Cardiology
Pulmonology
Nephrology
Endocrinology
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DNA Viruses
Notes
Pituitary Disorders
Panhypopituitarism Etiology Tumors Metastasis Adenoma Rathke cleft cyst Meningioma Craniopharyngioma Lymphoma Conditions Hemochromatosis Sarcoidosis Histiocytosis X Trauma Radiation Syndromes Sheehan Kallmann ↓LH/FSH Anosmia Renal agenesis (50%) Infection Fungi TB Parasites Autoimmune Lymphocytic penetration Presentation Hypothyroidism Hypoadrenalism ↓ Prolactin Men → Normal, Extreme ↑ can cause ED Women → No lactation...
Read moreChildhood Rashes
Erythema infectiosum (Fifth Disease) Etiology Parvovirus B19 Presentation Prodrome None Low fever URI ? Rash Arm → Trunk → Leg Slapped cheek Parvovirus B19 in mother can cause Hydrops fetalis in newborn Diagnosis → Clinical Complications Arthropathy Aplastic crisis in Sickle cell Spherocytosis Iron deficiency anemia Treatment → Supportive Measles...
Read moreSkin Infections
Impetigo Etiology Superficial infection Staph = Strep Presentation Weeping Crusting Oozing Draining Complications Bullous Impetigo → Staph → Can progress to SSSS Scarlet fever → Strep → Sand-paper rash Treatment Amoxicillin Clindamycine Mild → Topical Mupirocin Ratapamulin Bacitracin Severe (Fever) → Oral Dicloxacillin Cephalexin Community acquired MRSA Doxycycline Clindamycin TMP/SMX...
Read moreAmebiasis
Etiology Entamoeba histolytica Travel to developing country Presentation Up to 3m incubation period Bloody diarrhea Severe abdominal pain Fever Chronic form Mimics IBD Liver abscess Lung abscess Diagnosis Fecal sample Oocyte/Trophozoit → Carrier Trophozoit with RBC inside → Active disease Serology Colonoscopy → Flask-shaped ulcers CT scan → Abscess Complications Steroid ⇒ Fatal...
Read moreMI Complications
MI Complications Hypotension → Seen in all complications, not specific Bradycardia Sinus bradycardia Vascular insufficiency to SA node Presentation Bradycardia NO cannon A wave Treatment Atropin Pacemaker 3rd degree AV block Presentation Bradycardia Cannon A wave Bounding jugular wave bouncing up into neck Atrial systole against closed tricuspid valve Treatment...
Read moreHeart Disease in Pregnancy
Peripartum Cardiomyopathy Worst heart disease in pregnancy Etiology Antibody against pericardium Presentation LV dysfunction → Often reversible Mostly develops after pregnancy Next pregnancy → More Ab → Worse Treatment ACEi/ARB Beta blocker Spironolactone Diuretic Digoxin Transplant Eisenmenger Syndrome Second worst heart disease in pregnancy Etiology VSD → L to R shunt → Pulmonary hypertension →...
Read moreAortic Disease
Aortic Dissection Etiology Hypertension Smoking Presentation Chest pain Sudden Shearing Radiate to scapula Different blood pressure between arms History of smoking Hypertension Diagnosis Best initial → CXR → Mediastinum widening Most accurate → Angiography CT Angio = MRA = TEE Renal failure → TEE Treatment Best initial → Control blood pressure Beta...
Read morePeripheral Vascular Disease
Peripheral Vascular Disease Etiology DM Hyperlipidemia Hypertension Smoking Presentation Leg pain (calves) on exertion → Intermittent claudication Both walking UP and DOWN hill Spinal stenosis is worse walking DOWN hill Smooth shiny skin Loss of Hair follicle Sweat gland Sebaceous gland Diagnosis Best initial → Ankle-brachial index (ABI) → <0.9...
Read morePericardial Disease
Pericarditis Etiology Infectious Viral → Coxackie B Staph Strep Fungi Autoimmune SLE Wegener Goodpasture RA PAN Uremia Post-MI Peri-infarction pericarditis Dressler Syndrome 🔗 Aortic dissection Radiation Cancer Drugs Presentation Sharp chest pain Change intensity with respiration, position Worsen by lying down Improved by sitting up Diagnosis Best initial → ECG...
Read moreCardiomyopathy
Dilated Cardiomyopathy = Systolic Dysfunction = Low EF Etiology Ischemia Alcohol Postviral myocarditis Radiation Toxins → Doxorubicin Chagas disease Presentation SOB on exertion Edema Rales JVD Gallop Diagnosis Best initial → Echo Most accurate → Echo ECG → Nonspecific CXR → Nonspecific Treatment Symptom control Diuretics Digoxin ↓ Mortality ACEi/ARB Beta...
Read moreValvular Heart Disease
General Etiology Congenital Rheumatic fever → Mostly MS Aging → AS Hypertension → Regurgitation Ischemia → Regurgitation Presentation SOB CHF symptoms Murmur Expiration → ⬆︎ Left preload → ↑ Left murmurs Inspiration → ⬆︎ Right preload → ↑ Right murmurs Diagnosis Best initial → TTE More accurate → TEE Most accurate → Catheterization → Valve diameter, Pressure gradient...
Read moreAcute Pulmonary Edema
Etiology Rapid fluid accumulation in lungs Presentation Acute SOB Rales JVD S3 gallop Edema Orthopnea Pink frothy sputum If sufficient time Ascites Organomegaly Diagnosis Best initial → ECG → To determine cardiac cause BNP → Normal excludes diagnosis CXR Vascular congestion Cephalization of flow Enlarged heart Pleural effusion Kerley B lines...
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