5/17 Flashcards
1
Q
What is dumping syndrome? Who gets it?
A
Posgastrectomy patients get poops and farts as well as palpitations and sweating after eating
2
Q
What causes dumping syndrome
A
Rapid emptying of hypertonic gastric contents into duodenum and small intestine, causing fluid shifts stimulating vasoactive peptides and autonomics
3
Q
retropertineal hematoma presentation after cardiac cath
A
Sudden hemodynamic instability and ipsilateral flank or back pain
4
Q
3 big drugs for interstitial nephritis
A
Penicillins, cephalosporins, and sulfonamides
5
Q
1st line therapy for PMDD
A
SSRIs
6
Q
Pregnancy excercise
A
> 30 min daily at low or moderate activity
7
Q
Type I vs II RTA issue
A
Type 1: poor hydrogen secretion into urine
Type 2: Poor bicarb reabsorption
8
Q
RTA tx
A
Oral bicarb replacement
9
Q
3 big complications of orbital cellulitis
A
- Orbital abscess
- Intracranial infection
- Cavernous sinus venous thrombosis
10
Q
What is Trypanosome cruzi
A
Protozoan
11
Q
Laryngomalacia vs Vascular ring
A
LM: Worsens in supine and improves in prone (4-8 months)
VR: Improves w/ neck extension, ass w/ cardiac abnormalities
12
Q
What part of adrenal gland is pheo in
A
Adrenal medulla
13
Q
3 big in Cushin’s
A
Hypertension
Hyperglycemia
Weight gain
14
Q
Two first line tx for tine corporis
A
Topical clotrimazole or terbinafine
15
Q
Topical nystatin for
A
Candidal skin infections
16
Q
2 big things pt’s with nephrotic syndrome at increased risk for
A
Atherosclerosis (hyperlipidemia) AV thrombosis (loss of antithrombin III)
17
Q
When to get vaccines for splenectomy
A
Either 2 weeks before or 2 weeks after
18
Q
What is most commonly associated w/ splenic abscesses
A
Infective endocarditis
19
Q
Guardia tx
A
Metronidazole
20
Q
PE of methanol ingestion
A
Optic disc hyperemia
21
Q
Most 1st degré AV blocks w/ normal QRS occur due to
A
Conduction delay in the AV node and need no further eval
22
Q
Who gets FSGS
A
AA and Hispanics
Fat people
HIV and heroin
23
Q
Who gets membranous nephropathy
A
Adenocarcinoma
NSAIDS
Hep B
SLE
24
Q
Who gets membranoproliferazive glomerulonephritis
A
Hep B and C
Lipodystrophy
25
MCD associated w/ what cance
Lymphoma
26
Def of chronic bronchitis
3 consecutive months of productive cough in 2 successive years
27
What is essential in distinguishing dementia from normal changes of aging
Impairment of daily functioning
28
Why can folic acid make B12 def worse
B12 used in processes other than RBC making, so the folate uses whats left in making RBCs to correct anemia first
29
B-blocker OD presentation
Bradycardia and hypotension --> cardiogenic shock
Hypoglycemia
Wheezing (bronchospasm)
30
B-blocker OD tx
Glucagon (also good for CCB OD)
31
Big drugs that precipitates myasthenic crisis
Fluorquinolones
Amingoclycosides
B-blockers
32
What is spared in polymyositis
respiratory muscles
33
Most significant complication of IIH
Blindness
34
Why put the women in left lateral decubitus position for abrubtion
To displace the uterus off the aortocaval vessels and maximize cardiac output
35
Heat stroke vs Heat exhaustion
Stoke: thermoregulation failure w/ CNS dysfunction
Exhaustion: Due to inadequate fluid and salt replacement (T
36
Think what w/ sudden onset pleural effusion w/ exudate and blood
PE
37
Primary murmur of TOF
Harsh, systolic ejection murmur over left upper sternal border from pulmonary stenosis
38
What age for S aureus in CF
```
Under 20 (highest around 10 years0
Older than that think pseudomonas
```
39
Xray of jejunal atresia?
| Risk factors?
xray: Tripple bubble and gasless colon
Risks: prenatal exposure to cocaine and other vasoconstrictive drugs
40
First step if COPD exacerbation not getting better
Noninvasive positive pressure ventilation
41
Persistent pneumothorax and air leak in pt w/ BAT following chest tube likely
Tracheobronchial rupture
42
What does alveolar hypoventilation refer to
Uniform fall in inspired O2 in all regions of the lung (narcotic overdose, neuromuscular weakness)
43
4 big causes of V/Q mismatch
1. Obstructive lung dz
2. Atelectasis
3. Pulmonary edema
4. Pneumonia
44
Shunt that doesn't correct w/ O2 besides cardiac
Extensive ARDs
45
What should be done if fetal movement decreases
NST (also done in high risk pregnancies starting at 32-34 weeks)
46
Reactive NST
At least 2 accelerations of 15 above baseline lasting 15 seconds each in 20 minutes
47
Pt's w/ positive RET mutation detected should get what
Total thyroidectomy
48
Xray of rotator cuff tear may show what
Underlying calcific tendinitis
49
2 big risks for untreated hyperthyroidism
Rapid bone loss from increased osteoclastic activity in bone cells and cardiac tachyarrhythmias
50
"Blood and thunder" appearance on ophthalmoscope in what
Central retinal vein occlusion
51
Pt's w/ non-inflammatory chronic pancreatitis are what
Afebrile and have irritative voiding symptoms
52
What alleviates pain in chronic pancreatitis
Sitting up or leaning forward
53
COPD exacerbation ABG
Respiratory acidosis and hypoxia
54
CHF exacerbation ABG
Hypocapnia and respiratory alkalosis
55
Suspect what in patients w/ hemolytic anemia and thrombocytopenia
TTP
56
Hypovolemic hypernatrema fluid flowchart
IV NS until euvolemic, then 5% dextrose in water, then free water
57
Kleptomania tx
CBT
58
Tx for UGIB
Supplemental O2
Bowel rest
IV fluids
IV PPI for acid suppression
59
Vaccine exception for premies
weight should be > 2 kg (4.6) before first hepatitis B vaccine
60
POV dx
- Increased serum FSH and LH levels
| - Decreased estrogen levels
61
How can hypomagnesemia cause hypocalcemia
By inducing PTH resistance as well as decreasing PTH secretion
*see in alcoholics*
62
Why does it take awhile for Ca to raise after treating low Mg
PTH levels increase rapidly but resistance persists despite improvement in mag levels
63
What provides relief in epiglottidis
Keeping neck hyperextended
64
Why are G6PD levels normal in acute episode
G6PD def RBCs are hemolyzed early and reticulocytes (normal G6PD levels) are abnormally high
65
Two path features of C diff
Enterotoxin A: Watery diarrhea
| Cytotoxin B: Colonic epithelial cell necrosis and fibrin deposition
66
Attributable risk percent formula
(RR-1) / RR
67
When surgery in pt's w/ native valve infective endocarditis
1. Significant valvular dysfunction
2. Persistent/difficult to treat infection
3. Recurrent embolism
68
Why hyponatremia in Addisons
Volume contraction (mineralocoritocoid def) and increased vasopressin secretion (lack of cortisol suppression)
69
Why pain relief in NO after MI
Dilation of veins and decrease in ventricular preload
70
Worsening postprandial pain that leads to avoidance of food characteristic of
Chronic occlusion of visceral arteries
71
Stepwise approach for treatment of ascites
1. Na and H2O restriction
2. Spironolactone
3. Loop diuretic
4. Frequent abdominal paracentesis (if renal function okay)
72
What do peptic structures cause
Symmetric and circumferential narrowing of the involved esophagus w/ dysphagia for solids but no weight loss
73
How can TMP-SMX cause hyperkalemia
Due to blockade of the epithelial Na channel in collecting tubule, also inhibits Cr secretion leading to falsely elevated level
74
What Ab can cause QT prlongation
Macrolides (also cholestasis)
75
How can long term analgesics cause CKD
Tubulointerstitial nephritis and hematuria due to papillary necrosis
76
Mammogram ages
50-75
77
What is elevated in intrahepatic cholestasis of pregnancy
Bile acids and LFTs
| *will have intense pruritus - esp on palms and soles*
78
What should you not do in congenital diaphragmatic hernia
bag and mask (intubate instead and place ng tube)
79
How can CDH cause polyhydramnios
Result of esophageal compression
80
Who gets worse Babesiosis dz
Those over 40
Those without a spleen
Immunocompromised
81
Babesiosis tx
Quinine-linda
| or Atovaquone-azithro
82
What is phyllodes tumor
Rare breast mass that presents as a unilateral, smooth painless and mobile firm breast mass (large fibroadenoma)
83
What can help distinguish peritonsillar abscess from epiglottitis
Deviation of the uvula and unilateral lymphadenopathy
84
Fetal hydantoin syndrome
Small body size
Microcephaly
Digital and nail hypoplasia
Cleft palate and rib abnormalities
85
5 big features of billiard atresia
1. Jaundice
2. Echoic stools or dark urine
3. Hepatomegaly
4. Inc direct bili
5. Mild LFT elevation
86
MC congenital heart defect in down's PTs
Complete AV septal defect
87
In B12 and folate def, what does replacing only folic acid do
Corrects megaloblasosis but leads to rapid progression of neurologic symptoms
88
Gallbladder imaging of pancreatic Ca
Intra and extra hepatic biliary tract dilation
89
CNs in the cavernous sinus
III, IV, V and VI
90
Eye manifestation of SS
Keratoconjunctivis sick (dry eyes, irritation, and photosensitivity)
91
Chronic epigastric pain that suddenly worsens and becomes diffuse w/ pneuomperitoneum concerning for
Likely perforated PUD
92
Cholestasis and biliar dilation
Dilated: extra hepatic
| Not dilated: intrahepatic
93
Stains for ALL
PAS (in lymphoblasts)
| TdT
94
Polymyositis dx
Muscle biopsy
95
What causes MVP
Myxomatous degeneration the mitral valve leaflets
96
Change after hyper filtration in DM II nephropathy
Thickening of the glomerular basement membrane
97
Osteomalacia vs Osteoporosis
Osteomalacia will have bone pain and muscle weakness
| Xray will show decreased bone density with thinning of cortex and pseudo fractures
98
"Steppage gait" MCC
L5 radiculopathy or neuropathy of the common peroneal nerve
