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  #1  
Old 12-08-2014
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Romania Highly tested topics from recent exam takers !!!!!!!!

Hey can someone construct a list of topics, where they had a lot of Quetions???
For example ANEMIA, most important micro, and macrocytic
Reproductive system
Endocrinology hormone synthesis pathways......
Heart murmurs/// etc.....
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  #2  
Old 12-10-2014
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Correct Answer Hi

Urinary retention is frequently tested side effect , caused by :

Atropine
TCAs
Antihistamines of first generation...


Causes of urinary retention
These are numerous and can be classified as:[1]

In men - benign prostatic hypertrophy (BPH), meatal stenosis, paraphimosis, penile constricting bands, phimosis, prostate cancer.
In women - prolapse (cystocele, rectocele, uterine), pelvic mass (gynaecological malignancy, uterine fibroid, ovarian cyst), retroverted gravid uterus.
In both - bladder calculi, bladder cancer, faecal impaction, gastrointestinal or retroperitoneal malignancy, urethral strictures, foreign bodies, stones.


Infectious and inflammatory:

In men - balanitis, prostatitis and prostatic abscess.
In women - acute vulvovaginitis, vaginal lichen planus and lichen sclerosis, vaginal pemphigus.
In both - bilharzia, cystitis, herpes simplex virus (particularly primary infection), peri-urethral abscess, varicella-zoster virus.
Drug-related:
Up to 10% AUR episodes are thought to be attributable to drugs. Those known to increase risk include:

Anticholinergics (eg, antipsychotic drugs, antidepressant agents, anticholinergic respiratory agents).
Opioids and anaesthetics.
Alpha-adrenoceptor agonists.
Benzodiazepines.
Non-steroidal anti-inflammatory drugs.
Detrusor relaxants.
Calcium-channel blockers.
Antihistamines.
Alcohol.
Neurological:
More often causing chronic retention but may cause AUR:

Autonomic or peripheral nerve (eg, autonomic neuropathy, diabetes mellitus, Guillain-Barré syndrome, pernicious anaemia, poliomyelitis, radical pelvic surgery, spinal cord trauma, tabes dorsalis).
Brain (eg, cardiovascular disease (CVD), MS, neoplasm, normal pressure hydrocephalus, Parkinson's disease).
Spinal cord (eg, invertebral disc disease, meningomyelocele, MS, spina bifida occulta, spinal cord haematoma or abscess, spinal cord trauma, spinal stenosis, spinovascular disease, transverse myelitis, tumours, cauda equina).
Other:

In men - penile trauma, fracture, or laceration.
In women - postpartum complications (increased risk with instrumental delivery, prolonged labour and Caesarean section),[2]urethral sphincter dysfunction (Fowler's syndrome).
In both - pelvic trauma, iatrogenic, psychogenic.

Last edited by ginseng plus; 12-10-2014 at 02:02 AM.
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  #3  
Old 12-10-2014
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Default

Good work, keep it going, I request all recent test takers to share topics which were asked..

Good luck to everyone..
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  #4  
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Default Bacterial Endocarditis

Bacterial endocarditis

Fever most common
Roth's spots on retina
Osler's nodes on fingers
New murmurs
Janeway lesions, on palms or soles
Anemia
Splinter hemorrhages on nail bed
Valvular damage
Can be caused by Staph aureus, as acute form
And caused by viridans streptococci as subacute form
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  #5  
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Romania Cranial nerve 4

https://www.youtube.com/watch?v=AWJg3Juuhvw

Vertical diplopia is the most noticeable when the affected eye looks toward the nose, as occurs when reading the NEWSPAPER OR WALKING DOWNSTAIRS...
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  #6  
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Romania Cavernous Sinus Syndromes

Cavernous Sinus Syndromes

Background
Cavernous sinus syndrome is defined by its resultant signs and symptoms: ophthalmoplegia, chemosis, proptosis, Horner syndrome, or trigeminal sensory loss. Infectious or noninfectious inflammatory, vascular, traumatic, and neoplastic processes are the principal causes. Examples of specific entities that may result in cavernous sinus syndrome are myriad and include carotid artery aneurysms, carotid-cavernous fistulas (C-C fistulas) (see image below), tumors, and Tolosa-Hunt syndrome, to name the most frequently discussed.

Carotid-cavernous fistula.
Carotid-cavernous fistula.
Pathophysiology
The cavernous sinuses are paired, venous structures located on either side of the sella turcica. They receive venous tributaries from the superior and inferior orbital veins and drain into the superior and inferior petrosal sinuses. The cavernous sinus contains the carotid artery, its sympathetic plexus, and the oculomotor nerves (third, fourth, and sixth cranial nerves). In addition, the ophthalmic branch and occasionally the maxillary branch of the fifth nerve traverse the cavernous sinus. The nerves pass through the wall of the sinus while the carotid artery passes through the sinus itself.


Physical
Cavernous sinus lesions are characterized by the following signs:
Unilateral and isolated third, fourth, or sixth cranial nerve palsy
Combination patterns of ophthalmoplegia
Painful ophthalmoplegia
Proptosis (pulsating exophthalmos suggests a direct C-C fistula)
Ocular and cranial bruits
Conjunctival congestion; arterialization of conjunctival veins
Ocular hypertension
Optic disc edema or pallor; retinal hemorrhages
Anesthesia in the ophthalmic division of the trigeminal nerve (V1) and/or decreased or absent corneal reflex and possibly anesthesia in the maxillary or V2 branch
Pupil in midposition and nonreactive if both sympathetics and parasympathetics from the third nerve are affected
Cavernous sinus tumors
Metastatic lesions - Isolated or combined ophthalmoplegia, painful ophthalmoplegia, anesthesia in the ophthalmic nerve
Pituitary tumors - Isolated or combined ophthalmoplegia (lateral extension); endocrine signs such as acromegaly, galactorrhea, and unitemporal or bitemporal visual field defects
Primary intracranial tumors - Isolated or combined ophthalmoplegia and/or primary aberrant regeneration of the third cranial nerve
Cavernous sinus aneurysms
Isolated or combined ophthalmoplegia
Painful ophthalmoplegia
Decreased pain sensation in the V1 ophthalmic division
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  #7  
Old 12-11-2014
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Romania Hi

Air vs. bone conductive hearing loss[edit]
Air conduction uses the apparatus of the ear (pinna, eardrum and ossicles) to amplify and direct the sound whereas bone conduction bypasses some or all of these and allows the sound to be transmitted directly to the inner ear albeit at a reduced volume, or via the bones of the skull to the opposite ear.

Description Relative Positive/negative
In a normal ear, air conduction (AC) is better than bone conduction (BC) AC > BC this is called a positive Rinne


In conductive hearing loss, bone conduction is better than air AC < BC negative Rinne


In sensorineural hearing loss, bone conduction and air conduction are both equally depreciated, maintaining the relative difference of bone and air conductions AC > BC positive Rinne


In sensorineural hearing loss patients there may be a false negative Rinne AC < BC negative Rinne
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  #8  
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Romania Bell's palsy

Bell's palsy, or cranial nerve VII involvement... LOWER MOTONEURON LESION

Complete destruction of the facial nucleus itself or its branchial efferent fibers

Peripheral ipsilateral facial paralysis with inability to close eye on involved side.

As complication of AIDS,Lyme disease, herpes simplex, sarcoidosis, tumors, diabetes...

Most commonly seen in LYME DISEASE AND SARCOIDOSIS...
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  #9  
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Romania Hi

Visual field defects
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Default Number needed to treat

Number needed to treat

The number needed to treat (NNT) can be thought of as the number of patients that need to be treated in order for one to benefit. It provides an attractive means of summarising the results of a clinical trial in a single figure, because the meaning of a sentence such as ‘20 patients need to be treated to avoid one additional death over a five year period’ is easily understood by both doctors and patients.1

Calculation

The NNT is the inverse of the absolute risk reduction – the difference between the proportion or rate of events in the active treatment intervention group (Pa) and the proportion of events in the control group (Pc):


Number needed to treat =1/(Pa-Pc)
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  #11  
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Romania Multiple Sclerosis

Multiple Sclerosis

Autoimmune inflammation and demyelination of CNS.
Patients can present with optic neuritis, MLF syndrome, hemiparesis, hemisensory, bladder and bowel incontinence.
Most often affects women in their 20s to 30s.
Findings increased IgG in cerebrospinal fluid.

Periventricular plaques.>>>> areas of oligodendrocyte loss and reactive gliosis.

Classic triad is:
Scanning speech
Intention tremor,
Incontinence
..............internuclear ophthalmoplegia , Nystagmus..
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  #12  
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Romania Tension headache

Tension headache

Consistent, non- throbbing pain ( lasts 4-6 hours up to 7 days)
Occurs in the frontal occipital regions ( most often bilateral)
Or as a band around the head

NO associated symptoms such as: Sensitivity to ligh or noise
vision disturbance
naussea or vomiting
FOcal neurological change
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Romania Migrane headache

Migrane headache

Most common in women
Al least 5 attacks
Headache lasting 4-72H
At least of the following:
Location>>>>>>>>>>> Unilateral
Quality>>>>>> throbbing, pulsating

Moderate to severe intensity( inhibits or prohibits daily activity)
Aggravated by routine physical activity
At least one of the following:
Nausea , vomiting
Photophobia or and phonophobia.


25% have AURA before
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Romania Cluster headache

Cluster headache

Strictly unilateral

Severe piercing, boring pain in the retroorbital, periorbital region
Does not throb like a migrane. No aura
Duration from 15 minutes to 3 hours, occurs daily
Often at the same time, i name this headache punctual and disciplinary and continues for an interval of 4-8 weeks
May be associated with partial Horner syndrometosis , myosis, anhydrosis.

Ipsilateral eye redness, tearing, rhinorrhea or nasal congestion
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Romania Tuberous sclerosis

Tuberous sclerosis

Hamartomas in CNS and skin,
Adenoma sebaceum( cutaneous angiofibromas)
Mitral valve regurgitation
Ash-leaf spots
Cardiac Rhabdomyoma (Tuberous sclerosis)
Autosomal dominant
Mental retardation
Renal Andiomyolipoma
Seizures
Shagreen patches
Increased incidence of subependymal astrocytomas ungual fibromas
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Romania Glioblastoma multiforme

Glioblastoma multiforme

Most common primary brain tumor.
Prognosis grave, less than one year expectancy. FOund in cerebral hemispheres.
Can cross corpus callosum and create a image like Butterfly glioma
Stain astrocytes for GFAP (Glial fibrillary acidic protein)

Pseudopalisading key word ,pleomorphic tumor cells, border central areas of necrosis and hemorrhage. Derived from glial cells
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  #17  
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Romania Pylocytic astrocytoma

Pylocytic astrocytoma

most common brain tumor in children
Usualy well circumscribed. found in posterior fossa.
May be supratentorial.
We know that majority of childhood tumors are infratentorial
GFAP positive.
Benign with a good prognosis

Rosenthal fibers- eosinophilic, corkscrew fibers.
Cystic plus solid (gross)
Arises in the cerebellum
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  #18  
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Romania Medulloblastoma

Medulloblastoma

Second most common brain tumor in children
Highly malignant cerebellar tumor
A form of primitive neuroectodermal tumor PNET
Can compress 4th ventricle , causing HYDROCEPHALUS.
Sheets of small cells with deeply basophilic nuclei, and scant cytoplasm

Rosettes or perivascular pseudorosette pattern of cells. Solid( gros). small blue cells histology

Cerebelar vermis is the most common location of a medulloblastoma symptoms include signs of increased intracranial pressure like morning headache, vomiting, lethargy,. Cerebelar dysfunction occurs as the tumor compresses adjacent structures.
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  #19  
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Romania Phenytoin

Phenytoin

Not as important as mechanism of action of clinical use as adverse effects

Use dependent blockade of Na+ channels, increase refractory period,
Inhibition of glutamate release which is excitatory neurotransmitter,

Clinical use: tonic clonic seizures. also a class IB antiarrhythmic

Toxicity :Nystagmus , ataxia, diplopia, sedation, SLE like syndrome, induction of P450, Chronic use produces gingival hyperplasia in children, peripheral neuropathy, hirsutism, megaloblastic anemia because decrease folate absorption. Teratogenic, as fetal hidantoin syndrome causes.

Concisely :
Gingival hyperplasia
Hirsutism
Fetal hydantoin syndrome
Induces P450
Stevens-Johnson syndrome
Drug induced lupus


Fetal Hydantoin Syndrome is a rare disorder that is caused by exposure of a fetus to the anticonvulsant drug phenytoin (Dilantin). The symptoms of this disorder may include abnormalities of the skull and facial features, growth deficiencies, underdeveloped nails of the fingers and toes, and/or mild developmental delays. Other findings occasionally associated with this syndrome include cleft lip and palate, having an unusually small head (microcephaly) and brain malformations with more significant developmental delays.
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  #20  
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Romania Neroleptic malignang syndrome

Neuroleptic malignant syndrome

Increased body temperature >38°C (>100.4°F), or
Confused or altered consciousness
Diaphoresis "sweat shock"
Rigid muscles
Autonomic imbalance


Differential diagnosis with :
encephalitis, toxic encephalopathy, status epilepticus, heat stroke, and malignant hyperthermia

Causes
NMS is usually caused by antipsychotic drug use, and a wide range of drugs can result in NMS.[1] Individuals using butyrophenones (such as haloperidol and droperidol) or phenothiazines (such as promethazine and chlorpromazine) are reported to be at greatest risk. However, various atypical antipsychotics such as clozapine, olanzapine, risperidone, quetiapine, and ziprasidone have also been implicated in cases.[10]

NMS may also occur in people taking dopaminergic drugs (such as levodopa) for Parkinson's disease, most often when the drug dosage is abruptly reduced.[11] In addition, other drugs with anti-dopaminergic activity, such as the antiemetic metoclopramide, can induce NMS.[12] Even drugs without known anti-dopaminergic activity have been associated with NMS; examples include amoxapines and lithium. Also, desipramine, dothiepin, phenelzine, tetrabenazine, and reserpine have been known to trigger NMS.[13] At the molecular level, NMS is caused by a sudden, marked reduction in dopamine activity, either from withdrawal of dopaminergic agents or from blockade of dopamine receptors.

The mechanism is thought to depend on decreased levels of dopamine activity due to:

Dopamine receptor blockade
Genetically reduced function of dopamine receptor D2


Pathophisiology

The most widely accepted mechanism by which antipsychotics cause neuroleptic malignant syndrome is that of dopamine D2 receptor antagonism. In this widely accepted model, central D2 receptor blockade in the hypothalamus, nigrostriatal pathways, and spinal cord leads to increased muscle rigidity and tremor via extrapyramidal pathways. Hypothalamic D2 receptor blockade results in an elevated temperature set point and impairment of heat-dissipating mechanisms. Peripherally, antipsychotics lead to increased calcium release from the sarcoplasmic reticulum, resulting in increased contractility, which can contribute to hyperthermia, rigidity, and muscle cell breakdown.

Beyond these direct effects, D2 receptor blockade might cause neuroleptic malignant syndrome by removing tonic inhibition from the sympathetic nervous system. The resulting sympathoadrenal hyperactivity and dysregulation leads to autonomic dysfunction. This model suggests that patients with baseline high levels of sympathoadrenal activity might be at increased risk. While this has not been proven in controlled studies, several such states have been proposed as risk factors for neuroleptic malignant syndrome.[5]

Direct muscle toxicity also has been proposed as a mechanism of neuroleptic malignant syndrome.

NMS is a medical emergency

Treatment:

stop the antipsychotic medication and treat the hyperthermia aggressively

Dantrolene has been used when needed to reduce muscle rigidity

Amantadine is another treatment option due to its dopaminergic and anticholinergic effects

Benzodiazepines may be used to control agitation

more recently dopamine pathway medications such as bromocriptine
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  #21  
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Romania Malignant hyperthermia

Malignant hyperthermia

Susceptibility to MH is often inherited as an autosomal dominant disorder, for which there are at least 6 genetic loci of interest,[2] most prominently the ryanodine receptor gene (RYR1). MH susceptibility is phenotypically and genetically related to central core disease (CCD), an autosomal dominant disorder characterized both by MH symptoms and myopathy

Symptoms

The typical symptoms of malignant hyperthermia are due to a hypercatabolic state, which presents as a very high temperature, an increased heart rate and breathing rate, increased carbon dioxide production, increased oxygen consumption, acidosis, rigid muscles, and rhabdomyolysis

Causes
Volatile anesthetics,
And single depolarizing muscle blocker Succinylcholine

Treatment
dantrolene
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  #22  
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Romania Mesothelioma

Mesothelioma


Mesothelioma is a malignant neoplasm arising from mesothelial cells.
Body cavities ( pleural, peritoneal, pericardial) are lined with mesothelium.
Asbestos exposure is the only significant risk factor
Individuals involved in asbestos mininm and industrial application of asbestos like insulation and shipbuilding

The symptoms of mesothelioma include DISPNEA AND CHEST PAIN
Hemorrhagic pleural infusion are frequently present.
Nodular or smooth pleural thickening is the main finding on Roentgen
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  #23  
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Romania Hi

Formulas from Renal physiology

Cx=UxV/P
Where Ux is urine concentration of X
V urine flow rate
Px plasma concentration of X

FF=GFR/RPF
Glomerular Filtration Rate, may use inulin because is freely filtered and aproximate with 100-120 mL/min

Renal plasma flow , may be used Paraaminohypuric because is both filtered and actively secreted.

RBF=RPF/ (1-hematocrit)
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  #24  
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Romania

Lateral medullary syndrome

Lateral medullary syndrome (also called Wallenberg syndrome and posterior inferior cerebellar artery syndrome) is a disorder in which the patient has a constellation of neurologic symptoms due to injury to the lateral part of the medulla in the brain, resulting in tissue ischemia and necrosis.

Signs and symptoms
This syndrome is characterized by sensory deficits affecting the trunk (torso) and extremities on the opposite side of the infarction and sensory deficits affecting the face and cranial nerves on the same side with the infarct. Specifically, there is a loss of pain and temperature sensation on the contralateral (opposite) side of the body and ipsilateral (same) side of the face. This crossed finding is diagnostic for the syndrome.

Clinical symptoms include swallowing difficulty, or dysphagia slurred speech, ataxia, facial pain, vertigo, nystagmus, Horner's syndrome, diplopia, and possibly palatal myoclonus.




Weber's syndrome

Weber's syndrome (superior alternating hemiplegia) is a form of stroke characterized by the presence of an oculomotor nerve palsy and contralateral hemiparesis or hemiplegia
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  #25  
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Romania Acute poststreptococcal glomerulonephritis

Acute poststreptococcal glomerulonephritis

on LM>>>> glomeruli enlarged and hypercellular, neutrophils, LUMPY_BUMPY appearance
on EM >>>> subepithelial immune complex humps
on IF>>>> granular appearance due to IgG, IgM, C3 deposition along th GBM and mesangium

Most frequently seen in children. Peripheral and periorbital edema and dark urine.
Resolves spontaneously.

Decreased level of C3

M protein define nephritogenic strains...
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Romania Focal segmental glomerulonephritis

Focal segmental glomerulonephritis

Most common in adults

on LM segmental sclerosis and hyalinosis
Most common glomerular disease in HIV, Heroin use, sickle cell disease
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  #27  
Old 12-12-2014
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Romania Polyarteritis nodosa

Polyarteritis nodosa

YOung adults

Hepatitis B seropositivity in 30% of patients.
Fever, weight loss, malaise, headache.
GI: abdominal pain, melena.
Hypertension, neurologic dysfunction, cutaneous eruptions., with palpable purpura

Transmural inflamation with ANCA negative

Typically involves renal and visceral vessels, NOT PULMONARY ARTERIES
Immune complex mediated.
Fibrinoid necrosis
Multiple aneurysms and constrictions on arteriogram.
Treat with corticosteroids, cyclophosphamide.
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  #28  
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Romania Buerger's disease

Buerger's disease

or thromboangiitis obliterans


Heavy smokers, males with less than 40 years old of age.
Intermittent claudication may lead to gangrene, autoamputation of digits, superficial nodular phlebitis, microabscesses.

Raynaud's phenomenon, cold sensitivity, with response to peripheral vasoconstriction, severe pain of affected part even at rest, due to neural involvement.

Segmental thrombosing vasculitis. Often extends
Treatment is smoking cessation if is posible
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  #29  
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Romania Wegener granulomatosis

Wegener granulomatosis

Langhan's giant cells

Upper respiratory tract: perforation of nasal septum, chronic sinusitis, otitis media, mastoiditis,
Lower respiratory tract: hemoptysis, cough, dyspnea.
Renal: hematuria, red cells casts

Suddle nose deformities

Triad :
Focal necrotizing vasculitis
Necrotizing granulomas in the lung and upper airway
Necrotizing glomerulonephritis
c-ANCA


Chest X ray: large nodular densities.
Treat with cyclophosphamide and corticosteroids...
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  #30  
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Romania Patau's syndrome 13

Normal alpha fetoprotein, normal B hCG, normal estriol, normal inhibin A

Findings: severe mental retardation, rocker bottom feet, microphthalmia, microcephaly, cleft LIP, PALATE, Holoprosencephaly Cyclop for same reason, polydactily, congenital heart disease, Death usualy occurs within 1st year of birth.

Abnormality arises during maternal meiosis I

Key points: Microphtalmia, cyclops, anophthalmia
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  #31  
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Romania Phenylketonuria

Phenylketonuria

Due to decrease phenylalanine decarboxylase or decrease in tetrahydrobiopterin cofactor named malignant phenylketonuria.

Tyrosine becomes essential
Increased phenylalanine leads to excess phenylketones in urine.

Findings.: Mental retardation, growth retardation, seizures, fair skin, eczema, musty body odor.
Treatment: Decrease phenylalanine from diet, that is contained in aspartame an NUtrasweet, and increase tyrosine diet...

Phenylketones like phenylacetate, phenyllactate, phenylpyruvate are formed.

Disorder of aromatic amino acid metabolism>>>>>>>>>>> musty body odor...
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  #32  
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Romania Gerstmann syndrome

Gerstmann syndrome

Gerstmann's syndrome is a cognitive impairment that results from damage to a specific area of the brain -- the left parietal lobe in the region of the angular gyrus. It may occur after a stroke or in association with damage to the parietal lobe. It is characterized by four primary symptoms: a writing disability (agraphia or dysgraphia), a lack of understanding of the rules for calculation or arithmetic (acalculia or dyscalculia), an inability to distinguish right from left, and an inability to identify fingers (finger agnosia). The disorder should not be confused with Gerstmann-Sträussler-Scheinker disease, a type of transmissible spongiform encephalopathy.

In addition to exhibiting the above symptoms, many adults also experience aphasia, (difficulty in expressing oneself when speaking, in understanding speech, or in reading and writing).

There are few reports of the syndrome, sometimes called developmental Gerstmann's syndrome, in children. The cause is not known. Most cases are identified when children reach school age, a time when they are challenged with writing and math exercises. Generally, children with the disorder exhibit poor handwriting and spelling skills, and difficulty with math functions, including adding, subtracting, multiplying, and dividing. An inability to differentiate right from left and to discriminate among individual fingers may also be apparent. In addition to the four primary symptoms, many children also suffer from constructional apraxia, an inability to copy simple drawings. Frequently, there is also an impairment in reading. Children with a high level of intellectual functioning as well as those with brain damage may be affected with the disorder.
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  #33  
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Romania Turner syndrome

Turner syndrome


Short stature, if left untreated , less than 5 feet, ovarian dysgenesis( streak ovary with infertility)
Shield chest, bicuspid aortic valve, defects in lymphatics>>>>>>>>>webbing of neck( cystic hygroma) and lymphedema in feet and hands, preductal coarctation of the aorta, horseshoe kidney, dysgerminoma most common cause of primary amenorrhea, No barr body.

Menopause before menarche
Decreased estrogen because ovaries are unfunctional or ABSENT ovaries.

, and increased LH and FSH.
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  #34  
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Romania Determination of hand and palm area as a ratio of body surface area

Determination of hand and palm area as a ratio of body surface area


The hand area (palm plus digits) is more closely represented to 1% of TBSA
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  #35  
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Romania Acute tubular necrosis

Acute tubular necrosis

When i heard tubular, compare imediately with blood vessel, ishemia cardio
Ishemic, secondary to low cardiac output during cardiac arrest.
Most common cause of acute renal failure in hospital. Self reversible fatal if left untreated. Death most often occurs during initial oliguric phase.

3 stages:

Inciting event
Maintanance phase, oliguric, lasts 1-3 weeks, risk for hyperkalemia
Recovery phase, polyuric, BUN and serum creatinin falls, risk of hypokalemia.

Associated with renal ischemia like shock, sepsis, cardiac arrest, hemorrhage, and all that decrease Volemia.

Key findings: muddy brown granular casts
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  #36  
Old 12-25-2014
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Romania Rifampin very high yield , at least one quetion

Rifampicin inhibits bacterial DNA-dependent RNA synthesis by inhibiting bacterial DNA-dependent RNA polymerase

Especialy moment about prophylaxis in Meningitis...
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  #37  
Old 12-27-2014
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Romania Hi

Renin-angiotesin-aldosterone sistem.
At leas one quetion on exam, pay atention on every step of activation, drugs that act on , and with accumulates in cases...
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  #38  
Old 12-27-2014
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Star

Thank you so much for your effort
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  #39  
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Romania Hi

Kawasaki disease, especialy founded in children, know a classic presentation of disease, and memorise everything, you know, rash on palms and soles, oral mucosa deterioration, and of course that one, affecting coronary vessels, if you see some pathology with coronary vessels + vasculitis, be sure it is Kawasaki...
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  #40  
Old 12-28-2014
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Romania Hi

Quote:
Originally Posted by sashabeliimd View Post
Acute tubular necrosis

When i heard tubular, compare imediately with blood vessel, ishemia cardio
Ishemic, secondary to low cardiac output during cardiac arrest.
Most common cause of acute renal failure in hospital. Self reversible fatal if left untreated. Death most often occurs during initial oliguric phase.

3 stages:

Inciting event
Maintanance phase, oliguric, lasts 1-3 weeks, risk for hyperkalemia
Recovery phase, polyuric, BUN and serum creatinin falls, risk of hypokalemia.

Associated with renal ischemia like shock, sepsis, cardiac arrest, hemorrhage, and all that decrease Volemia.

Key findings: muddy brown granular casts
Again want to mention combination of words like GRANULAR CASTS is indication of acute tubular necrosis... it's a clue
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  #41  
Old 12-28-2014
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Default Hi

Brachial plexus, and of course from popliteal below popliteal ramification.
Two important to know are :
Tibial posterior and peroneus common
open your book and make signs, what part and who innervate...
An you one mention i'm sure you know, when nerve produce contraction of muscle flexors, and it is injured, effect will be opposed, of muscle that extend...
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  #42  
Old 12-28-2014
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Romania Hi

Suggestions about First aid
This book is amazing for making your knowledge more strong and add thing in your brain.
But for my opinion you must review this book just after reviewing of something most detailed and with explanation...
First aid is very very high yield. and you must know all info from...

Another moment that you can add new information from sources like : Pathoma with complete missed info from pathollogy topic.
Or from Goljan , but Goljan in content is practicaly the same thing, more detailed and more images,
Images give you alternative chance to understand processes.
I know one girls personaly , which make all in images, i mean drawing everything

Do FA after kaplan, after pathoma or Goljan rapid review, after qbanks, and here WITH Doctors in training if this option working for you
DIT, make you feel atmosphere like you talking FA with someone
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  #43  
Old 12-30-2014
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Romania Beta blockers

You will have at least one question on exam with beta blockers...
Be sure you may differentiate selective from nonselective...
Know which side of action i mean receptors...


One example may be patient with some pulmonary disease, chronic or in acutization, and which beta blockers are safety, or does not aggravate the disease to this patient,
And one more mention about b blocker, and please remember, Action on renin, beta blockers block release of renin, and patient may develop slight decrease in blood pressure...
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  #44  
Old 12-30-2014
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Romania Two elements

Quote:
Originally Posted by sashabeliimd View Post
Bacterial endocarditis

Fever most common
Roth's spots on retina
Osler's nodes on fingers
New murmurs
Janeway lesions, on palms or soles
Anemia
Splinter hemorrhages on nail bed
Valvular damage
Can be caused by Staph aureus, as acute form
And caused by viridans streptococci as subacute form
If you see combination of Fever plus murmur, it should be definetily bacterial endocarditis, watch videos from Dr. Conrad Fisher about Bacterial endocarditis, and if you have time other 20 videos, that will add and make strong knowledge in the last few days before exam...
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  #45  
Old 12-30-2014
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Romania Hi

I want to tell for forum members who preparing for step 1 , that on exam you will not see exact quetion from some Qbank, and even somebody recall questions, it mean that you will be tested in same area, in this mode was created concise books like First Aid.
And if a said that headaches are very high yield information , and you will have one of them on exam, it will...
One good list was created by Doctors in training, search on Dit star topics for exam!!!!!!!!!!!!!!!!!!!!!!!!

i got runned all these star topics before exam 1 week, and was extremely helpful..
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  #46  
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Default

Hi..m really sorry,I juz saw ur message now.I tried to find the link here but I wasn't able too. But the one I downloaded too many pages where missing,so I purchased the book.
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  #47  
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Default

Hi I am really sorry i tried to find the link for you from here butq unfortunately I couldn't. The one I downloaded too had many pages missing..so I purchased the book itself
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