5/7-5/8 Flashcards
HUS triad
Hemolytic anemia
Thrombocytopenia
Acute renal failure
HSP purpura
On legs and booty in setting of a normal platelet count
Embolic stroke presentation timing
Sudden onset with maximal symptoms at the beginning
Tx for appendix abscess
IV hydration, antibiotics and bowel rest w/ appendectomy later when abscess shrinks
MCC of isolated aortic stenosis in elderly patients
Age-dependent idiopathic sclerocalcific changes
Suspect atrophic vaginitis in what patients
Post-menopausal females with symptoms of vaginal dryness and dysuria
Atrophic vaginitis exam
Pale, dry vaginal mucosa
Diminished labial fat pad
Scarce pubic hair
US features of appendicitis
Non compression and dilation of the appendix
Part of the pee with blood specifics
- Beginning - urethral
- End - Bladder
- All- w/in ureters or kidneys
Tx for lyme in pregnant and lactating patients
Amoxicillin
Acid-Base status effect on Calcium
Alkalosis - Inc. binding of Ca to albumin due to dissociation of H+ ions from albumin
Low risk pt’s with solitary small lung mass criteria
Kawasaki tx
Aspirin and IVIG
What maternal cancers does breast feeding reduce the risk of
Breast and ovarian cancer
Vaginal discharge after delivery
1-3 days - lochia rub
3-4 days- pale loch serosa
Then white and called loci alba
Suspect what with any foul smelling d/c postpartum
Endometritis
DKA acid base
Metabolic acidosis w/ respiratory compensation
What is winters formula
PaCO2 = 1.5 (HCO3) + 8
Used to calculate expected PCO2 during respiratory compensation for metabolic acidosis
What is Kussmaul breathing
Deep and rapid breathing
Seen in DKA
Tx for small, non-bleeding varices
Propranolol, Nadolol (non-selective B blockers)
Abdominal pain, constipation, and polydipsia, and polyuria think OD of what
Vit D leasing to hypercalcemia
Acute bleeding due to liver failure best treated with
FFP
Pain of hip osteoarthritis
Felt in groin, buttock, or pelvis and can radiate to lower thigh or knee
Negative predictive value varies with
Pre-test probability of a disease –> high probability leads to lower NPV
Does does a vitreous hemorrhage present? MCC?
Sudden loss of vision and onset of floaters
MCC is diabetic retinopathy
MPPx for meniere’s attack
Avoiding triggers than increase endolymphatic retention
void alcohol, caffeine, nicotine, and foods high in salt and fat
ABI higher than 1.3 suggestive of
Calcified and incompressible vessels
When are seizures seen in EtOH withdrawal
12-48 hours
What does high progesterone in pregnancy help with
To inhibit uterine contractions
Most common thyroid cancer
Papillary
Head CT of rupture saccular or berry aneursyms
Acute bleeding in cisterns along the major proximal cerebral blood vessels arising from the circle of willis
Drugs that potentiate warfarin
Acetaminophen
NSAIDs
Amioderone
Antibiotics
What is rationalization
Offering a rational, logical reason for an upsetting event or behavior rather than admitting the true reason in order to avoid anxiety or protect self esteem
Can’t make appointment cause had to pick up kids
What is internal tibial torsion
Physiologic finding in newborns, will usually self resolve
Central retinal artery occlusion tx
Ocular message and high-flow oxygen administration
Thalassemia what kind of disease
Hemoglobinopathy
What is the Thessaly,McMurray test
For MCL -=> palpable locking or catching when joint is extended while under load
Pt’s with acute onset of back pain and profound hypotension should be evaluated for
Presumptive diagnosis of rupture abdominal aortic aneurysm
Congenital long QT tx
Beta blockers with pacemaker
Indinavir MOA and AE
Protease inhibitor
Crystal induced nephropathy
Didanosine AE
Pancreatitis
current gold standard for Spherocytosis
Eosin-5-maleimide binding test (flow cytometry) + acidified glycerol lysis test
What confirms the diagnosis of premature ovarian failure
FSH elevation in the setting of >3 months of amenorrhea in a woman under the age of 40
Consider glactosemia in who
Newborn with FTT, bilateral cataracts, jaundice, and hypoglycemia
Patients with galactokinase def present with
Cataracts only
RDS factors decide prematurity
Male sex, prenatal asphyxia, maternal diabetes, C-section without labor
Why is constipation a common problem in trainers
Transition to solid food and cow’s milk
Toilet training
School entry
What comes before SJS/TEN
Acute influenza like prodrome
What is a cofounder
Extraneous factor which has properties linking it with exposure and the outcome of interest
Peritoneal part of the bladder
Bladder dome
Broad and waxy casts from
Chronic renal failure
Mobitz type 1
Progressive prolongation of the PR interval leading to a non-conducted P wave and a “dropped” QRS couples
Bening
What causes a mobitz type II
Block in the his-purkinje system below the AV node
Episodic and unpredictable absence of conduction b/w atria and ventricles
Pill esophagtitis scope
Discrete ulcers w/ relatively normal-appearing surrounding mucosa
Oral estrogen effect on thyroid meds
Increase levels of Thyroxine-binding globulin, which may lead to pt’s w/ hypothyroidism needing higher levothyroxin doses
TCA overdose tx
Sodium bicarb to treat cardiac toxicity (prolonged QRS)
Benzos to treat TCA
Drug to add to metformin if A1c high and weight loss desired
Eventide, liraglutide (GLP-1 agonists)
Sulfonylureas AE
Weight gain and hypoglycemia
DM drug that can be used in renal insufficiency
Sitagliptin (DPP-IV inhibitor)
Warfarin inhibits what factors
II, VII, IX, X, C and S
Sinusitis tx
Amox/clavulonic acid
Think what with necrolytic migratory erythema, diarrhea, and weight loss
Glucagonoma
Hypertensive intracranial hemorrhage timing
Presents initially w/ focal symptoms, but can rapidly progress to signs of elevated ICP (vomitng, HA, decreased alertness)
What is lone a-fib
Pt’s with paroxysmal, persistent, or permanent A-fib w/ no evidence of cardiopulmonary or structural heart disease
Next step is NST is non-reactive in pregnant patients with decreased fetal movement
Contraction stress test or biophysical profile
Normal contraction stress test indicates
Low likelihood of stillbirth within one week of the txt
Tx for NSAID induced dyspepsia
PPI
* h pylori testing for possible exposure pt’s*
Triad of refeeding syndrome
Electorate depletion
Arrhtymias
Heart failure
result from fluid and electrolyte shifts
What is hemophilic arthorpathy
Caused by iron/hemosiderin deposition leading to synovitis and fibrosis within the joint
Hemophilic arthropathy ppx
Factor concentrates
Common cause of iron def anemia in elderly
NSAIDs (causing GI blood loss)
What causes the primary ovarian failure in turners
Gonadal dysgenesis
Zinc def features
Alopecia
Skin infections
Abnormal tase
Impaired wound healing
What is prolonged in Lupus AP
PTT
will not correct if mixed 1:1 in normal plasma
Survivors of sexual assault at high risk for
PTSD
Depression
Suicidality
Guillain-Barre tx
IV IG or plasmapharesis
workup of pt w/ first unprovoked VTE
Age appropriate screening and CXR
3 main complications with a high PEEP
- Alveolar damage
- Tension pneumothorax
- Hypotension
Fundoscope of CMV retinitis
Fluffy, or granular retinal lesions near vessels
usually painless
HSV/VSV retitinitis in HIV pt’s
Acute very painful retinal necrosis
Fundoscope: peripheral pale lesions and central retinal necrosis
AAA screening age
65-75 in all smokers/former smokers
Mediastinitis features
Fever, CP, leukocytosis, and mediastinal widening on CXR
can also see sternal wound drainage
Mediatsinitis tx
Drainage, surgical debridement, and prolonged antibiotic therapy
Why moderate Prolactin elevation in non-functioning pituitary adenoma
Disruption of dopaminergic neural pathways that normally suppress prolactin levels
What suspected appendicitis pt’s should get imaging
- Non-classic symptoms
- Equivocal findings on initial assessment
- Delayed presentation
What should be suspected in any BPH pt with AKI
Bladder outlet obstruction
