8/11 Flashcards
what muscle is used to distinguish between different levels of axillary lymph nodes
pec minor
exposed bone post dental procedure, swollen gums old lady probable dx
bisphophonatevrelated osteonecrosis
poly arthritis nodosa
constitutional features
fever, weight loss, malaise
poly arthritis nodosa skin findings
nodules, lived reticular, ulcers, purpura
poly arthritis nodosa renal things
HTN, renal infarct, arterial aneurysm
poly arthritis nodosa neuro things
HA, seizures, mononeuritis multiplex
poly arthritis nodosa GI things
mesenteric ischemia/infarct
poly arthritis nodosa MSK things
myalgia and arthritis
poly arthritis nodosa ANCA and
ana?
negative
poly arthritis nodosa angio findings
micro aneurysms and segmental/distal narrowing
tissue biopsy of poly arthritis nodosa
non granulomatous trasmural inflammation
thyroid nodule post US with high or normal TSH next step
FNA unless super normal US
thyroid nodule post US with low TSH next step
reactive iodine scintigraphy- FNA for cold, medical management for hot
best predictors for lung resection outcomes
FEV1 DLCO
tx for septic bursitis
aspiration to get dx, systemic abx and drainage if safe like in knee
chromium deficiency signs
impaired glucose control
copper deficiency signs symptoms
brittle hair/hairloss skin depigmentation ataxia and peripheral neuropathy anemia osteoporosis
selenium deficiency
thyroid dysfunction
cardiomyopathy
immune dysfunction
zinc deficiency
alopecia pustular skin rash hypogonadism impaired wound healing impaired taste immune dysfunction
thyrogloassal duct cyst location and features
midline
tract between foramen cecum and base of anterior neck
cyst moves with swallowing and tongue protrusion
often presents after URI
dermoid cyst location and features
midline
cystic mass with trapped epithelial debris
occurs along embrionic fusion planes
no displacement with tongue protrusion
branchial cleft cyst location and features
lateral
may extend to the tonsils fossa (2nd brachial arch ) or pyriform recess (3rd branchial arch)
ANTERIOR to STERNOCLEIDOMASTOID
Mycobacterium avian lymphadenitis location and features
lateral
necrotic lymph node
violaceous discoloration of skin
often fistula
cystic hygroma location and features
posterior
dilated lymphatic vesels
what does histoplasmosis look like
narrow based budding yeast
histoplasmosis tx
itroconazole or amphoterain b
why do OHS patients have low cl
too much hypoventilation = hypercarbia, increases bicarb retention to maintain physiologic ph., This decreases cl reabsorbtion . note:m this happens in OSA also but resolves with normal daytime breathing
most common se of inhaledcorticosteroid use
oral thrush
3 top causes of chronic cough
post nasal drip, asthma, GERD
sarcoid DLCO
⬇️
sarcoid electrolyte abnormality
hep Ca
asbestosis diffusion lung capacity
down arrow ⬇️
heart thing that can develop asbestosis
cor pulmonale
TB causing primary adrenal insufficiency lab findings
hyponatremia, hyperk, hypoglycemia, eisonophillia
low dose ct recommendations for smokers age
55-80 yearly
low dose ct for lung cancer screening eligibility
30+ pack years of smoking. and patient is a current smoker or quit smoking in the last 15 years
transudative effusion ph pulmonary
7.4-7.55
exudative pleural effusion ph
7.3-7.45, <7.3 probably bacterial or tumor
what can SSRi do to physiologic tremors
increase them
sx looks like sarcoid but is a fungus
histoplasmosis
blastomyces signs and symptoms
skin lesions, osteolytic bone lesions or prostate involvement
when to get ct with uncomplicated pyelonephritis
no improvement in symptoms at 48-72 hours, or unusual urinary findings
vaccines recomended in chronic liver failure
tents: q10 years influenza ; anual PNA23: @dx and @65 Hep A and B if not immune
MAC tx
macrolide+ ethambutol
MAC manifestations
fever and weight loss
abdominal pain and diarrhea
LAD and heptosplenomegally
⬆️ alk phos
male urethritis nothing on gram stain
chlamydia
when do HIV patients get CMV prophylaxis
never but organ transplants if CMV-seropositive do
what is most common ekg finding of lyme myocarditis
AV block
mucormycosis/rhizopus tx
amphotericin b and surgical debridement
rpm and vldr neg but for sure it’s syphylis next test and why those were neg
treponema antibody, others negative early in primary infection
needle stick from HIV + patient
draw blood for test and start 3 drug therapy immediately
mycoplasma pneumonia signs, symptoms, tx
HA,Malasie,fever,persistant dry cough, pharyngitis(no exudates), macula/vesicular rash
tx macrolide and respiratory fluoroquinolone
What causes erysipelas and what are it’s signs and symptoms
strep progenies(group a)
superficial dermis and lymphatics, well demarcated edges. rapid spread and onset
fever in early course
can patients on TNFA alpha inhibitors get live vaccines
na
