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Family med > deck 38 > Flashcards

deck 38 Flashcards

1
Q

diverticulosis diagnosis

A

CT scan

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2
Q

diverticulosis GI presentation

A

acute diverticulosis more associated with N/V than diarrhea

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3
Q

management of gonorrhoea infection

A

Need to also screen for syphilis, hep B, chlamydia (high rate of coinfection)

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4
Q

secondary syphilis presentation

A

fever/malaise + widespread lymphadenopathy + diffuse maculopapular rash that begins on trunks and EXTENDS to extremities, including palms and soles + grey, mucous patches in mouth

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5
Q

cause of gallstones in TPN patients

A

gallbladder stasis

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6
Q

cause of mitral valve abnormality in HOCM

A

presence of systolic anterior motion of mitral valve leads to anterior motion of mitral valve leaflets toward the inter ventricular septum
- contact between the mitral valve and the thickened septum during systole leads to LV outflow tract obstruction

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7
Q

classic de quervain tenosynovitis pt

A

mother holding infant with thumb outstretched

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8
Q

de quervain tenosynovitis presentation

A
  • tenderness in radial side of wrist at base of hand

- tenderness with passive stretching of tendons by grasping flexed thumb into palm

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9
Q

initial management of lumbosacral radiculopathy

A
  • NSAIDS or acetaminophen. NO IMAGING.
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10
Q

most common findings of x ray in its with cervical spondylosis

A

osteophytes

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11
Q

amyloidosis etiology

A
  • *can also be secondary to chronic inflammation (eg chronic infections, IBD, RA)
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12
Q

drug used for treatment and prophylaxis of amyloidosis

A

colchicine

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13
Q

most common condition associated with dermatomyositis

A

malignancy (over 15% of patients)

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14
Q

most common cause of primary adrenal insufficiency

A

autoimmune (over 90%) in developed world

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15
Q

key distinguishing features between primary and secondary adrenal insufficiency

A

hyperkalemia + hyperpigmentation

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16
Q

demographic most effected by pernicious anemia

A

whites of northern European ancestry

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17
Q

length of time it would take for vegan to develop b12 deficiency

A

4-5 yrs of pure vegan diet (very high total body store)

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18
Q

preferred treatment of vasospastic angina

A

CCBs (dilitazem, amlodipine)

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19
Q

presentation of mild primary hyperparathyroidism

A

mild, asymptomatic hypercalcemia

20
Q

how to distinguish between exogenous thyroid intake vs. thyroiditis

A

serum thyroglobulin level (low with exogenous uptake, high with thyroiditis)

21
Q

well known complication of giant cell or temporal arteritis

A

aortic aneurysm

22
Q

major concern with hydroxychloroquine

A

retinal toxicity

23
Q

most common pathologies seen with analgesic nephropathy

A

papillary necrosis + chronic tubulointerstitial nephritis

24
Q

metabolic side effects of thiazide duiretics

A

hyperglycemia, increased LDL cholesterol and triglycerides, hyperuricemia,
hyponatremia, hypokalemia, hypomag, hypercalcemia

25
Q

presentation of amyloidosis

A

asymptomatic proteinuria + nephrotic syndrome + waxy skin + anemia + easy bruising + hepatomegaly

26
Q

cardiac amyloidosis presentation

A

CHF manifestations (progressive dyspnea, lower extremity edema, JVD, ascites) + LVH and non dilated LV cavity, especially absent HTN history

27
Q

why do high dose steroids cause adrenal insufficiency?

A

1) central mechanism. steroids act on pituitary to decrease release of ACTH.

28
Q

why do you get muscle weakness in cushings syndrome?

A

cortisol catabolizes skeletal muscle, leading to muscle atrophy.

29
Q

tachycardia-mediated cardiomyopathy pathophys

A

Chronic tachycardia causes LV dilation and myocardial dysfunction. This leads to LV dysfunction with decreased ejection fraction.

30
Q

treatment of tachycardia-mediated cardiomyopathy

A

aggressive rate control OR restoration of normal sinus rhythm

31
Q

why is adenosine used for narrow complex tachycardia?

A

1) slows sinus rate + increases AV nodal conduction delay + can cause a transient block in AV node conduction
2) allows you to identify P waves to clarify diagnosis of A flutter or atrial tachycardia.
3) can terminate PSVT by interrupting the AV nodal reentry circuit

32
Q

what does SVT refer to?

A

any tachycardia originating above His-bundle (sinus tachycardia, multifocal atrial tachycardia, a flutter, a fib, AVNRT, AVRT, junctional tachycardia)

33
Q

supraventricular arrhythmias on ECG

A
  • narrow complex
  • no regular P waves (buried in QRS complexes,
  • retrograde P waves: seen in beginning or end of QRS complex
34
Q

what is torsades de pointes?

A

polymorphic v tach occurring in the setting of a congenital or acquired prolonged QT

35
Q

torsades de pointes management

A

1) if hemodynamically unstable, then immediate defib

2) if stable, then IV mag sulfate

36
Q

aortic regurg murmur

A

early diastolic

37
Q

perivalvular abscess setting

A

patient with infective endocarditis who develops a new conduction abnormality (AV block) (abscess extends into adjacent conduction tissues) (usually happens in aortic valve in IV drug abusers)

38
Q

fluid dynamics of acute MR

A

leads to excessive diastolic volume overload, which causes elevated left ventricular end diastolic pressure. This elevated filling pressure is reflected back in the left atrium and pulmonary circulation and is responsible for signs/symptoms of acute pulmonary edema and CHF

39
Q

ECG with myocarditis

A

nonspecific ST segment changes

40
Q

signs of RV failure

A 
elevated JVP
RV 3rd heart sound
tricuspid regurg
hepatomegaly 
hepatojugular reflex
lower extremity edema, ascites, pleural effusions
41
Q

hearing loss in HIV patient

A

serous otitis media (lymphadenopathy or obstructing lymphoma leads to auditory tube dysfunction)

42
Q

AAA screening recommendation

A

aged 65-75 active or FORMER smokers with one time abdominal ultrasound

43
Q

carotid endarterectomy indications

A

patients with symptomatic carotid artery stenosis of 70-99%

44
Q

a fib with RVR definition

A

a fib with pulse over 100

45
Q

BNP value for CHF

A

high sensitivity

46
Q

cord compression management

A

IV glucocorticoids without delay, then get MRI

Family med (48 decks)

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