5/2 Flashcards
Adjustment disorder timing
Within 3 months of stressor
Rubin-Johnson high level of what
High levels of coproporphyrin I
Atelectasis blood gas
Hypoxemia
Hypocapnia
Respiratory alkalosis
Adenomyosis def
Presence of endometrial glands in uterine muscle
boggy and symmetrically enlarged
Earliest vaso-occlusive manifestation in SS
Dactylitis
B-HCG level to see intrauterine pregnancy
1,500-2000
Uremic pericarditis features? tx?
- When BUN >60
- EKG won’t look like other causes due to lack of inflammation
- Tx is dialysis
What causes anemia of pre-maturity? labs?
Diminished Epo levels, shortened RBC life span, and blood loss
-Labs will show decreased hgb and hct w/ relatively low retic count
Small HPV lesions tx
Trichloroacetic act or podophyllin
Best frostbite tx
Rapid re-warming with warm water
don’t debride tissue initially
MCC of gross lower GI bleeding in adults
Diverticulosis
Diverticulosis vs Angiodysplasia
Diverticulosis: high volume arterial bleeding, more common
Angiodysplasia: low volume venous bleeding
DMD gen location
Deletion of dystrophin gene on Xp21
Craniopharyngioma path
Nests of squamous cells in a loose stroma (looks like embryonic tooth bud enamel)
Think what with proximal muscle weakness + inc ESR and CK
Polymyositis or dermatomyositis
Fibromyalgia physical exam
Point muscle tenderness in mid trapezius, lateral epicondyle, chostochondral junction in chest, and greater trochanter
HSV encephalitis dx
Viral DNA PCR in the CSF
Colonoscopy schedule in UC
- Begin 8 years post diagnosis (12-25 if dz only in left colon)
- Colonoscopy with biopsy every 1-2 years
FAP colonoscopy schedule
Begin at age 10-12
Colonoscopy every year
LAD features
Delayed umbilical chord separation, recurrent skin and mucosal bacterial infections (w/ purulence) and server PERIODONTAL dz
GD features
- Infections from catalase pos organisms (S. aureus, serratia, burkholderia)
- Neg nitroblue tetrazolium test
- NO neutrophillia
Dermatitis herpetiformis treatment
Dapsone and gluten-free diet
will see on extensor surfaces
CMV vs Cryptosporidium diarrhea in AIDS pts
Crypto: Severe watery diarrhea
CMV: Frequent, small volume w/ hematocheiza and abdominal pain
Key feature of MAC diarrhea in AIDS pt
High Fever (> 39 C or 102.2 F)
Diffuse axonal injury CT scan
Numerous minute punctate hemorrhages with blurring of grey-white interface
PD tremor frequency
4-6 Hz (look for asymmetry and associated rigidity)
Drug for young PD with mainly tremor
Trihexyphenidyl (anticholinergic)
What is Lamivudine
Reverse transcriptase inhibitor used to treat HIV and Chronic Hep B
what is a pericardial knock
Mid-diastolic sound
Patients > 35 with gross hematuria workup
CT urogram and cystoscopy
PNA risk assessment for out vs inpt
Confusion Uremia (BUN > 20) RR-Tachypnea (> 30) BP - Hypotension 65 (age >) *CURB 65* (>2 do inpatient)
MCC of CAP
S. pneumo, Heamophilus, and atypicals
CAP input current guidlines
Inpt: Fluoroquinolone or Beta-lactam + macrolide
3 reasons for kidney stone with neg scan
- radiolucent stone (uric acid, xanthine)
2. Calcium stones
Tx of uric acid stones
Hydration
Alkalization of the urine (potassium citrate-also reduces crystallization)
Low purine diet
Drug for recurrent hypercalciruic renal stones
HCTZ - decreases urinary calcium excretion
What is Trastuzumab? What should be done before starting therapy
mAb for HER2
Do echo before starting
Electrical alternans EKG
Varying amplitude of the QRS complexes
this w/ sinus tach –> probs pericardial effusion
Thyroglobulin level in dx’ing hyperthyroid
Will be high in endogenous hyperthyroidism and low w/ exogenous use
How long to do cholecystectomy during acute cholecystitis
Within 72 hours
Pagets lab’s
Increase in alk phos and normal serum Ca and PO4 levels
Long term panic disorder tx
SSRI/SNRI and/or CBT
Displacement vs Projection
Displacement: transferring feelings to amore acceptible object
Projection: Attributing one’s own feelings to others
What is sublimation
Channeling impulses into socially acceptable behaviors
Common causes of neonatal polycythemia
Delayed clamping of umbilical chord, in-utero hypoxia (maternal HTN), poor placental gas exchange (maternal DM)
Neonatal polycythemia tx
Hydration for asymptomatic
Symptomatic need partial transaction of blood for NS
Symptomatic neonatal polycythemia features
respiratory distress, hypoglycemia, and neurologic manifestations
When to give Rhogam
28 weeks gestation and w/in 72 hours of delivery
What is the Kleihauer-Betke test
For Rho-gam dose needed - adult hgb spread on slide and exposed to acidic solution, and adult hemoglobin lyses
Lung consolidation PE findings
Bronchial breath sounds, dullness to percussion, increased fremitus
bronchial breath sounds have full expiratory phase
Pleural effusion PE findings
Fluid blocks sound transmission from the air-filled lungs –> decreasing errythang
Best test to dx intusseception
US
Multiple myeloma
Hypercalcemia
Renal
Anemia
Bone pain (also lytic lesions and fractures)
Protein levels in multiple myeloma
Paraprotein gap –> greater than 4 g/dL separating total serum protein and albumin
How long can the liver store Vit K
30 days (but acutely ill liver failure patients can run out in 7 days)
Vit K def labs
Prolonged prothrombin time flooded by prolonged PTT
Most common renal vascular lesions in HTN
Arteriosclerotic lesions of afferent and efferent renal arterioles and glomerular capillary tufts
DM nephropathy features
Increased ECM, BM thickening, mesangial expansion, and fibrosis
First stage of DM nephropathy
Glomerular hyper profusion and renal hypertrophy with increase in GFR
What is eplerenone
Very selective mineralocorticoid antagonist (like spironolactone but no hormonal stuff)
Drugs for bilateral adrenal hyperplasia or poor unilateral surgical candidates
Spironolactone or eplerenone (aldosterone antagonists)
Lead tox in adults
Nonspecific symptoms (fatigue, insomnia, irritability), myalgia, HTN, neurcog defects, perps
Bacillary angiomatosis in AIDs pt’s? tx?
Bright red, firm, friable, exophytic nodules
Tx is oral erythromycin
Features of lupus arthritis
Migratory, symmetric, polyarticular, and accompanied by brief morning stiffness (much shorter than RA)
NO evidence of joint destruction
Clindamycin often used for
Anaerobic infections (in particular lung abscesses and bacterial infections of mouth and neck)
All patients with new onset ascites need what
Paracentesis to determine the cause
Risk of sepsis lasts how long after splenectomy
Up to 30 years
Hereditary spherocytosis mutation
Lack of spectrin in red cell membranes
Superior vena cava syndrome features
Dyspnea
Venous congestion
Swelling of head neck and arms
Actinomyces micro
Anaerobic, gram pos and filamentous branching bacteria
colonizes oral cavity
Nocardia affects what
Brain, soft-tissue/skin, and lungs of immunocompromised folks
What does generalizability, or external validity, pertain to?
Applicability of study results to other populations
What is commonly employed to compare the means of two groups of subjects
Two-sample T test
What is the NOVA used for
To compare 3 or more means (vs two sample T test for 2)
Test to confirm abnormal capillary blood lead level
Venous blood level
Drug if lactulose doesn’t lower serum ammonia in hepatic encephalopathy
Rifaximin
First line for sever mania w/ acute agitation
Antipsychotic (works faster than lithium or valproate)
Cause of post-ischemic compartment syndrome
Interstitial edema and intracellular swelling following ischemia and subsequent repercussion
Preferred initial DVT test
Compression US
Infertility + ovarian mass + normal studies in young woman
Endometriosis
How does endometriosis cause infertility ? US of?
Distortion of pelvic anatomy with inflammation and adhesions
US will show cystic ovarian mass
MCC of stress incontinence
Pelvic floor muscle weakness
CXR of primary pulmonary hypertension
Enlargement of the pulmonary arteries with rapid tapering of the distal vessels and enlargement of the right ventricle
Partial 21-hydroxylase def
Presents in adolescence as hyperandrogegism (hirsituism), irregular menses, and elevated 17-hydroxyprogesterone
Breast engorgement tx
Cool compress acetaminophen, and NSAIDs
Meconium ileum associated with what dz
Cystic fibrosis
Hirschsprung dz with what other disease
down syndrome
What does squatting do in Tet spells
Increases SVR to less than pulmonary vascular resistance
4 tet featurs
- RV outflow tract obstruction
- RVH
- Over-riding aorta
- VSD
Think what in elderly men with dysphagia, regurg, and stinky breath? test to dx?
Zener’s diverticulum
Test to dx is contrast esophagram
Beck’s triad of pericardial tamponade
Distant heart sounds, distended jugular veins, and hypotension
Uterine rupture presentation and exam
Bleeding, pain, and fetal distress
Exam will show palpable fetal body parts abdominally at rupture site and no presenting fetal parts vaginally
Gait impairment in NPH vs AD
Early finding in NPH and late finding n AD
How does pernicious anemia lead to increased risk of gastric cancer
Chronic atrophic gastritis with decreased production of intrinsic factor by gastric parietal cells
What is the succession splash for
Gastric outlet obstruction –> splash sound will indicate hollow viscus filled with fluid and gas
tx of post herpetic neuralgia
TCAs (amitriptyline or notryptyline)
Pain with neck extension seen in what kind of abscess
Retropharyngeal
worry about spread into mediastinum
What decreases mitral valve prolapse murmur
Squatting from a standing position –> by increasing pre-load and thus left ventricular volume (but may increase in severe MVP)
Why is LCP disease less common in kids
Kids has 2 blood supplies (ascending arteries and foveal artery) and foveal artery may become obliterated in older patients
Indications for O2 in COPD
PaO2 55% or
Evidence or cor pulmonale
HIV ppx meds for pt’s with CD4
TMP-SMX for TCP and toxo
Azithromycin for MAC
Itraconazole for histo endemic areas
Massive PE is defined as
PE complicated by hypotension and/or acute right heart strain
Suspect what in post op patient with hypotension, JVD and new onset RBBB
Massive PE
Neonatal conjunctivitis timeline and tx
2-5 days - Gonococcal (eye erythromycin to prevent)
5-14 days - Chlamydial (oral erythromycin to treat)
Mucomycosis drug
Amphotericin
Consider what in a post bone marrow transplant pt who presents with pneumonitis and diarrhea
CMV
What is rosacea characterized by
Erythema, edema, and telangiectasias on central face
worse with spicy foods and inc temp
ABO mismatch features
Fever, flank pain, hemolysis, oliguric renal failure and DIC w/in an hour of tranfusion
MC adverse reaction to transfusion w/ features
Febrile non hemolytic transfusion reactions -Fever and chills w/in 1-6 hours of transfusion
Triad of multi-system atrophy
- Parkinsonism
- Autonomic dysfunction
- Widespread neurological signs
Hyper IgM features
X linked defect in CD40 ligand w/ H IgM, low IgG and IgA and normal lymphocyte populations
Symptomatic HCM drug
B-blockers
