deck 35 Flashcards
most beneficial therapy to reduce progression of diabetic nephropathy
strict blood pressure control
meds that can cause pancreatitis
valproic acid, diuretics, metronidazole
demographic for UC
bimodal distribution with second peak in 50-80
UC endoscopy
continuous involvement with erythematous and friable mucosa and ulcers
threshold for platelet transfusions
10,000
management of wide-complex tachycardia
anti arrhythmic drugs (amiodarone, procainamide, sotalol, lidocaine)
acalculous cholecystitis
acute inflammation of the gallbladder in the absence of gallstones
acalculous cholecystitis setting
usually seen in hospitalized and severely ill patients
features suggesting arterial ulcer
location at tips of digits, diminished pulses, skin pallor, loss of hair, claudication
cause of anemia in CKD
epo deficiency
caveat about epo replacement with CKD
need to give iron too because eps-induced surge in RBC production can precipitate an iron-deficient state
zinc deficiency presentation
hypogonadism + impaired taste + impaired wound healing + alopecia + skin rash w/ perioral involvement
panendoscopy
triple endoscopy (esophagoscopy, bronchoscopy, laryngoscopy)
concern with untreated hyperthyroid patients
rapid bone loss from increased osteoclastic activity in bone cells + tachyarrhythmias including afib
secondary pneumonia in a young patient?
- happens with MRSA following influenza.
- causes severe, necrotizing pneumonia that is rapidly progressive and often fatal
MRSA pneumonia in young patient presentation
high fever + productive cough w/ hemoptysis + multi lobar cavitary infiltrates
urinary infection with alkaline urine think..
proteus mirabilis
best markers indicating resolution of DKA
serum anion gap + beta-hydroxybutyrate levels
hypopituitarism features
glucocorticoid deficiency + hypogonadism + hypothyroidism
why are patients with MM at increased risk of infection?
bone marrow infiltration by neoplastic ells alters normal leukocyte population and causes hypogammaglobulinemia
caveat about adrenal insufficiency
patients can have cushingoid appearance with suppressed HPA axis
how to confirm adrenal insufficiency
8 AM serum cortisol + plasma ACTH + ACTH stimulation test (plasma ACTH is slow, and cosyntropin fast is test, so cosyntropin usually ordered too)
presentation of candida esophagitis
oral thrush + dysphagia/odynophagia
malaria chemoprophylaxis
atovaquone-proguanil, doxycycline, or mefloquine
presentation of myopathy w/ cushing’s
- progressive painless muscle weakness predominantly involving proximal muscles
(caused by direct effect of cortisol on skeletal muscle, leading to muscle atrophy)
other findings in parvovirus infection in adults
fever, fatigue, diarrhea, rash
management of ventilator-associated pneumonia
need lower respiratory tract sampling (gram stain and culture)
caveat about b12 anemia
can look hemolytic with hyperbilirubinemia (increased intramedullary hemolysis of immature megaloblasts)
other name for soap-bubble appearance of giant cell tumor
expansile and eccentric lytic area
diabetic age group that needs statin regardless of lipid levels
40-75
x-ray findings with osteomalacia
decreased bone density with thinning of cortex and pseudo fractures
management of hypercalcemia of malignancy (cancer patients with bone mets)
- bisphophonates (inhibit osteoclastic activity of bone, stabilizing destructive bony tumors and reducing risk of skeletal-related events such as pathologic fracture and malignant hypercalcemia)
TTP treatment
life threatening, requires emergent plasma exchange
cause of altered sensorium in hyperosmolar hyperglycemic state
high serum osmolality
induced sputum for pneumocystis
often negative so need bronchoalveolar lavage
management of PAC’s in asymptomatic patient
stop drinking alcohol and using tobacco
management of PAC’s in symptomatic patient
beta-blockers
salvage therapy definition
treatment for a disease when standard therapy fails
how to prevent febrile non hemolytic transfusion reaction
leukoreduction
labs with lactose intolerance
positive hydrogen breath test
positive stool test for reducing substances
low stool pH
increased stool osmotic gap
ethnic group in which lactose intolerance is most common
Asian-Americans
standard test for lactose intolerance
hydrogen breath test
metabolic abnormalities caused by hypothyroidism
hyperlipidemia (most hypothyroid its have hypercholesterolemia alone or combined hypertriglyceridemia and hypercholesterolemia)
hyponatremia
workup of isolated thrombocytopenia
Need to rule out Hep C and HIV before diagnosing ITP (can be initial presentation of HIV)
other common causes of thrombocytopenia
alcohol use
EBV
B12/folate deficiency
cardiomyopathy associated with acromegaly
concentric myocardial hypertrophy
consequences of hyperestrinism in cirrhosis
gynecomastia, testicular atrophy, decreased body hair, spider angiomas, palmar erythema
waldenstrom macroglobulinemia presentation
hyper viscosity syndrome + neuropathy + bleeding + HSM + lymphadenopathy
waldenstrom on labs
hyper IgM
positive urine bilirubin assay suggest
buildup of conjugated bilirubin (plasma buildup of conjugated bilirubin leaks into urine)
