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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
Q

What is eliminated in a case control study when neighbors of pt’s are chosen

A

Confounders

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26
Q

Euthyroid sick syndrome characterized by

A

Fall in total and free T3 levels w/ normal T4 and TSH

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27
Q

Chikungunya fever presentation

A

Caribbean trip and back with Polyarthralgias, rash, lymphopenia, and thrombocytopenia

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28
Q

What classifies saline response vs unresponsive metabolic alkalosis

A

Saline responsive will have low urinary chloride (

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29
Q

3 PE findings of aortic stenosis

A
  1. Pulsus parvus et trades (delayed and diminished)
  2. Mid to late peaking systolic murmur
  3. Soft and single second heart sound
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30
Q

Why single soft S2 in aortic stenosis

A

Aortic valve closure is delayed and occurs simultaneously w/ pulmonic valve closure

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31
Q

Duodenal hematoma mgmt

A

Conservatively w/ nasogastric suction and parenteral nutrition

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32
Q

Odansetron MOA

A

Blocks 5HT3 receptors

for preventing chemotherapy induced nausea and vomiting

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33
Q

Next step if a CXR identifies a new suspicious pulmonary nodule

A

CT scan

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34
Q

High risk pulmonary nodule features

A

Size > 2.0cm
> 60 years old
Current or

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35
Q

CXR diagnostic indicator of diaphragmatic rupture

A

Nasogastric tube in the pulmonary cavity

36
Q

why is aldosterone normal in pan-hypopituitarism

A

Aldosterone secretion from adrenal glands is ACTH independent and primarily regulated by RAAS

37
Q

Vit D def labs

A

Low Ca and PO4

elevated PTH

38
Q

What mediates Vit D absorption in the intestine

A

Chylomicrons

39
Q

Why is insulin good for GDM

A

It does not cross the placenta

40
Q

Gold standard dx for bowl ischemia

A

Mesenteric angiography

41
Q

Suspect PML in who

A

HIV infected patient with focal neurological signs and multiple non-enhancing lesions w/ no mass effect on CT scan

42
Q

When does subacute sclerosing panencephalitis occur?

What does CT scan show?

A

Many years after antecedent measles infection

CT scan shows scarring and atrophy

43
Q

MCC of thyrotoxicosis w/ low RAI uptake? why?

A

Subacute painless thyroiditis

From leakage of thyroid hormones into the circulation

44
Q

2 drugs that cause serum-sickness like reaction

A

B-lactams (penicillin, amoxicillin, cefaclor) or TMP-SMX

45
Q

Hx of CAD + severe dyspnea after fluids likely

A

Pulmonary edema

46
Q

SEM of alports? big 3 features?

A

Alternating areas of thinned and thickened capillary loops w/ splitting of GBM
Recurring hematuria, sensorineural deafness, and fam hx of renal failure

47
Q

What is chlorpheniramine

A

1st gen antihistamine

48
Q

Fever and sore throat in patient on anti-thyroid drugs suggestive of

A

Agranulocytosis –> stop taking and count WBC

49
Q

Volvulus Abdominal xray

A

“corkscrew”

50
Q

Gold standard for diagnosing malrotation

A

Upper GI contrast study

51
Q

When does pyloric stenosis manifest

A

1-2 year olds

52
Q

Most common source of PE

A

Proximal deep leg veins (Iliac, femoral, popliteal)

53
Q

Cutaneous findings of coccidioidmycosis

A

Erythema multiform and erythema nodosum

54
Q

2 big screenings all patients with cirrhosis need

A
  1. Endoscopy for varies

2. HCC screening w/ US every 6 months

55
Q

Tx for asymptomatic variceals

A

Non-selective B-blockers

56
Q

What characterizes normal hyperventilation of pregnancy

A
  1. Increased TV
  2. Inc minute ventilation
  3. Chronic respiratory alkalosis
57
Q

Presentation and cause of dysarthria-clumsy hand syndrome

A 
Bulbar dysfunction (dysarthria, dysphagia)
Contralateral facial and limb weakness
Due to infarction in paramedic basis points
58
Q

Risk w/ Hashimoto’s thyroiditis

A

Thyroid lymphoma

59
Q

Langerhan’s histiocytosis presentation

A

Solitary, painful lytic long bone lytic lesion w/ overlying swelling and hypercalcemia

60
Q

What are ahminoglycosides used for

A

Serious gram negative infections

61
Q

What is present in AIN urine

A

WBCs and eosinophils

62
Q

Hallmark EKG of ventricular aneurysm

A

Persistent ST-segment elevation after a recent MI and deep Q waves in the same leads

63
Q

Immunofluorescence of bullous pemhigoid

A

IgG and C3 distributed linearly along BM zones

64
Q

Pemphigus vulgaris Ab

A

Surface bound IgG to desmoglein

65
Q

What is adjustment disorder characterized by

A

Increased anxiety, depression, or disturbed behavior that develops in response to a stressor

66
Q

4 features of atypical depression

A
  1. Hypersomnia
  2. Increased appetite
  3. Rejection sensitivity
  4. Leaden paralysis
67
Q

Most important steps in management of lactic acidosis from septic shock

A

IV Normal saline with or without vasopressor therapy to maintain the intravascular pressure and Ab

68
Q

Can laboring patients w/ placental abruption deliver?

A

Yes, unless mother is hypotensive w/ severe bleeding or if the condition of the fetus deteriorates

69
Q

Inevitable vs Incomplete abortion

A

Inevitable: products of conception may be seen or felt at or above cervical os
Incomplete: some products of conception expelled and some remain

70
Q

Arrhythmias after MI

A

Immediate (0-10 min) - reentrant ventricular (f-fib)

Delayed (10-60 min) from abnormal automaticity

71
Q

3 causes for travelers diarrhea lasting longer than 2 wees

A
  1. Cryptosporidium
  2. Cyclospora
  3. Giardia
72
Q

What causes Amebiasis

A

Entamoeba histolytic (bloody diarrhea from Asia)

73
Q

How does type IV RTA present? Who gets it?

A

Hyperkaelmia, mild renal insufficiency, and non anion-gap metabolic acidosis
-Pt’s with poorly controlled DM get it

74
Q

GAS treatment in kids vs adults

A

Always test in children w/ rapid streptococcal antigen testing prior to starting Ab

75
Q

What is needed to make dx of delayed sleep phase syndrome

A

Accurate history and/or sleep diary

76
Q

Caustic poisoning presentation

A

Dysphagia, severe pain, heavy salivation, and mouth burns

not change in consciousness

77
Q

Bitter almond odor with

A

Cyanide inhalation

78
Q

2 things elevated in Pagets

A

Alk phos

Urinary hydroxyproline levels

79
Q

5 AE w/ amioderone

A
  1. Pulm fibrosis
  2. Thyroid dysfunction
  3. Hepatotoxic
  4. Corneal deposits
  5. Blue skin color
80
Q

Levodopa/Carbidopa AE

A
  1. Hallucinations
  2. Dizziness
  3. Headache
  4. Agitation
81
Q

TSS presentation

A

Fever, myalgias, marked hypotension, and diffuse erythematous macular rash

82
Q

Azathioprine tox

A

Dose related diarrhea, leukopenia, and hepatoxocity

83
Q

major tox of mycophenolate

A

bone Marrow suppression

84
Q

Main cyclosporine AE

A 
Nephrotoxicity
Hyperkaelmia
Hypertension 
Gum hypertrophy
Hirsutism
Tremor
85
Q

MC cyclosporine AE

A

Nepphrotoxicty

86
Q

What causes HTN in thyrotoxicosis

A

Hyper dynamic circulation resulting form increased myocardial contractility and heart rate

World week 1 (17 decks)

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