Acute bronchitis Infection of the large bronchi Most often caused by a virus RSV Rhinovirus Influenza 5-10% are bacterial Usually follows a URI Clinical Presentation Shortness of breath Cough can last for more than three weeks Wheezing Fever Labs, Studies and Physical Exam Findings Prolonged expiration Wheezing or rhonchi X-ray showing hyperinflation of the lungs […]
Pneumonia Community Acquired Pneumonia From oxford dictionary – Lung inflammation caused by bacterial or viral infection, in which the air sacs fill with pus and may become solid. Inflammation may affect both lungs ( double pneumonia ), one lung ( single pneumonia ), or only certain lobes ( lobar pneumonia ). Causes include Streptococcus pneumoniae […]
Restrictive Pulmonary Disease Idiopathic pulmonary fibrosis The development of scar tissue within the lungs Clinical presentation Dyspnea Dry cough Chest discomfort Labs, Studies and Physical Exam Findings Fine crackles at the bases may be present FEV1 is reduced FVC is reduced Lung volumes are reduced Chest x-ray may not be helpful CT Wedge biopsy Treatment […]
Obstructive Lung Diseases Spirometry The most used pulmonary function test. It measures volume and speed of exhalation and inspiration. Total lung capacity (TLC) The volume of the lungs at maximal inflation Tidal volume The volume of air moved into and out of the lungs during normal resting respirations Vital Capacity The volume of air exhaled […]
Acanthosis Nigricans Typically occurs in African Americans Causes May be inherited May appear in a healthy individual May be directly related to an underlying health issue which is usually an endocrine disorder Insulin resistant disorders are most common DM type 2 PCOS Hypo or hyperthyroidism Cushing’s disease Acromegaly Clinical Presentation Brown or black poorly defined […]
Kaposi’s Sarcoma A systemic disease caused by herpes virus 8 Most often have lesions on the skin surface. Typically a very slow developing illness, but in conjunction with the AIDS virus it progresses very quickly. These lesions became linked directly with AIDS during the 1980’s. Clinical Presentation Skin lesions Flat or raised Purple Widespread or […]
Acne Vulgaris Obstruction and inflammation of hair follicles and sebaceous glands The most common skin disease affecting 80% of the US population Sebum is an oily secretion from the sebaceous glands How it happens Follicles get clogged with sebum and keratinocytes Follicles are colonized by Propionibacterium acnes which is a normal human anaerobe Inflammation occurs […]
Papulosquamous disorders Conditions which present with both papule and scales Lichen simplex chronicus (not on 2019 blueprint) A skin disorder characterized by repetitive itching and scratching. This may be secondary to eczema, psoriasis, bug bites, psych disorders etc. Clinical Presentation & Physical Exam findings Itching Lichenified (leathery) skin with well defined borders Labs, Studies and […]
Dyslipidemia Low-density lipoprotein (LDL) (lousy) Increased LDL correlates with an increased risk of heart disease. High-density lipoprotein (HDL) (happy) Increased HDL correlates with a decreased risk of heart disease. Triglycerides An increase in triglycerides is correlated to a an increased risk of heart disease. Causes and correlations Straight out of the Merck Manual “The most […]
Addison’s Disease Addison’s = Primary adrenocortical insufficiency More frequently in women than in men. Causes Autoimmune problem is 80% of the cause. TB Genetic disorders Removal of adrenals Adrenal infarct Etc. Clinical findings Sparse axillary and pubic hair Hyperpigmentation of skin especially of creases or pressure areas (waistband/bra line) Hypotension, generally systolic under 110 […]
The Hypothalamic, Pituitary Adrenal Axis In response to low serum cortisol or stress the hypothalamus secretes corticotropin releasing factor (CRF). In response to CRF the pituitary releases adrenocorticotropic hormone (ACTH). In response to ACTH the adrenal glands secrete cortisol In response to elevated cortisol levels the hypothalamus decreases production of CRF Cortisol Produced by the […]
Parathyroid There are four parathyroid glands located adjacent Produces parathyroid hormone (PTH) PTH increases calcium concentration in the bloodstream in response to low serum calcium Hyperparathyroidism Affects women 3:1 over men Primary Typically this is caused by an adenoma Maybe hyperplasia or carcinoma. Secondary Chronic renal failure Poor production of vitamin D which will decrease […]
Thyroiditis Inflammation of the thyroid Hashimoto’s thyroiditis Also known as chronic lymphocytic thyroiditis Subacute thyroiditis Also known as granulomatous thyroiditis, de Quervain’s thyroiditis and giant cell thyroiditis Thought to be caused by a virus. Postpartum thyroiditis Believed to be autoimmune Occurs in 7.2% of women post delivery Riedel thyroiditis Invasive fibrous, woody, ligneous are […]
Disorders of the Thyroid Hormones TSH = thyroid stimulating hormone Created and secreted by the anterior pituitary T4 = thyroxine T3 = triiodothyronine Primary caused by disease in the thyroid Secondary Caused by diseases in the hypothalamus or pituitary Hyperthyroidism Elevated levels of free T4 and T3 Amiodarone may cause thyrotoxicosis Causes Graves disease The […]
Atherosclerosis Components of atherosclerosis Lipid deposition Fibrosis Calcifications Plaque in the intima of medium and large blood vessels Atherosclerosis is the number one cause of cardiac-related death and disability. Risk Factors HTN Dyslipidemia Smoking Diabetes Advancing age Family history Males to Female = 4:1 Clinical Presentation No symptoms at all Symptoms of ischemia by location […]
Atrial fibrillation Fibrillation Muscular twitching involving individual muscle fibers acting WITHOUT coordination The most common chronic arrhythmia Onset is PSVT before becoming chronic First event will spontaneously convert 60% of the time within the first 24 hrs Risk Factors Can occur without any risk factors Chronic HTN Coronary artery disease Valve disorders Hyperthyroid Clinical presentation […]
Ovarian Cysts Common findings and are often part of a normal menstrual cycle including follicular and corpus luteum cysts. The most common types of benign cysts found are serous and mucinous adenomas and teratomas or dermoid cysts. Postmenopausal cysts are presumed to be malignant until proven otherwise. Clinical Presentation Pain Abnormal menstrual changes Incidental finding […]
Your questions answered. 1) What do you think of live, 3-5 day review courses?
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6) I'm in Dermatology. How am I ever going to pass the PANRE?
Cervical Dysplasia and Carcinoma Neoplasia is an abnormal growth of cells Dysplasia is an abnormal development typically with an excess of immature cells Cervical dysplasia and carcinoma have been linked to human papillomavirus (HPV) Risk factors Sexual activity increases risk for exposure to HPV The younger the age of first intercourse the greater the risk […]
Menstrual cycle Follicular phase Day one of the cycle begins with menses Estrogen increases causing the uterine lining to thicken Follicular stimulating hormone (FSH) increases, stimulating the follicles On day two or three of the cycle one follicle in the ovary becomes dominant About day 14 a surge in luteinizing hormone (LH) causes the dominant […]
Preterm Labor Labor is the the presence of uterine contractions which are strong and frequent enough to expel the products of conception from the uterus. Preterm labor is labor which occurs between 20 and 37 weeks. This is the leading cause of neonatal mortality in the United States. Risk factors Multiple gestation (approximately 10% of […]
Rh Incompatibility Mother is Rh (-) and baby is Rh (+). Mother has potential to create anti Rh (+) antibodies. RBC’s do not cross the placenta, but IgG antibodies do. There must be a traumatic event when the fetus’s blood comes in contact with the mother’s blood to trigger antibody production. Uterine trauma Amniocentesis Delivery […]
Routine Prenatal Care Terminology Estimated date of confinement (EDC) Last menstrual period (LMP) Miscarriage/abortion (Ab) Gravida (G) = pregnancy Parity (P) = deliveries Advanced Maternal Age (AMA) = >35 years old Shorthand A patient’s simplified OB history can be written using the common abbreviations Gravida (number of pregnancies) = G Parity (number of births) […]
Child Abuse Things you should know The physical, sexual or emotional maltreatment or neglect of a child or children Classification: Neglect Physical Abuse Psychological or Emotional Abuse Sexual Abuse: Several studies have shown that in North America Studies that as many as 25% of women and 12% of men have experienced sexual abuse as a […]
Substance Dependence Things you should know Use of one or more substances leads to a clinically significant impairment or distress Signs and Symptoms See Diagnosis below Diagnosis Physical assessment Laboratory test Toxicology screening – using either blood or urine sample Psychological assessment using Diagnostic and Statistical Manual of Mental Disorders (DSM-5) One may have […]
Schizophrenia Things you should know Patient exhibits abnormal behavior and is unable to differentiate real from imaginary. Chronic and debilitating Disruption of the usual balance of emotions and thinking M>F Signs and Symptoms Positive symptoms – Extra feelings or behaviors which are usually not present Delusions and paranoia Hallucinations Irrational, bizarre or odd statements […]
Sorry, but it’s not gonna happen this week. 🙁 The kids, my wife and I all have had bronchitis / sinus infection / pnuemonia who knows for about 2 weeks now. No end in site and I can’t speak long enough without coughing to do the show. I’ll have one up as soon […]