Figure it out, man Flashcards
What are some potential side effects of cyclophosphamide?
Hemorrhagic cystitis
Bladder cancer
Sterility
Myelosuppression
What is a more common nephrotic syndrome, membranous or membranoproliferative?
Membranous is more common
MPGN can be either nephritic or nephrotic
What is the next step if a FAST exam is inconclusive after blunt abdominal trauma?
Diagnostic Peritoneal Lavage
A patient has occasional flushing, diarrhea, abdominal cramps, a right-sided valve issue, and occasional bronchospasms. What does this person likely have? What else could be going on?
Carcinoid syndrome
Niacin (B3)…dermatitis, diarrhea, and dementia
How can central retinal artery occlusion be treated?
Intra-arterial thrombolytics w/in 4-6 hours
Ocular massage and high flow oxygen
What causes the D-xylose test to have low D-xylose in the urine?
Celiac’s disease and other proximal small intestine malabsorption diseases
What is the most premalignant colon polyp?
Villous
How does tamoxifen work? What is a potential side effect?
It is a Selective Estrogen Receptor Modulator (SERM)…it has both agonist and antagonist effects
It can cause endometrial cancer
What differentiates an acute leukemoid reaction from CML?
Leukemoid reaction has an elevated Leukocyte Alkaline Phosphatase (LAP)
CML has a decreased LAP
Old lady has vulvar excoriations, and skin is thin, dry, and white. What should be done? What is likely? What can be done?
Vulvar punch biopsy…possibly lichen sclerosus et atrophicus
Treat with topical corticosteroids
An older person has periods of decreased alertness and visual hallucinations and has had balance issues. What should be considered?
Lewy-body dementia
What can cause hypotension after an epidural is placed? How can it be prevented? How can it be managed?
Blockage of sympathetic nerves responsible for vascular tone
Aggressive IV fluid expansion prior to placement
Put mom on her left side (improves venous return); fluids; pressors
A child is found to have elevated lead levels on capillary blood draw?
Draw venous lead level
Undetectable –> nothing to do
5-44 –> redraw in 1 month
44-69 –> DMSA
70+ –> dimercaprol + EDTA
What happens physiologically with ARDS?
Decreased lung compliance
Impaired gas exchange
Pulmonary hypertension
When is trihexyphenidate used?
Newly diagnosed Parkinson’s patients with tremors as only real concern
What is affected with GBS?
Peripheral nerve demyelination
Which lung cancer secretes PTHrP?
Squamous cell carcinoma
How can lactose deficiency be diagnosed?
Hydrogen breath test after lactose ingestion
When can ‘Odds Ratio’ and ‘Relative Risk’ be considered the same?
Rare diseases
Where do most PEs come from?
Proximal deep veins: iliac, femoral, popliteal
A person with expected HIV presents with an illness. What should be done?
Treat the illness…wait to start HAART until after well (risk of immune reconstruction syndrome)
What is the most common cause of erysipelas?
Strep pyogenes (GAS)
What is the first approach to treating alzheimer disease?
Cholinesterase inhibitors (donepezil, rivastigmine, galantamine)
Young, otherwise healthy young man has chronic low back pain that is worse at night and better with activity + elevated ESR = ?
Ankylosing spondylitis…can have restricted chest wall motion
Thin, green, vaginal discharge that smells…
Trichomoniasis (flagellated organism)…treat couple with metronidazole
What can be given to measles patients to reduce morbidity/mortality?
Vitamin A…Immune enhancement + GI and respiratory epithelium regeneration
What is the believed cause of vitiligo?
Autoimmune
A Marfanoid patient has a pheochromocytoma and elevated calcitonin in the presence of a hard thyroid nodule. What does this patient likely have? What else has to be considered?
MEN2B (RET-oncogene)
Mucosal (tongue, eyelids, lips) and intestinal neuromas
What is the most common cause of bacterial pneumonia in kids (less than 20yo)? Adults?
Kids get staph a infections
Adults get pseudomonas infections
How does risperidone cause decreased libido?
Decreased dopamine activity in the tuberoinfundibular pathway
A patient has a predominant mood disorder…but has multiple episodes of schizophrenia like symptoms in the absence of mood disorder. What is the diagnosis?
Schizoaffective disorder
How is candida vaginitis treated?
Oral fluconazole
How are absence seizures treated?
Ethosuximide; OR
Valproic acid
What are some possible effects of nephrotic syndromes?
Hyperlipidemia
Increased coagulability
Patient has conjunctivitis with corneal neovascularization (pannus). What is the diagnosis?
Chlamydia trachomatis serotype A-C…Trachoma
What is the most common form of kidney disease with HIV?
FSGS
What can be used to help with ALS?
Riluzole…glutamate inhibitor
