Deck 3 Flashcards
how do you diagnose PCKD
abdominal ultrasound
SBP xray findings
dilated loops of bowel and also air in colon in rectum
what infection causes trismus
tetanus
risk of SGLT2 inhibitors
euglycemic DKA, yeast infections
common drugs that cause acute pancreatitis
anti epileptics, steriods, protease inhibitors, etc.
what are some things that cause an exudate
infection, malignancy, PE, autoimmune,
what can cause transudate effusion
cirrhosis, nephrotic syndrome, CHF
BMP abnromalities in milk-alkali syndrome
high bicarb, hypercalcemia, hypophosphatemia (from intestinal binding) and hypomagnesia
what are the main differences in athletets heart vs. HCM echo
athletes heart: mild LV enlargement, mild wall thickening vs. // HCM: small LV cavity size, moderate wall thickness
how soon should a patient increase their hemoglobin after starting iron therapy
within 4 weeks, so if they dont improve in 4 weeks then its not iron deficienc
cautions for opioids and renal insufficiency
metabolites are excreted by the kidney so they can accumulate better to use things like
what drugs can you use in terms of opioids for renal insufficiency
fentanyl, methadone, buprenorphine, hydromorphone
when do you typically start getting AMS from hyponatremia
<120-125
acute digoxin toxicity signs
GI symptoms, lethargy, fatigue
what leads in an RCA infarct
II, III, aVF
what causes amaurosis fugax
this is vasculitis or blockage of the retinal artery from a cardioembolic source
typical signs of necrotizing otitis exerna
granulation tissue along the floor of the ear canal
what are the most common causes of referred otalgia
dental disease and TMJ
which immunosuppresion medication causes tremor
calcineurin inhibitors, tacrolimus and cyclophosphamide
what is seen on peripheral smear of CLL
mature lymphocytosis and smudge cells
what does intensive DM therapy decrease/have no change with
decreases microvascular complications but does not have an affect on all cause mortality or macrovascular complications
what is sodium like in primary polydipsia
it is extremely low because you are taking on too much water
what is sodium like in diabetes insipidus
you get hypernatremia because no water is being kept, and the urine is extremely dilute
compare aldosterone in primary adrenal deficiency vs. panhypopituitarism
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
miliary TB signs chest XRAY
diffuse reticulnodular pattern
urine excretion of Ca in familial hypocalciuric hypercalcemia vs. parathy adenoma
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
why is FRC and RV high in ankylosing spondylitis
becaues of chest wall motion restriction so there is fibrosis which causes the lungs to stick to chest wall which increases volume
cause of decreased thyroid levels in acute illness
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
labratory signs of legionella
elevated sodium, transaminitis
do you need to stop isoniazid if it causes elevated liver enzymes
nope
what are the two primary manifestations of chagas disease
megagolon and esophagitis, cardiac disease (heart failure)
TSH in piuitary adenoma vs medication adverse effect
TSH in pit adenoma is low and in med side effect (risperidone) it is normal
which tremor/disease state gets better with voluntary movements
parkinson tremor
effect of caffeine/alcohol on physiologic tremor
increases in intensity
crystal shape in pseudo vs. regular gout
pseudo = rhomboid // reg= needle shaped
what is associated (in the joint) with pseudogout
chondrocalcinosis (calcium deposition along joint line)
signs of acute rejection on kidney biopsy
intimal arteritis and lymphocytic infiltration
main effect of nitrates on the heart
they are systemic venodilators so they cause decreased preload which lowers end diastolic volume
iron level in lead toxicity
high iron
late complications of pericarditis
hepatojugular reflux, JVD
small testes, gynecomastia, tall stature, infertility, decreased virulization
klinefelter
FSH and LH in klinefelter
elevated because no testosterone is being produced
low fecal elastase dx
chronic panc
what lab value is elevated in terms of lymphocytes in acute interstitial nephritis
eosinophilia
intitial pharmacotherapy for acute asthma exacerbation
SABA, anticholinergic, steroid
treatment of kaposi sarcoma from HIV superficial vs. visceral
superficial: antiretrovirals // visceral: systemic chemo
what should a patient also on isoniazid be put on
B6
sideroblastic anemia peripheral smear
micro and normocytic anemia, basophilic stippling
signs of pagets disease of the bone
osteoclast dysfunction, hearing loss, headaches, back pain, bone pain
which nodules hot or cold are increased risk of malignancy
cold nodules
biggest risk of untreated hyperthyroidism
bone loss due to increased osteoclastic bone resorption
how do you prevent contrast kidney injury
you can do 0.9% IV fluids before contrast admin, avoid nephrotoxic agents
what to administer for warfarin induced bleeding
prothrombin concentrate or FFP
where do patients typically feel the pain for OA of the hip
groin, buttock, lateral hip
when is the stridor in tracheomalacia
expiratory stridor
what counts as low urine osmolality
<300
palpable thrill and harsh holosystolic murmur 4 days after MI
interventricular septum rupture
treatment of gastroparesis
metoclopromide or erythromycin
what is the cause of hyponatremia after marathon
loading of hypoosmotic fluid while losing salt from perspiration and ADH release
what does having a splenectomy put you at risk for
encapsulated bacteremia (strep pneumo, hib, neisseria meningitidis)
what else occurs with guillan barre along with paralysis typically
autonomic symptoms (bladder retention, arrythmias, tachycardia)
what effect does hepatorenal syndorome have on acid base status
it causes metabolic acidosis because you cant clear acids
what can happen after intubation
tracheal injury that causes a scar and resulting stenosis
what lab abnormalities cause calciphylaxis
hyperphosphatemia and hypercalcemia
BUN level in upper GI bleeds
elevated because hemoglobin breaks down and then the urea gets reabsorbed in the small intestine leading to elevated BUN
treatment of primary adrenal insufficiency
supplementation with glucocorticoids (hydrocortisone and prednisone) and mineralicorticoids (fludircortisone)
which is more common in alcoholics B12 or folate deficiency
folate
what vasculitis occurs secondary to HCV
mixed cryoglobulinemia syndrome
buprenorphine activity
it is a partial agonist
naloxone activity
this is a potent opiod antagonist
why do CKD patients have platelet dysfunction
because they have increased NO which
what is trastuzumab used for and what is the main AE
HER2 positive breast CA and main AE is cardiotoxicity
what infections are immunosuppressed people at risk of
PCP, CMV
diagnosis of PCP
sputum or BAL
what causes AKI with CHF exacerbation (cardiorenal syndrome)
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.
why do diuretics help with GFR in CHF exacerbation
this is because they decrease CVP which leads to less of a backup in the kidneys
treatment of a patient with isolated facial swelling on an ARNI
ER because likely angioedema, IV epi,
what effect does spironolactone have on acid/base
metabolic acidosis
aldosterone effects on acid base
metabolic (contraction) alkalosis
cause of hammer/claw toes
can be due to chronic incorrect shoe size, or chronic uncontrolled diabetes
where are arterial ulcers
tips of toes, pressure points, lateral malleolus
what type of nephrotic syndrome do HIV patients get
focal segmental glomerulosclerosis due to direct infection of the podocyte
what is associated with pulsus paradoxus
cardiac tampanode, severe asthma, pericarditis
what paraneoplastic syndrome is associated with small cell lung cancer
lambert eaton, SIADH
consequence of acromegaly on heart
HTN, concentric LV hypertrophy –> diastolic dysfunction –> heart failure
what does dehydration do to hematocrit
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
treatment of ITP
steroids if plts <30k, platelet transfusion <10k
