FM Shelf Flashcards
The earliest sign of diabetic nephropathy is what?
Microalbuminuria
This is defined as Albumin/Creatinine ratio greater than 30 mg/g
If a diabetic has either Albuminuria or HTN present, ACE/ARBs are indicated to slow progression of diabetic nephropathy
What is the first sign of puberty in most girls? what age does it typically occur?
Unilateral, firm, tender mass posterior to the nipple – Thelarche (Development of breast bud)
Typically age 10 but as early as age 8
Breast growth is often asymmetric
Menarche typically begins 2ish years after that
Foods that should be avoided in children under the age of 4?
Whole grapes, Raw vegetables, Peanuts, Popcorn
Remain rear facing in car seat until the age of 4 as well
Purulent vs. Nonpurulent Cellulitis MC bugs?
Nonpurulent = S. Pyogenes
Purulent = S. Aureus
Flat, indistinct borders
Screening for Pheochromocytoma vs. Diagnostic testing?
Screen Urine/Serum Metanephrines (Breakdown of Epi & NE)
If positive – Abdominal imaging required to confirm DX
Fibromuscular Dysplasia MC presenting symptom?
HY clues?
DX & TX?
Recurrent HA caused by Carotid Artery Stenosis or aneurysm (Carotid Bruit)
HTN from Renal Artery Stenosis leads to secondary Hyperaldosteroneism
A subauricular systolic bruit is highly suggestive of FMD in any age patient
DX = Duplex ultrasound, CT, MRI
TX = ACE / ARB (1st line) & definitive management with Percutaneous Transluminal Angioplasty
Lichen Planus HY association?
TX?
Associated with Hepatitis C
Topical Glucocorticoids (Betamethasone)
Drug-Induced LP (ACE, Thiazides) has a much more diffuse presentation than idiopathic LP (Wrist, Oral Mucosa, Genitalia)
Potential complications of Sjogren syndrome?
Non-Hodkins lymphoma
Corneal Ulceration
Acute bacterial Prostatitis presentation?
Patients appear acutely ill w/ Lower UTI sx
dx is generally confirmed with DRE showing markedly swollen & tender ANTERIOR prostate
Must obtain urine culture to establish organism
tx is typically 6 weeks of TMP-SMX or Fluoroquinolone (Levofloxacin)
What are the 2 most non-pharmacologic interventions that decrease BP?
Weight loss
DASH diet
Irritant contact diaper dermatitis vs. Candida diaper dermatitis?
Candida is much more beefy red & involves the skinfolds
TX for Candida dermatitis is Topical Antifungal (Nystatin)
TX for contact is a topical barrier (Petrolatum, Zinc Oxide)
What is the only trimester you can use TMP-SMX in a pregnant patient?
2nd Trimester
Not in the 1st d/t disruption of folic acid metabolism
Not in the 3rd d/t risk of neonatal kernicterus
Fosfomycin you can use whenever
Trachoma caused by which bug?
How does it present?
Caused by Chlamydia Trachomatis (A,B,C)
Look for Inflamed Tarsal Conjunctivae – Top of the eye
Chronic infection causes inversion of eyelashes (Trichiasis) & corneal scarring (blindness)
Patients with symptomatic carotid atherosclerotic disease should undergo endarterectomy with what % of stenosis?
70 %
Inciting event of Morton Neuroma?
MC seen in runners
Numbness / Pain in b/t the 3rd & 4th toes
Clicking sensation
What are the cardioprotective diabetic drugs?
GLP-1 Receptor Agonists (Liraglutide)
SGLT-2 Inhibitors (Canagliflozin)
MCL Injury happens with force to what side of knee?
Blow to the lateral knee (Out to in)
Appreciable laxity when the leg is forced into abduction (Valgus test)
MRI most sensitive
What in the fuck is Hidradentitis Suppurativia? Risk factor?
Recurrent painful nodules w/ scarred plaques in the axillae
Keratinocyte proliferation & differentiation – Inflammatory occlusion of folliculopilosebaceous units
Strong risk factor = Tobacco use
Also can have a foul odor
OCP contraindications?
Smokers, prior VTE, Uncontrolled HTN, active breast cancer, greater than 35 YO
Ganglion cyst Pathophys, presentation, treatment?
Mucoid degeneration of periarticular tissue
Rubbery cystic nodule
Transillumination (+)
TX = Observation for asymptomatic cysts, can aspirate but associated w/ high degree of recurrence. Next step would be surgical excision
Step-wise approach to treatment of Acne Vulgaris?
Start w/ Topical Retinoid (Tretinoin) + Benzyl Peroxide
If this ineffective – Topical Clindamycin
If acne exceeds face i.e. back – Oral Doxycycline can be used as well
Key features of Rosecea?
Constant facial erythema & flushing
Telangiectasias
Can lead to permanently flushed skin
Clinical features of epididymitis?
Posterior testicular swelling & tenderness
PHREGN SIGN = Tenderness improves w/ elevation of the testes
NORMAL Cremasteric reflex
< 35 = Gonorrhea & Chlamydia
> 35 = E. Coli
What the fuck is CSF Rhinorrhea?
DX?
TX?
Unilateral Rhinorrhea that increases at times of relatively increased ICP i.e. Straining / bending over
Usually d/t head trauma
DX = Testing the nasal discharge for CSF specific proteins i.e. Beta-2-Transferrin & Beta-trace protein
TX = Inpatient management (elevate the head) to monitor for possible meningitis
