Notes

Acute Rheumatic Fever

Due to strep pyogenes (Group A) pharyngitis and cross reaction with M protein (Hypersensitivity type 2) JONES Criteria Joints → Migratory polyarthritis ♥︎ → Carditis Nodules (subcutaneous) Erythema marginatum Sydenham’s Chorea

Spinal tracts

Spinothalamic, Dorsal column/medial lemniscus Corticospinal tract

Somatoform Disorders

Illness Anxiety Disorder Previously → Hypochondriasis Preoccupation with an illness Somatic Symptom Disorder Somatization Having 1 or more symptoms that has no correlation to physical findings Conversion Disorder Functional Neurologic Symptom Disorder Factitious Munchausen Munchausen by proxy Malingering

Gender Dysphoria

Dissociative Disorders

Dissociative Identity Disorder Dissociative Amnesia Without Fugue (Travel) With Fugue Depersonalization/Derealisation Disorder

Catatonia

Presentation Stupor → ↓ Alertness and ↓ response to stimuli Catalepsy → Can be put in any position Waxy flexibility → Slight, even no resistance to positioning (and holding) Mutism → No verbal response when once there was Negativism → Motiveless resistance to instructions Stereotypy → Repetitive, non-goal directed...

PTSD

PTSD/Acute Stress Disorder Presentation PTSD → >1m Acute Stress Disorder → 2d-1m after event Treatment Best initial -> Group therapy Best initial med Paroxetine Sertraline Nightmares → Prazosin Relaxation techniques Psychotherapy Reactive Attachment Disorder/DSED Adjustment Disorder

Alopecia

Hypopigmentation

Tinea Versicolor Fungus → Malassezia furfur Scaly macules Varying color Areas don’t tan Diagnosis KOH prep → Spaghetti and meatballs Treatment Selenium shampoo Ketoconazole Vitiligo Autoimmune destruction of melanocytes Sharply demarcated patches White Complete depigmentation Diagnosis Woods lamp Biopsy → No melanocytes Treatment Local High potency topical steroid Tacrolimus...

Hyperpigmentation

Mole Benign From melanocytes If hair inside definitely benign If ABCDE biopsy Asymmetry Border irregular Color mixed Diameter >5mm Evolving Dermatofibroma (Benign fibrous histiocytoma) Nontender hyper pigmented nodule <1cm Young patient Lower extremity Pinching ⇒ Central dimple Benign Cosmetic excision Seborrheic Keratoses Benign From keratinocytes GI cancer → Explosive onset of...

Neck Trauma

Chest Trauma