Carlos Shared "Carlos Velez Favorite Creations" - 12 Picmonics
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Resulting from increased mitochondria and myoglobin concentration (increased oxidative phosphorylation), leading to sustained contraction (example: maintaining posture)
Proportion increases after endurance training.
Type 2 muscle
Fast twitch; white fibers
Resulting from decreased mitochondria and myoglobin concentration (increased anaerobic glycolysis)
Proportion increases after weight/resistance training, sprinting.
STAINING
Under cytochrome oxidase stain, Type I stains dark while type II stains light
Congenital hypothyroidism (cretinism)
Severe fetal hypothyroidism
causes
Maternal hypothyroidism
Thyroid agenesis
Thyroid dysgenesis (most common cause in US and developed countries)
Iodine deficiency (Most common cause in the rest of the world)
Dyshormonogenetic goiter
Findings
Pot-bellied, Pale, Puffy-faced child with Protruding umbilicus, Protuberant tongue, and Poor brain development
Horner Syndrome
Cause
Sympathetic Denervation of Face and Iris
Associated with lesion of spinal cord above T1
Symptoms
Ptosis
Anhidrosis
Flushing on affected side
Miosis (pupil constriction)
Anisocoria
Associated Lesions
Pancoast Tumor
Brown-Séquard Syndrome
Syringomyelia
SYMPATHETIC DENERVATION OF IRIS
If the damage is to the third-order neuron (postganglionic fibers) the pupil will not dilate. If the damage is to first- or second-order neurons the pupil will dilate.
Pancoast Tumor
Carcinoma that occurs in the apex of lung
May cause Pancoast syndrome by invading cervical sympathetic chain
SYMPTOMS of PANCOAST SYNDROME
Severe, constant ipsilateral shoulder pain that may progress to involve the upper extremity in a C8–T2 distribution, if the adjacent spinal nerves are also involved
Horner syndrome due to involvement of the ipsilateral stellate ganglion
Atrophy of the ipsilateral intrinsic hand muscles
Upper extremity edema due to vascular compression
Compression of Recurrent laryngeal nerve leads to hoarseness
Compression of Superior vena cava leads to SVC syndrome
Sensorimotor deficit
Juvenile Idiopathic Arthritis (JIA)
Most common cause of Arthritis in Children. Onset before Age 10.
More common in females
Persistent joint swelling (synovial thickening, accumulation of synovial fluid)
Subtypes
Polyarticular JIA
Severe symmetrical arthritis
Dactylitis
Pauciarticular JIA
Typically involves large joints (shoulders, elbows, hips and knees)
20-25% have Uveitis. Increased risk of blindness in children.
Systemic-onset JIA
Also known as Still's disease
Begins with systemic symptoms (fever, rash, elevated WBC, anemia, hepatosplenomegaly, lymphadenopathy). Described as "spikes of rash and fever."
Arthritis begins later in the course of the disease
Tearing chest pain, of sudden onset, radiating to the back
Unequal BP in arms (due to compression of left subclavian vein)
CXR shows mediastinal widening.
Cystic Medial Degeneration (Necrosis) is the classic histologic finding in Aortic Dissection
COMPLICATIONS
Organ Ischemia
Aortic Rupture
Death
Stanford type A (proximal)
Stanford type A involves Ascending aorta. May extend to aortic arch or descending aorta.
May result in acute aortic regurgitation or cardiac tamponade.
Treatment: surgery
Stanford type B (distal)
Stanford type B involves descending aorta and/or aortic arch. No ascending aorta involvement
Treat medically with β-blockers, then vasodilators
AV Block Types
1st Degree
1st degree
The PR interval is prolonged (> 200 msec)
Benign and asymptomatic. No treatment required
Slow conduction of AV Node
2nd degree
Mobitz type I (Wenckebach)
Mobitz type I (Wenckebach)
Progressive lengthening of PR interval until a beat is “dropped” (a P wave not followed by a QRS complex)
Usually asymptomatic
Variable RR interval with a pattern (regularly irregular)
Slow conduction of AV Node
Mobitz type II
Mobitz type II
Dropped beats that are not preceded by a change in the length of the PR interval (as in type I)
PR interval normal because problem is in Bundle of His, not AV node
May progress to 3rd-degree block.
Often treated with pacemaker
3RD DEGREE (COMPLETE)
3rd degree (complete)
The atria and ventricles beat independently of each other.
P waves and QRS complexes not rhythmically associated.
Atrial rate > ventricular rate.
Usually treated with pacemaker.
Can be caused by Lyme disease.
Congenital Long QT Syndrome
PATHOGENESIS
Inherited Disorder of Myocardial Repolarization
Potassium (K+) Channel Mutations
SYMPTOMS
Prolonged QT Interval
Torsades de Pointes
Increased Risk of Sudden Cardiac Death (SCD)
TYPES OF SYNDROMES
Romano-Ward Syndrome
Autosomal Dominant
Pure Cardiac Phenotype (No Deafness)
Jervell and Lange-Nielsen Syndrome
Autosomal Recessive
Sensorineural Deafness
4 mins
Charcot-Marie-Tooth disease
Autosomal Dominant
Most Common Inherited Neuropathy
Defective production of proteins involved in the structure and function of peripheral nerves or the myelin sheath
Peripheral Neuropathy
May lead to Muscle Atrophy
Pes Cavus (High arches)
Lower Extremity weakness
Sensory deficit
Decreased Deep Tendon Reflexes (DTRS)
Deep peroneal nerve affected
Menkes Disease
pathophysiology
Connective tissue disease
X-linked recessive
Problem with collagen cross-linking
Impared Copper Absorption and Transport
Due to defective Menkes protein (ATP7A)
symptoms
Decreased activity of Lysyl Oxidase
Brittle, Kinky Hair
Hypotonia
Growth Retardation
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