1 Flashcards
big toe is innervated by `
sciatic nerve
best test to confirm ascending cholangitis
ERCP
young adult with “atypical” pneumonia s/s, think?
Mycoplasma pneumonia
sympathetic innervation to the head and neck
T1-4
pain onset in duodenal vs gastric ulcers
gastric ulcers: pain is worst right after a meal
duodenal ulcers: pain worse a few hours after meal (acidic bolus travels down)
pH, pCO2, pO2, HCO3- in chronic COPD
pH: 7.30, pCO2: ^60, pO2: 90 HCO3: ^30
chronic respiratory acidosis, low pH, ^pCO2 and HCO3-
when to use myocardial perfusion imaging
uses radioactive tracer to assess function of the myocardium, compares perfusion during resting and stressed states
indications: wall abnormalities found on echo, active CP and no EKG changes
renal stone specific treatments
uric acid stones: alkalinize the urine with citrate
thiazides: help retain calcium so good for calcium oxalate/phosphate
cystine stones: penicillamine
posterior radial head shows restriction in ?
restricted supination of forearm and anterior glide of the radial head
hypotension, polydipsia, GI complaints, w/l, hyperpigmentation, think?
Addisonian crisis
PPD is considered +if more than 10mm in what populations
IVDU, nursing home residents, prisoners, homeless, those living in developing countries, kids less than 4 or exposed to high-risk adults, health care workers
when PPD is + if less than 5mm
HIV, abnormal CXR, close contact with person with active TB, immunosuppressed
second MCC of hyperthyroidism after Graves
Plummer’s disease: toxic multinodular goiter
see patchy uptake on thyroid scan
ankylosing spondylitis may have ? which are bony growths in the ligaments
syndesmophytes
most appropriate tx for post-herpatic neuralgia?
nortriptyline?
pregabalin: 2nd line
levels of evidence
level 1: best: RCT
level 3: case reports, case series
what can precipitate AIN
meds: NSAIDs, PPIs, rifampin, PCN, cephs
infections, collagen vascular disease, AI
what can precipitate ATN
renal ischemia, sepsis, nephrotoxins: contrast, ampB, sulfa, ACE/ARBs, NE/EPI
rhabdo, MM, crystal disease
depolarizing NM blocker with 2 phases
succinylcholine:
phase 1: membrane potential above threshold, constantly depolarized
phase 2: non-depol. blockade, ACh antagonized
(involved K+ efflux, rapid, no refractory period)
angiodysplasia (AVM) of colon may be associated with ?
aortic stenosis
Heyde’s syndrome
proximal muscle weakness with Gottron’s papules (knuckles), and rash over eyes (heliotrope) +/- calcifications in the subQ fatty tissue, think?
dermatomyositis
^CK and aldolase
dx: muscle biopsy
tx: steroids
pleural effusion after pneumonia refractory to tx, what to do?
thoracentesis: dx and tx
definitive tx for DeQuervain’s tenosynovitis (after conservative- NSAIDs)
surgical release of abductor polices longs tendon
most common risk factor for ectopic pregnancy
PID
CA-125?
CA-19-9?
AFP?
CEA?
CA-125: ovarian cancer
CA-19-9: parncreatic, biliary cancer
AFP: nonseminomatous testicular cancer, hepcell cancer
CEA: colorectal cancer
back pain in pt with known malignancy + bowel/bladder control problems suggests?
how to dx/tx?
spinal cord compression
dx: MRI of spine
tx: dexamethasone to save motor function
neonatal tetanus may be from?
tentanus spores infecting umbilical cord of poorly immunized mother
lab derangements in Kawasakis
^WBCs, ^PLTs, ^acute phase reactants (ferritin), ^WBCs in CSF, normocytic anemia
other hyperkalemia findings with hyperK+ besides cardiac arrhythmias
muscle weakness and depressed DTRs
hypothermia, AMS, respiratory depression, edema +/- desquamating rash, think?
myxedema coma in the setting of hypothyroidism (body is unable to compensate for hypothyroidism, typically elderly females with undx hypothyroidism)
dx: TSH
tx: thyroxine (synthroid) and cortisol (check levels 1st) in case of adrenal insufficiency
oral ferrous iron salts utilize what transporter?
divalent metal transporter-1 (DMT-1)
carpal tunnel 1st line diagnosis
electrophysiology studies
polymyositis labs
^CK, ^aldolase, +anti-Jo
restrictive cardiomyopathy with endomyocardial fibrosis with eosinophilic infiltrate, think?
Loeffler’s endocarditis
too much calcium carbonate may lead to milk-alkali syndrome, most common complication?
acute renal failure not CV collapse
tx: lasix
what causes symptoms in lead toxicity?
generation of reactive oxygen species
