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1 Flashcards

1
Q

Angioedema

A

Ace inhibitors

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2
Q

Brucellosis incubation period

A

Varies widely : weeks-months

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3
Q

Brucellosis - first antibody to appear

A

IgM

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4
Q

Brucellosis treatment

A

1 IM streptomycin + PO tetracycline (e.g doxy)

Alternative : Aminoglycoside ( IV gentamicin)

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5
Q

Brucellosis treatment duration

A

Adults- acute non-focal disease -> a 6 week course
Complex or focal disease-> 3 or more months

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6
Q

Most common cause of asymptomatic hypercalcemia in otherwise healthy individuals

A

PRIMARY hypERparathyroidism

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7
Q

Cerebral Toxoplasmosis Tx

A

6 wks sulfadiazine and pyrimethamine

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8
Q

Antibodies to HIV appear

A

3-12 weeks after infection

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9
Q

COPD exacerbation- PaCO2 > 45 mmhg

A

Non-invasive positive pressure ventilation NIPPV

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10
Q

NIPPV contraindications

A

Cardiovascular instability
Impaired mental status / inability to cooperate
Copious secretions/ inability to clear secretions
Respiratory arrest
-> INTUBATE

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11
Q

CKD + Hx of recurrent UTIs in childhood

A

Reflux nephropathy

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12
Q

Early signs of aortic regurgitation

A

Palpitations while lying down

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13
Q

Most sensitive test for cardiac involvement in amyloidosis

A

Cardiac MRI

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14
Q

Amyloidosis Dx

A

Fat pad or rectal biopsy or biopsy from an involved organ
Congo red -> apple green

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15
Q

Alabaster-coloured pale skin

A

SECONDARY adrenal insufficiency only

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16
Q

Erythropoietin treatment -> iron deficiency anemia

A

Increased iron demand and usage

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17
Q

Bronchiectasis Dx imaging of choice

A

CT

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18
Q

Multiple myeloma most common infections & pathogens

A

Pneumonia ( streptococcus pneumonia & staphylococcus aureus) and pyelonephritis (E. coli)

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19
Q

Renal failure in multiple myeloma

A

25% of pts

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20
Q

Mitral leaflet perforation->

A

Heart failure

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21
Q

Tricuspid valve endocarditis ->

A

Pulmonary abscess

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22
Q

Most common cause of a paravalvular abscess

A

Aortic valve endocarditis

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23
Q

Major modified duke criteria

A

1) positive blood cultures of typical bacteria >12h apart / Coxiella burnetti titer IgG>1:800
2) characteristic echocardiography findings

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24
Q

Cardio - prophylactic antibiotics indications

A
  • prosthetic heart valves
  • Hx of previous endocarditis
  • unrepaired cyanotic CHD, including palliative shunts
  • within 6 months of CHD repair
  • incomplete repair of CHD, leading to residual defect near the prosthetic material
  • post-cardiac transplantation valvopathy
  • LV assist device or implantable heart
  • surgical or transcatheter pulmonary artery valve or conduit placement
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25
Q

Streptococcus endocarditis Tx

A

Penicillin G / Ceftriaxone

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26
Q

Enterococcus endocarditis Tx

A

Ampicillin (+/- Gentamicin)

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27
Q

Endocarditis - Staph - MSSA on NATIVE valve Tx

A

Cefazolin/ Naficillin/ Oxacillin/ Flucloxacillin/ Vancomycin

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28
Q

Endocarditis - Staph - MSSA on PROSTHETIC valve Tx

A

Naficillin / Oxacillin / flucloxacillin + Gentamicin + Rifampin

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29
Q

Endocarditis MRSA on a NATIVE valve Tx

A

Vancomycin

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30
Q

Endocarditis MRSA on a PROSTHETIC valve Tx

A

Vancomycin + Gentamicin + Rifampin

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31
Q

Endocarditis Coxiella burnetti Tx

A

Doxycycline + Hydroxychloroquine

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32
Q

Paravalvular abscess can present with

A

Arrhythmia

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33
Q

Every pt with diabetic nephropathy should be screened for concomitant _________

A

Retinopathy

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34
Q

Kidneys in diabetic nephropathy are ________ in size

A

Relatively large

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35
Q

Most common bacterial pathogens in Bronchiectasis

A

Pseudomonas and H.influenza

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36
Q

______ is necessary for the Dx of IBS

A

Abdominal pain

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37
Q

Asthma Dx - reversibility with SABA - FEV1/FVC & FEV1 increase by

A

> 12% + 200ml

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38
Q

Asthma Dx - Methacholine test

A

REDUCES FEV1 by 20%

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39
Q

PCO2 in Acute asthma attack

A

Usually LOW due to hyperventilation

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40
Q

Steroids in acute asthma attack

A

ORAL (systemic)

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41
Q

Aspirin-sensitivity Asthma

A

Asthma, aspirin sensitivity, nasal polyps

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42
Q

Churg-Strauss

A

Asthma + eosinophilia + granulomatous vasculitis

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43
Q

First-line Tx for Crohns fistula

A

Anti-TNF (infliximab)

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44
Q

Hemoglobinuria , pancytopenia, venous thrombosis (e.g hepatic vein; budd-chiari)

A

Paroxysmal nocturnal hemoglobinuria

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45
Q

PNH definite Dx

A

Flow cytometry CD55 CD59 (absent)

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46
Q

Giant cell arteritis is closely associated with

A

Polymyalgia rheumatica

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47
Q

Negative-birefringent NEEDLE-shaped crystals

A

GOUT

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48
Q

Gout in pts with Renal failure - Tx

A

Steroids

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49
Q

Calcifications affecting the hilar lymph node “eggshell” appearance
X-ray: opacities affecting the UPPER lung lobes

A

Silicosis

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50
Q

UC salvage therapy

A

Cyclosporine

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51
Q

Gingival hyperplasia is a SE of

A

Cyclosporine

52
Q

Atypical pneumonia -Tx

A

Macrolides/ Fluoroquinolones/ Tetracyclines

53
Q

Tx of pneumonia outpatient- no comorbidities

A

Doxycycline or
Macrolide or
Doxycycline/Macrolide + Amoxicillin

54
Q

Tx of pneumonia outpatient- with co-morbidities

A

Respiratory fluoroquinolone ( levofloxacin/moxifloxacin/gemfloxacin) OR
Macrolide/Doxycycline + Amoxi-clav/ Cephalosporin

55
Q

Tx of pneumonia - Inpatient- Non-severe

A

Beta-lactam (penic/cephalo) + Macrolide OR
Respiratory Fluoroquinolone

56
Q

Tx of pneumonia Inpatient- severe

A

Beta-lactam + Macrolide OR
Beta-lactam + Respiratory Fluroquinolone

57
Q

Pneumonia with suspicion for MRSA Tx

A

Vancomycin or Linezolid

58
Q

Pneumonia with suspicion for Pseudomonas Tx

A

Carbapenems / Tazocin/ Cefepime/ Ceftazidime/ Aztreonam

59
Q

Polycythemia with decreased erythropoietin

A

Polycythemia Vera (1ry)

60
Q

Test of choice to diagnose Paget’s dz of the bone

A

Alkaline phosphatese (also for follow-up)

61
Q

SBP most common pathogen

62
Q

SBP Tx

A

IV Ceftriaxone 5 days

63
Q

TTP Pentad

A

Fever
Anemia
Thrombocytopenia
Renal involvement
Neurological involvement (confusion)

64
Q

TTP Tx

A

Plasma exchange

65
Q

TTP ADAMTS13<10% - Tx to reduce mortality

A

Caplacizumab and Anti-vWF antibody

66
Q

_______________ is an antipseudomonal beta-lactam

A

Piperacillin-tazobactam

67
Q

Small or large painful reddish maculopapular lesions unique to P.auroginosa

A

Ecthyma gangrenosum

68
Q

First-line for mild-mod UC

A

5-ASA (Sulfasalazine and Mesalamine)

69
Q

5-ASA side effects

A

Pancreatitis
Agranulocytosis
Hypersensitivity pneumonitis

70
Q

COVID19 ; _____ of pts are asymptomatic

71
Q

Chronic mitral regurgitation

A

HOLOsystolic murmur
Wide split of S2
S3

72
Q

Chronic MR murmur _________ with handgrip

73
Q

Benign ventricular arrhythmia after reperfusion (esp with fibrinolytics), No Tx needed

A

Accelerated Idioventricular rhythm (AIVR)

74
Q

The typical pneumonia of CMV is ________ with ___________ predominance

A

Bilateral, Interstitial

75
Q

Mononeutitis multiplex (drop foot) could be a feature of

A

Eosinophilic granulomatosis with polyangiitis (Churg-Strauss)

76
Q

Churg-Strauss

77
Q

Octreotide/somatostatin MOA in variceal bleeding

A

Splanchnic artery vasoconstriction

78
Q

Antibiotic prophylaxis in Variceal bleeding is with

A

Ceftriaxone

79
Q

Variceal bleeding - unstable pt/Massive - failure of endoscopy ->

A

Blakemore tube

80
Q

Salmonella typhi is a Gram

A

Negative bacilli

81
Q

________ are the sole reservoir for Salmonella typhi

A

Humans
(It’s unique to humans)

82
Q

S.typhi penetrates into the walls of the __________ intestine

83
Q

Rose spots (maculopapular rash)

A

Salmonella

84
Q

S.typhi Tx

A

Ceftriaxone
Azithromycin
Ciprofloxacin

85
Q

LBBB and a wide QRS ->

A

CRT (cardiac resynchronisation therapy)

86
Q

RVMI suspected (MI + hypotension) ->

A

Right precordial leads ECG + IV fluids

87
Q

E-lyte disturbance with PPIs

88
Q

HIT Dx

A

ELISA - antibodies against platelet factor 4 (PF4)

89
Q

HIT Tx

A

D/c LMWH
With thrombosis risk-> Fondaparinux or Argatroban

90
Q

Congenital hypothyroidism- Dx imaging

A

Scintigraphy (Technetium scan)

91
Q

Fever, hives and joint pains in children after certain drugs (beta-lactams e.g penicillin or Sulfa-drugs)

A

Serum Sickness-Like Reactions (SSLR)

92
Q

Severe Serum sickness like reactions Tx

A

Prednisone

93
Q

Bacterial Osteomyelitis-like picture with STERILE cultures and recurrent attacks in CHILDREN

A

CHRONIC RECURRENT MULTIFOCAL OSTEOMYELITIS (CRMO)

94
Q

ADULT form of CRMO

A

SAPHO Syndrome
(Synovitis, Acne, Pustulosis, Hyperostosis, Osteitis)

95
Q

CRMO Tx

A

Initial: NSAIDs
2nd-line: Corticosteroids, TNF-inhibitors, Bisphosphonates.

96
Q

Persistent hydrocele >12-18months of age ->

97
Q

Cough, coryza, conjunctivitis
Cephalocaudal rash
Koplik spots

98
Q

Most common complication of measles

A

Otitis media

99
Q

_________ reduces measles complications

100
Q

In young children Eosinophilic esophagitis initial management

A

Elemental diet

101
Q

Peds- formula for selecting ET tube size

A

(Age in years/4)+4

102
Q

Systolic murmur, pectus excavatum, biphasic T waves on ECG

A

Marfans syndrome - Mitral valve prolapse

103
Q

In infancy - cardiomegaly, hypotonia, macroglossia, hepatomegaly, normal glucose

A

Pompe disease - Acid alpha-glucosidase deficiency
(Glycogen storage dz)

104
Q

Pompe diseases Tx

A

Enzyme replacement therapy

105
Q

Glasgow coma scale

A

Eye opening (4) spontaneous, to voice, to pain, none
Verbal response (5) oriented, confused, inappropriate, incomprehensible, none
Motor response (6) obeys, localizes pain, withdraws, flexion, extension, none

106
Q

Prolonged severe limb pain after injury, pain is disproportionate, possible edema
Normal labs and imaging

A

Complex regional pain syndrome
(More in female children)

107
Q

Complex regional pain syndrome Tx

A

Physical therapy and cognitive-behavioural therapy

108
Q

Crepitus during knee flexion

A

Patellofemoral pain syndrome

109
Q

Localized tenderness at the tibial tubercle

A

Osgood-Schlatter disease

110
Q

Ataxia-telangiectasia therapy

A

SUPPORTIVE

111
Q

Hypertrophic gastropathy management

112
Q

Known adrenal insufficiency + stressor event (illness/surgery) , steroid dose _____

A

Regular dose should be INCREASED to stimulate an adrenal stress response

113
Q

Opsoclonus-myoclonus
Peri-orbital ecchymoses
Rosette cells
Urine VMA HVA

A

Neuroblastoma

114
Q

Males📍
Adrenal insufficiency
Neurological abnormalities (e.g Academically, behavioural, seizures)
Testicular dysfunction

A

X-linked ADRENO-LEUKOdystrophy
(Adrenal) (brain)

115
Q

In AdrenoLeukodystrophy, there’s accumulation of

A

Very Long Chain Fatty Acids (VLCFAs)

116
Q

To prevent refeeding syndrome

A

Add vitamin B1 IV beforehand

117
Q

Nisseria meningitis Tx

A

Penicillin IV+ Ceftriaxone 5-7days

118
Q

PHACE syndrome

A

Posterior fossa
Hemangioma
Arterial anomalies
Cardiac anomalies
Eye anomalies

119
Q

Apgar score

A

HR: absent=0, <100=1, >100=2
Resp: absent=0, irregular=1, good=2
Tone: limp=0, mild flexion=1, active=2
Nostril cath response: absent=0, grimace=1, cough/sneeze=2
Color: pale/blue=0, pink body&blue extremities=1, pink=2

120
Q

Constricted pupils (miosis), hypotension, respiratory depression

A

OPIOID poisoning
Give NALOXONE

121
Q

Mydriasis (dilation), TACHYcardia, dry skin, HYPERthermia, flushed skin
(As in a desert; hot, dry, confused, flushed, dilated eyes)

A

Anticholinergics poisoning
Antidote: Physostigmine

122
Q

Tuberous sclerosis is associated with cardiac

A

Rhabdomyomas

123
Q

Fetal alcohol syndrome triad

A

Narrow eye slits
Smooth philtrum
Thin upper lip

124
Q

Indications for antibiotic Tx in Gastroenteritis

A

Age < 3 months
HIV (even if treated)
Cancer / Immunodeficiency / Immunosuppression
Sickle cell disease
-> empirical antibiotics until culture results are available

125
Q

Antibiotics for salmonella (certain cases)

A

Cefotaxime 5-14 days
Ceftriaxone 7 days
Ampicillin 7 days
Cefixime 7-10 days

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