4/30/16 Flashcards
Bereaved patients who experience depressive symptoms at least 2 weeks after a major loss should get what
Psychotherapy and a trial of antidepressants
Therapy for stable wide complex tachycardia
IV antiarrhythmics (Amoiderone and procainamide)
Therapy for stable vs unstable narrow complex tachycardia
Stable: Vagal maneuvers or IV Adenosine or CCB
Unstable: Immediate synchronized DC cardioversion
Steroid induce myopathy features
Painless proximal muscle weakness, more prominent in LE
ESR and CK Normal
Pansystolic murmur heard loudest at apex 3 days after MI
Mitral regurg due to papillae muscle dysfuction
Ventricular septal muscle rupture murmur
Pansystolic murmur best heard at left sternal border
Often has a thrill
Ventricular free wall rupture classical results in
Pericardial tamponade
HIT type 2
Autoimmune disorder due to antibodies against heparin-platelet factor 4 complexes
When to suspect HIT
When platelet counts fall > 50% from baseline 5-4 days after starting heparin
Gold standard to dx HIT
Serotonin release assay
Why a high level of false negatives in serologic testing for primary syphillis
Many patients have yet to form antibodies
Odd place cholecystitis hurts
Right shoulder
What is osteomalacia due to? What does it lead to
Due to defective mineralization of the organic bone matrix MC due to severe bit D def, leading to decreased intestinal Ca and PO4 absortion with resultant secondary Hyper-PTH
Typical osteomalacia labs
Hypophosphatemia, hypocalcemia, and eleavted Alk-phos
Best way to remove FB in kid trachea vs esophagus
Flexible endoscopy for esophagus
Rigid for trachea
MCC of congenital hypothyroidism
Thyroid dysgenesis
What do you need to dx uncomplicated pancreatitis
Clinical features and 3x increased amylase and lipase
don’t need CT if other 2 are pos- just 2 of 3
Pneumo vaccine schedule for patients with chronic medical conditions
PPSV23 once, then reactivation with PCV 13 and PPSV23 at age 65
Pneumo vaccine schedule for healthy adults
PCV12 for all adults over 65 with followed by 23-valent PPSV23 after at least 6-12 months
Infection in what space carries the highest risk of spread into the mediastinum
Retropharyngeal
What kind of bias is loss to follow up
A type of selection bias known as attrition bias
What is surveillance bias
When the exposed group undergoes increased monitoring relative to the general population –> tends to increase disease diagnosis relative to general population
Most common causes of viral meningitis
Non-polio enteroviruses, such as echovirus and coxsackieviruses
3 facial features of FAS
- Small palpebral fissures
- Smooth philtrum
- Thin vermilion border
FEV1/FVC for obstructive pattern
Why octreotide for variceal bleed
Inhibits release of vasodilator hormones –> leads indirectly to splanchnic vasoconstriction and decreased portal flow
3 steps for fixing hyperkalemia
- Membrane stabilization with calcium
- Shifting K intracellularly
- Decreasing total serum K cocentration
Folate effect on homocysteine
Lowers by acting as a cofactor for the enzyme cystathionine B-synthase (turns homocysteine into cystathionine)
3 reasons for diabetic foot ulcers
Neuropathy, microvascular insufficiency, and relative immunosuppresion
Colvesical fixture MCC
Diverticular dz
Hepatorenal syndrome features
Acute renal failure (Cr > 1.5) with a very low urine Na level, and absence of blood, casts, or proteinic urine
usually doesn’t improve with IV fluid resuscitation
Vertebral compression fracture features? MCC of non-traumatic fracture?
Acute back pain and point tenderness
MCC of non traumatic VCF is osteoporosis
