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Sicular > Day 5- nephrology, infx disease > Flashcards

Day 5- nephrology, infx disease Flashcards

1
Q

nephrotic syndrome + retinopathy = think?

A

DM nephropathy

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2
Q

Familial HypOcalcuric HypERcalemia –> Ca levels in Serum and Urine?

A
  • High Ca in Serum

- Low Urine Ca

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3
Q

Blood Ca high next steps?

A

1) See if related to albumin
2) See if PTH causing
3) Check Urine Ca level

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4
Q

Hyperparathyroidism –> Ca levels in Serum and Urine?

A

Both high

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5
Q

Sestamibi scan looks for?

A

Parathyroid adenomas

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6
Q

HypERcalcemia causes what EKG findings?

A

Short QT syndrome

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7
Q

HypOcalcemia causes what EKG findings?

A

Long QT syndrome

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8
Q

dysmorphic RBC = think where is the problem?

A

glomerulus –> glomerular nephritis

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9
Q

RBC casts = think where is the problem?

A

glomerulus –> glomerular nephritis

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10
Q

Gold standard/best to localize and determine which type of glomerular nephritis ?

A

Renal biopsy

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11
Q

Anorexia has what type of metabolic derangement?

A

Hypochloremic Metabolic Alkalosis

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12
Q

WBC casts = think?

A

Pyelonephritis

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13
Q

sore throat –> >1wk later kidney disease = think?

A

Poststrep Glomerulonephritis

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14
Q

sore throat –>

A

IgA nephritis

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15
Q

How to differentiate b/t Poststrep Glomerulonephirtis and IgA nephritis

A

Timeline!

>1wk from sore throat to kidney disease = PSG

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16
Q

Interstitial nephritis look for what buzzword?

A

Eosinophil

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17
Q

muddy brown casts = think?

A

Acute tubular necrosis

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18
Q

muddy brown casts + eosinophils - think?

A

Interstitial nephritis

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19
Q

anion gap

A

normal!

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20
Q

anion gap > 15 = think?

A

MUDPILES

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21
Q

What are 2 main causes of focal segmental glomerulosclerosis?

A
  • HIV

- IV drug use

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22
Q

Membranoproliferative glomerulonephritis is associated w/ what disease?

A

Hep C

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23
Q

leg trauma (or trauma not to kidney/abdomen) + hematuria = think?

A

Rhabdomyolysis

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24
Q

Rhabdomyolysis - helpful labs?

A
  • Urinanalysis

- Serum Creatinine Kinase

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25
Q

tense extremity = think?

A

compartment syndrome

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26
Q

Na high, K low = think?

A

HypERaldosteronism

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27
Q

Aldosterone causes what metabolic derangement?

A

Alkalosis

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28
Q

Spirinolactone and Acetazolamide cause what metabolic derangement?

A

Acidosis

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29
Q

Furosemide and Thiazides cause what metabolic derangement?

A

Alkalosis

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30
Q

To determine primary or secondary hypERaldosteronism, look at what?

A

Renin

  • Low - primary hypERaldosteronism
  • High - renovascular disease
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31
Q

diffuse mesangial proliferation = think?

A

IgA nephropathy

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32
Q

What vitamins/electrolytes do you give pts w/ renal failure?

A

Calcium supplementation

Vit D supp

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33
Q

Treat SIADH (mmm

A

mild - water restriction
moderate - loop diuretic and nL saline
severe - hypertonic saline

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34
Q

Minimal change disease adult treat?

A

Oral Steroids

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35
Q

Middle ear stuff

A
  • strep pneumo

- H influenza

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36
Q

Outside ear stuff think?

A

pseudemonas

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37
Q

salivary gland infection = think?

A

Mumps virus

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38
Q

recent (w/in 6 mo) hemorrhagic stroke can’t give?

A

anticoagulants

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39
Q

if grandparent has had chicken pox has contact w/ grandkid w/ chickenpox, and they breakout with Zoster is it related?

A

NO!

  • Zoster is a reactivation of their own chickenpox virus, not a new infx! (caused by stress on body)
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40
Q

pinpoint lesions in nails = think?

A

these are splinter hemorrhages

THINK: ENDOCARDITIS

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41
Q

esophagitis caused by (3) ?

A
  • Herpes (acyclovir)
  • CMV (gancylovir)
  • Candida (fluconazole)
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42
Q

Esophagitis w/ BIG ULCER = think?

A

CMV

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43
Q

pneumonia + alcohol abuse what microbes thinking?

A
  • strep pneumo (for everyone, regardless of AA)
  • klebsiella (esp in AA)
  • anaerobes (esp in AA - bc of aspiration, should be serious w/ some bad smelling and should be in RLL)
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44
Q

Aspiration pneumonia/abscess treat w/?

A

Clindamycin

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45
Q

Bad smelling breath w/ RLL abscess and productive cough, think?

A

Aspiration pneumonia likely due to anaerobes (treat w/ clindamycin)

46
Q

Pneumonia treatment if sending pt home?

A

cephalosporin + macrolide

Fluoroquinilone alone

47
Q

Walking pneumonia w/o scary stuff, treat w/?

A

Azithromycin

48
Q

cavitary lesion diff dx (5)?

A
  • TB
  • Lung abscess
  • Aspergillis
  • Cancer
  • Septic Emboli
49
Q

Treatment for active TB (4)?

A
  • Rifampin
  • Isoniazid
  • Pyrazinamide
  • Ethambutol

“RIPE”

50
Q

Most common cause of seizures in pts from mexico?

A

Neurocysticercosis

51
Q

Neurocysticercosis is?

A

Infectious parasitic disease caused by eggs of Taenia solium (pork tapeworm) found in contaminated pork. Neurocysticercosis occurs when cysts formed by the infection grow within the brain causing neurologic syndromes such as epileptic seizures.

52
Q

Partial seizure –> generalized seizure indicates?

A

Structural lesion, NOT drug/toxin induced

53
Q

positive PPD but neg chest xray –> indicates? treat?

A
  • Latent TB

- Treat w/ Isoniazid for 9 mo (1st line), rifampin 4mo (2nd line)

54
Q

What can you give w/ isoniazid to avoid vit def?

A

Pyridoxine to avoid B6 def (which isoniazid can cause)

55
Q

Post exposure prophylaxis for HIV?

A

PEP - truvada + ____

56
Q

syphilis spread of rash pattern?

A

starts on trunk –> spreads to hands and feet

57
Q

rickettsia spread of rash pattern?

A

Hands and feet –> spread to trunk

58
Q

How to differentiate b/t syphilis rasha dn rickettsia rash?

A

Pattern of spread

  • Syphilis: trunk –> hands/feet
  • Rickettsia: hands/feet –> trunk
59
Q

Treat of adult bacterial meningitis?

A

strep pneumo –> vanc
Neisseria –> ceftriaxone
Listeria –> ampicillin

60
Q

Adults bacterial meningitis most common?

A

1) Strep pneumo (vancomycin)
2) Neisseria meningitis (ceftriaxone)
3) Listeria (elderly pt - ampicillin)

61
Q

Old pt w/ bacterial meningitis treat w/ what while waiting on cultures?

A

vanc, ceftriaxone, and ampicillin

strep pneumo, neisseria, and listeria, respectively

62
Q

Baby w/ bacterial meningitis treat w/ what while waiting on cultures?

A

cephalosporin, aminoglycoside, and ampicillin

GBS, E.coli, & Listeria, respectively

63
Q

Treat baby bacterial meningitis?

A

GBS –> cephalosporin
E.coli –> aminoglycoside (ie gentamicin)
Listeria –> Ampicillin

64
Q

Needle stick, most likely virus to contract?

A

Hep B

65
Q

What are percentages of contracting HBV, HCV, or HIV from needle stick?

A

Hep B –> 30%
Hep C –> 3%
HIV –> 0.3%

66
Q

second line for gonorrhea?

A

azithromycin (ie if pt allergic to beta-lactams)

67
Q

Nephrotic syndrome + flank pain = think?

A

renal vein thrombosis

68
Q

Kidney issues + high edema + flank pain = think?

A

renal vein thrombosis

69
Q

CD4 count 50 –> worry about? Treat w/?

A

PCP and Toxo

treat w/ TMP-SMX

70
Q

CD4 count worry about? Treat w/?

A

MAC

treat w/ azithromycin

71
Q

Main 4 groups to vaccinate for meningitis?

A
  • military groups
  • adolescents prior to going to college
  • complement deficiency
  • asplenia
72
Q

meningitis + papilledema, what do you not do?

A

Lumbar puncture!

73
Q

Meningitis symp, next step?

A

fundoscopy to check for pailledema

74
Q

Meningitis symps workup?

A

1) fundoscopy
2) LP (unless papilledema then go to 3) [WBC! then gram stain and/or cx]
3) CT

75
Q

Zidovudine-related toxicity causes?

A
  • -> muscle problems, proximal (thighs & shoulders)

- Not neuronal (so no incontinence, etc)

76
Q

HIV pt w/ UMN issues + Normal MRI of head - think?

A

Vacuolar HIV myelopathy

77
Q

Mono what greatest risk/what could kill?

A

splenic rupture

78
Q

Eating shellfish + diarrhea –> think?

A

vibrio cholerae

79
Q

shucking oysters + cuts self –> think?

A

vibrio vulnificans

80
Q

When do you give steroids for PCP pneumonia in addition to TMP-SMX?

A

PaO2

81
Q

cruise ship + cough = think?

A

Legionella

82
Q

treat legionella?

A

macrolide (ie erythromycin)

83
Q

conference + pneumonia –> think?

A

Legionella

84
Q

Treat Neurocysticercosis?

A

-bendazole

85
Q

rabbits, what microbe?

A

tularemia

86
Q

gram pos + filamentous = think?

A

nocardia

87
Q

gram neg + filamentous = think

A

actinomyces

88
Q

Nocardia vs actinomyces treatment?

A

“SNAP”
sulfa - nocardia
penicillin - actinomyces

89
Q

Reasons for endocarditis prophylaxis?

A
  • Surgery that may predispose to endocarditis (ie big abdominal or heart surg, dental procedures)
    AND
  • Risk factor for endocarditis (ie valve/structural problem w/in heart, hx of endocarditis)
90
Q

Endocarditis abx prophylaxis?

A

Oral amoxicillin

91
Q

jaw spasms/problems think?

A

Tetanus

92
Q

Edema + big kidneys + neg HIV test= think?

A

Amyloid nephropathy

93
Q

Main 2 reasons for big kidneys?

A
  • AIDS nephropathy (post HIV test)

- Amyloid nephropathy (neg HIV test)

94
Q

End stage lyme disease (severe, in CSF) –> treat?

A

IV penicillin G

95
Q

Treat rhizopus?

A
  • surgical debridment

- amphotericin B

96
Q

branching septate hyphae in lungs = thinks?

A

Aspergillis

97
Q

Treatment of choice for aspergillosis?

A

Voriconazole

98
Q

line infx while waiting for cx treat w/?

A

vanc

99
Q

lyme disease which tick?

A

Ixodes

100
Q

treatment of bacterial meningitis >50yo and don’t know what microbes, how treat?

A

Vanc (Strep pneumo)
Ceftriaxone (Neisseria)
Listeria (Ampicillin)

101
Q

treatment of bacterial meningitis

A

Vanc (Strep pneumo)

Ceftriaxone (Neisseria)

102
Q

Lancet-shaped gram-positive diplococci + meningitis, empiric treat?

A

Vanc + ceftriaxone (to cover for resistent stuff until sensitivities come back)

103
Q

Lyme disease ECG finding?

A

atrioventricular block

104
Q

CD4

A

cryptococcus

105
Q

Adolescent + seizure + temporal lobe hemorrhage = think? treat?

A

HSV encephelopathy

IV acyclovir

106
Q

chronic sinusitis +severe headache + papilledema/protrusion of eyes + seizures + cranial nerve issues (R eye pointed down, non-constriction of eye, etc) –> think?

A

cavernous sinus thrombosis

107
Q

continuous machinery murmur

A

PDA

108
Q

holosystolic murmur w/ radiation to axilla

A

MR

109
Q

MR vs TR louder on inspiration or expiration?

A

TR - louder on INspiration
MR - louder on EXpiration

“TRI MRE” - try Mr.E spelled wrong

110
Q

most specific test for Mono?

A

Measure IgM to EBV viral capsule antigen

111
Q

Mexico + liver abscess = think?

A

Entomeoba

treat w/ metronidazole

Sicular (9 decks)

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