everything Flashcards
a child with recurrent UTIs, b/l hydronephrosis on ultrasound, a thickened and dilated bladder, and proximal urethral dilation has _____
Posterior urethral valve
posterior urethral valve is diagnosed by ____
voiding cystourethrogram
______ is the most accurate measurement of Fe stores
Ferritin
first line treatment for restless leg syndrome
pramipexole, ropinirole
Routine preoperative PFTs are/are not done
Are not done. Only do before lung resection, to optimize COPD control, evaluate undiagnosed dyspnea
hirschprung disease is diagnosed via
rectal suction biopsy
symptoms of hirschprung disease
delayed meconium passage, abdominal distention, contrast enema with dilated descending colon and narrow resctosigmoid colon
Dx: delayed meconium passage, abdominal distention, contrast enema with dilated descending colon and narrow resctosigmoid colon
Hirschprung disease
a solitary pulmonary module requires surveillance if it is larger than _____cm
0.8 cm
ACLS for PEA arrest
Compressions, no shock
torsades can be provoked by ______ in patients with long QT
bradyarrhythmia, hypoMg, hypoK, low Temp, SSRIs, HIV
treat torsades with _____
IV Mg
definition of recurrent UTIs
2+ in 6 months, 3/year
treatment for recurrent UTI
suppression therapy
medications that decrease Levothyroxine absorption
Iron, Ca, AlOH, PPIs, sucralfate
management of mild hidradenitis
topical clinda, lifestyle modifications (weight loss, smoking cessation, hygiene)
treatment for hidradenitis with nodules, tracts, or scarring
(moderate disease) PO doxy
when using amiodarone and warfarin together, ______
reduce warfarin dose by 20-50% (amio increases serum concentration of warfarin)
when do you treat people with salmonella infection?
patients <12 months, immunocompromised, >50 with atherosclerosis
treatment for salmonella
cipro, bactrim, ceftriaxone
side effects of carbamazepine
bone marrow suppression, SIADH in elderly, glaucoma, urinary retention
in a patient with suspected brain death with neuro exam positive for brain death what is the next test?
apnea test
in a patient with suspected brain death with difficult neuro exam, what is the next test?
EEG or CT
most common cause of sudden death with steering wheel MVC injuries?
Aortic injuries
_____ is the most sensitive test for diagnosing osteonecrosis of the femoral head
MRI
most common cause of secondary dilated cardiomyopathy
CAD (ischemic cardiomyopathy)
Dx: mild crampy abd pain (peripheral), fecal urgency, bloody diarrhea in patient w/ CAD. ^WBC, lactic acidosis. Friable edematous mucosa on cscope
colonic ischemia
Dx: patient with HIV, altered mental status, rash of papules w/ central umbilication/necrosis
Disseminated cutaneous cryptococcosis
Dx: cold symptoms, then development of muscle weakness, paresthesias, dec deep tendon reflexes, dysautonomia
Guillain Barre
time course of guillain barre
symptoms worsen over 2 weeks, plateau for 2-4 weeks, recover over months
when do you treat Guillain Barre with IVIG?
if non ambulatory or if symptoms developed in past 4 weeks
Dx: sudden onset of muscle weakness triggered by emotional episodes
cataplexy
treatment for cataplexy
stimulants, SSRIs, SNRIs, TCAs
Name TIMI criteria
- age 65+
- 3+ CAD risk factors
- known CAD >50%
- recent ASA use
- 2+ anginal episodes 24hr
- pos trop
- ST changes >0.5mm
a TIMI score of ____ would stratify a person with NSTEMI/unstable angina to cath within 24 hours
3-7
A TIMI score of 0-2 would stratify a person with NSTEMI/unstable angina to _____
stress test
- ______
- 3+ CAD risk factors
- known CAD >50%
- recent ASA use
- 2+ anginal episodes 24hr
- pos trop
- ST changes >0.5mm
- age 65+
- age 65+
- ______
- known CAD >50%
- recent ASA use
- 2+ anginal episodes 24hr
- pos trop
- ST changes >0.5mm
- 3+ CAD risk factors
- age 65+
- 3+ CAD risk factors
- _______
- recent ASA use
- 2+ anginal episodes 24hr
- pos trop
- ST changes >0.5mm
- known CAD >50%
- age 65+
- 3+ CAD risk factors
- known CAD >50%
- ________
- 2+ anginal episodes 24hr
- pos trop
- ST changes >0.5mm
- recent ASA use
- age 65+
- 3+ CAD risk factors
- known CAD >50%
- recent ASA use
- _____
- pos trop
- ST changes >0.5mm
- 2+ anginal episodes 24hr
- age 65+
- 3+ CAD risk factors
- known CAD >50%
- recent ASA use
- 2+ anginal episodes 24hr
- _____
- ST changes >0.5mm
- Pos trop
- age 65+
- 3+ CAD risk factors
- known CAD >50%
- recent ASA use
- 2+ anginal episodes 24hr
- pos trop
- _____
- ST changes >0.5mm
clinical factors that determine if a child with ITP needs IVIG?
mucosal bleeding or hemorrhage
CLL diagnosis on labs?
smudge cells, +flow cytometry (tissue bx not required)
what symptoms of CLL confer worse prognosis?
multiple chain lymphadenopathy, hepatosplenomegaly, anemia, thrombocytopenia
EKG findings in AVNRT?
narrow complex tachycardia with regular r-r intervals, can have pseudo p in inferior leads
Wolf Parkinson’s White is associated with development of ____
AVRT
saw palmetto is used for ___
BPH
side effects of Saw Palmetto
G.I. upset, increased bleeding risk
risk factors for children < 1 with iron deficiency anemia?
delayed introduction of solids, cow/soy/goat milk
risk factors for children > 1 with iron deficiency anemia?
> 24 oz milk /day, < 3 servings Fe rich food
how to differentiate microcytic anemia of Fe def and thalassemias?
mentzner index. if > 13 —> Fe def
how do you calculate mentzner index?
MCV/RDW
Dx: shoulder pain, ipsilateral miosis and anhidrosis, weakness of ipsilat hand muscles, pain 4&5th digits
Pancoast tumor
describe horner syndrome
ipsilateral miosis, enopthalmos, anhidrosis
describe nerve symptoms of pancoast tumors
weakness/atrophy intrinsic hand muscles, pain/paresthesia of 4&5th digits, medial arm, forearm
What are the signs of spinal cord compression in pancoast tumor?
decrease in lower extremity deep tendon reflexes +/- back pain
abdominal pruritis in a pregnant patient with no rash is _____
pregnancy induced skin changes
Dx: pruritic, erythrematous papules on the abdomen of a pregnant patient that spreads to the extremities but spares the face/pals/soles
polymorphic eruption of pregnancy
Dx: truncal rash in pregnant patient that starts at belly button as urticaric plaques and moves to vesicles and bullae. No mucosal involvement
pemphigoid gestationis
pemphigoid gestationis is treated with ____
high potency steroids, antihistamines
when do you start diabetic patients on a statin?
at age 40
Dx: delirium, megaloblastic anemia, inc indirect bill in an elderly patient
B12 deficiency