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medicine > emma holliday > Flashcards

emma holliday Flashcards

1
Q

meds to hold before stress test

A

BBs

CCBs

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2
Q

MC cause of death post MI

A

arrhythmias

Vfib

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3
Q

persistent ST elevation ~1 mo after MI and systolic MR murmur

A

ventricular aneurysm

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4
Q

cannon A waves post MI

A

AV dissociation

V fib or 3rd degree heart block

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5
Q

CP at rest/night, migraine HA

A

Prinzmetals!
dx ergonovine
tx CCB/nitrates

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6
Q

causes of dilated cardiomyopathy

A 
viral
etoh (reversible!)
cocaine
chagas
idiopathic
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7
Q

causes of diastolic HF

A

HTN
amyloid
hemochromatosis (reversible!)

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8
Q

drugs that improve survival in HF

A

ace-i
BBs
spironolactone in class III/IV

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9
Q

drugs that improve sx in HF

A

dig (sx and hosp)

lasix (sx)

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10
Q

pleural effusion w/low glucose

A

RA

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11
Q

pleural effusion with high lymphocytes

A

TB

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12
Q

pleural effusion with blood

A

malignant or PE

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13
Q

transudative pleural effusion

A

CHF
nephrotic
cirrhotic

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14
Q

dx of ARDS

A

PF < 200
B/L alveolar infiltrates on CXR
PCWP < 18

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15
Q

indications to start O2 in COPD

A

PaO2 < 55

SpO2 < 88

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16
Q

new clubbing in COPD

A

hypertrophyic osteoarthropathy!

get a CXR - most likely underlying malignancy

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17
Q

asthma tx pathway (OP)

A

albuterol –> add inhaled CS –> add long acting B-ag –> add montelukast and oral steroids

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18
Q

upper lung nodule with eggshell calcifications

A

silicosis
get yearly TB test
give INH for 9 mos if >1cm

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19
Q

lower lobe reticulonodular process with pleural plaques

A

asbestosis

MC cancer = bronchogenic carcinoma

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20
Q

patchy lower lobe infiltrates, thermophilic actinomyces

A

hypersensitivity pneumonitis

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21
Q

popcorn calcification

A

hamartoma

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22
Q

adenocarcinoma of lung

A

MC in non smokers
peripheral!
mets to liver, bone, brain, adrenals
effusion: exudative with high hyaluronidase

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23
Q

squamous cell paraneo

A

PTHrP

low P, high Ca

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24
Q

small cell paraneo

A

SIADH
Lambert Eaton
Pancoast

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25
Q

Crohn’s buzzwords

A

fistulae
granulomas
transmural

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26
Q

Q fever

A

coxiella burnetti
assoc with cows
give doxy

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27
Q

franciella tularensis

A

assoc with rabbits

give streptomycin, gentamycin

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28
Q

rifampin SEs

A

orange

CYP450 inductino

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29
Q

INH SEs

A

peripheral neuropathy and sideroblastic anemia - give pyridoxine
hepatitis with mild LFT bump

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30
Q

pyrazinamide SEs

A

benign hyperuricemia

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31
Q

ethambutol SEs

A

optic neuritis

vision abnormalities

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32
Q

tx of endocarditis

A

strep viridans: PCN

staph: naf+ gent or vanc

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33
Q

zidovudine SEs

A

GI
leukopenia
macrocytic anemia

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34
Q

didanosine SEs

A

pancreatitis

peripheral neuropathy

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35
Q

abacavir SEs

A

HS rash, fever, N/V, muscle aches, SOB in 1st 6 weeks

D/C AND NEVER USE AGAIN

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36
Q

indinavir SEs

A

nephrolithiasis and hyperbili

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37
Q

efavirenz SEs

A

sleepy, confused, psycho

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38
Q

HIV post exposure ppx

A

AZT
lamivudine
nelfinavir

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39
Q

when to add steroids for PCP PNA

A

PaO2 < 70

Aa gradient > 35

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40
Q

CMV diarrhea in HIV

A

blood diarrhea

tx: ganciclovir, foscarnet

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41
Q

MAC diarrhea

A

diarrhea, wasting, fevers, night sweats
tx: clarithro, ethambutol, rifampin
azithro ppx

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42
Q

crypto diarrhea

A

dog poo, swimming pools
watery with mucus!
acid fast oocysts

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43
Q

HIV with multiple ring enhancing lesions

A

toxo!

pyrimethamine sulfadiazine + folate

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44
Q

HIV with one ring enhancing lesion

A

CNS lymphoma, assoc with EBV

tx: HAART

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45
Q

HIV with meningitis sx

A

think crypto
india ink
ampho –> fluconazole maintenance

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46
Q

HIV with hemisensory loss, visual impairment, Babinskis

A

PML/JC virus

brain biopsy!

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47
Q

immune suppressed with cavitary lung dz and weight loss

partially acid fast G+ aerobes

A

nocardia

tx: bactrim

48
Q

neck/face infection with draining yellow material, G+ anaerobes

A

actinomyces!

tx: PCN

49
Q

risk of fast correction of hypoNa

A

central pontine myelinolysis

50
Q

risk of fast correction of hyperNa

A

cerebral edema

51
Q

type I RTA

A

distal, can’t excrete H
lithium, SLE, sickle
hypoK

tx: replete K, oral bicarb

52
Q

type II RTA

A

proximal, can’t reabsorb HCO3
Fanconi, myeloma, amyloid
hypoK

tx: replete K, mild diuretic

53
Q

type IV RTA

A

diabetes, Addisons, sickle
hyper K, hyperCl

tx: fludrocortisone

54
Q

muddy brown casts w/ ampho, AG, cisplatin, or ischemia

A

ATN

give fluids

55
Q

protein, blood, eos in urine w/ bactrim

A

AIN

stop offending agent + steroids if no improvement

56
Q

tx rhabdo

A

bicarb (prevent precipitation)

57
Q

envelope crystals on UA

A

ethylene glycol intox

tx: dialysis or NaHCO3

58
Q

cyclophosphamide SE

A

hemorrhagic cystitis

59
Q

hematuria 1-2 d after URI

A

Bergers (IgA)

60
Q

hematuria 1-2w after strep

A

PSGN

get ASO titer

61
Q

hematuria + hemoptysis

A

Goodpasture

Ab to collagen IV

62
Q

hematuria + deafness

A

Allport

XLR in collagen IV

63
Q

Wegeners

A

dx: biopsy
tx: steroids or cyclophosphamide

64
Q

Churg Strauss

A

dx: lung bx
tx: cyclophosphamide

65
Q

PAN

A

no lung involvement

tx: cyclophosphamide

66
Q

foley + alkaline pee and stones

A

struvite stone

proteus! kleb, staph, pseudo

67
Q

stone + bowel resection for volvulus

A

pure oxylate stone

68
Q

stone + leukemia/chemo

A

uric acid stone

tx: alkalinize urine, hydrate

69
Q

proteinuria + heroin/HIV

A

FSGS

limited response to steroids

70
Q

proteinuria + hepatitis

71
Q

anemia + mycoplasma + cyanosis of fingers/ears/nose

A

cold AIHA

no steroid response

72
Q

anemia + PCN/ceph/sulfa/rifampin/cancer

A

warm AIHA

steroids then splenectomy

73
Q

dark urine in AM, Budd Chiari, weird thromboses

A

PNHH
defect in PIG-A, complement lysis
increased risk for aplastic anemia

74
Q

ITP tx

A

prednisone
then splenectomy
IVIG if plt < 10k
ritux

75
Q

recurrent epistaxis, normal plts, increased bleeding time and PTT

A

VWD
DDAVP for bleeding or pre op
replace fVIII

76
Q

factors depleted in cirrhosis

A

1st: VII –> PT increase
2nd: viii and vWF

77
Q

causes of DIC

A

sepsis, rhabdo, adenocarcinoma
pancreatitis, snake bites
tx of m3 aml

78
Q

HIT tx

A

stop heparin
reverse warfarin with vit K
start lepirudin/other anticoag

79
Q

clots on heparin

A

AT III deficiency

80
Q

leser trelat

A

eruption of multiple seb keratoses

paraneo: GI, breast, lung, GU

81
Q

porphyria cutanea tarda

A

skin blistering in sunlight

uroporphyrinogen decarboxylase deficiency

82
Q

behcet’s

A

genital and oral ulcers

ocular, GI, lung involvement possible

83
Q

thyroid storm tx

A

PTU
iodine
propranolol

84
Q

MC thyroid ca

A

papillary
psammoma bodies
lymph metastasis

85
Q

follicular thyroid ca

A

blood spread

excise whole thyroid

86
Q

medullary thyroid ca

A

MEN: look for pheo, hyperca

87
Q

hasimotos and thyroid

A

predisposes for thyroid lymphoma

88
Q

screening of adrenal insufficiency

A

cosyntropin stimulation test

89
Q

tx of Addison’s

A

saline resuscitation

dexamethasone and fludrocortisone replacement long term

90
Q

MEN1

A

parathyroid hyperplasia
pancreatic islet tumors
pituitary adenomas

91
Q

MEN2A

A

medullary thyroid ca
pheo
parathyroid

92
Q

MEN2B

A

medullary thyroid ca
pheo
marfans

93
Q

MCC of death in DM

A

CV disease

94
Q

tx subarachnoid hemorrhage

A

nimodipine to reduce ischemic stroke

95
Q

L hemiplegia/hemisensory

A

R MCA stroke

96
Q

L hemiplegia/hemisensory + confusion, behavior

A

R ACAstroke

97
Q

L hemiplegia + R ptosis

A

R Webber’s stroke (midbrain)

98
Q

falling to L and R ptosis

A

R Benedikt’s stroke (PCA or basilar)

99
Q

tx of partial seizures

A

carb or phenytoin

then vpa or lamictal

100
Q

tx generalized seizures

A

vpa

then lamictal/carb/phenytoin

101
Q

3 hz spike and wave

A

absence sz

ethosux

102
Q

diffuse background slowing on EEG

103
Q

hypsarrhythmia

A

infantile spasms

tx ACTH

104
Q

tx pseudotumor cerebri

A

weight loss
acetazolamide
shunt or optic n sheath fenestration

105
Q

tx myasthenia

A

IVIG/plex acute
pyridostigmine, GCs/azathioprine, thymectomy chronic
AVOID AGs and BBs

106
Q

dysphagia in HIV

A

candida
HSV
CMV

107
Q

whipples dz

A

T whipplei
malabsorption diarrhea
weight loss, jt pain

108
Q

> 20% blasts

A

acute leukemia

109
Q

CALLA or TdT

110
Q

auer rods, myeloperoxidase, esterase

A

AML

risks; radiation, downs, myeloprolif

111
Q

tartrate resistant acid phosphatase, decreased monos, CD11, CD22

A

hairy cell

tx cladirbine

112
Q

ALL tx

A

danorubicin, vincristine, pred
intrathecal MTX if CNS recurrence
BM txp

113
Q

AML tx

A

danurubin + araC

if M3 give TRA

114
Q

bone pain, punched out lesions on XR, hyper CA

A 
MM
SPEP
BM b
BM txp, pred
hydrataion and furosemide then bisphosphonates
115
Q

dizziness, HA, hearing/vision probs, monoconal IgM

A

Waldenstrom

116
Q

IG spike found incidentally

medicine (3 decks)

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