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Family med > deck 37 > Flashcards

deck 37 Flashcards

1
Q

acute liver failure definition

A

acute onset of severe liver injury with encephalopathy + impaired synthetic function (defined as INR greater than 1.5) in a patient without cirrhosis or underlying liver disease

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2
Q

management of bone pain in prostate cancer patients

A

radiation therapy

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3
Q

USPSTF mammogram recommendation

A

biennial after age 50 to age 75

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4
Q

antibiotic regimen of choice for immunosuppressed patients with bacterial meningitis

A

cefepime + vancomycin + ampicillin

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5
Q

abx for meningitis age 2-50

A

vancomycin + 3rd generation cephalosporin

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6
Q

abx for meningitis age over 50

A

vancomycin + ampicillin + 3rd generation cephalosporin

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7
Q

splenic abscess presentation

A

fever + leukocytosis + LUQ pain

- can also develop left-sided pleuritic chest pain, left pleural effusion, and splenomegaly

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8
Q

most common cause of splenic abscess

A

infective endocarditis

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9
Q

preferred treatment for hep b

A

tenofovir (most potent drug with limited drug resistance)

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10
Q

when to treat hep B patients

A

1) acute liver failure
2) clinical cirrhosis
3) high serum hep B virus DNA

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11
Q

when use dependence is seen

A

Class I (especially IC) and Class IV (CCBs) antiarrhythmics

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12
Q

when use dependence is seen

A

Class I (especially IC) and Class IV (CCBs) antiarrhythmics

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13
Q

other common causes of pancreatitis

A

hypertriglyceridemia
drugs (thiazides, azathioprine, valproic acid)
infections (CMV, aspergillus, legionella)

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14
Q

autoimmune hemolytic anemia presentation

A

normocytic anemia + splenomegaly + reticulocytosis + jaundice

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15
Q

autoimmune hemolytic anemia presentation

A

normocytic anemia + splenomegaly + reticulocytosis + jaundice

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16
Q

treatment for AIHA

A

high-dose glucocorticoids

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17
Q

treatment for AIHA

A

high-dose glucocorticoids

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18
Q

other exam findings with OA

A
  • crepitus and pain with motion
  • small joint effusion without erythema or warmth
  • popliteal (baker) cyst behind the joint
  • varus or valgus angulation of the tibia
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19
Q

classic pes anserinus pain pt

A

obese female

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20
Q

pes anserinus presentation

A

insidious + pain worse overnight or in the morning

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21
Q

pes anserinus pain syndrome strongly associated with

A

diabetes

22
Q

lumbar spinal stenosis pain etiology

A

NOT cord compression

  • neurogenic claudication
  • considered subtype of OA
  • narrowing of the spinal canal leads to compression of lumbar nerve ROOTS
23
Q

lumbar spinal stenosis pain etiology

A

NOT cord compression

  • neurogenic claudication
  • considered subtype of OA
  • narrowing of the spinal canal leads to compression of lumbar nerve ROOTS
24
Q

workup for patients with suspected secondary raynaud’s phenomenon

A

UA
ANA and RF
ESR and C3/C4

25
Q

common joint complication of sickle cell disease

A

osteonecrosis of the femoral head (end arteries supplying femoral head become occluded, leading to necrosis and collapse of periarticular bone and cartilage)

26
Q

common joint complication of sickle cell disease

A

osteonecrosis of the femoral head

27
Q

workup of patients with first unprovoked VTE

A
  • need to be screened for cancer (colonoscopy)

- Scan if pt has symptoms of malignancy

28
Q

when to work up VTE patient for coagulopathy

A
  • age under 45, recurrent DVT, multiple or unusual sites of thrombosis, family history of VTE
29
Q

most common cause of an isolated, asymptomatic elevation of alk phos in elderly patient

A

Paget disease of bone

30
Q

paget’s presentation

A
  • **most patients are asymptomatic

- bone pain + HA + hearing loss + spinal stenosis + radiculopathy + long bone bowing/fracture + arthritis

31
Q

paget’s labs

A
  • elevated alk phos + normal calcium and phosphorus
32
Q

behcet’s presentation

A

recurrent, painful oral ulcers + genital ulcers + eye lesions (uveitis) + skin lesions (erythema nodosum, acneiform lesions) + thrombosis

33
Q

goal INR

A

2-3

34
Q

acute treatment of DVT and PE

A
  • Xa inhibitors are preferred (rivaroxaban, apixaban) (rapid onset and don’t need lab monitoring).
  • also LMWH
35
Q

when to use thrombolytics for patients with DVT/PE

A

Used for PE patients that are hemodynamically unstable

36
Q

vertebral compression fracture presentation

A

acute back pain + point tenderness after strenuous activity + pain at night
- decreased spinal mobility after bending, coughing, or lifting

37
Q

trigger points in fibromyalgia

A

mid trapezius, lateral epicondyle, costochondral junction, greater trochanter

38
Q

other way to differentiate upper vs. lower GI bleeding on labs

A

upper GI bleeds often lead to elevated BUN/creatinine ratio (increased urea production from intestinal breakdown of hemoglobin AND increased urea reabsorption in proximal tubule due to hypovolemia)

39
Q

CD4 count at which CMV is common

A

very low, below 50

40
Q

CMV colitis presentation

A

frequent small volume bloody stools + abdominal pain

41
Q

management of CMV diarrhea

A

1) colonoscopy w/ biopsy

2) need ocular exam to rule out concurrent retinitis

42
Q

patellofemoral syndrome patient

A

chronic anterior knee pain in young women that is worse when climbing stairs with extension at knee

43
Q

patellofemoral syndrome test

A

patellofemoral compression test (pain elicited by extending knee while compressing the patella) + reproduced while squatting

44
Q

presentation of bacillary angiomatosis in HIV patient

A

bright red, firm, friable, exophytic nodules in HIV patient

45
Q

bacillary angiomatosis treatment

A

erythromycin

46
Q

where does eikenella corrodes live

A

anaerobe, common constituent of normal human oral flora

47
Q

CLL presentation

A
  • almost exclusively elderly patients

- marked leukocytosis + mature lymphocytes + smudge cells

48
Q

associations of mallory-weiss tear

A

alcohol abuse + hiatal hernia

49
Q

management of GI bleeder with depressed LOC and ongoing hematemesis

A

intubate (need to protect airway. hematemesis is a major risk for aspiration)

50
Q

cardiac index

A

cardiac output divided by body surface area

- reduced in HF

Family med (48 decks)

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