What's special about Pancreatic Cancer?
Trosseau's Syndrome = Migratory Thrombolembolism secondary to Pancreatic Cancer (redness and tenderness on palpation of extremities)
- Poor prognosis; usually already met-ed on presentation.
- Pancreatic head cancer causes obstructive jaundice
- Remember Tumor Marker is CA-19-9! Wish stephanie had lived to be 199, but she first had problems with her pancreas
Rule of 9s for burn evaluation.
Where does leischmaniasis live
Which of the three adrenal cortex hormones is not controlled at all by ACTH?
Zona Glomerulosa - Aldosterone!
What is considered a positive Western Blot for HIV?
- need positive for 2 out of the 3 enzymes which are...
- p24 (capsid protein)
- gp41 (fusion and entry)
- gp121 (attachment to t-cell)
Where do Munro Microabcesses occur?
- from adenoma of adrenal gland
Diabetic Retinopathy versus Roth Spots
- Diabetic Retinopathy = Cotton Wool Spots with Macular Edema
- Roth Spots = Round white sponts on retina with hemorrhage
Difference between DHEA and DHEAS
- DHEA = Product of 17 alpha hydroxylase
- DHEAS = Inactive product of Cortisol breakdown.
Sign of Premature Menopause
Reduced Inhibin Levels
What disease will give you a false + on syphilus tests?
- SLE. Due to antiphospholipid antibodies.
- This also explains why people with SLE although hypercoaguable can show long PTT, it's because antibodies react to phospholipids used in that reaction.
What is Lichen Planus?
- Purple, Polygonal, Pruritic, Papules. Sawtooth infilitrate of lymphocytes at dermal-epidermal junction.
- ASSOCIATED WITH HEP C. Usually self-resolves.
- T-cell mediated.
What is erythema nodosum associated with?
Inflammatory lesion of SC fat on anterior shin.
"Herald Patch" Solitary pink / flesh colored path on otherwise healthy adolescent or young adult.
Followed by "Christmas tree" papules and plaques on trunk and upper extremities several days later.
Self-resolving. Viral etiology.
Different effects of Aspirin at different doses
- Low does (<300 mg) = decreases platelet aggregation
- Med. Dose (<300-2400mg) = Anti-pruritic, analgesic
- High dose 2400-4000 mg = Anti-inflammatory.
Why can NSAIDS cause renal damage?
- They block the action of Prostaglandins, which dilate the afferent arteriole
- This increases RPF and GFR (but keeps FF constant)
Suffix for bisphosphonates?
- Inhibits osteoclast activity!
What is the difference between etanercept and infliximab/adalimumab?
- Infliximab and adalimumab are Anti-TNF-alpha antabodies
- etanercept is a TNF-alpha receptor decoy!
What does Teres Major always go with?
- Latissimus Dori
- Note that Teres Major is Innervated by lower subscapular
Difference between flexor digitorum profundis and superficiales
Flexor Digitorum Profundis = All Jts. Separated Median/Ulnar nerve.
- Flexor Digitorum Superficiales = MCP and PIP
- Only Median Nerve.