medical english exam 1

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

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