Associated Clinical Sciences Pt 1 (Pt II Boards)

chlamydia chancre

painful, soft, weepy

chancroid chancre

painful, soft, bloody

syphilis chancre

painless and hard

DDX of chlamydia

lymphoganuloma (swollen genital lymph)

PID (e coli, staph, gonorrhea)

Reuters disease (feet)

asymptomatic female DDX

chlamydia

gonorrhea (knee)

HPV (internal)

asymptomatic male ddx

trichomonas (tricky dick)

Candida albicans (yeast)

gonorrhea discharge

copious and clear

trichomonas discharge

frothy, foul, itchy

chronic vaginitis discharge

foul and itchy

candidiasis discharge

curdy and itchy

herpes discharge

watery

chlamydia discharge

yellow

chlamydia info

MC STD in the US

nongonococcal

painful and soft lesions

asymptomatic in females

gonorrhea info

gram negative

males: urethritis and epididimitis

females: vaginitis, salpingitis, arthritis

herpes info

painful red vesicles with oozing yellow center

type I and II are recurrent

prodrome itching (before breakout)

hides inf DRG

treatment of herpes

Valtrex, l-lysine, acyclovir

trichomonas info

protozoa

females: foul discharge, itchy, green

males: asymptomatic

chancroid info (he do have a bloody chancre on his wanker)

heamophilus ducery (soft)

large, painful, blood and pus

candidiasis info

Candida albicans, thrush, test, fungus, moniliasis

gram positive, red and itchy

female: white cheesey

male: asymptomatic

candidiasis treatment

acidophilus and lactobacillus

syphilis info

treponema pallidum

spirochete that crosses the placenta because mom can't protect from them (IgG does NOT protect)

primary syphilis

4-8 weeks

painless lesion, hard, indurate, singular

indurated

hard, latent

DRG hider

secondary syphilis

LOTS of warts on the skin

12 weeks later

rash (80%), persists for months

lymphadenopathy in 50%

condylomata lata (Lots of warts)

alopecia

tertiary syphilis

1/3 develop if untreated

gumma (viscera granulomatous lesion)

general paresis (dementia) argyll robertson pupil

tabes dorsalis, rombergs test, charcots joint (posterior column tests)

condylomata acuminata

HPV

testing for tertiary syphilis

FTA-ABS: specific and expensive

VDRL, RPR, wassermann, dark field microscopy

hutchinson triad

saddle nose, interstitial keratoses, peg teeth

tertiary syphilis

lymphogranuloma venereum

chlamydia

enlarged regional inguinal lymph nodes that may lead to elephantitis and rectal structures and abscesses

granuloma inguinale

donovania granulomatous (ugly)

painless, velvety and slow growing

bright and beefy

Donovan bodies

genital warts

HPV 16 and 18

condylomata acuminata

cervical dysplasia leading to cervical cancer

small, itchy, cauliflower like cluster

speculum to screen and PAP to confirm

mollusco contagiosum

muscle skin tags that exfoliate

waxy papules

pemphigoid (1)

autoimmune

MC bulla lesion

lethal, middle aged, South Americans

IgG

pemphigoid

bullous

dermatitis herpetiformis

ichthyosis bullies Siemens

genital and extensor lesions

IgA

gluten sensitive

hereditary in blacks and asians

frontal lobe and cerebellum

voluntary motor

frontal lobe

personality, problem solving

anterior edge of parietal lobes

somatosensory (temp, pressure, position sense)

occipital lobe

vision (color and shape)

superior temporal lobe

auditory and smell

brocas area in frontal lobe

speech (motor)

wenicke's area (junction of partial, temporal, occipital lobes)

speech (sensory, planning, understanding)

hypothalamus

biological drives (thirst and hunger)

temporal lobe

emotions (limbic)

right parietal

visual and spatial

left parietal

understand language

left hemisphere jobs

speech, aware of time

movement and sensation of right side of body

vision in right have of visual field reason to follow rules and enjoys sensory stimulation

right hemisphere jobs

music and art appreciation, drawing

movement and sensation of left side of body

vision in left half of visual field

follows rules, likes to observe rather than participate

dementia

nonreversible deterioration of cognition and behavior

delirium

often reversible, acute confusion that may fluctuate

affect disorders (mood and thymic)

bipolar

cyclothymic

unipolar

dysthymic

seasonal affect disorder

psychotic disorder

schizophrenia

psychopath

sociopath/antisocial

dissociative

somatoform disorders

physical complaint with no organic pathology

dysmorphic

food

coversion

hypochondriac

somatization

somatoform pain

morgellons

munchausen

munchausen by proxy

anxiety disorders

generalized anxiety

panic attacks

phobias

obsessive compulsive

PTSD

neurosis

bipolar disorder

Mania (necessary) and melancholia (eventually happens)

elevated rate in obesity, HTN, DM, hyperlipidemia (potato chip disease)

treatment of bipolar

lithium, drug stabilizers, mood charting, brain salts

cyclothymic disorder

causes hypomanic and mild depressive episodes

unipolar disease (depression, hopelessness, suicidal)

50% are misdiagnosed/unrecognized, self inflicted injuries

2 weeks of 3 symptoms of loss of appetite, insomnia, agitation, worthlessness, suicidal, poor concentration

risk factors for unipolar disease

alzheimers, DM, parkinsons, heart, stroke, cancer, HIV, fibromyalgia, chronic pain

medications: blood pressure, hormones, antibiotics

females

dysthymic

similar to depression but diagnosis is 2 years of at least 3 symptoms

treatment for depression and dysthymic

personal therapy, drugs, ECT, nutrition, B6, magnesium, vitamin D, calcium, omega 3

schizophrenia

young adults are MC affected, reality and perception is altered, episodic, hallucinations

rhythmic clang

alogia

poverty of speech

schizophrenia

avolition

lack of purposeful action or motivation

schizophrenia

disorganized schizo

old term is hebephrenic

unpredictable mood shifts

catatonic schizo

rigid posture, expression flat affect (flat facies)

paranoid schizophrenia

delusion of persecution

schizophreniform

adolescent/young adult onset, contradictory messages

short event (

paraphrenia

geriatric paranoid

psychopath

no regard for self or others

abnormal lack of empathy

combines with amoral conduct masked by an inability to appear outwardly normal

verbal therapy not effective

sociopath/antisocial

believes they are superior, grandiose, lack remorse, shallow emotions, need stimulation, pathological liar, violent

dissociative

multiple personalities, childhood trauma, can be short term event

dysmorphic disorder

convinced of a body flaw and preoccupied with it (anorexia nervosa)

food disorders

anorexia nervosa: fear of fat

bulimia: binge and purge (barretts)

pica: no nutritional value

conversion disorder

psychic conflict causing physical symptom, caused by emotional event

somatization disorder (briquets syndrome)

females under 30 (usually starts in adolescence), multiple systems, confusing

morgellons disease

delusional parasitosis, believes they are invaded by insects, parasites, hair

somatoform pain disorder (psychogenic pain disorder)

underlying emotional process with pain often allowing escape from responsibility

GAD

constant excessive fear, hypervigilant

twitching, sweating, dry mouth, headache, stomach ache, urinary frequency

GAD causes what conditions

heart failure. head injury, hormone imbalance, endocrine disease, pneumonia, COPD

drug causes of GAD

cannabis, analgesics, caffeine, amphetamines

panic attacks

occur with GAD, phobias, OCD, PTSD

phobias

they know their fear is unreasonable

social: provoked by people or performance issues

specific: provoked by object or situation

obsessive compulsive

repetitive thought (obsession), repetitive action (compulsion)

globus hystaricus

can't swallow in panic attack

PTSD

fear and anxiety following an emotional event

flashbacks, sleep disorders

fibromyalgia (tender points)

MFS (trigger points)

Restless leg syndrome

neurosis

low self esteem and hard on themselves

defense mechanisms working overtime

support and enlighten for tx

masochist

likes abuse

Sadist

inflicts abuse

voyeur

enjoys watching abuse

exhibitionist

enjoys showing

fetal alcohol syndrome

antisocial and poor development, microencephaly

autism

preoccupation with ones own throughs, slow language development

autism diagnosis

no smiling by 6 months

no babble by 12 months

repeated phrases by 24 months

ADD

impulsive patter inattentive often dyslexic, reading and sleep disorders are common, active leg decreases deep sleep

poor focus and academics

reaction formation

transfer one drive to opposite expression

displacement

act out of emotion on someone else

denial

no feelings

repression

ignore feelings

regression

act younger