Transcript usmle Dr.Danil Hammoudi 1 Sinoe Medical Association

usmle
Dr.Danil Hammoudi
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Sinoe Medical Association
OSTEOARTHRITIS IS LEAST LIKELY TO
BE ASSOCIATED WITH:
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ULCERATIVE COLITIS
Sinoe Medical Association
OSTEOARTHRITIS
ASSOCIATED WITH
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GOUT
HEMOPHILIA
WILSON’S DISEASE
EHLERS DALOS SYNDROME
Sinoe Medical Association
AMBIGOUS GENITALIA
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ADRENAL HYPERPLASIA
Sinoe Medical Association
EYES MUSCLES ABDUCTING
EYEBALL
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INTERNAL RECTUS
Sinoe Medical Association
EXTRINSIC EYE MUSCLES AND
ROLE
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MUSCLE
INNERVATION
MOVEMENT
LATERAL RECTUS
ABDUCENS [VI]
LATERAL
MEDIAL RECTUS
OCULOMOTOR [III]
MEDIAL
SUPERIOR RECTUS
OCULOMOTOR
SUPERIOR AND
MEDIAL
INFERIOR RECTUS
OCULOMOTOR
INFERIOR AND MEDIAL
INFERIOR OBLIQUE
OCULOMOTOR
SUPERIOR AND
LATERAL
SUPERIOR OBLIQUE
TROCHLEAR [IV]
INFERIOR AND
LATERAL
Sinoe Medical Association
EXTERNAL MUSCULATURE OF
THE EYE
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LEVATOR PALPEBRAE SUPERIORIS
MUSCLES OPEN THE UPPER EYELID
ORBICULARIS OCULI, A SPHINCTER
LIKE MUSCLE, CLOSE EYELIDS
Sinoe Medical Association
STAPHYLOCOCCAL FOOD
POISONING:
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2 TO 4 HOURS
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KRABBE’S DISEASE
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GLOBOID CELL LEUKODYSTROPHY
ONSET IN INFANT WITH RIGIDITY
TERMINAL BLINDNESS
DEFICIENCY OF BETA
GALACTOSIDASE
ACCUMULATION OF
GALACTOCEREBROSIDE.
Sinoe Medical Association
COBALT IS AN ESSENTIAL
COMPONENT OF:
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CYANOCOBOLAMIN [B12]
Sinoe Medical Association
HIRSUTISM ARE ASSOCIATED
WITH
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ADRENAL TUMOR
HYPOTHYROIDISM
DANAZAL THERAPY
CYCLOSPORINE THERAPY
Sinoe Medical Association
INCREASED IN VMA IS USUALLY
SEEN IN :
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NEUROBLASTOMA
PHEOCHROMOCYTOMA
Sinoe Medical Association
LANGHERAN’S CELL
HISTIOCYTOSIS CLINICAL
FORMS
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LETTER SIWE DISEASE
HAND SCHBLIER CHRISTIAN DISEASE
EOSINOPHILIC GRANULOMA
HASHIMOTO PRITZKER DISEASE
Sinoe Medical Association
HISTIOCYTOSIS, LETTERER
SIWE DISEASE
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ONSET IN THE FIRST YEAR
HAVE SEBORRHEIC RASH
OTITIS MEDIA
LYMPHADENOPATHY, PURPURA ANEMIA,
HEPATOSPLENOMEGALY
EXTENSIVE LYTIC SKULL LESION =RAINDROP SKULL
UNKNOWN ETIOLOGY
WORST PROGNOSIS
Sinoe Medical Association
HISTIOCYTOSIS X
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INTENSE PROLIFERATION OF
RETICULOHISTIOCYTIC CELLS
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EOSINOPHILIC GRANULOMA
HAND SCHULLER CHRISTIAN DISEASE
LETTER SIWE DISEASE
Sinoe Medical Association
EOSINOPHILIC GRANULOMA: EG
-60-80% OF HISTIOCYTOSIS X
-AGE 5-10 YRS MOST COMMON
-BEST PROGNOSIS
HAND SHULLER-CHRISTIAN DISEASE
-AGE 1-3 YRS
LETTERER SIWE DISEASE
-AGE 0-1YRS
-WORST PROGNOSIS : MORTALITY 70%]
-=MALIGNANT FORM OF HISTIOCYTOSIS
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Sinoe Medical Association
HAND SCHUELLER CHRISTIAN
DISEASE
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1-3 YRS,
MOST COMMON HISTIOCYTOSIS FORM
SKULL – MANDIBULE LESION SEMILAR EOSINOPHIL GRANULOMAS
BUT MORE NUMEROUS
GEOGRAPHIC SKULL “FLOATING TEETH”
ADENOPATHY
HEPATOSPLENOMEGALY
SKIN LESION
DIABETES INSIPIDUS
EXOPHTALMOS
LUNG DISEASE
Sinoe Medical Association
LETTERER SIWE DISEASE
SYNONYMS
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ACUTE DIFFUSIBLE HISTIOCYTOSIS
ACUTE INFANTILE
RETICULOENDOTHELIOSIS
ACUTE RETICULOSIS OF INFANCY
GENERALIZED HISTIOCYTOSIS
NON LIPID RETICULOENDOTHELIOSIS
Sinoe Medical Association
CURLING ULCER OF THE
STOMACH /MARJOLIN OF THE
SKIN ARE CAUSES BY:
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BURNS
Sinoe Medical Association
CEREBROSPINAL FLUID IN
VIRAL ENCEPHALITIS SHOWS:
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VARIABLE PLEOCYTOSIS
DECREASED SUGAR LEVEL
INCREASED PROTEIN LEVEL
Sinoe Medical Association
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MORE COMMON IN WOMEN THAN IN
MEN
ASSOCIATED WITH PRURITUS,
JAUNDICE,XANTHOMATOUS LESIONS
INCREASED ALKALINE PHOSPHATASE
AND CHOLESTEROL
MITOCHONDRIAL ANTIBODIES AND
INCREASED SERUM IgM.
Sinoe Medical Association
SABER SHIN OCCURS MAINLY
IN CHILDREN WITH:
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CONGENITAL SYPHILIS
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THE MOST COMMON
INTRACRANIAL GERM TUMOR
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GERMINOMA
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GERMINOMAS
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HIGHLY RADIOSENSITIVE
Sinoe Medical Association
TYPES OF GLIOMAS
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ASTROCYTOMAS
EPENDYNOMAS
GANGLIOMAS
OLIGODENDROGLIOMAS
MIXED GLIOMAS
Sinoe Medical Association
CHILDHOOD GLIOMAS
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ASTROCYTOMAS
EPENDYMOMAS
GANGLIOGLIOMAS
Sinoe Medical Association
GERM CELL TUMORS [CGTs]
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GERMINOMAS
TERATOMAS
CHORIOCARCINOMAS
ENDODERMAL SINUS TUMORS
EMBRYONAL CARCINOMAS
MIXED GCTs
Sinoe Medical Association
PINEAL PARENCHYMAL
TUMORS
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PINEOBLASTOMAS
PINEOCYTOMAS
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PINEAL GLIOMAS
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ASTROCYTOMAS
EPENDYMOMAS
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PINEAL NEOPLSMS
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5% OF ALL PEDIATRICS BRAIN
TUMORS
Sinoe Medical Association
OSGOOD SCHLATTER DISEASE
USUALLY OCCURS IN
CHILDREN AGED
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11 TO 13 YEARS
Sinoe Medical Association
OSGOOD SCHLATTER
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OSTEOCHONDROSIS
PARTIAL AVULSION OF THE TIBIA TUBEROSITY, WITH NO
INVOLVEMENT OF THE TIBIA PHYSIS
COMMON CAUSES CAUSES OF KNEE PAIN IN ADOLESCENT
SWELLING AND TENDERNESS JUST BELOW THE KNEE OVER
THE SHIN BONE [TIBIA]
MORE COMMON IN BOYS
8-13 YEARS GIRLS, 10-15 BOYS
GROWTH SPURT AND MAY AFFECT BOTH KNEES ,
ENLARGEMENT OF THE TIBIAL TUBERCLE.
GOES AWAY WITH TIME
Sinoe Medical Association
RED SCALY WITH A SHARP
RAISED BORDER ON THE
PERINEUM , THIGHS AND
BUTTOCKS ARE SEEN IN TINEA
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CRURIS [JOCK ITCH]
Sinoe Medical Association
TINEA CRURIS= JOCK ITCH
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ANY ITCHING IN THE GROIN RASH IN MEN
WHEN CAUSED BY A FUNGUS = RASH=TINEA
CRURIS
CAUSE OF TINEA CRURIS= FUNGUS
DERMATOPHYTES=RINGWORM FUNGI
NOT CONTAGIOUS
BILATERAL
DO NOT INCLUDE PENIS AND SCROTUM
MIGRATE TO THE BUTTOCK AND GLUTEAL CLEFT
AREA
Sinoe Medical Association
DERMATOPHYTES INFECTION
IN TINEA CRURI
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MICROSPORUM
TRICHOPHYTON
EPIDERMOPHYTON
Sinoe Medical Association
THE MOST COMMON CAUSE
OF A VIGINITIS IN A 10 YEARS
OLD GIRL IS
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FOREIGN BODY
Sinoe Medical Association
RETINOBLASTOMA
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MOST COMMON IN LESS THAN 3
YEARS OF AGE
SHOW WHITE CAT’S EYES REFLEX ON
FUNDOSCOPY
ARE AUTOSOMAL DOMINANT
BILATERAL 30% OF CASES
ARE THE MOST INTRAOCULAR TUMOR
IN CHILDREN
Sinoe Medical Association
RETINOBLASTOMA
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LEUKOCORIA [WHITE PUPIL REFLEX]
STRABISMUS
EXOTROPIA
ESOTROPIA
RED PAINFUL EYE
POOR VISION , INFLAMMATION TISSUE AROUND THE EYE
ENLARGED OR DILATATED PUPIL
HETEROCHROMIA
FAILURE TO THRIVE
EXTRA FINGERS OR TOES
MALFORMED EARS
RETARDATION
Sinoe Medical Association
NOT A CLINICAL FEATURE OF
ANOREXIA NERVOSA
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HISTORY OF CHILDHOOD
HYPERACTIVITY
Sinoe Medical Association
ANOREXIA NERVOSA
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AMENORRHEA
BRADYCARDIA
ONSET BEFORE 25 YEARS OF AGE
Sinoe Medical Association
CHROMOSOMAL ANALYSIS IS
USEFUL IN
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TESTICULAR FEMINIZATION
GONADAL DYSGENESIS
Sinoe Medical Association
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Sinoe Medical Association
DIFFERENTIAL DIAG OF TINEA
CRURIS
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INTERTRIGO
ERYTHRASMA
SEBORRHEIC DERMATITIS OF THE
GROIN
PSORIASIS OF THE GROIN
CANDIDIASIS OF THE GROIN
Sinoe Medical Association
SINDING LARSEN JOHANSSON
SYNDROME
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RESEMBLES OSGOOD SCHLOTTER DISEASE, EXCEPT SYMPTOMS
LOCALIZED IN THE INFERIOR POLE OF PATELLA
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CHRONIC OVERTENSION OF EXTENSOR MECHANISM
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PAIN
OSSIFICATION DISTURBANCE
SWELLING
WEAK QUAD
REPETITIVE LOADED KNEE FLEXION ACTIVITIES:
 LIGAMENT AVULSION
 SOFT TISSUE CALCIFICATION
 STRESS FRACTURE
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Sinoe Medical Association
OSTEOCHONDROSIS
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LEGG CALVE PERTHES DISEASES =CAPITAL FEMORAL
EPIPHYSIS
KOHLER DISEASE =TARSAL NAVICULAR
OSGOOD SHLATTER DISEASE=TIBIAL TUBEROSITY
SCHEUERMANN DISEASE=VERTEBRAL RING
EPIPHYSES
FREIBER INFRACTION =METATARSAL HEAD
SEVER DISEASE = APOPHYSIS OF OS CALCIS
OSTEOCHONDRITIS DISSECANS
Sinoe Medical Association
OSTEOCHONDROSIS
DISSECANS
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SUBCHONDRAL FATIGUE FRACTURE
COMMONLY SEEN IN ADOLESCENT
CAPITELLUM OF THE ELBOW
KNEE [MEDIAL FEMORAL CONDYLE
CLOSE TO FOSSA INTERCONDYLARIS]
TALUS
MOUSE= OSTEOCHONDROTIC FRAGMENT
MOUSE BED= SCLEROSED PIT IN ARTICULAR SURFACE
Sinoe Medical Association
SEVER DISEASE
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OSTEOCHONDROSIS
APOPHYSIS OF THE OS CALCIS
[UNDERGOES FRAGMENTATION]
Sinoe Medical Association
FREIBERG INFRACTION
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OSTEOCHONDROSIS
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METATARSAL HEAD
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2ND COMMON
3RD AND 1ST LESS COMMON
INFARCTION OR STRESS FRACTURE
LATE ADOLESCENCE
A END ARTICULAR BECOMES FLATTENED
SMALL OSSICLES MAY FORM AFTER HEALING
DJD IS COMMONLY LATE COMPLICATION
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Sinoe Medical Association
SCHMORL NODE
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CHONDRIFICATION DEFECTS WHERE
PERIOSTEAL VESSELS PENETRATE
CARTILAGE PLATE OF DISC
Sinoe Medical Association
KOHLER DISEASE
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OSTEOCHONDROSIS OF TARSAL
NAVICULAR
Sinoe Medical Association
LEGG CALVE PERTHES
DISEASE
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OSTEOCHONDROTIS DEFORMANS
COXA PLANA
IDIOPATHIC AVASCULAR NECROSIS OF PROXIMAL FEMORAL
EPIPHYSIS
MALE
UNILATERAL
4-8 YRS OLD
UNCOMMON BEFORE 3Y/O
SELF LIMITED
CAN PROGRESS TO COXA PLANA
Sinoe Medical Association
MEDIASTINAL ADENOPATHY IS
NOT SEEN IN
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IDIOPATHIC PULMONARY FIBROSIS
Sinoe Medical Association
MEDIASTINAL ADENOPATHY IS
SEEN IN
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SARCOIDOSIS
MILARY TUBERCULOSIS
PNEUMOCYSTIS CARNII PNEUMONIA
Sinoe Medical Association
ANTERIOR MEDIASTINAL
MASSES
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THYMOMA
TERATOMA
THYROID [ECTOPIC]
LYMPHOMA
Sinoe Medical Association
MIDDLE MEDIASTINAL
MASSES
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ADENOPATHY:
INFECTION [BACTERIAL,
GRANULOMATOUS]
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NEOPLASM : LEUKEMIA, LYMPHOMA METASTASES
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BRONCHOPULMONARY FOREGUT
MALFORMATIONS:
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ESOPHAGAL DUPLICATION CYST
BRONCHOGENIC CYST
SEQUESTRATION
Sinoe Medical Association
POSTERIOR MEDIASTINAL
MASSES
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SYMPATHETIC GANGLION TUMORS
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MASSES] NEUROBLASTOMA
GANGLIONEUROBLASTOMA
GANGLIONEUROMA [95% OF POSTERIOR MEDIASTINAL MASSES
NEUROFIBROMAS
 NEURENTERIC CYST
 EXTRAMEDULLARY HEMATOPOESIS
 PARAVERTEBRAL SOFT TISSUE MASS FROM
INFECTION
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Sinoe Medical Association
BEHAVIOR PSYCHOTHERAPY IS
DISTINGUISHED FROM
COGNITIVE PSYCHOTHERAPY
BY:
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THE VIEW OF BEHAVIOR AS A
RESPONSE TO THE ENVIRONMENT
Sinoe Medical Association
OF ALOPECIA THAT ARE
WOOD’S LAMP POSITIVE
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TINEA CAPITIS
DUE TO :
MICROSPORUM CANIS
TRICHOPHYTON SPECIES [TOSURANS]
MICROSPORUM SPECIES FLIORESCE A BRIGHT BLUE GREEN
COLOR
EPIDERMOPHYTON FLOCCOSUM IS A CAUSE OF TINEA
CRURIS
Sinoe Medical Association
CANDIDA ALBICANS IS
RESPONSIBLE FOR
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ORAL RUSH
DIAPER DERMATITIS IN INFANTS
Sinoe Medical Association
MUMPS IS A COMMON CAUSE
OF:
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VIRAL PAROTITIS
Sinoe Medical Association
ASSOCIATED WITH EYE PAIN
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ACUTE ANTERIOR UVEITIS
OPTIC NEURITIS
ACUTE GLAUCOMA
Sinoe Medical Association
CENTRAL RETINAL VEIN
OCCLUSION
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SUDDEN, PAINLESS, UNILATERAL
LOSS OF VISION IN PATIENTS WITH :
1/HYPERCOAGULABILITY STATE
[POLYCUTHEMIA RUBRA VERA]
2/DIABETES MELLITUS
3/ GLAUCOMA
Sinoe Medical Association
RETINAL EXAM OF CENTRAL
RETINAL VEIN OCCLUSION
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SWELLING OF THE OPTIC DISC
VENOUS DILATATION
TORTUOSITY
WIDESPEAD RETINAL HEMORRHAGE
COTTON WOOD EXUDATE
Sinoe Medical Association
HEPARIN
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INCREASES EFFECTIVENESS OF
ANTITHROMBIN III
Sinoe Medical Association
COUMARIN [WARFARIN]
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CAUSE THE PLASMA LEVELS OF
PROTHROMBINE, FACTORS VIII, IX, X
TO FALL
WARFARIN COMPETE WITH VIT K
Sinoe Medical Association
AUER ROD
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ACUTE MYELOCYTIC LEUKEMIA
Sinoe Medical Association
REED STENDBERG CELLS
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HODGKIN’S DISEASE MIXED
CELLULARITY
Sinoe Medical Association
ERB DUCHENNE PALSY
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INJURY TO C-5 AND C-6
Sinoe Medical Association
NEUROBLASTOMA
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THE MOST COMMON LOCATION
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ABDOMEN
Sinoe Medical Association
NEUROBLASTOMA
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IT ACCOUNT FOR 15% OF ALL
CHILDHOOD CANCER DEATH
35% OF CASES APPEAR DURING THE
FIRST YEAR OF LIFE
IT IS ONE OF THE MOST COMMON
CHILDHOOD EXTRACRANIAL SOLID
CANCER
Sinoe Medical Association
CHILDREN WITH NEUROBLASTOMA [THE
MOST COMMON CONGENITAL TUMOR
OCCURING DURING THE FIRST YEAR OF
LIFE] USUALLY PRESENT:
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PALPABLE ABDOMINAL MASS
Sinoe Medical Association
THE MOST COMMON SOLID
MALIGNANT TUMOR IN
CHILDREN UNDER THE AGE OF
4 YEARS IS
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NEUROBLASTOMA
Sinoe Medical Association
PHEOCHROMOCYTOMA AND
NEUROBLASTOMA ARE ASSOCIATED
WITH INCREASED URINARY
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VANILLYLMANDELIC ACID [VMA]
Sinoe Medical Association
IN PATIENT WITH
NEUROBLASTOMA , THE
INCIDENCE OF METASTASES AT
TIME OF INITIAL DIAGNOSIS IS
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Sinoe Medical Association
SCREENING FOR
NEUROBLASTOMA IS MADE BY
VMA AND HVA [HOMOVANILLIC
ACID]
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Sinoe Medical Association
THE MOST PRIMARY SITE OF
NEUROBLASTOMA IS:
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ADRENAL GLAND
Sinoe Medical Association
IN NEUROBLASTOMA, CALCIFICATION
IS PRESENT IN:
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45%
Sinoe Medical Association
CHARACTERISTIC FEATURE
OF
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NEUROBLASTOMA
Sinoe Medical Association
SPLENOMEGALY
CHARACTERISTICS OF
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GALACTOSEMIA
CYSTINOSIS
PORPHYRIA
GAUCHER’S DISEASE
Sinoe Medical Association
NEUROBLASTOMA IS
ASSOCIATED WITH
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SPONTANEOUS REGRESSION
Sinoe Medical Association
THE INFANT OF A DIABETIC
MOTHER COMMONLY
DEVELOPS :
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HYPOGLYCEMIA
HYPERBILIRUBINEMIA
HYPOCALCEMIA
POLYCYTHEMIA
INCREASED INCIDENCE OF CONGENITAL
MALFORMATION [HEART AND SQUELETTAL
DEFECT]
Sinoe Medical Association
ASSOCIATION OF HORNER’S
SYNDROME WITH A NECK
MASS IN CHILREN IS MOST
LIKELYDUE TO:
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NEUROBLASTOMA
Sinoe Medical Association
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Sinoe Medical Association
A CHILD WITH A POSTERIOR
MEDIASTINAL MASS THE MOST
LIKELY DIAGNOSIS IS
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NEUROBLASTOMA
Sinoe Medical Association
MEGALOBLASTIC ANEMIA
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Sinoe Medical Association
OCCUR DURING NORMAL
GROWTH IN THE FIRST 12
MONTHS OF LIFE
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AT LEAST A DOUBLING OF THE INITIAL BIRTH
WEIGHT
TRIPLE THEIR WEIGHT BY 12 MONTHS
CLOSURE OF THE POSTERIOR FONTANELLE [2-4
MONTHS]
ANTERIOR FONTANELLE CLOSES AT 6-18 MONTHS
ERUPTION OF AN AVERAGE OF 6-8 DECIDUOUS
TEETH
INCREASE IN LENGTH OF 25 – 30 CM
Sinoe Medical Association
TODDLER 24 MONTHS CAN
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LINK 3-4 WORDS TOGETHER IN
SIMPLE SENTENCES
ASSIST IN UNDRESSING SELF
HANDLE SPOON AND CUP WELL
BUILD A TOWER OF A 5-6 CUBES
Sinoe Medical Association
HEMOPHILUS INFLUENZAE B
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UNDER 2YRS OLD
MENINGITIS
SEPTIC ARTHRITIS
BUCCAL CELLULITIS
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OLDER CHILD
EPIGLOTTITIS
PNEUMONIAE
Sinoe Medical Association
HEMOPHILUS INFLUENZAE B
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SEPTIC ARTHRITIS IN A 4 MONTH OLD
INFANT
MENINGITIS IN A 3 YRS OLD CHILD
EPIGLOTTITIS IN A 6 YRS OLD CHILD
BUCCAL CELLULITIS IN A 15 MONTH OLD
INFANT.
Sinoe Medical Association
PNEUMOCOCCAL SEPSIS IS A DITINCT
POSSIBILITY IN PATIENTS WITH THE
FOLLOWING UNDERLYING DISEASES
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PATIENT WITH ASPLENIA
10 YRS OLD WITH SICKLE CELL ANEMIA
5YR OLD SURVIVOR OF HODGKIN’S
DISEASE FOLLOWING SPLENECTOMY
8 YRS OLD WITH CHRONIC
GRANULOMATOUS DISEASE
Sinoe Medical Association
ESOPHAGEAL ATRESIA
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Excessive secretions noted in the new
born nursery
Difficulty feeding with cyanotic episode
Inability to pass a catheter into the
stomach
A history of polyhydramnios
Commonly associated with
tracheoesophageal fistula
Sinoe Medical Association
OTITIS MEDIA COMPLICATION
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Hearing loss
Brain abscess formation, meningitis, focal
encephalitis.
Cholesteatoma
Facial nerve paralysis
Perforation of tympanic membrane
Sinoe Medical Association
Otitis media
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S. pneumoniae , H.influtenzae are the
most common causative agents
Most prevalence infectious diseases in the
childhood.
Sinoe Medical Association
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Sinoe Medical Association
Congenital hypothyroidism
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Newborn screening programs have been initiated in
most states due to the difficulty in identifying the
affected children
Delay in therapeutic can lead to brain damage
Premature infants frequently have transiently low
levels of thyrotropin releasing factor
The breast fed infants with hypothyroidism is
partially protected due to the presence of maternal
thyroid hormone in the milk
Normal birth weight , length , head circumference
Sinoe Medical Association
The most common type of seizure
seen in the new born period is:
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96
Subtle seizures [eye deviations,sucking,
posturing with the extremities]
Sinoe Medical Association
Most common manifestation of
acute valvular disease during the
initial stages of rheumatic fever:
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97
Mitral regurgitation
Tachycardia
Cardiomegaly
Pericardial effusion
Complication later: valvular stenosis
Sinoe Medical Association
Normal hematologic values in the
full term infant
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98
Polycythemia with a normal hb of 16-18 and hct of 45-60
HT and HB relatively high declining by 7 weeks of age for
premature and 2- 3 months for for the term infant = physiologic
anemia in infancy.
Predominance of fetal hemoglobin
Mcv =mean corpuscular volume high during neonatal period
but declines during the later infancy.
Normal white blood cell count ranging from 5000 to 30000 in
the first 48h after birth with a granulocytes predominance
Midly prolonged prothrombin time [PT] and PTT
Sinoe Medical Association
New born anemia
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99
Hemolytic diseases
Acute blood loss
Chronic blood loss
Impaired red blood cell production
Sinoe Medical Association
New born anemia etiology
I/ hemolytic disease
of the new born
=erythroblastosis
fetalis
Blood group
incompatibility
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100
Sinoe Medical Association