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DecisionDx-Melanoma Test
Gene expression profile test designed to identify high risk Stage I and II patients based on biological information from 31 genes within their tumor tissue. It is an independent predictor of a patients metastatic risk, regardless of all other staging factors.Found to enhance the accuracy of sentinel lymph node biopsy in predicting metastasis. Performed on formalin-fixed, paraffin embedded primary tumor tissue from either biopsy or excision. TERM 2
Hepatitis B surface antibody (anti-HBs)
DEFINITION 2
The body normally produces antibodies to HBsAg as part of
the normal immune response to infection. HBsAg is the
antigen used to make hepatitis B vaccine.Hepatitis B surface
antibody (anti-HBs): The presence of anti-HBs is generally
interpreted as indicating recovery and immunity from
hepatitis B virus infection.
TERM 3
Dupuytren's Contracture
DEFINITION 3 Progressive contracture of the palmar fascial bands, causing flexion deformities of the fingers. Earliest manifestation is a tender nodule in the palm, most often near the middle or ring finger. Next a superficial cord forms and contracts the MCP joints and interphalangeal joints of the fingersTreatment is with corticosteroid injection, surgery, or injections of clostridial collagenase. TERM 4
Chromogranin A (CgA)
DEFINITION 4
Chromogranin A is a protein released from neuroendocrine
cells. The CgA test may be used to help detect, diagnose,
and/or monitor neuroendocrine tumors, especially carcinoid
tumors. Examples include carcinoid tumors, insulinomas,
small cell lung cancers, and neuroblastomas.
TERM 5
Angiotensin-Converting Enzyme (ACE) level
DEFINITION 5
To help diagnose and monitor sarcoidosis. The level of ACE in
the blood may increase when sarcoidosis-related granulomas
develop. When monitoring the course of the disease, an ACE
level that is initially high and then decreases over time
usually indicates spontaneous or therapy-induced remission
and a favorable prognosis.
Ichthyosis vulgaris
A type of ichthyosis, a group of related skin conditions that interfere with the skin's ability to shed dead skin cells, causing extremely dry, thick skin. Extremely dry, scaly skin is known as xerosis.Often called fish scale disease because the scales that characterize the condition look like fish scales.No known cure for the condition, but the consistent and regular use of moisturizers and exfoliants are often enough to resolve symptoms. TERM 7
Pulmonary Arterial Hypertension
DEFINITION 7 Progressive narrowing of distal pulmonary arteries causing high blood pressure in the lungs. In PAH, increased pressure in the vessels is caused by obstruction in the small arteries in the lung. Cause can be unknown, drug-related, HIV infection, connective tissue/autoimmune disorders such as scleroderma.Diagnosis: labs, EKG, echo, PFT, 6 minute walk test, right heart catherizationSigns of right ventricular heart failure: JVD, hepatomegaly, ascites, peripheral edema, tricuspid regurgitation murmur TERM 8
Sniff Test (Chest Fluoroscopy)
DEFINITION 8
Exam that checks how the diaphragm moves when breathing
normally and when inhale quickly. A sniff test shows if there
are problems with the phrenic nerve, which controls
movement of the diaphragm.
TERM 9
Delayed Sleep
Phase
DEFINITION 9 Last sleep onset as well as late wake-up time. Results in excessive daytime sleepiness and insomnia. Patient has a 'night owl' sleep pattern.Diagnosis: sleep diary and actigraphy monitoring for at least 1 week.Management: sleep hygiene, Melatonin 3 mg po at least 1.5 hours prior to desired bedtime, limit bright light exposure prior to bedtime. Bright light therapy on awakening. Shift melatonin/light exposure 1 hour earlier every 5-7 days until desired schedule is achieved. TERM 10
Neurodermatitis
DEFINITION 10 Response to chronic atopic dermatitis.Symptoms: Bouts of intense itching. Rash does not appear until after scratching starts. Itching awakens person from sound sleep. Associated with emotional stress or depressed mood.Signs: red papules and plaques.Management: frequent application of skin lubricants (replaces habit of scratching). Bedtime antihistamines such as Doxepin, Sarna lotion,
Sydenham Chorea
Childhood movement disorder. Occurs within 8 months of Streptococcal infection, specifically Group A Beta Hemolytic Streptococcus. Late manifestation of Rheumatic Fever.Signs: choreiform movements (abrupt, puroseless, nonrhythmic involuntary movement), hyperextended joints, motor weakness, clumsiness, hypotonia, diminished deep tendon reflexes, dysarthriaLabs: Intracerebral pressure, CSF glucose, CSF leukocyte count all increased.Self limited. Improvement within 3-6 weeks. Complete resolution by 2-3 years. TERM 17
Restless Leg Syndrome
DEFINITION 17
Dopamine deficiency in brainstem or spinal cord.
Endogenous opiate deficiency. Small fiber peripheral
neuropathy.Signs: periodic flexions- occur every 20-
seconds during non-REM sleep.Labs: serum ferritin (<
ng/ml associated), serum glucose, serum creatinine.Oher
labs to consider: TSH, serum magnesium, serum folate
TERM 18
Narcolespy
DEFINITION 18
Characterized by chronic excessive daytime sleepiness,
often with sudden loss of muscle tone (cataplexy). Diagnosis
is by polysomnography and multiple sleep latency testing.
Treatment is with modafinil, various stimulants, or Na
oxybate.
