5/15 Flashcards
Test for acromegaly after IGF-1
GH measurement after oral glucose load (if pos will se paradoxical increase in GH levels)
Further eval of unstable pt’s after BAT w/ negative DPL should look for what
Possible pelvic fracture w/ retroperitoneal hemorrhage
When does selective survival bias occur
In case control studies when cases are selected from the entire disease population instead of just those that are newly diagnosed
3 agents that shift K intracellularly
- Insulin and glucose
- Sodium bicarb
- Beta-2 agonists
MC pediatric tumor
Benign astrocytomas (for both infra and supratentorial)
Development of AV blok in a patient with infective endocarditis should raise suspicion for what
Pervivalvular abscess extending into the adjacent cardiac conduction tissues
Typical presenting symptom of a choleseatoma
New onset hearing loss or chronic ear drainage despite therapy
Otoscope of cholesteatoma
Granulation tissue and skin debris within retraction pockets of TM
DiGeorge CATCH
Conotruncal cardiac defects Abnormal facies Thyimic aplasia Cleft Palate Hypocalcemia
Two tests for when Digeorge is suspected
Serum calcium levels and echocardiography
Complication of Mono
Autoimmune hemolytic anemia and thrombocytopenia due to cross reactivity of EBV induced Ab against RBCs and platelets
Legionella PNA tx
Quinolone or macrolide
Murmur heard after aortic dissection
Aortic regurg - early diastolic crescendo/decrescendo
C. diff risk drugs besides Ab
PPIs and H2 blockers
Anti HbE seen in what phase of Hep B
Recovery phase
Extra pulmonary sarcoid big 3
Arthritis
Uveitis
Erythema Nodosum
What is elevated in alcoholic hepatitis besides AST/ALT
GGT and ferritin (ferritin is an acute phase reactant)
Benign murmur features
Grade I or II, early or mid systolic, and decreases with standing
Suspect what in a young female w/ bilateral TN
MS
Anticoagulation good for pt’s w/ renal dz
Unfractionated heparin (reduced renal clearances makes direct Xa inhibitors stronger) then warfarin
Dendritic ulcer in eye
Herpex simplex keratitis
Why no try to convert breech presentation prior to 37 weeks
Majority self correct by then
Ovarian tumor that can produce estrogen
Granulosa cell tumors
What is Leriche syndrome
Arterial occlusion at the bifurcation of the aorta into the common iliac arteries
impotence almost always present
Best test for virilizing neoplasm? interpretation?
Serum testosterone and DHEAS levels
Inc T w/ normal —–DHEAS indicate ovarian source
-Inc. DHEAS w/ normal T indicates adrenal source
4 big complications in DES daughters
- Clear cell adenocarcinoma of vagina and cervix
- Structural anomalies of repro tract
- Pregnancy problems
- Infertility
Why is right sided ovarian torsion more common than left
Longer length or uretero-ovarian ligament and left rectosigmoid colon occupies the space around the left ovary
What should be suspected in pt’s who have combo of hemolytic anemia, cytopenias, and hyper coagulable state
Paroxysmal nocturnal hemoglobinuria
2 GI complications of HSP
GI hemorrhage or intussusception (small bowel or ileo-ileo)
Adult women w/ rubella get what
Arthritis than can last up to a month after resolution of other symptoms
Why steatorrhea in ZE syndrome
Inactivation of pancreatic enzymes
SAIDH tx
Fluid restriction ( hypertonic saline for severe symptomatic or resistant hyponatremia)
Acid base status in Fe overdose
Anion gap metabolic acidosis
WAS gene defect
X-linked recessive WAS (impaired cytoskeleton changes in leukocytes and platelets)
Hallmark brain damage of prolonged seizures
Cortical laminar necrosis
MCC when brain abscess results from sinusits
S viridians
3 causes of ARDs
- Impaired gas exchange
- Decreased lung compliance (stiff lungs)
- Increased pulmonary arterial pressure (pulmonary HTN)
All pt’s w/ hx of rheumatic fever should be on what
Penicillin ppx until 21 years old
Tx for toxo
Sulfadiazine and pyrimethamine (TMP-SMX is for ppx)
What causes cirrhotic ascites
Increased hydrostatic pressure within hepatic capillary beds
Depressed phase of bipolar drug
2nd gen antipsychotics
Why oligohydramnios in late term
Aging placenta may have decreased fetal perfusion, resulting in decreased renal perfusion and decreased urinary output from the fetus
MCC predisposing factor for acute bacterial sinusitis
Viral URI
How does perianal or genital trauma cause priapism
Laceration of the cavernous artery
How to reduce febrile non hemolytic transfusion reaction
Leukoreduced
Thing things washing RBCs before transfusion prevents
- IgA def pt’s
- Complement def- autoimmune hemolytic anemia
- Continued allergic reactions despite antihistamine tx
2 important diagnostic factors for Waldenstroms
- IgM spike on electrophoresis
2. Hyperviscosity
Labs of 2nd hyper-PTH
Dec vit D leads to hypocalcemia, hyperphsophatemia, and compensatory rise in PTH
Labs of abnormal hemostasis in CKD? tx?
Bleeding time is prolonged, but PT, PTT and platelet count are normal
Tx is DDAVP
How was trachoma present
Follicular conjunctivitis and panes (neovascularization) formation in the cornea
What is ramsay hunt syndrome
Form of herpes zoster infection that causes Bell’s palsy (will see vesicles on the outer ear)
How does skin SCC cause numbness
Early perineurial invasion
Two biggest non-pharm ways to lower BP
Weight loss and DASH diet
Weakness after high steroid tx think
Hypokalemia (from B2 agonists driving K into cells)
Actinomyces vs Nocardia
Nocardia weakly acid fast, acintomyces not
