Primary Care for COMLEX Level 1 - Dr. Jahan Eftekar

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      Heart Failure

      •Left-sided; Pulmonary edema

      •Right-sided; Hepatomegaly, Nutmeg liver

      Rubella

      •Patent Ductus Arteriosus

      •IgM antibody (anti-rubella) indicates recent primary infection

      •Congenital associated with deafness, cataracts, glaucoma, and mental retardation

      •Prenatal worse than postnatal

      Cardiomyopathies

      •Hypertrophic: autosomal dominance, obstructive. AKA. Idiopathic hypertrophic sub-aortic stenosis

      •Dilated: Congestive. Associated with ethanol, doxorubicin (adriamycin), mercury and lead poisoning, thyrotoxicosis, hypophosphatemia, hypocalcemia, thiamine deficiency. Left and right congestive failure.

      •Restrictive: Impaired diastolic filling. Sarcoidosis, amyloidosis, and carcinoid syndrome

      2. VASCULAR PATHOLOGY

      Atherosclerosis

      •Mural thrombus

      •Men more than women

      •Hypercholesterolemia

      •Abdominal aorta, coronary artery and carotid artery

      •Inverse relation to HDL cholesterol

      Pulmonary Embolism

      •Wasted ventilation in the affected, and over-perfusion of the remaining lung tissue

      •Wedge-shaped infarcts

      •Immobilized post-op patients

      •Deep venous thrombosis

      •Lower extremity

      Syphilitic Aortic Aneurysm

      •Ascending aorta

      •Tree bark appearance

      •Tertiary syphilis

      •Aortic valve insufficiency

      Aortic Dissecting Aneurysm

      •Cystic medial necrosis

      •Longitudinal intraluminal tear

      •Ascending aorta

      •Marfan’s Syndrome

      •Hypertension and Hemopericardium

      Idiopathic Hypertrophic

      Subaortic Stenosis

      •Haphazard Myocardial Arrangement

      •Ca++ channel blockers

      Wegener’s Granulomatosis

      •Paranasal sinuses

      •Otitis media

      •Necrotizing arteritis and glomerulonephritis

      •Granuloma formation

      •C-ANCA

      •TRT: Methotrexate

      Malignant Hypertension

      •Young male Afro-Americans

      •Accelerated, early death

      •Flea-bitten Kidney

      Berry Aneurysm

      •Circle of Willis

      •Bifurcation of cerebral arteries

      •Subarachnoidal hemorrhage

      Secondary Hypertension

      •Renal ischemia, stenosis

      •Coarctation of aorta

      •Pheochromocytoma

      •Hyperthyroidism

      •Cushing’s syndrome

      •Primary aldosteronism

      Thromboangiitis Obliterans

      •Buerger’s disease

      •Young Jewish men

      •Heavy smoking

      •Ischemia of extremities

      Polyarteritis Nodosa

      •P-ANCA

      •Small-medium sized arteries

      •Increased ESR

      Budd-Chiari Syndrome

      •Occlusion of inferior vena cava

      •Central lobular hepatic necrosis

      •Congestive liver disease

      •Polycythemia vera

      3. HEMATOLOGY AND ANEMIA

      Hereditary Spherocytosis

      •Spectrin defect

      •Increased RBC Brittleness

      •Increased mean corpuscular hemoglobin concentration

      Glucose 6-Phosphate

      Dehydrogenase Deficiency

      •Antimalarial induced hemolysis

      •X-linked

      •Episodic and acute

      •Mediterranean heritage + Blacks

      •Sulfa drugs induced hemolysis

      •Fava beans

      •Intravascular hemolysis

      Pyruvate Kinase Deficiency

      •Autosomal recessive

      •Chronic anemia, non-episodic

      •Non-spherocytic hemolytic anemia

      Sickle Cell Anemia

      •Substitution of VAL for glutamic acid

      •Afro-Americans

      •Resistance to malaria

      •Small spleen in adults

      •Pigment gallstones

      •Chronic leg ulcers

      •Painful occlusion of vessels

      β-Thalassemia

      •Fetal hemoglobin (HbF) increases

      •Hemosiderosis

      •Mediterranean anemia

      •Microcytosis, hypochromia

      •Splenomegaly

      α-Thalassemia

      •HbA2

      •Hb Bart in fetal life

      •Southeast Asia

      Megaloblastic Anemia

      •B12 or Folate deficiency

      •Pancytopenia

      •Oval Macrocytosis

      •Increased MCV

      •Increased MCH

      Pernicious Anemia

      •B12 deficiency (megaloblastic)

      •Anti-intrinsic factor

      •Gastric

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