First Aid Rapid Review Step 2 CK Flashcards
Antihypertensive for a diabetic patient with proteinuria
ACE inhibitor
Beck triad for cardiac tamponade
Hypotension, distant heart sounds, and JVD
Drugs that slow heart rate
B-blockers, CCBs, digoxin, amiodarone
Hypercholesterolemia tx that leads to flushing and pruritus
Niacin
A systolic ejection murmur heard along the lateral sternal border that increases with decreased preload (Valsalva maneuver)
Hypertrophic obstructive cardiomyopathy (HOCM)
A diastolic, decrescendo, low-pitched blowing murmur that is best heard sitting up; increases with increased afterload (handgrip maneuver)
Aortic insufficiency
A systolic crescendo/decrescendo murmur that radiates to the neck; increases with increased preload (squatting maneuver)
Aortic stenosis
A holosystolic murmur that radiates to the axilla; increases with increased afterload (handgrip maneuver)
Mitral regurgitation
A diastolic, mid-to late, low-pitched murmur preceded by an opening snap
Mitral stenosis
An autoimmune reaction with fever, pericarditis, and increased ESR occuring 2-4 weeks post-MI
Dressler syndrome
Classic ECG findings in pericarditis
Low-voltage, diffuse ST-segment elevation and PR depression
Diagnostic test for pulmonary embolism
Spiral CT with contrast
Reverses the effects of heparin
Protamine
Most common cause of HTN in young women
OCPs
Most common cause of HTN in young men
Excessive EtOH
Water bottle-shaped heart
Pericardial effusion
“Stuck on” waxy appearance
Seborrheic keratosis
Red plaques with silverly-white scales and sharp margins
Psoriasis
Most common type of skin cancer; lesion is a pearly-colored papule with a translucent surface and telangiectasias
Basal cell carcinoma
Honey-crusted lesions
Impetigo
+ Nikolsky sign
Pemphigus vulgaris
- Nikolsky sign
Bullous pemphigoid
A 55 y/o obese patient presents with dirty, velvety patches on the back of the neck
Acanthosis nigricans. Chest fasting blood glucose
Dermatomal distribution
Varicella zoster
Flat-topped papules
Lichen planus
Irislike target lesions
Erythema multiforme
Presents with one large patch and many smaller ones in a treelike distribution
Pityriasis rosea
A premalignant lesion from sun exposure that can lead to squamous cell carcinoma
Actinic keratosis
Flat, often hypopigmented lesions on the chest and back; KOH prep has a spaghetti-and-meatballs appearance
Tinea (pityriasis) versicolor
Cradle cap
Seborrheic dermatitis
Inflammation and epithelial thinning of the anogenital area, predominantly in postmenopausal women
Lichen sclerosus
Exophytic nodules on the skin with scaling or ulceration; the second most common type of skin cancer
Squamous cell carcinoma
Most common cause of hypothyroidism
Hashimoto thyroiditis
Exopthalmos, pretibial myxedema, and decreased TSH
Graves disease
The most common cause of Cushing syndrome
Iatrogenic corticosteroid administration
A patient post-thyroidectomy presents with signs of hypocalcemia and increased phosphorous
Hypoparathyroidism (iatrogenic)
Stones, bones, groans, psychiatric overtones
Signs and symptoms of hypercalcemia
HTN, hypokalemia and metabolic alkalosis
Primary hyperaldosteronism (due to Conn syndrome or bilat adrenal hyperplasia)
A patient presents with tachycardia, wild swings in BP, headache, diaphoresis, AMS, and a sense of panic
Pheochromocytoma
Which should be used first in treating pheochromocytoma?
alpha-blockers (phenoxybenzamine)
A patient with a hx of lithium use presents with copious amounts of dilute urine
Nephrogenic DI
Tx of central DI
Administration of DDAVP and free-water restruction
A postop pt with significant pain presents with hyponatremia and normal volume status
SIADH due to stress
An anti-diabetic agent associated with lactic acidosis
Metformin
A pt presents with weakness, nausea, vomiting, weight loss, and new skin pigmentation. Lab results show hyponatremia and hyperkalemia
Primary adrenal insufficiency (Addison disease). Treat with glucocorticoids, mineralocorticoids, and IV fluids
Bone pain, hearing loss, and increased alkaline phosphatase
Paget disease
Increased IGF-1
Acromegaly
Galactorrhea, amenorrhea, and bitemporal hemianopia
Prolactinoma
Increased serum 17-hydroxyprogesterone
Congenital adrenal hyperplasia (21-hydroxylase deficiency)
Pancreas, pituitary, parathyroid tumors
MEN 1
A patient presents with sudden onset of severe, diffuse abdominal pain. Exam reveals peritoneal signs, and abdominal radiograph reveals free air under the diaphragm. Management?
Emergent laparotomy to repair a perforated viscus
The most likely cause of acute lower GI bleeding in patients > 40 years of age
Diverticulosis
Diagnostic modality used when US is equivocal for cholecystitis
Hepatobiliary iminodiacetic acid (HIDA) scan
Inspiratory arrest during palpation of the RUQ
Murphy sign (seen in acute cholecystitis)
The most common cause of SBO in patients with no hx of abdominal surgery
Hernia
The most common cause of SBO in patients with a hx of abdominal surgery
Adhesions
Most common bacterial organism causing diarrhea
Campylobacter
Recent abx use causing diarrhea
C. difficile
Camping diarrhea
Giardia
Traveler’s diarrhea
Enterotoxigenic E. coli (ETEC)
Church picnics/mayonnaise causing diarrhea
S> aureus
Uncooked hamburgers diarrhea
E. coli O157:H7
Fried rice diarrhea
B. cereus
Poultry/eggs diarrhea
Salmonella
Raw seafood diarrhea
Vibrio, HAV
AIDS diarrhea
Isospora, cryptosporidium, MAC
Pseudoappendicitis
Yersinia, campylobacter
A 25 y/o Jewish man presents with pain and watery diarrhea after meals. Exam shows fistulas between the bowel and skin and nodular lesions on his tibias
Crohn disease
Inflammatory disease of the colon with an increased risk pf colon cancer
Ulcerative colitis (greater risk than Crohn)
Extraintestinal manifestations of IBD
Uveitis, ankylosing spondylitis, pyoderma gangrenosum, erythema nodosum, Primary sclerosing cholangitis
Medical tx for IBD
5-ASA agents and steroids during acute exacerbations
A 30 y/o man with UC presents with fatigue, jaundice and pruritus
Primary sclerosing cholangitis
Medical tx for hepatic encephalopathy
Decrease protein intake, lactulose, rifaximin
A 4 y/o presents with oliguria, petechiae, and jaundice following an illness with bloody diarrhea. Most likely diagnosis and cause?
HUS due to E coli O157:H7
Tx after exposure to Hep B
HBV immunoglobulin
Classic causes of drug-induced hepatitis
TB meds (INH, rifampin, pyrazinamide), acetaminophen, and tetracycline
A 40 y/o obese woman with elevated alkaline phosphatase, elevated bilirubin, pruritus, dark urine, and clay colored stools
Biliary tract obstruction
Hernia with highest risk of incarceration
Femoral hernia
Severe abdominal pain out of proportion to the exam
Mesenteric ischemia
Diagnosis of ileus
Abdominal radiographs (could also use CT scan)
Anemia from chronic disease, occult blood loss, vague abdominal pain. What side is the colon cancer?
Right-sided
Obstructive symptoms, change in bowel movements. What side is the colon cancer
Left-sided: “apple-core” lesio
Presents with watery diarrhea, dehydration, muscle weakness, and flushing
VIPoma
Presents with palpable, nontender gallbladder
Courvoisier sign (suggests pancreatic cancer)
Four causes of microcytic anemia
Thalassemia, Iron deficiency, anemia of Chronic disease, and Sideroblastic anemia (TICS)
Precipitants of hemolytic crisis in patients with G6PD deficiency
Sulfonamides, antimalarial drugs, fava beans
The most common inherited cause of hypercoagulability
Factor V Leiden mutation
The most common inherited bleeding disordered
von Willebrand disease
The most common inherited hemolytic anemia
Hereditary spherocytosis
Diagnostic test for hereditary spherocytosis
Osmotic fragility test
Pure RBC aplasia
Diamond-Blackfan anemia
Anemia associated with absent radii and thumbs, diffuse hyperpigmentation, café au lait spots, microcephaly, and pancytopenia
Fanconi anemia
Thrombotic thrombocytopenic purpura pentad?
Fever, Anemia, Thrombocytopenia, Renal dysfunction, Neuro abnormalities (FAT RN)
An 8 y/o boy presents with hemarthrosis and increased PTT with normal PT and bleeding time
Hemophilia A or B
A 14 y/o girl presents with prolonged bleeding after dental surgery and with menses, normal PT, normal or increased PTT, and increased bleeding time
von Willebrand disease (treat with desmopressin, FFB or cryo)
Reed-Sternberg cells
Hodgkin lymphoma
A 10 y/o boy presents with fever, wt loss and night sweats. Exam shows an anterior mediastinal mass. Diagnosis?
Non-Hodgkin lymphoma
An 80 y/o man presents with fatigue, lymphadenopathy, splenomegaly, and isolated lymphocytosis; smudge cells
Chronic lymphocytic leukemia
Auer rods on blood smear
Acute myelogenous leukemia
AML subtype associated with DIC. Treatment?
M3. Treat with retinoic acid
A 50 y/o man presents with early satiety, splenomegaly, and bleeding. Cytogenetics show t(9;22).
CML
Virus associated with aplastic anemia in pt’s with sickle cell
Parvovirus B19
A significant cause of morbidity in thalassemia patients. Treatment?
Iron overload. Tx with deferoxamine