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World week 1 > 5/17 > Flashcards

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

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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

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3
Q

retropertineal hematoma presentation after cardiac cath

A

Sudden hemodynamic instability and ipsilateral flank or back pain

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4
Q

3 big drugs for interstitial nephritis

A

Penicillins, cephalosporins, and sulfonamides

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5
Q

1st line therapy for PMDD

A

SSRIs

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6
Q

Pregnancy excercise

A

> 30 min daily at low or moderate activity

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7
Q

Type I vs II RTA issue

A

Type 1: poor hydrogen secretion into urine

Type 2: Poor bicarb reabsorption

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8
Q

RTA tx

A

Oral bicarb replacement

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9
Q

3 big complications of orbital cellulitis

A
  1. Orbital abscess
  2. Intracranial infection
  3. Cavernous sinus venous thrombosis
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10
Q

What is Trypanosome cruzi

A

Protozoan

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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

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12
Q

What part of adrenal gland is pheo in

A

Adrenal medulla

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13
Q

3 big in Cushin’s

A

Hypertension
Hyperglycemia
Weight gain

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14
Q

Two first line tx for tine corporis

A

Topical clotrimazole or terbinafine

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15
Q

Topical nystatin for

A

Candidal skin infections

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16
Q

2 big things pt’s with nephrotic syndrome at increased risk for

A 
Atherosclerosis (hyperlipidemia)
AV thrombosis (loss of antithrombin III)
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17
Q

When to get vaccines for splenectomy

A

Either 2 weeks before or 2 weeks after

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18
Q

What is most commonly associated w/ splenic abscesses

A

Infective endocarditis

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19
Q

Guardia tx

A

Metronidazole

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20
Q

PE of methanol ingestion

A

Optic disc hyperemia

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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

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22
Q

Who gets FSGS

A

AA and Hispanics
Fat people
HIV and heroin

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23
Q

Who gets membranous nephropathy

A

Adenocarcinoma
NSAIDS
Hep B
SLE

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24
Q

Who gets membranoproliferazive glomerulonephritis

A

Hep B and C

Lipodystrophy

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25
Q

MCD associated w/ what cance

A

Lymphoma

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26
Q

Def of chronic bronchitis

A

3 consecutive months of productive cough in 2 successive years

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27
Q

What is essential in distinguishing dementia from normal changes of aging

A

Impairment of daily functioning

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28
Q

Why can folic acid make B12 def worse

A

B12 used in processes other than RBC making, so the folate uses whats left in making RBCs to correct anemia first

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29
Q

B-blocker OD presentation

A

Bradycardia and hypotension –> cardiogenic shock
Hypoglycemia
Wheezing (bronchospasm)

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30
Q

B-blocker OD tx

A

Glucagon (also good for CCB OD)

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31
Q

Big drugs that precipitates myasthenic crisis

A

Fluorquinolones
Amingoclycosides
B-blockers

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32
Q

What is spared in polymyositis

A

respiratory muscles

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33
Q

Most significant complication of IIH

A

Blindness

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34
Q

Why put the women in left lateral decubitus position for abrubtion

A

To displace the uterus off the aortocaval vessels and maximize cardiac output

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35
Q

Heat stroke vs Heat exhaustion

A

Stoke: thermoregulation failure w/ CNS dysfunction
Exhaustion: Due to inadequate fluid and salt replacement (T

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36
Q

Think what w/ sudden onset pleural effusion w/ exudate and blood

A

PE

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37
Q

Primary murmur of TOF

A

Harsh, systolic ejection murmur over left upper sternal border from pulmonary stenosis

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38
Q

What age for S aureus in CF

A 
Under 20 (highest around 10 years0
Older than that think pseudomonas
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39
Q

Xray of jejunal atresia?

Risk factors?

A

xray: Tripple bubble and gasless colon
Risks: prenatal exposure to cocaine and other vasoconstrictive drugs

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40
Q

First step if COPD exacerbation not getting better

A

Noninvasive positive pressure ventilation

41
Q

Persistent pneumothorax and air leak in pt w/ BAT following chest tube likely

A

Tracheobronchial rupture

42
Q

What does alveolar hypoventilation refer to

A

Uniform fall in inspired O2 in all regions of the lung (narcotic overdose, neuromuscular weakness)

43
Q

4 big causes of V/Q mismatch

A
  1. Obstructive lung dz
  2. Atelectasis
  3. Pulmonary edema
  4. Pneumonia
44
Q

Shunt that doesn’t correct w/ O2 besides cardiac

A

Extensive ARDs

45
Q

What should be done if fetal movement decreases

A

NST (also done in high risk pregnancies starting at 32-34 weeks)

46
Q

Reactive NST

A

At least 2 accelerations of 15 above baseline lasting 15 seconds each in 20 minutes

47
Q

Pt’s w/ positive RET mutation detected should get what

A

Total thyroidectomy

48
Q

Xray of rotator cuff tear may show what

A

Underlying calcific tendinitis

49
Q

2 big risks for untreated hyperthyroidism

A

Rapid bone loss from increased osteoclastic activity in bone cells and cardiac tachyarrhythmias

50
Q

“Blood and thunder” appearance on ophthalmoscope in what

A

Central retinal vein occlusion

51
Q

Pt’s w/ non-inflammatory chronic pancreatitis are what

A

Afebrile and have irritative voiding symptoms

52
Q

What alleviates pain in chronic pancreatitis

A

Sitting up or leaning forward

53
Q

COPD exacerbation ABG

A

Respiratory acidosis and hypoxia

54
Q

CHF exacerbation ABG

A

Hypocapnia and respiratory alkalosis

55
Q

Suspect what in patients w/ hemolytic anemia and thrombocytopenia

A

TTP

56
Q

Hypovolemic hypernatrema fluid flowchart

A

IV NS until euvolemic, then 5% dextrose in water, then free water

57
Q

Kleptomania tx

A

CBT

58
Q

Tx for UGIB

A

Supplemental O2
Bowel rest
IV fluids
IV PPI for acid suppression

59
Q

Vaccine exception for premies

A

weight should be > 2 kg (4.6) before first hepatitis B vaccine

60
Q

POV dx

A
  • Increased serum FSH and LH levels

- Decreased estrogen levels

61
Q

How can hypomagnesemia cause hypocalcemia

A

By inducing PTH resistance as well as decreasing PTH secretion
see in alcoholics

62
Q

Why does it take awhile for Ca to raise after treating low Mg

A

PTH levels increase rapidly but resistance persists despite improvement in mag levels

63
Q

What provides relief in epiglottidis

A

Keeping neck hyperextended

64
Q

Why are G6PD levels normal in acute episode

A

G6PD def RBCs are hemolyzed early and reticulocytes (normal G6PD levels) are abnormally high

65
Q

Two path features of C diff

A

Enterotoxin A: Watery diarrhea

Cytotoxin B: Colonic epithelial cell necrosis and fibrin deposition

66
Q

Attributable risk percent formula

A

(RR-1) / RR

67
Q

When surgery in pt’s w/ native valve infective endocarditis

A
  1. Significant valvular dysfunction
  2. Persistent/difficult to treat infection
  3. Recurrent embolism
68
Q

Why hyponatremia in Addisons

A

Volume contraction (mineralocoritocoid def) and increased vasopressin secretion (lack of cortisol suppression)

69
Q

Why pain relief in NO after MI

A

Dilation of veins and decrease in ventricular preload

70
Q

Worsening postprandial pain that leads to avoidance of food characteristic of

A

Chronic occlusion of visceral arteries

71
Q

Stepwise approach for treatment of ascites

A
  1. Na and H2O restriction
  2. Spironolactone
  3. Loop diuretic
  4. Frequent abdominal paracentesis (if renal function okay)
72
Q

What do peptic structures cause

A

Symmetric and circumferential narrowing of the involved esophagus w/ dysphagia for solids but no weight loss

73
Q

How can TMP-SMX cause hyperkalemia

A

Due to blockade of the epithelial Na channel in collecting tubule, also inhibits Cr secretion leading to falsely elevated level

74
Q

What Ab can cause QT prlongation

A

Macrolides (also cholestasis)

75
Q

How can long term analgesics cause CKD

A

Tubulointerstitial nephritis and hematuria due to papillary necrosis

76
Q

Mammogram ages

A

50-75

77
Q

What is elevated in intrahepatic cholestasis of pregnancy

A

Bile acids and LFTs

will have intense pruritus - esp on palms and soles

78
Q

What should you not do in congenital diaphragmatic hernia

A

bag and mask (intubate instead and place ng tube)

79
Q

How can CDH cause polyhydramnios

A

Result of esophageal compression

80
Q

Who gets worse Babesiosis dz

A

Those over 40
Those without a spleen
Immunocompromised

81
Q

Babesiosis tx

A

Quinine-linda

or Atovaquone-azithro

82
Q

What is phyllodes tumor

A

Rare breast mass that presents as a unilateral, smooth painless and mobile firm breast mass (large fibroadenoma)

83
Q

What can help distinguish peritonsillar abscess from epiglottitis

A

Deviation of the uvula and unilateral lymphadenopathy

84
Q

Fetal hydantoin syndrome

A

Small body size
Microcephaly
Digital and nail hypoplasia
Cleft palate and rib abnormalities

85
Q

5 big features of billiard atresia

A
  1. Jaundice
  2. Echoic stools or dark urine
  3. Hepatomegaly
  4. Inc direct bili
  5. Mild LFT elevation
86
Q

MC congenital heart defect in down’s PTs

A

Complete AV septal defect

87
Q

In B12 and folate def, what does replacing only folic acid do

A

Corrects megaloblasosis but leads to rapid progression of neurologic symptoms

88
Q

Gallbladder imaging of pancreatic Ca

A

Intra and extra hepatic biliary tract dilation

89
Q

CNs in the cavernous sinus

A

III, IV, V and VI

90
Q

Eye manifestation of SS

A

Keratoconjunctivis sick (dry eyes, irritation, and photosensitivity)

91
Q

Chronic epigastric pain that suddenly worsens and becomes diffuse w/ pneuomperitoneum concerning for

A

Likely perforated PUD

92
Q

Cholestasis and biliar dilation

A

Dilated: extra hepatic

Not dilated: intrahepatic

93
Q

Stains for ALL

A

PAS (in lymphoblasts)

TdT

94
Q

Polymyositis dx

A

Muscle biopsy

95
Q

What causes MVP

A

Myxomatous degeneration the mitral valve leaflets

96
Q

Change after hyper filtration in DM II nephropathy

A

Thickening of the glomerular basement membrane

97
Q

Osteomalacia vs Osteoporosis

A

Osteomalacia will have bone pain and muscle weakness

Xray will show decreased bone density with thinning of cortex and pseudo fractures

98
Q

“Steppage gait” MCC

A

L5 radiculopathy or neuropathy of the common peroneal nerve

World week 1 (17 decks)

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