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Sicular > Day 3 - radiology, neurology > Flashcards

Day 3 - radiology, neurology Flashcards

1
Q

cavitary lesion in upper lobe = think?

A

TB

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2
Q

intubation then sudden white out on L afterwards indicates?

A

Tube in R main bronchus –> airway obstruction of L

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3
Q

Next step after intubation?

A

Xray to make sure in right place
OR
Listen to lung to ensure it is in right place

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4
Q

Numerous eosinophilic cells n bronchioalveolar lavage = think?

A

Eosinophilic pneumonia

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5
Q

What medications decrease mortality in CHF pts?

A
  • ACE
  • Beta blockers
  • Spirinolactone
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6
Q

What decreases mortality for COPD pt?

A
  • Oxygen

- Stop Smoking

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7
Q

What disease has kidney issues + cerebral aneurysm + cardiac valve issues?

A

polycystic kidney disease

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8
Q

polycystic kidney disease associated w/?

A
  • aortic aneurysm –> AR, sometimes MVP
  • berry aneurysm
  • liver cyst
  • Kidney issues
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9
Q

What 3 diseases associated w/ aortic aneurysm, cardiac valve issues, and berry aneurysm?

A
  • Polycystic kidney disease
  • Marfans
  • Erhlos Danlos
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10
Q

tumor starts outside of the brain but next to it = think?

A

meningioma

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11
Q

tumor starts outside of the brain but next to it + pressing on temporal lobe = think?

A

meningioma

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12
Q

alcoholics w/ bloody cough = think?

A

Klebsilla or at least gram neg rods

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13
Q

pulm issue after being in CAVES = think?

A

Histoplasmosis

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14
Q

brain tumors 2 most common types?

A
  • metastasizes

- glioblastoma

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15
Q

workup of valve disease -?

A

initial - Transthoracic echo
2) Transesophageal echo
Confirmatory/gold standard - Catheterization and angiography

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16
Q

Work up for ejection fraction issues –?

A

initial - Transthoracic echo

cofirmatory/gold standard - MUGA scan

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17
Q

L sided colon CA most common presenting symptom =?

A

Obstruction

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18
Q

R sided colon CA most common presenting symptom =?

A

Microcytic Anemia/bleeding

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19
Q

60 yo w/ iron deficiency anemia most likely cause?

A

Colon cancer (likely R sided)

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20
Q

tubular, “finger like” consolidation in lung = think?

A

Allergic bronchopulmonary aspergilosis

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21
Q

Central mass (closer to trachea) get biopsy how?

A

Bronchoscopy (needle through bronchus)

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22
Q

Peripheral mass (closer to outside of lung) get biopsy sample how?

A

CT-guided lung biopsy

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23
Q

Lung Nodule dx pathway?

A

1) Xray
2) CT
3) Biopsy
4) PET scan

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24
Q

multiple ring enhancing lesions in HIV pts = think?

A

Toxo

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25
Q

1 ring enhancing lesion in HIV pt = think (2)?

A
  • Toxo

- Primary CNS lymphoma

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26
Q

Treatment of toxo = ?

A

Pyrimethamine and sulfadiazine

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27
Q

HIV pt w/ single solitary ring enhancing lesion on imaging, what is next step?

A

Brain biopsy to determine proper treatment

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28
Q

ankylosing spondylitis treatment?

A
  • NSAIDs (indomethacin)
  • if above doesn’t work, then start intense autoimmune meds that are not steroids (DMARDs - Disease-modifying antirheumatic drug)
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29
Q

Ankylosing spondylitis give steroids or not?

A

NO

  • doesn’t work well
  • may predispose to spinal fracture b/c it predisposes to ostepenia
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30
Q

Subfalcine herniation would present with what on imaging?

A

Midline shift

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31
Q

image of cerebellar head asking about herniation = think?

A

Cerebellar tonsillar herniation

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32
Q

Transtentorial herniation presents how on imaging?

A

Roof of cerrebellum (tentori), brain can push through tentori –> see tentori and brain appears to be squishing brainstem (uncal may appear similar)

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33
Q

Transcalvarial herniation presents how on imaging?

A

Brain pushes through skull (ie through fracture)

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34
Q

polycystic kidney disease caused by what?

A

Defect in epithelial cell differentiation

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35
Q

Mutation Transmembrane Conductance Regulator Protein = think?

A

Cystic Fibrosis

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36
Q

Mutation of a connective tissue protein think?(2)

A

Marfans (fibrillin) or Erlos Danlos

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37
Q

Treatment for breast cancer = ?

A

1) Surgery - lumpectomy v mastectomy (size determines)
1a) w/ lumpectomy ALWAYS do radiation too (regardless of nodes)
2) Add Chemo for cases w/ CA in nodes/metastases
3) Add Tamoxifin - only for those that are estrogen receptor +

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38
Q

Reasons to admit to ICU ()?

A
  • Need to intubated
  • Renal failure (pre, post, ATN)
  • VS severely abnl (esp RR >30)
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39
Q

Fine tremor at rest = think?

A

Parkinsonism

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40
Q

tinnitus, hearing loss, vertigo = think?

A

Meniere’s Disease

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41
Q

Positional vertigo = think?

A

Benign positional vertigo

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42
Q

Vertigo due to medication/toxin is?

A

Toxic labyrinthitis

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43
Q

Toxic labyrinthitis can be cause by what family of meds?

A

Aminoglycoside

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44
Q

Vertigo non-positional, not due to meds, w/o hearing loss = think?

A

Vestibular neuronitis (Benign recurrent vertigo)

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45
Q

Teenage boy w/ bleeding nasal mass is?

A

Juvenile nasopharyngeal angiofibroma

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46
Q

treat juvenile naopharyngeal angiofibroma how?

A

Embolization

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47
Q

opthalmoplegia + alcoholic = think?

A

Wernike encephalopathy b/c thiamine deficiency

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48
Q

Wernike encephalopathy treat how and in what order?

A

Give thiamine BEFORE glucose

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49
Q

best initial test for dx of guillane barre in non-emergent case?

A

CSF studies

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50
Q

Confirmatory/gold standard test for dx of guillane barre in non-emergent case?

A

Motor nerve conduction test

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51
Q

fasciculations are a what type of motor neuron problem?

A

LMN

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52
Q

Deep tendon reflex are brisk indicate what type of motor neuron problem?

A

UMN

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53
Q

UMN and LMN problems = think?

A

ALS

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54
Q

MVA and clear discharge from ear –> concerned for? Dx by?

A

CSF leak

Test w/ Beta 2 transferrin

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55
Q

Test for CSF fluid with?

A

Beta 2 transferrin level

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56
Q

lambert eaton pathophys?

A

Ab-mediated detruction of presynaptic calcium channels

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57
Q

Muscle weakness improved with activity = think?

A

Lambert Eaton

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58
Q

Muscle weakness worse with activity = think?

A

Myasthinia Gravis

59
Q

What is associated w/ Lambert Eaton?

A

Lung CA

60
Q

Myasthinia Gravis pathophys?

A

Immune-mediated nicotinic acetylcholine receptor blockade

61
Q

Lambert Eaton pre or post synaptic?

A

PRE-synaptic

62
Q

Myasthinia Gravis pre or post synaptic?

A

POST-synaptic

63
Q

Dandy Walker is?

A

Absence of the posterior cerebellar vermis

64
Q

Chiari malformation type 1 = ?

A

Type I involves the extension of the cerebellar tonsils (the lower part of the cerebellum) into the foramen magnum, without involving the brain stem. Normally, only the spinal cord passes through this opening.

65
Q

Chiari malformation type 2 = ?

A

“Arnold Chiari” involves the extension of both cerebellar and brain stem tissue into the foramen magnum. Also, the cerebellar vermis (the nerve tissue that connects the two halves of the cerebellum) may be only partially complete or absent.

66
Q

Chiari malformation type 2 associated w/?

A

myelomeningocele

67
Q

Chiari malformation type 1 associated w/?

A

syringomyelia/spinal cavitations

68
Q

tongue deviated to one side = ?

A

Hypoglossal nerve damage

69
Q

Tongue deviated towards the lesion or away?

A

TOWARDS – “Lick the Lesion”

hypoglossal nerve

70
Q

issue in caudate = think?

A

Huntington’s disease

71
Q

Winged scapula = what nerve damaged?

A

Long thoracic nerve

72
Q

morning headaches = think?

A

Inc ICP

73
Q

morning headaches –> think Inc ICP + worry about what types of masses (2)?

A

1) Astrocytoma

2) Medulla blastoma

74
Q

Trigeminal neuralgia treatment?

A

Carbamazipine

2nd line gabapentin

75
Q

MRI shows what for Trigemnial neuralgia

A

NOTHING!

76
Q

nuchal rigidity + severe headache = dx pathway?

A

CT head w/o contrast

LP if CT head non-diagnostic

77
Q

Nuchal rigidity happens when?

A

meniges are irritated

1) Meningitis
2) Subarachnoid Hemorrhage

78
Q

In SIADH what is the vol status and urine sodium?

A

Euvolemic or hypervolemic (chronic v acute)

Urine Na HIGH bc water being sucked out

79
Q

Reasons to give contrast w/ CT?

A

If worried about:

  • infx
  • tumor
  • something in a vessel (embolism, mass, etc)
80
Q

nL lab values (esp CK) + muscle weakness + on steroids = ?

A

Steroid induced muscle weakness –> taper

81
Q

Hearing Loss diff dx (5)?

A
  • Meniere disease (+tinnitus, vertigo)
  • Acoustic neuroma (+tinnitus, vertigo, mass on imaging)
  • Presbycusis (sensory-neural hearing loss, old ppl)
  • Chronic otitis media (hx, TM scarred/bulging/dull)
  • Otosclerosis (conductive hearing loss, genetic)
82
Q

Pain in the eye/around eye + watery eye = think?

A

Cluster headache

83
Q

Treat cluster headache (2)?

A

Step 1) Oxygen

Step 2) Sumatriptan

84
Q

Trigeminal Neuralgia treat?

A

Carbamazepine

85
Q

Treatable causes of dementia

A
  • Pseudodementia (depression)
  • Hypothyroid
  • Syphillis
  • NPH (get CT/MRI)
  • B12 deficiency
86
Q

IV drug user + back pain = think?

A

Epidural abscess

87
Q

Test for epidural abscess w/?

A

MRI (sensitive + specific)

88
Q

things for child abuse

A
  • CBC
  • coag studies
  • Chem panel
  • Fundoscopic exam
  • CT head
  • skeletal scan
89
Q

Most common pituitary tumor in kids =?

A

craniopharyngioma

90
Q

Craniopharyngioma looks like

A

cystic

91
Q

Cause of Lambert Eaton?

A

Lung CA

92
Q

degenerative joint disease + back pain + neurological claudication = indicates?

A

spinal nerve compression (spinal stenosis)

93
Q

DJD + back pain + neurological claudication + MRI show compression of nerve roots, next step?

A

Treat spinal stenosis w/ surgical decompression

94
Q

ant spinal a. occlusion –> what nerve findings?

A

Sudden pain + temp loss

Sensory intact

95
Q

Dry mouth, dry eyes, = think?

A

Sjogren Syndrome

96
Q

What Ab found in Sjogren?

A

Anti-SS, Anti-Rho

97
Q

Sjogren syndrome effect fetus how?

A

Congenital AV block

98
Q

Sjogren syndrome pathophys =?

A

Lymphocytc infiltration of salivary and lacrimal glands

99
Q

Essential tremor treated w/?

A

Beta Blocker

100
Q

Pseudoclaudication -?

A

Neurologic claudication, can result from spinal stenosis –> compression of nerves

101
Q

Huntington’s treat?

A

Anti-psychotic (ie haloperidol)

102
Q

Gold standard confirmatory test for Myasthenia Gravis?

A

EMG under repetitive stimulation

103
Q

Prevent migraines/headaches - ?

A

Beta blockers

104
Q

Abort meds for migraines?

A

Sumatriptan

105
Q

brain death gives you what type of pupils –> ?

A

Dilated

106
Q

Opiate overdose type of pupil?

A

Constricted (pinpoint)

107
Q

Anticholinergic agent overdose type of pupil?

A

Dilated

108
Q

Brainstem hemorrhage type of pupil?

A

Dilated

109
Q

low back pain + fever = think?

A

Epidural abscess

110
Q

itchy rash + asthma + excoriation + papules + other family member w/ = think?

A

Eczema

111
Q

Treat Eczema ?

A

Regular use of over the counter bland emollients

112
Q

Acne treatment (mild, mod, severe) ?

A

mild - topical drug (esp benzoyl peroxide)
mod - oral doxy +/- topical retinoid
severe - isotretinoin

113
Q

scaly, keratotic, erythematous macules and papules on the anterior scap, arms, and dorsal hands = t

A

Actinic keratosis

114
Q

Actinic keratosis puts at risk for ?

A

squamous cell CA

115
Q

Erythema nodosum details?

A

PAINFUL on shins, many autoimmune diseases associated w/

116
Q

Pyoderma gangerenosum details?

A

Associated w/ Ulcerated Colitis, NOT painful

117
Q

Ulcerated colitis associated w/ what type of cutaneous disease?

A

Pyoderma gangerenosum

118
Q

Crohn’s associated ssociated w/ what type of cutaneous disease?

A

Erythema nodosum

119
Q

Actinic keratosis caused by?

A

Excessive Sun exposure

120
Q

Squamous cell CA can be caused by?

A
  • Excessive sun exposure

- Arsenic

121
Q

Silica predisposes to?

A

TB bc weakens upper lungs

122
Q

Arsenic exposure predisposes for?

A

Squamous Cell CA

123
Q

Vitiligo caused by?

A

Autoimmune destruction of melanocytes

124
Q

3 categories of drugs often associated w/ allergies?

A
  • Abx: Penicillin or Cephalosporin
  • Sulfa drugs
  • NSAIDs
125
Q

Pitarysis rosea clinical findings?

A

1) heralding patch (1 patch)

2) Christmas tree distribution (2nd rash comes in that is more diffuse)

126
Q

Compound nevus found ?

A

Multiple layers of epidermis + dermis

127
Q

Intradermal nevus found?

A

Dermis

128
Q

Lentigo is?

A

benign pigmented macules that result from increased activity of epidermal melanocytes

129
Q

Junctional nevus found?

A

Dermoepidermal junction

130
Q

Halo nevus?

A

a mole that is surrounded by a depigmented ring or ‘halo’ associated with vitiligo

131
Q

Vermilion border lower lip

A

Squamous cell CA

132
Q

Upper lip

A

Basal cell CA

133
Q

pearly papule = think?

A

Basal cell CA

134
Q

greasy mole = think?

A

Seborrheic keratosis

135
Q

Most imp pronostic factor in melanoma?

A

Depth

136
Q

hypopigmented patches = think?

A

Tinea Versicolor (caused by malassezia fungi)

137
Q

Treat Tinea Versicolor?

A

Selsin blue shampoo

138
Q

Tinea Versicolor cause by?

A

malassezia fungi

139
Q

Dermitis herpetiformis associated w/?

A

Celiac disease

140
Q

Anti-tissue transglutaminase Ab associated w/?

A

Celiac disease

141
Q

vesicles w/ erythematous base w/ excoriations on extensor surfaces (elbows knees) = think?

A

Dermititis herpetiformis

142
Q

Treatment for CMV

A

Ganciclovir

143
Q

Treatment of Shingles?

A

Valcyclovir

144
Q

Vascular raised papule w/ thin collarette of scale = think?

A

Pyogenic granuloma (misnomer)

Sicular (9 decks)

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