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Notes
Personality Disorders
Cluster A Paranoid Suspicious Mistrustful Secretive Isolated Question loyalty Schizoid Solitary activity No close friends Emotional coldness Don’t enjoy close relationship Schizotypal Ideas of reference Magical thinking Odd thinking Eccentric Social anxiety Brief psychotic episodes Cluster B Histrionic Center of attention Promiscuous Self-dramatize Physical appearance Antisocial Don’t conform to...
Read moreSoduim Disorders (Na)
Hypernatremia Na >145 Etiology Free water loss (6 Ds) Diuresis Dehydration Sweating Burns Fever Diarrhea Doctors (Iatrogenic) Disease Pneumonia → Hyperventilation Sickle cell Diabetes Insipidus Central DI → ↓ADH CNS disorder Very high Na → No thirst Nephrogenic DI → ↑ but ineffective ADH Na not very high → Patient is...
Read moreHypertension
SBP >140 DBP >90 Most common disease in US Most common risk factor for MI Etiology 90% → Essential hypertension Other causes Renal artery stenosis Glomerulonephritis Coarctation of aorta Acromegaly Obstructive sleep apnea Pheo Hyperaldosteronism Cushing syndrome Congenital adrenal hyperplasia Presentation Majority asymptomatic → Found on screening Renal artery stenosis → Continuous...
Read moreNephrolithiasis
Etiology Ca oxalate Alkaline urine Ca overexcretion ↓Ca intake → Ca in gut will not bind oxalate ⇒ ↑Oxalate absorption Crohn disease → ↑ Oxalate absorption Fat malabsorption Metabolic acidosis/RTA 2 → Remove Ca from bone ↓Citrate → Citrate will not bind to Ca in urine and Ca will deposit ↑Oxalate Struvite...
Read morePCKD
Cyst Complexity Simple cyst → Do NOT aspirate Echo free Smooth, thin wall Sharp demarcation No debris inside Complex cyst → Potential cancer → Aspirate Mixed echogenicity Irregular, thick walls Lower density on back wall Debris in cyst Polycystic Kidney Disease ADPKD Etiology Familial ADPKD1, ADPKD2 gene Presents >30y Presentation Pain Hematuria...
Read moreTTP/HUS
TTP/HUS Etiology ↓ Metalloproteinase ADAMTS 13 ADAMTS 13 is vWF-cleaving enzyme ⇒ Large vWF multimers PLT mictothrombi → Block off small vessels → End-organ damage TTP → Adults Hereditary HIV Cancer SLE Drugs Cyclosporine Ticlopidine Clopidogrel HUS → Children E. coli 157:H7 Shigella Presentation ↓PLT Intravascular hemolysis → Most important, Always present Microangiopathic hemolytic anemia...
Read moreCKD/ESRD
CKD = GFR <60 for >3m Kidney damage DM Hypertension Glomerulonephritis PCKD ESRD = Uremia (GFR <30) Etiology Leading cause → DM → Basement membrane thickened, Mesengial expansion, fibrosis HTN → Nephrosclerosis, Glomerulosclerosis Tubular damage Glomerular damage RPGN Presentation Uremia Anorexia N/V Uremic frost → Urea crystals on face Indications for Dialysis...
Read moreAnalgesic Nephropathy
Etiology NSAIDs Presentation ATN AIN Membranous glomerulopathy Vascular insufficiency NSAIDs inhibit prostaglandins → Constrict afferent artriole Papillary necrosis Papillary Necrosis Etiology Sloughing off renal papillae NSAIDs Sudden vascular insufficiency Presentation Sudden flank pain Fever Hematuria Extra NSAIDs in the setting of Sickle cell Diabetes Urinary obstruction Chronic pyelonephritis Diagnosis Best...
Read moreAcute Kidney Injury
AKI (ARF) Etiology Prerenal azotemia Hypotension Sepsis Anaphylaxis Bleeding Dehydration Hypovolemia Diuretics Burns Pancreatitis CHF ↓Albumin Cirrhosis NSAIDs ACEi Renal artery stenosis Postrenal azotemia BPH Nephrolithiasis Cervical cancer Neurogenic bladder Retroperitoneal fibrosis Bleomycin Methylsergide → Migraine/Cluster Radiation Intrinsic renal disease ATN Toxins NSAIDs Aminoglycoside Amphotericin Cisplatin Cyclophosphamide Prolonged ischemia...
Read moreCervical Cancer
Risk Factors HPV Prevention HPV vaccine → 11-26y Pap smear >21y → Every 3y → Until 65y Pap smear + HPV testing → Every 5y Diagnosis Pap smear High-grade hyperplasia → Colposcopy → Biopsy Low-grade hyperplasia → Colposcopy → Biopsy ASCUS → HPV testing ⨁HPV → Colposcopy + Biopsy ⊖HPV → Repeat Pap in 6m ASCUS = Atypical squamous cells...
Read moreOvarian Cancer
Surface derived → From Ovary, Fallopian tube, Peritoneum tissue Serous (most common) Cystadenoma → cysts with ciliated cells Cystadenocarcinoma → Psammoma bodies Mucinous Cystadenoma → cysts with mucus secreting cells Cystadenocarcinoma → Pseudomyxoma peritonei Endometrioid Associated with endometrial carcinoma Brenner Resemble bladder (transitional), coffee bean nuclei Germ cell Dysgerminoma ↑LDH, Turner Yolk sac (Endometrial...
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