04 JAN 2017 2028 IM Flashcards
what is the triad of trichenellosis?
- periorbital edema
- myositis
- eosinophilia
aortic regurgitation has what kind of murmur? what movement elicits it best?
- early decrescendo diastolic murmur
- patient sitting up, leaning forward, holding breath in full expiration
what are the two most common types of cancer that cause a pancoast tumor?
- squamous cell carcinoma
- adenocarcinoma
what is the characteristic colonoscopic finding seen with laxative abuse?
melanosis coli - dark brown discoloration of the colon with pale patches of lymph follicles that can give the appearance of alligator skin
what are Hollenhorst plaques? what do they indicate?
- bright yellow refractile plaques in the retinal artery
- indicate a proximal source such as the internal carotid artery
what is the relationship of citrate to calcium levels in the body?
- citrate binds calcium, leading to hypocalcemia (e.g. in large blood transfusions)
- typically occurs in patients with liver damage, since the liver usually metabolizes citrate and renders it ineffective at causing hypocalcemia anyway
What is the most common cause of sudden cardiac death during an acute MI?
VF
Patients with VF or pulseless V tach should be managed with ________________
Immediate defibrillation
Cardiac index = ?
CO / body surface area
*relates cardiac performance to the size of the individual
How does bronchiectasis differ from chronic bronchitis?
Bronchiectasis has more prominent sputum production, and exacerbations are typically bacterial and require antibiotics (chronic bronchitis has viral exacerbations)
What is the best diagnostic tool for bronchiectasis? What does it show?
High resolution CT – characteristic bronchial dilation, lack of airway tapering, bronchial wall thickening
What is used to treat hypertensive encephalopathy?
Labetalol
Acetaminophen taken at higher doses (over 2g/day) for over 1 week may significantly (increase / decrease) the anticoagulant effects of warfarin
Increase
When is PCV13 recommended?
- All adults 65 or older (then followed by PPSV23 6-12 months later)
- Sequential PCV13 and PPSV23 for adults under 65 with certain high risk underlying conditions (CSF leaks, sickle cell, cochlear implants, congenital or acquired asplenia, immunocompromised, chronic renal failure)
When is PPSV23 alone recommended?
Adults under 65 who are current smokers or have certain medical conditions (heart or lung disease, diabetes, chronic liver disease)
What is salvage therapy?
For of treatment for a disease when a standard treatment fails
What is the most definitive diagnostic test for polymyositis?
Muscle biopsy
How do ventricular aneurysms present on ECG?
- Persistent ST elevation after a recent MI
- Deep Q waves in the same leads
What type of cell is seen in CLL?
Smudge cell
What is the hallmark lab result in CLL?
Dramatic lymphocytosis
What drug is used for diabetic gastroparesis? What is the MOA?
- Metoclopramide
- Has both prokinetic and antiemetic properties and is useful for symptomatic relief of nausea, bloating, and postprandial fullness in patients with diabetic gastroparesis
What is the main adverse effect of metoclopramide?
Extrapyramidal effects
The anemia in anemia of chronic KIDNEY disease is due to a deficiency of _______________. Treatment consists of __________
- Erythropoietin
- IV iron preparations (e.g. iron dextran)
compare: anemia seen in chronic disease = infection, chronic immune activation, and malignancy. These conditions all produce massive elevation of Interleukin-6, which stimulates hepcidin production and release from the liver, which in turn reduces the iron carrier protein ferroportin so that access of iron to the circulation is reduced.
What is the hallmark of ischemic hepatopathy (shock liver)?
Rapid and massive increase in the transaminases with modest accompanying elevations in total bilirubin and alkaline phosphatase
What is the most common side effect of levodopa / carbidopa?
Hallucinations
