Deck 4 Flashcards
painless lymphadenopathy
this is likely due to malignancy, autoimmune causes, or sarcoid
signs of salicylate poisoning
tachypnea, elevated lactate, anion gap metabolic acidosis, confusion, hyperthermia
difference in presentation of salicylate poisoning vs. carbon monoxide poisoning
salicylate has hyperthermia and carbon monoxide is no hyperthermia
treatment of legionella
fluoroquinolone or macrolide
cause of kidney injury in a patient with acute liver failure due to cirrhosis
hepatorenal syndrome –> renal hypoperfusion
treatment of pagets disease
bisphosphonates
what is the normal stool osmotic gap
50-120
what does it mean if the stool osmotic gap is low
this means the diarrhea is secretory
what types of things cause secretory diarrhea
toxins, CF, unabsorbed bile acids
are breath sounds increased or decreased in pneumonia
breath sounds are increased in pneumonia because sound travels faster in fluid than in air
compare breath sounds in pleural effusion vs. pneumonia
in pleural effusion breath sounds are decreased because the fluid outside the lung acts as a barrier for the sound but in pneumonia the fluid consolidation increases the sound
signs of cyanide poisoning
hyptertension, tachycardia, tachypnea, headache, cherry-red skin, elevated anion gap metabolic acidosis
treatment of cyanide poisoning
100% O2, hydroxybobalamin
what is an early test/abnormality that signals macular degeneration
distortion of straight lines that appear wavy, grid test
effect of antiphospholipid antibodies on PT/PTT
antiphospholipid Abs increase PTT because they bind to the phospholipids in PTT tests which prevents coagulation
does PTT change or improve iwth the addision of normal plasma in antiphospholipid syndrome
no it does not because its not a coagulation factor issue its an assay issue in which the autoAbs are binding to the reagents in the PTT assay
presentation of acute ischemic colitis
sudden onset abdominal pain, sudden urge to defecate, cramping
recurrent painless GI bleeding
angiodysplasia
von willebrand levels in patients with aortic stenosis
decreased because the multimers get broken up when they go through the turbulent valve
who gets angiodysplasia
CKD, von willebrand disease, aortic stenosis
what does low cortisol do to eosiophil levels
eosinophilia
evaluation of a patient with primary adrenal insufficiency
am cortisol, ACTH level, cosyntropin (ACTH stim test)
Cl and bicarb relation in the kidney excretion
adequate chloride is needed to be delivered to the DCT to allow for bicarb excretion
what is an infection of the medial canthus called
this is dacryocystitis
urinalysis of acute interstitial nephritis
wbc casts, microscopic hematuria, sterile pyuria
If a patient had normal PaCO2 but is hyperventilating what does this indicate
impending respiratory collapse, because there should be low Co2 when a patient is hyperventilating
how do you get bacillary angiomatosis
from bartonella infection
Who gets bacillary angiomatosis
ppl with cats, homeless people, HIV, immunocompromise
maifestations of bacillary angiomatosis
vascular cutaneous lesions, systemic sx
what endocrine abnormalities can cause recurrent pregnancy loss
thyroid disease, PCOS, DM, hyperprolactinemia
what Abs are positive in Hashimotos
anti thyroperoxidase
what is the most common bug that causes septic arthritis in prosthetic joints several months post op
staph epidermidis
joint aspiration leukocyte count of infected prostetic joint
not as high as a native joint, 10k
what is K like in DKA
typically elevated or normal becaues of osmotic diuresis
what are total body K actually like in DKA
there is actually low K because of the osmotic diuresis
non-anion gap metabolic acidosis and hyperkalemia
renal tubular acidosis
what is osler-webber-rendu syndrome
this is when you have widespread AVMs, recurrent epistaxis, and telangectasias
methods to avoid ARDS in intubated patients
limiting alveolar distension, lowest feaseable FiO2 to avoid O2 toxicity, permissive hypercapnia (O2)
signs of R sided heart failure
cirrhosis, JVD, pedal edema
pulmonary complications of sickle cell disease
pulmonary fibrosis, pulmonary hypertension, asthma
causes of R sided heart failure
pulm artery htn, pulmonic stenosis
systemic symptoms with skin lesions, kidney dysfunction, joint pain and low complement
small vessel vasculitis
what infection is associated with mixed cyroglobulinemia syndrome
hep C
between multiple myeloma vs. waldenstrom which has hyperviscocity
waldenstrom
what autoAbs are present in atrophic gastritis
Abs towards intrinisc factor and towards parietal cells
what counts as acute liver failure
encephalopathy, coagulopathy INR >1.5, elevated LFTs
management of acute liver failure
transplant
