Deck 5 COPY Flashcards
PJP vs. CMV pneumonitis presentation
PJP is more indolent (less acute onset) and CMV is more acute, both have diffuse interstitial infiltrates
next step in a thyroid nodule in a patient with low TSH
radionucleotide scan
nontender bilateral enIargement of the parotid glands
sialodenosis from malnutrition
when to intervene surgically in infective endocarditis
acute heart failure, extension of the infection (fistula etc), recurrent septic emboli, large vegetations
do you need a upper GI study for dx dumping syndrome
nope just clinical unless you arent super clear
what organism is the culprit for puncture wounds
pseudomonas
signs of SIBO
chronic watery diarrhea, bloating, flatulence
how to dx SIBO
carbohydrate breath test
where do most cases of ludwig angina arise from
dental infections
signs of ankylosing spondylitis
enthesis (heel pain), back pain, SOB from trouble with chest wall expansion, dactylitis, uveitis
complications of ankylosing spondylitis
aortic regurg, cauda equina syndrome, vertebral compression fractures
LFTs in HCC
normal or elevated
do you have back pain in scoliosis
not typically–> investigate other causes
treatment of small pneumothorax
oxygen
which is cholangitis is associated with UC
primary sclerosing cholangitis
breast necrosis signs physical exam
skin retractions and dimpling
breast necrosis management after biopsy
nothing, just observation
what is the protein that binds thyroid hormone
thyroxine-binding-globulin
precursor to thyroid hormone
thyroglobulin
ECG cahnges for cardiac aneurysm
persistent ST elevation and deep Q waves
what ejection fraction % is considered for surgical repair of mitral regurg
30-60% bc the regurg overestimates the actual stroke volume
what is adhesive capsulitis
glenohumoral capsule contracture,
clinical signs of adhesive capsulitis
increased stiffness for 2 months, then trouble lifting shoulder over head, and pain with ROM
treatment of adhesive capsulitis
ROM exercises, NSAIDs, corticosteroids injection
how to treat acute hyponatremia
hypertonic (3%) saline boluses
what can happen after heparin if someone starts bleeding
HIT
A-a gradient in ARDS
high
does diffuse pulmonary edema correct with supplemental O2
nope
does atelectasis, lobar pneumonia, empyema etc correct with supplemental O2
yes because it is a localized process
how do you get splenic abcess
hematogenous spread
does TB cause air fluid levels
not as common
does TB have foul smelling sputum
no
complications of myopia
retinal detachment, macular degeneration
what do patients need to be given who are on warfarin before they go into surgery
prothrombin complex concentrate to reverse the effects of the warfarin AND IV vitK
when do you take a patient to surgery for cholecystitis
when they have complications like emphysematous choly
treatment of purulent pericarditis
pericardiocentesis
treatment of noncomplicated calculous cholecystitis
NPO, ABX, fluids, lap chole within 72 hours
when do you get a HIDA scan
when U/S is inconclusive of gallbladder disease
treatment of chronic pancreatitis
pancreatic enzyme supplement
imaging findings of chronic pancreatitis
calcifications, pancreatic atrophy
what happens around 3 days post MI
papillary muscle rupture
primary treatment of papillary thyroid cancer
surgical resection
treatment of acute cholangitis
ERCP with spincterotomy and drainage
do you do EGD on a patient that has possible perfed ulcer
nor, do a CXR instead to see if there is free air
how to tell if ascitic fluid is from portal hypertension
SAAG (serum-fluid albumin)
do empyemas or lung abcesses have air fluid levels
abcesses
treatment of trochanteric bursitis
exercise, NSAIDs, steroid injection
how do you dx subclavian steal syndrome
you test blood pressures in each arm
which arm has lower blood pressure in subclavian steal synd
the arm with the stenosis
which skin cancer has telangectasias
basal cell CA
pathophys of fibromuscular dysplasia
multifocal fibrous and muscular thickening of the arterial wall leading to stenosis
initial management of suspected AAA rupture
point of care US, no time for CTA
petechiae/skin rash with purpura after PCI for MI
cholesterol embolization syndrome from dislodged cholesterol bits that damange vessels
wide fixed split S2
ASD
mass within a mass in the lung dx
likely aspergilloma inside a prior TB cavitation
treatment of esophagitis from GERD
PPI (omeprazole) and an antacid
labs for pancreatitis
elevated amylase and lipase specifically
what does peritonitis signs indicate
perforated hollow viscus (diverticuliits, appy, ulcer)
treatment of transitional cell carcinoma in situ
endoscropic resection
treatment of transitional cell carcinoma that invades bladder wall
partial or full cystectomy
frist step before surgery of bony mets
steriods to reduce inflammation
clinical signs of ovarian torsion
sudden onset lower abdominal pain, hypertension, tachy, fever, palpable mass
treatment of ovarian torsion
laporoscopy
physical exam of testicular torsion
testicle with abnormal lie (typically transverse), absent cremastic reflex, exquisite pain
treatment of peripheral arterial disease after conservative measures
arterial bypass
normal urine pH
6-7.5
lab values indicating refeeding syndrome
hypophosphatemia and hypomagnesia
signs of hypercalcemic crisis
somnolence, lethargy, short QT
in tension pneumo, do you do needle or intubate first
needle then intubate
where is the break if there is wrist drop
distal humerus
signs of acute congestive heart failure
tachycardia, tachypnea, hypoxia, JVD, end expiratory wheezing,
what is cor pulmonale
RHF from chronic pulmonary hypertension
at what size do AAA need operating
> 5.5cm
management of smaller AAA
serial imaging
management of thrombophelbitis
source control by removiing IV and the segment of vein infected
cause of bone pain in Squamous cell lung CA patients
paraneoplastic syndrome of PTPrP which causes increased osteoclast activity and eats away at bone
lung abcess vs. empyema air fluid level
abcess HAS the air fluid level
dx imaging for intusscussception
abdominal ultrasound, then air enema with U/S
next step of management of variceal bleeding after fluids
endoscopy and variceal banding
breast mass eval in a pt. younger than 30
ultrasound
overlying skin characteristics in abcesses
fluctuance, erythema, skin changes
colors of breast cyst fluids
clear, brown, green etc
steps of thyroid CA dx
physical exam, TSH, radio scinitigraphy, FNA
treatment of hypercalcemia
normal saline infusion, bisphosphonates
what is pulsus paradoxus
drop in systolic bp during inspiration
when do you see pulsus paradoxus
pericarditis, cardiac tampenode, pneumothorax
gastrographin vs. barium for esophagraphy
gastrographin if suspected perf, barium for regular swallow bc barium can irritate the esophagus and cause mediastinitis
