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Internal Medicine > Deck 3 > Flashcards

Deck 3 Flashcards

1
Q

how do you diagnose PCKD

A

abdominal ultrasound

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2
Q

SBP xray findings

A

dilated loops of bowel and also air in colon in rectum

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3
Q

what infection causes trismus

A

tetanus

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4
Q

risk of SGLT2 inhibitors

A

euglycemic DKA, yeast infections

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5
Q

common drugs that cause acute pancreatitis

A

anti epileptics, steriods, protease inhibitors, etc.

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6
Q

what are some things that cause an exudate

A

infection, malignancy, PE, autoimmune,

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7
Q

what can cause transudate effusion

A

cirrhosis, nephrotic syndrome, CHF

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8
Q

BMP abnromalities in milk-alkali syndrome

A

high bicarb, hypercalcemia, hypophosphatemia (from intestinal binding) and hypomagnesia

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9
Q

what are the main differences in athletets heart vs. HCM echo

A

athletes heart: mild LV enlargement, mild wall thickening vs. // HCM: small LV cavity size, moderate wall thickness

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10
Q

how soon should a patient increase their hemoglobin after starting iron therapy

A

within 4 weeks, so if they dont improve in 4 weeks then its not iron deficienc

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11
Q

cautions for opioids and renal insufficiency

A

metabolites are excreted by the kidney so they can accumulate better to use things like

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12
Q

what drugs can you use in terms of opioids for renal insufficiency

A

fentanyl, methadone, buprenorphine, hydromorphone

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13
Q

when do you typically start getting AMS from hyponatremia

A

<120-125

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14
Q

acute digoxin toxicity signs

A

GI symptoms, lethargy, fatigue

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15
Q

what leads in an RCA infarct

A

II, III, aVF

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16
Q

what causes amaurosis fugax

A

this is vasculitis or blockage of the retinal artery from a cardioembolic source

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17
Q

typical signs of necrotizing otitis exerna

A

granulation tissue along the floor of the ear canal

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18
Q

what are the most common causes of referred otalgia

A

dental disease and TMJ

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19
Q

which immunosuppresion medication causes tremor

A

calcineurin inhibitors, tacrolimus and cyclophosphamide

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20
Q

what is seen on peripheral smear of CLL

A

mature lymphocytosis and smudge cells

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21
Q

what does intensive DM therapy decrease/have no change with

A

decreases microvascular complications but does not have an affect on all cause mortality or macrovascular complications

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22
Q

what is sodium like in primary polydipsia

A

it is extremely low because you are taking on too much water

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23
Q

what is sodium like in diabetes insipidus

A

you get hypernatremia because no water is being kept, and the urine is extremely dilute

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24
Q

compare aldosterone in primary adrenal deficiency vs. panhypopituitarism

A

in primary adrenal insufficiency you get no aldosterone because the adrenal gland is not working at all and in hypopituitarism you have normal aldosterone because it can be controlled by RAAS

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25
Q

miliary TB signs chest XRAY

A

diffuse reticulnodular pattern

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26
Q

urine excretion of Ca in familial hypocalciuric hypercalcemia vs. parathy adenoma

A

in FHH there is minimal excretion because there is high PTH which causes increased reabosorption and in parathy adenoma there is high excretion because the kidneys are overloaded

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27
Q

why is FRC and RV high in ankylosing spondylitis

A

becaues of chest wall motion restriction so there is fibrosis which causes the lungs to stick to chest wall which increases volume

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28
Q

cause of decreased thyroid levels in acute illness

A

there is increased catabolism and so there is more glucocorticoids which causes decreased TRH feedback and then also there is less caloric intake so you have less energy to make proteins which decreases thyroglobulin

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29
Q

labratory signs of legionella

A

elevated sodium, transaminitis

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30
Q

do you need to stop isoniazid if it causes elevated liver enzymes

A

nope

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31
Q

what are the two primary manifestations of chagas disease

A

megagolon and esophagitis, cardiac disease (heart failure)

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32
Q

TSH in piuitary adenoma vs medication adverse effect

A

TSH in pit adenoma is low and in med side effect (risperidone) it is normal

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33
Q

which tremor/disease state gets better with voluntary movements

A

parkinson tremor

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34
Q

effect of caffeine/alcohol on physiologic tremor

A

increases in intensity

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35
Q

crystal shape in pseudo vs. regular gout

A

pseudo = rhomboid // reg= needle shaped

36
Q

what is associated (in the joint) with pseudogout

A

chondrocalcinosis (calcium deposition along joint line)

37
Q

signs of acute rejection on kidney biopsy

A

intimal arteritis and lymphocytic infiltration

38
Q

main effect of nitrates on the heart

A

they are systemic venodilators so they cause decreased preload which lowers end diastolic volume

39
Q

iron level in lead toxicity

A

high iron

40
Q

late complications of pericarditis

A

hepatojugular reflux, JVD

41
Q

small testes, gynecomastia, tall stature, infertility, decreased virulization

A

klinefelter

42
Q

FSH and LH in klinefelter

A

elevated because no testosterone is being produced

43
Q

low fecal elastase dx

A

chronic panc

44
Q

what lab value is elevated in terms of lymphocytes in acute interstitial nephritis

A

eosinophilia

45
Q

intitial pharmacotherapy for acute asthma exacerbation

A

SABA, anticholinergic, steroid

46
Q

treatment of kaposi sarcoma from HIV superficial vs. visceral

A

superficial: antiretrovirals // visceral: systemic chemo

47
Q

what should a patient also on isoniazid be put on

A

B6

48
Q

sideroblastic anemia peripheral smear

A

micro and normocytic anemia, basophilic stippling

49
Q

signs of pagets disease of the bone

A

osteoclast dysfunction, hearing loss, headaches, back pain, bone pain

50
Q

which nodules hot or cold are increased risk of malignancy

A

cold nodules

51
Q

biggest risk of untreated hyperthyroidism

A

bone loss due to increased osteoclastic bone resorption

52
Q

how do you prevent contrast kidney injury

A

you can do 0.9% IV fluids before contrast admin, avoid nephrotoxic agents

53
Q

what to administer for warfarin induced bleeding

A

prothrombin concentrate or FFP

54
Q

where do patients typically feel the pain for OA of the hip

A

groin, buttock, lateral hip

55
Q

when is the stridor in tracheomalacia

A

expiratory stridor

56
Q

what counts as low urine osmolality

A

<300

57
Q

palpable thrill and harsh holosystolic murmur 4 days after MI

A

interventricular septum rupture

58
Q

treatment of gastroparesis

A

metoclopromide or erythromycin

59
Q

what is the cause of hyponatremia after marathon

A

loading of hypoosmotic fluid while losing salt from perspiration and ADH release

60
Q

what does having a splenectomy put you at risk for

A

encapsulated bacteremia (strep pneumo, hib, neisseria meningitidis)

61
Q

what else occurs with guillan barre along with paralysis typically

A

autonomic symptoms (bladder retention, arrythmias, tachycardia)

62
Q

what effect does hepatorenal syndorome have on acid base status

A

it causes metabolic acidosis because you cant clear acids

63
Q

what can happen after intubation

A

tracheal injury that causes a scar and resulting stenosis

64
Q

what lab abnormalities cause calciphylaxis

A

hyperphosphatemia and hypercalcemia

65
Q

BUN level in upper GI bleeds

A

elevated because hemoglobin breaks down and then the urea gets reabsorbed in the small intestine leading to elevated BUN

66
Q

treatment of primary adrenal insufficiency

A

supplementation with glucocorticoids (hydrocortisone and prednisone) and mineralicorticoids (fludircortisone)

67
Q

which is more common in alcoholics B12 or folate deficiency

A

folate

68
Q

what vasculitis occurs secondary to HCV

A

mixed cryoglobulinemia syndrome

69
Q

buprenorphine activity

A

it is a partial agonist

70
Q

naloxone activity

A

this is a potent opiod antagonist

71
Q

why do CKD patients have platelet dysfunction

A

because they have increased NO which

72
Q

what is trastuzumab used for and what is the main AE

A

HER2 positive breast CA and main AE is cardiotoxicity

73
Q

what infections are immunosuppressed people at risk of

A

PCP, CMV

74
Q

diagnosis of PCP

A

sputum or BAL

75
Q

what causes AKI with CHF exacerbation (cardiorenal syndrome)

A

because there is decreased CO, there is increased central venous pressure which backs up to the renal veins which in turn causes a dramatic decrease in GFR because nothing can be filtered.

76
Q

why do diuretics help with GFR in CHF exacerbation

A

this is because they decrease CVP which leads to less of a backup in the kidneys

77
Q

treatment of a patient with isolated facial swelling on an ARNI

A

ER because likely angioedema, IV epi,

78
Q

what effect does spironolactone have on acid/base

A

metabolic acidosis

79
Q

aldosterone effects on acid base

A

metabolic (contraction) alkalosis

80
Q

cause of hammer/claw toes

A

can be due to chronic incorrect shoe size, or chronic uncontrolled diabetes

81
Q

where are arterial ulcers

A

tips of toes, pressure points, lateral malleolus

82
Q

what type of nephrotic syndrome do HIV patients get

A

focal segmental glomerulosclerosis due to direct infection of the podocyte

83
Q

what is associated with pulsus paradoxus

A

cardiac tampanode, severe asthma, pericarditis

84
Q

what paraneoplastic syndrome is associated with small cell lung cancer

A

lambert eaton, SIADH

85
Q

consequence of acromegaly on heart

A

HTN, concentric LV hypertrophy –> diastolic dysfunction –> heart failure

86
Q

what does dehydration do to hematocrit

A

causes elevated hematocrit bc this is a measure of the percent RBC in plasma and if youre dehydrated then you have greater percent compared to euvolumia

87
Q

treatment of ITP

A

steroids if plts <30k, platelet transfusion <10k

Internal Medicine (6 decks)

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