5/13 Flashcards by Robby Skinner

Migraines in children

Often bifrontal and shorter in duration

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Recurrent pneumonias in the same anatomic region suggest

Bronchial obstruction due to an underlying abnormality (bronchogenic carcinoma most worrisome)

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RA + Nephrotic syndrome think what

Amyloidosis (AA amyloidosis)

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Next step in suspected achalasia after barium swallow

endoscopy to rule out malignancy (can mimic achalasia)

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What frequently follows umbilical stump infection in neonates

Neonatal tetanus (generally seen in infants born to unimmunized mothers)

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Measles vs Rubella

Fever higher in measles (up to 104)

Rash in measles is darker and spreads more gradually (reddish brown compared to pink)

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HIV pt’s w/ signs of inc ICP, HA, and low grade fever should be evaluated for

Cryptococcal meningitis

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Mech for esophageal dysmotility in SS

Atrophy and fibrosis of the smooth muscle in the lower esophagus

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What is eosinophils esophagitis

Heartburn that does not respond to standard medications for GERD
Manometry will show esophageal hyper contractility

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What can AVMs in the lung cause

Shunting of blood from right to left side of the heart, causing chronic hypoxemia and a reactive polycythemia

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Hep B a risk for what glomerular disease

Membranous nephropathy

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How do anticholinergic drugs cause urinary retention

Reducing detrusor contraction and preventing urethral sphincter relaxation

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What should be done after any central venous catheter is placed

CXR to confirm proper placement

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Who should get DM screening

All patients w/ sustained BP > 135/80

Maybs everyone over 45

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How does mesothelioma present

Unilateral pleural abnormality with a large pleural effusion on CXR

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Laps of VIPoma

Hypokalemia and achlorhydria

Hypercalcemia and hyperglycemia

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Why replace volume before intubating in those in hypovolemic shock

Positive pressure ventilation increases intrathoracic pressure, which decreases preload, which can cause circulatory collapse if volume isn’t fixed first

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MCC of bloody diarrhea in absence of fever

E. coli

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2 first steps in sever hypercalcemia

IV saline bolus and calcitonin

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Myasthenic crisis mgmt

Endotracheal intubation followed by treatment w/ plasmapheresis or IVIg and steroids

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Systemic manifestations of Fe poisoning

Abdominal pain
Hematemesis
Shock
Metabolic acidosis

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MCC of empyema

Bacterial seeding of a parapneumonic effusion in setting of bacterial pneumonia

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AE of hydroxychlorquine

Retinopathy

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What causes placental abruption

Bleeding into decidua-placenta interface after rupture of maternal decidual blood vessels

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US that is pathognomonic for placental abruption

Retroplacental hemorrhage on US

What is E corrodes

Gram neg anaerobe normally seen in oral flora

Hallmark of ischemic hepatopathy

Rapid and massive increase in transaminases w/ modest accompanying elevations in T bili and alk phos

Signs of hypernatremia

Mainly neurologic: lethargy, AMS, irritability, and seizures

Why never hypotonic solutions in hypernatremia

They quickly exit the intravascular system and lower the sodium too rapidly

Fever, chills and deep abdominal pain suggest

Retroperitoneal abscess

3 things on WPW EKG

1. Shortened PR interval 2. Delta waves 3. Widening of QRS

What is not elevated in acute pericarditis

aVR (reciprocal depression)

What is Dressler's syndrome

Pericarditis that occurs weeks after an MI, due to immunologic phenomena

Cyanide tox tx

Sodium thiosulfate

Primary vs 2nd hyper PTH labs

2nd wil have much higher PTH and low to normal serum Ca levels

What is erysipelas

Sudden onset of a sharply-demarcated erythematous tender skin lesion with raised borders + Fever Due to GAS

Diffusely narrow colon or "microcolon" on neonates Ab xray

Meconium ileus

Where is the obstruction in Hirschsprungs

Rectosigmoid colon

Finasteride MOA

5-alpha reductase inhibitor

What is sympathetic opthalmia

Damage to one eye after penetrating injury to the other, due to uncovering of hidden antigens

Mass outside of the testis that does not change with position

Spermatocele

What brain bleed site has eyes deviating towards hemhorrage

Thalamic

What stroke has deep coma and total paralysis w/in minutes

Pons | *look for pinpoint pupils*

Atraumatic hip pain + Lupus + Normal xray

Osteonecrosis -->get MRI

What is needed for bipolar II

Hypomanic episode(s) + at least one major depressive episode

Hairy cell leukemia tx

Cladribine

Why firm uterus in abruption

Blood may have a uterotonic effect, and will have usually low-amplitude frequent contractions

Down's test before 10 weeks gestation

Cell-free fetal DNA

Two downs tests that offer definitive karyotype diagnosis

Chorionic villus sampling and amniocentesis

Tx for scaphoid fracture

Wrist immobilization for 6-10 weeks | *If X-ray non-diagnostic, repeat x-ray in 7-10 days for CT*

Aspirin exacerbated respiratory disease triad

1. Asthma 2. Chronic rhinosinusitis w/ nasal polyps 3. Bronchospasm w/ asthma

3 things given to woman in labor at

1. Steroids 2. Tocolytics 3. Mag sulfate

Erythema nodosum in young AA women think? what else do you see

Sarcoidosis | Will also see cough, arthritis, uveitis, and hilar adenopathy

3 dietary recs for patients w/ renal calculi

1. Increased fluid intake 2. Decreased sodium intake 3. Normal dietary calcium intake

Wegner's Ab

c-ANCA

3 reasons for post-op cholestasis

1. Increased pigment load from transfusion 2. Decreased liver functionality 3. Dec bilirubin excretion

Retinal detachment symptoms

Sudden onset of photophobia and floaters and "curtain coming down over eyes"

Drug induced lupus drugs

Hydralazine Procainamide Isoniazid

Exudative effusion _ was is seen in complicated parapneumonic effusion

Pleural fluid (pH

Clubfoot management

Initially w/ stretching and manipulation of the foot, followed by serial plaster casts, malleable splints, or taping

3 extra hepatic manifestations of Hep C

1. Essential mixed cryoglobulinemia 2. Porphyria cutanea tarda 3. Membranoproliferazive glomerulonephritis

Baseline studies before starting lithium

1. BUN, Cr, Ca, UA 2. TFT 3. ECG in pt/s with coronary risk factors 4. UPT

Most common tumor in lynch besides clon

Endometrial

What is spondylolisthesis

Developmental disorder w/ forward slip of vertebra w/ back pain, neuro dysfunction, and palpable step off

Prolactin level needed to dx prolactinoma

>200

Most common site of HTN hemhorrages

Putamen

How does oropharyngeal dysphagia present

Difficulty initiating swallowing ass w/ coughing, chocking, aspiration, or nasal regurg

First step in workup of oropharyngeal dysphasia

Videoflouroscipic modified barium swallow study