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Clinical Medicine > ClinMed_test3 > Flashcards

ClinMed_test3 Flashcards

1
Q

Define Medical emergency

A

An injury or illness that is acute and poses an immediate risk to a person’s life or long term health

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2
Q

Name the ABCDEFGHI in medical emergency

A 
Airway
Breathing
Circulation
Disability
Exposure
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3
Q

What to do in a case of Airway

A

Make sure they have patent airway.

Not busting out the epinephrine

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4
Q

What is the leading cause of morbidity and mortality in the US

A

Acute myocardial infarction (Heart attack)

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5
Q

Heart attack In men vs heart in chicks

A

Men-Levine Sign

Females - heartburn, SOB, back pain, vomiting.

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6
Q

Name the two types of acute stroke

A

Ischemic - most common(perform carotid bruit-looking for plaques). There is blockage
Hemorrhagic(Bleeding in the brain)

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7
Q

What should u check if pt reports had a severe stroke?

A

Check VF

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8
Q

What does the FAST protocol consist of

A

Face - smile
Arms - raise them
Speech - say a sentence
Time- call 911

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9
Q

Define Orthostatic Hypotension

A

A sudden drop in BP when you change position. This can happen if you stand up too fast, get dehydrated, or take certain medicines, such as ones for high BP

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10
Q

T/F

Fever will always be present before a seizure

A

False

It can present itself afterwards.

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11
Q

What is the trt of choice for anaphylaxis?

A

Epinephrine

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12
Q

What is the goal for ppl suffering from seizures

A

Prevent secondary injury

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13
Q

What is the cause of seizure

A 
Spontaneous epilepsy, drugs, metabolic disorders (hypoglycemia), 
rapidly increasing fever, 
brain tumor 
aneurysm
med withdrawal, stroke
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14
Q

how often do u need to inject epinephrine in a pt suffering from anaphylaxis

A

`5 to 15 mins

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15
Q

what are some signs seen with anaphylaxis

A

Angioedema
Urticaria
hypotension
Bronchospasm

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16
Q

Name possible trt for anaphylaxis

A

Steroids
Antihistamines
Beta-adrenergics (epinephrine, albuterol)

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17
Q

what is the best place to insert epipen

A

Rectus femoris site

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18
Q

What is the entity for cluster headaches?

A

Horner’s syndrome

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19
Q

Where is the pain on Horner’s syndrome

A

Facial pain radiating to the ipsilateral eye

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20
Q

Name the worst HA of your life

A

Can be subarachnoid bleed

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21
Q

Retrobulbar

A

Pain on eye mvts

No retinopathy.

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22
Q

Name the evidence for a person with end organ damage

A

Chest pain
Severe HA
Nausea, vomiting

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23
Q

Define Hypertensive emergency

A

Severe HTN + End Organ Damage

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24
Q

How do you prepare for emergencies?

A

Staff training
Community resources
Office equipment

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25
Q

What is the leading cause of death in the US

A

CVD-cardiovascular disease
There are diff types of the disease.
CAD-coron art disease!!!!!

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26
Q

Name the top two Cardiovascular disease leading to death

A

Coronary heart disease akak coronary artery disease-coronary arteries is blocked.
Stroke

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27
Q

Name some uncontrollable factors for Cardiovascular disease (CVD)

A

Sex
Race
Age
Hereditary

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28
Q

Name some controllable factors for Cardiovascular disease (CVD)

A 
Physical activity
Obesity
Smoking
Stress and anger
Diabetes
High blood pressure(biggest risk)
high blood cholesterol
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29
Q

Brittle diabetic

A

Their A1C is hard to control due to other factors like metabolic syndrome

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30
Q

T/F

Risk of cardiovascular disease double for every increase of 20 points over 115

A

True

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31
Q

name the most common type of heart disease?

A

Coronary heart disease aka Coronary artery disease

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32
Q

Define acute coronary syndrome

A

Umbrella term used to cover any grp of clinical symptoms compatible with acute myocardial ischemia

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33
Q

T/F

Woman are 5X more likely to die from cardiovascular disease than from breast cancer

A

True

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34
Q

Define angina pectoris

A

Uncomfy pressure, fullness, squeezing or pain in the center of the chest.

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35
Q

List the pts most likely to present w/o chest pain

A 
Elderly
Diabetes
Neuropathy
Stroke
Female
Non-white
CHF
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36
Q

What is the most common time of day for MI

Common day of week?

A

6am to 12pm

Monday

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37
Q

Name the drug used as preventative care for CAD

A

Aspirin.
It thins the blood.
Side effects: Subconj Heme

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38
Q

List the medical management of CAD

A 
Aspirin-antiplatelet
Anticoagulants
Beta blockers
Thrombolytics
Nitrates 
Morphine
ACEI's
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39
Q

INR values

A

Less than 2 = too thin
2-3 = normal
More than 3 = too thick

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40
Q

What is the most common immediate cause of death in a myocardial infarction?

A

Arrhythmia

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41
Q

What should u suspect if u witness a roth spot heme?

A

Suspect endocarditis
Diabetes
HTN
Vascular

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42
Q

What is the white spot found in the center of the roth spot heme

A

CWS
Lymphoma
Septic Emboli

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43
Q

What are the top two things leading to bacterial endocarditis

A

Tooth extraction

Brushing teeth

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44
Q

Osler nodes

A

Small painful ischemia on the palm of the hand or feet

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45
Q

What do osler nodes indicate

A

Thrombocytopenia

Inflammatory disease

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46
Q

Diff b/w osler nodes and Janeway lesions

A

Janeway are Painless

Osler are painful

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47
Q

What kind of hypersensitivity rxn is Janeway lesion

A

Type III

Need to r/o Syphillis

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48
Q

Where do splinter hemes appear

What condition

A

Petech heme on inf plap conj or conj

Bacterial endocarditis

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49
Q

Name the most common arrhythmia that requires trt

A

Atrial Fibrillation

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50
Q

TQ: signs and symptoms of CHF

A 
Periph Edema
Pulmonary Edema
SOB
Dyspnea or exterion/exercise intolerance
Paroxysmal nocturnal dyspnea
Orthopnea
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51
Q

Medical management for CHF

A 
Diuretics
ACEI's or ARBS
Beta Blockers
Aldosterone receptor antagonists
Digoxin
52
Q

Look up Marfan Disease

A

Okee

53
Q

Signs of Margan disease

A 
Reduced upper to lower body seg
Arm span exceeding ht
Arachnodacyl of fingers and toes with pos thumb and wrist signs
Scoliosis
Dilation of the Aorta
Aortic dissection
Ectopia lentis
Dural ectasia
54
Q

Function of the normal kidney

A

Major waste management plant of the body

  1. Filters and excretes metabolic waste products
  2. Excretion of nitrogenous wastes
  3. Detoxifies and eliminates toxins
  4. Regulates red blood cell production
  5. BP regulation
  6. Keep the acid/base concentration of your blood constant
  7. Regulates fluid and electrolyte balance
55
Q

Name the two parts to a nephron

A

Glomerulus

Tubules

56
Q

What does Blood Urea Nitrogen(BUN) represent

A

Reflects excretory capacity of kidney.

It is the final breakdown product of protein

57
Q

What is the normal value of BUN

A

10-20 mg/dl

58
Q

What is creatinine

A

Product of skeletal muscle metabolism.

Freely filted by glomerulus, not reabsorbed; minimally secreted by tubules.

59
Q

Name the 2things that effect Creatinine

A

Age

Muscle mass

60
Q

T/F

Creatinine clearance gives an accurate estimation of GFR

A

False

Overestimation

61
Q

what is the normal GFR for men and woment

A

Males: 130 ml/min
Women: 120 mL/min

62
Q

define Prerenal ARF

A

Reduced renal perfusion due to volume depletion and/or decreased perfusion.
Biggest cause is dehydration

63
Q

What is the biggest cause of Pre-renal ARF

TQ

A 
Dehydration
Others:
volume loss(bleedg)
heart failure
shock
liver disease
64
Q

What is post-renal ARF

A

Any obstruction to urinary outflow from renal calyces and pelvis to urethral meatu.
OBSTRUCTION-THIS IS PAINFUL
THIS IS AN EMERGENCY

65
Q

How many pts die from ARF

A

50%

66
Q

What are the ocular findings in ARF

A 
Uveitis
Ocular Muscle paralysis
Hollenhorst crystals
Roth spots in endocarditis
Lupus retinopathy
67
Q

Lupus retinopathy and kidney?

A

U will see acute lupus nephritis.

Biggest cause of death in pts.

68
Q

Name the two conditions that cause CKD

A

Diabetes

HTN

69
Q

Define Chronic Kidney disease

A

Presence of markers of kidney damage for three months.

70
Q

Name some ocular disorders in CKD

A

Band K
Calcium deposits in conj, hyperemia
HTN retinopathy
Cranial nerve involvement: nystagmus, miosis, pupillary, EOM palsy

71
Q

Name the three trt options for renal disease

A
  1. Hemodialysis
  2. Periotneal Dialysis
  3. Kidney transplantation
72
Q

Name the indications for dialysis

A 
A E I O U
A; intractable metabolic acidosis
E: electolyte imbalance, esp hyperkalemia
I: intoxications
O: overhydration
U: uremia
73
Q

What is the most common renal tumor in childhood?

A

Wilms tumor

95% before age 10

74
Q

What is

WAGR

A

Wilms Tumor
Aniridia
GU anomalies
Mental retardation

75
Q

Name the 7 types of primary lesions

A 
Macule
Papule
Plaque
Hives
Nodule
Vesicle
Bulla
76
Q

Name the 9 secondary lesion

A 
Crust
Scale
Erosion
Ulcer
Fissure
Atrophy
Scar
Lichenification
Excoriation
77
Q

What is another name for actinic keratosis

A

Pre-cancer to squamous cell carcinoma

78
Q

Where is actinic keratosis usually found

A

On skin exposed areas

79
Q

Is actinic keratosis progressive

A

Not really.

It is slowly growing, can take yrs to develop unless immunocompromised.

80
Q

Which skin condition may develop a horn like texture

A

Actinic keratosis

81
Q

How to trt actinic keratosis

A
  1. Burning
  2. Curettage and electrodesiccation
  3. Excision
  4. Cryotherapy
  5. 5-FU and Imiquimod: creams
82
Q

What happens to the skin during therapy for actinic keratosis with 5-FU

A

As abnormal cells are eradicated, skin becomes redder, crusts and peels.

83
Q

Name the three types of skin cancers

A

Basal Cell Carcinoma
Squamous Cell Carcinoma
Malignant Melanoma

84
Q

T/F Basal cell carcinoma spreads throughout the body

A

False

85
Q

Are basal cell carincoma curable

A

Yes; high cure rate.

But, there is a 20-40% chance of developing another case.

86
Q

Name the skin cancer that accounts for 80% of new skin cancer cases

A

BCC

87
Q

Can squamous cell carincoma spread?

A

claro que si

88
Q

How to treat BCC and SCC

A

Surgical excision
Mohs sx
5 FU, Imiquimod cream
Radiation therapy

89
Q

What is the worst skin cancer

A

Malignant Melanoma

80% of skin cancer deaths

90
Q

Is malignant melanoma curable?

A

Si

91
Q

What are the ABCDE of Melanoma

A 
Asymmetry
Border
Color
Diameter >6mm
Elevation
92
Q

What is superficial spreading melanoma

A

It grows as small plaque for 6 to 24 months and then develops nodule.
It is highly invasive.

93
Q

What are some lab studies to include when diagnosing a possible skin cancer

A 
Liver function test
Dermoscopy
Wood's lamp
CBC w/ diff
Pet Scan
94
Q

Prognosis of melanoma sizes

A

Less than 1mm have good prognosis

Lesion that are greater than 3mm have guarded prognosis

95
Q

Managment of melanoma

A

Excision
Lymph node dissection
Examination and lab screening for metastasis
Trt for metastatic dz usually unsatisfactory

96
Q

What is allergic contact dermatitis

A

A delayed hypersensitivity rxn caused by contact with an allergen

97
Q

Management of eczematous dematitis in all stages

A 
Topical steroids
Immunomodulators
IM seroids
Antihistmaines
Antibiotics
Lubrication
98
Q

What is eczema herpeticum

A

Disseminated HSV
Painful, umbilicated pustular vesicals
Fever, malaise, lymphadenopathy
Significant morbidity and mortality

99
Q

What is molluscom contagiosum caused by

A

Pox virus.

Dome shaped papules with central plug and umbilication

100
Q

What kinds of pts does molluscum occur in

A

Children
Young adults
Immunocompromised pts

101
Q

Which pathogen causes impetigo

A

Staph aureus

102
Q

Describe impetigo

A

Pustular vesicles with straw colored discharge

103
Q

Trt of impetigo

A

Self limiting
Systemic antibiotic
Topical Bactroban ung - TID for ten days

104
Q

What is Dermatomyositis

A

Acquired, idiopathic connective tissue disease.

Charact by proximal muscle weakness, rash on eyelids, scalp.

105
Q

Pathognomonic features of dermatomyositis

A

Heliotrope rash

Gottron’s papules

106
Q

What is the name of the sign that is on the tip of the nose in Zoster

A

Hutchingson’s sign.

Means there are ocular complications

107
Q

Management of zoster

A

Antiviral agents: valtrex, famvir, acyclovir
Prednisone
Anti staphy Abs
Oc lubs

108
Q

Can nevus of ota cause glaucoma

A

Si

Up to 10%

109
Q

What is syringoma

A

Benign adnexal neopaslm

Formed by well diff ductal elements

110
Q

What is a Hidrocystoma

A

Cystic lesion of either the apocrine or eccrine sweat glands

111
Q

What is xanthoma

A

Lipid deposit in the skin and tendons

112
Q

Xanthelasma -

A

yellowish plaques on the eyelids.

50% have normal cholesterol but higher LDLs

113
Q

Rosacea-Derm findings

A 
Facial erythema
Telangiectasia
Red papules
Pustules
Sebaceous gland hypertrophy
Rhinophyma
114
Q

Trt of Rosacea

A 
Oral tetracyline, doxycycline
Oral erythromycin
Topical metronidazole
Isotretinoin
Lid hygient
Ats
Topical steroids
115
Q

Rosacea - Complications

A

Corneal scarring
COrneal perforation
Bleph
COnjunctivitis

116
Q

What is seborrehic dermatitis

A

Common, chronic, inflammatory dermatitis
Associated with overgrowth of yeast Pityosporum ovale
Face, scalp, presternal, upper back.

117
Q

Trt of seborrheic dermatitis

A 
Sodium sulfacetamide
Metronidazole
Ketoconazole shampoo
Tar shampoo
Topical steroids
Immunomodulators (elidel and protopic)
118
Q

Psoriasis

A

Lifelong and characterized by chornic, recurrent exacerbations and remissions that can be emotionally and physically debilitating `

119
Q

Pesudoxanthoma elasticum in the eye?

A

Angioid straks

120
Q

Define metabolic syndrome

A

Group of risk factors that occur together and increase the risk for coronary artery disease and stroke

121
Q

Name some risks for AMD

A 
Age
Genetics
Gender
Smoking
Sunlight exposure
High levels of LDL and low levels of HDL
High BMI
122
Q

What percentage of AMD cases are linked to Dry AMD

A

90%

10% = Wet AMD

123
Q

T/F

BMI of 30 or higher was associated with a twofold higher risk of AMD

A

True

124
Q

T/F

Obese men were 2x more likely to have dry AMD

A

true

125
Q

T/F

Genetics plus higher BMI increased risk of AMD almost sixfold

A

True

126
Q

What was the Diabetes Prevention Program

A

Modest wt loss through dietary changes and increased physical activity could prevent or delay the onset of type II diabetes in study participants by 58%.

127
Q

What did the ARIC and cardiovascular health study find?

A

Obese persons were found to have a nearly four-fold increased risk of retinal vein occlusion

Clinical Medicine (3 decks)

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