B+W

Question 1

Elevated, edematous disks with blurred margins and tortuous engorged veins.
OR
normal appearing disk with gray folded elevations of retina

Answer 1

Retinal detachment

Elevations are detached portions of the retina

Question 2

Small hemorrhagic spots each with a central white area

Answer 2

Roth spots associated w/ 25% of all bacterial endocarditis pts

Question 3

Extra numerous narrow tortuous blood vessels superimposed over the normal vasculature

Answer 3

Diabetic retinopathy (hyperproliferation)

Question 4

Grayish white ovoid lesions with irregular, wool like margins of varying sizes, some just slightly smaller than the size of the disk

Answer 4

HTN

Cotton wool patches are soft exudates

Question 5

If a patient comes in with symptomatic atrial fibrillation, what must be done?

Answer 5

anticoagulate before cardioversion
unless… do not convert without anticoagulation unless a transesophageal echocardiogram is performed to rule out presence of intra-atrial clot.

Question 6

What are some causes of a fib?

Answer 6

alcohol
hyperthyroid
underlying valvular disease
Age is risk factor

Question 7

Why does hemachromatosis lead to the triad of skin pigmentation, bronze diabetes, cirrhosis, arthritis and CHF?

Answer 7

Iron accumulation in the heart –> CHF
liver –> hepatitis which leads to cirrhosis
pancreas –> DM
MCP Hand –> arthritis

Question 8

What are the symptoms and sequalae in the liver with hemachromatosis?

Answer 8

Hepatitis –> Cirrhosis –> HEPATOCELLULAR CARCINOMA

Question 9

How do you treat hemochromatosis?

Answer 9

regular phlebotomy

Question 10

Pt with Hx of RA, s/p appendectomy develops severe hypotension refractory to meds and hyperkalemia. How to tx her?

Answer 10

Pt is in adrenal crisis
Give IV steroids
Confirm dx with serum cortisol