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How does basal cell carcinoma present?
Slow growing waxy nodular lesions with a rolled edge. Most common on skin areas chronically exposed to sun
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Basal cell carcinoma treatment
Mohs surgery, excision or imiquimod cream
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What is the 2nd most common form of skin cancer in the US and how does it present?
- Squamous cell carcinoma
- Most commonly arises from actinic keratosis, sun exposed areas including backs of hands and tips of ears.
- Soft mobile with red inflamed base and adherent scale.
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Conditions promoting pleural transudate
- CHF
- Atelectasis
- superior vena cava syndrome
- nephrotic syndrome
- (
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Transudate definition:
- Clear fluid produced from increased hydrostatic or fluid pressure or decreased oncotic pressure of plasma.
- Low spec grav, low protein, less protein than serum, more albumin than blood.
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Exudate definition:
- Cloudy fluid produced from changes in pleural membrane permeability. such as inflamed areas
- Pleural fluid to serum fluid ratio >0.5
- Pleural fluid to serum LDH ratio > 0.6
- +/- increased cholesterol levels
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Conditions that cause exudative effusion
- pneumonia (parapneumnonic effusion most common)
- empyema
- Tb
- malignancy
- RA
- SLE
- infections
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Etiology of superior vena cava syndrome
malignant mediastinal masses
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Presentation of superior vena cava syndrome
- Dyspnea
- facial swelling, headache, plethora
- papilledema, JVD
- chest pain
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Boerhaave syndrome vs mallory weiss tear:
- Boerhaave: (transmural esophageal rupture)
- pain following repeated retching, not usually with hematemesis
- Mallory weiss: (mucosal tear)
- repeated retching leading to hematemesis
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Treatment for eradication of H pylori infection
- either triple or quadruple therapy:
- -PPI + Metronidazole, clarithromycin, tetracycline, bismuth or amoxicillin
-PPI+ Levofloxacin, rifabutin, furazolidone, doxycycline, nitazoxanide
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Four major complications of peptic ulcers
- hemorrhage
- stenosis
- intractability
- perforation
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Clinical findings of Primary sclerosing cholangitis:
- jaundice, fatigue, pruritis
- elevated alk phos, elevated ast/alt
- may have increasing bilirubin level
- stong association between pANCA with coexisting colitis
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What is charcods triad and what disease is it associated with?
CHOLANGITIS (inflammation of CBD)
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What is reynolds pentad?
- -fever
- -jaundice
- -RUQ pain
- -AMS
- -Hypotension
ASCENDING SUPPURATIVE CHOLANGITIS
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Labs in Cholangitis
- high AST/ALT
- rising alk phos and bilirubin
- high amylase/lipase with secondary pancreatitis
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