Fall 2017 Flashcards
QTc normal interval time for M and F
M < 420 ms; F < 460ms
what is the MC cardiac rhythm disturbance
atrial dysrhythmias
Earliest reliable sign that AMI (acute MI) has occurred
ST segment elevation
Adverse rxn of non-DHP CCBs
Verapamil and to some degree diltiazem will decrease cardiac contractility and HR
Serum triglycerides (mg/dL) levels (normal, borderline, high, very high)
<150, 150-199, 200-499, >500
protective HDL level
> 60 mg/dL
What does posterior (descending) interventricular artery supply
posterior adjacent areas of both ventricles
Main reason for non-compliance of Niacin and its use
flushing (increases HDL and reduces LDL)
What is Beck’s Triad
JVD, Hypotension, Pulsus paradoxus
Doses of Epi and Ami for Sustained unstable V-tach
Epi = 1 mg IV, Ami = 300mg IV
Is the rate of stroke different in pts with paroxysmal vs permanent a-fib?
No, same rate of stroke
How much stenosis is needed to produce sxs
70% is exertional angina; 90% unstable angina
What test should you get for all pts w/ inferior myocardial infarction
right sided EKG
Infective Endocarditis is more likely to affect what valve in IVDA
Tricuspid valve
normal range of creatinine
0.8-1.2 mg/dL
What adverse reaction does phenazopyrideine (Pyridium) cause and what is it used for
bladder anesthetic causes Methemoglobinemia (and acute renal failure, hemolytic anemia)
GFR criteria for starting dialysis
GFR 10-15 ml/min
Mg, Na, K, Ca normal ranges
1.5-2.5 Mg, 135-145 Na, 3.5-5.5 K, 8.5-10.5 Ca (Little Maggie is 1.5-2.5 yo and swam in the ocean for 135-145 minutes and then ate 3.5-5.5 bananas and drank 8.5-10.5 oz of milk
classic ekg finding of hyperkalemia
peaked t waves
Classic physical exam findings of hypocalcemia
Chvostek Sign and Trousseau sign (more reliable)
Describe Chvostek sign
tap facial nerve at angle fo jaw; facial muscles on ipsilateral side will contract (hyperexcitability)
Describe Trousseau sign
carpal spasm w/ occlusion of the brachial artery with BP cuff
Physiologic gold standard testing for urinary incontinence (hint disadvantage is that it’s invasive)
Urodynamic testing
What should you think of if you find crescentic lesions on bx
rapidly progressive glomerulonephritis (3 types and Anti-GBM GN is type I RPGN); must diagnosis quickly or pt will die
Bence Jones proteinuria pathognomonic for
Multiple Myeloma
Blueberry Muffin Baby what dz
Congenital Rubella
Hutchinson’s sign what virus
VZV/Trigeminal Nerve/V1
Koplik spots with what disease
Measles
What does gram stain tell us (and what colors)
if bacteria is + (blue) or - (red)
Drug of choice for hookworm
mebendazole
sandpaper like rash
scarlet fever
painless vision loss
Retinal artery occlusion
definition of mydriasis
dilation (miosis=constriction)
which sinus does osteomyelitis most commonly affect
frontal sinus
granulation tissue present at floor of osseocartilaginous junction is pathognomonic for what
malignant otitis externa (MOE)
What are the 4 centor criteria for likelihood of group a streptococci?
fever 101+, ant cervical lymphadenopathy, tonsillar exudate, absence of cough
only reversible disease of the gum
gingivitis
Which zone of the neck is the pharynx in?
Zone III (Apex of lungs is zone 1; trachea is zone 2)
HgbA1c goal for healthy pts with DM of short duration, long life expectancy, w/o signif CVD
6.5% or less
Explain Somogyi effect
AM hyperglycemia = nocturnal hypoglycemia causes surge of counterregulatory hormones causing hyperglycemia by 7 am
leading cause of death in T2DM
MI
Metformin BBW
can cause alctic acidosis w/ elevated lactate and anion gap acidosis, w/o ketones
What disease do you measure vanillylmandelic acid levels?
Pheochromocytoma (tumors of chromaffin cells which secrete norepinephrine and other catecholamines)
