Cardiology
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Endocrinology
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Hem/Onc
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DNA Viruses
Notes
Lung Cancer
Small Cell (SCLC) Etiology Notes Histology Paraneoplastic Small Cell Smoking myc oncogene Central Undifferentiated Aggressive Metastasis → LABBs Liver Adrenal Brain Bone Kulchitsky cells Small, dark blue Neuroendocrine Chromogranin A ⨁ Cushing → ACTH SIADH → ADH → ↓Na Lambert-Eaton Peripheral neuropathy Subacute cerebellar degeneration Non-Small Cell (NSCLC) Etiology Notes...
Read moreBreast Cancer
Risk Factors Family history HRT in menopause Most common → Adenocarcinoma Presentation Early findings Asymptomatic Sudden mammography finding Mass Single Nontender Immovable Hard to touch Ill-defined margins Unilateral bloody nipple discharge → Intraductal papilloma Locally advanced findings Axillary lymphadenopathy Breast enlargement Pain Peau d’orange → Suggests inflammation Redness Thickening...
Read moreCirrhosis Causes
VW Happens Viral Hepatitis (Chronic) Presentation Cirrhosis Liver cancer PAN Diagnosis Hep B → ⨁ Surface Ag (DNA PCR) >6m Biopsy has no significance Only treat if ⨁ E-Ag OR DNA polymerase Hep C → PCR RNA viral load Treat anyone with ↑ RCR RNA viral load Treat anyone...
Read morePancreas Disorders
Insulinoma MEN 1 Whipple triad Hypoglycemia on blood test Associated symptoms Sweating Palpitation Anxiety Tremor Headache Confusion Resolution of symptoms with correction glucose Best initial test → Fasting insulin + C-peptide Most accurate → 72-hour fasting test Localize tumor and resect VIPoma VIP-producing malignant tumor Presentation Classic triad Watery...
Read moreColon Cancer
Colon Cancer Second cause of cancer mortality in US Etiology Polyps >2 cm Sessile > Pedunculated Villous > Tubular Presentation Right-sided Anemia → Chronic blood loss ↓ Weight Anorexia Diarrhea Vague abdominal pain Left-sided Obstruction → Apple-core Bowel habit change Constipation ↓ Caliber Blood-streaked stool Rectal Bright red blood...
Read moreDiverticular Disorders
Diverticulosis Etiology False diverticula Meat diet Low fiber High fat Presentation Asymptomatic Constipation Bleeding Anemia Diagnosis Best initial → CT scan Most accurate → Colonoscopy Barium studies → Acceptable but not as accurate Complications Diverticular hemorrhage Diverticulitis Treatment Bran Psyllium Methylcellulose ↑ Dietary fiber Diverticulitis Etiology Diverticular infection Fecalith Presentation Old age...
Read moreInflammatory Bowel Disease (IBD)
Crohn Ulcerative Colitis Skip lesion Continuous Transmural Mucosal Perianal disease Rectum always Fistula Pseudopolyp Noncaseting granuloma No granuloma ASCA Ab pANCA Crohn Disease Etiology Idiopathic Presentation Diarrhea Blood in stool Weight loss Fever Extraintestinal Arthralgia Anemia Aphthous stomatitis Eye Uveitis Iritis Episcleritis Skin Erythema nodosum → Indicator of disease activity...
Read moreIrritable Bowel Syndrome
Etiology Idiopathic Women 20-30y Psychiatric disorder Presentation Abdominal Pain → 3d in 3m Relieved by a bowel movement Less at night Relieved by change in bowel habit Diarrhea, Constipation OR Both NO weight loss NO malabsorption Diagnosis Diagnosis of exclusion NO blood/WBC in stool Treatment Fiber in diet Antispasmodic...
Read moreDiarrhea
Stool Osmotic Gap 290 – 2(Na+K) Normal = 50-100 Diarrhea Classification Acute Invasive → RBC/WBC IBD C. diff Campylobacter Salmonella Shigella EHEC Entamoeba histolitica Vibrio parahemolyticus Yersinia Non-invasive → No RBC/WBC Medication Viral Parasite Giardia Cryptosporidium ETEC Bacillus cereus Staph Chronic Secretory → Normal OG Gastrinoma VIPoma Carcinoid C....
Read moreGI Bleeding
Etiology Upper GI Bleeding PUD → Most common Gastritis Esophagitis Duodenitis Cancer Varices Lower GI bleeding Diverticulosis → Most common Angiodysplasia (AVM) → Related to Aortic Stenosis Polyps Cancer IBD Hemorrhoids Upper GI bleeding with rapid transit time Presentation Blood loss 15-20% → Orthostasis → ↑PR >10 OR ↓SBP >20 30% → PR>100...
Read moreGastric Disorders
Gastritis Gastropathy → Inflammation/erosion of gastric lining Etiology Acute Gastritis Alcohol NSAIDs H. pylori Portal hypertension Stress Burn → Curling ulcer Brain injury → Cushing ulcer Trauma Sepsis Multiorgan failure → Uremia Chronic Gastritis Type A → Fundus → Parietal cell Ab → Pernicious Anemia Type B → Antrum → NSAIDs, H. pylori → PUD Presentation History of NSAIDs,...
Read moreEpigastric Pain
Etiology Most common → Non-ulcer dyspepsia Presentation Gastric ulcer → Pain Greater with food, Weight loss Duodenal ulcer → Pain Decreases with food Cancer → Weight loss Pancreatitis → Tenderness GERD → Bad taste, Cough, Hoarseness Gastroparesis → Diabetes, Bloating Non-ulcer dyspepsia → No other associated symptom Diagnosis Most accurate...
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