Def1 Flashcards

1
Q

A complication of Infectious mononucleosis?

A

acute airway obstruction(C/S inpatient with risk of o)
Hemolytic anemia and thrombocytopenia
Splenic rupture

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2
Q

hyperkalemia managment indication?

A

if >=6.5

If symptomatic

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3
Q

management?

A

Insulin + glucose

calcium gluconate

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4
Q

vestibular neuritis?

A

Acute persistent vertigo
may have an ass. nausea, vomiting, and ataxia
following URT viral infection
may have hearing loss and fullness sensation

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5
Q

erythropoietin indication?

A

ESRD + Hg < 10 g

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6
Q

S/E?

A

mild or severe HTN

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7
Q

age-related Sicca syndrome?

A

Dry eye and oral area
d/t from shorgen(in young and posetive ANA)
associated with DM and throid disease

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8
Q

Arsenic poisoning symptoms?

A
ACUTE
Garlic breath
vomiting 
Diharoa
QT prolongation
Hepatitis
pancytopenia
Chronic
skin hypo/hyperpigmentation
mees line(horizontal straination of finger line
stock glove pnurophaty
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9
Q

Precontemplation?

A

patient dosnt ready to change

not acknowledge it

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10
Q

action?

A

encourage the patient to evaluate the consequences of his behavior

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11
Q

Contemplation?

A

patient ambivalent

acknowledge it

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12
Q

action?

A

evaluate the pros and cons of his action

promote new behavior

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13
Q

preparation?

A

ready to change

encourage small initial action

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14
Q

action?

A

start to change

help to identify an appropriate strategy

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15
Q

maintenance?

A

change integrated
give follow up and social support
prevent relapse

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16
Q

Identification?

A

action is automatic

praise

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17
Q

marijuana(cannabis) intoxication sign?

A
tachycardia
tachypnea
dry mouth
injected conjunctiva
increase appetite
slow reaction time
impaired concentration
short term memory, cognition, and coordination may be affected
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18
Q

Transient tachypnea of newborn pathophysiology?

A

Defect in reabsorption of fluid produced by alveoli

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19
Q

Risk factor?

A

Prematurity
C/S
Maternal DM

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20
Q

CM?

A

Tachypnea
Clear chest on auscultation
Hypoxia
CXR:Hyperinfleted lung and fluid in intraaleveolar space

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21
Q

management?

A

Supportive
Nutrition and o2
self resolve within 1-3 week

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22
Q

other than ABCDE for melanoma suspicion?

A

Ugley duck sign: Melanoma different appearance to other surrounding nevi
Elevation from the surrounding area
Firm to palpation
continuous growth

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23
Q

electrolyte abnormality in tumor lysis syndrome?

A
High PKU(Pos.Pot.UA)
LOW Ca
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24
Q

Macrocephaly in children’s definition?

A

HC>97%

can be pathologic or benign

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25
Q

benign cause?

A
MCC
Familial macrocephaly
due to megalocephaly
treatment not needed
only U/S needed to exclude other pathology
No need of MRI/CT
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26
Q

Clinical feature for benign?

A

normal development
no syndromic feature
No sign of ICP
No sign of infection

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27
Q

Fibrocystic change of breast?

A

due to estrogen and progesterone dysregulation
Bilateral ,fibrocystic ( cord-like) mass.
perimenestruan difuse breast and chest tenderness

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28
Q

management?

A

1stL: NSAID
2nd: OCP

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29
Q

peripheral single blu inclusion in RBC?

A

Immature RBC Nuclear remaining(HJB)
Normally cleared by splenic macrophage
Occur inpatients with functional absence or complete absence of the spleen.

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30
Q

Differentials?

A
Lead poisoning (ribosomal remaining, Multiple blue staining(striping))
G6PD(oxidized Hgb Onley seen by CV staining and will have bite cells)
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31
Q

what to do inpatient with first DVT w/o underlying risk?

A

age-appropriate cancer screening

32
Q

when to r/o genetic cause?

A

age <45
recurrent
unesual site/multiple site VT
family history

33
Q

lung cancer screening protocol?

A

low dose CT is recommended
yearly
55-80
more than 30 pack smoking hx/quite in last 15 year
terminate if age 80, stoped >15 years or unable to perform lung surgery or other medical condition lower life expectancy

34
Q

varicocele management?

A

resection inpatient who desire fertility and have testicular atrophy/infertility
Support and NSAID in older who do not need fertility

35
Q

things to do in hyperkalemia?

A

first, do ECG
Treatment(Caglu/Insulin + Glucose) if symptomatic/ECG changes, or if K>7 or rapid raising K in executive tissue releasing pathology(TLS),

36
Q

the first step in the management of BZD toxicity?

A

maintain respiration

then flumazenil can be given

37
Q

MRI sign of MS?

A

A multifocal ovoid lesion in the periventricular area, Corpus callosum, cerebellum, optic nerve, and spine.

38
Q

acute exacerbation management?

A

IV Corticosteroid

Plasma exchange if not respond

39
Q

idiopatic ICH in prepubertal?

A
visual sx(diplopia, visual loss, optic disk swelling and blind spot enlargement be noticed)
headache is not common
40
Q

common underlying valvular pathology in IE?

A

MVP with MR

41
Q

atypical lymphocyte?

A

large vacoulated cell
EBC(+ MST)
CMV(-ve MST and + IgM 0

42
Q

age-induced sleep disorder?

A
inc sleep latency
frequent nighttime awakening
morning awakeness
slow-wave from sleep
daytime napping
non-pharmacologic treatment is recomended
43
Q

when to suspect medication-induced mania/depression?

A

pt with no previous psychotic sx

dopamine agonist usage

44
Q

medication-induced headache?

A

not daily sx

hx of analgesic abuse

45
Q

warning sign inpatient in headache that requires early imaging?

A
seizure, AMS, and FND
change frq, intensity and character of headache
onset age >40
trauma hx
awakening headache
sudden onset
46
Q

Rapid eye movement sleep behavior disorder?

A

Due to degeneration of spinal nuclei which inhibit motor activity during REM
Common in elderly
Maybe sign of neurodegenerative disorder
Common in late night when REM pase increase

47
Q

CM?

A

Motor activity while on sleep
The patient remember the dream but not the activity
Increase frequency as it persists
may have motor symptoms of neurodegenerative disease

48
Q

what about a nightmare?

A

occur in REM as RBD

but have no motor symptom

49
Q

what about sleepwalking?

A
Occur in younger
Occur in Non-REM (N3)
difficult to awake
they may have motor activity
doesn't remember the episode
confusion after awakening
50
Q

night terror?

A

scream and are very frightened and confused.
They thrash around violently and are often not aware of their surroundings.
may not be able to respond to being talked to, comforted, or awakened.
maybe sweating, breathing very fast (hyperventilating), having a fast heart rate, and widened (dilated) pupils.
The spell may last 10 to 20 minutes, then
occur in N3
doesn’t remember

51
Q

schizoaffective disorder?

A

MDD/MANIA incongruent with psychosis
>2 weeks of psychotic SX in absence of MDD/MAnia
Mood SX are prominent and recurent

52
Q

Pediatric migraine?

A

MCC of pediatric headache

unlike adult bifrontal and have a short duration

53
Q

what management is atypical in granulosal cell tumors?

A

ENdometrial biopsy

54
Q

fecal incontinence in postpartum?

A

if anal sphincter function is intact consider benign(EAS relaxation)—reassurance and obs.(Pelvic exersise)
If anal sphincter fun is lost or irregularity–Do U/S and then surgery

55
Q

cause of primary ovarian insuf.?

A
TS
FXS
Chemo
Radiotherapy
Autoimmune ophoritis
galactosemia
56
Q

triads of conjenital toxo?

A

chorioretinitis(late infancy)
diffuze intracranial calcification
hydrocephalus

57
Q

specific sign for eating disorder?

A

AN: BMI<18.5
BN: Compensatory behavior for excessive feeding
BED: Binge eating w/o compensatory behavior

58
Q

drug for each of NR and CBT fails?

A

AN:Olanzepine
BN:SSRI
BED:SSRI/lixdexamphitamin/topiramet

59
Q

common cardiac anomaly in Edward?

A

VSD

60
Q

cyanosis in the neonate in the first few days?

A

acrocyanosis: benign usually
central: Hypoxia

61
Q

club foot?

A

thallus bone deformity due to congenital/compression

gentle manipulation/stretching and intermittent casting

62
Q

risk for vesicovaginal fistula?

A

pelvic surgery
radiation
obstetric related
pelvic ca

63
Q

Dx?

A

continuous clear vaginal leakage and granulating tissue

cystoscopy/dye if PE did not diagnose it

64
Q

postoperative pulmonary complication prevention?

A
smoking cessation 4-8 weeks prior
deep breathing exercise
pain control
incentive spirometry
treating underlying pulmonary disease
65
Q

gout topi?

A
hard mass can involve
bursa
tendon 
ligament
nearby joint
can erode nearby bone
66
Q

gout and bursa?

A

acute bursitis
chronic bursitis
gout topi

67
Q

what to do if a cataract causes visual impairment?

A

surgical removal and replace with artificial lenses

68
Q

Peyronie disease managment?

A

normally resolve within 1-2 year
if active progressive(NSAID,Phentoxiphylin and intralesional colagenase)
surgery in refractory disease

69
Q

moderately increased urine albumine/Cr ratio?

A

30-300
need ace/arb
if >300 need SGCTI

70
Q

factorial design?

A

2 or more interventional groups with 2 or more variable study

71
Q

classification of metabolic alkalosis?

A

1–low urine chloride(<20 meq)/saline responsive

2–High urine chloride(>20 meq)/saline not responsive

72
Q

LUC cause?

A

vomiting
NG tube aspiration
diuretics

73
Q

HUC cause?

A

1-Hypovolumic–Gitlman/bartner syndrome

2-Hypervolumic–PHA/PHA/Cushing and ectopic ACTH

74
Q

a common cause of cellulitis after a puncture wound?

A

S.A

Pseudomonas

75
Q

treatment of ankylosing spondylitis?

A

1st: exercise
2nd: NSAID
3rd: TNF alpha inhibitor/anti-IL-17 (secukinumab)