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medicine > emma holliday high yield lecture > Flashcards

emma holliday high yield lecture Flashcards

1
Q

what is electrolyte abnormalities in pt with numbness, Chvostek or Troussaeu sign, prolonged QT interval

A

hypocalemia

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2
Q

what is electrolyte abnormalities in pt with bones, stones, groans, psycho, Shortened QT interval

A

hypercalemia

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3
Q

what is electrolyte abnormalities in pt with paralysis, ileus, ST depression, U waves

A

hypokalemia

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4
Q

what is electrolyte abnormalities in pt with peaked T waves, prolonged PR and QRS, sine waves

A

hyperkalemia

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5
Q

what is treatment of patient with hyperkalemia

A
  • calcium-gluconate (to stabalize cardiac cell membrane)
  • insulin +glucose
  • albuterol and sodium bicarb
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6
Q

What is diagnosis of pt with muddy brown casts in pt taking ampho, AG, Cisplatin or prolonged ischemia

A

Acute Tubular necrosis

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7
Q

what is treatment of patients with acute tubular necrosis

A

fluids and stop medication

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8
Q

What is diagnosis of pt with protein, blood, eosinophils, plus fever and rash who took bactrim 1-2 weeks ago

A

Acute Interstitial nephritis

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9
Q

What is diagnosis of pt who is army recruit or crush victim with CPK of 50K plus + blood on dipstick but no RBC

A

Rhabdomyolysis

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10
Q

What is best FIRST test of pt with rhabdomyolysis?

A

Check K lever or ECG

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11
Q

What is tx of patient with Rhabdo

A

tx with bicarb to alkalinize the urine and prevent precipitation

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12
Q

What is diagnosis of pt with enveloped shaped cyrstals on UA

A

Ethylene glycol intoxication.

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13
Q

What is tx of pt with ethylene glycol intox

A

Fomepizol

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14
Q

What is diagnosis of pt with Bump in creatinine 48 hours s/p cardiac cath or CT scan

A

contrast nephropathy

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15
Q

What is diagnosis of pt with blood in urine 1-2 days after runny nose, sore throat and cough

A

IgA nephropathy

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16
Q

What is diagnosis of pt with 1-2 weeks after sore throat or skin infection

A

Post strep GN

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17
Q

What is best first step of pt with post strep GN

A

ASO titer

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18
Q

What is diasnosis for pt with Hematuria and Hemoptysis in young male

A

Goodpasture’s syndrome

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19
Q

What is diagnosis of pt with Hematuria and deafness

A

Alport syndrome

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20
Q

What is diagnosis of young pt with viral URI w/ renal failure, abd pain, arthralgia and purpura

A

Henoch- Schonlein Purpura (IgA)

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21
Q

What is tx of pt with Henoch-Schonlein Purpura

A
  • Steroids for supportive tx
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22
Q

What is diagnosis of pt with c-ANCA, kidney, lung and sinus involvement

A

Wagener’s Granuolmatosis.

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23
Q

What is tx for pt with Wagner’s

A

steroid and cyclophosphamide

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24
Q

What is diagnosis of pt with p-ANCA, renal failure, astham and eosinophilia

A

Churg strauss

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25
Q

Best tx for Churg Strauss

A

Cyclophosphamide

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26
Q

p-ANCA, no lung involvement, Hep B association (can effect all other organs)

A

Polyarteritis Nodosa

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27
Q

What is best test for Kidney stones

A

CT

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28
Q

Most common type of Kidney stone?

A

Calcium oxylate

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29
Q

What type of kidney stone is seen in a kid with family history of stones?

A

Cysteine (cant resorb certain AA)

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30
Q

What is most likely type of stone seen in pt with indwelling foley and alkaline pee

A

Struvite

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31
Q

What are common bacteria that cause Struvite stones?

A

Proteus, staph, pseudomonas, klebsiella

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32
Q

What is the most common cause of death in dialysis patients?

A

Cardiovascular disease ( 20% acute MI, 60% sudden cardiac deaths)

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33
Q

What is tx for uric acid stones.

A

Copyright (c) UWorld, Please do not save, print, cut, copy or paste anything while a test is active.

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34
Q

What is diagnosis in pt with palpable purpura, proteinuria, and hematuria, arthralgia, hepatosplenomegaly and hypocompliment in pt with Hep C?

A

Mixed cryoglobinemia

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35
Q

What are common symptoms of patient with salicylate intoxication?

A
  • tinnitus
  • fever
  • tachypnea
  • nausia
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36
Q

What type of drugs are triamterene and amiloride?

A

potassium-sparing diuretics.

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37
Q

What is drug you would use to decrease calcium stones?

A

Thiazide diuretics

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38
Q

what is cause of increase creatine in patients on IV acyclovir and what is tx?

A

acyclovir in high levels exceeds solubility and crystallizes and causes renal tube damage.
- have to tx with adequate hydration.

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39
Q

what is diagnosis for nephrotic patient that suddently develops flank pain

A

suspect renal vein thrombosis due to loss of ATIII and protein C and S

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40
Q

What is first test for pt who you believe has renal vein thrombosis

A

CT or US stat

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41
Q

What is diagnosis for pt with splenomegally, family history of this, bilirubin gallstones and Increased MCHC

A
  • Hereditary spherocytosis (AD loss of Spectrin)
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42
Q

What is tx of pt with hereditary spherocytosis

A
  • splenectomy
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43
Q

What is diagnosis for pt with dark urine i the morning and budd-chiari syndrome?

A

Paroxysmal nocturnal hemoglobinuria. (lysis of complement)

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44
Q

if you have normocytic anemia and you believe hemolysis is occuring what is the next test you would do?

A

smear

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45
Q

What is test you would do to diagnose pt with paroxygsmal nocturnal hemoglobinuria?

A

flow cytometry (CD55 - cells)

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46
Q

sudden onset of anemia after use of drugs like dapsone, tmp, nitrofurotoin, primiquine, fava beans

A

G6PD def

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47
Q

What will you see on smear of pt with G6PD def?

A

Heinz bodies

bite cells

48
Q

What is best test for G6PD deficiency?

A

G6PD levels

cant be checked during an attack has to be 6-8 weeks after

49
Q

What is most likely diagnosis for young female patient with autoimmune disease in family, recurrent epistaxis, heavy menses and petechiae. In labs only abnormality is low platelets.

A
  • ITP.
50
Q

What is first line and second line tx for pt with ITP

A
  • steroids
  • spenectomy
  • IVIG if < 10,000
51
Q

What is diagnosis for patient with recurrent epistaxis, heavy menses, petechiae, normal platelets, but increased bleeding time and PTT

A

VWD.

52
Q

What is most likely diagnosis for patient who enjoys eating a lot of meat and just recently finished an antibiotic coarse who has hemarthroses, and oozing from venipuncture sites.

A

Vit K def

53
Q

What is treatment for patient with acute vit K def

A

FFP and Vit K shot

54
Q

What is diagnosis for patient who is extremely sick and then starts to bleed and on labs decreased platelets, increased PT/PTT, dec fibrinogen and increased D dimer

A

DIC

55
Q

What is diagnosis of pt with fever anemia thrombocytopenia and labs show normal PT/PTT, fibrinogen and d dimer and smear shows schictoyctes

A

TTP

56
Q

What is treatment for TTP

A

exchange transfusion

57
Q

what is diagnosis of patient 7 days post-op develops and arterial blood clot. Platelets are found to be 50% less tan pre-op?

A

HIT

58
Q

What is most likely diagnosis of pt with knee pain, DIP involvement no
swelling or warmth, worse @ the
end of the day, crepetence.

A

Osteoarthritis

59
Q

what is most likely diagnosis of pt w DIP involvment, rash w silvery scale on elbows and knees, pitting nails and swollen fingers

A

Psoriatic arthritis

60
Q

PIP and wrists bilaterally, worse in the AM, low grade fever.

A

RA

61
Q

Pt comes in w acute swollen painful joint. what is first test?

A

tap it

62
Q

What is most likely diagnosis for patient with tapped joint that comes back with > 50,000 WBC

A

septic arthritis

63
Q

What is likely diagnosis of patient “who travels a lot” and has tenossynovitis and arm pustules.

A

Gonococcal septic arthritis.

culture may be negative.

64
Q

What is most likely diagnosis for septic arthritis in older individual with no sexual history

A

staph aureus

65
Q

what is tx for septic arthritis caused by staph aureus

A
  • nafcillin

- or vanco

66
Q

What are two antibodies test for RA?

A
  • RF

- Anti-CCP

67
Q

What is antibodies for CREST syndrome?

A
  • Anti-centromere
68
Q

What is antibodie for systemic sclerosis?

A
  • Anti-Scl-70, Anti-topoisomerase
69
Q

What is tx of prolactinoma?

A
  • Bromocriptine or cabergoline.
70
Q

What is most likely diagnosis in pt that has polyuria, polydipsia, hypernatremia, hyperosm, dilute urine

A

Diabetes insipidus

71
Q

What is test you would do for patient you are testing for diabetes insipidus

A

water deprivation test

72
Q

What will you see in patient who you has central diabetes insipidus when you do a water deprivation test? what would be the second test you would preform?

A
  • urine osmo still down, you would then give desmopressin and would see that the urine osm would increase
73
Q

what will you see in patient who has nephrogenic diabetes insipidus when you do a water deprivation test? what would be the second test you would preform?

A
  • urine osmo still down, then give desmopressin and would still be down.
74
Q

What is the tx for patient with nephrogenic diabetes insipidus

A
  • hydroclorothyazide

- amiloride

75
Q

What type of cancer does hashimoto’s predispose you to?

A

Thyroid lymphoma

76
Q

what is most likely diagnosis for patient with weakness, hypotension, weight loss, hyperpigmentation and labs show inc K, dec Na and pH

A

suspect adrenal insufficiency

77
Q

What is best screening test for adrenal insuficiency

A

Cosyntropin stimulation test.

78
Q

What is most common cause of adrenal insuficinecy?

A

Autoimmune disease (addison’s)

79
Q

What is test to look for pheochromocytoma?

A

urine and plasma free metanephrines

80
Q

What is most likely diagnosis for patient with high blood pressure and low K and plasma renin levels

A

primary aldosteronism

81
Q

what is test to look for primary aldosteronism

A

plasma aldosterone-to-renin ratio

82
Q

What is most likely cause of post MI patient who has a persistant ST elevation 1 month later and a systolic MR murmur

A

Ventricular wall aneurysm

83
Q

What is most likely cause of post MI patient who has a new systolic murmur 5-7 days later

A

mitral reguritation due to papillary muscle rupture

84
Q

What is most likely cause of post MI patient who has a cannon A-waves on physical exam?

A

-Third degree heart block

85
Q

What is most likely cause of post MI patient who has pleuritic CP, low grade fever 5-10 weeks later

A

Dressler syndrome (most likely autoimmune pericarditis)

86
Q

How do you treat dressler syndrome?

A

NSAIDS

87
Q

Young patient comes in with chest pain it is worse on inspiration, better with leaning forward, friction rub and diffuse ST elevation

A
  • Pericarditis
88
Q

What is most likely diagnosis of patient with chest pain occurs at rest, more often at night, few cardiac risk factors and has migrains with transient ST elevation during episodes

A

Prinzmetal angina

89
Q

What is diagnostic step for pt with prinzmetal angina

A

Ergonovine stim test

90
Q

What is tx for prinzmetal angina

A

CCB or nitrates

91
Q

What is first line treatment of SVT

A
  • Carotid massage
92
Q

If you suspect patient has PE what is first step?

A

give heparin!

93
Q

What is likely diagnosis in young patient who had flu like symptoms three weeks ago and now has SOB on exertion or needs three pillows at night

A

Viral myocarditis

94
Q

What is most likely diagnosis of patient who has kidney stones, constipation, malaise and a central lung mass?

A

squamous cell carcinoma that is producing a paraneoplastic syndrome that is making PTH like peptide

95
Q

What do you think about when AST> ALT and high GGT?

A

Alcoholic Hepatitis

96
Q

What do you think about when ALT> AST and in the 1000s

A

Viral Hepatitis

97
Q

What do you think about when AST and ALT in the 1000s after surgery or hemorrhage

A

ischemic hepatitis

98
Q

What do you think about when you have an elevated Direct Bilirubin

A
  • Obstruction (stone or cancer)
  • Dubin Johnsons
  • Rotor
99
Q

What do you think about when Indirect bilirubin is elevated

A
  • Hemolysis
  • Gilbert (stress)
  • Crigler-Najjar syndrome
100
Q

What do you think about when you see elevated alk phos and GGT

A

Bile duct obstruction

101
Q

What do you think about when see high Alk phos but normal GGT and Ca

A

Pagets disease

102
Q

What is most common bugs to cause Meningitis?

A

Strep Pneum
H. flu
N. Meningitidi

103
Q

What is treatment for most common bugs for meningitis

A

Ceftriaxone and Vanco

104
Q

What do you want to add for tx of meningitis in old and young patients?

A

Ampicillin to cover lysteria

105
Q

What is order for tx if you think patients has Meningitis?

A
  • start empiric tx
  • get CT look in eyes for intercranial pressure
  • LP
106
Q

Best first step for pt you think has pneumonia?

A

CXR

107
Q

What do you give for roommate of kid who has n.meningitis?

A

Rifampin

108
Q

What is most likely cause of pneumonia of pt who just skinned a rabbit and lives in Ark.
- What do you do to tx it?

A

Franciella Tularensis

  • streptamycin or gentimycin
109
Q

What is most likely cause and how will you tx patient who just had the flu and now you think they have pneumonia?

A
  • MRSA

- Vanco

110
Q

If screening (XCR and sputum) for TB is postive in normal person what do you do?

A
  • tx w 4 drug RIPE regimen for 6 months.
111
Q

What are side effects of Rifampin?

A
  • turns tears and urine orange

- Inducer of CytoP450

112
Q

What are side effects of INH?

What else do you have to do?

A
  • Peripheral neuropathy and sideroblastic anemia

- give B6

113
Q

What are side effects of Ethambutol

A

Optic neuritis

color vision abnormalities

114
Q

When do you start HAART therapy?

A

CD4 <350 or viral load >55,000

115
Q

What HIV drug causes GI side effects, Leukopenia and macrocytic anemia?

A

Zidovudine

medicine (2 decks)

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