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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
Q

Drug to prevent gallstone formation in patients w/ gastric bypass surgery

A

Ursodeoxycholic acid (higher risk due to increase in bile concentration)

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26
Q

Secondary hyperparathyroidism features

A

Elevated phosphate and low Calcium in setting of CKD

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27
Q

What is tertiary hyperparathyroidism

A

Chronic PTH stimulation leads to development of autonomously functioning adenomas w/ very high PTH levels and hypercalcemia

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28
Q

Neurologic manifestations of SLE

A

Cognitive dysfunction and seizures

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29
Q

What kind of pain is the crampy pain in SBO

A

Viceral (mechanical stretching of small bowel viscera)

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30
Q

Somatic abdominal pain features

A

Well localized, and usually 2/2 peritoneal irritation

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31
Q

2 broad categories of hypoglycemic symptoms

A

Neurogenic (sympathetic)

Neuroglycopenic (dec supply of glucose to brain causing mental status changes)

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32
Q

2 first line treatments of neurogenic bladder

A
  1. Augmented voiding techniques

2. Cholinergic agonists

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33
Q

Two B-blockers used to reduce the risk of esophageal vatical hemorrhage

A

Propranolol and nadolol

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34
Q

What can myocarditis develop into

A

Dilated cardiomyopathy

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35
Q

What is elevated in cholestatic jaundice

A

T bili and alk phos

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36
Q

What should always be considered in evaluation of patients w/ a-fib

A

Hyperthyroidism (TSH and free t4)

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37
Q

Symptoms of meniscal tear

A

Joint line tenderness
Effusion
Locking or catching when the joint is extended while under load

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38
Q

Prognosis of astrocytomas most affected by?

A

Tumor grade

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39
Q

First line therapy for CLL

A

Rituximab (CD20 mAb) and Fludarabine

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40
Q

IL-1 receptor antagonists useful in

A

Treatment of RA

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41
Q

How can extra-renal fluid losses lead to hypovolemic hyponatremia

A

Due to secretion of ADH and retention of free water

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42
Q

Ab for sepsis in SS kids

A

3rd gen cef (for presumed s pneumo)

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43
Q

Two MCC of malignant pleural effusion

A

Breast and Lung

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44
Q

Two drugs classes for rate control in A-fib

A 
B blockers (metoprolol, esmolol)
non-dihydropyridine CCBs (verapamil and diltiazem)
45
Q

3 murmers of large ASD (w/ L to R shunt)

A
  1. Wide and fixed split S2
  2. Midsystolic murmur of LUSB
  3. Mid-diastolic rumble
46
Q

Next step in septic shock if pt doesn’t respond to fluids

A

Vasopressors (dopamine or NE)

47
Q

Check of anti-endomysial Ab in who

A

Patients suspect of having celiac spure

48
Q

MCC of renal failure in multiple myeloma

A

Toxic effect of light chain casts on renal tubules

49
Q

Fragile X features

A

Delayed milestones, autistic behavior, ID, elongated face, large testes

50
Q

pH of urine in women w/ yeast infections

A

Normal (3.8-4.5)

51
Q

Alpha thal minor symptoms

A

Asymptomatic but mild fatiguability

Hypo chromic anemia w/ severe microcytosis and target cells

52
Q

Initial workup of new psych symptoms

A
  1. Head CT
  2. CBC
  3. TFTs
  4. Syphilis screen
  5. metabolic panel
  6. Urine tox
53
Q

What should be suspected in any pt w/ fever and monoarticular joint symptoms

A

Septic arthritis (even when pt’s have pre-existing joint disease)

54
Q

Bleeding in meckels from

A

Ectopic gastric tissue

55
Q

Anemia most commonly seen w/ DIC

A

Microangiopathic hemolysis

56
Q

Mitral stenosis murmur

A

Low pitched diastolic murmur best heard at the apex (earlier in beginning and can become holosytolic in severe dz)

57
Q

Mammogram age

A

50-75

58
Q

Good step to reduce pressure ulcers on LE

A

Pillows under the legs

59
Q

What should be suspected in pt’s that develop rapid accumulation of pleural effusion, SOB, and hemodynamic instability after thoracentesis

A

Hemothorax

60
Q

Who gets focal segmental glomerulosclerosis

A

AA and Hispanics
Obese folds
HIV and heroin use

61
Q

Glomerular dz ass w/ Hep B and C

A

Mebranoproliferative glomerulonephritis

62
Q

First day of pulmonary contustion

A

Airspace opacity on CXR and findings c/w alveolar fluid on physical exam

63
Q

Presentation of juvenile myoclonic epilepsy

A

Progression from absence seizures to myoclonic to generalized
Typically occur upon awakening and worse w/ sleep deprivation

64
Q

How do nitrates reduce pain in MI

A

Venous dilation (thus reducing preload leading to reduction in myocardial O2 demand)

65
Q

Bacterial meningitis empiric tx

A

Ceftriaxone and vanc

66
Q

Aortic regurg mumur

A

Decrescendo diastolic murmur

67
Q

What is albuminocytologic dissociation

A

In CSF when protein is elevated and WBC is normal

seen in GB

68
Q

MCC of spinal epidural abscess

A

S. aureus

69
Q

No tx or further workup in kids w/ pharyngitis when

A

Cough, runny nose, and oral vesicles present (likely viral)

70
Q

Smear of MDS

A

Ovalo-macrocytes and neutrophils w/ decreased segmentation

71
Q

What is seen after peaked T waves in hyperkalemia

A

Loss of P waves

Then widened QRS w/ sine wave pattern

72
Q

What part of adrenal gland makes catecholamines

A

Renal medulla (Epi and NE)

73
Q

GAS impetigo can lead to

A

Glomerulonephritis

rheumatic fever follows strep throat

74
Q

Most common complication of neutropenia

A

Infection (septic signs may be more subtle than in an immunocompetent patient)

75
Q

Labs of tumor lysis syndrome

A

Hypocalcemia
Hyperphosphatemia
Hyperkalemia
Elevated Uric Acid levels

76
Q

When is debridement alone in a diabetic ulcer ok

A

When there is no infection and the ulcer does not involve the bone

77
Q

3 big things in hyperprolactinemia

A
  1. Irregular menstrual periods
  2. Infertility
  3. Galactorrhea
78
Q

What is susceptibility bias

A

Selection bias where a pt’s treatment regimen is selected based on the severity of their condition

79
Q

What causes DKA

A

Lack of insulin causing breakdown of fatty acids to ketones in the liver
(FFA from peripheral tissue due to HIGH level of catecholamines)

80
Q

AIDs drug that causes bizarre CNS effects

A

Efavirenz

81
Q

Pancreatitis w/ what AIDs drug

A

Didanosine

82
Q

Abacavir AE

A

Lactic acidosis
Hepatitis
Hypersensitivity reaction

83
Q

Half of HSP cases preceded by

A

URI (thought to trigger abnormal immune response)

84
Q

Light microscopy of HSP

A

Leukoclastic vasculitis in the post capillary venules

85
Q

Bartholin’s gland abscess presentation

A

Extremely painful unilateral labial sweeping, often making it very painful to sit and screw

86
Q

Nail manifestations of Graves

A

Oncholysis

Aropachy (ail clubbing in setting of hyperthyroidism)

87
Q

Why is mild hypercalcemia seen in Graves

A

Increased bone turnover

88
Q

Triptan + Ergot can cause

A

Severe prolonged vasoconstriction resulting in elevated BP, MI, or stroke

89
Q

“Glare” while driving at night classic manifestation of

A

Cataracts

painless loss of vision that is worse at night

90
Q

Look for what in pt’s w/ splenectomy

A

Thrombocytosis b/c spleen removes old platelets from circulation

91
Q

5 Drugs that dec. mortality in LV dysfunction ***

A
  1. ACEi
  2. ARBs
  3. B-blockers
  4. Aldosterone antagonists
  5. Hydrazine + nitrates
92
Q

3 best B-blockers for CHF

A

Metoprolol succinate
Carvedilol
Bisoprolol

93
Q

Avoid what B-blockers in CHF? Why?

A

PIndolol and acebutolol

These have intrinsic sympathomimetic activity

94
Q

Carpal tunnel in pregnancy due to

A

Accumulation of fluid w/in the tunnel

95
Q

What causes carpal tunnel in RA

A

Tenosynovial inflammation

96
Q

How does Mag cause neuromuscular depression

A

Reducing act release at myoneural junction

97
Q

First line tocolytics that can cause pulmonary edema? how?

A

Terbutaline and ritodrine (B-agonists) due to inc HR causing dec. diastolic filing time combined with excess plasma volume in pregnant patients

98
Q

Why does SS not get infants

A

Protective effect of fetal hemoglobin

99
Q

Hypertriglyceridemia tx

A

Fenofibrate (fabric acid derivative)

100
Q

What is cholestyramine

A

Bile acid binding resin that can reduce LDL (but raise TG)

101
Q

Ezetimibe MOA

A

Prevents dietary absorption of cholesterol from gut

*LDL double dec when used w/ statin

102
Q

Drug to use w/ statin to reduce LDL a lot

A

Ezetimibe

103
Q

Most effective tx in slowing progression of diabetic nephropathy

A

Maintaining BP less than 130/80

104
Q

Sulfonylurea MOA

A

Acts on pancreas to increase endogenous insulin production

105
Q

COCs dec risk of what cancers

A

Ovarian and endometrial

106
Q

Confirmatory HIT test

A

ELISA Ab test

107
Q

Typical volume status in severe hypercalcemia

A

Typically volume depleted due to increased natriuresis

108
Q

Sudden onset of syncope w/out a prodrome most likely

A

Ventricular arrhythmia

109
Q

4 big risk factors for torsades

A
  1. Antiarrhythmic drugs
  2. Structural heart disease
  3. Hypokalemia
  4. Hypomagnesemia

World week 1 (17 decks)

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