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World week 1 > 5/11 > Flashcards

5/11 Flashcards

1
Q

When are symptoms during somatic symptom disorder usually worse? tx?

A

During periods of stress

Focus on discussing the role of psychosocial stressors and promote stress reduction/healthy behaviors

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2
Q

Meds to withhold before stress testing? how long?

exception?

A

B-blockers, CCBs and nitrates for 48 hours

Exception: in pt’s with known CAD to asses efficacy of anti-anginal drugs

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3
Q

Why low intubation threshold in burns

A

Progressive airway edema may preclude incubator later in clinical course

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4
Q

Pre-patellar bursitis features

A

Anterior knee pain, tenderness, and localized swelling

By S. aureus

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5
Q

Who gets patellar tendonitis

A

Athletes in jumping sports or occupations with repetitive forceful knee extension

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6
Q

What test can be considered in a woman w/ very strong hx of ovarian Ca

A

BRCA1 and 2

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7
Q

Think of what in a patient w/ erythema gangrenosum

A

IBD, RA, or AML (underlying systemic disease)

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8
Q

Most useful test for re-occlusion following recent MI

A

CK-MB (typically returns to normal w/in 1-2 days)

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9
Q

3 things that dec HOCM murmur

A

Sustained hand grip
Squatting
Passive leg raise

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10
Q

What does valsalva do to pre-load

A

Decreases it

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11
Q

Best step for undiagnosed pleural effusion on CXR

A

Thoracentesis, except inpatients w/ clear-cut evidence of CFH

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12
Q

Acid/Base status of Conn’s

A

Metabolic alkalosis

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13
Q

MC site of ulnar nerve entrapment

A

Elbow where the ulnar nerve lies at the medial epicondylar groove

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14
Q

Why UA for bedwetting after age 5

A

Screen for UTI, DM, and DI

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15
Q

4 tests for all pt’s w/ new HTN diagnosis

A
  1. UA (occult hematuria and protein/cr ratio)
  2. Chemistry panel
  3. Lipid profile
  4. Baseline EKG
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16
Q

Erlichiosis labs

A

Leukopenia
Thrombocytopenia
Elevated LFTs and LDH

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17
Q

What should be considered when a pt suspected of sarcoidosis decompensated following steroids

A

Histoplasmosis (closely mimics - normally caseating granulomas but can have non)

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18
Q

Type 2 RTA causes

A

Defective tubular HCO3 reabsorption

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19
Q

What differentiates acute Hypercarbia from chronic CO2 retention in COPD

A

Acute has associated acidosis and low bicarb level

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20
Q

What can happen with changes in head position in papilledema

A

transient vision loss lasting a few seconds

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21
Q

4 big pancreatitis complications

A
  1. Pleural effusion
  2. ARDS
  3. Ileus
  4. Renal failure
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22
Q

What causes morton’s neuroma

A

Mechanically induced neuropathic degeneration of the interdigital nerves

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23
Q

Pleural fluid indicators of empyema? what do you do

A

pH

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24
Q

Always do what in croup before intubation

A

Give a trial of race-epi

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25
What is eliminated in a case control study when neighbors of pt's are chosen
Confounders
26
Euthyroid sick syndrome characterized by
Fall in total and free T3 levels w/ normal T4 and TSH
27
Chikungunya fever presentation
Caribbean trip and back with Polyarthralgias, rash, lymphopenia, and thrombocytopenia
28
What classifies saline response vs unresponsive metabolic alkalosis
Saline responsive will have low urinary chloride (
29
3 PE findings of aortic stenosis
1. Pulsus parvus et trades (delayed and diminished) 2. Mid to late peaking systolic murmur 3. Soft and single second heart sound
30
Why single soft S2 in aortic stenosis
Aortic valve closure is delayed and occurs simultaneously w/ pulmonic valve closure
31
Duodenal hematoma mgmt
Conservatively w/ nasogastric suction and parenteral nutrition
32
Odansetron MOA
Blocks 5HT3 receptors | *for preventing chemotherapy induced nausea and vomiting*
33
Next step if a CXR identifies a new suspicious pulmonary nodule
CT scan
34
High risk pulmonary nodule features
Size > 2.0cm > 60 years old Current or
35
CXR diagnostic indicator of diaphragmatic rupture
Nasogastric tube in the pulmonary cavity
36
why is aldosterone normal in pan-hypopituitarism
Aldosterone secretion from adrenal glands is ACTH independent and primarily regulated by RAAS
37
Vit D def labs
Low Ca and PO4 | elevated PTH
38
What mediates Vit D absorption in the intestine
Chylomicrons
39
Why is insulin good for GDM
It does not cross the placenta
40
Gold standard dx for bowl ischemia
Mesenteric angiography
41
Suspect PML in who
HIV infected patient with focal neurological signs and multiple non-enhancing lesions w/ no mass effect on CT scan
42
When does subacute sclerosing panencephalitis occur? | What does CT scan show?
Many years after antecedent measles infection | CT scan shows scarring and atrophy
43
MCC of thyrotoxicosis w/ low RAI uptake? why?
Subacute painless thyroiditis | From leakage of thyroid hormones into the circulation
44
2 drugs that cause serum-sickness like reaction
B-lactams (penicillin, amoxicillin, cefaclor) or TMP-SMX
45
Hx of CAD + severe dyspnea after fluids likely
Pulmonary edema
46
SEM of alports? big 3 features?
Alternating areas of thinned and thickened capillary loops w/ splitting of GBM Recurring hematuria, sensorineural deafness, and fam hx of renal failure
47
What is chlorpheniramine
1st gen antihistamine
48
Fever and sore throat in patient on anti-thyroid drugs suggestive of
Agranulocytosis --> stop taking and count WBC
49
Volvulus Abdominal xray
"corkscrew"
50
Gold standard for diagnosing malrotation
Upper GI contrast study
51
When does pyloric stenosis manifest
1-2 year olds
52
Most common source of PE
Proximal deep leg veins (Iliac, femoral, popliteal)
53
Cutaneous findings of coccidioidmycosis
Erythema multiform and erythema nodosum
54
2 big screenings all patients with cirrhosis need
1. Endoscopy for varies | 2. HCC screening w/ US every 6 months
55
Tx for asymptomatic variceals
Non-selective B-blockers
56
What characterizes normal hyperventilation of pregnancy
1. Increased TV 2. Inc minute ventilation 3. Chronic respiratory alkalosis
57
Presentation and cause of dysarthria-clumsy hand syndrome
``` Bulbar dysfunction (dysarthria, dysphagia) Contralateral facial and limb weakness Due to infarction in paramedic basis points ```
58
Risk w/ Hashimoto's thyroiditis
Thyroid lymphoma
59
Langerhan's histiocytosis presentation
Solitary, painful lytic long bone lytic lesion w/ overlying swelling and hypercalcemia
60
What are ahminoglycosides used for
Serious gram negative infections
61
What is present in AIN urine
WBCs and eosinophils
62
Hallmark EKG of ventricular aneurysm
Persistent ST-segment elevation after a recent MI and deep Q waves in the same leads
63
Immunofluorescence of bullous pemhigoid
IgG and C3 distributed linearly along BM zones
64
Pemphigus vulgaris Ab
Surface bound IgG to desmoglein
65
What is adjustment disorder characterized by
Increased anxiety, depression, or disturbed behavior that develops in response to a stressor
66
4 features of atypical depression
1. Hypersomnia 2. Increased appetite 3. Rejection sensitivity 4. Leaden paralysis
67
Most important steps in management of lactic acidosis from septic shock
IV Normal saline with or without vasopressor therapy to maintain the intravascular pressure and Ab
68
Can laboring patients w/ placental abruption deliver?
Yes, unless mother is hypotensive w/ severe bleeding or if the condition of the fetus deteriorates
69
Inevitable vs Incomplete abortion
Inevitable: products of conception may be seen or felt at or above cervical os Incomplete: some products of conception expelled and some remain
70
Arrhythmias after MI
Immediate (0-10 min) - reentrant ventricular (f-fib) | Delayed (10-60 min) from abnormal automaticity
71
3 causes for travelers diarrhea lasting longer than 2 wees
1. Cryptosporidium 2. Cyclospora 3. Giardia
72
What causes Amebiasis
Entamoeba histolytic (bloody diarrhea from Asia)
73
How does type IV RTA present? Who gets it?
Hyperkaelmia, mild renal insufficiency, and non anion-gap metabolic acidosis -Pt's with poorly controlled DM get it
74
GAS treatment in kids vs adults
Always test in children w/ rapid streptococcal antigen testing prior to starting Ab
75
What is needed to make dx of delayed sleep phase syndrome
Accurate history and/or sleep diary
76
Caustic poisoning presentation
Dysphagia, severe pain, heavy salivation, and mouth burns | *not change in consciousness*
77
Bitter almond odor with
Cyanide inhalation
78
2 things elevated in Pagets
Alk phos | Urinary hydroxyproline levels
79
5 AE w/ amioderone
1. Pulm fibrosis 2. Thyroid dysfunction 3. Hepatotoxic 4. Corneal deposits 5. Blue skin color
80
Levodopa/Carbidopa AE
1. Hallucinations 2. Dizziness 3. Headache 4. Agitation
81
TSS presentation
Fever, myalgias, marked hypotension, and diffuse erythematous macular rash
82
Azathioprine tox
Dose related diarrhea, leukopenia, and hepatoxocity
83
major tox of mycophenolate
bone Marrow suppression
84
Main cyclosporine AE
``` Nephrotoxicity Hyperkaelmia Hypertension Gum hypertrophy Hirsutism Tremor ```
85
MC cyclosporine AE
Nepphrotoxicty
86
What causes HTN in thyrotoxicosis
Hyper dynamic circulation resulting form increased myocardial contractility and heart rate

World week 1 (17 decks)

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