5/16 Flashcards by Robby Skinner

Presentation of angiofibroma

Adolescent w/ nasal obstruction, visible nasal mass, and frequent nosebleeds
can erode local bone

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Whipples dz characterized by

Arthralgia’s, weight loss, fever, diarrhea, and abdominal pain

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Cutaneous larva migrans characterized by

Pruritic, elevated, serpiginous lesions on the skin

Often acquired through contact with sand

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DS quad

Low AFP and estriol

Inc B-HCG and inhibit A

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First test after abnormal quad

US to evaluate anatomy and measure growth

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Only infant absolute contra to breastfeeding

Galactosemia

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When is varicella infectio a contra to breastfeeding

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TCA OD characterized by

CNS depression
Hypotension
Anticholinergic effects

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How does the body compensate for chronic hypercapnia

Increasing renal bicarb retention (Like in COPD)

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What is membranoproliferazive glomerulonephritis type 2 characterized by

Persistent activation of the alternative complement pathway

dense deposit disease

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Anti-GB antibodies characteristic of

Goodpastures syndrome

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What is Courvoisier’s sign

Non-tender but palpable gallbladder at the right costal margin in a jaundiced pt
for pancreatic Ca

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What is D-xylose

Monosaccharide that is absorbed in the proximal Si w/out degradation by pancreatic or bush border enzymes

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Who has D-xylose absorption impairment? normal?

Small intestinal mucosal disease with have impaired

Patient’s with malabsorption due to enzyme def will have normal

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How can AS pt’s get restrictive lung dz

Due to diminished chest wall and spinal mobility

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Electrolyte abnormalities most often observed in Cushing’s

Hypokalemia and hypernatremia

Hypo K b/c corticosteroids have some mineralocorticoid activity

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Tx for febrile neutropenia

Empiric mono therapy w/ an anti-pseudomonad agent (Cefepime, meropenem, pip-taco)

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Features of cervical sponydlosis

Chronic neck pain
Limited neck rotation
Sensory def (due to osteophyte induced radiculopathy)

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3 predisposing features to cellulites

Obesity
Venous insufficiency
Skin disruption

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What can PDD (dysthymia) be thought of as

Chronic, low-grade depression that lasts for years

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Main objective in mgmt of a rib fracture

Pain relief

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What is sialadenosis

Benign non-inflammatory enlargement of the salivary glands seen in pt’s w/ advanced liver dz

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What is scleroderma renal crisis

Acute onset of oliguric renal failure w/ malignant hypertension, thrombocytopenia, and microangiopathic hemolytic anemia

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What are case control studies

Analytical observational studies that retrospectively associate outcomes with specific risk factors

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Case control vs Retrospective cohort

CC: Determine outcome and then look for associated risk factors RCS: Ascertain risk factor exposure and then determine the outcome

Mainstay of COPD therapy

Inhaled anticholinergics (ipratropium and tiotropium)

Baby w/ fair eyes and hair, developmental delay, and CVA

Homocystinuria | *also can have marfinoid habitus*

Dx of homcysteinuria based on? tx?

Elevated homocysteine and methionine levels | Tx: Vit B6, folate, and B12 to lower homocystiene levels

Best means of measure respiratory function in GB

Serial measurements of FVC (spirometry) | *Peak flow can be used if spirometry unavailable*

Extra-renal feature of ADPKD

1. Cerebral aneurysms 2. Hepatic and pancreatic cysts 3. Cardiac valve disorders 4. Diverticulosis 5. Ventral and inguinal hernias

What causes vasospasm post SAH coiling

Arterial narrowing at the base of the brain due to degradation of blood and its metabolites

Cysteine stone shape? tx?

Hexagonal crystals | Urinary cyanide nitroprusside test can detect elevated cysteine levels

What is parinaud syndrome

Pressure on the pretectal region of the midbrain and CN II pressure causing limitation of upward gaze and bilateral eyelid retraction

What causes parinaud syndrom

Pineal gland mass

Think what in pt w/ severe HTN and recurrent flash pulmonary edema

Renovascular HTN

Increased 24 hour urinary free coristol excretion seen in

Cushings syndrome

Strange things seen in ACA occlusion

Dyspraxia, emotional disturbances, urinary incontinence, abulia (lack of will or initiative)

Imaging for head vs tail of pancreas Ca

Head: US (jaundice) Tail: CT (No jaundice)

Osteoid osteoma feature

Pain typically relieved w/ NSIDs

Osteoid osteoma Xray

Small, round lucency w/ sclerotic margins and sometimes central ossification

Drug for ppx and tx of Amyloid AA

Colchicine

All pt's w/ ITP should be tested for

HIV and Hep C virus

What is "clasp knife" phenomenon

Velocity dependent resistance to passive movement of the limb seen in pt's w/ hypertonia due to pyramidal tract dz

MCC of ductopenia or "vanishing duct syndrome"

Primary biliary cirrhosis

MC AE of Tamoxifen

Hot flashes

Pulmonary contusion CXR

Patchy irregular alveolar infiltrates

3 first line drugs for uncomplicated UTI

1. Nitrofurantoin 2. TMP-SMX 3. Fosftomycin * Quinolones for complicated*

Massive PE does what to heart

Inc. RV pressure, causing right ventricular hypokinesis and dilation, decreased preload, and hypotension

Test to run when pt has recurrent bacterial infections (adult)

Serum IgG levels to look for humoral immunity defect

Nonallergic rhinitis featurs

One of the chronic rhinitis symptoms without a specific etiology Use intranasal antihistamine + glucocorticoids

Suspect what in palpable purpura + proteinuria and hematuria

Mixed cryoglobulinemia

MCC of viral conjunctivitis

Adenovirus

Think what w/ recurrent sinopulmonary and GI infections after 6 months of age? what will be on PE?

X-linke agammablobulinemia | PE: Absence of lymphoid tissue on examination

Bronchial breath sounds feature

Louder and have a more prominent expiratory component (seen in consolidation)

What differentiates lupus flare from pre-eclampsia

Overt RBCs in urine in addition to protein

Dermatitis of pellagra

Rough hyper pigmented scaly skin over sun-exposed areas

Two things elevated in anorexia

Cholesterol and carotene levels

Risks for pregnant women w/ hx of anorexia

``` Miscarriage IUGR Hyperemeis gravidarum Premature birth C-section PPD ```

Giant cell tumor of bone xray

"Soap bubble" - expansile and eccentrically placed lytic area in the epiphysis

Serum iron and ferritin in thalassemia

Normal to high serum Fe and ferritin level

What type of therapy identifies and challenges maladaptive thoughts

CBT (to change emotions and behaviors)

What does psychodynamic psyschotheraphy do

- Explores past relationships and conflicts - Utilizes transference - Breaks down defense mechs

What does interpersonal psychotherapy do

Targets social and interpersonal context of the patients illness, focusing on the "here and now" to deal with fried and such

What does CBT focus on

Reducing automatic negative thoughts and avoidance behaviors that cause distress

3 clorquine resistant malarial drugs

1. Atovaquone-porguanil 2. Doxy 3. Mefloquine (use in pregnancy)

CMV esophagus features

Large linear ulcerations and presence of intranuclear and intracytoplasmic inclusions on biopsy Tx: Ganciclovir

How is PKU tested in newborn screen

Tandem mass spectrometry