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what are causes of oropharyngeal dysphagia?
laryngeal cancer
pharyngeal cancer
stroke
parkinson’s disease
neuromuscular dysfunction
peptic structure causes what type of dysphagia?
dysphagia in solids only with progressive symptoms
esophageal cancer causes what type of dysphagia?
dysphagia in solids only with progressive symptoms
what type of dysphagia does EoE cause?
solids only with intermittent symptoms
what type of dysphagia does plummer-vinson syndrome cause?
solids only with intermittent symptoms
what type of dysphagia does lower esophageal ring cause?
solids only with intermittent symptoms
what disease causes dysphagia of solids and liquids?
achalasia
what cranial nerves are involved in oral phase of swallowing?
5, 7, 12
what cranial nerves are involved in pharyngeal phase of swallowing?
5, 9, 10, 12
what cranial nerves are involved in esophageal phase of swallowing?
9, 10
esophageal web, dysphagia, iron-deficiency anemia, and glossitis are symptoms of… (WeDIG)
plummer vinson syndrome
A scientific report of the results of original clinical research is?
original article
A scientific report of original research in areas such as economics, policy, ethics, law and health care delivery?
special article
Original article and special article are written in what format?
IMRaD
A scientific report usually solicited by journal editors that summarizes the current state of understanding on a specific topic, analyzing or discussing research previously published by others, rather than reporting new experimental results is?
review article
a short essay usually solicited by journal editors that provides commentary and analysis concerning an article in the issue of a medical journal in which they appear is?
editorial
a forum report consisting of “Letters to the Editors” and “Author Reply” providing an opportunity for readers to discuss articles recently published in the journal with authors is?
correspondence
a short essay which covers a wide variety of topics of current interest in health care, medicine, and the intersection between medicine and society is…?
perspective article
それぞれのcaseを観察し、diagnostic&therapeutic challenges(effects)を報告する
case series
それぞれの病気のgroupを比較し、disease incidenceとrisk factorの関係性を示唆する。
このrisk factor関係あるんじゃね、みたいな。conclusionには至らない。
cross-sectional study
研究開始時に、(w/ disease), (w/o disease)で分け、それぞれ過去を比較して、risk factorsの違いを探す。
⇒ 最初に罹患者と非罹患者で分ける
case-control study
研究開始時点でexposureとnon-exposureでチーム分けし、未来のdisease incidenceを比較する。
prospective cohort study
研究開始時に、過去のexposureとnon-exposureで分け、それぞれのグループの人が、現地点でどのようなdisease developmentがあったのかを調べる。
retrospective cohort study
Control(placebo)とIntervention(treatment)で分け、comparing endpoints.
Endpoints-clinical, surrogate.
randomized control trial
Summary of RCT.
systematic review
3 major arterial supply for GIT
celiac trunk, inferior mesentric artery, superior mesentric artery
what is the definition of diarrhea? (amount, consistency, frequency)
passage of loose or liquid stool at least 3 times a day
what are the 4 causes of diarrhea? (provide examples for each cause)
osmotic (such as lactose intolerance)
secretory (such as cholera toxin and neuroendocrine tumors)
inflammation (such as IBD)
altered motility (such as IBS, hyperthyroidism, and anxiety)
differentiate Crohn’s disease and ulcerative colitis
crohn’s disease: can happen in any part of the GI tract. the lesions are “skip lesions” with a cobblestone appearance. symptoms are chronic diarrhea and abdominal pain
ulcerative colitis: only happens in the distal parts of the colon and rectum. the lesions are continuous and friable (red). symptoms are chronic bloody diarrhea and abdominal pain.
what is the definition of constipation?
less than 3 bowel movements a week
what are the causes of constipation?
lack of transit of stool, intestinal obstruction, difficulty in defecation (using pelvic muscles and anal sphincter muscles)
what are the complications of diarrhea?
hypovolemia, hypokalemia, loss of HCO3- (metabolic acidosis)
what are the complications of constipation?
anal fissures, hemorrhoids, fecal impaction
what is tenesmus?
a feeling of incomplete bowel movements
what is sarcopenia?
loss and weakening of muscles
hypothyroidism causes diarrhea or constipation?
constipation
how can we convert from celsius to fareinheit?
for each increase or decrease in 1 degree F, the degrees celsius increases or decrease 0.5 degrees C.
98.6 degrees F = 37 degrees C
what is the criteria for SIRS?
→Two or more of the following
38ºC or <36ºC
HR>90/min
RR>20/min
WBC>12,000/mm3 or <4,000/mm3
what diseases are included in acute coronary snydrome?
unstable angina and AMI
describe each type of angina pectoris?
stable angina: chest pain exacerbated by exertion. accumulation of fat plaques in the coronary artery.
unstable angina: chest pain comes suddenly. led by a blood clot fully clogging the coronary artery.
variant angina: caused by vasospasms. after tied with smoking and the parasympathetic nerve
what is diaphoresis?
abnormal sweating
what is pyrosis?
heartburn
what are vesicles?
small blisters
what are the chest pain red flags?
coronary artery disease, aortic dissection, pulmonary embolism
what diseases cause hemoptysis?
pulmonary embolism, tuberculosis, lung cancer, bronchiectasis
what do clubbed fingers indicate?
chronic hypoxemia
what does leukonykia indicate?
hypoalbuminemia
when is CRT (capillary refill time) considered abnormal and what does it indicate?
more than 2 seconds. indicates poor peripheral circulation
differentiate between heaves and thrills
Thrills: Strong murmur まあまあスリルがある
Heaves: Strong palpitation ドキドキしてヒィ-
how do we check for tactile/vocal fremitus?
by feeling the vibrations on the patient’s back as they repeat phrase (such as ninety-nine)
low fremitus indicates excess air in the cavity (pneumothorax, emphysema)
high fremitus indicates lung consolidation (typical pneumonia, etc.)
how do we check egophany?
auscultation of the lung while a patient sounds the letter E. when the E sounds like A, it indicates lung consolidation
describe the heart movements during each heart sound. which heart sounds are pathological?
S1: MV + TV closure
S2: AV + PV closure
S3: blood rushes rapidly from the heart's atrium into the ventricle (can indicate HF, can be pathological)
S4: reduced ventricular compliance. (can indicate MI. always pathological)
what are the signs and symptoms of aortic stenosis?
Crescendo-decrescendo systolic murmur that radiates to carotids.
“Pulsus parvus et tardus”… weak (parvus) pulse w/ a delayed peak
Can lead to SAD (syncope, angina, dyspnea on exertion)
60y/o… due to calcification, < 60 y/o… bicuspid AV
what are the signs of bacterial endocarditis?
FROM JANE
fever
roth spots
osler nodes
heart murmurs (especially the mitral valve)
janeway lesions
anemia
nail-bed hemorrhage
emboli
what is globus pharyngeus?
sensation of a lump in the throat unrelated to swallowing.
what is xerostomia?
dry mouth
what are 4 questions in history taking that are important to ask abut when a patient has dysphagia?
history of stroke, neurological symptoms, reflux disease, and tobacco use.
what are the risk factors of peptic stricture?
older age, male, longer duration of reflux symptoms.
besides dysphagia, peptic stricture can cause…
chronic heartburn and regurgitation
what is steakhouse syndrome?
lower esophageal ring.
often occurs after eating and drinking alcohol at a fast pace.
dysphagia is caused by a ring of mucosal tissue in the lower esophagus.
what are the causes of upper GI bleeding (in order of most frequent to less frequent)
peptic ulcers (60-80%)
Esophageal varices (15-20%),
esophageal tears (5-10%)
other causes: inflammation in the esophagus, cancer in stomach or esophagus, gastritis/esophagitis
what % of upper GI bleeding leads to hematochezia?
10%
what is the portal BP when esophageal varices occur?
above 12mmHg (normal is 5-10)
differentiate between internal and external hemorrhoids
internal: painless, bright red rectal bleeding
external: w/pain and swelling, dark coloured bleeding
Note 
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