Deck 5 Flashcards

1
Q

PJP vs. CMV pneumonitis presentation

A

PJP is more indolent (less acute onset) and CMV is more acute, both have diffuse interstitial infiltrates

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2
Q

next step in a thyroid nodule in a patient with low TSH

A

radionucleotide scan

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3
Q

nontender bilateral enIargement of the parotid glands

A

sialodenosis from malnutrition

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4
Q

when to intervene surgically in infective endocarditis

A

acute heart failure, extension of the infection (fistula etc), recurrent septic emboli, large vegetations

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5
Q

do you need a upper GI study for dx dumping syndrome

A

nope just clinical unless you arent super clear

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6
Q

what organism is the culprit for puncture wounds

A

pseudomonas

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7
Q

signs of SIBO

A

chronic watery diarrhea, bloating, flatulence

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8
Q

how to dx SIBO

A

carbohydrate breath test

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9
Q

where do most cases of ludwig angina arise from

A

dental infections

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10
Q

signs of ankylosing spondylitis

A

enthesis (heel pain), back pain, SOB from trouble with chest wall expansion, dactylitis, uveitis

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11
Q

complications of ankylosing spondylitis

A

aortic regurg, cauda equina syndrome, vertebral compression fractures

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12
Q

LFTs in HCC

A

normal or elevated

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13
Q

do you have back pain in scoliosis

A

not typically–> investigate other causes

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14
Q

treatment of small pneumothorax

A

oxygen

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15
Q

which is cholangitis is associated with UC

A

primary sclerosing cholangitis

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16
Q

breast necrosis signs physical exam

A

skin retractions and dimpling

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17
Q

breast necrosis management after biopsy

A

nothing, just observation

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18
Q

what is the protein that binds thyroid hormone

A

thyroxine-binding-globulin

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19
Q

precursor to thyroid hormone

A

thyroglobulin

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20
Q

ECG cahnges for cardiac aneurysm

A

persistent ST elevation and deep Q waves

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21
Q

what ejection fraction % is considered for surgical repair of mitral regurg

A

30-60% bc the regurg overestimates the actual stroke volume

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22
Q

what is adhesive capsulitis

A

glenohumoral capsule contracture,

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23
Q

clinical signs of adhesive capsulitis

A

increased stiffness for 2 months, then trouble lifting shoulder over head, and pain with ROM

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24
Q

treatment of adhesive capsulitis

A

ROM exercises, NSAIDs, corticosteroids injection

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25
Q

how to treat acute hyponatremia

A

hypertonic (3%) saline boluses

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26
Q

what can happen after heparin if someone starts bleeding

A

HIT

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27
Q

A-a gradient in ARDS

A

high

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28
Q

does diffuse pulmonary edema correct with supplemental O2

A

nope

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29
Q

does atelectasis, lobar pneumonia, empyema etc correct with supplemental O2

A

yes because it is a localized process

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30
Q

how do you get splenic abcess

A

hematogenous spread

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31
Q

does TB cause air fluid levels

A

not as common

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32
Q

does TB have foul smelling sputum

A

no

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33
Q

complications of myopia

A

retinal detachment, macular degeneration

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34
Q

what do patients need to be given who are on warfarin before they go into surgery

A

prothrombin complex concentrate to reverse the effects of the warfarin AND IV vitK

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35
Q

when do you take a patient to surgery for cholecystitis

A

when they have complications like emphysematous choly

36
Q

treatment of purulent pericarditis

A

pericardiocentesis

37
Q

treatment of noncomplicated calculous cholecystitis

A

NPO, ABX, fluids, lap chole within 72 hours

38
Q

when do you get a HIDA scan

A

when U/S is inconclusive of gallbladder disease

39
Q

treatment of chronic pancreatitis

A

pancreatic enzyme supplement

40
Q

imaging findings of chronic pancreatitis

A

calcifications, pancreatic atrophy

41
Q

what happens around 3 days post MI

A

papillary muscle rupture

42
Q

primary treatment of papillary thyroid cancer

A

surgical resection

43
Q

treatment of acute cholangitis

A

ERCP with spincterotomy and drainage

44
Q

do you do EGD on a patient that has possible perfed ulcer

A

nor, do a CXR instead to see if there is free air

45
Q

how to tell if ascitic fluid is from portal hypertension

A

SAAG (serum-fluid albumin)

46
Q

do empyemas or lung abcesses have air fluid levels

A

abcesses

47
Q

treatment of trochanteric bursitis

A

exercise, NSAIDs, steroid injection

48
Q

how do you dx subclavian steal syndrome

A

you test blood pressures in each arm

49
Q

which arm has lower blood pressure in subclavian steal synd

A

the arm with the stenosis

50
Q

which skin cancer has telangectasias

A

basal cell CA

51
Q

pathophys of fibromuscular dysplasia

A

multifocal fibrous and muscular thickening of the arterial wall leading to stenosis

52
Q

initial management of suspected AAA rupture

A

point of care US, no time for CTA

53
Q

petechiae/skin rash with purpura after PCI for MI

A

cholesterol embolization syndrome from dislodged cholesterol bits that damange vessels

54
Q

wide fixed split S2

A

ASD

55
Q

mass within a mass in the lung dx

A

likely aspergilloma inside a prior TB cavitation

56
Q

treatment of esophagitis from GERD

A

PPI (omeprazole) and an antacid

57
Q

labs for pancreatitis

A

elevated amylase and lipase specifically

58
Q

what does peritonitis signs indicate

A

perforated hollow viscus (diverticuliits, appy, ulcer)

59
Q

treatment of transitional cell carcinoma in situ

A

endoscropic resection

60
Q

treatment of transitional cell carcinoma that invades bladder wall

A

partial or full cystectomy

61
Q

frist step before surgery of bony mets

A

steriods to reduce inflammation

62
Q

clinical signs of ovarian torsion

A

sudden onset lower abdominal pain, hypertension, tachy, fever, palpable mass

63
Q

treatment of ovarian torsion

A

laporoscopy

64
Q

physical exam of testicular torsion

A

testicle with abnormal lie (typically transverse), absent cremastic reflex, exquisite pain

65
Q

treatment of peripheral arterial disease after conservative measures

A

arterial bypass

66
Q

normal urine pH

A

6-7.5

67
Q

lab values indicating refeeding syndrome

A

hypophosphatemia and hypomagnesia

68
Q

signs of hypercalcemic crisis

A

somnolence, lethargy, short QT

69
Q

in tension pneumo, do you do needle or intubate first

A

needle then intubate

70
Q

where is the break if there is wrist drop

A

distal humerus

71
Q

signs of acute congestive heart failure

A

tachycardia, tachypnea, hypoxia, JVD, end expiratory wheezing,

72
Q

what is cor pulmonale

A

RHF from chronic pulmonary hypertension

73
Q

at what size do AAA need operating

A

> 5.5cm

74
Q

management of smaller AAA

A

serial imaging

75
Q

management of thrombophelbitis

A

source control by removiing IV and the segment of vein infected

76
Q

cause of bone pain in Squamous cell lung CA patients

A

paraneoplastic syndrome of PTPrP which causes increased osteoclast activity and eats away at bone

77
Q

lung abcess vs. empyema air fluid level

A

abcess HAS the air fluid level

78
Q

dx imaging for intusscussception

A

abdominal ultrasound, then air enema with U/S

79
Q

next step of management of variceal bleeding after fluids

A

endoscopy and variceal banding

80
Q

breast mass eval in a pt. younger than 30

A

ultrasound

81
Q

overlying skin characteristics in abcesses

A

fluctuance, erythema, skin changes

82
Q

colors of breast cyst fluids

A

clear, brown, green etc

83
Q

steps of thyroid CA dx

A

physical exam, TSH, radio scinitigraphy, FNA

84
Q

treatment of hypercalcemia

A

normal saline infusion, bisphosphonates

85
Q

what is pulsus paradoxus

A

drop in systolic bp during inspiration

86
Q

when do you see pulsus paradoxus

A

pericarditis, cardiac tampenode, pneumothorax

87
Q

gastrographin vs. barium for esophagraphy

A

gastrographin if suspected perf, barium for regular swallow bc barium can irritate the esophagus and cause mediastinitis