5/16 Flashcards
Presentation of angiofibroma
Adolescent w/ nasal obstruction, visible nasal mass, and frequent nosebleeds
can erode local bone
Whipples dz characterized by
Arthralgia’s, weight loss, fever, diarrhea, and abdominal pain
Cutaneous larva migrans characterized by
Pruritic, elevated, serpiginous lesions on the skin
Often acquired through contact with sand
DS quad
Low AFP and estriol
Inc B-HCG and inhibit A
First test after abnormal quad
US to evaluate anatomy and measure growth
Only infant absolute contra to breastfeeding
Galactosemia
When is varicella infectio a contra to breastfeeding
TCA OD characterized by
CNS depression
Hypotension
Anticholinergic effects
How does the body compensate for chronic hypercapnia
Increasing renal bicarb retention (Like in COPD)
What is membranoproliferazive glomerulonephritis type 2 characterized by
Persistent activation of the alternative complement pathway
dense deposit disease
Anti-GB antibodies characteristic of
Goodpastures syndrome
What is Courvoisier’s sign
Non-tender but palpable gallbladder at the right costal margin in a jaundiced pt
for pancreatic Ca
What is D-xylose
Monosaccharide that is absorbed in the proximal Si w/out degradation by pancreatic or bush border enzymes
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
How can AS pt’s get restrictive lung dz
Due to diminished chest wall and spinal mobility
Electrolyte abnormalities most often observed in Cushing’s
Hypokalemia and hypernatremia
Hypo K b/c corticosteroids have some mineralocorticoid activity
Tx for febrile neutropenia
Empiric mono therapy w/ an anti-pseudomonad agent (Cefepime, meropenem, pip-taco)
Features of cervical sponydlosis
Chronic neck pain
Limited neck rotation
Sensory def (due to osteophyte induced radiculopathy)
3 predisposing features to cellulites
- Obesity
- Venous insufficiency
- Skin disruption
What can PDD (dysthymia) be thought of as
Chronic, low-grade depression that lasts for years
Main objective in mgmt of a rib fracture
Pain relief
What is sialadenosis
Benign non-inflammatory enlargement of the salivary glands seen in pt’s w/ advanced liver dz
What is scleroderma renal crisis
Acute onset of oliguric renal failure w/ malignant hypertension, thrombocytopenia, and microangiopathic hemolytic anemia
What are case control studies
Analytical observational studies that retrospectively associate outcomes with specific risk factors
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
- Cerebral aneurysms
- Hepatic and pancreatic cysts
- Cardiac valve disorders
- Diverticulosis
- 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
- Nitrofurantoin
- TMP-SMX
- 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
- Atovaquone-porguanil
- Doxy
- 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
