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Internal medicine > Emma Holiday Cards > Flashcards

Emma Holiday Cards Flashcards

1
Q

Right ventricular infarct

A

V4-V6; may show ST segment depression

S/s: Hypotension, tachycardia, clear lungs, JVD

Tx: Fluid resuscitation to improve preload; DO NOT GIVE NITRO

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2
Q

Coronary angiography indications for CABG

A

Left main disease

> 3 vessel disease

> 70% occlusion

Pain despite maximum medical tx

Post-infarction angina

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3
Q

Work-up for unstable angina (no toponins and negative EKG after chest pain)

A

Exercise EKG

-Exercise echo if the pt. is on Digoxin, has baseline ST elevation, or old LBBB

-If pt. has chest pain reproduced, ST depression, or hypotension, test is positive
=»Coronary angiography

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4
Q

Post-MI pt. who has “step up” in O2 conc. from RA to RV

A

IV septal rupture

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5
Q

Post-MI pt. who has persistent ST elevation and systolic MR one month later

A

Ventricular aneurysm

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6
Q

Canon A-waves

A

Pt. with bounding jugular veins

-Indicates AV dissociation in post-MI pts.; could be 3rd degree block as well

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7
Q

Pt. with canon a-waves on exam and has a regular P-P and R-R interval

EKG shows irregular PR intervals

A

Multifocal atrial tachycardia

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8
Q

Patient with a regular rhythm but HR between 150-220 bpm

Pt. has palpitations and dizziness

EKG shows rapid HR with barely any Repolarization time

A

SVT

DOC: Carotid massage THEN adenosine

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9
Q

Holosystolic murmur that radiates to the left axilla w/ LAE

A

Mitral regurgitation

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10
Q

Rumbling diastolic murmur with an opening snap, LAE, and possible A-fib

A

Mitral stenosis

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11
Q

Young pt. who has a history of viral infxn and now presents with signs of CHF

A

Consider myocarditis

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12
Q

CXR with “thickened peritracheal stripe and splayed carina bifurcation”

A

Possible mediastinal tumor

or

LAE

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13
Q

Light’s Criteria

A

Transudative if:

LDH <200

LDH eff/LDH serum <0.6

Protein eff/Protein serum <0.5

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14
Q

Best prognostic indicator for COPD

A

FEV1 value

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15
Q

Goal for SpO2 in COPD

A

94-95

Hypercapnea keeps their respiratory drive going

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16
Q

CXR showing nodules with eggshell calcifications

A

Silicosis

***Pts. need yearly TB testing

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17
Q

Patchy lower lobe infiltrates with thermophilic actinomycetes

A

Hypersensitivity pneumonitis

“Farmer’s lung”

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18
Q

Sarcoidosis findings that are sometimes thrown out there (3 things)

A

Increased ACE

Pts. haver hypercalcemia due to increased Vit D from pulmonary macrophages

25% have anterior uveitis =» GET OPTHO REFERRAL

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19
Q

Lung nodule with “popcorn calcification”

A

Hamartoma

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20
Q

Lung nodule with eccentric calcification or spiculated calcifications

A

Signs of malignancy; get biopsy

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21
Q

Effusion in adenocarcinoma

A

High in hyaluronidase and exudative

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22
Q

Lung cancer that has a tendency for distant mets and peripheral calcification

A

Large cell carcinoma

23
Q

Patient who has an AST or ALT in the 1000s after surgery or trauma

A

Suspect shock liver

24
Q

Pneumonia in a farmer who has vomiting and diarrhea

A

Coxiella

Tx: Doxycycline

25
Q

Pt with pneumonia who is a gardener

A

Don’t rule out Fransicella

Tx: Gentamicin or streptomycin (AGCs from Sketchy)

26
Q

Kid under 4 exposed to TB

A

Isoniazid prophylaxis for 9 months

27
Q

1 cause of death during endocarditis

A

2 is septic emboli

CHF

28
Q

Indications for prophylaxis for endocarditis

A

Prosthetic valve

Hx of EC

Uncorrected congenital lesion

29
Q

Ziovudine ADRs

A

GI

Leukopenia

Macrocytic anemia

30
Q

Pt who develops asymptomatic hyperuricemia after being treated for TB

A

Due to pyrazinimide

31
Q

Abacavir ADRs

A

Rash, fever, muscle aches

IF HIV pt states they had this rxn after treatment, NEVER USE THIS DRUG AGAIN

32
Q

HIV pt who has a seizure with deja-vu beforehand and CSF shows RBCs

A

HSV encephalitis

Give acyclovir AS SOON as you suspect

33
Q

HIV pt. w/ hemisensory loss, visual impairment, loss of Babinski

A

PML

MRI shows demyelination at the gray-white jnxn

34
Q

HIV pt. with memory and gait problems

A

AIDS-dementia complex

Check blood, CSF, and MRI to be sure it’s nothing else tho

35
Q

Neutropenic pt. in the ER; what should you not do?

A

DRE

36
Q

Pt. with neutropenic fever and does not improve after 5 days of cefepime and Vanc but there has been no cause found

A

Add antifungal treatment

37
Q

Erlichiosis tx in kids

A

Doxycycline!

38
Q

Test to check if metabolic alkalosis

A

Urine chloride

If Cl>20 and pt. has HTN =» Hyperaldosteronism

              if nomotensive =>> Barter's or Gittelman's

If Cl <20 =» Vomiting, diuretics, antacids

39
Q

Type I RTA

A

Distal; due to the kidney being unable to excrete H+

Causes: Lithium, Ampho B, analgesics

Findings: Urine pH >5.4, hypokalemia, kidney stones

Tx: Replete K+, oral bicarb

40
Q

Type II RTA

A

Proximal; due to the kidney not reabsorbing HCO3-

Causes: Fanconi’s syndrome, myeloma

Findings: Hypokalemia, ostemalacia

Tx: Replete K+; replacing bicarb DOESNT HELP

41
Q

Type IV RTA

A

Hyperrenin, hypoaldost

Cause: Diabetes

Findings: Hyperkalemia, hypchlorremia, high urine Na+ even with salt restriction

Tx: Fludrocortisone

42
Q

Pt with rhabodmyolysis and kidney failure treatment

A

Get serum K+ and EKG to rule out cardiac probs

HCO3- to alkalinize urine to prevent precipitation

43
Q

Kid who recently had a viral syndrome and now has arthralgia, palpable purpura (Especially on the butt), and renal failure

A

Henoch-Schonlein

Tx: Supportive; steroids if severe

44
Q

Pt. with renal failure, asthma, eosinophilia, and + p-ANCA

A

Churg-Strauss

Tx: Cyclophosphamide

45
Q

Cardiac pt. with renal failure, hemolytic anemia, decreased platelets, fever, AMS

A

TTP

Tx: Plasmapheresis

46
Q

Polyarteritis nodosa tx

A

Cyclophosphamide

47
Q

Tx for stones 5mm-2cm

A

Shockwave lithotripsy

48
Q

Sideroblastic anemia lab findings

A

Iron: Increased

Ferritin: Increased

TIBC: Decreased

MCV: Decreased

49
Q

Thalassemia CBC

A

Iron: Very low, like 60

RDW: Decreased

50
Q

Liver disease CBC

A

MVC: Increased

Acanthocytes present on peripheral smear

51
Q

Rosacea Tx

A

Avoid triggers

️Topical metronidazole if refractory

52
Q

Tx of Keratocanthoma

A

Observation

53
Q

Tx of Seborrheic dermatitis

A

Sunlight exposure

Dandruff shampoo

️Topical ketoconazole

️Topical steroids

Internal medicine (3 decks)

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