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IM Rotation > Floor Notes > Flashcards

Floor Notes Flashcards

1
Q

differential diagnostic tool for atrial fibrilation?

A

PIRATES

Pulmonary (PE, COPD, congestion)
Iatrogenic and infection
Rheumatic heart dx
Atherosclerosis and alcohol
TSH (hypo or hyper)
Electrolytes
Sick sinus syndrome and sepsis
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2
Q

can a-fib cause a cardiomyopathy within months?

A

yes

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3
Q

cardiac enzymes are?

A

tropinin I
- most sensitive and specific to myocardial dmg, released from cytosol of dead myocytes
- lvls measurable in 2-4 hours (not before), normalizes in 7 days
CK (creatine kinase)
- normalizes in 3 days

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4
Q

define malingering

A

exaggerating or to feign illness to escape duty

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5
Q

Cardizem is?

A

diltiazem, a CCB (vasodilator) used for severe HTN

  • should NOT be taken w/ BB
  • SE: constipation, peripheral edema, lupus-like rash
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6
Q

what happens to WBC count during an infarct?

A

WBC increases d/t inflammation

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7
Q

CTA is?

A

CT (computed tomography) angiogram, a vascular study that uses iodine-rich contrast
- also involves radiation

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8
Q

what is the anti-coag cocktail?

A

Plavix (Clopidogrel), ASA, statin

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9
Q

what is the MOA of Clopidogrel? what’s the main risk?

A

adenosine-diphosphate R inh > dec platelet aggregation

bleeding

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10
Q

what does DAPT stand for?

A

dual anti-platelet therapy = ADP R inh + ASA

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11
Q

can PVD cause skin color changes?

A

yes

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12
Q

what should you ask from a patient when checking lung sounds?

A

take deep breaths with their mouth open

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13
Q

define munchausen syndrome

A

psychiatric illness where a person attempts to fake an illness to receive medical care

GI bleed from Italy that taxi’d from GB to Mani only to not enter the hospital and ditch the taxi fare.

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14
Q

what does fib stand for?

A

fucking Illinois bastard

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15
Q

what’s ordered to test for polycythemia vera?

A

JAK2 mutation

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16
Q

myotonic dystrophy

A

multisystem disorder d/t trinucleotide expansion (CTG) on c19

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17
Q

what can high BP limit in the kidneys?

A

perfusion and thus urine creation

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18
Q

alternative to furosemide? advantage?

A

bumetanide (bumex), easier on kidneys

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19
Q

dobutamine

A

b1 agonist (sympathomimetic), inc heart contractility and thus CO

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20
Q

mobilizing fluid causes what?

A

lots of urination

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21
Q

can the heart rebuild itself from heart failure?

A

yes

22
Q

broken heart syndrome

A

takotsubo syndrome, LV becomes stunned causing acute heart failure

takotsubo = fishing pot for trapping octopus

23
Q

INR can increase due to?

A

antibiotics, 4-5 days without significant vit K, illness

24
Q

one can’t do what over the phone?

A

read body language

25
Q

regarding blood pressure medication, what should be noted in plan section?

A

hold guidelines for when systolics get too low

26
Q

what’s protocol for chronic steroid doses in post-op pts?

A

double the dose to avoid adrenal insufficiency

27
Q

one ounce of prevention equals..

A

one pound of cure

28
Q

instant patient, just..

A

add water

29
Q

what do steroids do?

A

bump WBC count

30
Q

FFP is..

A

fresh frozen plasma

31
Q

VRE is..

A

vancomycin resistant enterococci

32
Q

pronator drift

A

UMN dysfunction, eyes closed and arms out, palms drift towards pronation/away from supination

33
Q

no such thing as bad weather, only..

A

bad clothing

34
Q

at what point has a stress test provided adequate information?

A

9 minutes for treadmill, normal at this time = good prognosis

35
Q

what should be added to patient charts post-op ortho?

A

blood loss anemia

36
Q

what’s included in an ABG?

A

pH: 7.35 - 7.45
pCO2: 35 - 45
HCO3: 22 - 26
pO2: 80 - 200

37
Q

LDH

A

lactate dehydrogenase, enzyme found in most cells that when found in serum suggests cell damage and death is occurring somewhere

38
Q

ear infections can lead to..

A

disequilibrium, vertigo, light-headedness (feeling like one might faint)

39
Q

what class of drugs carries risk of strokes in elderly pts with dementia?

A

second gen antipsychotics

40
Q

if a pt is cognitively impaired and isn’t eating, what’s that mean?

A

red flag! figure it out

41
Q

don’t prescribe what to females?

A

inserts

42
Q

RVR

A

rapid ventricular rate, seen in a-fib

43
Q

ivf

A

intravenous fluids

44
Q

fluctulance

A

wave-like feeling to palpation

45
Q

induration

A

increase in fibrous elements in tissue, associated with inflammation and loss of elasticity

46
Q

Zosyn

A

Pipercillin + Tazobactam

47
Q

Levaquin benefits

A

G- and G+ coverage, lacks psuedomonal coverage though

48
Q

Phlegmasia cerulea dolens

A

painful leg swelling that turns the LE blue

49
Q

SIRS criteria

A

fever > 100.4F, hypthermic 96.8
WBC > 12000 or > 10% bands
tachy (HR > 90)
hypervent (> 20 bpm) or PaCO2 < 32mmHg

50
Q

what can cause hypercalcemia?

A

bone cancer, or metastasis to the bone, all d/t bone breakdown

IM Rotation (4 decks)

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