Prognosis & Outcomes – Lecture Review

A comprehensive set of Q&A flashcards summarizing prognostic facts and outcomes across multiple diseases and clinical scenarios from the lecture notes.

What is the long-term prognosis for a Kawasaki patient who develops a coronary artery aneurysm?

Lifelong increased risk of future coronary events (ischemia, myocardial infarction).

What happens to untreated Kawasaki disease within the first 10 days?

High likelihood of developing a coronary artery aneurysm.

What is the long-term risk for women on hormone-replacement therapy (HRT)?

Increased incidence of breast cancer, typically evident within 5 years.

Prognosis for a newborn with thalassemia major treated with hyper-transfusions?

Survival for only a few years; progressive organ damage from iron overload.

Overall prognosis of pulmonary sarcoidosis after glucocorticoid therapy?

About 75 % resolve over time and do not recur after 12–24 months of steroids.

Late-life depression (>65 yr): long-term outlook?

Greater risk of developing Alzheimer disease and other dementias.

Which sarcoidosis patients have the worst outcomes?

Age >40, African American, progressive pulmonary fibrosis, cardiac or neurologic involvement, cor pulmonale, or nephrocalcinosis.

Behavioral-variant frontotemporal dementia: expected course?

Typically fatal within 8 years of symptom onset.

Long-term sequelae of parvovirus B19 infection?

None; it is self-limited with no chronic complications.

Essential (familial) tremor – natural history?

Tremor gradually worsens but life expectancy and overall function are generally normal.

List at least three favorable prognostic factors in schizophrenia.

Female sex, late/acute onset with positive symptoms, good premorbid function, mood symptoms, identifiable stressor, strong family support, no family history of schizophrenia, short duration of active illness.

Outcome of late Lyme arthritis in children after a 28-day antibiotic course?

Most are disease-free within 6–12 months.

Autosomal dominant polycystic kidney disease (ADPKD): renal prognosis?

≈50 % require dialysis or transplant by age 60.

Untreated PML in HIV: expected survival?

Death in 3–6 months; HAART may extend survival >2 years.

Risk to the fetus from Lyme disease in pregnancy after appropriate treatment?

Minimal to none when treated with amoxicillin or cefuroxime.

Common long-term sequelae after surviving ARDS?

Neurocognitive deficits, muscle weakness, reduced lung function, psychiatric illness.

Key predictor of full recovery after compartment syndrome?

Time from onset to surgical decompression (earlier = better).

Course of hand-foot-mouth disease lesions?

Oral and skin lesions self-resolve within 1 week; patient remains contagious for weeks.

Significance of respiratory acidosis (CO₂ >40 mm Hg) in acute asthma?

Signals impending respiratory failure; requires ICU care and possible intubation.

Onychomycosis counseling points?

Discuss hepatotoxicity risk of therapy and high rates of treatment failure/recurrence.

Asymptomatic bacteriuria in older women: natural course?

Usually transient and resolves within 2 weeks; no treatment or repeat culture needed (except in pregnancy, pre-urologic surgery, recent transplant).

Endocrine recovery after anabolic-androgenic steroid abuse?

Testosterone normalizes in weeks-months, but chronic use can cause prolonged or permanent suppression.

Renal cell carcinoma localized to the kidney – prognosis after nephrectomy?

Usually curative; ≈65 % present with localized disease.

Management implications of a solitary pulmonary nodule <0.6 cm?

Very low malignancy risk; no further follow-up required.

Persistent negative symptoms in schizophrenia require what intervention?

Referral for social-skills and vocational training programs.

Expected hematologic response timeline to oral iron in children with IDA?

Reticulocytosis within 1–2 weeks; Hb rises ≥1 g/dL after 1 month.

Dietary strategy to control dumping syndrome after gastrectomy?

High-protein, low-carbohydrate, small frequent meals to slow gastric emptying.

Prognosis of simple febrile seizures in children?

Self-limited; no long-term neurologic sequelae; antipyretics do not prevent recurrence.

Infant feeding recommendations for HIV-positive mothers in the USA vs developing countries?

USA: formula only; developing nations: breast-feed if safe water is lacking.

Perinatal HIV transmission rate with maternal ART and neonatal zidovudine?

One-year mortality for invasive pulmonary aspergillosis even with treatment?

80 %.

Course of iodine-induced thyrotoxicosis once iodine source is stopped?

Often self-limiting but may persist for months; usually resistant to antithyroid drugs.

Jarisch-Herxheimer reaction duration?

Self-limited, resolves within 48 hours.

Outcome of pelvic organ prolapse managed with a pessary?

Most patients achieve symptom resolution.

Typical course of acute viral rhinosinusitis?

Spontaneous resolution; antibiotics only if symptoms last >7–10 days or worsen.

Most common fatal complication of measles infection?

Pneumonia; vitamin A lowers morbidity in deficient children.

Key prenatal goal for women with phenylketonuria (PKU)?

Maintain phenylalanine <6 mg/dL before conception and throughout pregnancy.

Hepatitis E in the third trimester carries what maternal mortality?

Up to 20 % due to fulminant hepatic failure.

RA serology and prognosis: significance of positive RF or anti-CCP?

Associated with more aggressive disease and joint erosions (worse prognosis).

What proportion of HLA-B27-positive individuals develop ankylosing spondylitis?

Only about 5 %.

Exercise advice for individuals with sickle-cell trait?

Gradually acclimate, avoid dehydration/overheating to lower rhabdomyolysis risk; rare splenic infarct at high altitude.

Subcutaneous emphysema from NPPV usually resolves with what step?

Stopping NPPV (if possible) and supportive care; most cases are self-limited.

Life expectancy impact of benign essential tremor?

Normal life expectancy and minimal disability.

When is herpes zoster contagious and how can spread be minimized?

From rash onset until full crusting; keep lesions covered and avoid high-risk contacts.

Leading cause of death in systemic lupus erythematosus?

Premature cardiovascular disease (accelerated coronary atherosclerosis).

Hydroxychloroquine eye risk and monitoring schedule?

Retinal toxicity after 5–7 yrs; baseline exam, then annual screening after 5 yrs.

Natural history of chronic idiopathic urticaria?

Spontaneous remission in 30–50 % at 1 yr and up to 70 % by 5 yrs.

Melanoma prognosis is primarily determined by what factor?

Depth of vertical invasion (Breslow thickness).

Diffuse axonal injury after head trauma – expected outcome?

Very poor; supportive care focuses on limiting intracranial hypertension.

Long-term course of multiple sclerosis?

Highly variable but generally progressive with cumulative disability.

Five-year survival in pancreatic adenocarcinoma?

Why are alkaline ocular burns worse than acidic burns?

Alkali penetrates tissues more deeply, causing greater damage and a poorer prognosis.

Main prognostic determinant in congenital diaphragmatic hernia?

Degree of lung development/hypoplasia, not size of hernia.

Most life-threatening comorbidity in Turner syndrome?

Left-sided cardiovascular defects leading to aortic root dilation/dissection.

Most effective modifiable factor to slow abdominal aortic aneurysm expansion?

Smoking cessation.

Childhood absence epilepsy – likelihood of remission?

Often remits by early puberty; medication may be tapered after 2 yrs seizure-free.

Significance of ampicillin rash in infectious mononucleosis?

Not a true drug allergy; patient can receive penicillins in the future.

Optimal timing of orchiopexy for cryptorchidism and benefits?

Before 1 year; lowers torsion and cancer risk, improves future fertility.

Desmoid tumor behavior and recurrence risk?

Locally aggressive with a high postoperative recurrence rate.

Usual course of cat-scratch disease lymphadenitis?

Self-limited over months; azithromycin accelerates resolution; suppuration is most common complication.

Typical recovery outlook for Erb–Duchenne (C5-C7) palsy in newborns?

Spontaneous motor recovery over weeks to months.

Major metabolic complication in primary biliary cholangitis and required screening?

Progressive bone loss (osteopenia/osteoporosis); screen with DEXA scan.

Effect of bisphosphonates on pagetic hearing loss?

Slows progression but does not restore lost hearing.

Dermatomyositis and cancer relationship?

Strongly linked to underlying adenocarcinomas; myositis may improve if cancer is treated.

Most common cause of maternal mortality during pregnancy?

Pulmonary embolism.

Prognosis of late-life pseudodementia after antidepressant response?

Cognitive symptoms may improve, but high future risk of true dementia remains.

Primary causes of death in tuberous sclerosis complex (TSC)?

Neurologic complications (tumor mass effect, status epilepticus) followed by renal angiomyolipomas.

Outcome when developmental dysplasia of the hip is treated in infancy?

95 % achieve normal hip reduction and function.

Risks of poorly controlled asthma during pregnancy?

Higher maternal mortality, prematurity, low birth weight, and preeclampsia.

Best prognostic sign in HIV-associated primary CNS lymphoma?

Rising CD4 count after initiation of HAART.

Lung cancer risk after >15 years of smoking cessation?

Risk reduced by 80–90 % vs current smokers, but still higher than never-smokers.

Which antibiotics increase pyloric stenosis risk in infants?

Erythromycin or azithromycin.

List two non-drug risk factors for infantile pyloric stenosis.

First-born male family history and bottle feeding.

Long-term outlook of seborrheic dermatitis after initial therapy?

Needs intermittent re-treatment every 1–2 weeks; durable remission is uncommon.

Typical prognosis of IgA nephropathy?

Usually benign, but may progress to rapidly progressive GN or nephrotic syndrome.

Post-streptococcal GN prognosis in children vs adults?

Good in children; adults can progress to chronic kidney disease.

Significance of humoral hypercalcemia of malignancy (HHM) on overall outlook?

Indicates advanced cancer and portends a poor prognosis.

Prognosis of congenital hypothyroidism with and without early treatment?

Excellent with prompt thyroid hormone; untreated leads to permanent intellectual disability.

Which lupus nephritis subtype has the worst prognosis?

Class IV (diffuse proliferative) – requires aggressive immunosuppression.

Response rate and recurrence risk after intralesional steroid treatment of keloids?

~70 % respond; high recurrence, may need additional therapies.

Persistence of ADHD symptoms into adulthood?

Occurs in 33–66 % and, if untreated, increases risk of academic, occupational, and behavioral problems.

Potential complication of untreated complete rectal prolapse?

Strangulation and gangrene; prognosis is good with timely medical or surgical management.

Prognosis once clinical rabies symptoms appear?

Almost uniformly fatal; care is palliative.

Outcome of transient hypertrophic cardiomyopathy in infants of diabetic mothers?

Spontaneous resolution within weeks; echocardiogram normalizes by 1 year.

Why must acute limb ischemia be revascularized within 4–6 hours?

To prevent irreversible myonecrosis and potential limb loss.

Natural course of pemphigoid gestationis after delivery?

Symptoms usually resolve postpartum but may recur in future pregnancies; preterm birth and FGR are possible.

Which initial field cardiac arrest rhythms carry the worst prognosis?

Bradyarrhythmias and asystole.