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World week 1 > 5/12 (UWSA) > Flashcards

5/12 (UWSA) Flashcards

1
Q

Most common complication w/ TPN

A

Catheter tip infection

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2
Q

Methanol vs Ethylene glycol ingestion characteristics

A

Methanol- Visual disturbances

Ethylene glycol -RTA damage and formation of calcium oxalate crystals

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3
Q

When is an NST complete

A

Two or more accelerations of 15 ppm above baseline for at least 15 seconds over 20 mins

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4
Q

What is Ecthyma grangrenosum

A

Pseudomonas bacteremia w/ rapidly progressive skin lesions that develop into non-tender ulcers w/ central necrosis

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5
Q

What is decreased first in tamponade

A

Right atrial filling, leading to an increase in systemic venous pressure

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6
Q

CSF findings of HSV encephalitis

A
  • Lymphocytic pleocytosis
  • Increased protein
  • Elevated RBC
  • Normal glucose
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7
Q

CSF of mycobacterial meningitis

A

Lymphocytic pleocytosis w/ decreased glucose, increased protein

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8
Q

MRI finding of spinal stenosis

A

narrowing of lumbar spine

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9
Q

Most common cause of paraneoplastic cushings

A

Small cell lung cancer

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10
Q

What makes ACTH

A

Cleavage of POMC (also yielding melanocyte stimulate hormone)

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11
Q

Most effective treatment to decrease risk of stroke in A-fib

A

Anticoagulation w/ warfarin

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12
Q

TB pleural effusion features

A

Exudative w/ protein > 4 and lymphocytic leukocytosis w/ no gross purulence

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13
Q

Why are SVC headaches worse w/ leaning forward

A

Decrease gravitational effects on the blood column

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14
Q

MCC of SVC syndrome? Presentation?

A

Malignancy (either lung or lymphoma)

Presents w/ headache, facial swelling, and jugular venous engorgment w/out peripheral edema

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15
Q

Dx of SBP w/

A

Ascitic fluid neutrophil count > 250 in the appropriate clinical setting

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16
Q

Two labs that are elevated in breakdown of muscle tissue

A

LDH and CPK

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17
Q

Why hypotension in a tension pneumothorax

A

High intrathoracic pressure decreases venous return

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18
Q

2 lower motor neuron signs of denervatio

A

Atrophy and fasciculation’s

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19
Q

What is serositis

A

CP w/ pleural effusion and pericardial effusion

Seen w/ SLE

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20
Q

Wide complex tachycardia considered what until proven otherwise? tx?

A

Ventricular in origin

Tx w/ loading dose of amioderone in stable patients

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21
Q

Esophageal rupture usually leads to what

A

Mediastinitis

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22
Q

Why CT scan in primary hyperaldosteronism

A

To identify if it is bilateral adrenal hyperplasia or aldosterone producing adenoma

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23
Q

Drug for pt’s ww/ bilateral adrenal hyperplasia

A

Aldosterone antagonists

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24
Q

Serum Ca levels in hypercalcemia of malignancy vs Primary hyper PTH

A

Generally much higher in HOM than primary hyper PTH

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25
Drug to prevent gallstone formation in patients w/ gastric bypass surgery
Ursodeoxycholic acid (higher risk due to increase in bile concentration)
26
Secondary hyperparathyroidism features
Elevated phosphate and low Calcium in setting of CKD
27
What is tertiary hyperparathyroidism
Chronic PTH stimulation leads to development of autonomously functioning adenomas w/ very high PTH levels and hypercalcemia
28
Neurologic manifestations of SLE
Cognitive dysfunction and seizures
29
What kind of pain is the crampy pain in SBO
Viceral (mechanical stretching of small bowel viscera)
30
Somatic abdominal pain features
Well localized, and usually 2/2 peritoneal irritation
31
2 broad categories of hypoglycemic symptoms
Neurogenic (sympathetic) | Neuroglycopenic (dec supply of glucose to brain causing mental status changes)
32
2 first line treatments of neurogenic bladder
1. Augmented voiding techniques | 2. Cholinergic agonists
33
Two B-blockers used to reduce the risk of esophageal vatical hemorrhage
Propranolol and nadolol
34
What can myocarditis develop into
Dilated cardiomyopathy
35
What is elevated in cholestatic jaundice
T bili and alk phos
36
What should always be considered in evaluation of patients w/ a-fib
Hyperthyroidism (TSH and free t4)
37
Symptoms of meniscal tear
Joint line tenderness Effusion Locking or catching when the joint is extended while under load
38
Prognosis of astrocytomas most affected by?
Tumor grade
39
First line therapy for CLL
Rituximab (CD20 mAb) and Fludarabine
40
IL-1 receptor antagonists useful in
Treatment of RA
41
How can extra-renal fluid losses lead to hypovolemic hyponatremia
Due to secretion of ADH and retention of free water
42
Ab for sepsis in SS kids
3rd gen cef (for presumed s pneumo)
43
Two MCC of malignant pleural effusion
Breast and Lung
44
Two drugs classes for rate control in A-fib
``` B blockers (metoprolol, esmolol) non-dihydropyridine CCBs (verapamil and diltiazem) ```
45
3 murmers of large ASD (w/ L to R shunt)
1. Wide and fixed split S2 2. Midsystolic murmur of LUSB 3. Mid-diastolic rumble
46
Next step in septic shock if pt doesn't respond to fluids
Vasopressors (dopamine or NE)
47
Check of anti-endomysial Ab in who
Patients suspect of having celiac spure
48
MCC of renal failure in multiple myeloma
Toxic effect of light chain casts on renal tubules
49
Fragile X features
Delayed milestones, autistic behavior, ID, elongated face, large testes
50
pH of urine in women w/ yeast infections
Normal (3.8-4.5)
51
Alpha thal minor symptoms
Asymptomatic but mild fatiguability | Hypo chromic anemia w/ severe microcytosis and target cells
52
Initial workup of new psych symptoms
1. Head CT 2. CBC 3. TFTs 4. Syphilis screen 5. metabolic panel 6. Urine tox
53
What should be suspected in any pt w/ fever and monoarticular joint symptoms
Septic arthritis (even when pt's have pre-existing joint disease)
54
Bleeding in meckels from
Ectopic gastric tissue
55
Anemia most commonly seen w/ DIC
Microangiopathic hemolysis
56
Mitral stenosis murmur
Low pitched diastolic murmur best heard at the apex (earlier in beginning and can become holosytolic in severe dz)
57
Mammogram age
50-75
58
Good step to reduce pressure ulcers on LE
Pillows under the legs
59
What should be suspected in pt's that develop rapid accumulation of pleural effusion, SOB, and hemodynamic instability after thoracentesis
Hemothorax
60
Who gets focal segmental glomerulosclerosis
AA and Hispanics Obese folds HIV and heroin use
61
Glomerular dz ass w/ Hep B and C
Mebranoproliferative glomerulonephritis
62
First day of pulmonary contustion
Airspace opacity on CXR and findings c/w alveolar fluid on physical exam
63
Presentation of juvenile myoclonic epilepsy
Progression from absence seizures to myoclonic to generalized Typically occur upon awakening and worse w/ sleep deprivation
64
How do nitrates reduce pain in MI
Venous dilation (thus reducing preload leading to reduction in myocardial O2 demand)
65
Bacterial meningitis empiric tx
Ceftriaxone and vanc
66
Aortic regurg mumur
Decrescendo diastolic murmur
67
What is albuminocytologic dissociation
In CSF when protein is elevated and WBC is normal | *seen in GB*
68
MCC of spinal epidural abscess
S. aureus
69
No tx or further workup in kids w/ pharyngitis when
Cough, runny nose, and oral vesicles present (likely viral)
70
Smear of MDS
Ovalo-macrocytes and neutrophils w/ decreased segmentation
71
What is seen after peaked T waves in hyperkalemia
Loss of P waves | Then widened QRS w/ sine wave pattern
72
What part of adrenal gland makes catecholamines
Renal medulla (Epi and NE)
73
GAS impetigo can lead to
Glomerulonephritis | rheumatic fever follows strep throat
74
Most common complication of neutropenia
Infection (septic signs may be more subtle than in an immunocompetent patient)
75
Labs of tumor lysis syndrome
Hypocalcemia Hyperphosphatemia Hyperkalemia Elevated Uric Acid levels
76
When is debridement alone in a diabetic ulcer ok
When there is no infection and the ulcer does not involve the bone
77
3 big things in hyperprolactinemia
1. Irregular menstrual periods 2. Infertility 3. Galactorrhea
78
What is susceptibility bias
Selection bias where a pt's treatment regimen is selected based on the severity of their condition
79
What causes DKA
Lack of insulin causing breakdown of fatty acids to ketones in the liver (FFA from peripheral tissue due to HIGH level of catecholamines)
80
AIDs drug that causes bizarre CNS effects
Efavirenz
81
Pancreatitis w/ what AIDs drug
Didanosine
82
Abacavir AE
Lactic acidosis Hepatitis Hypersensitivity reaction
83
Half of HSP cases preceded by
URI (thought to trigger abnormal immune response)
84
Light microscopy of HSP
Leukoclastic vasculitis in the post capillary venules
85
Bartholin's gland abscess presentation
Extremely painful unilateral labial sweeping, often making it very painful to sit and screw
86
Nail manifestations of Graves
Oncholysis | Aropachy (ail clubbing in setting of hyperthyroidism)
87
Why is mild hypercalcemia seen in Graves
Increased bone turnover
88
Triptan + Ergot can cause
Severe prolonged vasoconstriction resulting in elevated BP, MI, or stroke
89
"Glare" while driving at night classic manifestation of
Cataracts | *painless loss of vision that is worse at night*
90
Look for what in pt's w/ splenectomy
Thrombocytosis b/c spleen removes old platelets from circulation
91
5 Drugs that dec. mortality in LV dysfunction ***
1. ACEi 2. ARBs 3. B-blockers 4. Aldosterone antagonists 5. Hydrazine + nitrates
92
3 best B-blockers for CHF
Metoprolol succinate Carvedilol Bisoprolol
93
Avoid what B-blockers in CHF? Why?
PIndolol and acebutolol | These have intrinsic sympathomimetic activity
94
Carpal tunnel in pregnancy due to
Accumulation of fluid w/in the tunnel
95
What causes carpal tunnel in RA
Tenosynovial inflammation
96
How does Mag cause neuromuscular depression
Reducing act release at myoneural junction
97
First line tocolytics that can cause pulmonary edema? how?
Terbutaline and ritodrine (B-agonists) due to inc HR causing dec. diastolic filing time combined with excess plasma volume in pregnant patients
98
Why does SS not get infants
Protective effect of fetal hemoglobin
99
Hypertriglyceridemia tx
Fenofibrate (fabric acid derivative)
100
What is cholestyramine
Bile acid binding resin that can reduce LDL (but raise TG)
101
Ezetimibe MOA
Prevents dietary absorption of cholesterol from gut | *LDL double dec when used w/ statin
102
Drug to use w/ statin to reduce LDL a lot
Ezetimibe
103
Most effective tx in slowing progression of diabetic nephropathy
Maintaining BP less than 130/80
104
Sulfonylurea MOA
Acts on pancreas to increase endogenous insulin production
105
COCs dec risk of what cancers
Ovarian and endometrial
106
Confirmatory HIT test
ELISA Ab test
107
Typical volume status in severe hypercalcemia
Typically volume depleted due to increased natriuresis
108
Sudden onset of syncope w/out a prodrome most likely
Ventricular arrhythmia
109
4 big risk factors for torsades
1. Antiarrhythmic drugs 2. Structural heart disease 3. Hypokalemia 4. Hypomagnesemia

World week 1 (17 decks)

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