11 JAN 2017 0659 IM Flashcards
What is the best therapeutic option for a single brain metastasis in a surgically accessible location (ie gray white matter junction)?
Resection (followed by stereotactic radiosurgery or whole brain radiation)
What is brachytherapy? Why is it effective?
- Implantation of a radioactive source directly into an intracerebral mass or surgical cavity
- It allows higher radiation doses to be delivered directly to the brain without affecting other organs
What condition leads to fibrous tissue replacement of smooth muscle in the esophagus? What diagnostic modality is used for diagnosis?
- Systemic sclerosis
- Manometry shows LOW LES pressure
What is the drug of choice for cyclosporine-induced HTN?
CCBs
Major toxicities of cyclosporine?
- Nephrotoxicity (reversible acute azotemia, irreversible progressive renal dz)
- HTN (treat with CCBs)
- Neurotoxicity
- Glucose intolerance
- Infection
- Malignancy (SCC, lymphoproliferative)
- GINGIVAL HYPERTROPHY*
- HIRSUTISM*
- GI (N, V, anorexia)
Major toxicities of azathioprine?
- Dose related diarrhea
- Dose related leukopenia
- Dose related hepatotoxicity
Major toxicities of mycophenolate?
- Marrow suppression
- Mycophenolate = Marrow suppression
What is the “rare disease assumption?”
In a case control study, if the disease is rare, disease incidence is typically low, and the OR generally approximates the RR
What is the best imaging modality for acoustic neuromas seen in neurofibromatosis type II?
MRI with gadolinium
What are the classic autoantibodies associated with dermatomyositis?
Anti-Jo-1 and anti-Mi-2
What is the main complication associated with dermatomyositis?
Malignancy (ovarian, lung, pancreatic, stomach, colorectal, non-Hodgkin lymphoma)
What will raising the cut off point of a screening test do to sensitivity and specificity?
- DECREASE sensitivity
- INCREASE specificity
What is a morton neuroma?
Mechanically induced neuropathic degeneration of the interdigital nerves that cause numbness, aching, and burning in the distal forefoot from the metatarsal heads to the third and fourth toes
What is the female athlete triad?
- Oligomenorrhea
- Decreased caloric intake
- Osteopenia / osteoporosis
Why does pyridoxine deficiency lead to peripheral neuropathy?
Pyridoxine is a cofactor for neurotransmitters
What is the MOA of niacin-induced pruritis? How can it be treated?
- Increased prostaglandins – vasodilation
- Low dose aspirin
What drugs are used for restless leg syndrome?
- Dopamine agonists (pramipexole, ropinirole)
- a2-delta calcium channel ligands (gabapentin)
What is the initial screening test for primary hyperaldosteronism? What test confirms it?
- Ratio of plasma aldosterone concentration to plasma renin activity
- Adrenal suppression test
What test differentiates adrenal adenoma and bilateral adrenal hyperplasia?
Adrenal venous sampling
