14 APR 2017 0839 MIX Flashcards
fetal sleep cycles can last as long as _______
40 minutes
how do OCPs increase the risk for HTN?
increased angiotensin synthesis by estrogen during first hepatic pass metabolism
placenta accreta typically only occurs in what situations?
- prior cesarean delivery
- myomectomy
- D&C
what is the earliest renal abnormality seen in diabetic nephropathy? what is the first change that can be quantified?
- glomerular hyperfiltration
- thickening of glomerular basement membrane
what is the medical treatment for dermatitis herpetiformis?
dapsone
what are the light microscopy and IF findings in dermatitis herpetiformis?
- light: microabscesses at tips of dermal papillae
- IF: deposits of anti-epidermal transglutaminase IgA in the dermis
how long does it take for ischemic strokes to become hypodense on noncontrast CT?
24 hours or longer
what is the cause of anemia / possible jaundice in infectious mononucleosis?
- cross reactivity of EBV-induced IgM cold-agglutinin antibodies against RBCs and platelets
- causes complement mediated destruction of RBCs
when should CRC screening with colonoscopy and biopsy be offered to patients with UC?
beginning 8 years after diagnosis and repeated 1-2 years thereafter
what are the essential measures in managing DKA?
- hydration with 0.9% (NORMAL) saline within 1-2 hrs (regardless of sodium levels)
- IV regular insulin
- serial assessment of electrolytes, esp potassium
- treat underlying precipitating factors
insulin deficiency (e.g. in DKA) causes an __________________ (intracellular / extracellular) shift of potassium
extracellular
when managing DKA potassium should be added to IV fluids once serum potassium is ________
5.2 mEq/L or less
why does 5% dextrose cause an intracellular shift of fluid?
as dextrose is metabolized the solution becomes hypotonic, promoting water shift out of the intravascular space
when is the sequential PCV13 / PPSV23 vaccine combo recommended? PPSV23 alone?
COMBO:
- all adults 65 and older (followed by the PPSV23 at least 6-12 months later)
- adults under 65 with high risk comorbidities (CSF leak, sickle cell, cochlear implant, asplenia, immunocompromised)
PPSV23 ALONE:
- one time vaccine for adults under 65 who are current smokers or have other chronic medical conditions (hear / lung disease, diabetes, chronic liver disease)
- they then receive PCV12 / PPSV23 after 65
what should the initial evaluation of primary adrenal insufficiency include?
8am cortisol and plasma ACTH / ACTH stimulation test
