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Key Points!!! By Dr. Stepkowski!!!

Key Points!!! By Dr. Stepkowski!!!. Please note that the number of exclamation points is not indicative to how important the statement is!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!. Glositis Causes!!!. Glositis - Tongue atrophy not inflammation seen in: -Pernicious Anemia (B12)! -Kawasaki!!

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Key Points!!! By Dr. Stepkowski!!!

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  1. Key Points!!!By Dr. Stepkowski!!! Please note that the number of exclamation points is not indicative to how important the statement is!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

  2. Glositis Causes!!! Glositis - Tongue atrophy not inflammation seen in: -Pernicious Anemia (B12)! -Kawasaki!! -Plummer Vincen Syndrome!!!

  3. Mumps in Adults! Think Orchitis and Pancreatitis!

  4. Steven Johnson Syndrome!! Think Antibiotic use!

  5. Koplic Spots!!!!!! Measels!

  6. Oral Cancer Mutation!!! P53!!!!!

  7. Laryngeal Cancer Risk Factors! 1. Smoking! 2. Alcohol!!

  8. Causes of Gingival Thickening 1. AML M5! This may be the first sign 2. Phenytoin!!!

  9. Mucormycosis!!! Think Diabetic!

  10. Vignette! A 45 yr old lady presents with food sticking in her throat and fatigue. PE: Pale, cheilosis, Red Beefy Tongue Tests: Upper endoscopy shows upper esophageal web. Microcytic anemia and iron deficiency.

  11. Diagnosis???????

  12. Diagnosis!!! Plummer Vinson Syndrome!!!!

  13. Vignette!! A 29 yr old Hispanic man presents with dysphagia, heart failure and constipation. Relevant hx is that he was born in rural Mexico and moved to the US at 10. He had a severe illness at age 5 characterized by fever and swollen face for 10 days.

  14. PE!!! Pedal Edema Bilateral Lung Crackles

  15. Tests!!!! BNP = 300 Upper Endoscopy = dilated esophagus = achalasia ECHO = Dilated Cardiomyopathy EKG = LVH Toxic Megacolon

  16. Diagnosis??????

  17. Diagnosis! Chagas Disease!!!!!!!!!!

  18. Vignette! 45 yr old man brought to the ED with substernal pain radiating to the back. This followed severe vomiting after binge drinking

  19. Diagnosis???????

  20. Diagnosis!!!!!!!!!!!!!!!!!!!!! Boerhaave Syndrome!!!!!

  21. Adult with Orchitis! Mumps!!!

  22. Patient with Facial Palsy!!! Salivary Gland Tumor!!

  23. Characteristics of Plummer Vinson Syndrome!! Anemia Cheilosis Upper Esophageal Web Glositis

  24. Conditions that Cause Glositis!! Plummer Vinson Sydrome! Kawasaki!!!!!!!!!!!!!!!!!!!!!!! Pernicious Anemia!!!!!!!!!

  25. Nasopharyngeal Cancer Viral Association!!! EBV!!!!!!!!!!!

  26. Boorhave Syndrome Perforation of the esophagus associated with alcohol consumption

  27. Locations of Varices!! Coronary Veins! Esophageal Venous Plexus!! Hemorrhoids!!!!

  28. Zenker Diverticulum! Has an upper esophageal neck mass!!! Located immediately above the upper esophageal sphincter!!!!!!

  29. Mallory Weis Syndrome!!!! Longitudinal tear of the esophagus associated with retching after binge drinking!

  30. Barret Esophagus!!!!!!!!! Intestinal type metaplasia of the lower third of the esophagus!!!!!

  31. Nocturnal Massive Fluid Regurgitation!! Epiphrenic Diverticulum!! Located above the lower esophageal sphincter!!!!!!

  32. Vignestte!!!!!! A 55 year old alcoholic presents with splenomegaly and hematemesis.

  33. Diagnosis?????????????

  34. Diagnosis!!! Esophageal Varices!!!

  35. Pathology of Esophageal Varices!! Portal hypertension!!!!!

  36. Prognosis for patients with esophageal varices!!!! Shitty!

  37. Vignette!! A 25 year old woman presents with hematemesis following a fun night of binge drinking!!!!!

  38. Diagnosis??????

  39. Diagnosis!!!!!!!!!!!! Mallory Weis Syndrome!! Longitudinal tears in the esophagus!!!!!!!!!!!!!!!!!!!!!!

  40. Vignette! A 3 year old boy presents with croup and epiglotitis!!!!!

  41. Diganosis?

  42. Diagnosis!!!!!!! Parainfluenza Virus!!!!!!

  43. Vignette!!!!! A 50 year old diabetic presents with a swollen, painful left cheek and eye!!!

  44. Diagnosis??

  45. Diagnosis!!!! Mucormycosis!!!!!!!!

  46. Vignette!! A 50 year old male presents with a mass in his nasopharynx!!!! It’s a nasopharyngeal carcinoma!

  47. Pathogenesis of Nasopharyngeal Carcinoma!!! Epstein Barr Virus!!!!!

  48. Histology of Nasopharyngeal Carcinoma!!!!! Epithelial Cells!! Lymphocytes!

  49. Vignette!! A 65 year old woman presents with a mass anterior to her left ear! She has developed facial palsy!!!!!!

  50. Dignosis????

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