Form 1 Block 3 - Created July 20 Flashcards
who should get an implantable cardioverter-defibrillator to improve survival
- prior MI and LVEF < 30%
- HF w/ sxs and LVEF < 35%
- prior episodes of V. tach
indications for cardiac resync therapy
LVEF < 35% w/ long QRS or LVEF <30% w/ long QRS and LBBB
MCC of inherited thrombophilia
Factor V Leiden -> protein C resistance -> thrombosis
ways people can get enterohemorrhagic E.coli (EHEC)
farms, petting zoos, undercooked beef
ways people can get Shigella
contaminated food or water
which subtype of E.coli makes Shiga toxins
O157:H7
presentation and ESR/CK levels in glucocorticoid-induced myopathy
progressive proximal m. weakness and atrophy; no pain; legs more involved; normal levels
presentation and ESR/CK levels in polymyalgia rheumatica
muscle pain & stiffness in shoulder/pelvic girdle; tender w/ decr. RON at shoulder, neck, hip; responds to steroids; elevated ESR
presentation and ESR/CK levels in inflammatory myopathies
muscle pain, tenderness, and proximal muscle weakness; skin rash and infl. arthritis may be present; ESR and CK elevated
presentation and ESR/CK levels in statin-induced myopathy
prominent muscle pain/tenderness; rare rhabdo; elevated CK
presentation and ESR/CK levels in hypothyroid myopathy
muscle pain, cramps, and weakness in proximal mm; delayed tendon reflexes and myoedema; occ. rhabdo; features of hypothyroid; elevated CK
hypothyroidism features that are not classic features
carpal tunnel, mild normocytic anemia, mild hypoNa, hyperLipid, borderline elevation in Cr, muscle pain made worse with exercise
preventive meds for migraines
BBs, TCAs, valproate
abortive meds for migraines
ergotamines or triptans
strategy to decrease incidence of vent associated lung injury
low tidal volume ventilation (6-8 mL/kg of predicted body wt)
what 2 things to adjust on ventilator to maintain oxygenation within acceptable range
FiO2 and PEEP; do not keep FiO2 above 60% for long; high PEEP may be needed to prevent alveolar collapse
minute ventilation equation
RR x TV
If decreasing TV to decr. chance of alveolar overdistention, be sure to increase RR accordingly.
what can mechanical ventilation cause (quick and fixable complication)
hypotension
possible complication of severe nephrotic syndrome
thromboses (mostly renal vv and deep vv of legs) and infections (with typical bugs)
when to consider hemochromatosis as a diagnosis instead of depression
50 yo Male who is weak/tired, poor concentration, low libido, mildly elevated LFTs, high ferritin
skin manifestation in hereditary hemochromatosis
hyperpigmentation
MSK manifestations in hereditary hemochromatosis
arthralgia, arthropathy, chondrocalcinosis
GI manifestations in hereditary hemochromatosis
hepatomegaly (early), cirrhosis (later), HCC (much later)
endocrine manifestations in hereditary hemochromatosis
DM, hypogonadism, hypothyroidism
cardiac manifestations in hereditary hemochromatosis
restrictive or dilated CMP; possible MI or stroke from thick blood
infectious manifestations in hereditary hemochromatosis
Listeria, Vibrio vulnificus, Yersinia enterocolitica
1st line tx for bulimia nervosa
CBT; fluoxetine may be added on; hospitalize if SI, uncontrolled purging, or medical complications
which med is contraindicated in bulimia nervosa?
bupropion
associated risk in pregnant patients who take oral fluconazole
spontaneous abortion, cleft palate, femoral bowing, congenital heart dz
how urine chloride level can help differentiate btwn major causes of metabolic alkalosis with hypokalemia
- low - ext. loss of gastric acid (V, NG suction)
2. high - diuretics or Gitelman/Bartter
way elderly depression can look
increased restlessness, anxiety, behavioral agitation
when to suspect gallbladder pathology based on labs
elevated bilirubin (>1.0) and elevated alk phos
