4/14 Flashcards
what does hemorrhagic stoke from av malformation look like on ct
hyperdensefluid collection with irregular margins
what markers are elevated in rheumatic fever
esr
crp
what does rsv cause
bronchiolitis
what is hyposthenuria
low urine osmolarity despite fluid restriction, normal serum sodium. Common in sickle cell
2nd line otitis media
amoc-clauv
pen allergic otitis media
clindamycin or azithromycin
bartonella henselae tx
azithromycin
intraventricular hemorrhage signs
seizures or apnea
full fontanel
acute anemia
can be asymptomatic
primary risk factor intraventricular hemorrhage
prematurity-germinal matrix not developed enough
what is spondylolisthesis and what are sx
forward slip of vertebral body. persistant back pain in child or adolesent on lumbar extension. step off. can cause radiculopathy
what neuro thing does tet of fallot increase risk for
brain abscess, r to l shunt allows bacteria to by pass pulm circulation so less phagocytosis
Gross motor milestones 2m,4m,6m,9m,12m
2 = lifts head/chest in prone position 4 = sits with trunck support, begins rolling 6=sits momentarily propped on hands 9 = pulls to stand, cruises 12 = sstands wellwalks first steps
Fine motor milestones 2m, 4m, 6m, 9m, 12m
2 =hands unfisted 50%, tracks past midline
4 = hands mostly open, reaches midline
6 = transfers objects hand to hand
9 =3 finger pincer grasp, holds bottle or cup
12 = 2 finger pincer
Language milestones 2m 4m 6m 9m 12m
2 = coos, alert to sound 4 = laugh, turn to voice 6 = responds to name, babbles 9= mama dada 12 = other words
social/cog milestones 2m 4m 6m 9m 12m
2 = social smile, recognizes parents 4 = enjoys looking around 6 = stranger anxiety 9 = waves bye, pat-a-cake 12 = separation anxiety, comes when called
double birth weight by _____and triple by____
4 months, 1 year (height increases by 50%)
tinea capitus tx
oral griseofulvin or terbinafine
anaphylaxis blood first blood transfusion
selective IgA def
central stellate scar on well circumscribed solitary hypodense liver nodule
Focal nodular hyperplasia, common in women 20-50
electrolyte abnormality rcc
hypercalcemia
most common cause of cervical myelopathy
spondylosis
how to check for gastric cancer
EGD
how often is afp elevated hcc
50%
3 indications to test for pheo
classic triad:ha, tachy, sweating
Resistant htn with unexplained increase in glucose
Family hs of Men2, NF1, VHL
Cancers associated with VVHL
cerebellar and retinal hemangioblastomas
pheos
rcc (clear)
Autosomal dominant
pre eclampsia increases mothers risk of
stroke
why can epidurals cause hypotension
nerve fibers for vascular tone blocked = venous pooling
post delivery: difficulty ambulating, radiating suprapubic pain, pubic symphysis pain, intact neuro exam dx?
pubic symphysis diastasis, treat conservatively
extra lab at initial visit high risk pre e
24 hr urine protein
atypical glandular cells on pap test next steps
endometrial biopsy. also do postmenopausal bleeding if over 45
besides epithelial ovarian cancer what else can elevate ca125
tubo-ovarian access. c reactive protein will also be elevated
where us blasto mycosis and what are its sx
great lakes, PNA, weight loss, lytic lesions, skin lesions
where is coccidioidomycosis endemic
southwest
esr and ck in steroid induced myopathy-
normal
ESR/CK in statin myopathy
ESR = normal
CK = elevated
same as hypothyroid myopathy
ESR/CK in polymyalgia rheumatica
ESR = elevated
CK =normal
what meds cause problems with sideifil
alpha blockers and nitrates
autoimmune atrophic gastritis pathophys
autoimmune against parietal cells =decreased b12
hearing loss, high alk phos
paget’s
what bp med can cause hearing loss
loop diuretics
higher risk if kidney failure
aspirin exacerbated respiratory disease triad
asthma
bronchospasm r nasal congestion after aspirin/nsaids
chronic rhinosinusitis with polyps
tmj risk factors
joint trauma
psych disorder
most common site of renal stone impaction
uretero vesicular junction
radio paque stones
calcium oxalate (normal people), struvite, calcium phosphate (hyperparathyroid or renal tubular acidosis)
radiolucent stones
uric acid(treat by alkalizing urine) and cysteine
tumors that cause increased EPO
HCC, pheo, hemangioblastoma,RCC
meds that cause acute interstitial nephritis
PPI abx NSAIDs allopurinol diuretics
acute interstitial nephritis labs
increased bun and creatinine
eosinophilia
maybe white blood cell casts
post step glomerulonephritis electron micrograph
subepithelial humps of IgG and C3
goodpastures fluorescent micro
linear
Alport syndrome H&P + cause + EM findings
hematuria, renal failure, hearing loss,, eye disease, type 4 collagen defect. Split basement membraneson EM
ANCA1 + kidney dz
RPGN
c anca + kidney dz
Wegners
who gets FSGS
HIV, Drug users, african americans, most common nephrotic overall
foot process on EM
minimal change
nephrotic syndrome with lupus and EM appearance.
Membranous Nephropathy , spike and dome
Groups at risk Memranoproliferative glomerulonephritis and FM apperance
Heb B and C, also lupus, subactue bacterial endocarditis
train track appearance
congo red apple green birefringence kidney dz
amyloidosis
Nephritic syndromes, location and urinalysis
glomerulus, RBC casts
Interstitial nephritis/pyelonephritis location and urinalysis
interstium, WBC casts, eiosinopillia for IN only
ATN location and urinalysis
tubule, granular casts
renal failure location and urinalysis
pre or post renal, hyaline casts
causes of non ion gap metabolic acidosis
Diarrhea, renal tubular acidosis, TPN, hyperaldosteronism
hyponatremia first decision
check serum osmolarity
low serum osmolarity in hyponatremia next step
✔️ urine osmolarity
hyponatremia, low serum [ ], low urine[ ] ,hypovolemia causes
Gi loss, skin loss, third spacing
hyponatremia, low serum [ ], low urine [ ] euvolemia, causes
psychogenic polydipsia
hyponatremia, low serum [ ], low urine [ ] , hypervolemia causes
nephrosis, cirrhosis , CHF
hyponatremia, low serum [ ], normal/high urine[ ] ,hypovolemia causes
thiazides
hyponatremia, low serum [ ], normal/high [ ] euvolemia, causes
SIADH, Hypothyroid, Addisons, MDMA, Preg
hyponatremia, low serum [ ], normal/high [ ] , hypervolemia causes
Renal failure
Hyponatremia normal serum osmols
Pseudohyponatremia
Hyponatremia high serum osmols, high glucose
hyperglycemia
Hyponatremia high serum osmols, normal glucose
manitol
HypoK first decision
is there hypertension
HypoK with HTN
=Hyperaldosteronism
HypoK without HTN next ✔️
is there a metabolic acidocis
Hypo K, no HTN , Metabolic acidosis
Renal tubular acidocis
Hypo K, no HTN , NO Metabolic acidosis next step
urine K+. If >20 intrarenal loss else extrarenal loss
Chronic blistering on sun exposed areas, liver problems.
Porphyria cutanea tarda
tx with sunscreen (hydroxy)chloroquine
tx for actinic keratosis
5flurouricil, cryo, imiquimod
