Emma Ramahi Internal Medicine Review Flashcards
Which leads indicate left circumflex occlusion?
I
aVL
V4-V6
Symptoms of a right-sided MI include _______________.
- JVD
- Hypotension
- Tachycardia
- No pulsus paradoxus
- Lungs clear
Treat with fluids –NO nitro.
Contraindications to thrombolytic therapy in MI include _______________.
bleed, recent surgery, and CHI
The most sensitive marker of a repeat MI within two days is _________________.
myoglobin (normalizes within 24 hours –faster than CKMB at 72 hours)
List three indications for CABG.
- Left-main disease
- ≥3 vessel disease
- ≥ 2 vessel disease in a diabetic
What medicines must you discontinue before a stress test?
- Beta-blockers
- CCBs
- Digoxin
Describe some features that make a stress test undoable.
- LBBB
* Baseline ST elevation
Positive stress test is given by _______________.
hypotension, ST elevation, or pain
The most common cause of death post-MI is ____________.
arrhythmia
Persistent ST elevation 1 month after an MI is ____________.
ventricular aneurysm
“Cannon A waves” (prominent JVD pulsations) after an MI could indicate ____________.
3rd-degree heart block
Prinzmetal angina is usually worse _____________.
at night
The diagnostic test for Prinzmetal angina is ____________.
ergonovine
The delta wave passes through the bundle of ____________.
Kent
What drugs are contraindicated in WPW?
Anything that slows conduction through the AV node. Doing this causes a greater dissociation between the bundle of Kent and the AV node, thus increasing the likelihood of arrhythmia.
- Beta-blockers
- CCB
- Digoxin
Low amplitude QRS waves could indicate?
Tamponade
Late systolic murmur that increases with valsalva?
Mitral valve prolapse
The trifecta of medicines for acute pulmonary edema is ____________.
Lasix, morphine, and nitrates
What are the two reversible causes of dilated cardiomyopathy?
Alcoholic anc hemochromatosis
What two bacteria can cause lung abscesses?
- S. aureus
* Anaerobes
If a pleural effusion is transudative and has low glucose, then it is likely _____________.
RA
The three criteria that define ARDS: ____________.
- PaO2/FiO2 < 200
- PCWP < 18
- Bilateraly infiltrates on CXR
The best prognostic indicator for COPD is _____________.
FEV1
Upper lobe lesions with eggshell calcifications?
Silicosis
In addition to pleural plaques, those with asbestosis also have ____________.
reticulonodular opacifications
Lower lobe infiltrates with thermophilic actinomyces?
Farmer’s lung (aka hypersensitvity pneumonitis)
Popcorn calcifications in the lung are indicative of ___________.
hamaromas
Concentric lung calcifications are indicative of ____________.
granulomas
Ptosis that improves with upward gaze is suggestive of ______________.
LEMS
Peripheral cavitations with early mets is characteristic of ______________.
large cell carcinoma
What does an ALT>AST ratio suggest?
HAV
Antimitochondrial antibody is positive in ___________.
PBC
Meningitis in a person who’s recently had brain surgery is likely caused by ___________.
Staph
The most common cause of pneumonia in young, healthy people is _____________.
Mycoplasma
Old smokers with COPD are more likely to get pneumonia from ____________.
H. influenzae
The best first step in evaluating PNA is ______________.
CXR
List three indications for prophylactic antibiotics for endocarditis.
- Mechanical valve
- Prior endocarditis
- VSD/ASD
What are some of the more obscure presentations of HIV?
- Thrombocytopenia and fatigue
* Bilateral Bell’s palsy
What HAART drug causes macrocytic anemia and GI upset?
Zidovudine
HAART drug most likely to cause pancreatitis?
Didanosine
Psychotic symptoms from HAART?
Efavirenz
Kidney stones and HAART?
Indinavir
Pneumonia and elevated LDH?
PCP
Add ________________ to PCP that is progressively getting worse.
steroids
Which diarrhea is acid-fast positive?
Cryptosporidium
AIDS and multiple ring-enhancing lesions?
Toxo
Lymphoma is usually singular.
HSV encephalitis often causes what neuro symptom?
Deja vu
Never do __________ on a patient with neutropenic fever.
DRE
Tick bite with elevated ALT?
Ehrliciosis (give doxycycline)
Describe the pathophysiology and treatment of RTA I.
- Failure of the distal tubule to acidify the urine, resulting in buildup of acid in the blood.
- Give bicarb.
