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Davis' Flashcards

1
Q

basic tx of CHF (systolic)

A

B blocker, loop diuretic, ACE-I

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2
Q

tx of diastolic heart failure

A

diuretics and b blockers (improve ventricular filling by dec HR) and nondihydropyridine CCB, verap and dilt (improve ventricular compliance)

Diastolic due to aquired LVH (HTN, AS), or congenital LVH (HOCM, coarct of aorta), or infiltrative dx (amyloidosis), MI (transient stiffness)

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3
Q

Increased serum level of _____ appears to be more sensitive for dx of b12 def as red cell indices and b12 levels may be normal

A

methylmalonic acid

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4
Q

normal pressure hydrocephalus presents with

A

dementia PLUS abnormal gait AND urinary incontinence / urgency

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5
Q

G6PD

A

x-linked
acute hemolysis related to infection, meds or stress
elevated unconjugated bili

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6
Q

triad of cholangitis

A

abdominal pain, jaundice and fever

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7
Q

medications causing hepatotoxicity

A

methotrexate (folate reduces this risk)
amiodaroneisoniazid
Statins
Niacin

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8
Q

cocaine-induced MI/ CP

A

BENZOS!
no B blockers!!!!
also ASA, NTG, CCV, alpha blocker
combined b and alpha (labetalol) may be used

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9
Q

Common causes of SVC syndrome

A

small cell carcinoma of lung
non-hodgkins
thrombosis around indwelling central venous cath

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10
Q

MCC constrictive pericarditis in US

A

prior chest radiation

others: cardiac surgery, conn tissue dx, bacterial/TB pericarditis
Rare from viral pericarditis

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11
Q

Preferred initial test in aortic dissection

A

TEE

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12
Q

extraintestinal manifestation of crohns

A

arthritic (lg joint arthritis and spondylitis) - also UC
clubbing - also UC
cholelithiasis - malab of bile salts from terminal ileum

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13
Q

primary biliary cirrhosis

A

high alk phos

ANA found; antimitochondrial antibodies in 95%

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14
Q

SE of lithium therapy

A

tremor, hypothyroidism (inhibits thyroid hormone synthesis and release), cogwheel rigidity

thiazide diuretics (not loop) increase lithium levels

take w meals; avoid pregnancy

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15
Q

meds to monitor for hypothyroidism with

A

lithium, amiodarone, interfeon alfa, interleukin-2

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16
Q

hirschsprungs disease - cause and dx

A

absense of ganglion cells in colon

suction biopsy and rectal manometry

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17
Q

dx of CF w mecnium ileus

A

newborn screening via immunoreactive trypsin (IRT)

follow w sweat chloride tsting (hard in first 6 mo)

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18
Q

SE of prednisone

A 
hyperglycemia
osteoporosis (ca + vit d if on >3mo) (all men and post-meno women take bisphosphonate)
Peptic ulcer
cataracts
skin thinning w purpura
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19
Q

diseases associated with acanthosis nigricans

A

obesity, DM, GI cancer, cushing’s syndrome

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20
Q

complications of MONO

A

aseptic meningitis, bell’s palsy, hemolytic anemia, pericarditis, guillian-barre, thrombocytopenia, neutropenia, pericarditis (uncommon)

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21
Q

tumor lysis syndrome

A

from rapid tumor cell death
common in leukemia/lymphoma
give hyperkalemia, hyperphophatemia, hyperuricemia
may cause ARF

22
Q

carcinoid syndrome

A

from carcinoid tumors primarily found in GIT and bronchi
release humoral factors
flushing, diarrhea, wheezing
tricuspid or pulm valve dx may occur
dx by urinary excretion of 5-hydroxyindoleacetic acid (5-HIAA)

23
Q

dx of sarcoidosis

A

elevated serum ACE (50%) and serum calcium (3-5%)

24
Q

PFTs in restrictive lung disease

A

reduced total lung capacity and decreased CO diffusing capacity
FEV1/FVC ratio is normal or increased

25
Q

PFTs in obstructive lung disease (asthma/chronic bronchitis)

A

decreased FEV1/FEV ratio

ratio in normal person is dep on age… 80% in 20-39 y/o and 70% in pt 60-80

26
Q

Causes of diplopia

A

Cranial nerve III palsy
myasthenia gravis
multiple sclerosis (VI palsy - assoc w nystagmus)
inflamm/metabolic/vascular/neoplastic dx
cerebral aneurysms
DM (**PUPIL SIZE NORMAL - otherwise III palsy)
Wernicke’s (+nystagmus and disorientation/inattentive)

27
Q

Cranial n III palsy

A

ptosis, lateral deviation of eye, dilated pupil

28
Q

horner’s syndrome

A

ptosis, miosis, anhydrosis

29
Q

ABG in restrictive lung disease

A

siffness of lungs = hyperventilation and reduced oxygen diffusion. No outflow obstruction.

hypoxemia with hypocapnia
respiratory akalosis

30
Q

if b12 levels are borderline or pernicious anemia is suspected, test _______

A

methylmalonic acid levels

31
Q

Causes of clubbing of fingers and toes

A

Lung mets/CA, cyanotic congenital heart dx (ex: tetrology of fallot), endocarditis (late), cystic fibrosis, mesothelioma, bronchiectasis, lung abscess, idiopathic pulmonary fibrosis, hepatic cirrhosis, Crohn’s dx

***COPD is not assoc with clubbing ; look for another cause

32
Q

Hypertrophic osteoarthropathy (HO) is found in pts with clubbing who have

A

lung cancer, mesothelioma, bronchiectasis, cirrhosis

33
Q

QT prolongation is assoc with what electrolyte abn

A

hypomagnesemia

hypocalcemia

34
Q

when to use verapamil in place of adenosine for PSVT

A

when adenosine is contraindicated or ineffective. **adenosine may worsen bronchospasm in pt with obstructive lung disease!!!!!

35
Q

palpable purpura

A

henoch-schonlein purpura

post-URI; renal manifestation of acute glomerulonephritis, arthritis, and abdominal pain

36
Q

Polycystic kidney dx and coarctation of aorta both have a risk of what congenital problem??

A

congenital cerebral aneurysm (can result in rupture = SAH)

cerebral aneurysm that is not congenital can result from smoking, HTN, or HLD.

37
Q

Treatment of bacterial meningitis (neonates-3mo)

A

Ampicillin + cefotaxime/ceftriaxone

38
Q

Treatment of bacterial meningitis (3mo-55 y/o)

A

vancomycin + cefotaxime or ceftriaxone

39
Q

Treatment of bacterial meningitis (older than 55 of adults with alcoholism / debilitating illness)

A

vancomycin + cefotaxime or ceftriaxone + ampicillin

40
Q

Treatment of bacterial meningitis (hospital-aquired, posttraumatic, post neurosurgery, or if immunocompromised)

A

vancomycin + cefazidime + ampicillin

41
Q

Treatment of brain abscesses

A

IV PCN + chloramphenicol, metronidazole or both

add Nafcilin if staph aureus is suspected.

42
Q

Brown-sequard

A

unilateral cord lesion resulting ipsilateral motor disturbance with impairment of proprioception
contralateral loss of pain and temperature below lesion.

43
Q

Treatment: CAP typical

A

doxy, erythro, macrolides (clarithro, azithro), or fluoroquinolones
ceftriaxone/cefotaxinme +azithro or fluoro if admission needed

44
Q

pneumovax

A

> 65 y/o q 6 yrs

earlier if cardiopul dx, sickle cell, splenectomy, liver dx

45
Q

atypical PNA tx

A

erythromycin (mycoplasma/legionella)

tetracycline (chlamydia)

46
Q

HCAP MC pathogens

A

staph aureus, gram-neg

**pseudomonas in ICUs

47
Q

tx HCAP

A

empiric: cefepime, ticarcillin/calvulanic acid, piperacillin/tazobactam, meropenem

48
Q

HIV-related PNA (MCC and tx)

A

Pneumocystis jiroveci

**BACTRIM

49
Q

caseating granulomas

A

TB

50
Q

ghon complexes and ranke complexes

A

TB

51
Q

MCC croup

A

parainfluenza

Review tests (6 decks)

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