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Sicular > Day4 - derm, nephrology, pulm, ambulatory, rheum > Flashcards

Day4 - derm, nephrology, pulm, ambulatory, rheum Flashcards

1
Q

Pearly nodule = think?

A

Basal cell Cancer

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2
Q

Multiple Purple lesions = think?

A

Karposi Sarcoma (HHV-8)

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3
Q

Yellow skin lesion = think?

A

SOMETHING W/ FAT! (ie necrobiosis lipoidica)

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4
Q

Bullous pemphigoid location (in skin layers and body)

A
  • junction of dermis epidermis
  • ## not in mouth
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5
Q

Pemphigus vulgaris location (in skin layers and body)

A
  • dermis
  • found in the mouth
  • serious
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6
Q

Blisters that rupture easily, can be painful, in mouth think?

A

Pemphigus vulgaris

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7
Q

Blisters that rupture easily, can be painful, NONE in mouth think?

A

Bullous pemphigoid

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8
Q

Keloid vs hypertrophic scar?

A

Differentiate by growth pattern

  • Keloids grow beyond wound border (irregular)
  • Hypertrophic scar does NOT grow beyond wound border
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9
Q

Treat Keloids?

A

Inject w/ steroids

- NEVER cut off – will just grow back, potentially worse

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10
Q

Treat hypertrophic scar?

A

Inject w/ steroids

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11
Q

Pruritic coin-shaped lesions = think?

A

Nummular Dermatitis

- Nummular = coin in latin

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12
Q

Classic location of stasis dermatitis?

A

Around Medial Malleoli

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13
Q

What goes over Medial Malleoli?

A

Great Saphenous vein

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14
Q

Venous insufficiency –> rash where?

A

Back up to great saphenous vein –> rash on Medial Malleoli (stasis dermatitis)

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15
Q

Brown rash and edema @ medial malleoli = think?

A

Stasis dermatitis (due to venous insufficiency)

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16
Q

Arterial insufficiency –> skin changes where?

A

Distal!!

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17
Q

Upper lip nodule (above crease) –> think?

A

Basal cell CA

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18
Q

Lower lip nodule (below crease) –> think?

A

Squamous cell CA

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19
Q

One patch –> multiple patches in “christmas tree like distribution” (or at least diffusely) = think?

A

Pityriasis rosacea

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20
Q

Facial rashes where cheeks look red diff dx (4)?

A
  • Lupus (doesn’t effect nasolabial folds + has systemic issues)
  • Parvo Virus B19 (viral illness)
  • Rosacea (facial flushing rash DOES effect nasolabial folds, “shy” or “embarrased” all the time, NO systemic issues)
  • Dermatomyositis (Purple rash around eyes, papules on knuckles)
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21
Q

Most common melanoma?

A

Superficial spreading melanoma

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22
Q

Worst melanoma?

A

Nodular melanoma

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23
Q

Nodular melanoma clinically presents?

A

ONE nodule, lesion is RAISED (never flat)

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24
Q

Subungual = ?

A

Under the nail

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25
Q

Acral lentiginous melanoma found?

A

Palms and soles of the feet on darker skinned individuals

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26
Q

Genetic generalized fine scaly skin over the whole body = think?

A

Icthyosis vulgaris

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27
Q

Icthyosis described as?

A

“lizard skin” or “Scaling skin”

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28
Q

Lizard or scaling skin over entire body = think?

A

Icthyosis

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29
Q

Most common icthyosis?

A

Icthyosis vulgaris

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30
Q

Metal allergy is what type of hypersensitivity?

A

Delayed hypersensitivity (type 4)

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31
Q

Poison ivy is what type of hypersensitivity?

A

Delayed hypersensitivity (type 4)

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32
Q

waxy/greasy nodule that looks pasted on face = think?

A

Seborrhic keratosis

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33
Q

Tetracyclines predispose to what?

A

Rash w/ sunexposure that looks like sunburn

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34
Q

anti-U1-ribonucleoprotein Ab = think?

A

Mixed connective tissue disease

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35
Q

Anti-centromere = think?

A

CREST

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36
Q

SCL70 = think?

A

Scleroderma

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37
Q

Anti-histone Ab = think?

A

Drug induced lupus

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38
Q

Anti-smooth muscle Ab = think?

A

Autoimmune Hep

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39
Q

Anti-mitochondrial Ab = think?

A

PBC

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40
Q

Anti-peroxidase Ab, anti-microsomal Ab = think?

A

Hashimoto

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41
Q

Anti-transglutamidase, antigliadin, antiendomisial = think?

A

Celiac

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42
Q

What meds cause drug induced lupus (2)?

A

Hydralazine

Isoniazid

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43
Q

What antibodies found in celiac that are specific (3)?

A

Anti-transglutamidase
Antigliadin
Antiendomisial

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44
Q

Hashimoto Ab’s are (2)?

A

Anti-peroxidase Ab

Anti-microsomal Ab

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45
Q

Bilateral hilar fullness = think?

A

Sarcoid

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46
Q

What does Sarcoid release?

A

1,25 dihydroxycholecalciferol –> more Vit D

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47
Q

Squamous cell releases what?

A

PTHrp or PTH

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48
Q

Lytic bone lesions and Interlukin release

A

Multiple myeloma

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49
Q

Familial HyperCalciurea is?

A

Altered calcium sensing and blunted PTH feedback loop

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50
Q

Bowed legs, high alk phos, and hearing issues = think?

A

Paget’s Disease

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51
Q

How do you treat Paget’s Disease?

A

Bisphosphonates

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52
Q

blanching of hands in cold = think?

A

Raynaud’s

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53
Q

Anti-Ro (aka Anti SS-A) Ab = think?

A

Sjogren Syndrome

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54
Q

CREST syndrome is?

A 
"Limited Scleroderma"
Calcinosis
Raynaud phenomenon
Esophageal dysmotility
Sclerodactyly
Telangiectasia
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55
Q

Resistance to thumb abduction and extension w/ ttp of the radial styloid = think?

A

DeQuarvains Tenosynovitis

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56
Q

DeQuarvains Tenosynovitis has what 2 tendons effected?

A
  • Extensor pollicis BREVIS
  • Abductor Pollicis

(two tendons rub up on each other –> irritate)

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57
Q

DeQuarvains Tenosynovitis happens in what population?

A

Post-pregnancy

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58
Q

Osteoarthritis what can be found on radiograph of joint (3)?

A
  • Osteophyte formation
  • Subchondral sclerosis (bc bones rubbing)
  • Subchondral cysts
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59
Q

Bone erosions found in RA or OA?

A

RHEUMATOID Arthritis

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60
Q

Reactive arthritis can come from what types of infx?

A
  • GI (campylobacter)

- STD (chlamydia)

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61
Q

Treat chlamydia?

A

Doxycycline

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62
Q

Lupus w multiple miscarraiges = think?

A

Anti-phospholipid Antibody Syndrome

63
Q

Anti-phospholipids Syndrome Abs (2)?

A

Lupus anti-coagulant Ab

Anti-cardiolipin Ab

64
Q

Anti-phospholipid syndrome effect on coagulation?

A

Prolonged aPTT

65
Q

Cryglobulinemia associated w/?

A

Hep C

66
Q

Cold agglutinins = think?

A

Cryglobulinemia

67
Q

Lupus anti-coagulant Ab + Anticardiolipin Ab = think?

A

Anti-phospholipid Antibody Syndrome

68
Q

Septic Arthritis treat?

A

1) Arthrocentesis –> analysis + cx

2) Abx

69
Q

fever + swollen knee = think?

A

septic arthritis (esp w/ high WBC)

70
Q

fever + swollen knee + high WBC, but no organisms found on analysis (cx pending) –> most appropriate initial management step?

A

Ceftriaxone and Vancomycin

to cover gonnorhea and staph, respectively

71
Q

Heberden node located?

A

HeberdEN’s node at the END –> DIP

72
Q

Bouchard node located?

A

MIP

73
Q

Heberden and Bouchard nodes found in what type of arthritis?

A

OA

74
Q

STD + discharge - think?

A

Chlamydia or Gonorrhea

75
Q

Syphilis has how many ulcers?

A

ONE! (not multiple) – painless

76
Q

Treatment of ankylosing spondylitis?

A

Anti-TNF-a agent

77
Q

Anti-histidyl-tRNA synthetase (jo-1) Ab = ?

A

Myositis

78
Q

Anti-Jo 1 Ab = ?

A

Myositis

79
Q

Myositis Ab?

A

Anti-histidyl-tRNA synthetase (Jo-1) Ab

80
Q

Polymyalgia rheumatica main muscle complaint?

A

PAIN

81
Q

Polymositis main muscle complaint?

A

WEAKNESS

82
Q

Fibromyalgia medication treatment?

A

“FMAM radio”
FM - fibromyalgia
AM - Amitriptyline

83
Q

Firbomyalgia treatment?

A

1) Aerobic exercise

2) Amitriptyline

84
Q

Back pain relieved by sitting and leaning forward = think?

A

Lumbar spinal stenosis (diff position relieves compression on nerves from bony osteophytes)

85
Q

Bowed femur + dec hearing + bone scan w/ intense uptake –> think?

A

Paget’s Disease

86
Q

Uptake in bone scan indicates?

A

osteoBlasts are working

87
Q

Muscle weakness + CK elevated = think?

A

Polymyositis

88
Q

Interstitial lung disease aka?

A

Restrictive lung disease

89
Q

Definitive dx test for polymyositis?

A

Muscle Biopsy

90
Q

What is initial dx test for polymyositis?

A

Check Anti-Jo Ab levels

91
Q

rhomboid-shaped crystals w/ weak positive birefringence = think?

A

Pseudogout

92
Q

Negative needle shaped birefringent crystals = think?

A

gout

93
Q

Pseudogout caused by?

A

Calcium Pyrophosphate dihydrate

94
Q

Most specific for lupus?

A

Anti-ds DNA

95
Q

Most sensitive for lupus?

A

Antinuclear Ab

96
Q

ptosis w/ constricted pupil = think?

A

Horner’s syndrome (ptosis, miosis, and anhydrosis)

97
Q

lung stuff + horner’s syndrome = think?

A

Pancoast tumor

98
Q

Asthma looks like what on xray?

A

NORMAL

99
Q

What is normal tidal volume?

A

500mL/breath

100
Q

Cirrhosis + pleural effusion is?

A

Hepatic Hydro Thorax

101
Q

Treat hepatic hydro thorax w/?

A

Thoracentesis

102
Q

Need to be careful how you treat COPD pts w/ what?

A

DON’T GIVE TOO MUCH OXYGEN (so not 100%) –> may cause to be decreased respiratory drive

103
Q

Chest xray + solid nodule –> dx steps?

A

1) compare to previous

2) CT (if no previous to compare)

104
Q

Popcorn calcifications in a nodule is malignant or benign?

A

Benign

105
Q

Workup for PE?

A

1) Sprial CT, if can’t have –> V/Q scan
2) Unstable –> TPA (thrombolysis), unless can’t give then embolectomy (ie pregnancy, hemorrhagic stroke in past)
2) Stable –> LMWH

106
Q

Definitive test/gold standard for PE

A

Pulmonary angiogram

107
Q

COPD pts should all receive what vax?

A

Pneumococcal vax

108
Q

When do you give COPD home oxygen therapy?

A

Think of speed limits (road + back to the future)

PO2 of

109
Q

lung cancer + low Na = think?

A

Small Cell CA

110
Q

Small Cell CA can release (2)?

A
  • ACTH

- ADH –> SIADH

111
Q

Small Cell CA can lead –> ?

A

Lambert Eaton

112
Q

Squamous Cell CA can release (2)?

A

PTH

PTHrp

113
Q

Serious complication of silicosis is?

A

TB

114
Q

Upper lobe environmental disease (ie rock miner…)

A

Silicosis

115
Q

Needle should go above or below rib?

A

ABOVE to avoid vessels

116
Q

NSAIDs –> what happens to leukotriene or prostaglandins

A

Increased leukotriene production and dec prostaglandins

117
Q

Kid w/ nasal polyps think?

A

Cystic fibrosis

118
Q

hilar mass w/ sheets of small round cells = think?

A

Small cell CA

119
Q

Central lung CA (3)?

A
  • Squamous CA
  • Small cell CA
  • Carcinoid
120
Q

Peripheral lung CA?

A

Adenocarcinoma

121
Q

long bones broken + dyspnea + petichae = think?

A

FAT embolism

122
Q

COPD findings on chest x-ray?

A

Too much air in lungs!

  • Flattening of the diaphragm
  • Increased retrosternal air space
  • Long narrow heart shadow
123
Q

Multiple small nodules in the upper lungs?

A

Silicosis or TB

124
Q

Diaphragmatic calcifications =?

A

asbestos

125
Q

Severe allergic rhinitis not helped by antihistamine + intranasal steroids, what is next step?

A

Oral steroids

126
Q

COPD two types?

A
  • Emphysema (pink puffer)

- Chronic bronchitis (blue bloater)

127
Q

COPD

A

Decreased diffusion capacity

128
Q

Bronchodilator response = think?

A

Asthma

129
Q

COPD w/ cyanosis?

A

Chronic bronchitis

130
Q

amiodarone induced lung disease main finding?

A

“foamy” macrophages

131
Q

Most common cancer in women (1-3)?

A

1) Breast
2) Lung
3) Colon

132
Q

Most common cancer to kill in men (1-3)?

A

1) Lung
2) Prostate
3) Colon

133
Q

Most common cancer to kill in women (1-3)?

A

1) Lung
2) Breast
3) Colon

134
Q

Most common cancer in men (1-3)?

A

1) Prostate
2) Lung
3) Colon

135
Q

DM fasting glucose?

A

> 126

136
Q

impaired fasting glucose #?

A

slightly below 126

137
Q

Impaired glucose tolerance #?

A

slightly below 200

138
Q

When do you give tetanus immunoglobulin?

A

Wound Status - dirty

Vaccinated? - no or unknown

139
Q

What causes endometrial hyperplasia?

A

Tamoxifin

140
Q

Does Raloxifene cause endometrial hyperplasia?

A

NO, just tamoxifin

141
Q

Raloxifene can be used for CA and for what?

A

Osteoporosis prevention and treatment

142
Q

Diffuse mesangial proliferation = think?

A

IgA nephropathy (Berger’s Disease)

143
Q

HTN + kidney disease - preferred treat of HTN?

A

ACE inhibitor

144
Q

Glomerular nephropathies that steroids are helpful for (4)?

A
  • Minimal Change
  • Lupus
  • Membranous
  • Post-Strep
145
Q

HyperKalemia causes what ECG change?

A

Peaked T waves

146
Q

stethoscope in abdomen =?

A
  • AAA (midline)
  • Renal artery stenosis (on side)
  • Hyperperistalsis of small bowel obstruction
147
Q

Confirmatory test for renal artery stenosis is?

A

Duplex Doppler U/S

  • Can’t do angiography b/c in renal failure can’t give contrast
148
Q

Renal tubular acidosis type 1 is? Causes?

A

Poor hydrogen ion secretion into urine (DISTAL)

  • genetic disorders
  • med toxicity
  • Autoimmune diseases (ie sjogren, RA)
149
Q

Renal tubular acidosis type 2 is? Causes?

A

Poor bicarbonate resorption (PROXIMAL)

- Fanconi syndrome (glucosuria, aminoaciduria, phophaturia) –> loose stuff in the urine

150
Q

Renal tubular acidosis type 4 is? Causes?

A

Aldosterone Resistence

  • Obstructive uropathy
  • CAH
151
Q

When deciding b/t Renal tubular acidosis types steps?

A

1) Determine Anion Gap (Na - [Cl + HOCO3] – should be normal
2) Look at K ( high = type 4, low - either 1 or 2)
3) Type 1 (stones, pH >5.5) v Type 2 (pH

152
Q

Distinguish b/t RTA types 1 and 2?

A

Type 1 - distal, gets stones in kidney

Type 2 - proximal, losing a lot of stuff in urine (glucose, amino acids, phosphates), loose Ca from bones

153
Q

Td booster timing depends on what?

A

Dirty wound - 5 yrs

Clean wound - 10 yrs

Sicular (9 decks)

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