Deck 77: Internal Medicine Flashcards

1
Q

what causes markedly impaired alveolar ventilation in acute pneumonia? What does this result in?

A

alveolar consolidation

  • hypoxemia
  • intrapulmonary shunting
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2
Q

Dead space ventilation

A

ventilation of ares of lung that are not perfused with blood

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3
Q

headache that manifests as constant pressure in the temporal and occipital regions without nausea or visual symptoms and that are unchanged of quality from prior

A

tension-type headache

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4
Q

what can cause tension headaches

A

stress

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5
Q

what can cause cluster headaches

A

sleep

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6
Q

Unilateral recurrent periorbital headache pain that resolves and recurs with associated ipsilateral miosis and ptosis

A

Cluster

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7
Q

Headaches that are pulsatile and throbbing in character, often unilateral

A

Migraine

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8
Q

what is often associated with migraine without arura

A

nausea, vomiting, and photophobia

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9
Q

how is leprosy diagnosed

A

biopsy from active edge of lesion

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10
Q

symptoms for leprosy

A

chronic, anesthetic, hypopigmented lesions with peripheral nerve involvement

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11
Q

Ichthyosis vulgaris

A

diffuse dermal scaling

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12
Q

coarsening of facial features, pharyngeal crowding, and enlargement of hands and feet

A

acromegaly

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13
Q

heart problem in acromegaly

A

concentric myocardial hypertrophy
diastolic dysfunction
left ventricular dilation
global hypokinesis

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14
Q

typical presentation of anaphylaxis

A

hypotension
tachycardia
urticarial rash
wheezing

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15
Q

fat embolism that occurs following a long-bone fracture has what clinical symptoms

A

dyspnea
neurological impairment ( confusion, seizure)
petechial rash

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16
Q

Timing difference between fat embolism from bone fracture and anaphylaxis reaction

A

anaphylaxis: quickly

fat embolism: 12-24 hours

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17
Q

Acanthosis nigricans is associated with what

A

younger patients: insulin resistance states

Older: GI malignancy

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18
Q

characterize laxative abuse

A

frequent, watery, nocturnal diarrhea

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19
Q

how do you diagnose positive laxative abuse

A

positive laxative screen

colonoscopy: melanosis coli ( dark brown discoloration with pale patches of lymph follicles)

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20
Q

characterize VIPoma diarreha

A

tea-colored

hypokalemia with hypochlorhydria

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21
Q

What distinguished peritonsillar abscess from epiglottis

A

Pertonsillar abscess: deviation of uvula and unilateral lymphadenopathy

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22
Q

what cancers are associated with lynch syndrome

A

colorectal cancer
endometrial carcinoma for female carriers
ovarian cancer

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23
Q

associated cancer with familial adenomatous polyposis

A

colorectal
desmoid and osteomas
brain tumors

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24
Q

cancer associated with von Hippel-Linau syndrome

A

Hemangioblastomas
Clear cell renal carcinoma
pheochromocytoma

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25
MEN1
parathyroid ademona pituitary adenoma pancreatic adenomas
26
MEN2
Meduallary thyroid cancer pheochromocytoma Parathyroid hyperplasia
27
BRCA1 and BRCA2
breast and ovarian cancer
28
X-ray finding for osteomalacia due to vitamin D deficiency
decreased bone density with thinning of cortex | pseudofractures (Looser zones)
29
absence of identifiable bacteria on culture or gram stain, a mucopurulent urethral discharge in a patient who is sexually active suggests? what tests confirms diagnosis
chlamydial urethritis | Nucleic acid amplification
30
which drugs have survival benefit in CHF ? which help symptoms
survival: ACE inhibitors, ARB, beta blockers, spironolactone symptomatic: Digoxin, furosemide
31
treatment for papillary thyroid cancer?
surgical resection | if high recurrence rate: radioiodine and thyroid replacement to suppress TSH
32
what is performed for initial evaluation of thyroid nodules
thyroid scintigraphy
33
thyroid peroxidase is marker for
hashimoto thyroiditis
34
presentation of cyanide toxicity
altered mental status lactic acidosis seizures coma
35
what causes cyanide toxicity
nitroprusside
36
how does respiratory alkalosis impact Calcium
Hydrogen ions dissociate from albumin | calcium binds albumin
37
PE causes what acid base disturbance
respiratory alkalosis
38
Most effective intervention in overweight patients for controlling hypertension
weight control | other ideas: DASH diet
39
when can an abnormal S4 be heard in a person with CAD
acute phase of myocardial infarction due to ischemia induced Myocardial dysfunction
40
when should an HIV patient get the live attenuated varicella vaccine
CD4 count greater than 200
41
patient outstretch arms with palms up and eyes closed. Arm drifts downward and palm turns (pronates) toward the floor
Pronator drift | Upper motor neuron or pyramidal tract disease
42
what is romberg test and what does it test for
stand with feet together, arms to the sides and eyes closed. propioception
43
Treatment for Dressler syndrome
NSAID
44
what lab value is elevated in pneumocysitis pneumonia
lactate dehydrogenase
45
is a lupus patient what is the difference ebtween pneumocysitis and pulmonary fibrosis
same except timing | pulmonary fibrosis shows up later
46
Common cause of cyclic breast pain in women of reproductive age? PE?
fibrocystic breast: nodular breasts with non-focal tenderness, no nipple discharge or lymphadenopathy
47
Treatment for costochondritis
reassurance and symptomatic pain management
48
What will cause decrease airflow rate during inspiration and expiration, flattening both the top and bottom of the flow-volume loop
fixed upper-airway obstruction
49
Mild persistent asthma? treatment
2 day per week 3-4 nightly awakenings per month inhaled corticosteroid short-acting beta-2 agonist
50
exaggerated fall in systemic blood pressure (10 or more) during inspiration
Pulsus paradoxus
51
when can you find pulsus paradoxus
cardiac tamponade severe asthma COPD
52
how does aortic regurgitation prevent pulsus paradoxus
- increase left ventricular end-diastolic pressure | - precludes interventricular septum to shift left
53
Light criteria
exudative if - pleural fluid protein/ serum protein .5 or more - pleural fluid LDH/ serum LDH .6 or more - pleural fluid LDH greater 2/3 of upper limit of normal for serum LDH
54
heart failure and hypoalbuminemia are associated with what type of effusion
transudative
55
most common cause of liver mass in the US
matastatic disease
56
what is Beck's triad? and what is it associated with
hypotension, distended neck veins, muffled heart sounds | - cardiac tamponade
57
What causes symptoms in cardiac tamponade
- exaggerated shift of interventricular septum toward left | - reduces left ventricular preload, stroke volume and cardiac output
58
Strongyloides stercoralis causes
mild intermittent skin, GI, and pulmonary symptoms
59
Immediate treatment for frostbite
WATER bath rewarming
60
most common cause of constrictive pericarditis in developing countries
TB