14 APR 2017 1825 MIX Flashcards
how is the gait characterized in normal pressure hydrocephalus?
broad based and shuffling
what is the most common cause of B12 deficiency in whites of northern european background?
pernicious anemia
how long does it take to develop B12 deficiency on a purely vegan diet? what about for folate deficiency?
- B12: 4-5 years
- folate: 4-5 months
what are the side effects of isoniazid?
- peripheral neuropathy
- hepatotoxicity
- sideroblastic anemia
how does an increase in true positives and false positives affect PPV?
decrease, because PPV = (TP / [TP + FP])
in slipped capital femoral epiphysis where is the pain often referred?
knee
what is the presentation of slipped capital femoral epiphysis? what is the diagnostic imaging of choice?
- loss of abduction and internal rotation of the hip
- hip / thigh is externally rotated when being flexed
- frog leg xray
what are the physiologic renal and urinary changes in pregnancy? what are the lab findings?
PHYSIOLOGIC:
- increased renal blood flow
- increased GFR
- increased renal basement membrane permeability
LABORATORY:
- decreased serum BUN
- decreased serum creatinine
- increased renal protein excretion
what is the treatment for latent TB? active TB?
- latent: isoniazid and pyridoxine
- active: rifampin, isoniazid, pyrazinamide, ethambutol
what are the potential complications of asymptomatic bacteriuria in pregnancy? what is the definition of asymptomatic bacteriuria? what is the treatment?
- acute pyelonephritis
- low birth weight
- preterm labor
- 100,000 CFU
- treatment: cephalexin, augmentin, nitrofurantoin, fosfomycin
atypical glandular cells seen on pap test indicates what three management procedures?
- endometrial biopsy
- colposcopy
- endocervical curettage
- focal substernal burning pain
- odynophagia
- large linear ulcerations, distal esophagus
- intranuclear and intracytoplasmic inclusions on biopsy
what is the diagnosis and treatment?
- diagnosis: CMV esophagitis
- treatment: ganciclovir
- multiple, small, well circumscribed esophageal lesions with round / ovoid “volcano like” appearance
- cells show ballooning degeneration and eosinophilic intranuclear inclusions
what is the diagnosis and treatment?
- diagnosis: HSV esophagitis
- treatment: acyclovir
what drug is used for the prevention and treatment of pneumocystis pneumonia in patients with advanced HIV who cannot take TMP-SMX?
pentamidine
how is DI classified based on urine osmolality? what about based on etiology? what are the cutoffs?
- complete: urine osmolality under 300 mOsm/kg
- partial: urine osmolality 300-600 mOsm/kg
- serum osmolality is elevated in both types
- central: decreased ADH
- nephrogenic: renal ADH resistance
what is the treatment for lithium induced nephrogenic DI?
- salt restriction
- discontinuation of lithium
how does cardiac tamponade lower right and left ventricular filling?
increased intrapericardial pressure above the diastolic ventricular pressure, restricting venous return to the heart
eggshell calcification of a hepatic cyst on CT is indicative of __________________ and the treatment is _______________________
- hydatid cyst (ecchinococcus granulosus)
- surgical resection under the cover of albendazole
what is the formula for determining the degree of respiratory compensation in primary metabolic alkalosis?
PaCO2 = (0.9 x bicarb) + 16 +/- 2
what are the microscopy features of Lewy bodies?
- eosinophilic intracytoplasmic inclusions representing alpha-synuclein protein
- may be seen in substantia nigra, locus ceruleus, dorsal raphe, substantia innominata
how does elevated pH lead to decreased levels of ionized calcium?
- hydrogen ions dissociate from albumin molecules, thereby freeing up the albumin to bind with calcium
- increased affinity of albumin for calcium leads to decreased levels of ionized calcium
why can people with respiratory alkalosis present with signs of hypocalcemia?
- elevated pH leads to dissociation of protons from albumin
- albumin is freed up to bind with calcium
- increased affinity of albumin for calcium leads to decreased levels of ionized calcium (which is the active form of calcium)
subchondral lucency on xray is indicative of:
avascular necrosis of bone
for gender dysphoria, hormone suppression therapy can be offered by Tanner stage __ of development to delay puberty and give patients time to decide how to proceed
2
