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How does basal cell carcinoma present?
Slow growing waxy nodular lesions with a rolled edge. Most common on skin areas chronically exposed to sun
Basal cell carcinoma treatment
Mohs surgery, excision or imiquimod cream
What is the 2nd most common form of skin cancer in the US and how does it present?
- Squamous cell carcinoma
- Most commonly arises from actinic keratosis, sun exposed areas including backs of hands and tips of ears.
- Soft mobile with red inflamed base and adherent scale.
Conditions promoting pleural transudate
- superior vena cava syndrome
- nephrotic syndrome
- Clear fluid produced from increased hydrostatic or fluid pressure or decreased oncotic pressure of plasma.
- Low spec grav, low protein, less protein than serum, more albumin than blood.
- Cloudy fluid produced from changes in pleural membrane permeability. such as inflamed areas
- Pleural fluid to serum fluid ratio >0.5
- Pleural fluid to serum LDH ratio > 0.6
- +/- increased cholesterol levels
Conditions that cause exudative effusion
- pneumonia (parapneumnonic effusion most common)
Etiology of superior vena cava syndrome
malignant mediastinal masses
Presentation of superior vena cava syndrome
- facial swelling, headache, plethora
- papilledema, JVD
- chest pain
Boerhaave syndrome vs mallory weiss tear:
- Boerhaave: (transmural esophageal rupture)
- pain following repeated retching, not usually with hematemesis
- Mallory weiss: (mucosal tear)
- repeated retching leading to hematemesis
Treatment for eradication of H pylori infection
- either triple or quadruple therapy:
- -PPI + Metronidazole, clarithromycin, tetracycline, bismuth or amoxicillin
-PPI+ Levofloxacin, rifabutin, furazolidone, doxycycline, nitazoxanide
Four major complications of peptic ulcers
Clinical findings of Primary sclerosing cholangitis:
- jaundice, fatigue, pruritis
- elevated alk phos, elevated ast/alt
- may have increasing bilirubin level
- stong association between pANCA with coexisting colitis
What is charcods triad and what disease is it associated with?
CHOLANGITIS (inflammation of CBD)
What is reynolds pentad?
- -RUQ pain
ASCENDING SUPPURATIVE CHOLANGITIS
Labs in Cholangitis
- high AST/ALT
- rising alk phos and bilirubin
- high amylase/lipase with secondary pancreatitis