amboss 7/10 Flashcards
what can occur with B12 def
subacute combined degeneration of the spinal cord
presents as decreased vibratory sensation at first. macrocytic anemia
what causes the demyelination in B12 def
reduced fatty acid synthesis
what is the heterophile antibody test
when the serum from a patient is mixed with a horse it aggregates. this is the test for EBV
treatment for Epstein barr
fluids, analgesics, antipyretics. watch for splenic rupture for at least 3 weeks after the onset of symtopsm
what is the treatment for rickets
sunlight, vitamin D and calcium supplmentation.
what is osteomalacia
disorder of impaired mineralization of osteoid. this is essentially adult rickets. usually presents with bone pain and tenderness. leads to bending and pathological fractures
what is rickets
a disorder of impaired mineralization of cartilaginous growth plates. usually presents with boney deformities. leads to bending and pathological fractures
what are the labs for osteomalacia and rickets
Calcium ↓
Phosphate ↓
Alkaline phosphatase ↑
Parathyroid hormone ↑
what is the treatment for cyanide poisoning
hydroxycobalamin
what is the treatment for carbon monoxide
100% o2 nasal cannula, or hyperbaric oxygen
what is the presnetation of carbon monoxide poisoning
hypertension, confusion, agitation, unsteady gait, short-term memory loss, headache
what is the treatment for reactive arthritis
NSAIDs, glucocorticoids, sulfasalazine or MTX
what is reactive arthritis
post infectious autoimmune disorder due to gonococcal or chlamydial infections
OR Post-enteritis: after infection with Shigella, Yersinia, Salmonella, or Campylobacter
what can happen to the palms and soles of reactive arthritis
they can get hyperkeritinization and lesions that look like nodules
what is leukocytoplastic vasculitis
umbrella term for vasculitides, including Henoch-Schönlein purpura (HSP). HSP is an acute immune-complex mediated vasculitis of the small vessels that is often preceded by an upper respiratory infection.
Henoch-Schönlein purpura (HSP) presentation
HSP can also manifest with bloody stools or occult bleeding Renal disease is seen in up to 50% with features of nephritic syndrome (e.g., hematuria, proteinuria),
Henoch-Schönlein purpura (HSP) labs
↑ Platelet count which is most telling feature.
↑ IgA in serum
↑ Creatinine and/or BUN
Urinalysis to assess possible renal disease
Hematuria, often with RBC casts
Possibly proteinuria
↑ Inflammatory markers
what are the skin findings and kidney damage from HSP mediated by
IgA and C3 deposition
mesangial IgA deposition is the hallmark
how to diagnose hemochromatosis
genetic testing for C282Y or H63D
liver biopsy used to be the test of choice, now it is confirmatory
what is the presentation of hemachromatosis
a high ferritin and a transferrin saturation, especially in the presence of diabetes, hepatomegaly, and hyperpigmentation.
iron accumulates in the heart, pancreas and liver causing end organ damage through cardiomyopathy, cirrhosis, diabetes
what is the treatment for lyme in children under 8
amoxicillin; but can use doxycycline if the treatment course is short <21 days
never pick tetracycline
is the screening test for Lyme disease.
ELISA Peripheral facial nerve paralysis is the most common cranial neuropathy in Lyme disease. If ELISA is positive, Western blot should be performed to confirm the diagnosis.
the first-line treatment for Lyme carditis associated with arrhythmias
Intravenous ceftriaxone,
patient went on a hunting trip recently and now has fever, myalgia, periorbital edema, splinter hemorrhages, eosinophilia, and an increased serum creatine kinase concentration, all of which suggest an infection with
Trichinella spiralis.