-
which condyloma is thin, flat, moist, and is associated with secondary syphilis
condyloma lata
-
which condyloma is papillary or elevated, is NOT syphilis
condyloma acuminata
-
what are the strands of HPV that can cause condyloma acuminata
-
what is another name for anogenital warts
condylomata
-
what are the frequent offenders of vaginits
- - candida albicans- most common (fungus)
- - trich vaginalis (parasite)
-
an overgrowth of Gardnerella vaginalis due to a decrease in normal flora and increased pH is known as what
bacterial vaginosis
-
what are the clinical characteristics of bacterial vaginosis
thin, malodorous vaginal d/c
-
which lab is done to check for bacterial vaginosis
- - saline wet prep- "clue cells"
- - fishy amine odor released with application of KOH
- - pH of vaginal secretion >4.5
-
vulvar tumors affect women usually older than 60 y/o and many are what type of carcinoma
squamous cell carcinoma
-
which strand of HPV may be responsible for vulvar tumors
HPV 16
-
what do you want to look for when looking for vulvar tumors
look for areas of leukoplakia in any regions of vulva or adjacent skin
-
what type of vaginal cancers occur in children younger then 5 y/o
sarcoma botryoides
-
an inflammation of the cervix is known as what
cervicitis
-
what are the pathogens that can cause cervicitis
- - chlamydia trachomatis
- - ureaplasma urealyticum
- - trich vaginalis
- - candida species
- - Neisseria gonorrhea
- - HSV 2
- - HPV
-
in cervical carcinoma, what is there an increase in discovery of
cervical intraepithelial neoplasias (CIN)
-
what type of tumors of the cervix can be seen on cytology smears
- - ASCUS= atypical squamous cells of undetermined significance -- repeat PAP 6 mo's
- - AGUS= atypical glandular cells
- - LSIL= low grade intra-epithelial lesion
-
what is CIN I in tumors of the cervix
mild dysplasia (low grade)
-
what is CIN II in tumors of the cervix
moderate dysplasia (high grade)
-
what is CIN III in tumors of the cervix
severe dysplasia (high grade)
-
what is CIS in tumors of the cervix
carcinoma in situ
-
what are the risk factors for CIN and invasive CA
- - early age at first sexual intercourse
- - multiple sexual partners
- - partner with multiple sex partners
- - smokers
- - persistent infx by high-risk HPV
- - invasive carcinoma of the cervix
-
what are the high risk HPV subtypes
16,18
-
what are the low-risk HPV types
6,11
-
the inner lining of the uterus is known as what
endometrium
-
the muscular walls of the uterus are known as what
myometrium
-
tubes, ovaries and ligaments of the uterus are known as what
adnexa
-
excessive or irregular bleeding with no physical lesion is known as what
Dysfunctional uterine bleeding
-
This is usually due to an excess estrogen relative to progestin and in time it can give rise to endometrial carcinoma
Endometrial hyperplasia
-
These are often called fibroid tumors
Leiomyoma
-
These are common benign tumors of uterine smooth muscle, they are found in 30 to 50% of pts during reproductive years, it is more common in blacks and whites usually greater than 30 years old, they do shrink after menopause and are usually multiple and asymptomatic
leiomyoma
-
These are unusual, they are cancers arising from myometrium, do not arise from leiomyoma, they are usually solitary lesions and recurrence after removal is common
leiomyosarcoma
-
This is caused by endometrial tissue outside the uterus
Endometriosis
-
Endometriosis is more common in which patient population
Nulliparity, early menarche/late menopause, tall/thin Caucasians
-
Endometriosis is less common in which patient population
Individuals with multiple births, long lactation, late menarche, black/Asian
-
This is a growth of basal layer of endometrium down into the myometrium
adenomyosis
-
What can patients present to the clinic with when suspecting adenomyosis
Menorrhagia, dysmenorrhea
-
These typically produced bleeding from the uterus as the earliest manifestation
Tumors of endometrium and myometrium
-
These can occur at any age, generally at time of menopause, and they result in abnormal uterine bleeding
Endometrial polyps
-
Post menopausal vaginal bleeding must be evaluated for what
Cancer
-
What is the most common GYN cancer in the United States, the average age at presentation is 61, and most present with abnormal uterine bleeding
Endometrial carcinoma
-
Endometrial carcinoma frequently arises from what
Endometrial hyperplasia
-
What are the well-defined risk factors for endometrial carcinoma
- - Obesity/increased synthesis of estrogen in fat deposits
- - diabetes
- - hypertension
- - infertility
-
This type of infection in endometritis is usually caused by bacterial infections after delivery or miscarriage, and is associated with pain, discomfort, and fever
Acute infection
-
This type of infection is associated with endometritis and is associated with either retained gestational tissue, intrauterine contraceptive devices, or chronic gonorrhea pelvic disease
Chronic infections
-
Inflammation of the fallopian tubes, nearly always bacterial in origin is known as what
Salpingitis
-
What are the species that cause salpingitis
Chlamydia, mycoplasma hominis
-
What are the species that has postpartum salpingitis
Streptococci and staphylococci
-
What is an infection of the pelvic organs be on the body of the uterus called
Pelvic inflammatory disease
-
What are the principle biochemical abnormalities of polycystic ovaries
- - Excessive production of androgens
- - high luteinizing hormone
- - low follicle stimulating hormone
- - multiple cystic follicles in the ovaries
-
What are the clinical presentations of polycystic ovaries
- Oligomenorrhea
- hirsutism
- infertility and obesity
-
Risk factors for ovarian cancer are what
- Family history
- nulliparity
- high-fat diets
- anouvulation
-
Post menopausal vaginal bleeding can because by what
Endometrial carcinoma
-
Postpartum uterine infection can because by what
endometritis
-
tubal infection is known as what
Salpingitis
-
A painful menses is known as what
Dysmenorrhea
-
A heavy menses is known as what
Menorrhagia
-
Ectopic endometrial tissue is known as what
Endometriosis
-
Implantation fertilized egg outside the endometrium is normally called what
ectopic pregnancy
-
an interruption of pregnancy before fetal viability is known as what
Abortion
-
This type of abortion usually has no identifiable cause, many unknown pregnancies end in this type of abortion
Spontaneous abortion (miscarriage)
-
This type of abortion is surgically performed at the women's request
Induced abortion
-
Which type of spontaneous abortion is when the fetus and placenta are completely expulsed, and woman resumes normal menses
Complete spontaneous abortion
-
Which type of spontaneous abortion is when there is cervical dilation and expulsion of some fetal parts with some parts of placenta being retained
Incomplete spontaneous abortion
-
Which type of spontaneous abortion can result in endometritis if it becomes infected
Incomplete spontaneous abortion
-
Which type of spontaneous abortion is when there is a death of a fetus, which remains in utero
Missed spontaneous abortion
-
Which type of spontaneous abortion is where there is cervical bleeding, but cervix does not dilate and pregnancy may continue uneventfully
Threatened spontaneous abortion
-
This is a result of abnormally functioning placenta or abnormal materno-placental interaction
Toxemia of pregnancy a.k.a. eclampsia
-
What are some clinical features of pre-eclampsia
Hyper/reflexia, hypertension, proteinuria, generalized edema
-
What are some clinical features of eclampsia
- Hyper/reflexia
- hypertension
- proteinuria
- generalized edema
- seizures or coma
-
What is HELLP syndrome
Hemolytic anemia, Elevated Liver enzymes, Low Platelets
-
What is the function of the hypothalamus
Regulates hunger, thirst, sleep and wakefulness plus most of your involuntary mechanisms including body temperature
-
What is the function of your thyroid glands
Regulates your energy and your metabolism
-
What is the function of your pancreas
Aids in the digestion of proteins, fats and carbohydrates. It produces insulin which controls blood sugar levels
-
What is the function of ovaries
Influences how your blood circulates and determines your mental vigor and your sex drive
-
What is the function of your pituitary gland
Controls all of the endocrine glands, influences growth, metabolism and regeneration
-
What is the function of the parathyroid
Secretes the hormones necessary for calcium absorption
-
What is the function of the thymus
Helps build resistance to disease
-
What is the function of the adrenal glands
Secretes hundreds of compounds including cortisone and adrenaline which helps to react to emergencies. Regulates your metabolic processes in the cells, water balance, blood pressure
-
Which hormone stimulates secretion of cortisol and aldosterone by the adrenal cortex
ACTH
-
Which hormone stimulates reabsorption of water by kidneys, reducing the concentration of solute in the blood
ADH
-
Which hormone stimulates egg production in females, stimulates sperm production males
Follicle stimulating hormone
-
Which hormone regulates development of muscles and bones
Growth hormone
-
Which hormone stimulates progesterone and estrogen production, initiates ovulation in females, stimulates testosterone production
Luteinizing hormone
-
Which hormone initiates uterine contractions during childbirth, stimulates flow of milk from breast during lactation
Oxytocin
-
Which hormone stimulates milk production and breasts during lactation
Prolactin
-
Which hormones regulate secretion of the thyroid hormones; thyroxine and triiodothyronine
Thyroid stimulating hormone
-
Which type of hormones stimulate functions of other endocrine glands
trophic hormones
-
A flat lesion measuring less than 2 cm in diameter, it is not raised or depressed, primarily a change in skin color (ie, freckle) is known as what
Macule
-
This is similar to a macule but larger than 2 cm (skin rash that occurs in measles)
Patch
-
This type of skin lesion is slightly elevated, small induration of skin, with a diameter of less then 1 cm (these are the hallmark of eczema)
Papule
-
This type of skin lesion is similar to a papule but larger (1-5 cm diameter)
Nodule
-
A nodule at the diameter exceeding 5 cm is known as what
Tumor
-
A fluid filled elevation of the epidermis measuring less than 1 cm in diameter is known as what
vesicle
-
a large vesicle measuring more than 1 cm in diameter is known as what
Bulla
-
A vesicle filled with pus is known as what
pustule
-
A defect or erosion of the epidermis is known as what
ulcer
-
A skin defect covered with coagulated plasma or blood is known as what
Crust
-
keratin layers that cover the skin in flakes or sheets, and that can easily be scrapped away are known as what
Scales
-
A superficial skin defect caused by scratching
Excoriation
-
A sharp edged defect in the dermis that extends into the deeper layers of the skin is known as what
Fissure
-
This is an autosomal dominant trait that has thick scales resembling fish skin
ichthyosis congenita
-
This term is used to denote several skin disorders
Epidermolysis bullosa
-
This congenital skin disorder is also known as port wine Mark
Nevus flammeus
-
An aggregate of small blood vessels usually on the face is known as what
nevus flammeus
-
A superficial tearing of epidermal cells is known as what
Abrasion
-
"bruise"- bleeding into the soft tissues due to disruption of underlying small blood vessels is known as what
Contusion
-
A jagged tear, often seen with stretching of the skin and/or underlying tissue is known as what
Laceration
-
A clean, sharp cut is known as what
Incised wound/incision
-
A deep tubular wound produced by a sharp thin object is known as what
Puncture wound
-
What type of puncture wound is when the puncture pierces the tissues
Penetrating puncture wound
-
Which type of puncture wound is when the puncture transverses the tissue to make an exit
Perforating
-
Which degree burn includes the epidermis only, appears with erythema; blanches with pressure, sensations are intact; mild to moderate pain,and the healing takes about three – six days without scarring
First degree
-
What type of second-degree burn includes the epidermis and superficial dermis; skin appendages intact, appears with erythema, blisters, its moist, elastic, and blanches with pressure, sensations are intact; with severe pain, healing takes about 1-3 weeks; scarring unusual
Superficial second-degree burn
-
What type of second-degree burn is when the epidermis and most of the dermis is involved; most skin appendages are destroyed, will have a white color appearing with erythamtous areas dry, waxy looking, less elasticity, reduced blanching to pressure, decreased sensation; maybe less painful, healing takes greater than three weeks; often with scarring and contractures
Deep second-degree burns
-
Which degree burn involves the epidermis and all of the dermis; destruction of all skin appendages, appears white, charred, tan, thrombosed vessels; dry and leathery; does not blanch, anesthetic not painful (although surrounding areas of second-degree burns are painful), does not heal; severe scarring and contractures
Third-degree burns
-
Which type of cold injury is when the tissue injury results from prolonged exposure to non-freezing cold and moisture presents with skin necrosis, with blisters and ulcers
Immersion foot – "trench foot"
-
Which type of cold injury is caused by subfreezing temperatures, involves mostly fingers, toes, ears, nose. Upon rewarming, area may appear blotchy red and swollen
Frostbite
-
In electrical injuries the most severe damage usually involves what areas near the entry or exit point
The deeper tissues and possibly internal organs
-
In electrical injuries when there is damage to the blood vessels what may occur
- May result in thrombosis secondary to vessel damage
- Subsequent muscle infarctions may result
- Fasciotomy to try to prevent this
-
Which type of radiation injury may result in partial thickness burns, chronic exposure damages the skin and may accelerate the aging of skin and may develop into cancer
Sunlight injury
-
Which type of radiation injury is due to prolonged or repeated exposures of large doses which can cause significant lesions
Ionizing radiation (x-ray, including CT)
-
What are the four groups within neoplasms of skin
- Tumors of the epithelial cells
- Tumors of the pigmentary cells (melanocytes)
- Tumors of the dermal connective tissue
- Tumors of the blood-borne cells
-
What are the A – B – C – D of skin cancer diagnoses
- A – asymmetry of the lesions
- B – Borders
- C – color
- D – diameter of the lesion – typically greater than 6 mm
-
This type of tumor of the epithelial cells is the most common benign skin tumor, is usually friable and easily removed, has a brownish, solitary or multiple flat-topped lesions, and sometimes even a stuck on appearance
Seborrheic keratosis
-
What type of tumor of the epithelial cells is the most common malignant one, is seen on sun exposed areas, has a pearly (shiny) surface, often heaped up, with central ulcer, is locally invasive, but does not metastasize
Basal cell carcinoma
-
Which type of epithelial cell tumor is seeing on sun exposed areas, considered precancerous, might lead to squamous cell carcinoma, and may progress into a more atypical lesion: carcinoma in situ
Actinic keratosis
-
Which type of epithelial cell tumor is most often in sun exposed areas (like basal cells), is a small flat plaque, a persistent ulcer, or slightly elevated. Histologically, indistinguishable from other squamous cell carcinoma, and locally invasive and metastasizes
Squamous cell carcinoma
-
Tumors of the pigmentary cells arise from where
Melanocytes
-
This is a macule or patch of the skin in which the melanocytes show hyper-reactivity to UV light
ephelis (freckle)
-
This is a sharply demarcated macule occupied by increased number of melanocytes; is unresponsive to UV
lentigo
-
This developmental skin abnormality is consisting of an overabundance of melanocytes such as dermal nevus, functional nevus, compound nevus
Nevus
-
What is the most common congenital skin anomaly
nevus
-
This is composed of normal skin elements arranged in an abnormal manner, is composed of melanocytes, and are usually innocuous lesions that require no treatment
Nevus
-
Which type of nevus is malignant and can require a full thickness excision and skin graft
Hairy nevus
-
This is a cancerous tumor originating from the melanocytes, half originate from normal skin, the other half from freckles or pre-existing nevi
Melanoma
-
What are some common forms of bacterial skin infections
- Impetigo
- Folliculitis
- Furuncle
- Carbuncle
-
This type of bacterial skin infection is a superficial infection involving streptococci or Staphylococcus aureus, is characterized by honey colored scabs, it's most found on the face of small children, and highly contagious but responds well to antibiotics
Impetigo
-
Which type of bacterial skin infection is an infection that is limited to the hair follicles, most often caused by Staphylococcus aureus, and typically involves hairy areas, such as the beard
Folliculitis
-
Which type of bacterial skin infection involves the hair shaft and perifollicular tissue – "boil"
Furuncle
-
Which type of bacterial skin infection is where the original furuncle now involves multiple hair shafts and become much larger, is often located on the head or neck, and is more common in males than females
Carbuncle
-
What is a chronic recurring infection commonly in the axilla and groin
Hidradenitis suppurativa
-
What are dermatophytes caused by
Fungal pathogens
-
What tend to live in dead tissue, cause almost no inflammation in underlying skin, and the name often implies the location
Dermatophytes
-
Where is tinea pedis located
foot
-
Where is tinea capitis located
Scalp
-
Where is tinea manum located
Hand
-
where is tinea unguium located
naiil
-
where is tinea corporis located
body
-
What is the cause of thrush in children
Candida albicans
-
Which type of fungi are found primarily in tropical climates
Blastomycosis, coccidiomycosis
-
Some invasive deep fungal infections cause large destructive lesions and tumor like lesions called what
mycetomas
-
This is an abnormality of skin langerhan (dendritic) cells, which modulate inflammation and can be accompanied by localized edema, papules, and vesicles, and usually is accompanied by pruritis
Eczema
-
What are the two major forms of eczema and what can cause them
- Exogenous eczema – environmental cause
- Endogenous eczema – immune basis?
-
This is a widespread chronic disease affecting 10 to 20% of the US population, presents with erythema, scaling, and itching of the skin especially nasolabial folds, eyebrows, upper chest, often leads to abundant dandruff, and treatments typically provide little to moderate relief
Seborrheic dermatitis
-
This affects 1 to 2% of populations, is T- lymphocyte mediated autoimmunity involving keratinocytes, results in slightly elevated papules and patches that are covered with a silvery scale, mostly on extensor surfaces of extremity such as elbows and knees, and eruptions typically occur symmetrically, then slowly fade away
Psoriasis
-
Which penis malformation has an abnormal location of the urethral orifice on the ventral aspect of the shaft
Hypospadias
-
Which penis malformation has an abnormal location of the urethral orifice on the dorsal aspect of theshaft
epispadias
-
And inflammation of the glans penis is known as what
Balanitis
-
And inflammation of the glans and foreskin is known as what
balanoposthitis
-
In balanoposthitis what is an accumulation of desquamated epithelials, sweat, debris that act as a local irritant
smegma
-
This occurs when the prepuce (foreskin) cannot retract back over glans, it is stuck to the glans, and most cases are due to scarring from previous episodes of balanoposthitis
phimosis
-
Swollen foreskin that cannot pull back down to the original position that causes swelling and can impair blood supply to the glans is known as what
Paraphimosis
-
A penile erection of at least four hours, not associated with sexual stimulation is known as what
Priapism
-
Which type of priapism is a complication that is similar to compartment syndrome; later erectile dysfunction result of not quickly corrected
Ischemic priapism
-
Which type of priapism is due to trauma to the perineum, spinal cord, and might require only observation
Non-ischemic priapism
-
This is the most common STI in the United States
Genital herpes
-
Which type of STI produces vesicles with clear fluid, most people are not aware of the infection, patients may have flulike symptoms with the first outbreak, may have several outbreaks the first year and then have decreased frequency, there's no permanent cure
Genital herpes
-
This is the most frequent bacterial STI reported in the United States, it is caused by Chlamydia trachomatis, is transmitted via vaginal, anal, or oral sex, and it can be passed to babies during vaginal delivery
Chlamydia
-
in males this STI presents as a purulent urethritis, they will have dysuria, yellow urethral discharge 2 to 5 days after exposure, invades mucosa of urethra and periurethral glands, and if left untreated it can lead to infertility
Gonorrhea
-
This STI is caused by Treponema pallidum, it has three clinical stages: primary, secondary, tertiary
Syphilis
-
Which stage of syphilis is a painless ulcer (chancre) that appears 1 to 12 weeks after exposure
Primary syphilis
-
Which stage of syphilis shows within two months to two years after primary infection, the systemic symptoms are a fever, rash (condyloma lata)
Secondary syphilis
-
Which stage of syphilis is seen in untreated patients to 2-20 years after primary infection, and is dangerous to CV systems and CNS
Tertiary Syphilis
-
Neoplasms of the penis mostly originate from which type of cells
Squamous epithelium
-
Which types of HPV can form neoplasms of the penis
Types 16 and 18
-
What is the most common form of neoplasm of the penis in which 10% become invasive squamous cell carcinoma's
Bowen disease
-
Failure of the testes to descend into the scrotum is known as what
Cryptorchidism
-
What is the most common type of groin hernia and both sexes, the congenital defect can be patent process vaginalis, the sac might extend into the scrotum
Indirect inguinal hernia
-
This type of hernia cannot be reduced and it requires immediate consult to the surgeon to prevent strangulation
Incarcerated hernia
-
What is the difference between a strangulated hernia and an incarcerated hernia
A strangulated hernia is caused by a blood supply that becomes impaired to the incarcerated herniated part
-
This is a collection of serious fluid in the peritoneal sac around the testes, usually presents as unilateral, can be congenital and infants, and acquired which results in local inflammation in adults
Hydrocele
-
If a patient presents to you with unilateral swelling of the testes what do you want to look for
Infection, testis tumor, trauma
-
How can you tell if a patient has a hydrocele
By using transilluminate
-
A collection of blood in the scrotal sac is known as a what
Hematocele
-
This may begin as a UTI or prostatitis, usually caused by gram-negative bacteria in elderly individuals, or chlamydia causes this in young adults, and it may progress to orchitis
Epididymitis
-
Inflammation of the testes is known as what
Orchitis
-
Which is more serious epididymitis or orchitis
Orchitis
-
This is more common in young adult white males, and is always considered cancer until proven otherwise
Testicular neoplasms
-
What tests are run to determine testicular neoplasms
- First – scrotal ultrasound
- Chest radiograph
- serum tumor markers
-
Surgery that removes the testes is known as what
Orchiectomy
-
95% of these are germ cell tumors back and differentiate into different cell types
Testicular neoplasms
-
If a patient presents with acute scrotal/testicular pain, swelling, and erythema, what do you want to suspect
Testicular torsion
-
What is the treatment for a testicular torsion
Surgery to untwist the testicle and permanently affixed it to the tunica
-
This feels like a bag of worms in the scrotum superior to the testicle, can cause testis atrophy or sterility, and no treatment is required but can be surgically repaired if painful or causing sterility
Varicocele
-
Dilated veins of pampiniform plexus is known as a what
Varicocele
-
If the patient has a varicocele on the right side what must you evaluate for
Retroperitoneal mass occluding gonadal veins
-
Which type of prostatitis is usually caused by E. coli, the patient will present to you with dysuria, lower back pain, pelvic pain, fever/chills, may have a painful ejaculation, in blood in the semen
Acute bacterial prostatitis
-
Which type of prostatitis presents as a persistent low-grade infection, can be an incidental finding on a urinalysis or rectal exam, and the prostate may be tender and soft
Chronic prostatitis
-
This type of prostate disorder peaks in the 70s, most men greater than 80 years old are effected, occurs when the nodules grow gradually squeezing the urethra, it can result in a complete urethral obstruction and that leads to hydronephrosis or renal dysfunction
Benign prosthetic hyperplasia also known as nodular hyperplasia of the prostate
-
If the patient presents to you with a progressive decrease in size and strength of a urinary stream, complains of urinary urgency where he has to go all the time and only a little comes out and also urinary frequency, if you feel an easy palpable enlarged prostate on the rectal exam what do you suspect
Nodular hyperplasia of the prostate also known as benign prosthetic hyperplasia
-
This usually occurs in older men greater than 60, it is more common than long cancer, but not as deadly, most are adenocarcinomas
Prostate cancer
-
A congenital absence of the breast is known as what
Amastia
-
Development of more than two breast is known as what
Polymastia
-
Breast tissue with or without a netball (occasionally found and axilla), is known as what
Accessory breast
-
Additional breast along the milk line (as in cats and dogs) is known as what
Supernumerary breast
-
Supernumerary nipples without glands is known as what
Polythelia
-
An operation that lifts ptotic breasts is known as what
Mastopexy
-
Most common inflammatory disease of the breast that usually occurs during lactation, the common pathogens are staph and strep, and a patient has diffuse or localized edema and/or erythema, pain, tenderness to palpation, possible purulent discharge from the nipple is known as what
Acute mastitis
-
This type of mastitis is caused by an unknown etiology, and a biopsy to confirm diagnosis and rule out cancer is required
Chronic mastitis
-
What are the main symptoms of mastitis
Breast pain, swelling, redness, fever, enlargement, changed nipple sensation, discharge, itching, tenderness, and/or a breast lump
-
This is the most common tumor of the female breast, is usually seen in young women, and almost never becomes malignant
Fibroadenoma
-
These are usually benign, but may become malignant, it is much less common than the fibroadenomas, is a leaf-like tumor that can grow large to massive in size, and in about 50% of malignant ones they tend to metastasize to different sites
phyllodes tumor
-
This can mimic breast-cancer both radiographically and on physical exam, patient has a history of trauma in about 50% of the cases, and a needle biopsy is needed for diagnosis
fat necrosis
-
This is often called fibrocystic disease in the past, is extremely common in childbearing women, and common findings are breast pain, nipple discharge, and masses
Fibrocystic breast
-
This is mostly common in older women, 5th and 6th decades, it can mimic carcinoma clinically and on mammogram, it is a thick, sticky, green to greenish-black discharge that plugs the ducts, and spills into surroundings stroma which leads to plasma cell mastitis
Mammary duct ectasia
-
When do you do an excisional biopsy on a breast mass
When the woman or man is more than 35 years old (Or excise at any age if patient requests)
-
A neoplastic papillary growth within the lacteriferous duct is as known as a what
Intraductal papilloma
-
If a patient presents to you with a serous or bloody nipple discharge and you notice a few millimeter subareolar wart like tumor on the nipple, what are you going to suspect
Intraductal papilloma
-
This is second only to lung cancer as the leading cause of cancer death in women, and typically occurs on the left side slightly more than the right
breast cancer
-
What are the higher risks for breast cancer
- Female gender
- Greater than 30 years of age
- Caucasians
- Nulliparity
- Late age first pregnancy
-
What are the lower risks for breast cancer
- Male gender
- Less than 30 years of age
- East Asians
- Multiparity
- Pregnancy at early age
- Breast-feeding
-
When the skin thickens around exaggerated hair follicles due to obstruction of dermal lymphatics by cancer, this is known as what
peau d'orange
-
This is a ductal carcinoma involving the nipple, may or may not have a palpable mass, may have nipple itching or burning, or an eczematoid, crusted lesion of the nipple areola
Paget's disease
-
If there is a microcalcification (without mass), how is it excised
Excise with margin of normal tissue
-
If you have a mass how is it removed
lumpectomy with margin of normal tissue
-
This type of cancer most arises from epithelial cells, 80% are infiltrating ductal carcinoma's, most metastasize via lymphatics, most often via the axillary lymph nodes and sometimes the internal mammary nodes
Breast cancer
-
Which type of lesions typically spread first to the axillary nodes
Outer quadrant and centrally located lesions
-
The external surface of bone, containing osteoblasts, fibroblasts, blood vessels and nerves is known as the what
Periosteum
-
Spaces where osteocytes (osteoclast and osteoblasts) live within the osteons are called what
Lacunae
-
these within the osteons extends from the osteocytes
canaliculi
-
Layers of collagen within osteons are called what
Lamellae
-
these secrete collagen and ground substance to build bone matrix; called osteocytes after maturing
Osteoblast
-
These cleave or resorb bone
Osteoclasts
-
What type of ossification increases the length of the bone
Endochondral ossification
-
What type of ossification increases the width of the bone
Intramembranous ossification
-
The growth plate part of the long bone is known as the what
Metaphysis
-
Which hormone stimulates the breakdown of bone
PTH
-
Which hormone stimulates bone formation
Calcitonin
-
This is a lateral curvature of the spine
Scoliosis
-
An exaggerated forward curvature of the thoracic spine is known as what
Kyphosis
-
This congenital or hereditary disease is known as brittle bone disease, it occurs with an abnormal development of type 1 collagen (most are autosomal dominant disorders), patient presents with multiple bone fractures and/or blueish tinge to the sclera
Osteogenesis imperfecta
-
This congenital or hereditary disease is known as marble bone disease, it is caused by deficient osteoclastic activity, and occurs as both autosomal recessive and dominant forms
Osteopetrosis
-
An impaired maturation of cartilage in the developing growth plate that causes a major form of dwarfism and is the most common disorder growth plate, is known as what
Achondroplasia
-
This occurs when there is low bone mass micro – architectural deterioration
Osteoporosis
-
This is the most common bone disorder seen in the clinic, occurring in elderly, and mainly women
Osteoporosis
-
This type of osteoporosis has an unknown etiology but does appear to be caused by decreased estrogen, appears after the age of 30 with bone loss exceeding deposition, common with small frames rather than larger frames, and more common in Caucasians than blacks
Primary osteoporosis
-
This type of osteoporosis is caused by prescription drugs such as corticosteroids, can because by malignancies, malabsorption or in adequate intake of calcium phosphate or vitamin D, and can be caused by smoking and alcohol abuse
Secondary osteoporosis
-
Osteomalacia of growing bones in children is known as which type of disorder
Ricketts
-
This is caused by a vitamin D deficiency, aluminum and some antacids that binds to phosphorus, hyperparathyroidism that leads to high serum calcium, low phosphorus, osteoclast breakdown bone and releases calcium into the blood, and promotes the loss of phosphorus blocking reabsorption from urine
Osteopenia
-
Which type of bone tumors can metastasize from other tumors
Secondary bone tumors
-
What are the types of benign bone tumors
- Osteoma
- Chondroma
- Nonossifying fibroma
-
What are the types of malignant bone tumors
- Osteosarcoma
- Ewing's sarcoma
- Giant cell tumor
- Chondrosarcoma
-
Which malignant bone tumor is more commonly seen between the ages of 10 to 25 years of age and most often involves the metaphysis of the long bones
Osteosarcoma
-
Which malignant bone tumor is more commonly seen between the ages of 10 to 20 years of age and is typically found in the metaphysis of the long bone
Ewings sarcoma
-
Which malignant bone tumor is more commonly seen between the ages of 20 to 40 years of age
Giant cell tumor
-
Which malignant bone tumor is more commonly seen between the ages of 35 to 60 years old
Chondrosarcoma
-
A fracture that heals solidly, without abnormal motion between fragments, but has angulation or displacement is known as a what
Malunion
-
When a fracture heals with abnormal motion between fragments it is known as a what
Nonunion
-
What are the factors that promote fracture healing
- Immobilization of fracture fragments
- Good blood supply
- Vitamin C, D, calcium, phosphorus in diet
- Good alignment of fragments to avoid mal- union
-
What are the factors that impair fracture healing
- Motion between fracture fragments where calluses are replaced by collagenized fibrous tissue instead of bone that leads to a nonunion
- Soft tissue between fractured fragments
- Infection (osteomyelitis)
-
Osteomyelitis in children is often associated with what
Bacteremia
-
This type of infection can spread to bone infection of nearby joints tissue, can occur in IV drug users, infection causes swelling and increased pressure within bone as PMN arrive forming pus, and treatment typically involves IV antibiotics in surgery to drain the pus
Osteomyelitis
-
a necrotic piece of bone in area of infection within chronic osteomyelitis is known as what
Sequestrum
-
Surrounding an area of new bone formation in chronic osteomyelitis is what
involucrum
-
A fracture through a diseased bone is known as what type of fracture
Pathologic fracture
-
a fracture with an overlying laceration is known as what type of fracture
Open fracture
-
The most common malignant bone tumor in children is what
Osteosarcoma
-
What is the most common form of joint disease that is common in everyone as we age
Osteoarthritis
-
This is a chronic systemic autoimmune disorder, onset of symptoms is usually insidious, it is characterized by chronic symmetrical inflammation of joints, laboratory findings often nonspecific, and extra articular manifestations are anemia, pericarditis, episcleritis, and skin lesions
rheumatoid arthritis
-
This occurs in rheumatoid arthritis patients where the extensor tendons cannot reach over enlarged joints, so they go around the joints, what is this known as
Rheumatoid arthritis
-
This type of arthritis is caused by lyme disease that is transmitted to human via deer ticks, may occur weeks to months after a bite and is associated with a migrating skin rash, most often affects the knee and can be treated with antibiotic treatment that cures the arthritis
Infectious arthritis
-
This is caused by a deposition of uric acid crystals in tissues, can be found in joints, subcutaneous tissue, and kidneys, it causes hyperuricemia which leads to uric acid renal stones
gout
-
What is the most common cause of metabolic primary gout
Acid over-production
-
What is the cause of renal primary gout
Uric acid under excretion
-
This type of gout has less inflammation and more bone deformities, is associated with painless subcutaneous deposits of uric acid mostly found on the ears, olecranon, and patella, hypertension is common with this type of gout and can further damage the kidneys, and some have uric acid kidney stone
Chronic gout
-
A target like skin lesion and knee pain is associated with what
Lyme disease
-
ulnar deviation is classical in this disorder
Rheumatoid arthritis
-
Which arthritis is due to chronic wear and tear
Osteoarthritis
-
Which arthritis has extra articular symptoms
Rheumatoid arthritis
-
This is an autoimmune disorder of neuromuscular junction that is characterized by muscle weakness, where anti-bodies are directed against acetylcholine receptors
Myasthenia gravis
-
A patient comes into your clinic complaining of being easily fatigued and has muscle weakness, the symptoms usually are worse later in the day, and you notice that their eyelids often show proptosis. What do you suspect
Myasthenia gravis
-
This is a muscle disease and which muscle cells degenerate that result in marked weakness, may be inherited as autosomal or sex linked traits, differences between the dystrophies are based on mode of inheritance, age of onset, muscle groups initially expected, and severity of the disease
Muscular dystrophy's
-
This is the most common muscular dystrophy
Duchenne – type muscular dystrophy
-
This disorder is caused by a defect in the gene for dystrophin, which normally maintains so integrity
Duchenne – type muscular dystrophy
-
a mother of a four-year-old pt is brought into your clinic with complaints that she notices her son has a waddling gait that becomes uncontrollable, the patients mother notes that she has noticed severe muscle wasting and weakness of the respiratory muscles, what is your possible dx
Duchenne – type muscular dystrophy
-
What is the most common form of muscle weakness in children, and is an upper motor neuron disease
Cerebral palsy
-
This type of myopathy results from chronic hypoperfusion of muscles and peripheral nerves
Diabetic myopathy
-
This type of myopathy is when anti-bodies to the tumor antigens cause an immune response that causes damage to the muscles
Cancer myopathy
-
This is a necrosis of striated muscle due to either trauma, crush injury, electrical burn, compartment syndrome, ischemia – reperfusion, overuse or hypothermia, may result in over-use or swollen muscles
Rhabdomyolysis
-
Tissue damage after establishing blood flow to an area that was previously deprived of blood flow is known as what type of injury
Ischemia – reperfusion injury
-
This can be caused by vascular trauma that leads to ischemia – reperfusion that eventually leads to swelling, long bone fractures that lead to swelling, or intraosseous needle for infusing fluids
Compartment syndrome
-
How is compartment syndrome prevented and treated
Fasciotomy
-
If you have a patient with proptosis with sustained upward gaze what do you think the disorder is
Myasthenia gravis
-
This disorder results in myoglobinurea
Rhabdomyolysis
-
This disorder can be discovered by amniocentesis
Muscular dystrophy
-
This disorder is caused by antibiotic is against the acetylcholine receptors
Myasthenia gravis
-
Pseudo – hypertrophy of calf muscles is known in which disorder
Muscular dystrophy
-
In soft tissue calcifications, explain dystrophic calcification
- Normal serum calcium
- Often associated with healing after inflammation or tissue necrosis
-
In soft tissue calcification, explain metastatic calcification
- Elevated serum calcium
- Not related to cancer
- Involves derangement of calcium metabolism
-
This type of ossification is when there is bone formation in soft tissues, and can be caused after trauma or surgery of joints or long bones
Heterotopic ossification
-
This causes bone formation in areas of muscle injury or inflammation
myositis ossificans
-
Inflammation of a muscle is known as what
Myositis
-
This is a malignant mesenchymal neoplasm with skeletal muscle differentiation and is the most common sarcoma in the pediatric population
rhabdomyosarcoma
-
A common, benign well circumscribed neoplasm of smooth muscle is known as what
Leiomyoma
-
What is the most common type of leiomyoma
Uterine fibroids
-
A malignant smooth muscle tumor is known as what
leiomyosarcoma
-
What is the most common place for leiomyosarcoma's
Uterus and G.I. tract
-
What is the second most common sarcoma of adults
Liposarcoma
-
Soft tissue calcification after healing is known as what
Dystrophic calcification
-
A common benign fatty tumor is known as what
Lipoma
-
Temporary dysfunction of the facial nerve or cranial nerve VII is known as what
Bell's palsy
-
What are the clinical signs of a basilar skull fracture involving the eye
Peri orbital ecchymosis
-
What are the clinical signs of a basilar skull fracture involving the ear
CSF otorrhea or hemotympanum
-
What are the clinical signs of a basilar skull fracture involving the nose
CSF rhinorrhea
-
What type of skull fracture is a straight line
Linear
-
What type of skull fracture has pieces pushing in toward the brain
Depressed
-
What type of skull fracture has an overlying laceration
Open
-
with increased ICP what is Cushing's triad
- bradycardia
- Hypertension
- irregular respiration
-
An accumulation of blood between the skull and dura mater is known as what
Epidural hematoma
-
A patient comes to see you reporting they had a loss of consciousness and then regained consciousness and now are having severe headaches what could you expect to be happening
Epidural hematoma
-
This is an accumulation of blood between the Dura and the arachnoid where the brain itself is injured by blunt trauma
Subdural hematoma
-
What are the lateralizing signs of a subdural hematoma
- Weakness on one side of the body
- Dilated pupil on one side
- Abnormal posturing
-
What is caused by injury to middle meningeal artery from a temporal fracture
Epidural
-
Which is caused by injury to the brain itself
Subdural
-
What are the two signs of a brain herniation
- Abnormal pupils
- Abnormal motor response
-
What is the term for unequal pupils
anisocoria
-
Bleeding between the arachnoid membrane and pia mater is known as what
Subarachnoid hemorrhage
-
What is a clinical sign of a subarachnoid hemorrhage
Nuchal rigidity
-
What are the causes of a subarachnoid hemorrhage
- Most often caused by brain trauma
- Vascular abnormalities
-
These are small aneurysms often found in the circle of Willis
Berry aneurysms
-
This type of aneurysm is sometimes associated with polycystic kidney disease and the patient will present with a sudden severe headache, vomiting followed by coma
Berry aneurysms (cerebral)
-
These type of aneurysms usually involve larger cerebral arteries, usually the vertebral, basilar, and internal carotid arteries. These fibrose and might not rupture but they do provide a site for a thrombus to form, leading to an ischemic stroke
Atherosclerotic aneurysms
-
This is caused by a contusion/hematoma in the brain, with bleeding from ruptured intracerebral vessels
Intracerebral hemorrhage
-
Which area of the brain recognizes the meaning of words
Wernicke's area
-
Which area of the brain is used for speech and is usually on the left side
Brocas area
-
What are the clinical characteristics of a cerebrovascular disease
- Weakness or paralysis of contra lateral side of the body
- Difficulty speaking or understanding
- TIA – transient ischemic attack – resolves within hours
-
Which type of stroke is more common, is caused by a thrombosis that causes gradual onset of symptoms, and an embolism causes abrupt cerebral dysfunction, a rapid CT is needed to rule out hemorrhagic stroke
ischemic
-
This type of stroke is caused from high blood pressure or ruptured aneurysms
Hemorrhagic stroke
-
What are the two types of strokes
Ischemic and hemorrhagic
-
Which type of stroke is caused by an embolus or a thrombus
Ischemic
-
Which type of stroke is caused by bleeding into the brain
Hemorrhagic
-
Which type of stroke is treated with a fibrinolytic
Ischemic
-
Which type of brain tumors do not metastasize
Malignant
-
Which type of brain tumors can still cause much harm and death
benign
-
Most primary brains cancers are what
Gliomas
-
And abnormal neuron firing in the brain can cause what
Seizure
-
Recurrent seizures due to abnormal biochemical/electrical activity in the brain are known as well
Epilepsy
-
This metabolic abnormality is due to a lack of vitamin B1 (thiamine), is caused by chronic alcoholism, malabsorption, or bariatric surgery
Wernecke encephalopathy
-
What are the symptoms of Wernicke's encephalopathy
Confusion, ataxia, nystagmus
-
This is due to a high neonatal bilirubin, child might need speech therapy, physical therapy for hypertonia, or cochlear implants
Kernicterus
-
Involuntary repetitive eye movements either horizontal, vertical, rotatory, or mixed is known as what
nystagmus
-
This is caused by an injury to the brain before, during or after birth. the child will have muscle tightness or spasms, gait disturbance or other motor disturbances, abnormal sensation and perception, site, hearing, or speech impairment, and maybe seizures
Cerebral palsy
-
Destruction of oligodendroglial cells which surround the nerve fibers in the brain leads to what
Multiple sclerosis
-
This typically affects the white matter of the brain and is presumed to be autoimmune, and destroys of the oligodendroglial cells which surround brain nerve fibers
Demyelinating disease
-
what is the most common autoimmune CNS disease
Multiple sclerosis
-
What are the sensory and motor abnormalities of multiple sclerosis
- Loss of touch, with tingling
- Blurred vision is a frequent early symptom
- Motor symptoms include: muscle weakness, unsteady gait, uncoordinated movements, and/or sphincter abnormalities such as urinary incontinence
-
Which diagnostic study is useful in confirming the diagnosis of multiple sclerosis
MRI
-
What is an autoimmune disorder involving demyelination of peripheral nerves
Guillain-Barre' syndrome
-
What are some signs or symptoms of Guillain-Barré syndrome
- Sensory changes in hands/feet
- Later muscle weakness/paralysis
- Might require mechanical ventilation
-
This is a form of dementia with unknown etiology, there are deposits of beta amyloid in plaques and vessels in the cerebral cortex. The microtubule proteins form neurofibril tangles, and it is a progressive neurologic disorder
Alzheimer's disease
-
This is due to a loss of pigmented neurons in substantial Niagara, they are neurons that control muscle activity. The patient has a slowness of voluntary muscular movement and a resting tremor of the hands, Cogwell rigility is found on the physical exam, face will gradually lose expressiveness/might drool, and patient often has depression and dementia
Parkinson disease
-
This is an autosomal dominant neurodegenerative disorder that primarily affects the caudate nucleus in motor cortex, patient presents with motor disturbances including involuntary gyrating movement of trunk and limb, postural instability, rigidity, progressive dementia, and abnormal behavior
Huntington's Chorea
-
This is due to a loss of motor neurons in the anterior horn cells of the spinal cord, midbrain, and eventually the cerebral cortex, it results in muscle wasting and weakness but intellect is not affected
amyotrophiclateral sclerosis a.k.a. Lou Gehrig's disease
-
Which neurodegenerative disorders have memory loss, amyloid plaques, and neurofibril tangles
Alzheimer's disease
-
Which neurodegenerative disorder involves a movement disorder such as cogwheel rigidity, pill rolling and has decreased dopaminergic neurons in the substantia nigra
Parkinson
-
Which neurodegenerative disorder includes the triad of motor, cognitive, behavioral problems. It is autosomal dominant and includes the caudate nucleus and cerebral cortex
Huntington's chorea
-
Which neurodegenerative disorder includes a movement disorder of weakness and fasciculations, and a loss of motor neurons in the spinal cord, medulla, and cerebral cortex
Amyotrophic lateral sclerosis
-
This occurs when there is purulent exudate that forms along the meninges, the most common organisms are group B streptococci and E. coli, Haemophilus influenza, streptococcus pneumonia, neisseira meningitidis
Bacterial meningitis
-
A patient presents to the clinic with a headache, vomiting, fever, altered mental status, and possibly having a seizure. You notice that the patient has nuchal rigidity and a positive Kernig's sign, and Brudzinski's sign, what do you think their diagnosis is
Meningitis
-
This is usually seen in children and young adults, the common pathogens are coxsackievirus B, echovirus, mumpd, Epstein-Barr virus, or herpes, the patient presents with headaches, vomiting and a fever has a positive Brudzinski and Kernig sign and also new nuchal rigidity
Viral meningitis
-
This is nearly nearly always a fatal type of encephalitis, the virus is transmitted by saliva of infected animal and travels via peripheral nerves to the CNS
Rabies
-
What is the name for nearsighted patients
Myopes
-
What is the name for farsighted patients
Hyperopes
-
This is related to irregularity of the cornea or lens
Astigmatism
-
Farsightedness of old age, where the lens is not able to accommodate for near vision is known as what
Presbyopia
-
unequal pull of extra ocular muscles is known as what
Strabismus
-
If you have clear mucus and suspect conjunctivitis which type of conjunctivitis is it
Viral conjunctivitis
-
If you have sticky pus and suspect conjunctivitis which type of conjunctivitis is it
Bacterial conjunctivitis
-
This is when conjunctivitis infections extends into the cornea
Keratitis
-
What is the major cause of blindness in underdeveloped countries
Chlamydia trachomatis
-
A blocked tear duct, plus haemphilus, staff, strep causes what
dacryocystitis
-
Inflammation of the eyelid, accompanied by redness and swelling that is caused by staff aureus is known as what
Blepharitis
-
A blockage of a meibomian gland that is not infected is known as what
chalazion
-
Infection of the hair follicle or sweat gland caused by staff aureus in the eye is known as what
Hordeolum (stye)
-
This is a bad inflammation of the iris and ciliary body, is caused by trauma and the patient presents to you with pain and photophobia what is it
Uveitis (iridocyclitis)
-
Demyelination of the optic nerve by either an autoimmune disorder or multiple sclerosis is known as what
Optic neuritis
-
Blood in the anterior chamber is known as what
Hyphema
-
Bleeding in the orbit from trauma, anticoagulation, or other disorders that increases the pressure risking the optic nerve is known as what
Retrobulbar hemorrhage
-
What is the most common type of cataract
Senile cataract
-
A defect in the formation and circulation of aqueous humor that leads to increased intraocular pressure is known as what
Glaucoma
-
Which form of glaucoma is due to a chronic and impaired absorption; intraocular pressure slowly increases
Primary open angle glaucoma
-
Which form of glaucoma presents with painful red eye and vision loss; increased intraocular pressure only during the attack
Acute closed angle glaucoma
-
Which type of eye disorder is treated by a phakectomy
Cataract
-
Which eye problem is treated by a lateral canthotomy
Retrobulbar hematoma
-
This is a defect causing loss of central vision and a grid is used to test for this
Age related macular degeneration
-
When the retinal pulls away from the back of eye caused by trauma or bleeding, and a patient may see floaters or flashes of light is known as a what
retinal detachment
-
Swelling of the optic disc due to increased intracranial pressure is known as what
Papilledema
-
This is a malignant tumor of the eye, it is inherited genetically and often involves both eyes, and a small child presents with a white pupil is known as a what
retinoblastoma
-
What causes dark pigment spots in the retina
Retinitis pigmentosa
-
Opacification of the lens causes what
Cataract
-
Name a cancer of the skeletal muscles of the eye
Rhabdomyosarcoma
-
Prolonged high concentration of oxygen in a newborn can cause what
Retinopathy of prematurity
-
Night blindness is associated with which deficiency
Vitamin a
-
This is a pearly white appearance in the ear, it is not cancer but a benign tumor and is caused by a birth defect or a chronic infection, there is negative pressure in the middle year that pulls in the squamous cells, forming a cyst
cholesteatoma
-
This disease can be mild to severe with episodic vertigo that last one to several hours, has sensori–neural hearing loss for low-frequency sounds, and tinnitus. There are hydrops and endolymphatic systems of the cochlea and may be caused by an imbalance of pressures between compartments of the inner ear
Ménière's disease
-
This type of hearing loss is usually from the external or middle ear due to a foreign body, cerumen, or otitis media
Conductive hearing loss
-
This type of hearing loss is due to cochlear abnormalities due to repetitive noise trauma
Sensory hearing loss
-
This type of hearing loss is due to old age
Presbycusis
-
This is the least common type of hearing loss and it is due to lesions of the cranial nerve VIII – acoustic neuroma
neural hearing loss
-
This type of hearing loss is due to loud sudden impulse sounds or loud repetitive sounds, can also cause tinnitus, and sounds greater than 85 dB can cause hearing loss
Noise induced hearing loss
-
A patient comes in complaining of bilateral hearing loss that is worse in one ear, has a family history of hearing loss which often begins between the ages of 30 to 40, it is an autosomal dominant disorder where bone deposits occur on both sides of the oval window
Otosclerosis
-
This is a benign slow-growing tumor of the nerve sheath of the acoustic nerve that causes hearing loss, tinnitus, and a balance disorder. If large enough, it can cause cranial nerve VII deficit
Acoustic Neuroma
|
|