03 APR 2017 1256 MIX Flashcards
Painless hematuria in sickle cell disease is due to what type of renal pathology?
Renal papillary ischemia or necrosis
What are the renal complications of sickle cell disease?
- Renal papillary ischemia or necrosis
- Inability to concentrate the urine (vasa recta damage with inability to maintain concentrated medullary gradient)
- Distal renal tubular acidosis (tubular damage with impaired proton secretion)
What is the treatment for invasive pulmonary aspergillosis?
- 1-2 weeks IV voriconazole plus an echinocandin (caspofungin)
- Followed by prolonged therapy with voriconazole alone
What is the gold standard test for diagnosing DM2 in patients with PCOS? Why?
- Oral glucose tolerance test
- More sensitive in detecting glucose intolerance than standard screening tests (fasting glucose, HbA1C)
Why is creatinine clearance not used as a screening tool for diabetic nephropathy?
Creatinine clearance is high early in kidney disease due to glomerular hyperfiltration, and low later on
Why is dipstick testing not indicated as screening for protein in diabetic nephropathy?
Can only detect macroproteinuria (over 300 mg/24hr)
What is the medication profile for severe asthma exacerbation?
- SABAs
- Ipratropium nebulizer
- Systemic corticosteroids
Adding ________________ to SABAs may cause greater bronchodilation than either agent alone and is recommended during emergency care of severe asthma exacerbations
Ipratropium
After an hour of severe asthma exacerbation following SABAs, ipratropium, and systemic corticosteroid therapy, what medication can be used?
Magnesium sulfate, one time infusion
Urinary retention caused by anticholinergic agents results from impairment of:
Detrusor muscle contraction, and to a lesser extent internal sphincter contraction
In adjustment disorder, symptoms must present within ____ months of an identifiable stressor and last no more than ____ months after the stressor ends
3, 6
What is the treatment for acute dystonia?
Benztropine or diphenhydramine
What is the treatment for akathisia?
BB (propanolol) or benzodiazepine (lorazepam)
What is the treatment for parkinsonism (drug-induced)?
Benztropine or amantadine
The most common site of metastatic spread of a choriocarcinoma is the:
Lungs
Head sparing growth lag suggests fetal growth restriction that occurred during what trimester(s)?
2nd or 3rd
The most common cause of vaginal bleeding and discharge in the neonatal period is:
Maternal withdrawal of estrogen
What is the first line imaging study in a woman over 30 with a palpable breast mass? What about women under 30?
- Over 30: mammography
- Under 30: US
Definition: lochia
Vaginal discharge containing blood and mucous – normal up to 6-8 weeks postpartum
Most patients who fall ill with vibrio vulnificus infection have underlying ______________ and show manifestations of:
- Liver disease (hemachromatosis most common)
- Necrotizing fasciitis with hemorrhagic bullous lesions, septic shock
What are the unfavorable metabolic side effects of thiazide diuretics? What are the electrolyte abnormalities?
Metabolic:
- Hyperglycemia
- Increased LDL and plasma trigs
- Hyperuricemia
Electrolyte:
- Hyponatremia
- Hypokalemia
- Hypomagnesemia
- Hypercalcemia
Osteomalacia can be a consequence of what type of renal tubular acidosis?
Type 2 (proximal)
Maternal serum AFP is used primarily to screen for:
- Open neural tube defects
- Fetal abdominal wall defects
- Multiple gestations
How can tay sachs and nieman pick disease be distinguished?
- Tay sachs: hyperreflexia
- Nieman pick: areflexia
