4/31-5/1 Flashcards
Important AE of buproprion
Decreases seizure threshold
esp Anorexia pt’s with electrolyte abnormalities
Acute glaucoma drugs
Mannitol, acetazolamide, pilocarpine, or timolol
MCC of aortic dissection
Hypertension
Marfan’s mutation
Fibrillin
How high can the diaphragm go during expiration
As high as 4th thoracic dermatome on right and 5th on the left (nipples)
Lithium tx timeline guidlines
1 year after first episode of Bipolar
If more than two consider years, if not lifetime
How is a complete mole formed
When 2 sperm fertilize an ovum lacking genetic material –> no fetal tissue
How can a molar pregnancy use bilateral ovarian enlargement
2/2 hyperstimulation and ovarian cyst formation (theca lutein cysts)
Type 2 DM dx criteria
- FPG > 126 x2
- A1C > 6.5%
- 2 hr OGTT > 200
- Random plasma glucose > 200
Acid-Base status of hypertrophic pyloric stneosis
Hypochloremic, hypokalemic metabolic acidosis
Vitamin that helps with measles
Vitamin A
Why make sure you give iron with Epo
Epo-induced surge in RBC production can precipitate an iron-deficient state
Posterior vermis syndrome main feature
Truncal dystaxia
OA features on hand
Prominent osteophytes at DIP (heberden nodes) and PIP (bouchard nodes)
Why no furosemide for kidney stones
Can promote calciuria
When does tamsulosin act
On the distal ureter, lowering muscle tone and reducing reflex ureteral spasm
Most distinguishing feature of bath salt use
Prolonged duration of the effect
What is interstitial cystitis
“Painful bladder syndrome” –> worse by bladder filling and relieved by voiding
will also see urinary urgency, frequency, and chronic pelvic pain
MCC of cor pulomale (besides left heart failure)
COPD
CXR of cor pulmonale
Enlarged central pulmonary arteries and loss of retrosternal air space due to RVH
What is pulsus paradoxus
> 10 mm Hg decrease in systemic blood pressure with inspiration
2 major products of fires in closed spaces
Hydrogen cyanide and carbon monoxide
Cyanide tox tx
Hydroxocobalmin or sodium thiosulfate
What causes methemoglobinemia
Exposure to oxidizing agents (dapsone, nitrates, topical/local anesthetics)
Biopsy of UC shows
Mucosal inflammation and crypt abscesses
Also suspect tropical sprue in what patients
Living in tropical areas and having diarrhea for more than one month
Biopsy of tropical sprue
Blunting of villi with chronic inflammatory cells (lymphocytes, plasma cells, and eosinophils)
What is Rotor’s syndrome
Chronic hyperbilirubinemia due to a defect in hepatic secretion of conjugated bill into biliary system
Tx for premature atrial contractions (symptomatic)
Beta blockers
Positive bronchodilator response criteria
> 12% increase in FEV1
Suspect hUS in who
A child who has recently recovered from a diarrheal illness and presents with acute renal failure, microangiopathic hemolytic anemia, fever, thrombocytopenia and smear with schistocytes
McCune-Albright features
Precocious puberty, cafe au last spots and multiple bone defects (polyostotic fibrous dysplasia)
Puetz-Jeghers featuers
GI tract polyposis and mucocutaneous pigmentation
can have estrogen secreting tumor
Suspect what in basilar prominent COPD
Alpha-1 antitrypsin disease
What do statins dec that may lead to myopathy
Coenzyme Q10 synthesis
Cauda equina vs Conus medullarus syndrome
Cauda: all lower motor neuron signs
Conus: Upper and lower motor neuron signs
How can GERD make asthma worse
Exacerbates airflow obstruction through increased vagal tone, heightened bronchial reactivity, and micro aspiration of gastric contents into upper airway
Osteomyelitis + Sickle Cell
Salmonella
Pelvis US of septic abortion
Retained products of conception, increased vascularity, echogenic material in the cavity, and thick endometrial stripe
What causes placenta accreta
When uterine villi attach directly to the myometrium instead of the decidua
Placenta accreta risk factors
- Prior C-sectio
- Hx of d/c
- Age >35
US of placenta accreta
Intraplacental villous lakes and absence of placental-myometrial interface
COC prevent what cancers
Endometrial and ovarian
Also decrease risk of benign breast disease
Tamoxifen MOA
Estrogen antagonist in breast
Agonist at uterus and bone
C1 inhibitor def leads toe elevated levels of
C2b and bradykinin
Janeway lesions vs Osler nodes
Janeway - non-tender on palms and soles
Osler- painful and purple on fingertips and toes
Cat scratch disease tx
Oral azithromycin
Most common predisposing factor to orbital cellulitis
Bacterial sinusitis
DM + Odd eye infection
Rhizopus causing mucormycosis
Most common congenital cyanotic heart disease? Characteristic findings?
Transposition of the great vessels
Findings: single S2 and narrow mediastinum (egg on a string)
Pagets tx
Bisphosphonates: inhibit osteoclasts to suppress bone turnover
Metabolic syndrome risks with what anti-psychotics
Olanzapine and clozapine
do routine fasting glucose and lipids
MEN 2A vs 2B
2A: Medullary TC, Pheo, PTH hyperplasia
2B: MTC, Pheo, and mucosal/interstinal neuromas and marfinoid habitus
A-a gradient
P(A)O2- P(a) O2
Class 1C drugs and features
Flecanide and propafenone (a-fib drugs)
In patients with faster HR, have “use dependence”, where QRS is widened
Digoxin MOA
Inhibits ATP-ase and inc intracellular Na, causing inc Ca
Also enhances vagal tone
Cause of coarctation of the aorta
Thickening of the tunica media near the junction of ductus arterioles and aortic arch
When can you hear an S4
Pt’s with decreased LV compliance
Why can O2 make COPD worse
Increased dead space perfusion causing V/Q mismatch, decreasing affinity of oxyhemoglobin for CO2, and reduced alveolar ventilation
TF, breath sounds and percussion on PE patient
TF decreased
BS decreased
Percussion dull
CXR of pneumonia vs effusion
PNA would not cause blinding of the costophrenic angles
Analgesic nephropathy types
MC papillary necrosis and chronic tubulointersitial nephritis
