11 Flashcards by Elizabeth DeGroot

what can increase risk of digoxin toxicity?

viral illness, excessive diuretic use (esp. loop), hypokalemia
volume depletion or renal injury may acute elevate the digoxin level

How well did you know this?

Not at all

Perfectly

dig tox SEs

n/v, decreased appetite, confusion, weakness, diarrhea, scotomata, blurry vision with color changes, blindness

How well did you know this?

Not at all

Perfectly

in case-control studies, when is the odds ratio a close approximation of the relative risk?

if the outcome is uncommon in the population (“rare disease assumption”)

How well did you know this?

Not at all

Perfectly

pheos can be precipitated by

^intra-abdominal pressure, sx procedures, meds (anesthetic agents)

How well did you know this?

Not at all

Perfectly

cellulitis vs erysipelas

cellulitis: deep dermis and subQ fat with flat, indistinct borders (S. pyogenes or S. aureus)
erysipelas: epidermis and superficial dermis with raised sharp borders and intense erythema (S. pyogenes)

How well did you know this?

Not at all

Perfectly

erythema nodosum is associated with ?

S. pharyngitis, sarcoidosis, IBD

How well did you know this?

Not at all

Perfectly

what is found in the anterior mediastinum?
middle?
posterior?

anterior: thymoma
middle: bronchogenic cysts
posterior: neurogenic tumors

How well did you know this?

Not at all

Perfectly

PCOS treatment to regulate menstruation

other treatments

OCPs for menstrual regulation
Clomiphene citrate for ovulation induction
spironolactone for control of hirsutism
(weight loss is 1st line)
(leuprolide is for endometriosis, not PCOS)

How well did you know this?

Not at all

Perfectly

how does lymphoma result in ^Ca2+?

^1,25-OH vitamin D leads to ^Ca2+ absorption

PTH will be low, vitamin D is elevated

How well did you know this?

Not at all

Perfectly

most common cause of early decrescendo diastolic murmur in y. adults in developed countries

bicuspid aortic valve

this is aortic regurgitation

How well did you know this?

Not at all

Perfectly

sharp, localized pain and tenderness over the anteromedial part of the tibial plateau

pes anserinus pain syndrome

How well did you know this?

Not at all

Perfectly

ratio in ARDS

P/F: PaO2/FiO2 is decreased (less than 300 mmHg)

partial pressure of arterial O2 decreases and leads to an increased fraction of inspired O2 requirement

How well did you know this?

Not at all

Perfectly

histoplasmosis vs coccidiodomycosis lung presentation

histo: bilateral infiltrates with granulomas on biopsy
coccid: unilateral infiltrate with spherules with endospores on biopsy

How well did you know this?

Not at all

Perfectly

pyelonephritis with urine pH greater than 8 think ?

urease producing bacteria: most commonly Proteus, also Klebsiella

How well did you know this?

Not at all

Perfectly

rare but dangerous complications of infectious mono

airway compromise, autoimmune hemolytic anemia and thrombocytopenia
due to cross-reactivity of EBV-induced Abs against RBCs and plots
+Coombs, ^retic count, ^bilirubin, ^transaminases

How well did you know this?

Not at all

Perfectly

if test result is negative, the probability of having disease is ?

1 - NPV

NPV = true negative results / all negative results

How well did you know this?

Not at all

Perfectly

dilutional hyponatremia with NS?

free water content in NS is not high enough to cause significant dilution hyponatremia in absence of SIADH

How well did you know this?

Not at all

Perfectly

hypokalemia EKG

U waves, flat, broad T waves, PVCs

How well did you know this?

Not at all

Perfectly

two sample t-test vs chi-square test

chi-square compare proportions, or categorical values (i.e. “high CRP” vs. numerical values)
two sample t- and z- tests are used to compare 2 means
ANOVA compares 3+ means
meta-analysis pools data from several studies to do an analysis of having a relatively big statistical power

How well did you know this?

Not at all

Perfectly

leukoplakia vs squamous cell carcinoma

leukoplakia: white granular lesions
sqcc: nodular, erosive, ulcerative lesions with surrounding erythema or induration
both cannot be scraped off

How well did you know this?

Not at all

Perfectly

1st line therapy for stable angina with ASA and nitrates (decrease preload)

B-blockers to decrease myocardial contractility and O2 demand
CCBs as alternatives, dihyro. CCBs additional to BB for after load reduction
ranolazine (decrease myocardial Ca2+ influx) for refractory angina

melanocyte disorders

peibaldism: AD, patchy absence of melanocytes
vitiligo: regional destruction of melanocytes (autoimmune)

acute decomp. HF tx

supplemental O2, assisted ventilation, aggressive IV diuresis, +/- vasodilator therapy (nitro)

RA pts are at ^risk of developing what bone condition?

osteoporosis, osteopenia, fractures

another name for paget disease of bone

osteitis deformans

tx for CML is a ? inhibitor

imatinib, tyrosine kinase inhibitor

carcinoid syndrome may result in deficiency of what vitamin

niacin | ^production of serotonin from tryptophan (required for niacin synthesis)

50+ with pain/stiffness in neck, shoulders, pelvis | ^ESR, think ?

polymyalgia rheumatica, tx with low-dose prednisone

primary treatment for papillary thyroid carcinoma

surgical resection | if increased risk recurrence: radio iodine ablation + suppressive doses of thyroid hormone

Leydig cell tumors will show an elevation in ?

testosterone +/- estrogen (^aromatase expression) secondary inhibition of FSH, LH most common type of testicular sex cord stromal tumors

seminomas have elevation of what tumor markers?

NONE, usually normal, possibly B-hCG if contain syncytiotrophoblastic giant cells yolk salk: ^AFP choriocarcinoma: ^hCG

most common cause of sudden cardiac arrest in the immediate post-infarction period

reentrant ventricular arrhythmias (v tach, v fib*) | AV block may occur with acute MI (esp. inferior) but typically transient and resolve after tPa or PCI

B-cell vs non B-cell tumor

both may produce hypoglycemia B-cell (insulinoma): ^insulin, ^C-peptide, ^proinsulin levels non B-cell (mesenchymal tumors, produce IGF-II): low insulin and C-peptide

why may hypocalcemia develop after blood transfusion? | why may hyperkalemia develop?

^plasma citrate (substance added to stored blood) chelates calcium and Mg+ and reduces levels stored RBCs lose intracellular K+ to solution-->K+

if trigeminal neuralgia presents bilaterally, suspect ?

MS | demyelination of the nucleus of the trigeminal nerve

osteomalacia is commonly due to ? | what levels of Ca2+, phos, PTH?

commonly due to vit D deficiency: malabsorption, CKD decreased absorption of Ca2+ and phos, reflexively ^PTH, so low/normal Ca2+ and very low phos features: thinning cortex, codfish vertebrae, pseudofx

acute blood surrounding brainstem and basal cisterns on noncontrast head CT

SAH, if non traumatic most commonly from ruptured berry aneurysm HTN encephalopathy will NOT show acute hemorrhage!

gout, hepatosplenomegaly, pruritus after shower, think ?

myeloproliferative disorder | overproduction of uric acid: gout

cryptococcus meningitis typically seen in HIV pts with CD4 less than ? CMV retinitis?

100 | less than 50

how do nitrates reduce angina?

systemic vasodilation leads to decrease in LV EDV (less blood into LV) and reduced wall stress resulting in less myocardial O2 demand

lipoma vs epidermal inclusion cyst

lipoma dose not regress/recur epidermal inclusion cysts have a small central punctum, may gradually increase in size, +/- produce a discharge; typically resolves spontaneously

acute, severe unilateral periorbital pain with ipsilateral mitosis and/or lacrimation, think ? how to treat?

cluster headache | tx with 100% O2, subQ sumatriptan

pts who receive solid organ transplantation and are on immunosuppressants should receive ppx for what?

PCP pneumonia: TMP-SMX!!! vaccines for pneumococci and hep B prior to transplant, intranasal influenza yearly +/- ppx for CMV: ganciclovier, valganciclovier

severe ear pain, fever, ^ESR, granulation tissue in ear canal, think ? and treat with ?

malignant (necrotizing) otitis externs caused by Pseudomonas (old ppl, DM, immunosuppressed) tx with IV ciprofloxacin

metabolic abnormalities in hypothyroidism

hyperlipidemia, hyponatremia, ^CK, ^AST, ALT

causes of "steppage" gait

L5 radiculopathy and compression peroneal neuropathy | L5 will also have weak foot inversion and plantar flexion

painful, acute retinal necrosis + keratitis, uveitis in HIV+ pt

HSV or VSV retinitis CMV retinitis is painless, not associated with keratitis or conjunctivitis and has hemorrhages, fluffy/granular lesions around retinal vessels

progressive bilateral loss of central vision

macular degeneration

1st degree AV block treatment

if normal QRS duration: observation | if prolonged QRS: may have conduction delay below AV nod and should have electrophysiology testing

post-op pt with hypotension, JVD, and new-onset RBBB

massive PE