5/13 Flashcards
Migraines in children
Often bifrontal and shorter in duration
Recurrent pneumonias in the same anatomic region suggest
Bronchial obstruction due to an underlying abnormality (bronchogenic carcinoma most worrisome)
RA + Nephrotic syndrome think what
Amyloidosis (AA amyloidosis)
Next step in suspected achalasia after barium swallow
endoscopy to rule out malignancy (can mimic achalasia)
What frequently follows umbilical stump infection in neonates
Neonatal tetanus (generally seen in infants born to unimmunized mothers)
Measles vs Rubella
Fever higher in measles (up to 104)
Rash in measles is darker and spreads more gradually (reddish brown compared to pink)
HIV pt’s w/ signs of inc ICP, HA, and low grade fever should be evaluated for
Cryptococcal meningitis
Mech for esophageal dysmotility in SS
Atrophy and fibrosis of the smooth muscle in the lower esophagus
What is eosinophils esophagitis
Heartburn that does not respond to standard medications for GERD
Manometry will show esophageal hyper contractility
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
Hep B a risk for what glomerular disease
Membranous nephropathy
How do anticholinergic drugs cause urinary retention
Reducing detrusor contraction and preventing urethral sphincter relaxation
What should be done after any central venous catheter is placed
CXR to confirm proper placement
Who should get DM screening
All patients w/ sustained BP > 135/80
Maybs everyone over 45
How does mesothelioma present
Unilateral pleural abnormality with a large pleural effusion on CXR
Laps of VIPoma
Hypokalemia and achlorhydria
Hypercalcemia and hyperglycemia
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
MCC of bloody diarrhea in absence of fever
E. coli
2 first steps in sever hypercalcemia
IV saline bolus and calcitonin
Myasthenic crisis mgmt
Endotracheal intubation followed by treatment w/ plasmapheresis or IVIg and steroids
Systemic manifestations of Fe poisoning
Abdominal pain
Hematemesis
Shock
Metabolic acidosis
MCC of empyema
Bacterial seeding of a parapneumonic effusion in setting of bacterial pneumonia
AE of hydroxychlorquine
Retinopathy
What causes placental abruption
Bleeding into decidua-placenta interface after rupture of maternal decidual blood vessels
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
- Shortened PR interval
- Delta waves
- 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
- Asthma
- Chronic rhinosinusitis w/ nasal polyps
- Bronchospasm w/ asthma
3 things given to woman in labor at
- Steroids
- Tocolytics
- 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
- Increased fluid intake
- Decreased sodium intake
- Normal dietary calcium intake
Wegner’s Ab
c-ANCA
3 reasons for post-op cholestasis
- Increased pigment load from transfusion
- Decreased liver functionality
- 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
- Essential mixed cryoglobulinemia
- Porphyria cutanea tarda
- Membranoproliferazive glomerulonephritis
Baseline studies before starting lithium
- BUN, Cr, Ca, UA
- TFT
- ECG in pt/s with coronary risk factors
- 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
