BR medicine Flashcards
What is Leriches syndrome?
Impotence with buttock, calf, and back pain.
Seen with aortoiliac disease
Define hypertensive emergency
Diastolic pressure over 115 mmHg
With proven end organ damage.
What is levedo reticularis?
A bluish red discoloration of the skin resulting from vasospasm of the arterioles.
condition is worsened by the cold.
You hear normal ventilation with decreased perfusion what should you be thinking?
Pulmonary embolism causing a decreased perfusion of oxygen from the lungs into the blood flow.
What is the gold standard for DVT diagnosis?
Use to be a venogram.
Venous duplex ultrasound is quickly becoming the new gold standard.
What is the gold standard for PE diagnosis?
Pulmonary angiography?
CT pulmonary angiography has now become the gold standard.
What percentage of postoperative fvers are caused by atelectasis?
90%
Why does post operative atelectasis matter so much?
If it proceeds for longer than 72 hours it can lead to pneumonia increasing mortality rates.
Why dont you want to place a COPD patient on high flow oxygen?
You supress the hypoxic ventilatory drive.
What are the side effects of treating tuberculosis with isoniazid?
Neuropathy ***
Lupus like syndrome
Hepatitis
Anion gap acidosis
Erythema nodosum is most commonly related to?
Most commonly related to GI pathology including irritable bowel syndrome, ankylosing spondylitis, uveitis etc.
Most common cause of hypophosphatemia?
Renal disease!
Chronic and acute
Signs and symptoms of adrenal insufficiency?
Hyper pigmentation
orthostatic hypotension
Weakness/fatigue etc.
How long must a generalized tonic-clonic seizure last without a period of consiousness to be considered status epilepticus?
30 minutes!
Pseudohypertrophy of the calves is characteristic of which type of muscular dystrophy?
Duchennes muscular dystrophy.
Hypertrophy is caused by fatty infitrate of the muscles.
What is the most common presenting symptom of multiple sclerosis?
Optic neuritis
After penicillin what is the most common cause of anaphylaxis related deaths?
Insect stings!
What is Lhermitte sign in ankylosing spondylitis?
Seen with rheumatoid arthritis and multiple sclerosis as well.
A sensation of electric shock that radiates down the back when the neck is flexed.
This is a sign that atlantoaxial subluxation and C-spine instability may be present.
SLE, Juvenile rheumatoid arthritis, and rheumatoid arthritis are related to what cardiac condition?
Pericarditis.
A patient who cannot walk on his or her toes has a lesion in which spinal level?
S1
A patient with back pain who cannot walk on there heels has a lesion at which spinal level?
L5
Below what platelet count is spontaneous hemorrhage likely to occur?
<10,000 mm3
What is the only coagulation factor not synthesized by hepatocytes?
8
Made by the liver sinusoidal cells.
Max dose of antidote protamine sulfate?
100mg
1mg will correcct 100 units of heparin
Why are quinolones contraindicated in children?
Have a negative effect on chrondrocytes.
Absent knee jerk involves which slinal level
L4
Absent achilles tendon involves which spinal level?
S1
Parasthesias of the great toe involve which spinous level?
L5
Parasthesias of the little toe involve which spinous level?
S1
What is Brudzinkis sign?
Check for meningitis, flexion of the neck causes flexion of the knees.
What is the minimal rate of blood flow necessary to produce an audible signal?
4 cm/sec
What pressure difference between segmental pumps is considered pathologic?
20-30 mmHg
Which heart valve is most commonly effected in IV drug users?
Tricuspid
What additional heart sound is heard in patients undergoing an MI?
S4 atrial gallop
What blood marker rises and falls most rapidly following an MI?
Creatinine phosphokinase
What is the most specific cardiac marker to trend after an MI?
LActic dehydrogenase (LDH)
It is also used as an index of myocardial necrosis.
What are the two forms of hypertension and which is most common?
Essential hypertension: unknown cause and most common
Secondary hypertension
Hypochromia and microcytosis are morphological findings in which type of anemia?
Iron deficiency anemia.
Which anemia can have neurologic manifestations?
Anemia due to Vitamin B12 deficiency can cause peripheral neuropathy, posterolateral column degeneration and behavioral changes.
Megaloblastic anemia.
What is polycythemia vera?
A neoplastic myeloproliferative disorder with red cell proliferation and variable degree of thrombocytosis and leukocytosis.
Majority of symptoms due to hyperviscosity of the blood.
What causes hemophilia A?
Bleeding disorder due to an inherited deficiency in vonwillibrand factor 8
ONLY MEN ARE EFFECTED this is transferred through a sex linked recessive pattern.
What is the deficient plasma coagulant protein in Christmas disease?
Hemophilia B
Deficient in factor 9
What platelet count is considered thrombocytopenic?
<150,000
