5 Flashcards
Paroxysmal nocturnal hemoglobinuria: pres?
flow cytometry?
hemolysis –> fatigue, cytopenia, venous thrombosis (abd, cerebral)
absent CD55/CD59
PNH: tx?
Fe, folate, eculizumab
Pineal mass: pres?
Parinaud syndr (loss of upward gaze, ptosis, upper eyelid retr, pupillary abn)
obstr hydrocephalus
central precocious puberty
S/s CMV inf in ICH:
pneumonitis UGIT/LGIT ulcers (a/w D, abdp) BM suppr athralgia/myalgia esophagitis
Shy-Drager (Multiple system atrophy) =
- parkinsonism
- autonomic dysf
- neurological signs
(monitor for bulbar dysf/laryngeal stridor)
Shy-Drager (Multiple system atrophy) tx?
increase intravasc vol with fludrocortisone, salt suppl, alpha blockers, compression stockings
Rotator cuff impingement/tendonitis versus tear?
Rotator cuff impingement/tendonitis improved w lidocaine
Amyloidosis s/s?
- asymp proteinuria or nephrotic syndr
- restr CM
- hepatomeg + organ enlargement
- periph (CTS) +/- autonomic neuropathy
- waxy/thickening + easy bruising skin
Amyloidosis = a/w?
dx?
infl arthritis, chr inf, IBD, malig, vasculitis
tissue biopsy (abd fat pad)
greatest risk factor for stroke?
htn (4x incr risk)
Cauda equina syndrome: pres?
- sensory to saddle
- motor to sphincters
- parasymp (bowel/bladder) *late
- asymm motor weakness
- decr reflexes
- unilat, severe, radicular pain
Conus medullaris syndrome: pres?
- sudden, severe BP
- perianal hypoanesthesia
- symm motor weakness
- increased reflexes
- early bowel/bladder dysf
Heart defect a/w DiGeorge?
truncus arteriosus
Total anamolous pulm venous return =
RA receives blood from pulm and systemic venous systems (causes RA/RV enlargement)
NF1:
axillary freckling, cafe au lait, optic glioma (causes VL)
Dx/tx of lead poisoning:
- capillary sampling, if elevated..
- venous lead level, if elevated…
- mild -> recheck in 1 mo
- mod -> DMSA
- severe -> dimercaprol + EDTA
indicated for tx of resistant schizophrenia with persistant suicidality
clozapine
Hemorrhage at basal ganglia:
- contralat hemiparesis and hemisensory loss
- homonymous hemianopsia
- gaze palsy
Hemorrhage at cerebellum:
- facial weakness
- ataxia
- nystagmus
- neck stiffness +/- HA
Hemorrhage at thalamus:
- contralat hemiparesis and hemisensory loss
- nonreactive miotic pupils
- upwards gaze palsy
- eyes *Towards paresis
Hemorrhage at cerebral lobe:
- contralat hemiparesis (if frontal)
- contralat hemisensory loss (if parietal)
- homonymous hemianopsia(if occ)
- seizures
- eyes away from paresis
Hemorrhage at pons:
- coma and paralysis (in minutes)
- pinpoint, reactive pupils
How does increased extracellular pH affect Ca?
decreased H binding to albumin –> Ca++ binds to albumin, decreased ionized Ca levels
Types of drug induced chr renal failure:
pres?
papillary necrosis + chr tubulointerstitial nephritis
- early = sterile pyuria, polyuria
- HTN, mild proteinuria, impaired urinary conc
Histo tx:
mild/mod: none or itraconazole
- severe/dissem/ICH: ampho B, then itraconazole
S3 + clinical findings =
LV failure
SIADH tx:
- fluid restr
- hypertonic saline (if needed)
- demeclocycline (rarely needed)
Mitral stenosis: cardiopulm effects?
- LA dil –> afib and cardiac emboli
2. incr pulm vasc pressure –> dyspnea, cough, *hemoptysis
