Anemia of Chronic Dz (ACD): Inflammatory cytokines (IL-6) --> hepcidin production --> Blocks duodenal Fe absorption --> Traps Fe in macrophages & hepatocytes --> iron deficiency despite good Fe stores / Iron is TRAPPED (↓Iron, ↓TIBC) but STORED (↑Ferritin)

Vibrio vulnificus - skin infections (post wound exposure to contaminated seawater), septicemia (consumption of contaminated raw or undercooked seafood); Immunocompromised (HIV/AIDS, chronic liver dz, cancer, chronic steroid use) at ↑ risk

CHA₂DS₂-VASc score - Estimates annual risk of thromboembolic events/stroke in atrial fibrillation, guiding anticoagulation: CHA₂DS₂-VASc score of 2 or more in men or 3 or more in women generally indicates the need for oral anticoagulation to reduce stroke risk

Lithium enters cells in collecting ducts via epithelial Na+ channels —> disrupting ADH signaling —> interferes with cAMP 2nd messenger essential for aquaporin-2 insertion —> Renal collecting ducts resistant to ADH → ↓ water and Na+ reabsorption → polyuria and polydipsia

Atrial septal defect = MC type = ostium secundum (~75-80%); Adult s/s: fatigue, dyspnea, systolic ejection crescendo-decrescendo pulmonic flow murmur @ LUSB w/ fixed S2, loud S1 (closing tricuspid); Later: L-to-R shunt (volume & psi overload right heart --> pulmonary HTN

Fragile X syndrome - CGG-repeat expansion of 5' noncoding FMR1 region --> Messenger RNA loss; s/s: autism, delayed speech, anxiety, hyperactivity, tantrums, social deficits, prominent long ears & face, high palate, flat feet, hyperextensible joints, pubescent macroorchidism

SLE-Specific Antibodies.1. Anti-Smith (Anti-Sm) - ↑ SLE specific (~99%); Found in 20-30% of SLE (low sensitivity).2. Anti-dsDNA - ↑ SLE specific for SLE (~95%); Correlates with dz activity (lupus nephritis); In 60-70% of SLE (↑ sensitivity than Anti-Sm).Screen? ANA.

Axis deviation of the heart? Look at leads I and AVF (either positive/above isoelectric) or negative/below isoelectric); Both leads positive = NL axis deviation

Bisphosphonates MOA - Osteoclast inhibition & programmed apoptosis, Bone matrix binding, RANK/RANKL Pathway impact (reduction of mature osteoclasts available to respond to RANKL stimulation) --> Stop bone loss and rebuild matrix

Six medication’s that cover MRSA - clindamycin, vancomycin, ceftaroline, doxycycline, bactrim, daptomycin

After bilirubin is conjugated in the liver, how is it eliminated from the body?

Candidal Esophagitis: opportunistic C. albicans (MC) infection; s/s: mucosal inflammation, ulceration, white plaques, odynophagia, dysphagia, retrosternal discomfort, low-grade fever; Risk: CD4 <200 (AIDS-defining illness), DM, chemo, steroids, transplant, PPIs, chronic antibx

"Red flag" evidence of end organ damage in hypertensive emergency:

What's the difference? HYPERTENSIVE EMERGENCY vs URGENCY - The CRITICAL Distinction: It's NOT about the blood pressure number --> it's about END-ORGAN DAMAGE / "E = Emergency = End organ damage"

Defining hypertension

Somatic symptom disorder - excessive thoughts, focus, feelings, behaviors related to somatic s/s; History vague, highly sensitive to meds, seek care from multiple providers. Symptoms > 6 mos. 1 or more somatic s/s are distressing w/ persistent thoughts, anxiety, time devoted

Pneumonia - classified as "typical" or "atypical based" on causative pathogens, clinical presentation, and lab/imaging findings.

Secondary hypertension (HTN) = ↑BP (≥130/80 mmHg) caused by an identifiable underlying condition, as opposed to primary (essential) HTN, which has no single clear cause. Causes of Secondary HTN (Renal overall MC):

Diminished left atrial appendage (LAA) velocities = <40 cm/s, reduced blood flow speeds within left atrial appendage, typically detected during transesophageal echocardiography (TEE) --> indicates blood stasis & increased risk of thrombus formation; Dx: Atrial fib (MC)

Immunoglobulin A deficiency = serum IgA level <7 mg/dL in individuals > 4 y/o, w/ NL serum IgG and IgM; s/s: recurrent resp or GI infections, allergic disorders, autoimmune dzs; Path: Defect in differentiation of B lymphocytes into IgA-secreting plasma cells