BUZZ3 Flashcards
Pneumonia: CBC
- Increased WBC (NV: 4500 -
11000) - Increased Neutrophils (NV:
2500 - 8000) - Decreased Lymphocytes (NV:
1000 - 4800)
Gram +, lancet-shaped
Streptococcus pneumoniae
Antibiotic of choice for
pneumonia caused by
Streptococcus
pneumoniae
No co-morbid illness:
Amoxicillin (DOC)
Extended macrolides
(azithromycin, clarithromycin)
Stable co-morbid:
B- lactam/BLIC combination
2nd generation Cephalosporins
+/- extended macrolides
40/M with CC: DOB
(+) fever, dry cough for 5
days; PE: crackles at
both bases & right mid
lung fields
Expected PE findings
- RR of 32/min
- HR of 120/min
- Apical S3 or 3rd heart sound
40/M with CC: DOB
(+) fever, dry cough for 5
days; PE: crackles at
both bases & right mid
lung field
Expected ABG findings
- Oxygen saturation of 80%
- pH of 7.45
- Partial pressure of oxygen of
55 mmHg
40/M with CC: DOB
(+) fever, dry cough for 5
days; PE: crackles at
both bases & right mid
lung field
PaO2/FiO2 ratio
150
Differential diagnoses
for 52/M, smoker,
hypertensive, diabetic
(+) severe, crushing
chest pains, cold sweats,
shortness of breath 1-hr
duration
- Acute pulmonary embolism
- Acute massive myocardial
infarction - Acute aortic dissecting
aneurysm
Possible ECG findings
for 52/M, smoker,
hypertensive, diabetic
(+) severe, crushing
chest pains, cold sweats,
shortness of breath 1-hr
duration
- 3-4mm ST elevation in V1-V6
- 3-4mm ST depression in V1-V6
- Diffusely low QRS voltages
with pathologic Q waves - T wave inversion in V1-V5, I,
AVL, II,III, AVF
52/M, smoker,
hypertensive, diabetic
(+) severe, crushing
chest pains, cold sweats,
shortness of breath 1-hr
duration
Trop I = 0.40 ng/ml; BP:
80/60; HR: 120 bpm
Most appropriate
intervention
Percutaneous coronary
intervention
Case: HF in CKD?
Values expected in the
case
- Hyperkalemia
- Hypernatremia
- Hypertriglyceridemia
- Elevated HbA1c
Anti-diabetic drug to be
avoided if the estimated
GFR is
29/ml/min/1.73/m2
Metformin
Recommend renal
replacement therapy
GFR less than
15ml/min/1.73/m2
Diarrhea due to cholera
Secretory diarrhea
Ion lost most
significantly in cholera
Sodium
Intestinal fluid secreted
in cholera
Isotonic
Diarrhea associated
with bowel movement
of 6 or more per day
Secretory diarrhea
Diarrhea associated
with inhibition of
absorption in the gut
Osmotic diarrhea
Diarrhea caused by
ingestion of excessive
sugar or salt
Osmotic diarrhea
Elderly patient rushed to
ER presenting with sudden
on dyspnea and orthopnea
preceded by chest
discomfort
PE: apical S3, high-pitched
blowing systolic murmur,
bilateral crackles
Acute mitral regurgitation
Most likely cause of acute
mitral regurgitation in the
case above
Ischemic papillary muscle
Acute mitral
regurgitation
management
- Diuretics
- Beta-blockers
- ACE inhibitors
- Digitalis
- Intravenous vasodilator
Serum amylase and
lipase in acute
pancreatitis
- Lipase is more sensitive to
pancreas and remains
elevated longer - Serum lipase rises within 3-6
hours from onset of
pancreatitis - Have no role in assessing
disease severity
Normal serum amylase
in acute or chronic
pancreatitis
Suppression of pancreatic
zymogens or proenzymes
Falsely elevated serum
amylase
Salivary gland disease
Bowel obstruction, infarction
Perforated ulcer
Confirm the presence of
a nodule and assess the
status of thyroid gland
Thyroid ultrasound
Evaluate the physiologic
function of thyroid
nodules
- TSH assays: assessment of thyroid
function - Antithyroid antibodies: determine
etiology of thyroid dysfunction - Thyroid UTZ: diagnosis and
evaluation of nodular thyroid disease - Calcitonin test: marker for
medullary thyroid carcinoma - Fine needle aspiration: most
accurate test for determining
malignancy
Detection of metastases
of thyroid cancer
Scintigraphy
51/F, lost to follow up
with her endocrinologist
Erratically taking
Methimazole
Presents with acute
onset of restlessness
and agitation, confusion,
vomiting and diarrhea
Thyroid storm
Expected findings in
thyroid storm
- Pyrexia
- CNS alterations (agitation,
delirium, psychosis, seizure, coma) - GI dysfunction (diarrhea,
jaundice) - Tachycardia
- CHF
Management for thyroid
storm
- Stop production of thyroid
hormone: PTU, methimazole,
hydrocortisone - Block peripheral effect of
thyroid hormone: propranolol - Inhibit hormone release: SSKI,
sodium iodide
Most common extra
articular
manifestation of
ankylosing spondylitis
Anterior uveitis (20-30%)
Others:
* Inflammatory bowel disease
* Heart conduction disturbances
* Aortic insufficiency
* Psoriasis
* Renal abnormalities
* Osteoporosis
* Vertebral fractures
Minimum size of
kidney stone that can
block ureter
8mm
(Ureteral diameter is 5-8mm)
Anemia of
inflammation usually
associated with
Cancer-related anemia
a.k.a. Anemia of chronic disease
Most common type of
hallucination in
psychotic patients
Auditory hallucinations
Specific treatment for
dysuria caused by UTI
Phenazopyridine
Lymphocyte cells
commonly associated
in lymphocytic
leukemia
B-cells
Most common cause of
uncontrolled BP
elevation in secondary
hypertension
Renovascular stenosis
OSAHS is likely
contributory to the
following
comorbidities
- Pericardial effusion, pulmonary
hypertension, or right-sided
heart failure - NAFLD
- Refractory hypertension,
systemic hypertension,
coronary artery disease, cardiac
arrhythmias, heart failure and
stroke - Metabolic syndrome and Type 2
diabetes - Neuropsychiatric dysfunction
Minimum duration of
productive cough in
acute bronchitis
At least 3 months in each of 2
consecutive years
Rapid correction of
hyponatremia may
lead to
Osmotic demyelination syndrome
(ODS), previously known as
Central Pontine Myelinolysis
(CPM)
Acute gouty arthritis
- Higher vitamin C intake is
independently associated with a
lower risk of gout. Supplemental
vitamin C intake may be beneficial
in the prevention of gout. - negatively birefringent needleshaped
monosodium urate
crystals in aspirated joint fluid - occurs commonly in beerdrinkers
and meat eaters - blood uric acid levels may be
normal during an attack
Viral or idiopathic
pericarditis treatment
- Aspirin or Ibuprofen
- Colchicine
- Corticosteroids
Most predominant
underlying cause of
acne vulgaris
Genetic predisposition
95% of cells in the
epidermis
Keratinocytes
Effective treatment in
acute severe allergic
reactions
- Epinephrine (adrenaline) –
reduction of body’s allergic response - Oxygen – to aid in breathing
- IV antihistamine and
corticosteroids – reduction of
inflammation of air passages and
improvement of breathing - Beta-agonists – relief of breathing
symptoms
Tried to retard
progression of
rheumatoid arthritis
Hydroxychloroquine
HIV / AIDS
Prolonged asymptomatic stage after
initial infection
Median time: ~ 10 years
Fast phase nystagmus
Peripheral vestibular
lesion
Cold water in the ear, which causes
ipsilateral vestibular dysfunction,
produces nystagmus to the opposite
side
(Mnemonic: “cows”)
Supportive treatment
of acute dengue
- Maintaining hydration with oral or
parenteral fluids - Paracetamol as antipyretic or analgesic
- Platelet transfusion in more severe cases
of thrombocytopenia - NSAIDs are contraindicated for
management of pain and fever because of
potential increase in bleeding risk
HbA1c goal for
patients with Type 2
DM
<7.0%
Antibody in allergic
reactions
IgE
Dengue vaccine
indications
9 to 16 years old with laboratoryconfirmed
previous dengue
infection and living in endemic
areas
Allergic reactions
Immunoglobulin binds to allergen
and mast cells
Metabolic syndrome
Criteria:
* Central obesity – Waist circumference
>102cm (M) or >88cm (F)
* TG ≥ 150 mg/dL or use of specific
medication
* HDL <40mg/dL (M) or <50mg/dL or use of
specific medication
* BP ≥130 systolic or ≥85 diastolic or use of
specific medication
* ≥100 mg/dL or use of specific medication
or previously diagnosed T2DM
Most common primary
cancer that cause
brain metastasis
Lung cancer
Prevention of oral
thrush in patients on
inhaled steroids
Rinse mouth with water
immediately after using inhaler
Most common
offending organisms in
infective endocarditis
Streptococci and Staphylococci
Sjögren syndrome
Dry skin, mouth, eyes, nose
Confirmed by tissue biopsy
Avoid antihistamines like
diphenhydramine
Long term inhaled
steroids increase risk
for
Pneumonia
Most common cause of
UTI
E. coli
Primary antibiotics for
UTI
Nitrofurantoin and Fosfomycin
Nerve associated with
sinus arrhythmia
Vagus nerve
Drug associated with
development of renal
cell carcinoma
Aspirin, Ibuprofen, Paracetamol
Smoking increases risk
for kidney cancer by
how much
2 times the risk
Bruising in flanks of
hemorrhagic
pancreatitis
Grey-Turner sign
Scleroderma
- woman with thickened skin, tight
fingers “sclerodactyly - Raynaud’s phenomenon or digital
pitting scars – dark shiny skin on
distal phalanges of both arms - Associated with sclerodactyly
- Associated with Vitamin D
deficiency
