1. Whipple's disease: 
- Malabsorption diarrhea
- PAS+ lamina propia
- Migratory polyarthropathy
- Chronic cough
- Myocardial or valve disease - may get CHF or valve regurg
- May get low grade fever, skin pigmentation
- Late stage disease may get CNS involvement - dementia, supranuclear ophthalmoplegia, myoclonus
2. Hypochloremic hypokalemic metabolic alkalosis 
- Vomiting -> Lose HCl -> excess HCO3- generated in serum as you try to make more HCl to replace losses -> loss of gastric acidity means less HCO3- secreted by pancreas into GI tract meaning more HCO3- is retained in blood -> volume depletion activates renin-angiotensin system -> aldosterone causes losses of H+ and K+ in urine in an attempt to retain fluid and Na.
- Manage with fluid resuscitation
- In very severe cases, can consider infusion of ammonium chloride but this can be toxic esp in people with impaired hepatic function
- HCl is used very rarely because it can cause hemolysis- saved for very severe metabolic alkalosis
3. Isolated systolic hypertension: 
- Should be treated because of association with risk for cardiovascular events
- Treat with thiazide, ACE, CCB
4. Macular degeneration
- Earliest signs are difficulty reading or driving, as they require fine visual acuity
- One of the earliest findings is that straight lines appear wavy
- Can now be treated with stem cells! Who needs magic when you have science
5. Basophilic stippling 
- Can be seen in lead poisoning, which typically causes a microcytic anemia
- Can also be seen in alocholism - ribosomal precipitates form blue granules in RBC cytoplasm.
- Can also be due to thalassemias.
6. Acute management of STEMI:
- Reperfusion (either with balloon angioplasty or tPA; angioplasty preferred within 90 mins of hospital arrival, 12h of onset of symptoms; tPA associated with higher risk of ICH and recurrent MI, only use if angioplasty CI or unavailable in the window of time)
- Antiplatelet: full dose aspirin (chew tab for fast release) + P2Y12 receptor blocker (ie clopidogrel, ticagrelor)
- Heparin gtt
- Oxygen
- Beta blocker, unless patient is bradycardic, has CHF, or is in cardiogenic shock... (which is hopefully obvious)
- Nitrates - contraindicated if patient is preload dependent, like aortic stenosis, RV infarct (which happens in 30% of people with inferior wall MIs i.e. STEMI in II, III, aVF). Also contraindicated if patient has had recent phosphodiesterase inhibitor use.
- Morphine for pain control if nitrates are not enough
7. Placental hormones: 
- Placental estrogens inhibit GnRH secretion during pregnancy; levels drop quickly with evacuation of placenta
- Human placental lactogen (hPL) is produced while placenta is in body-- has insulin antagonist effect; causes maternal lipolysis and insulin resistance which increases nutrition for fetus.
8. Stepwise approach to the treatment of asthma: 
- mild intermittent: albuterol PRN
- next step up: low dose inhaled steroid + albuterol PRN
- next step up: med dose inhaled steroid + albuterol PRN
- next step up: med dose inhaled steroid + LABA + albuterol PRN
- next step up: high dose inhaled steroid + LABA + albuterol PRN
- next step up: oral steroids + high dose inhaled steroid + LABA + albuterol PRN
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9.  Asthma severity: 

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Essentially for older kids (>5)
- < 2x/week attacks, <2x/month nighttime attacks = intermittent
- 2x/week to almost daily attacks, 3-4x/month nighttime = mild persistent
- Daily attacks, weekly nightttime awakenings = mod persistent
- Multiple times a day attacks, multiple times a week awakenings = severe persistent
10. Dermatology cancer terms 
- Marjolin ulcer = SCC that arose in a wound. Tend to have more aggressive behavior than SCC that didn't
- Dysplastic nevi = melanocytic nevi with odd characteristics (size > 6mm, irregular borders/coloration, cytologic atypia and disorder). I imagine they are precursor/precancerous lesions? These are usually monitored clinically