Thread Rating:
  • 0 Vote(s) - 0 Average
  • 1
  • 2
  • 3
  • 4
  • 5
@_@_@...HY Facts For CK...@_@_@ - savi
#31
1.Pain, loss of function (without clear-cut sensory or motor deficits), and a localized autonomic impairment are called reflex sympathetic dystrophy (also known as shoulder-hand syndrome or causalgia). Precipitating events in this unusual syndrome include myocardial infarction, shoulder trauma, and limb paralysis. In addition to the neuropathic-type pain, autonomic dysfunction, possibly resulting from neuroadrenergic and cholinergic hypersensitivity, produces localized sweating, changes in blood flow, and abnormal hair and nail growth as well as edema or atrophy of the affected limb. Treatment is difficult; however, anticonvulsants such as phenytoin and carbamazepine may be effective, as they are in other conditions in which neuropathic pain is a major problem.

2. Typical radiographic findings in osteoarthritis include joint space narrowing, subchondral bone sclerosis, subchondral cysts, and osteophytes (bony spurs). In the small interphalangeal joints of the fingers , central erosions may be seen within the joint space.

3. Addiction has identifiable risk factors, including genetic factors. The most well-established risk factors for addiction are family history and male sex.

4. HTN+Glocuma treatment? Beta-blocker

5. In cocaine toxicity, serum and urine tests are useful when they are positive, but they are of limited utility when they are negative because of the short duration of detectability of cocaine (6 to 8 hours) and cocaine metabolites (2 to 4 days). Cocaine does not produce compensatory adaptations in brain regions that control somatic functions and therefore does not produce dependence. Dependence and, therefore, withdrawal are not produced by highly addictive compounds such as cocaine.
____________________________________________________________________________________________________________________
Reply
#32
1. The benzodiazepines (e.g., chlordiazepoxide, diazepam, lorazepam, and oxazepam) are the safest and most effective medications for treatment of alcohol withdrawal.

2. Glucagonoma and gastric adenocarcinoma are associated with acanthosis nigrans.

3. Nasopharyngeal carcinoma and burkitt's lymphoma t8:14 are associated with EBV.

4. Findings in Von Recklinghausen's disease: Cafe-au-lait spots, neural tumors, Lisch nodules (pigmented iris hamartomas), skeletal disorders (scoliosis), and increased tumor susceptibility.

5. Findings of Cri-du-chat syndrome: microcephaly, severe MR, high pitched crying/mewing (Cri-du-chat is French for cry of the cat), cardiac abnormalities.
_______________________________________________________________________________________________________________
Reply
#33
1. Pathogenesis of Cystic Fibrosis: defective Cl- channel --> secretion of abnormally thick mucus that plugs lungs, pancreas, and liver --> recurrent pulmonary infections (Pseudomonas species and Staph aureus), chronic bronchitis, bronchiectasis, pancreatic insufficiency (malabsorption and steatorrhea), meconium ileus in newborns.

2. Which gene is affected in Fragile X ? methylation and expression of the FMR 1 gene is affected in this X-linked disorder.

3. Skin conditions in AIDS patients: one is a bacterial infection and the other is a viral cause; both look similar - kaposi's sarcoma-HHV 8 AND BACILLARY ANGIOMATOSIS-caused by bartonella henselea.

4. Genetic anticipation of Fragile X syndrome may be shown by what? Triplet repeat (CGG)n

5. Huntington's: gene involved and triplet repeat - chromosome 4p, CAG.
____________________________________________________________________________________________________________________
Reply
#34
1.Kidney cancer is a neoplastic condition that can initially appear with many different paraneoplastic manifestations. The initial presentation may include hypertension, flank mass, gross or microscopic hematuria, hypercalcemia, fever, weight loss, and/or polycythemia. This polycythemia is the presenting sign in 3% of cases of kidney cancer. In kidney cancer, polycythemia is secondary to a hypersecretion of tumor cytokines, including renin. The patient's erythropoietin level is usually high. Surgical removal of the cancer resolves the polycythemia. ull evaluation is important in patients presenting with polycythemia and hematuria. Kidney cancer is an important differential diagnosis of secondary polycythemia.

2. Esophagitis in HIV often presents with belly or epigastric pain that could be caused by CMV or herpes simplex, but Candida is most common (80%-90%); treat empirically with fluconazole 100 to 200 mg/day.

3. Cryptococcal meningitis in HIV: minority of p atients have meningeal signs; most have only fever and headache. Obtain head CT and lumbar puncture (LP); elevated opening pressure most common abnormality; cerebrospinal fluid (CSF)”can be normal; most have normal glucose; only 50% of patients have elevated protein; minority of patients have white blood cells in CSF; india ink simple test that detects 75% of cases; cryptococcal antigen >90% sensitive, but results take 1 to 2 days at most institutions. How do you treat? Treat with amphotericin B; flucytosine added in patients with severely elevated pressures; fluconazole as maintenance for rest of life.

4. LDH: nonspecific test; appears to be consistently greatly elevated in PCP; PCP unlikely if LDH normal (in HIV ).

5. Pneumocystis carinii pneumonia (PCP) less common now because many patients receiving medical care get prophylaxis for this organism; Pneumocystis carinii now considered closer to fungi than to protozoa; bacterial pneumonia now more common than PCP.
________________________________________________________________________________________________________________________________
Reply
#35
1. Antiretroviral treatment for HIV: no consensus on when to start; indications include acute HIV infection, symptomatic HIV infection, CD4 count <350 cells/µL, high viral load (ie, >55,000 copies/mL).

2. Kaposi's sarcoma: reddish/purplish lesions can be located anywhere (internal or external); characteristic appearance of sharp demarcation (HSV8).

3. Hairy leukoplakia: tends to occur on side of tongue; cannot be scraped off like thrush; related to Epstein-Barr virus.

4. What 2 neoplasms are associated with AIDS? Aggressive malignant lymphomas (non-Hodgkins) and Kaposi's sarcoma.

5. What 2 neoplasms are associated with Tuberous Sclerosis (facial angiofibroma, seizures, and mental retardation)? 1. Astrocytoma 2. Cardiac Rhabdomyoma.
___________________________________________________________________________________________________________________________
Reply
#36
1. Treatment for rhabdomyolysis involves intravenous saline infusions to maintain a high urine output and alkalization of urine with a target pH of 7-8 to prevent myoglobin deposition.

2. Aortic dissecting aneurysm caused by degeneration of tunica media-cystic medial necrosis.

3. Cardiac rupture most common 4-7 days post MI.; ventricular free wall rupture leads to cardiac tamponade.

4. New onset serous discharge from a laparotomy wound should raise the suspicion of wound dehiscence.

5. Acute angle-closure glaucoma, which is an ocular emergency that requires immediate treatment to prevent blindness: Immediate treatment includes mannitol (to reduce vitreous volume), acetazolamide and topical beta-blockers, such as timolol (to block aqueous production), and pilocarpine (to facilitate aqueous outflow). Ophthalmologic consultation should also be sought as soon as possible. A peripheral laser iridectomy is the definitive procedure and is usually performe d after the IOP is controlled.
________________________________________________________________________________________________________________________________
Reply
#37
wha i learned from my unknown teacher

1,benzo are good for withdrawal and delirium tremen

2 the glucagonama not only cauese that migratory dermatitis eczema like condition but also acanthosis nigrican; remember it s also in hair in syndrome

3 in young it is aw dm; in old -cancer

4.von reclihaushean is also aw scoliosis
5 ebv infectious mono and hair leuko

6.huntigton is cag repeat fragile x is cgg repeat. it is x linked

7 wht are othe x ; bruton gama hemophilia fabrys hunter mucopolysachridoses huntigyton g6pd pyruvate defi duchene muscle dystrophy

8. 8; polycythemia hematuria in rcc

9; cryptoccus w/o meningismus pressure m/b nl india ink 75% ANTIGEN 90% BLOOD IN CSF 100% AMPHOTERICIN + FLUCYTOCIN AND FLUCOCONAZOLE ALON FOR LIFE

10, no ldh no pcp in pcp no pleural effusion

11.hiv kaposhi and non hdk

12 kaposhi sharp demarcation

i2 hairy lukoplakia ebv

13 start hivrx in 350 andd 500000 copis

14 tuberous scelorisis brain tumo rhabdomyoma renal angiomyolipoma seizure facial angiofibroma and menta retardation

15rhabdomyelyssis can happen even when one is unconscious an in crush syndrome there is myoglobunaria and renal failure

16 rx is vigrous hydration osmotic diuresis and alkalinization target ph 7 8

7 cystic medial necrosi aortic aneurysm
8 car diac rupture on 5 days because necrosed wall is noncompliant and ld to tamponade.

9 ' new pink dcg in lap wound w; dehiscence

1o angle closure is emergency give acitazolamide mannitol to decrese volume in vitreous
11 an beta blocker to block production and pilocarpine only given later to facilliate the outflow

12. laser iridectomy is definite rx after crisis is over/


THANKS
Reply
#38
Thanks and GL,Jyoti & whiteblue.



1. How do you manage a patient with non massive (less than 100 cc in 24 hour) hemoptysis? The work-up begins with history and physical examination. A chest x-ray and laboratory studies should be ordered initially. If the chest x-ray is normal and the patient has risk factors for cancer, like smoking, a bronchoscopy should be ordered to localize the bleeding site and look for an endobronchial mass. If none is found, a high resolution CT scan should be considered. If a mass is found on a study, referral to a thoracic surgeon is necessary.

2. Once a biopsy diagnosis of cervical intraepithelial neoplasm has been made, an appropriate treatment option is a loop electrosurgical excision procedure, and the most common complication being postoperative bleeding.

3. Patients with dural sinus and cerebral venous thrombosis can present with headaches, stroke-like symptoms, and/or seizures. There are multiple etiologies including dehydration, sepsis, and trauma. In addition, hypercoagulable states such as sickle cell disease, leukemia, and pregnancy are also predisposing factors. Because the symptomatology of a dural sinus thrombosis is nonspecific, imaging studies play a critical ro le in the diagnosis. On non-contrast enhanced head CT, a cord sign or tubular hyperdensity may be seen in the acute setting along with cortical and subcortical hemorrhage due to venous stasis and infarction. The treatment of choice during pregnancy is intravenous heparin. Unfractionated heparin and low molecular weight heparin (LMWH) do not cross the placenta and are considered safe for the fetus, but must be administered parenterally.

4. Children with sickle cell disease, despite splenomegaly, have reduced function of the reticuloendothelial system (functional asplenia). Therefore, in a sickle cell patient with a fever, it is important that broad spectrum antibiotics are instituted as soon as possible to protect against septicemia from encapsulated organisms such as H. influenzae, Pneumococcus, and Neisseria.

5. Heat stroke can occur in athletes who exert themselves in conditions of high humidity and temperatures. Clinical signs of this condition include a core body temperature of >40.5 C (or 105 F), profuse sweating, and mental status changes. Patients with exertional heat stroke are at risk for disseminated intravascular coagulation and rhabdomyolysis.
________________________________________________________________________________________________________
Reply
#39
1. Treatment of Acne rosacea: avoidng exogenous factors,topical metronidazole, no response give tetracycline.

2. Risk factors for tubo-ovarian abscess (TOA) include IUD use, multiple sexual partners, and previous episodes of pelvic inflammatory disease. Intravenous cefoxitin is used because it is an antimicrobial agent that is active against Gram-negative and anaerobic organisms, the predominant bacteria found in these abscesses. What will you see in sonogram? Trasonography of the pelvis demonstrates a complex, cystic mass containing multiple septations and internal echoes in the left adnexa.

3. A tension pneumothorax is a unilateral pneumothorax that becomes loculated by a one-way valve mechanism and compromises the contralateral lung and the venous return to the chest. Diagnosis is made by the lack of ipsilateral lung sounds due to cardiopulmonary collapse or chest radiograph. Treatment is immediate chest tube insertion to relieve the pressure.

4. A pulmonary embolus creates ventilation perfusion mismatches on the ventilation perfusion scan. In trension pneumothorax the ventilation perfusion scan demonstrates lack of ventilation and perfusion.

5. How do you manage a syncopal episode in a young healthy adult? A young, healthy, athletic patient can have a syncopal episode which can be cardiogenic or neurogenic in origin. After the history and physical, blood work is usually sent to rule out anemia, infections, hypocalcemia, or hypomagnesemia and an EKG must be performed. An EKG may show evidence of cardiac abnormalities such as Wolf-Parkinson-White syndrome (r wave slurring), idiopathic hypertrophic subaortic stenosis, or congenital prolonged QT syndrome.
_________________________________________________________________________________________________________________________
Reply
#40
1..Higher prevalence enhances positive predictive value. Simply put, if more people actually have the disease, then a positive test result has a higher probability of being true. Note that for the reasons described here, diagnostic tests always have a higher positive predictive value than screening tests.

2. The definition of chronic sinusitis is a sinus infection greater than 3 months. The most common etiology is infectious and the organisms most responsible are rhinovirus, H. influenza, S. pneumoniae, and influenza. The hallmark of acute sinusitis compared with sinus inflammation is total ostial obstruction. Once obstructed, fluid accumulates and becomes infected. The diagnosis is suggested by clinical signs and symptoms although certain imaging studies are very useful. The only imaging study to consider is a sinus CT. If positive, the maxillary or ethmoid sinuses will be opacified.

3. Women who have very low body fat and/or participate in intense exercise are known to have a decrease in gonadotropin releasing hormone (GnRH), which in turn results in a diminished release of follicle stimulating hormone (FSH) and leuteinizing hormone (LH). Ovulatory dysfunction is responsible for approximately 20-25% of infertility cases.

4. Septic shock is characterized by decreased blood pressure despite euvolemia and is often seen with severe infection, especially with Gram-negative organisms. Release of inflammatory mediators is responsible for decreasing SVR. Patients are thought to be in a hyperdynamic state with increased cardiac output. Volume status is reflected by PAWP and is classically normal but can be normal, low, or high depending on the aggressiveness of hydration.

5. Decreased CI, increased SVR, and normal PAWP is an example of cardiogenic shock. This is common with cardiac tamponade or myocardial infarction. It should be thought of as pump failure. The cardiac index is low because the heart is not pumping well. The SVR is increased in an effort to maintain blood pressure. The PAWP is normal in these patients since volume is typically not the primary problem.
__________________________________________________________________________________________________________________
Reply
« Next Oldest | Next Newest »


Forum Jump: