Medicine

Antibodies

Antibody Disease ANA SLE Anti Smith (Sm) SLE Anti dsDNA SLE + Renal involvement Anti Histone Drug-induced SLE Lupus Anticoagulant Antiphospholipid Syndrome + ↑aPTT Anti Cardiolipin Antiphospholipid Syndrome + Spontaneous abortion Anti SS-A (Ro) Sjogren’s Neonatal SLE Anti SS-B (La) Sjogren’s Anti CCP RA RF RA Anti Scl-70 (Topoisomerase...

Complex Regional Pain Syndrome

Etiology After trauma 3 Phases Acute/Traumatic phase Dystrophic phase Atrophic phase Presentation Diffuse pain Out of proportion to injury Non-anatomic distribution Can occur anytime after injury Loss of function → of affected limb Sympathetic dysfunction Skin changes Soft tissue changes Blood flow changes Change in Skin temperature Hair growth...

Obstructive/Restrictive Lung Diseases

Obstructive Asthma Bronchiectasis COPD Chronic bronchitis Emphysema Restrictive Alveolar Edema Hemorrhage Pus Interstitial Idiopathic interstitial pneumonia Inflammatory Sarcoidosis Cryptogenic organizing pneumonia Cryptogenic means idiopathic Bronchiolitis obliterans organizing pneumonia (BOOP) Inflammation of bronchioles Seen in the context of Rheumatoid arthritis Dermatomyositis Amiodarone Idiopathic pulmonary fibrosis Neuromuscular Myasthenia Phrenic nerve palsy...

Porphyrias

Etiology Heme production abnormality ⇒ Porphyrin accumulation Porphyria Cutanea Tarda HCV Hemochromatosis Acute Intermittent Porphyria Erythropoietic Porphyria Lead Poisoning → Porphyria-like disorder Presentation General Photodermatitis Erythema Blisters Neuropsychiatric Psychosis Polyneuropathy Areflexia Visceral Abdominal pain Seizure Hemolytic anemia Pink/brown urine → Telltale sign Tachycardia Disease specific Porphyria Cutanea Tarda Most common...

ECG

Main things to check in each ECG Rate Normal → 60-100 (3-5 big boxes) Rhythm Sinus rhythm → P before every QRS and QRS after every P Axis Look at I and aVF Normal → I ↑, aVF ↑ Left axis deviation → I ↑, aVF ↓ Right axis...

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

Congenital Adrenal Hyperplasia

Congenital Adrenal Hyperplasia Etiology Inherited defect in steroid synthesis 21-hydroxylase (>90%) 11β-hydroxylase 17α-hydroxylase   Presentation Most common → Hypotensive child with severe electrolyte abnormalities Deficiency 21-hydroxylase 11β-hydroxylase 17α-hydroxylase Aldosterone ↓ ↓ ⬆︎ Cortisol ↓ ↓ ↓ Sex hormones ↑ ↑ ↓ 17-OH progesterone ⬆︎ — — 11-deoxycorticosterone (11-DOC) — ⬆︎...

Behçet Syndrome

Etiology Asian Middle Eastern Presentation Painful ulcers Oral Genital Ocular lesion Uveitis Blindness Erythema nodosum-like skin lesion Arthritis CNS lesions (mimics MS) Pathergy → Sterile skin pustules from minor trauma or needle stick Diagnosis Clinical No characteristic lab Treatment Corticosteroids To wean off Azathioprine Cyclophosphamide Colchicine Thalidomide

Joint Pain

Jaundice

Jaundice Pre-Hepatic → Isolated ↑Bilirubin Unconjugated ↑ Production Hemolysis Hemorrhage ↑ Enterohepatic circulation Breastfeeding J. → <7d → Poor feeding → Feed more Breast milk J. → >7d → No gut bacteria → Feed formula Pyloric stenosis Intra-Hepatic → Isolated ↑Bilirubin Unconjugated Uptake/Conjugation defect Physiologic J. Gilbert → Stress → Phenobarbital Craigler-Najjar Type 1...

Cirrhosis Complications

Cirrhosis → Chronic liver injury ⇒ Bridging fibrosis + Nodular regeneration Presentations and Treatments ↓Albumin Edema Coagulopathy (Except factor 8) FFP/Platelet → In bleeding Vitamin K is WRONG! Ammonia increase Asterixis → Liver flap Hepatic Encephalopathy Lactulose Rifaximin Estrogen metabolism problems Gynecomastia Spider angiomata Palmar erythema Portal hypertension ↓PLT → Splenic sequestration Ascites SAAG >1.1...

Malabsorption

Malabsorption Etiology Celiac disease → Gluten-sensitive enteropathy IgA mediated Whipple disease → Treponema whippli Tropical sprue → Infection Lactose intolerance Chronic pancreatitis Presentation Steatorrhea Fat malabsorption → Weight loss ADEK deficiency D → ↓Ca, Osteoporosis K → Bleeding, Easy bruising B12 deficiency → Anemia, Hypersegmentd PMN, Neuropathy Celiac Dermatitis herpetiformis (10%) Iron deficiency Osteoporosis Whipple...