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World week 1 > 5/2 > Flashcards

5/2 Flashcards

1
Q

Adjustment disorder timing

A

Within 3 months of stressor

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2
Q

Rubin-Johnson high level of what

A

High levels of coproporphyrin I

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3
Q

Atelectasis blood gas

A

Hypoxemia
Hypocapnia
Respiratory alkalosis

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4
Q

Adenomyosis def

A

Presence of endometrial glands in uterine muscle

boggy and symmetrically enlarged

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5
Q

Earliest vaso-occlusive manifestation in SS

A

Dactylitis

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6
Q

B-HCG level to see intrauterine pregnancy

A

1,500-2000

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7
Q

Uremic pericarditis features? tx?

A
  • When BUN >60
  • EKG won’t look like other causes due to lack of inflammation
  • Tx is dialysis
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8
Q

What causes anemia of pre-maturity? labs?

A

Diminished Epo levels, shortened RBC life span, and blood loss
-Labs will show decreased hgb and hct w/ relatively low retic count

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9
Q

Small HPV lesions tx

A

Trichloroacetic act or podophyllin

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10
Q

Best frostbite tx

A

Rapid re-warming with warm water

don’t debride tissue initially

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11
Q

MCC of gross lower GI bleeding in adults

A

Diverticulosis

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12
Q

Diverticulosis vs Angiodysplasia

A

Diverticulosis: high volume arterial bleeding, more common
Angiodysplasia: low volume venous bleeding

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13
Q

DMD gen location

A

Deletion of dystrophin gene on Xp21

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14
Q

Craniopharyngioma path

A

Nests of squamous cells in a loose stroma (looks like embryonic tooth bud enamel)

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15
Q

Think what with proximal muscle weakness + inc ESR and CK

A

Polymyositis or dermatomyositis

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16
Q

Fibromyalgia physical exam

A

Point muscle tenderness in mid trapezius, lateral epicondyle, chostochondral junction in chest, and greater trochanter

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17
Q

HSV encephalitis dx

A

Viral DNA PCR in the CSF

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18
Q

Colonoscopy schedule in UC

A
  • Begin 8 years post diagnosis (12-25 if dz only in left colon)
  • Colonoscopy with biopsy every 1-2 years
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19
Q

FAP colonoscopy schedule

A

Begin at age 10-12

Colonoscopy every year

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20
Q

LAD features

A

Delayed umbilical chord separation, recurrent skin and mucosal bacterial infections (w/ purulence) and server PERIODONTAL dz

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21
Q

GD features

A
  • Infections from catalase pos organisms (S. aureus, serratia, burkholderia)
  • Neg nitroblue tetrazolium test
  • NO neutrophillia
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22
Q

Dermatitis herpetiformis treatment

A

Dapsone and gluten-free diet

will see on extensor surfaces

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23
Q

CMV vs Cryptosporidium diarrhea in AIDS pts

A

Crypto: Severe watery diarrhea
CMV: Frequent, small volume w/ hematocheiza and abdominal pain

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24
Q

Key feature of MAC diarrhea in AIDS pt

A

High Fever (> 39 C or 102.2 F)

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25
Q

Diffuse axonal injury CT scan

A

Numerous minute punctate hemorrhages with blurring of grey-white interface

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26
Q

PD tremor frequency

A

4-6 Hz (look for asymmetry and associated rigidity)

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27
Q

Drug for young PD with mainly tremor

A

Trihexyphenidyl (anticholinergic)

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28
Q

What is Lamivudine

A

Reverse transcriptase inhibitor used to treat HIV and Chronic Hep B

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29
Q

what is a pericardial knock

A

Mid-diastolic sound

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30
Q

Patients > 35 with gross hematuria workup

A

CT urogram and cystoscopy

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31
Q

PNA risk assessment for out vs inpt

A 
Confusion
Uremia (BUN > 20)
RR-Tachypnea (> 30)
BP - Hypotension
65 (age >)
*CURB 65* (>2 do inpatient)
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32
Q

MCC of CAP

A

S. pneumo, Heamophilus, and atypicals

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33
Q

CAP input current guidlines

A

Inpt: Fluoroquinolone or Beta-lactam + macrolide

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34
Q

3 reasons for kidney stone with neg scan

A
  1. radiolucent stone (uric acid, xanthine)

2. Calcium stones

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35
Q

Tx of uric acid stones

A

Hydration
Alkalization of the urine (potassium citrate-also reduces crystallization)
Low purine diet

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36
Q

Drug for recurrent hypercalciruic renal stones

A

HCTZ - decreases urinary calcium excretion

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37
Q

What is Trastuzumab? What should be done before starting therapy

A

mAb for HER2

Do echo before starting

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38
Q

Electrical alternans EKG

A

Varying amplitude of the QRS complexes

this w/ sinus tach –> probs pericardial effusion

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39
Q

Thyroglobulin level in dx’ing hyperthyroid

A

Will be high in endogenous hyperthyroidism and low w/ exogenous use

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40
Q

How long to do cholecystectomy during acute cholecystitis

A

Within 72 hours

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41
Q

Pagets lab’s

A

Increase in alk phos and normal serum Ca and PO4 levels

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42
Q

Long term panic disorder tx

A

SSRI/SNRI and/or CBT

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43
Q

Displacement vs Projection

A

Displacement: transferring feelings to amore acceptible object
Projection: Attributing one’s own feelings to others

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44
Q

What is sublimation

A

Channeling impulses into socially acceptable behaviors

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45
Q

Common causes of neonatal polycythemia

A

Delayed clamping of umbilical chord, in-utero hypoxia (maternal HTN), poor placental gas exchange (maternal DM)

46
Q

Neonatal polycythemia tx

A

Hydration for asymptomatic

Symptomatic need partial transaction of blood for NS

47
Q

Symptomatic neonatal polycythemia features

A

respiratory distress, hypoglycemia, and neurologic manifestations

48
Q

When to give Rhogam

A

28 weeks gestation and w/in 72 hours of delivery

49
Q

What is the Kleihauer-Betke test

A

For Rho-gam dose needed - adult hgb spread on slide and exposed to acidic solution, and adult hemoglobin lyses

50
Q

Lung consolidation PE findings

A

Bronchial breath sounds, dullness to percussion, increased fremitus
bronchial breath sounds have full expiratory phase

51
Q

Pleural effusion PE findings

A

Fluid blocks sound transmission from the air-filled lungs –> decreasing errythang

52
Q

Best test to dx intusseception

A

US

53
Q

Multiple myeloma

A

Hypercalcemia
Renal
Anemia
Bone pain (also lytic lesions and fractures)

54
Q

Protein levels in multiple myeloma

A

Paraprotein gap –> greater than 4 g/dL separating total serum protein and albumin

55
Q

How long can the liver store Vit K

A

30 days (but acutely ill liver failure patients can run out in 7 days)

56
Q

Vit K def labs

A

Prolonged prothrombin time flooded by prolonged PTT

57
Q

Most common renal vascular lesions in HTN

A

Arteriosclerotic lesions of afferent and efferent renal arterioles and glomerular capillary tufts

58
Q

DM nephropathy features

A

Increased ECM, BM thickening, mesangial expansion, and fibrosis

59
Q

First stage of DM nephropathy

A

Glomerular hyper profusion and renal hypertrophy with increase in GFR

60
Q

What is eplerenone

A

Very selective mineralocorticoid antagonist (like spironolactone but no hormonal stuff)

61
Q

Drugs for bilateral adrenal hyperplasia or poor unilateral surgical candidates

A

Spironolactone or eplerenone (aldosterone antagonists)

62
Q

Lead tox in adults

A

Nonspecific symptoms (fatigue, insomnia, irritability), myalgia, HTN, neurcog defects, perps

63
Q

Bacillary angiomatosis in AIDs pt’s? tx?

A

Bright red, firm, friable, exophytic nodules

Tx is oral erythromycin

64
Q

Features of lupus arthritis

A

Migratory, symmetric, polyarticular, and accompanied by brief morning stiffness (much shorter than RA)
NO evidence of joint destruction

65
Q

Clindamycin often used for

A

Anaerobic infections (in particular lung abscesses and bacterial infections of mouth and neck)

66
Q

All patients with new onset ascites need what

A

Paracentesis to determine the cause

67
Q

Risk of sepsis lasts how long after splenectomy

A

Up to 30 years

68
Q

Hereditary spherocytosis mutation

A

Lack of spectrin in red cell membranes

69
Q

Superior vena cava syndrome features

A

Dyspnea
Venous congestion
Swelling of head neck and arms

70
Q

Actinomyces micro

A

Anaerobic, gram pos and filamentous branching bacteria

colonizes oral cavity

71
Q

Nocardia affects what

A

Brain, soft-tissue/skin, and lungs of immunocompromised folks

72
Q

What does generalizability, or external validity, pertain to?

A

Applicability of study results to other populations

73
Q

What is commonly employed to compare the means of two groups of subjects

A

Two-sample T test

74
Q

What is the NOVA used for

A

To compare 3 or more means (vs two sample T test for 2)

75
Q

Test to confirm abnormal capillary blood lead level

A

Venous blood level

76
Q

Drug if lactulose doesn’t lower serum ammonia in hepatic encephalopathy

A

Rifaximin

77
Q

First line for sever mania w/ acute agitation

A

Antipsychotic (works faster than lithium or valproate)

78
Q

Cause of post-ischemic compartment syndrome

A

Interstitial edema and intracellular swelling following ischemia and subsequent repercussion

79
Q

Preferred initial DVT test

A

Compression US

80
Q

Infertility + ovarian mass + normal studies in young woman

A

Endometriosis

81
Q

How does endometriosis cause infertility ? US of?

A

Distortion of pelvic anatomy with inflammation and adhesions

US will show cystic ovarian mass

82
Q

MCC of stress incontinence

A

Pelvic floor muscle weakness

83
Q

CXR of primary pulmonary hypertension

A

Enlargement of the pulmonary arteries with rapid tapering of the distal vessels and enlargement of the right ventricle

84
Q

Partial 21-hydroxylase def

A

Presents in adolescence as hyperandrogegism (hirsituism), irregular menses, and elevated 17-hydroxyprogesterone

85
Q

Breast engorgement tx

A

Cool compress acetaminophen, and NSAIDs

86
Q

Meconium ileum associated with what dz

A

Cystic fibrosis

87
Q

Hirschsprung dz with what other disease

A

down syndrome

88
Q

What does squatting do in Tet spells

A

Increases SVR to less than pulmonary vascular resistance

89
Q

4 tet featurs

A
  1. RV outflow tract obstruction
  2. RVH
  3. Over-riding aorta
  4. VSD
90
Q

Think what in elderly men with dysphagia, regurg, and stinky breath? test to dx?

A

Zener’s diverticulum

Test to dx is contrast esophagram

91
Q

Beck’s triad of pericardial tamponade

A

Distant heart sounds, distended jugular veins, and hypotension

92
Q

Uterine rupture presentation and exam

A

Bleeding, pain, and fetal distress

Exam will show palpable fetal body parts abdominally at rupture site and no presenting fetal parts vaginally

93
Q

Gait impairment in NPH vs AD

A

Early finding in NPH and late finding n AD

94
Q

How does pernicious anemia lead to increased risk of gastric cancer

A

Chronic atrophic gastritis with decreased production of intrinsic factor by gastric parietal cells

95
Q

What is the succession splash for

A

Gastric outlet obstruction –> splash sound will indicate hollow viscus filled with fluid and gas

96
Q

tx of post herpetic neuralgia

A

TCAs (amitriptyline or notryptyline)

97
Q

Pain with neck extension seen in what kind of abscess

A

Retropharyngeal

worry about spread into mediastinum

98
Q

What decreases mitral valve prolapse murmur

A

Squatting from a standing position –> by increasing pre-load and thus left ventricular volume (but may increase in severe MVP)

99
Q

Why is LCP disease less common in kids

A

Kids has 2 blood supplies (ascending arteries and foveal artery) and foveal artery may become obliterated in older patients

100
Q

Indications for O2 in COPD

A

PaO2 55% or

Evidence or cor pulmonale

101
Q

HIV ppx meds for pt’s with CD4

A

TMP-SMX for TCP and toxo
Azithromycin for MAC
Itraconazole for histo endemic areas

102
Q

Massive PE is defined as

A

PE complicated by hypotension and/or acute right heart strain

103
Q

Suspect what in post op patient with hypotension, JVD and new onset RBBB

A

Massive PE

104
Q

Neonatal conjunctivitis timeline and tx

A

2-5 days - Gonococcal (eye erythromycin to prevent)

5-14 days - Chlamydial (oral erythromycin to treat)

105
Q

Mucomycosis drug

A

Amphotericin

106
Q

Consider what in a post bone marrow transplant pt who presents with pneumonitis and diarrhea

A

CMV

107
Q

What is rosacea characterized by

A

Erythema, edema, and telangiectasias on central face

worse with spicy foods and inc temp

108
Q

ABO mismatch features

A

Fever, flank pain, hemolysis, oliguric renal failure and DIC w/in an hour of tranfusion

109
Q

MC adverse reaction to transfusion w/ features

A

Febrile non hemolytic transfusion reactions -Fever and chills w/in 1-6 hours of transfusion

110
Q

Triad of multi-system atrophy

A
  1. Parkinsonism
  2. Autonomic dysfunction
  3. Widespread neurological signs
111
Q

Hyper IgM features

A

X linked defect in CD40 ligand w/ H IgM, low IgG and IgA and normal lymphocyte populations

112
Q

Symptomatic HCM drug

A

B-blockers

World week 1 (17 decks)

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