8/5 Flashcards
crescendo-decrescendo systolic murmur over left second intercostal space and widened splitting S2
pulmonic stenosis-often asymptomatic until adulthood
risk factors for sigmoid volvulus
redundancy
dysmotility
skin thing with IBD
erythema nodosum (painful nodules usually on the shins)
what causes zenkers diverticulum
diminished relaxation of the criocopharyngeus causes increased intraluminal pressure.
why treat asymptomatic bacteria in pregnancy
it increases risk of pyelonephritis
why get a biophysical profile
to assess for utter-placental insufficiency
clinical presentation of abrupt placentae
sudden onset vaginal bleeding
abdominal and back pain
high frequency low intensity contractions
rigid, tender uterus
chest imaging for paraesophageal hilt hernia shows
retrocardiac air fluid level
post op illness tx
bowel rest and serial examinations
tx for sigmoid colon volvulus
therapeutic flexible sigmoidoscopy
how does arm look with anterior shoulder dislocation
abduction external rotation
how does arm look with posterior shoulder dislocation
adduction/ internal rotation
what causes SBO in crohns patients
fibrotic stricture
what type of acid base disturbance happens when pancreases or small intestine is losing fluid
Non ion gap metabolic acidosis- the fluid has a blot of bicarb and your losing all those bicarbs
what happens to length of mitral valve prolapse murmur with squatting
shortens
what does valsalva do
⬇️ venous return
what murmurs get louder with valsalva
HCM
MVP
What other maneuver besides valsalva makes
MVP and HCM louder
standing
3 changes squatting does to change cardiac murmurs
⬆️ venous return
⬆️ afterload
⬆️regurg fraction
3 changes handgrip does to change cardiac murmurs
⬆️ venous return
⬆️ blood pressure
⬆️regurg fraction
similar to squat besides middle one
murmurs that get louder with squatting and handgrip
AR
MR
VSD
what BP meds cause peripheral edema
dihydropyridine calcium channel blockers
most common cardiac thing SLE flare up
pericarditis
what EKG is relatively specific for digitalis tox
Atrial tachycardia with AV block
this is due to increased ectopy and increased vagal tone
what nerve can be damaged on anterior dislocation of the shoulder and how would this manifest
axillary, weak shoulder abduction, also can cause sensory loss of lateral shoulder
imaging for possible pancreatic cancer w jaundice
abdominal US
imaging for possible pancreatic cancer w/o jaundice
CT
who can’t get LMWH
ESRD
what are people with porcelain gallbladder at increased risk for
gallbladder adenenocarcinoma, consider removing before this
vasa previa PPROM 33 weeks next step
emergency c section
what is pseudocyesis
non prego women thinks she is prego and has sx, patient is not psychotic
severe menopause tx if no contraindications to birth control and has uterus
Estrogen and progesterone
severe menopause tx if no contraindications to birth control and has NO uterus
estrogen only
contra indications to estrogen
Breast cancer CAD Endometrial cancer liver disease thromboembolism
severe menopause but can’t have estrogen, what’s the tx
SSRI
RF osteoporosis
advanced age, postmenopausal, low body weight. excessive OH intake, sedentary lifestyle and smoking,
biggest risk factor for fragility fracture in person with osteoperosis
previous fragility fracture
how does chronic pancreatitis affect fecal elastase
⬇️
TX for PBC
ursodeoxycholic acid
how to dx PSC
MRCP
mononuclear infiltrates of the lamina propria and thickened college band dx
microscopic colitis
what does cerebellar gait look like
staggering wide based
what isassociated cerebellar gait
cerebellar degeneration
stroke
drug/alcohol into
vit B12 deficiency
what does gait apraxia look like
magnetic/freezing. start and turn hesitation
what causes gait apraxia
frontal lobe degeneration
normal pressure hydrocephalus
parson gait looks like
short steps, shuffling
what does step gate look like
FOOTDROP obvi, excessive hip and knee flexion while walking, slapping quality
what causes foot drop
motor neuropathy probs the common peroneal nerve up at the old L5
what does a vestibular gait look like
unsteady falling to one side, caused by the ear problems
what med for sure with Bell’s palsy
prednisone, acyclovir and valacyclovir are just maybes 🤷♂️
REM sleep disorder is correlated with increase risk of
parkinsons
bright lights cause eyes to shut dx
focal dystonia
or blepharospasm
moat common kidney stone type
calcium oxalate
besides wet, wobbly, and wacky what else does normal pressure hydrocephalus often have
UMN signs
meds for urge incontinence
antimuscurinic like oxybutinin
what is a Failure mode effects analysis
systematic team based approach that identifies steps in a process and finds solutions to problems that may arise
