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Family med > deck 36 > Flashcards

deck 36 Flashcards

1
Q

warfarin-induced skin necrosis due to underlying…

A

protein C deficiency

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2
Q

hemolytic disorder associated with hyper coagulable state

A

PNH

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3
Q

use of synthetic cannabinoids (dronabinol)

A

advanced HIV cachexia

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4
Q

caveat about empirically treating macrocytic anemia with folate

A
  • both folate and cobalamin are cofactors in conversion of homocysteine to methionine so folate can improve cobalamin deficiency
  • but folate can precipitate or worsen neurologic deficits of b12 deficiency
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5
Q

painless thyroiditis (silent thyroiditis)

A
  • acute thyrotoxicosis with mild thyroid enlargement + suppressed tSH
  • decreased radio iodine uptake
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6
Q

most common SE’s of epo

A
  • worsening of HTN + HA + flu-like symptoms
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7
Q

Why HIT is a major concern

A

HIT is highly thrombogenic and patients must be coagulated ur to risk of arterial and venous clots (HIT antibodies activate platelets, resulting in platelet aggregation and release of procoagulant factors)

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8
Q

Trousseau’s syndrome

A

hyper coagulability disorder presenting with recurrent and migratory superficial thrombophlebitis at unusual sites (eg, arm, chest area)
- usually associated with occult visceral malignancy such as pancreatic (most common), stomach, lung, or prostate

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9
Q

classic complication of HIT in patients receiving subcu heparin

A
  • skin necrosis at abdominal injection site
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10
Q

cause of NAFLD

A

peripheral insulin resistance leading to increased peripheral lipolysis, triglyceride synthesis, and hepatic uptake of fatty acids

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11
Q

presentation of chronic CO poisoning

A

HA + dizziness + nausea + polycythemia

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12
Q

important cause of reversible changes in memory and mentation

A

hypothyroidism

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13
Q

less common but impt features of hypothyroidism

A

hoarseness, memory changes

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14
Q

acute cholangitis

A

infection of the bile duct

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15
Q

acute cholangitis presentation

A

fever + jaundice + RUQ pain + confusion/hypotension sometimes seen

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16
Q

when to start statin for primary prevention

A

1) age 40-75 + 10-yr risk of atherosclerotic CV disease greater than 7.5
2) diabetic
3) LDL greater than 190
4) clinically significant atherosclerotic disease (ACS,MI/stable or unstable angina/coronary or other arterial revascularization/stroke/TIA/PAD)

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17
Q

management of bite from normal dog with regard to rabies

A

observe dog for 10 days, no prophylaxis

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18
Q

SBP presentation

A
  • can be very subtle so consider in any cirrhotic w/ fever or AMS (fever or changes in mental status are the most common)
  • abdominal pain often not prominent
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19
Q

most common cause of lower GI bleeding

A
  • diverticulosis (can be large volume)

- not always febrile

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20
Q

lab profile of alcoholic hepatitis

A
  • AST:ALT of 2:1

- *elevated ferritin (acute phase reactant)

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21
Q

isolated systolic HTN definition

A

systolic greater than 140 and diastolic less than 90

22
Q

RCA occlusion leds

A

V4-V6R

23
Q

LAD occlusion leds

A

some or all of leads V1-V6

24
Q

RCA or LCX

A

ST elevation in leads II, II, aVF

25
Q

presentation of bone pain secondary to metastasis

A

constant pain + awakens patient at night

26
Q

morton neuroma presentation

A
  • pain between third and fourth toes on plantar surface

- clicking sensation (under sign) that occurs when palpating space and squeezing metatarsal joints

27
Q

initial evaluation of thyroid nodule

A

TSH level + US

28
Q

initial therapy for low back pain

A
  • NSAIDs or acetaminophen + maintain moderate activity

- PT only if persistent (6-12 weeks)

29
Q

other name for charcot joint

A

neurogenic arthropathy

30
Q

charcot joint can also happen with

A

B12 deficiency

31
Q

presentation of hypercalcemia of malignancy

A

high calcium + very symptomatic patient

32
Q

epidural spinal cord compression setting

A
  • ## pt w/ history of malignancy with back pain + motor and sensory abnormalities
33
Q

first step of epidural spinal cord compression

A

IV glucocorticoids

34
Q

skeletal survey means

A

x-rays of major bones

35
Q

more common HCC or mets with solitary liver nodule?

A

mets

36
Q

folate and b12 involved in metabolism of what

A

homocysteine to methionine, thus homocysteine will be elevated

37
Q

secretory diarrhea

A

large volume stool + occurs during fasting or sleep (this is because luminal ion channels are disrupted in the GI tract, resulting in a state of active secretion)

38
Q

how to distinguish osmotic from secretory diarrhea

A
  • Stool osmotic gap (difference between plasma osmolality and stool osmolality)’
  • with osmotic diarrhea, nonabsorbed and unmeasured osmotically active agents are present in the GI tract. These elevate the osmotic gap.
  • secretory diarrhea is due to increased secretion of ions, therefore difference is reduced.
39
Q

common causes of secretory diarrhea

A

bacterial infections (cholera) + rotavirus + CF + post surgical changes (unabsorbed bile acids reach the colon and result in direct stimulation of luminal ion channels)

40
Q

other trigger of situational syncope

A

urinating (triggers cardioinhibitory response)

41
Q

situational syncope

A
  • form of reflex or neurally mediated syncope
  • cause an alteration in the autonomic response and can precipitate a predominant cardioinhibitory, vasodepressor, or mixed response
42
Q

colonoscopy recommendation for ulcerative colitis

A

start 8 yrs after initial diagnosis and repeat every 1-2 years

43
Q

condition in which patients are prone to diuretic-induced hypokalemia

A

primary hyperaldosteronism

44
Q

important other cause of cardiomyopathy

A

tachycardia-mediated

45
Q

ECG for ventricular aneurysm

A

persistent ST elevation + deep Q waves

46
Q

gastronome (zollinger-ellison syndrome) presentation

A

multiple stomach ulcers + thickened gastric folds on endoscopy

47
Q

acute erosive gastropathy

A

hemorrhagic lesions develop in gastric mucosa after exposure to various agents (eg, alcohol, aspirin, cocaine) (aspirin decreases protective prostaglandin production, cocaine results in vasoconstriction)

48
Q

effect of aspirin and alcohol on stomach

A

cause direct mucosal injury

49
Q

acute erosive gastropathy presentation

A

hematemesis + abdominal pain

50
Q

acute erosive gastropathy vs. mallory-weiss tear

A
  • mallory-weiss tear usually proceeded by multiple episodes of nausea/vomiting
  • acute erosive gastropathy presents with hematemesis with first episode of vomiting

Family med (48 decks)

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