2/5/13 b Flashcards
What disorder should be suspected in a diabetic pt w/ non-anion gap metabolic acidosis, persistent hyperkalemia, and renal insufficiency?
type 4 RTA
What is the pathophysiological mech of type 4 RTA?
deficiency of or insensitivity to aldosterone
What drugs can worsen type 4 RTA?
ACE-I’s and ARB’s
Where does the murmur of aortic stenosis typically radiate to?
the carotids
A mid-diastolic murmur and opening snap are characteristic of what valvulopathy?
Mitral stenosis
What is the biggest risk in ots w/ porcelain gallbladder?
gallbladder carcinoma
What must be formed preceding gallstone ileus?
fistula btwn gallbladder and small bowel
Toxicity from what vitamin can cause constipation, abdominal pain, weight loss, polyuria, and polydipsia?
D
What is the first diagnostic step in the evaluation of suspected biliary obstruction?
US or CT
What drugs are used to Tx ankylosing spondylitis?
analgesics and anti-TNF meds
What measures are most important for reducing the risk of contrast-induced nephropathy?
IV hydration w/ isotonic bicarb or saline + acetylcysteine
A renal mass on CT with thin walls, no solid component, no septae, and no enhancement is most likely ______.
a simple renal cyst and requires no intervention
How can you differentiate the pain of rotator cuff tear from rotator cuff tendonitis?
pain of tear does not resolve on injection of lidocaine
What is the imaging modality of choice for rotator cuff tears?
MRI
_______ ahould be suspected in any pt over 50 w/ new-onset temporal headache, jaw claudication, vision loss, or symptoms of polymyalgia rheumatica.
Temproal arteritis
What is the first step when temporal arteritis is suspected?
hi-dose steroids immediately (to prevent damage to retinal artery and vision loss or damage to other arteries)
About 50% of pts. with temporal arteritis also have what other rheumatological disease?
polymyalgia rheumatica
What are the main Sx of polymyalgia rheumatica?
pain in the shoulders and pelvic girdle, esp. in the morning, fatigue, anemia
How do you confirm the Dx of giant cell arteritis (once hi-dose steroids have been administered)?
temporal artery biopsy
What is the most common cause of painless hematuria in adults?
bladder tumors
What should be suspected in older children presenting w/ diffuse edema, including the face, limbs, genitalia, larynx (causing breathing difficulty), and bowels (causing colicky pain)?
hereditary angioedema
What is the common mechanism underlying both forms of hereditary angioedema?
C1 esterase inhibitor deficiency
A young black male presenting with painless hematuria is most typical for _______.
sickle cell trait
Progressive bilateral loss of central vision in a pt over 50 is what?
macular degeneration
