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Medicine > acute renal failure, cardiac, liver dz, pneumonia, DVT/PE > Flashcards

acute renal failure, cardiac, liver dz, pneumonia, DVT/PE Flashcards

1
Q

cut offs for pre-renal vs intrarenal for FeNa, FeUrea, and BUN:Cr

A

pre-renal:
FeNa<1
FeUrea <35
BUN: Cr >20

intrarenal:
FeNa>2
FeUrea >35
BUN: Cr <10

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2
Q

uremia sxs

A 
encephalopathy
lethargy
nausea
bleeding complication
pericarditis
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3
Q

manage hyperkalemia

A 
calcium gluconate
insulin plus dextrose
albuterol
lasix, fluids
kayexelate
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4
Q

do you get repeat CXR in pneumonia patients after treatment?

A

most dont

only if- immunocompromised, atypicals, smokers (post-obstructive cancer?)

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5
Q

what can you have hemoptysis from?

A 
Infection (TB, etc)
PE
pneumonia
trauma
lung cancer
Good pastures
Wegners
CF- bronchiectasis
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6
Q

what can you get calf tenderness from

A 
DVT
cellulitis
muscle spasm
trauma
baker cyst
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7
Q

acute vs chronic resp alkalosis

A

for every change in 10 pCO2

  • acute: change in pH by 0.08
  • chronic: change in pH by .03
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8
Q

normal Aa gradient

A

age/4 + 4

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9
Q

Well’s criteria measures probability of

A

probability of having PE

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10
Q

Well’s criteria components

A 
DVT signs/sxs
HR>100
previous VTE
Immobile >3 days or surgery
Malignancy
Hemoptysis
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11
Q

what PE workup should be done if low, intermediate, high probability or if sxs

A

low: PERC tool, CXR, other workup
intermediate: D-dimer

High: CT-PE

if sxs of DVT: DVT US–> treat

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12
Q

CT PE contra

A

allergy
pregnancy
renal failure

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13
Q

what test should you do if you cant do CT PE?

A

VQ scan

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14
Q

is pleural effusion from PE transudative or exudative?

A

exudative

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15
Q

anticoagulation duration for provoked vs unprovoked PE vs VTE in setting of cancer?

A

provoked: 3-6 months

unprovoked/cancer: life long if no bleeding risk

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16
Q

what should you do if bleeding on anti-coagulation?

A

retrievable IVC filter for 6 months

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17
Q

test for esophageal varices

A

UGI endoscopy

18
Q

treat esophageal varices

A

volume replete, PPI, abx for SBP

beta blockers

if active: octreotide, TIPS, ligatio

19
Q

Melt score

A

to determine liver transplant need

based on Cr, bili, INR

20
Q

non cirrhotic causes of portal HTN

A

cardiac dz- right heart failure

venous flow obstruction- budd-chiari, thrombosis

acute liver sz- alcoholic hepatitis

malignancy of liver

portal vein thrombosis

21
Q

ascites treatment

A

primary: less sodium intake, spirincolactone + lasix, paracentesis
secondary: TIPS

22
Q

ascites complications

A

tense ascites- CV compromise

hepatic hydrothorax- resp compromise

ubilical hernia- bowel incarceration or spontaneous rupture

23
Q

portosystemiatic enceophalopathy vs fulminant hepatic failure

A

both forms of hepatic-induced encephalopahty due to increased ammonia

PSE: cirrhosis cause, gradual onset

FHFL acute liver failure cause, rapid onset

24
Q

hepatic encepahlopathy treatment

A

lactulose

abx

restrict protein

25
Q

hepatorenal pathophys

A

inc CO, dec SVR –> sympathetic system, inc RAS

–> renal vasoconstriction

–> decrease GFR

26
Q

hepatorenal syn treatment

A

hemodialysis, transplant

alpha agonists- increase BP
albumin
octreotide

27
Q

S3 S4 heard best where

A

at apex

28
Q

when is HOCM murmur louder and softer

A

softer- LV vol inc- squat, handgrip, passive leg raise

louder- LV vol dec- valsalva, standing

29
Q

when is there paradoxical splitting

A

anything that makes aortic valve late

RBBB, HOCM, AS, left sided HF

30
Q

when is there a soft S1?

A

aortic regurgitation

1st degree AV block

31
Q

when is S1 loud?

A

mitral stenosis- LA larger keeps mitral valve open longer

Short PR interval

32
Q

which murmurs can be holosystolic

A

MR, TR, VSD

33
Q

where are TR and VSD best heard

A

LLSB

34
Q

where is MR best heard

A

at apex, radiates to axilla

35
Q

what characteristic of AS makes it more severe?

A

later- takes longer to emit blood

parvus et tardus

36
Q

where is pulmonic stenosis best heard

A

LUSB

37
Q

when is there a brisk carotid upstroke

A

AR, HOCM

38
Q

where is AR best heard

A

LUSB

39
Q

where is AS best heard

A

RUSB

40
Q

severity of AR and MS determined by

A

length of blowing- shorter is worse

Medicine (31 decks)

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