Medicine

COPD

COPD Definition Appearance Nickname Acid-Base Chronic Bronchitis Productive cough >3m/year 2y Overweight Edematous Blue bloater Early Hypercapnia hypoxia Emphysema Terminal airway Obstruction Dilation Thin Wasted Pursed lips Minimal cough Pink puffer Late Hypercapnia Hypoxia Etiology Chronic Bronchitis Tobacco smoke Emphysema Tobacco smoke → Centrilobular Alpha-1 antitrypsin deficiency → Panlobular...

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Asthma

PND → First-gen antihistamine Reversible airway obstruction Etiology Unknown Family history Atopic disorders Obesity Exacerbation causes Allergens → Pollen, Dust mite, Cockroaches, Cat dunder Infection Cold air Emotional stress Exercise Catamenial → Related to menses Drugs → Aspirin, NSAID, Beta blocker, Histamine, Nebulized meds Tobacco smoke GERD Presentation Wheezing Acute onset SOB Cough...

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Diabetes

Etiology Type 1 DM Insulin deficient Childhood onset HLA-DR3, HLA-DR4 Insulin dependent from beginning Not related to obesity Type 2 DM Insulin resistant Adult onset Related to obesity Presentation Polyurea Polyphagia (Type 1>2) Polydipsia ↓ Wound healing DKA (Type 1>2) Diagnosis 2x FBS >125 (two separate occasions) 1x Glucose >200...

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Adrenal Disorders

Hypercortisolism Etiology ↑ ACTH Pituitary source → Cushing Disease (70%) Ectopic source → Cushing Syndrome Small cell lung cancer, Carcinoid (10%) Unknown (5%) Adrenal source (15%) Presentation Fat redistribution Moon face Truncal obesity (↑ abdominal fat) Buffalo hump Thin extremities Skin Striae Easy bruising ↓ Wound healing Thin skin Osteoporosis...

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Calcium Disorders

Hypercalcemia Etiology Primary hyperpara Cancer Vit D intoxication Granulomatous disease (Sarcoidosis) Thiazide diuretics Hyperthyroidism Bone metastasis Multiple myeloma Presentation Stones → Nephrolithiasis Bones → Osteoporosis Groans Constipation Abdominal pain Moans Confusion Stupor Lethargy Short QT Syndrome Hypertension Diabetes insipidus Renal failure Treatment Ca >14 or Symptomatic → Saline at high volume...

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Thyroid Disorders

Hypothyroidism Etiology Hashimoto Thyroiditis Autoimmune Thyroid burnout Subacute Thyroiditis Postpartum Thyroiditis Postviral Thyroiditis Secondary Hypothyroidism Pituitary compromise Congenital Hypothyroidism FTT Hypotonia Umbilical hernia Prolonged jundice Generalized thyroid hormone resistance Iatrogenic → After surgery ↓ Iodine intake Lithium Amiodarone Presentation Bradycardia Constipation ↑Weight Fatigue, Lethargy, Coma ↓DTR Cold intolerance Hypothermia...

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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...

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Amebiasis

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...

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MI 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...

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Heart 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 →...

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Aortic 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...

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Peripheral 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...

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