Extra Cases Flashcards
2 types of seizures, ____ is complete loss of consciousness and ___ is altered consciousness but wakefulness is retained
____ and ____ LOWER the seizure threshold so it’s a higher risk for seizure
Toxoplasmosis presents as AMS, fever, HA, seizures and a ring enhancing lesion on MRI with + serology (IgG anti-toxoplasma) and CD4 less than ____
^** Toxo is an obligate INTRACELLULAR parasite
For both treat with ____ for prophylaxis
Since TMP-SMX interact with ____ substrate, if you also have a patient on ____ it complicates the problem since they interact and increase QTc interval causing a greater risk for ____ or syncope or cardiac death
Generalized, Partial
Tramadol and Bupriprion
100
TMP-SMX
CyP3A4, Methadone, Torsade de pointes
To treat Cerebral edema (Increased ICP) you can use a diuretic, IV ____, HyPERventilation, and invasive methods include decompressive craniotomy or ventriculostomy
If WBC count is greater than 1000mm and PMN is greater than 80% with + gram stain, think ____ infection
If WBC count is less than 1000mm and glucose is more than 40mg and protein is less than 200mg than think ____ infection
Mannitol
Bacterial
Viral
Assymetrical tremor that is often present at REST with Bradykinesia, Rigidity, gait problems, etc is a ____ tremor
Symmetrical, Postural, and involves Head (voice and neck) leading to deafness, dystonia (Twisting movements), etc… Is ____ tremor
Parkinson Disease
Essential
PD is due to loss of ___ neurons in the ____ and diagnosis is made via Triad of symptoms + Response to ____ replacement therapy
Along with L-dopa (Levodopa) you can give a dopamine agonist in young or advanced patients
Dopaminergic, Substantia nigra, L-dopa
___ can be used for A-fib, DVT/PE, Prosthetic valve or Mechanical valve and for all of them you want an INR of ___-___
Most common cause of supratherapeutic INR is interactions with ____ and its metabolism
Elevated INR is a major risk for ____
If INR is high, administer ____ and if extremely high you can supplement with 4-factor PCC or fresh frozen plasma
Warfarin, 2-3
Warfarin
Bleeding
Vitamin K
For the MMSE, normal is ___-___ and sever dementia is 10 or less
Also if a patient has a head injury, use CT with NO contrast
24-30
An elevated white count with a LEFT SHIFT indicates an ____ and a left shift simply means immature neutrophils aka ___ are pushed out of the marrow to fight something
Infection, bands
Headache, fever, nausea and vomiting, nuchal rigidity, and photophobia think ____
^** + Kernigs and Brudzinskis sign
Name the bacterial infection that causes meningitis
1) Less than 2 months
2) 2-12 months
3) Adolescents to young adults
4) 60+
Which antibiotics would you prescribe?
Meningitis
1) B-strep
2) Strep pneumonia, N meningitis, H influenza
3) N meningitis
4) S pneumonia
Vancomycin + Ceftriaxone
Reactive thrombocytosis is associated with an increased platelet count
Acute renal failure can be
Pre-renal = ___ BUN:Cr
Intrinsic
Post-renal
High
KDIGO is criteria of when serum Cr increases ____ mg/dl in 48 hours OR serum Cr becomes greater than ____ percent in 7 days
Stages are
1) Risk - Stage 1 (Represented by the above statement^)
2) Injury - Stage 2 (____% or more serum Cr increase)
3) Failure - Stage 3 (_____% or more serum Cr increase)
Urine output criteria is a urine output of LESS than ____ ml/kg/hr for more than ___ hours
1) Risk - As above ^**
2) Injury - ____ ml/kg/hr for more than ____ hours
3) Failure - ___ ml/kg/hr for more than ____ hours OR anuria for more than ___ hours
- 3, 50
2) 100%
3) 200% - 5, 6
2) 0.5, 12
3) 0.3, 24, 12
Peaked T waves, Prolonged QRS and PR intervals, and small P waves indicate ____
^** Causes include hypoaldosteronism or renal failure (not enough K+ excretion from urine) or hyperglycemia or rhabdomylosis (to much release from cells)
Can treat with ____ and ____ or NaHCO3 (to shift K+ into cells) or Na polystyrene sulfonate or a diuretic or hemodyalasis to remove the K+
Hyperkalemia
Insulin and glucose
Always get _____ in sepsis patients before antibiotics
Most common cause of UTI or pyelonephritis is ____
Anion gap = Na - (Cl+HCO3)
Kidney viscero-somatic reflexes = ____-____
Blood cultures
E.coli
T10-T11
_____ is when Abs initiate inflammation that destroy the GBM and BM in the Pulmonary alveoli
^** This causes RBC casts in the urine (Hematuria) AND coughing up blood (Hemoptysis)
For goopastures, order regular labs + Anti-GBM + ___ and ____-____
If ONLY the kidney’s GBM is destroyed, it’s called ____
Lung viscerosomatic reflexes = ____
RBC casts = _____ and if microscopic eval shows NO RBCs and + blood, think _____ or ____
Goodpastures syndrome
P and C-ANCA
Anti-GBM disease
T2-T7 (although we learned heart and lungs as T1-T6)
Glomerulonephritis, myoglobinuria or rhabdomylosis
Name the catheter
1) Indwelling (left in place)
2) Intermittent (brief in duration)
1) Foley
2) Straight
In a patient with goodpastures syndrome make sure you order to NOT give aspirin, NSAIDs or Cox-2 since it can cause bleeding or toxicity
If you decide you want to do a blood transfusion, ____ and ___ means you determined the blood group compatibility but you have NOT taken any blood out of the bank yet
___ and ____ final step to make sure comparability is correct aka you HAVE taken blood out of the bank and it is ready for a transfusion
Type and Screen
Type and Cross match
