Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Step Up 2 Medicine - IM > DIT crashcart notes > Flashcards

DIT crashcart notes Flashcards

1
Q

Non-invasive coronary heart disease tests

A

Stress echocardiography
Stress electrocardiogram
-Stress tests by treadmill or dobutamine

radionuclide myocardial perfusion imaging
Coronary artery calcium
Cardiac computed tomography angiopgraphy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Why are b-blockers contraindicated in pts with cocaine-induced angina and cocaine induced hypertension

A

Cocaine inhibits the reuptake of NE by the presynaptic neuron prolonging the effects of NE

NE works through the alpha and beta adrenergic receptors on vascular smooth muscle, including coronary arteries.

Beta blockers lead to unopposed alpha adrenergic activity leading to angina, MI, HTN

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

How is acute DIC diagnosed?

A

CBC: Thrombocytopenia - platelets less than 100K

Elevated D-dimer: increased fibrin degradation products (FDP)

Prolonged PT and PTT (d/t consumption of coagulation factors)

Decreased fibrinogen

Reduced antithrombin, protein C and protein S

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are the causes of DIC?

A

Sepsis or severe infections: GN or GP

Trauma

Obstetric complications

Acute pancreatitis

Malignancy

Transfusion reactions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Ddx for RUQ pain

A

Cholecystitis, cholangitis, liver abscess

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Ddx for LUQ pain

A

splenic rupture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Ddx for epigastrium pain

A

PUD, pancreatitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Ddx for RLQ pain

A

appendicitis, renal stones, ectopic pregnancy, ovarian torsion, PID

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Ddx for LLQ pain

A

Diverticulitis, renal stones, ectopic pregnancy, ovarian torsion, PID

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Clinical presentation of a spontaneous vs tension pneumothorax

A

Spontaneous: Young adults, rupture of emphysematous blebs, at rest

Tension: after blunt trauma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Tracheal deviation in a spontaneous vs tension pneumothorax

A

Spontaneous: slight to ipsilateral side

Tension: trachea and mediastinum shifts significantly to contralateral side

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Breath sounds in a spontaneous vs tension pneumothorax

A

Spontaneous: decreased

Tension: absent

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Treatment of a spontaneous vs tension pneumothorax

A

Spontaneous: observation, supplemental O2, may need chest tube

Tension: immediate needle decompression, (thoracentesis), chest tube (thoracostomy)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Hypertension + hypokalemia

A 
Primary hyperaldosteronism (Conn's)
-aldosterone secreting adenoma
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Hyponatremia + hyperkalemia + hyperpigmentation

A

Primary adrenal insufficiency (Addison’s) - will also have hypotension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Hypocalcemia + hyperphosphatemia + low PTH

A

Hypoparathyroidism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Features of nephrotic syndrome

A

caused by damage to glomeruli

Proteinuria >3.5 g/24 hrs
Hypoalbuminemia
Edema
Hyperlipidemia
Hypercoagulability
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Causative pathogens associated with osteomyelitis

A

MC: Staph aureus

IV drug use: S. aureus, Pseudomonas

Sickle Cell disease: S. aureas, Salmonella spp.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Diagnostic criteria for SLE

A

At least 4 of the 11

Malar rash
Discoid rash
Photosensitivity
Oral ulcers
Arthritis
Serositis
\+ ANA
Renal disease
Neurological d/o (seizures, psychosis)
Hematologic d/o (hemolytic anemia, leukopenia, thrombocytopenia)
Immunlogic d/o (anti-dsDNA, anti-Smith, anti-phospholipid)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

DKA lab abnormalities

A 
Increased serum glucose (>250)
Increased plasma osmolality
High anion gap metabolic acidosis
\+ ketones in serum and urine
Normal or elevated serum K+ but low total body K+
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Classic symptoms of Sjogren syndrome

A

dry eyes - sand in eyes

dry mouth - difficulty swallowing, tooth decay, parotid enlargement

Arthralgias

Other: Dry skin, nasal passages, vagina

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Diagnostic criteria for DM

A

One of the following criteria:

fasting plasma glucose >126 mg/dL

OGTT: Plasma glucose >= 200 mg/dL 2 hours after 75 g glucose load

Random plasma glucose >= 200 mg/dL with symptoms of hyperglycemia (polyuria, polydipsia)

hemoglobin A1c >= 6.5

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Pts that ACE inhibitors are considered first line treatments for essential htn

A

CHF or asx LV dysfunction - reduce mortality

Hx of STEMI - reduce mortality in post MI

Hx of NSTEMI w/:

  • anterior infarct
  • DM
  • systolic dysfunction

Proteinuric CKD - slow progression of proteinuria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Pts that ACE inhibitors are contraindicated

A

Pregnancy - teratogenic (fetal kidney problems)

Hx of angioedema from ACEI

B/l renal artery stenosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Profound fatigue with Heinz bodies and degmacytes (bite cells) on peripheral smear - most likely dx and cause of fatigue

A

G6PD deficiency

G6PD generates NADPH - needed to reduce glutathione which neutralizes ROS and hydrogen peroxide

Without G6PD - RBCs are susceptible to oxidation, which leads to hemolytic anemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Drugs provoking hemolytic anemia in G6PD deficiency

A

“Spleen Purges Nasty Inclusion From Damaged Cells”

Sulfonamides
Primaquine (antimalarial)
Nitrofurantoin
Isoniazid (INH)
Fava beans
Dapsone
Chloroquine (antimalarial)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

ST elevation in I, aVL, V5-6

A

Lateral wall MI

Circumflex artery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

ST elevation in II, III, aVF

A

Inferior wall MI
Posterior descending artery, usually d/t RCA occlusion (if right dominant heart), 10% have left dominant which is off of circumflex a.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

ST elevation in V1-V4

A

Anterior wall MI

LAD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Seronegative spondyloarthropathies

A

assoc w/ HLA-B27

"PAIR"
Psoriatic
Ankylosing spondylitis
IBD arthritis
Reactive arthritis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Asymmetric arthritis preceded by GI or GU infection

A

Reactive arthritis

“can’t see, can’t pee, can’t climb a tree”

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Inflammatory back pain + “bamboo spine” on x-ray

A

Ankylosing spondylitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Skin plaques with silvery scaling + pitting of nails + arthritis

A

Psoriatic arthritis

Pencil in cup deformity on Xray of hand

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Specific gravity difference between Exudative and Transudative pleural effusion

A

Exudate: > 1.020 (high)

Transudate: less than 1.012 (low)

35
Q

Protein content difference between Exudative and Transudative pleural effusion

A

Exudate: High

Transudate: low

36
Q

Cellularity difference between Exudative and Transudative pleural effusion

A

Exudate: highly cellular

Transudate: hypocellular

37
Q

Causes of Exudate pleural effusion

A

Exudates have “extra stuff”

Infection
Inflammation
Cancer
Lymphatic obstruction

38
Q

Causes of transudate pleural effusion

A

Transudates the fluid oozes out

Na+ retention
Increased hydrostatic pressure
decreased oncotic pressure (low protein states)

39
Q

Organisms associated with struvite renal stones

A

Caused by urease-producing bacteria

MC: Proteus mirabilis
Klebsiella spp
Enterobacter spp
Pseudomonas spp

40
Q

Achalasia

A

Failure of LES to relax + impaired peristalsis

Dysphagia to solids and liquids

Regurgitation of undigested food

Dx w/ esophageal manometry study

Barium swallow: birds beak sign

41
Q

Anti-dsDNA

A

SLE esp active lupus nephritis

42
Q

Anti-histone

A

Drug induced lupus

43
Q

Anti-La/SSB

A

Sjogren syndrome

44
Q

Anti-Smith

A

SLE

45
Q

Anti-topoisomerase 1

A

diffuse cutaneous systemic sclerosis

aka anti-SCL70 ab

46
Q

Anticentromere

A

Limited cutaneous systemic sclerosis aka CREST syndrome

47
Q

CREST syndrome

A 
Calcinosis cutis
Raynaud phenomenon
Esophageal dysmotility
Sclerodactyly
Telangiectasias
48
Q

Antihypertensives safe in pregnancy

A

Methyldopa
Labetalol
Hydralazine
Nifedipine

49
Q

Imaging study used r/i or r/o pulmonary embolism

A

CT pulmonary angiogram (contrast a concern with kidney disease)
V/Q scan
Traditional pulmonary angiogram

50
Q

EKG characteristics of 1st degree AV block

A

Prolonged PR interval, greater than 200 msec

51
Q

EKG characteristics of 2nd degree AV block (Mobitz I)

A

Progressive lengthening of PR interval then beat dropped (QRS not conducted)

52
Q

EKG characteristics of 2nd degree AV block (Mobitz II)

A

Dropped beat w/o progressive lengthening of the PR interval (aka normal PR interval)

May progress to a 3rd degree AV block

53
Q

EKG characteristics of 3rd degree AV block

A

atria and ventricles beat independently, no correlation between P and QRS

May have P on T wave or P wave on ST-T complex

54
Q

Medications used to reduce mortality in an acute exacerbation of systolic dysfunction CHF (dyspnea at rest, peripheral edema, JVD)

A

ACEI/ARBs
B-blockers
Aldosterone antagonists

Loop diuretic - improve sx, reduce volume overload, does not impact mortality

Digoxin - can decrease rate of hospitalizations, but doesn’t reduce mortality

55
Q

Lab markers suggestive of hemolytic anemia

A

low H and H
Normal MCV
High reticulocyte count (immature blood cells)
High indirect bilirubin
High LDH
Low haptoglobin (binds free hemoglobin, used up in hemolysis)

56
Q

Tests used to diagnose painful grouped vesicles in the groin area

A

Likely HSV-2

Require vesicular fluid of active lesion

Tests:
Viral culture of vesicular fluid
PCR of vesicular fluid
Direct fluorescent Ab test
Serum HSV antibodies
Tzanck smear - low sensitivity/low specificity
57
Q

Common risk factors associated with PUD?

A 
H. pylori
chronic NSAID use
Tobacco
alcohol 
corticosteroids
male gender
58
Q

Lab studies used to make diagnosis of PUD

A

H. pylori:
Urea breath test
IgG antibodies
+/- biopsy

59
Q

Temporal arteritis

A

Vasculitis affecting medium and large vessels, commonly cranial branches

Headache, visual disturbances, jaw claudication

Permanent vision loss potential complication

Diagnosis:
Gold standard: temporal artery biopsy
Elevated ESR (supports diagnosis)

60
Q

S/S of hypothyroidism

A 
Fatigue
Cold intolerance
depression
dry, coarse skin
hair loss
constipation 
wt gain
Menorrhagia
Bradycardia
Delayed relaxation of DTRs
61
Q

Causes of metabolic acidosis with elevated anion gap

A

“MUDPILES”

Methanol
Uremia (renal failure)
DKA
Paraldehyde, propylene glycol
Isoniazid (INH), Iron tablets
Lactic acidosis
Ethylene glycol
Salicylates
62
Q

S/S of infective endocarditis

A 
MC: fever
weakness
fatigue
anorexia
new regurgitation murmur
new heart failure
-Right sided if IV drug user
Septic emboli:
Splinter hemorrhages
Osler's nodes (painful, finger)
Janeway lesions (not painful, palms/soles)
Roth spots
Focal neurological deficits
Renal infarct and hematuria
Abdominal or shoulder pain

Systemic immune reaction:
Glomerulonephritis
Arthritis

63
Q

Microcytic anemia ddx

A

Iron deficiency
Anemia of chronic disease
Lead poisoning

64
Q

Megaloblastic anemia

A

Macrocytic anemia with hypersegmented neutrophils

B12 deficiency: neurological deficits, peripheral neuropathy

  • Dorsal column and lateral spinal column problems
  • symmetrical loss of vibration/sensation of feet
  • severe: cognitive problems, dementia

Folate deficiency

65
Q

Labs to differentiate B12 vs folate deficiency as cause of megaloblastic anemia

A

B12: high homocysteine and high methylmalonic acid

Folate: high homocysteine

66
Q

Small cell lung cancer paraneoplastic syndrome

A

ADH release: SIADH

ACTH release: Cushing syndrome

Lambert-Eaton myasthenic syndrome: Ab against presynaptic Ca2+ at NMJ causing weakness that improves with use

67
Q

Squamous cell lung cancer paraneoplastic syndrome

A

PTHrP secretion: Hypercalcemia

68
Q

Celiac disease antibodies

A

Anti-endomysial antibodies, bind to tissue transglutaminase

Anti-gliadin Ab - low positive predictive value

69
Q

Celiac disease intestinal biopsy

A

Blunting of duodenal and jejunal villi

70
Q

Mechanism and cause of cardiogenic shock

A

Failure of myocardial pump

MI, arrhythmias, cardiac tamponade, PE, cardiac contusion following trauma

71
Q

Mechanism and cause of septic shock

A

Decreased total peripheral resistance d/t peripheral dilation

GN bacteria, DIC, endotoxins

72
Q

Mechanism and cause of hypovolemic shock

A

Inadequate blood or plasma volume

Hemorrhage, severe burns, trauma

73
Q

Mechanism and cause of anaphylactic shock

A

Generalized hypersensitivity type 1 rxn
Mast cell degranulation leads to vasodilation

Allergic reaction

74
Q

Mechanism and cause of neurogenic shock

A

Autonomic dysfunction, peripheral vasodilation, bradycardia

CNS or spinal injury

75
Q

Lab result seen in pt’s successfully treated for syphilis

A

RPR and VDRL become negative (nontreponemal)

FTA-ABs remains positive for life (treponemal)

76
Q

Most common causes of acute pancreatitis

A

“PANCREATITIS”

hyperParathyroidism
Alcohol - chronic -MC
Neoplasm - blocking CBD
Cholelithiasis - MC
Rx - drugs (Ritonavir, reverse transcriptase inhibitors, sulfa drugs)
ERCP
Abdominal surgery
hyperTriglyceridemia
Infection (mumps)
Trauma
Idiopathic (20 percent)
Scorpion sting
77
Q

S/S of acute pancreatitis

A

severe epigastric pain, radiates to back
N/V
sitophobia
Cullen’s or Grey-turner’s sign

78
Q

Medications with highest risk of causing drug-induced lupus

A

SHIPP

Sulfonamides
Hydralazine
Isoniazid
Phenytoin
Procainamide
79
Q

Tumors associated with MENI

A

3 Ps

Parathyroid adenomas
Pancreatic tumors - endocrine
Pituitary adenomas

80
Q

Tumors associated with MENIIA

A

2P 1M

Pheochromocytoma
Medullary thyroid cancer
Parathyroid hyperplasia

81
Q

Tumors associated with MENIIB

A

1P 2M

Pheochromocytoma
Medullary thyroid cancer
Mucosal neuromas

82
Q

Acute Kidney Injury

A

aka acute renal failure

At least 1 of the following:

Increase in serum creatinine > 0.3 mg/dL within 48 hours

Increase in serum creatinine >50 percent within 7 days

Urine output less than 0.5 mL/kg/hr for at least 6 hours

83
Q

Chronic kidney disease

A

At least 1 of the following for >= 3 mo

eGFR less than 60 ml/min/1.73 m2

urinary abnormalities (proteinuria, microscopic hematuria, WBC or RBC casts)

Step Up 2 Medicine - IM (2 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions