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3 Flashcards

1
Q

features of sicca syndrome and best initial and diagnostic test

A
  • dry eyes, dry mouth

- secretory deficiency (Schrimer test) and autoantibody screen

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2
Q

positive biferengence test with rhomboid crystals is what? what disease is it related to?

A

pseudogout, seen in hemochromatosis

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3
Q

features of sarcoidosis

A
  • erythema nodosum
  • peripheral nerve disease
  • hepatic compromise
  • hilar lymph node enlargement–> need x-ray to diagnose
  • young population
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4
Q

definite diagnosis of sarcoidosis

A

biopsy of:

  • any palpable lymph node
  • subq nodule except erythema nodosum
  • enlarged parotid
  • lacrimal gland
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5
Q

Drugs that affect lithium level

A
  • diuretics
  • NSAIDs except aspirin
  • SSRI
  • Ace-I and ARBs
  • antiepileptics
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6
Q

Management of lobular carcinoma in situ (nonmalignant– DCIS is worse)

A
  • excisional biopsy then follow up surveillance

- alternative option: tamoxifen or raloxifene

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7
Q

Features and tests for chronic pancreatitis

A
  • steatorrhea secondary to fat malabsorption (bulky foul smelling stool difficult to flush)
  • epigastric pain with radiation to the back
  • text: CT scan of abdomen, NOT serum lipase and amylase (more for acute pancreatitis)
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8
Q

Treatment of chronic pancreatitis

A
  • first line: alcohol cessation and small meals with low fat
  • pancreatic enzymes and possible opiate medications
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9
Q

Endometriosis treatment

A
  • meds– NSAIDs, GnRH analogs, danazol (synthetic androgen), oral contraceptives
  • surgery
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10
Q

Medications in recent MI (q waves in lead II, III, avF)

A
  • antiplatelets
  • beta blocker
  • statins
  • Ace-I or ARB
  • aldosterone antagonist (eplerenone) IF LVEF <40%, add to beta blocker and ace-i
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11
Q

when should EGD be considered instead of colonoscopy as first step in hematochezia?

A
  • UGIB suspected

- hemodynamically unstable

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12
Q

How does biliary colic present?

A

constant epigastric or RUQ pain, can radiate to shoulder

  • n/v/diaphoresis
  • <6 hours
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13
Q

Management of gallstones w/ vs w/o stones on imaging

A

with: cholecystectomy, or ursodeoxycholic acid in poor surgical candidates or patients refusing surgery
without: CCK- stimulated cholesyntigraphy

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14
Q

How does amaurosis fugax present?

A
  • transient monocular blindness

- carotid bruit

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15
Q

How does IgA nephropathy usually present?

A
  • gross hematuria following acute URI
  • flank pain
  • dysmorphic RBCs in urine
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16
Q

How does acute post strep glomerulonephritis usually present?

A
  • strep throat/skin infection, then 10 days later renal issues
  • hypertensive
  • urine cast shows RBCs and RBC casts
  • decreased complement levels
17
Q

Timing, pathophysiology and signs of breastmilk jaundice

A
  • starts at 3-5 days, peaks at 2 weeks
  • high beta-glucuronidase in breast milk deconjugates intestinal bili and increase enterohepatic circulation
  • normal exam, spontaneous resolution
18
Q

Best prognostic indicator of acute pancreatitis

A

APACHE II

19
Q

Positive LR vs Negative LR

A 
\+= sensitivity/ 1- specificity
-= 1- sensitivity/specificity
20
Q

Which antibodies correlate to disease activity in SLE?

A

anti-ds DNA (most sensitive marker for disease as well)

21
Q

Treatment of SLE

A

hydroxychloroquine and prednisone

22
Q

Initial management of adrenal masses?

A
  • studies of hormonal production: dexamethasone suppression, 24 hr urine catecholamines, metanephrine, VMA, etc
  • if >4cm, then surgical excision
23
Q

Treatment of sunburn from doxy

A

NSAIDs, steroids if severe

24
Q

SE of isotretinoin (acne med)

A

hyperglycemia, hyptertriglyceridemia, hepatotoxicity, mucocutaneous rxns, teratogen (females need 2 concurrent contraception methods)

25
Q

Treatment of hypertrophic cardiomyopathy

A
  • first line: beta blockers

- verapamil, disopyramide

26
Q

how does traumatic LP present?

A
  • high RBCs without xanthochromia (this presents with SAH)
  • high protein, high glucose
  • WBC 1 in 1000 when compared to RBCs
27
Q

Risk factors for CRC

A
  • family history, FAP
  • IBS
  • Af American
  • alcohol intake, smoking >30 years
  • obesity
28
Q

What does paroxysmal supraventricular tachycardia look like on EKG?

A
  • Abrupt onset
  • unidentifiable P waves
  • narrow and regular QRS complexes
29
Q

4 Ts of HIT

A
  • thrombocytopenia
  • timing of drop (onset 5-10 days or <1 day if prior exposure in last 30 days for 2 points)
  • thrombosis
  • other causes
30
Q

Treatment of HIT

A

discontinue all forms of heparin, including warfarin
start direct thrombin inhibitor (i.e. argatroban)
avoid all forms of heparin for life

31
Q

What is endophthalmitis? tx?

A
  • infection of vitreous fluid
  • swollen eyelids, hypopon (layer of leukocytes in anterior chamber), conjunctivitis
  • tx: aspiration and vitrectomy, antibiotics via intravitreal route
32
Q

What should you watch for in patients with autosomal dominant polycystic kidney disease? Most common extrarenal manifestation?

A
  • renal function decline– treat with ACE-i
  • hypertension (maintain <130/80), NOT extrarenal manifestation
  • most common extra renal: hepatic cysts
  • 10% have berry aneurysms, only needs to be screened for family with positive SAH hx.
33
Q

choice of screening for asymptomatic family members with ADPKD

A

ultrasound

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