Term
|
Definition
|
|
Term
where does iron absorption occur in the body |
|
Definition
stomach, duodenum, and upper jejunum |
|
|
Term
In menstruating women, how much iron must be absorbed from the diet each day in order to avoid deficiency |
|
Definition
3-4mg per day - often requires supplementation |
|
|
Term
MCC of iron deficiency anemia? other causes? |
|
Definition
MCC - blood loss other causes - prolonged ASA use, anti-inflammatory durgs, menorrhagia, repeated blood donations, deficient diets, decreased absorption, increased requirements (prego, lactation), hemoglobinuria, pulmonary hemosiderosis |
|
|
Term
S&S of iron deficiency anemia |
|
Definition
fatigue, pica, koilonychia, pallor, dysphagia, tachycardia, palpitations, tachypnea on exertion, impaired muscular performance, glossitis, angular stomatitis, gastritis, RLS |
|
|
Term
what type of anemai is iron deficiency? |
|
Definition
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|
Term
tx for iron deficiency anemia |
|
Definition
ferrous sulfate 325mg PO TID |
|
|
Term
when PO ferrous sulfate is give to correct deficiency, how long does it take to work? |
|
Definition
3 wks hct should be halfway to normal 2m all values should be back to baseline should continue supplementation for 3-6m after correction |
|
|
Term
when response to PO iron is poor, what should be added to help absorption? |
|
Definition
ascorbic acid 500mg PO BID/TID and meat |
|
|
Term
which food supplements inhibit the absorption of iron in the body |
|
Definition
calcium fiber tea coffee wine cholestyramine colestipol neomycin quinolone abx tetracycline magnesium manganese zinc |
|
|
Term
what are some common sources of vitamin B12? how long is B12 stored in the liver? |
|
Definition
sources - meat, poultry, milk, eggs stores last 3+ years |
|
|
Term
who is at risk for iron deficiency anemia? |
|
Definition
strict vegans hx of gastric/intestinal surgery hx of atrophic gastritis pernicious anemia gastric malabsorption people who take acid blockers/PPIs |
|
|
Term
how does B12 deficiency present? |
|
Definition
megaloblastic anemia but can also present with peripheral neuropathy and neuropsychiatric complaints |
|
|
Term
sxs of B12 deficiency anemia |
|
Definition
parethesias ataxia decreased vibration sense + romberg pallor, petechiae glossitis, angular cheilitis cognitive impairment seizures, hypotonia |
|
|
Term
labs in B12 deficiency anemia |
|
Definition
elevated MCV, low HCT low B12, low retic count High MMA, homocysteine, LDH, indirect bilirubin |
|
|
Term
|
Definition
asx = diet and PO B12 sxs = Im cyanocobalamin |
|
|
Term
long term complications of B12 deficiency |
|
Definition
progrsesive neurologic damage progressive anemia, leukopenia, and thrombocytopenia gastric cancer - long term complication of untx pernicious anemia |
|
|
Term
what is pernicious anemia |
|
Definition
insufficiency of intrinsic factor (requiered for B12 absorption) |
|
|
Term
what foods contain folic acid |
|
Definition
fruits and green leafy veggies |
|
|
Term
what are the causes of folate deficiency? (4) |
|
Definition
malabsorption (celiac) malnutrition (alcoholics) increased requirements (prego/lactation) drugs (phenytoin, bactrim, sulfasalazine, ethanol, pyrimethamine, diphenylhydration, barbituates) |
|
|
Term
S&S of folate deficiency? |
|
Definition
sleep deprivation fatigue depression irritability forgetfulness prolonged diarrhea HA loss of apetite SOB pallor tachycardia, tachypnea |
|
|
Term
tx of folic acid deficiency? |
|
Definition
|
|
Term
complications of folate deficiency? |
|
Definition
leukopenia thrombocytopenia CV dz venous thrombosis colorectal cancer |
|
|
Term
what is anemia of chronic disease? |
|
Definition
normocytic, normochromic anemia in pts with long standing inflammatory disease, malignancy, AIDS, or chronic infection |
|
|
Term
whaty is erythropoesis stimulating agent? |
|
Definition
EPA - used in the tx of severely sx pts who have anemia of chronic disease, need urgent transfusions, jehovah's witnesses, rare blood types, and those with multiple alloantibodies |
|
|
Term
|
Definition
mortality is increased when Hb is raised to > 12 because there is increased likelihood of vascular events. monitor weekly |
|
|
Term
|
Definition
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|
Term
hx of sickle cell offers protection against |
|
Definition
|
|
Term
what provokes acute sickle cell crisis? |
|
Definition
infection dehydration hypoxia |
|
|
Term
MC places affected by sickle cell crisis |
|
Definition
bones (esp long bones and back), liver, heart, kidney, eyes, lungs |
|
|
Term
MCC of death in a person with sickle cell anemia |
|
Definition
multiple organ failure life expectancy 40-50 years |
|
|
Term
tx of acute sickle cell crisis |
|
Definition
exchange transfusion and hydroxyurea |
|
|
Term
|
Definition
non sickling disorder that produces mild jaundice with splenomegaly and pigment (calcium) gallstones |
|
|
Term
causes of aplastic anemia |
|
Definition
radiation, chemo, toxins, SLE/autoimmune suppression of hematopoiesis by a T cell mediated cell mechanism |
|
|
Term
pancytopenia is often indicative of |
|
Definition
|
|
Term
lab values of aplastic anemia |
|
Definition
2+ cytopenia decreased hb, platelet, and absolute neutrophil count low retic count hypocellular bone marrow - should be an absence of blasts |
|
|
Term
|
Definition
if not severe = supportive if infxn - abx only severe < 40 = allogenic stem cell transplant then immunosuppresive therapy > 40 = immunosuppressive therapy then allogenic stem cell transplant |
|
|
Term
aplastic anemia is closely related with what disorder? |
|
Definition
proxysmal nocturnal hemoglobinuria |
|
|
Term
how often should pts with severe aplastic anemia follow up with their health care provider? |
|
Definition
|
|
Term
complications of aplastic anemia |
|
Definition
graft failure following stem cell transplant graft vs host disease AVN following immunosuppressive therapy paroxysmal noctural hemoglobinuria myelodysplastic syndrome AML solid tumors |
|
|
Term
how do hemolytic anemias present? |
|
Definition
acute/subacute development of jaundice, pallor, SOB, dizziness, fatigue, orthostasis, mild splenomegaly, active infections, epidsodic dark urine (hemoglobinuria), exposure to cold |
|
|
Term
what are the common lab values in hemolytic anemia? |
|
Definition
low hgb high MCHC, retic count, indirect bilirubin, LDH low haptoglobin abnormal cells in peripheral smear - schistocytes, spherocytes, elliptocytes, spur cells hemaglobinuria |
|
|
Term
what does the direct antiglobulin test (coombs test) analyze in hemolytic anemia? |
|
Definition
+ = immune etiology - = nonimmune etiology |
|
|
Term
mutation of JAK2V617 is strongly associated with what blood disorder? |
|
Definition
|
|
Term
risk factors for polycythemia vera (3) |
|
Definition
> 40 Budd-Chiari Syndrome Affected Family Member |
|
|
Term
common S&S of polycythemia vera |
|
Definition
thrombosis hemorrhage HA weakness/fatigue post-bathing pruritis erythromelalgia redness of ringers/palms/toes/heels facial redness splenomegaly |
|
|
Term
common lab values seen in polycythemia vera |
|
Definition
elevated hgb, hct, wbc, platelet, serum uric acid low erythropoietin Bone Marrow bx shows hypercellularity |
|
|
Term
|
Definition
low dose ASA and phlebotomy phlebotomy - 250-500ml of blood is replaced with normal saline 2x/wk until hct <45% |
|
|
Term
how often should a pt with polycytehmia vera follow up with a hematologist? |
|
Definition
every 1-2 wks until stable and then every 2-3 after that |
|
|
Term
complications of polycythemia vera |
|
Definition
thrombosis hemorrhage severe erthromelalgia acute leukemia |
|
|
Term
lymphoproliferative disorder associated with monoclonal gammopathy that can present wiht an unexpected skeletal fx, renal failure, hematologic abnl, hypercalcemia, or a combo of these |
|
Definition
|
|
Term
|
Definition
bone pain anemia infections fatigue neuropathy renal failure heart failure |
|
|
Term
|
Definition
pulse corticosteroids in combo with chemotherapy |
|
|
Term
fever, sore throat, sandpaper rash, strawberry tongue |
|
Definition
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|
Term
renal complications following strep pharyngitis |
|
Definition
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|
Term
cardiac complication following strep pharyngitis |
|
Definition
|
|
Term
|
Definition
Major: carditis, erythema marginatum, subcutaneous nodules, chorea, arthritis Minor: fever, prolonged PR interval, elevated ESR and CRP, leukocytosis, polyarthralgias |
|
|
Term
residual complication of rheumatic fever |
|
Definition
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|
Term
|
Definition
|
|
Term
|
Definition
visual disturbances (diplopia, ptosis) followed by respiratory paralysis |
|
|
Term
gram positive box-car shaped rods in chains |
|
Definition
|
|
Term
|
Definition
cipro or another flouroquinolone, report to CDC |
|
|
Term
|
Definition
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|
Term
causative agent of uncontrolled spasm and exaggerated reflexes |
|
Definition
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|
Term
MC form of salmonella infection |
|
Definition
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|
Term
causative agent and tx of dysentery |
|
Definition
|
|
Term
tenacious grey membrane covering the pharynx |
|
Definition
|
|
Term
|
Definition
antitoxin obtained from CDC, PCN or erythromycin |
|
|
Term
real name for whooping cough |
|
Definition
pertusis coughing fits followed by high picthed inspiration |
|
|
Term
|
Definition
|
|
Term
mononucleosis and Burkitt's lymphoma are both associated with what virus? |
|
Definition
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|
Term
administration of amoxicillin to EBV patients induces |
|
Definition
|
|
Term
antibodies associated with EBV? |
|
Definition
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|
Term
causative agent of genital warts |
|
Definition
|
|
Term
|
Definition
|
|
Term
painful erruption following a dermatomal pattern |
|
Definition
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|
Term
hydrophobia - painful spasms caused by drinking water are associated with |
|
Definition
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|
Term
antigen to which HIV attaches |
|
Definition
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|
Term
|
Definition
|
|
Term
HIV diagnosed by which labs |
|
Definition
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|
Term
Infection similar to EBV without pharyngitis, respiratory sxs, or heterophile antibodies |
|
Definition
|
|
Term
tissue biopsy of CMV reveals |
|
Definition
intracytoplasmic inclusions "owl's eyes" |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
gram negative intracellular diplococci |
|
Definition
|
|
Term
|
Definition
ceftriaxone IM and concurrent doxycycline/azithromycin for chlamydia |
|
|
Term
MCC of urethritis and cervicitis |
|
Definition
|
|
Term
|
Definition
azithromycin, doxycycline, erythromycin |
|
|
Term
flagellated protozoan infects Skene's glands in females |
|
Definition
|
|
Term
|
Definition
malodorous, frothy-green discharge, motil flagellates on wet mount |
|
|
Term
|
Definition
|
|
Term
Bull's eye lesions are associated with |
|
Definition
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|
Term
drug of choice for pts with erythema migrans associated with Lyme Disease |
|
Definition
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|
Term
causative agent of Rocky Mountain Spotted Fever |
|
Definition
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|
Term
|
Definition
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|
Term
painless nodules associated with punctures by plant thorns, may progress to LAD |
|
Definition
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|
Term
honey colored crusts common in children |
|
Definition
|
|
Term
layers of skin superficial --> deep |
|
Definition
stratum corneum stratum lucidum stratum granulosum strautm spinosum stratum basale |
|
|
Term
cells that provide pigment |
|
Definition
|
|
Term
myelocytes (melanocytes) are present in what layer? |
|
Definition
|
|
Term
|
Definition
|
|
Term
yellowish-grey scaly macules or patches with greasy appearance |
|
Definition
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|
Term
|
Definition
hyperpigmentation of lwoer extremities associated with venous insufficiency |
|
|
Term
|
Definition
a pruritic plaque caused by excessive rubbing or scratching |
|
|
Term
causative agent of fifths disease |
|
Definition
|
|
Term
|
Definition
Fifth disease "slapped cheeks" |
|
|
Term
herald patch followed by widespread popular rash |
|
Definition
|
|
Term
Flesh colored umbilicated papules common in children |
|
Definition
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|
Term
"Tapioca" appearance of vessicles, common on hands and feet. Pruritic, sometimes painful |
|
Definition
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|
Term
pink plaque with silvery scales |
|
Definition
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|
Term
Type of psoriasis seen after viral illness |
|
Definition
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|
Term
|
Definition
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|
Term
rash on rash triggered by heat, alcohol, sun, spicy foods, etc |
|
Definition
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|
Term
rhinophyma is associated with |
|
Definition
|
|
Term
inflammation of hair follicles |
|
Definition
folliculitis (caused by staph aureus) |
|
|
Term
causative agent of hot tub folliculitis |
|
Definition
|
|
Term
life threatening condition involving high fever, photophobia, sore throat, mucosal inflammation, followed by cutaneous lesion |
|
Definition
Stevens Johnson Syndrome or Toxic Epidermal necrolysis |
|
|
Term
Disease of apocrine glands |
|
Definition
|
|
Term
deep seated infection of a single hair follicle |
|
Definition
|
|
Term
conglomerate mass of multiple infected hair follicles |
|
Definition
|
|
Term
swollen, hot, red, tender skin |
|
Definition
|
|
Term
tinea versicolor causative agent |
|
Definition
|
|
Term
|
Definition
|
|
Term
which scabies tx should be avoided in kids < 2 yo |
|
Definition
|
|
Term
|
Definition
|
|
Term
actinic keratosis can progress to |
|
Definition
|
|
Term
|
Definition
|
|
Term
most comomon neoplasm of the skin |
|
Definition
|
|
Term
hyperpigmentation associated with Dm and obesity |
|
Definition
|
|
Term
hyperpigmentations of sun exposed areas associated with pregnancy or OCP use |
|
Definition
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|
Term
hypopigmented skin commonly seen on hands |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
tx of vulvovaginal cadidiasis |
|
Definition
|
|
Term
candidal fungemia (systemic fungal infection) tx? |
|
Definition
|
|
Term
pt works with exotic birds and develops a cough |
|
Definition
|
|
Term
common cause of pneumonia in HIV pts |
|
Definition
|
|
Term
|
Definition
|
|
Term
mosquito that carries malaria |
|
Definition
female anopheles mosquito |
|
|
Term
tx and prophylaxis of malaria |
|
Definition
|
|
Term
causative agent of syphilis |
|
Definition
|
|
Term
painless ulcer with inderated margins in the inguinal region |
|
Definition
|
|
Term
|
Definition
|
|
Term
where is the infarct? weakness and cortical sensory loss in the contralateral leg and sometimes mild weakness of the arm, especially proximally. May be a contralateral grasp reflex, paratonic rigidity, and abulia or frank confusion. Can cause urinary incontinence. |
|
Definition
anterior communicating artery |
|
|
Term
brain infarction that can lead to behavioral changes |
|
Definition
bilateral anterior communicating artery |
|
|
Term
where is the infarct? leads to contralateral hemiplegia, hemisensory loss, and homonymous hemianopia. can lead to Wernicke Aphasia |
|
Definition
|
|
Term
where is the infarct? thalamic syndrome in which conrtalateral hemisensory disturbance occurs, followed by development of spontaneous pain and hyperpathia |
|
Definition
posterior cerebral artery |
|
|
Term
where is the infarct? ipsilateral spinothalamic sensory loss involving face, ninth and tenth cranial nerve lesions, ataxia and numbness, Horner syndrome, combined with contralateral spinothalamic sensory loss involving the limbs |
|
Definition
posterior inferior cerebellar artery |
|
|
Term
where is the infarct? vertigo, N/V, nystagmus, ipsilateral limb ataxia, contralateral spinothalamic sensory loss in the limbs |
|
Definition
|
|
Term
how long are thrombolytics a viable option for stroke? |
|
Definition
|
|
Term
when is endarterectomy recommended for carotid arteries? |
|
Definition
|
|
Term
|
Definition
|
|
Term
senile plaques, neurofibrillay tangles, neuronal loss, cortical atrophy |
|
Definition
|
|
Term
hallmark sxs of Alzheimers (3) |
|
Definition
memory loss impairment of daily activities neurobehavioral abnormalities |
|
|
Term
|
Definition
supportive - caregiver support, mental health support, home safety, exercise cholinesterase inhibitors (aricept, exelon, razadyne,) enhances or prevents decline of cognitive function anti-depressants (zoloft, celexa, lexapro) depression is common, SSRI's are first line antipsychotics (risperdal, zyprexa, seroquel, abilify) management of insomnia moderate for severe AD = memantine |
|
|
Term
characteristics of subcortical dementias |
|
Definition
motor impairments reduced attention psychomotor slowing loss of executive functioning personality change |
|
|
Term
personality changes + compulsive behavior without visuospatial changes |
|
Definition
Frontotemporal dementias (Pick Dz) associated with ALS |
|
|
Term
caused by acute deficiency of thiamine in a susceptible host |
|
Definition
Wernicke's Encephalopathy |
|
|
Term
tx of Wernicke's Encephalopathy |
|
Definition
stabilize/resuscitate thiamine (250-500mg in 100ml NS over 30 min TID x 3d), Mg (2-4g/d), multivitamin |
|
|
Term
|
Definition
Eyes - 4 Verbal - 5 Motor - 6 worst score = 3 best score = 15 |
|
|
Term
MCC of death in young people |
|
Definition
|
|
Term
what are secondary insults to the brain? (2) |
|
Definition
|
|
Term
|
Definition
injury to the middle meningeal artery |
|
|
Term
triad of brain herniation |
|
Definition
coma fixed, dilated pupils decerebrate posturing |
|
|
Term
likely location of bleeding in subdural hematomas |
|
Definition
|
|
Term
MCC of subarachnoid hemorrhage |
|
Definition
rupture of an aneurism or AV malformation |
|
|
Term
carpal tunnel syndrome is associated with what electrolyte abnormality? |
|
Definition
|
|
Term
heat intolerance cold intolerance |
|
Definition
heat = hyperthyroid cold = hypothyroid |
|
|
Term
polymorphonuclear neutrophils |
|
Definition
acute tubulointerstitial nephritis |
|
|
Term
mononuclear cell predominance |
|
Definition
chronic tubulointerstitial nephritis |
|
|
Term
4 MCC of nephrotic syndrome |
|
Definition
minimal change disease focal glomerular sclerosis membranous membranoproliferative |
|
|
Term
peripheral edema, hypoalbuminuria (< 3g/d), proteinuria (> 3.5 g/d), lipiduria |
|
Definition
|
|
Term
bones, stone, abdominal groans, psychic moans, with fatigue overtones |
|
Definition
|
|
Term
serm PTH, alk phos, and calcium are increased |
|
Definition
|
|
Term
+ Chovsteks and Trousseaus |
|
Definition
|
|
Term
tx of hyperparathyroidism |
|
Definition
IV hydration loop diuretics bisphosphonates calcimimetics surgery - remove pathological parathyroid gland |
|
|
Term
MCC of hypoparathyroidism |
|
Definition
|
|
Term
|
Definition
IV calcium gluconate calcium salts vitamin D calcitriol |
|
|
Term
|
Definition
|
|
Term
one or more lesions having high bone turnover and disorganized osteoid formation. weak and deformed bone structure |
|
Definition
|
|
Term
normal calcium normal phosphate extremely increased alk phos normal PTH |
|
Definition
|
|
Term
MCC subacute endocarditis |
|
Definition
|
|
Term
|
Definition
|
|
Term
review rheumatoid antibodies |
|
Definition
|
|
Term
|
Definition
calcinosis Raynaud's esophageal dysfunction sclerodactyly telangiectasias (specific type of limited scleroderma) |
|
|
Term
|
Definition
no specific rx PPI for reflux ACEI for renal disease avoidance of triggers CCB for Raynaud's immunosuppressive drugs for HTN |
|
|
Term
inflammatory disease of striated muscle affecting the limbps, neck, and pharynx |
|
Definition
polymyositis if it affects the skin as well = dermatomyositis (increased risk of malignancy) |
|
|
Term
|
Definition
high dose steroids, methotrexate, azathioprine until sxs resolve |
|
|
Term
dry mucous membranes + enlarged parotid glands |
|
Definition
|
|
Term
test of Sjogren's Syndrome |
|
Definition
Schrimer's test - decreased tear production |
|
|
Term
increased risk of what disease with Sjogren's Syndrome |
|
Definition
|
|
Term
disease associated with polyarteritis nodosa |
|
Definition
|
|
Term
|
Definition
|
|
Term
upper and lwoer respiratory tract involvement, pauci-immune glomerulonephritis |
|
Definition
|
|
Term
tests for thoracic outlet syndrome |
|
Definition
|
|
Term
MCC of osteomyelitis in sickle cell pts |
|
Definition
|
|
Term
MCC of osteomyelitis in normal population |
|
Definition
|
|
Term
causative agent in osteo from penetrating injury to the foot |
|
Definition
|
|
Term
most common benign bone tumor |
|
Definition
|
|
Term
MC benign tumor of the hands |
|
Definition
|
|
Term
highly malignant tumor that affects mostly children, typical "onion skin" reaction on xray |
|
Definition
|
|
Term
MC primary malignant lesion of the bone, sunburst pattern on xray |
|
Definition
|
|
Term
|
Definition
1-2.5 = osteomalacia (osteopenia) 2.5 + = osteoperosis |
|
|
Term
MC fracutres sites with osteoperosis |
|
Definition
spine(lumbar vertebra) and hip |
|
|
Term
proximal muscle weakness associated with fever, fatigue, weight loss, depression. also has an association with temporal arteritis |
|
Definition
|
|
Term
difference between Steven Johnsons Syndrome and Toxic Epidermal Necrolysis |
|
Definition
SJS if < 10% BSA involved TEN if > 10% BSA involved |
|
|
Term
common drugs associated with SJS and TEN (4) |
|
Definition
sulfonamides NSAIDs allopurinol anticonvulsants |
|
|
Term
pearly or waxy papule with telangiectasias, erythematous patch, or non healing ulcer in sun exposed areas |
|
Definition
|
|
Term
|
Definition
|
|
Term
lesions appear as small red, conical, hard nodules that occasionally ulcerate |
|
Definition
|
|
Term
leading cause of death due to skin cancer |
|
Definition
|
|
Term
|
Definition
|
|
Term
1st line meds for neuropathic pain |
|
Definition
|
|
Term
condition in which the pt has blindness, paralysis, or other nervous system symptoms which cannot be explained |
|
Definition
|
|
Term
a belief that real or imagined physical symptoms are signs of serious illness, despite medical reassurance and other evidence to the contraray |
|
Definition
|
|
Term
a long term condition in which a person has physical symptoms that are caused by psychological problems and no physical problem can be found |
|
Definition
|
|
Term
mental disorders in which a person acts as if he or she has physical or menal illness when in fact, he or she has consciously created his or her symptoms |
|
Definition
|
|
Term
4 major compoenents of ABG's |
|
Definition
|
|
Term
|
Definition
rule out endocarditis assess LAE |
|
|
Term
3 categories of info provided by PFT's |
|
Definition
lung volume flow rate diffusing capacity |
|
|
Term
contraindications to thoracentesis |
|
Definition
uncooperative pt coagulation/bleeding disorders |
|
|
Term
complications of thoracentesis (5) |
|
Definition
pneumothorax hemothorax hemorrhage hypotension pulmonary edema |
|
|
Term
indications for bronchoscopy (6) |
|
Definition
abnormal CXR hemoptysis opportunistic lung infection retained secretions and mucous plugs unexplained cough > 6 wks cancers |
|
|
Term
|
Definition
gives info about cardiac output, ejection fraction, velocity, and wall motion abnormalities thru use of radiolabeled RBC's injected into the pt to assess the fxn of the heart |
|
|
Term
best test to obtain info on peripheral vascular disease |
|
Definition
|
|