteries | CN III pupil involving

Answer 249

Meeting loop for the basilar artery, the ICA, and the anterior and posterior communicating arteries, which are small arteries bridging the basilar and ICA. The CoW forms an arteriolar circle beneath the Crain and allows for a system of redundancy for the flow of the blood to intracranial tissue

Answer 250

Extends upward and forward from the ICA

Answer 251

Frontal lobe

Answer 252

Last and largest branch of the ICA

Answer 253

Frontal lobe, lateral surface of the temporal and parietal lobe, and the occipital lobe.

Answer 254

Stems from the basilar artery

Answer 255

Temporal and occipital lobe

Answer 256

Logical thought, personality, and voluntary movement

Answer 257

Primary motor and sensory areas of the face, throat, hand, and arm, and areas for speech and vision

Answer 258

Contralateral hemiplegia, hemianopsia, color blindness, verbal dyslexia, and opposite VF defects

Answer 259

These single events may be caused by fevers, HA, stress, illness, or neurological deficits - epilepsy is a condition with recurrent seizures. Status epilepticus is a prolonged seizure lasting longer than 5m-medical emergency - treatment includes antiepitleptics (phenytoin, phenobarbital, carbamazepine, valproic acid). Absence seizures are treated with Klonopin

Answer 260

Abrupt, transient loss of consciousness lasting a few seconds to a few minutes due to decreased blood flow to the brain. Prompt recovery to full consciousness follows the syncopal episode. Causes include cardiac abnormalities, vascular problems, or neurological deficits. Specific causes can be hard to diagnose and are usually benign

Answer 261

- men 30-50 years old - orbital or temporal; usually unilateral - smokers and drinkers - HA wake patients up at night or early in the AM - generally 1-2 attacks per day, each lasting less than an hour - often present with red eyes and/or nasal stuffiness and can cause transient or permanent ipsilateral horners syndrome

Answer 262

Cluster HA

Answer 263

- all ages, females - worse with stress, and may precede a migraine - band like distribution and varying intensities

Answer 264

- women, certain triggers - ages 20-30, rarely after age 50 - usually present with or without an aura, nausea, or photosensitivity - migraines typically last anywhere from 4-72 hours and are aggravated by physical activity

Answer 265

- also cause HA and can occur in all ages and sexes - interrupt sleep - associated with nausea, vomiting, and visual changes, and steadily increase in severity with time. Brain tumor causing HA tend to be worse in the AM - a child with a brain tumor is likely to have 1 or mroe other physical symptoms (other than HA) and 1 or more other neurological deficits. Less than 1% of patients with brain tumors have HA as their only symptom

Answer 266

Inflammation of the meninges caused by various infectious agents such as viruses, bacteria, fungi, or chemical agents. Viral meningitis is common and extremely difficult to treat - 3 out of 100,000 people - often preceded by an URTI - fever, HA, and neck stiffness. May also have nausea, vomiting, sweats, weakness, myalgias, papilledema, and photophobia.

Answer 267

Glioblastoma multiforme

Answer 268

- the most common primary malignant brain tumor - cerebral hemispheres and can cross the corpus callosum - grave prognosis, less than 1 year life expectancy

Answer 269

Is from metastasis | -lung and breast are the most common primary tumor sites

Answer 270

- arachnoid cells - most common benign tumor of the brain although it can be malignant - usually in middle aged women

Answer 271

Meningioma

Answer 272

- tumor of Schwann cells. Can cause gradual onset of painless, progressive proptosis - often localized to the CN VIII (acoustic Schwannoma) - rare, young to middle aged adutls

Answer 273

- can be functional or non functional. Prolactin secreting tumor is the most common functional pituitary adenoma - bitemporal hemianopsia or junctional scotoma VF loss

Answer 274

AI disease marked by recurrent inflamamtion of the CNS that ultimately reuslts in demyelination. Typically affects females more than males, with onset 20-40yo. most common in caucasians living in northern latitudes and has genetic components

Answer 275

Two separate CNS lesions (separated in space) on two or more occasions (spearted in time). These lesion must include involvement of the white matter 2 lesions 2 MRIs White matter

Answer 276

Numbness, tremors, lack of coordination, vertigo, bowel and bladder dysfunction, and fatigue. Symptoms may occur abruptly and typically last weeks to months

Answer 277

Optic neuritis

Answer 278

``` Optic neuritis Pain on eye movement APD INO Diplopia ```

Answer 279

Classically present with a sudden, non-progressive onset of monocular vision loss. Can also report decreased acuity after increase in body temp (Uhtoff’s phenomenon) (exercise or hot shower)

Answer 280

Lesion of the MLF | Loss of ipsilateral adduction and contralteral nystagmus

Answer 281

inflammation and demyelination of peripheral nerves and motor fibers of the ventral roots. Classically presents with symmetric ascending muscle weakness that begins in the distal lower extremities. Ocular findings include - ADies tonic pupil, diplopia, facial diplopia - elevated protein in the CSF can cause papilledema

Answer 282

AI disease with autoAb directed against ACH receptros in the NMJ. This condition may affect all ages, but is more common among younger women and older men. It is assocaited with a thymic tumor (thymoma), RA, and lupus. Systemic symtoms include respiratory weakness and weakness of the jaw muscles. Ocular findings include - ptosis and diplopia - SYMPTOMS WORSE AT THE END OF THE DAY

Answer 283

Unknown reasons is develops Develop deposits (plaques) of a protein called beta amyloid, and disorganized masses of protein fibers within the brain cells known as neurofibrillary tangles. -this is the most common form of dementia affecting up to 10% of Americans over the age of 65 -more prevalent in women, people with head injuries, Down syndrome, prolonged exposure to chemicals, lower educational levels, and epilepsy -no cure, but donepizil helps slow progression (ACHase inhibitor)

Answer 284

- damaged areas of brain tissue secondary to reduced cerebral blood flow, due to vessels having blood clots or fatty deposits (cerebral microinfarcts) - more prevalent among people who are at risk for strokes, especially those with longstanding high BP and DM. It can occur together with Alzheimer’s disease

Answer 285

- deficiency of dopamine in the striatum due to degeneration of the neurons in the substantia Nigra - classic symptoms include tremor at rest, rigidity, Akinesia, and postural instability (TRAP). Slowness of moments if often the first sign of Parkinson’s disease, along with cogwheel rigidity and pill rolling tremor. - treatment: levodopa, bromocriptine, carbidopa, and sinemet

Answer 286

TRAP - tremor at rest - rigidity - akinesia - postural instability

Answer 287

After a closed head trauma like a fall or blow to the head, blood collects between the skull and the dura. The middle meningeal artery is often affected due to herniation of the temporal region of the skull. In general, the injury has three phases: an initial loss of consciousness, a period of lucidity, and another loss of consiouscness

Answer 288

Venous blood collects netween the dura and the arachnoid space. Patients may or may not experience symptoms depending in the severity of the causative trauma. In the elderly, this si commonly seen from a minor head injury, epically if on Coumadin. Symptoms vary, though altered mental state and HA are common

Answer 289

Changes in pupillary size (a blow pupil may signal impending uncal herniation) Nausea or vomiting Loss of consciousness

Answer 290

Lesion in the sympathetic pathway from the hypothalamus to the eye. Classified as preganglionic central, preganglionic, or postganglionic

Answer 291

Between the hypothalamus and the cilispinal center of Budge (C8-T2) -CVA, demyelinating disease, cluster HA, tumor, neck truama)

Answer 292

Between the cilispinal center of budge and the SCG | -pancoast tumor, thyroid mass, neck trauma, history of thyroid or neck surgery

Answer 293

Between the SGC and the iris dilator muscle (carotid artery dissesction, ICA aneurysm, cavernous sinus fistula, cavernous sinus syndrome, head trauma, cluster HA)

Answer 294

Preganglionic central

Answer 295

Preganglionic

Answer 296

Postganglionic

Answer 297

Ptosis, miosis, anhydrisis | Patients with carotid artery diessction can also have neck and shoulder pain

Answer 298

Most prominent in preganglionic central or pregnagnlion lesions. A postgagnlionic lesion will only result in anhydrosis of the ipsilateral forehead as most sweat fibers diverge away from the sympathetic fibers near the SCG

Answer 299

Less than 5% of cases and maybe due to birth truama causing a brachial plexus injury or thoracic or cervical neuroblastomas (life threatening tumor). Infants will present with heterochromia

Answer 300

- idiopathic condition Dx by excision after factoring out other causes if CN VII palsy - sudden deficit on the lower motor neuron in CN VII, causing facial muscle paralysis on the entire side of the face with ectropion and exposure keratopathy - treatment: patching or closing of the eyelid to decreased exposure K and corneal dryness. Short course of oral steroids or antivirals has been shown to increase the probability and speed of recovery, although 71% will have complete recovery in one year without treatment

Answer 301

- 10-20% of diabetic patients - Younger - Polyuria, polydipsia, and polyphagia (and weight loss) - Most are immune mediated and have positive HLA association - caused by a complete lack of insulin production due to beta cell destruction which can be triggered by environmental insult, virus, or genetics. Treatment includes insulin injections, and careful glucose and diet monitoring - complications: diabetic ketoacidosis, microangiopathy (retinopathy, nephropahy, neuropathy), cataracts and glaucoma

Answer 302

Insulin resistance or abnornal beta cell secretion of insulin. Obesity is associated with 80% of cases of type II diabetes, and most patients are over the age of 40. Most patients re asymptaomtic at the time of dx. Treatment includes diet, exercise, oral glycemic agents, and occasionally insulin

Answer 303

FGL (should be les than 126mg/dL) | HgA1c (should be less than 7%)

Answer 304

Always needed in type I, not always in type II

Answer 305

Type I has HLA DR 3 and 4 association

Answer 306

Stronger for type II

Answer 307

Severe B cell depletion in type I | Mild B cell depletion in type II

Answer 308

Much more common in type I

Answer 309

Severe in type I | Mild in type II

Answer 310

Type I within 5 years of diagnosis Type II upon diagnosis In both cases, yearly exams are indicated yields retinal findings indicate more frequent care. A significant increase in blood glucose is most likely to induce a myopic shift in the refractive error

Answer 311

Extreme thirst and polyuria resulting from lack of ADh or deficiency in renal repsosne to ADH. Treatment options consists of increased fluid intake, intranasal desmopressin (ADH analog), indomethacin, or HCTZ for the nephrogenic causes

Answer 312

Abnormality that hinders the appropriate production of thyroid hormones -cold intolerance, hypoactivity, weight gain, fatigue, lethargy, decreased appetite, constipation, weakness, myxedema, dry cool skin, coarse hair

Answer 313

AI mediated condition that attacks the thyroid gland. This is the most common cause of hypothyroidism in iodine sufficiency areas of the world. Common ages are 45-65. Females mroe liekly

Answer 314

85% caused by Graves’ disease, an AI condition caused by TSH autoAb; this reuslts in constant thyroid stimulation and excessive production of T3 and T4 - middle aged pateitns, female - 1% will have MG - common complaints: heart palpitations, weight loss, heat intolerance, and/or hair loss - testing reveals elevated T4 and decreased TSH

Answer 315

Proptosis and upper eyelid retraction | SLK can occur

Answer 316

Primary Hyperparathyroidism caused by hypercalcemia. This disease is caused by over secretion of parathyroid hormone. Symptoms include bone pain, pathologic fractures, renal stones, constipation, mental changes, and fatigue. May also have band keratopathy. Treatment is parathyporiedcomy

Answer 317

- most commonly seen following a parathyroidectomy. Symptoms include muscles cramps, tetany, irritability, capopedal spasms, convulsions, and mental retardation. Decreased serum calcium more prominent evidence - ocular findings: cataracts and uveitits, blurry vision

Answer 318

-adrenocortical deficiency that is a result of AI atrophy of the adrenal glands. Symptoms include weakness, fatigue, weight loss, nausea and vomiting, diarrhea, abdominal pain, muscle and joint pains, and amenorrhea. Treatment includes replacement therapy with a combo of glucocorticoids and mineralocorticoids

Answer 319

Hypercortisolism -effects of excessive corticosteroids on the body. Most are a result of chronic, prescribed corticosteroid medications. Usually present with central obesity, mood face, buffalo hump. May also have osteoporosis, HTN, poor wound healing, hyperglycemia, and elevated serum cortisol levels

Answer 320

Tumor secreting excessive amounts of NE and Epi. Located on one or both adrenal glands or anywhere along the sympathetic nervous chain - any age, usually 40-60 years old - elevated BP, papilledema, severe HA, perspiration, heart palpitations, and anxiety with a sense of impending doom - treatment is removing the tumor - should be suspected in patients with HTN accompanied by HA (pain), palpitations, pallor, and perspiration

Answer 321

Abrupt decline in renal functions with a decrease in GFR. Blood tests measuring kidney function include createnine and BUN -decreased GFR and increased createnine and BUN

Answer 322

Kidneys fail to make urine and excrete nitrogenous wastes. The main causes are DM and HTN

Answer 323

Inflammation of the glomerulus, two types 1. Nephritic syndrome 2. Nephrotic syndrome

Answer 324

Inflamamtion of the glomerulus | -associated with HTN, edema, and active urine sediment with hematuria, blood casts, and proteinuria

Answer 325

Glomerular inflammation | -greater than 3.5 grams of protein in the urine. Accompanied by hypoalbumineria, HLD, and edema

Answer 326

- Renal infection caused by groupie A beta hemolytic streptococci (pyogenes) - 7-21 days after respiratory or skin infection (5-15yo) - abrupt onset of hematurira, edema, HTN, and RBC casts in the urine

Answer 327

UTI is urethra to the bladder | Pyelonephritis is bladder to the kidneys

Answer 328

Bacterial infection of the kidneys. | Dysuria, frequency, urgency fever, chills, flank pain, nausea/vomiting

Answer 329

Usually asymptomatic, but if symptoms are present, they include the classic triad of flank pain, hematuria, and abdominal renal mass. The first diagnostic test is an abdominal US

Answer 330

AIC - chronic follicular conjunctivitis and papillae inferior - some mucopurulent DicK

Answer 331

Trachoma - follicular and papillary conj - artls line - Herberts pits

Answer 332

Azithromycin (1g single dose, makes people sick) | Doxy

Answer 333

STD that is caused by direct contact with neisseria gonorrhea. 85% of infected female patients are asymptomatic. The incubation period od 3-5 days following infection

Answer 334

Range from none, to vaginal discharge, pelvic pain, urethritis, and dysuria or urinary frequency. Males are most commonly asymptomatic or will hav burning upon urination

Answer 335

Severe, hyperacute, purulent discharge

Answer 336

Single dose of ceftriaxone 250mg IM plus doxycycline 100mg p.o. BID x 7 days

Answer 337

Type I and II. Dx is confirmed by multinucleated giant cells on a Wright-Giemsa stain. Type I is a mucosal lesion on the lips. Type II is associated with STD and is found on the mucosa of the male and female sex organs. Both types can be found in the eye - prodromal symtoms that include tingling, irritation, itching - treatment=acyclovir or famcyclovir orally

Answer 338

STD caused by spirochete treponema pallidum

Answer 339

Chancre (painless ulcer on gentitals)

Answer 340

Lesions involve the eye,kidney, mucous membranes, skin, CNS or liver

Answer 341

Nervous system and ophthalmic lesions including argyll Robertson’s pupil

Answer 342

1. Interstitial keratitis, retinitis, and retinal vasculitis 2. Salt and pepper fundus and flame shaped hemorrhages 3. Uveitis-less than 1% of uveitis cases are from this 4. CN and optic neuropathies 5. Acute multifocal chorioretinitis and vitritis (panuveitis) 5. Argyll Robertson pupil

Answer 343

Because of its variable presentation. Regardless of uveitis presentation, syphilis should always be considered in the list of diff

Answer 344

``` RPR VDRL FTA-ABS TPPA MHA-TP ```

Answer 345

Positive RPR and VDRL

Answer 346

Detmeins whether patient has active or latent disease. Will be positive for life if the patient has ever had syphilis

Answer 347

+ FTA-ABS | - PRP/VDRL

Answer 348

+ FTA-ABS | + PRP/VDRL

Answer 349

EIA and MFI -specific to treponema antigens and therefore result in less false positives. Most tests screen for syphillis IgG Ab

Answer 350

Does not have syphilis

Answer 351

PRP is performed, start back at the top - if the PRP is postive, the patient likely has an untreated active syphilis infection in the blood steam. No other testing is performed - if PRP is negative, FTA-ABs or TPPA is performed. If they are negative, the positive IgG test result was likely a false positive and the patients does not have syphilis. If the FTA-ABS or TPPA are postive, the patients has a pssible active and early syphilis infection (<6 weeks) or the patient was previously treated for syphilis and no longer has an active infection

Answer 352

Males over age of 50 - increased urinary frequency, urgency, nocturia, a weak stream, hesitancy, and dribbling - treatment includes conservative measures with A1 blockers (terazosin) which relaxes the prostate muscle. Surgical intervention is often necessary

Answer 353

2nd most common cause of cancer deaths in males - risk: over age 50, positive fam Hx, AA males - rectal exam reveals firm, rock-hard, non-tender localized area - elevated PSA test may indicate prostate cancer

Answer 354

Amenorrhea, nausea and vomiting, breast tenderness, and weight gain

Answer 355

Beta HCG levels

Answer 356

0-12 weeks 12-26 weeks 27-40 weeks

Answer 357

Triple screen to detect Down syndrome, STD testing, US, diabetic screening, Rhogram injection for Rh negative women (28 weeks), and group B strep test

Answer 358

Less than 20 weeks

Answer 359

After 20 weeks

Answer 360

Pregnancy within the Fallopian tube or anywhere outside of the uterus

Answer 361

Triad of BP greater than 140, protein in the urine, and swelling in the lower legs Can result in still birth and maternal death

Answer 362

Preeclampsia + seizures | Can result in still birth and maternal death

Answer 363

Oxytocin from the post pituitary allows milk ejection. Prolactin from the anteiror pituitary allows for milk production. Benefits include child mother bonding, and a transfer of immunoglobulins

Answer 364

Common but treatable cancer in women that begins as cervical dysplasia and progresses over time to malignancy - risk: early sex, multiple sex partners, HPC - diagnostic tests: Pap Smear

Answer 365

Starts in the tubes (ducts) that move milk from the breast to the nipple

Answer 366

Starts in parts of the breast, called lobules that produce milk

Answer 367

In many breast cancers, estrogen causes the breast cancer tumor to grow. This is called estoppel receptor positive cancer or ER-positive cancer. Risk factors include age, fam Hx of breast cancer, or defects in the BRCA1 and BRCA2 genes

Answer 368

Prostate Lung colon

Answer 369

Lung Prostate Colon

Answer 370

Spina bifida | Anencephaly

Answer 371

Reduced folic acid supplementation

Answer 372

100% fatal

Answer 373

Shunting of deoxy blood from the right atrium or ventricle to the left atrium of ventricle. Results in blue (cyanotic) babies because the oxygen deficit is immediately problematic. Example if tetralogy or Fallot. Worse or the two

Answer 374

Oxygenated blood from the left heart to the right heart -blue (cyanotic) babies after exertion (playing sports) Less problematic -VSD, ASD, PDA

Answer 375

Number one cause of congenital malformations

Answer 376

Generic term that includes non-progressive varied infections, toxins, and congenital malformations in infants. Signs and symptoms include mental slowness or retardation, impaired function of voluntary muscles, seizures, and speech and sensory defects

Answer 377

Mothers transfer this to the fetus. Side effects are microphthalmia, glaucoma, cataracts. Screened early in pregnancy

Answer 378

Small malformed globe

Answer 379

Causes mucous membrane lesions on the fetus. If untreated, the baby can develop interstitial keratitis and CNS disorders. This is screened for early in pregnancy

Answer 380

Can cause stillbirth | Most will develop brain or eye problems, including retinochoroiditis

Answer 381

Should raise suspicion for rubella or galactosemia

Answer 382

Movement of gastric juice from the stomach into the esophagus due to gastroesophageal junction incompetence; this results in heartburn. Risk factors include alcohol use; hiatal hernias, obesity, pregnancy, scleroderma, and smoking

Answer 383

Affects 20% of adults and is due to helicobacter pylori, chronic NSAID use, food intolerance and smoking. Treatment includes H2 blockers, PPIs, and combination therapy (H2 blocker and PPI plus 2 abx) for H pylori. Diagnostic studies include an upper endoscopy and barium swallow studies.

Answer 384

H blocker PPI 2 Abx

Answer 385

Duodenal ulcer | Gastric ucler

Answer 386

Symptoms include burning or hunger like pain, primarily in the epigastric area. Pain may occur or worsen when the stomach is empty and is worse in the middle of the night when acid secretion is greatest

Answer 387

Main symptoms is pain soon after eating

Answer 388

- normal esophageal lining is replaced by metaplastic columnar cells; occurs as a result of squamous changing to columnar cells - diagnosed via upper ednoscopay with biopsy to confirm cell change - can lead to esophageal adenocarcinoma, which requires surgical resection of the esophagus - treatment includes long-term PPIs

Answer 389

Crohn’s disease | Ulcerative colitis

Answer 390

Infectious

Answer 391

Any portion of the GI tract. Usually affects the terminal ileum, small intestine and colon. Rectal sparing. Has SKIP LESIONS

Answer 392

Colon Continuous lesions Rectal involvement

Answer 393

Transmural inflammation | Cobblestone mucosa, creeping fat, bowel wall thickening, ulcers and fistula

Answer 394

Mucosal inflammation | Friable pseudopolyps, crypt abscesses, colorectal carcinoma

Answer 395

Strictures, fistula, perinatal disease, malabsorption, and nutritional depletion

Answer 396

Severe stenosis, toxic megacolon, colorectal carcinoma

Answer 397

Non-granulomatous uveitis | 1-10%

Answer 398

Non-granulomatous uveitis | 1-5%

Answer 399

Think of a fat old crone skipping down a cobblestone road

Answer 400

Their leading cancer in both males and females in terms of incidence and cancer mortality - low fiber, high fat diets, exposure to toxins. - age, fam Hx of colon or breast cancer, and FAP - screening is colonoscopy

Answer 401

- disease of the liver - failure of copper to enter circulation in the form of ceruloplasmin. This leads to copper accumulation that is most concentrated in the liver, brain, and cornea (Kayser-Fleischer rings). Some manifestations include a sunflower cataract, cirrhosis of the liver, basal ganglia degeneration, and dementia

Answer 402

Penicillamine - chelating agent that used to treat Wilson’s - ocular side effects include ocular myasthenia, ocular pemphigoid, and optic neuritis

Answer 403

This causes swollen, necrotic liver due to alcohol consumption. Mallory bodies (hyaline), fatty changes, and sclerosis around the central vein are also present, with an increase in AST and ALT liver enzymes

Answer 404

Enzymes contained within liver cells that are released into the blood in increased concentrations in cases of hepatitis, regardless of etiology

Answer 405

Vaccine available | Spread via fecal oral route, limited infection

Answer 406

Vaccine available (0, 1, 6mos), spread via blood, IV drugs, and sex. Active infection typically has brief course

Answer 407

No vaccine | Spreads like hep B with the same affects. Chronic hepatitis develops in appx 80% of patietns with acute hep C infection

Answer 408

Carried only with Hep B as a superinfection. This increases morbidity and mortality D=Dwarf; only in presence of B

Answer 409

No vaccine | Fecal oral

Answer 410

Vowels to the bowels | A and E

Answer 411

Presence of fibrosis with creation of excessive extracellular matrix. Normal blood flow through the liver is hindered and nutrient and metabolite enhance are thus reduces. The liver initally enlarges, firm nodules are formed, and then the liver shrinks. The most frequent causes are alcohol and viral hepatitis; however, drugs, toxins, CHF, biliary obstruction, and AI complexes may also play a role. Complications include portal HTN, GI hemorrhage, and liver failure; the latter frequently results in death

Answer 412

Bilirubin pathway is obstructed in the liver or bilirubin is hemolyxed in the blood and cannot be excreted in the urine due to some other pathology. The build up of urobilinogen and bilirubin in the systemic blood stream causes a yellowing of the skin and conjunctiva. This is commonly seen in cirrhosis, hemolytic disorders, or obstructive gallbladder disorders

Answer 413

Occurs both acutely and chronically as a result of inflammation of the gallbladder lining secondary to obstructive cholesterol stones, sludge, or infection. Most common in overweight females of childbearing age. Patients have pain in the RUQ and a postive Murphys sign. Treatment involves surgery to remove the gallbladder

Answer 414

Occurs secondary to alcohol abuse or gallstones in 70-80% of cases, other causes include trauma, drugs, HLD, infection, or tumor. Patients present with pain around the umbilicus with possible radiation to the back. Lab studies show an increase in serum amylase and lipase

Answer 415

90% of cases are due to chronic alcohol abuse; most of these patients have a history of recurrent episodes of acute pancreatitis, periodic or contentious peri-umbilical pain radiates through to the back. Weight loss, steatorrhea, and DM are also common

Answer 416

Can be caused by loss of conduction, sensory loss and/or neural deficits. Loss of condition is the most common corm of hearing loss and is usually a result of cerumen impaction or trauma. Sensory hearing loss is due to deterioration of the cochlea, while neural hearing loss is due to damage of CN8. Two clinical tests, the Weber test and Rinne test, are used to determine which is the culprit

Answer 417

Loss of conduction

Answer 418

Characterized by pain in the ear. Caused by bacterial infection from strep pneumoniae and H influenzae. Treatment is amoxicillin or other gram + agents. Very common in infants and chidlren

Answer 419

Disease of the vestibular ear system causing dizziness and nystagmus. True vertigo is always associated with nystagmus. A condition that can cause vertigo is Meniere’s disease, which is assocaited with episodic and often severe vertigo, hearing loss, and tinnitus

Answer 420

Inflammation of the paranasal sinuses due to viral, bacterial, or fungal infections. Patients may have anterior and or posterior mucopurulent drainage, nasal obstruction, facial pain, pressure and/or fullness, and decreased sense of smell

Answer 421

Characterized by symptoms of runny nose, sneezing, conjunctival hyperemia, and watery eyes. Treatment includes histamine receptor blockers, nasal sprays, and eye drops such as pataday for ophthalmic symptoms

Answer 422

Signs and symptoms include enlarged cervical nodes, sore throat, and fever. Occurs as a result of viral or bacterial agents. Group A strep infections need to be treated with ABx such as penicillin or other gram + agents

Answer 423

Commonly located in the parotid or submandibular gland-swelling and pain of the gland will be present. Often caused by S aureus and treated with Abx. IV nafcilin is often used

Answer 424

80% of these will involve the parotid gland and only 50-60% will be benign. These present as an asymptomatic mass in the gland and can extend deep into the facial nerve area. MRI and CT scans are used to diagnose the tumor. Treatment involves removal of the tumor

Answer 425

Commonly a result of acute and chronic inflammation secondary to arthritis, dislocation, developmental anomalies, and other factors. Patietns will often complain of HA, facial pain, and jaw pain

Answer 426

Breathing disorder during sleep. Inadequate muscle tone of the tongue or airway dilator muscles resutls in obstruction of the upper airway which causes the patient to frequently stop breathing during sleep. OSA affected appx 3-7% of men and 2-5% of woman in the US. Appx 41% of people who are defined as obese based on BMI have OSA.

Answer 427

Disruptive snoring Daytime sleepiness Obesity (BMI 30 or greater) Large neck circumference (>42cm in men)

Answer 428

HTN, fatal and non fatal cardiovascular events, stroke, epilepsy, and DM. Ocular manifestations include floppy eyelid syndrome, NTG, and NAION

Answer 429

Obstruction of air flow, causing air to be trapped in the lungs. The leading cause of COPD is smoking.

Answer 430

Emphysema | Chronic bronchitis

Answer 431

Pink puffers Enlargement of air spaces and decrease in recoiling because of destruction of the alveolar walls. Shortness of breath, decreased breath sounds, and tachycardia

Answer 432

Blue bloaters Productive cough for 3 consecutive months in 2 or more years due to hyeortrophy of mucous secreting glands in the bronchioles. Common symptoms include cyanosis of the fingers and toes and wheezing/crackling of the lungs

Answer 433

1. Acute reversible bronchocosntriction: triggered by infection, allergens, stress. Symptoms include coughing, wheezing, dyspnea, and tachycardia. Treated with bronchodilators 2. Chronic inflammation of the airways. Treated with inhaled or oral steroids

Answer 434

Restrictive lung disease secondary to occupational inhalation of dust. The disease i given different names depending on the particular inhaled such as: Coal workers pneumoconiosis, Asbestosis, silicosis, and berylliosis - restrictive lung disease can cause shortness of breath, and decreased lung volumes and lung compliance - chest X-ray will show diffuse infiltrates with a ground glass appearance

Answer 435

Caused by airborne droplets of mycobacterium TB. The primary symptoms of TB include fever, cough, night sweats. All patients thought to have TB need to have a chest X ray

Answer 436

Night sweats

Answer 437

Positive test results but negative chest X ray

Answer 438

Positive test reuslts and positive chest X ray

Answer 439

RIPE - rifampin - isoniazid - pyrazinamide - ethambutol

Answer 440

- conjunctival granulomas - phlyctenuels - episcleritis - scleritis - keratitis - BILATERAL CHRONIC GRANULOMATOUS UVEITIS - CME ( determines acuity in most patietns) - unilateral optic disc edema or papilledema

Answer 441

TB and sarcoidosis

Answer 442

15mm or more=postive test in healthy person with normal immune system 10mm or more=postive test in healthcare working 5mm or more-positive in patients who are immunocompromised

Answer 443

Aid in the diagnosis of latent and active TB - positive result (TB infection likely): Nil<8, TB response >0.35IU/mL and >25% of Nil, and any mitogen resposne - negative results (TB not likely): Nil < 8, TB response <0.25 IU/mL or <25% Nil, and mitogen respsone >0.5 - indeterminate (uncertain likelihood of TB): Nil <8, TB response <0.25 or <25% of Nil, and mitogen respsone <0.5, OR Nil >8,any TB response, and any mitogen respsone Routine testing with and IGRA + TB skin test is generally not recommended except for special cirmustances. Note that QFT-GIT does NOT differentiated between active and latent TB

Answer 444

Infection of the lungs usually caused by bacteria or viruses. The most common cause is streptococcus pneuamoniae. Symptoms include productive cough, shortness of breath and fever. A less common form of pneumonia is “walking pneumonia” caused by agents such as mycoplasma pneumoniae

Answer 445

Acute respiratory illness caused by influnza A or B viruses. Symptoms include fever, cough, rhinitis, HA, and myalgias

Answer 446

Main cause of cancer deaths in both men and women. Adenocarcinoma of the lungs it he smot common lung cancer. Cigarette smoking is the leading caused, although secondary hand smoke can also caused lung cancer.

Answer 447

Pancost tumor | Horners syndrome can ensue

Answer 448

Cancers reuslt from a host of environmental and genetic factors that damage normal cells. The damaged cells are mutated and give rise to new populations of mutated cells. Typically cellular defense mechanisms such as apoptosis and suppressor genes are often inactivated in premalignant cells and are therefore not useful in halting abnormal cell growth. Further more, growth promoting oncogenes facilitate and encourage cancer mutation and growth

Answer 449

Benign Borderline Malignant

Answer 450

Well differentiated or poor differentiated

Answer 451

Epithelial (adenocarincoma, SCC), lymphoproliferative (leukemia, lymphoma), or mesenchyamal (Sarcoma)

Answer 452

Well circumscribed or infiltrative

Answer 453

Usually slow growing and well circumscribed - adenomas: benign epithelial Tumors arising in glandular patterns - cystadenomas: adenomas producing large cystic masses seen in the fat and ovaries - papilloaoms: epithelial tumors that form microscopic or macroscopic finger like projections - polyps: tumor that extends from the mucosa into the lumen of a hollow organ

Answer 454

Often aggressive with invasion of adjacent structures and have metastatic potential

Answer 455

Cancer that shifts from its origins to another body site

Answer 456

Arises from epithelial cells (SCC)

Answer 457

Arise from mesechymasl (connective) tissues | Bones, vessels, heart

Answer 458

CT cancer that causes bone destruction; it is the most common primary orbital malignancy

Answer 459

Abnormal growth of epithelial cells caused by a disruption in cell maturation

Answer 460

Concerned the earliest form of a pre cancerous lesion that is recognizable in a biopsy by a pathologist

Answer 461

Carcinoma in situ (CIN). Transformation of cancer is high, but treatment often still effective

Answer 462

Final step in the process of dysplasia. Growth penetrates the epithelial BM to invade the tissue

Answer 463

Refers to change from one mature cell type to another as an adaptive response from chronic irritation or a pathogen or carincogen. Treatment aims to reverse cell damage. If left alone, dysplasia and center can result. SCC, the 2nd most common form of skin cancer, results from metaplasia Barrett’s esophagus is also metaplasia

Answer 464

Abnormal, disorganized “new growth” in a tissue OT organ that leads to a formation of a growth or mass (neoplasm). Can be benign or malignant. Melanocytic nevi are among the most common benign neoplasms

Answer 465

Protein encoding gene that has the potential to cause cancer. Activated oncogenes allows mutated cells, which normally die secondary to apoptosis, to survive and proliferate into a cancer. Multiple oncogenes, such as the “ras” oncogene have been found to play a role in specific cancers

Answer 466

Either have a repressive effect on the regulation of cell cycle and/or promote apoptosis. They prevent DNA damage and regulate cellular activities. Loss of tumor suppressor genes, such as the BRCA gene in breast cancer, can lead to cancer

Answer 467

Distorted view of their body image and an overwhelming fear of being fat. They have decreased body weight (less than 85% of ideal body weight), and absence of at least three menstrual cycles. It affects females more than males

Answer 468

Episodes of binge eating two times a week for at least 3 months. They compensate for the binge eating by vomitting, over exercising, or by utilizing laxatives

Answer 469

Protein malnutrion | Very swollen belly

Answer 470

Decreased protein and decreased calories | Wasting appearance

Answer 471

Addiction to alcohol. Withdrawals cause tremo, tachycardia, HTN, nausea, seizures, delirium tremens, and hallucinations. More prone to gallstones, alcoholic hepatitis, and cirrhosis of the liver

Answer 472

Due to long term alcohol abuse, causing micronodular cirrhosis. Presenting symptoms include jaundice, hypoalbuminemia, coagulation factor deficiencies, and portal HTN

Answer 473

Assoacited with vit B1 (thiamine) deficiency

Answer 474

Toxic optic neuropathy that leads to bitemporal optic nerve pallor Macular fibers

Answer 475

Physical disease and drug abuse must be elimated Lab work and brain scans Diagnosed used DSM-IV

Answer 476

30% of patients have this -thought to be caused by inappropriate NT involvement, metabolic abnormalities, or psychological factors. There is also a strong genetic predispostion

Answer 477

More in women Early adulthood Treatment: benzodiazepines, antidepressants, and counseling

Answer 478

Increased dopamine in the Mesolithic region Massive disruption inf behavior, mood, and thinking for at least 6 months Treatment=antipsychotic meds

Answer 479

Delusions Thought disorders Inappropriate affect Increase in motor functions

Answer 480

Lack of speech and thought Loss of emotional response No effect Social isolation

Answer 481

Severe depression alternating with periods of mania - treatment is the same as severe depression - manic episodes are elevated mood, decreased need for sleep, flighty thought processes, decreased reonsing skills, increase activity, and aggressive behavior. Mania is often followed by periods of severe depression

Answer 482

White middle aged and elderly men most common Hospitalization Treatment of depression

Answer 483

Triad of compulsive drug use which includes a psychological dependence, physiological dependence, and drug tolerance

Systemic Disease Flashcards

(533 cards)