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Family > general questions II > Flashcards

general questions II Flashcards

1
Q

what is the godl standard treatment for bipolar

A

lithium

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2
Q

what are the SE of lithium

A

tremors, diabetes insipidus, hypothyropidism, weight gain

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3
Q

what are some of the second line therapies for bipolar

A

valproic acid, fcarbamezapine and atypical antipsychotics.

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4
Q

what are some of the atypical psychotics

A

risperidone, clozapine, quetiapine, ziprasidone

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5
Q

what are the components of rhett syndrome

A

incontinence, screaming fits, loss of speech, sensory problems, breath holding, stereotypic movements, chorea, bruxism, and dystonia.

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6
Q

diabetic nephropathy characteristics

A

foamy urine, proteinuria, hypertension in the setting of diabetes.

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7
Q

what is foamy urine a sign of>?

A

proteinuria

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8
Q

what is the treatment for diabetic nephropathy

A

ACEi and glycemic control

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9
Q

is the normal albumin/creatinine ratio of urine

A

less than 30. greater than 30 indicates that there is microalbuminuria

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10
Q

what is a technetium 99m pertechnetate study

A

this is looking at the GI tract and if there is ectopic uptake it strongly suggests Meckel diverticulum.

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11
Q

what is meckel diverticulum

A

patentcy of the vitelline duct. rule of 2. these are usually incidental findings unless there is blood, which indicates a lower GI tract bleed. the bleeds are caused by ulcerations of the small bowel from acid being secreted by the ectopic gastric mucosa int he diverticulum.

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12
Q

what is the rule of 2s for meckels diverticulum

A

occurs in 2% of the population, 2 inches long, 2 feet from the ileocecal valve, 2% of patients develop a complication over their life, male to female ratio is 2:1.

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13
Q

what metabolic disturbances will you find in bulimia nervosa

A

self-induced vomiting can result in hypokalemia, hypochloremic metabolic alkalosis.

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14
Q

what are the signs of bulimia

A

eroded teeth, inflammation of the esophagus, russell sign (calluses on the knuckles).

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15
Q

if suspected hypothyroidism what is the best test for the blood

A

first TSH. then look to free T4.

Do not look at T3, this is more likely to be variable.

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16
Q

what is highly associated with myastenia gravis and what test do you need to secure after diagnosis with edrophonium challenge

A

CT of the chest dumbass. this is for thymoma

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17
Q

what is assocaited with medulloblastoma?

A

nevoid basal cell carcinoma is the most common one to consider but the others are turcot and ataxia-telangiectasia

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18
Q

what is the mainstay of treatment for bells palsy

A

since this is an idiopathic peripheral lesion of the facial nerve glucocorticoid treatment is first line therapy. many cases of bells palsy can be caused by lyme disease, but watch for prodfromal symtpoms. if there are none, then glucocorticoids

also watch out for herpes voster infections. they can cause bells palsy. usually the steroids are given in conjunction with antivirals.

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19
Q

what is a risk factor for bell’s palsy

A

diabetes

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20
Q

what are the features of elaphantitis

A

low-grade fever, excessive lymphadenitis, rural china and a mosquito bite

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21
Q

what is the causal agent for elphantitis

A

wuchereria bancrofti

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22
Q

what is medial tibial stress syndrome

A

shin splints

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23
Q

how to diagnose a tibial stress fracture

A

radiographs will only pick up on it 46% of the time. bone scan within 72 hours picks up the stress fracture 96% of the time.

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24
Q

what is syringomyelia

A

fluid pocket filled with CSF forms within the spinal cord (syrinx).

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25
Q

what is the presentation of a syrinx or syringomyelia

A

selective loss of temperature and sensation in the upper extremity is very rare outside of syrinx/syringomyelia

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26
Q

what is associated with syringomyelia

A

arnold-chiari malformation type I. this causes disrupted flow through the foramen magnum and may result in the formation of a syringomyelia

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27
Q

what is the treatment for tuberculosis

A

isoniazid, rifampin, ethamutol, pyrazinamide

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28
Q

anisocytosis

A

variety in the size of erythrocytes. this is the same as red blood cell distribution width. An increased red blood cell distribution width is highly specific for iron-definiency anemia.

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29
Q

what is the number one cause of anemia in women of child-bearing age

A

menorrhagia

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30
Q

what is glanzmann thrombocytopenia

A

this is defective GpIIb/IIIa. characterized by an inability of platelets to aggregate

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31
Q

reaction formation is what

A

doing the opposite of the thought or feeling towards something

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32
Q

what is VACTERL congenital anomalies

A

vertebral anolalies, anal atresia, cardiac derfects, tracheoesophageal fistula/esophagela atresia, renal and radial (limb defects including thumbs) anomalies,

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33
Q

how does bladder present

A

80-90% of patients with bladder cancer have painless gross hematuria

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34
Q

what is the most common type of bladder cancer

A

transitional cell carcinoma

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35
Q

what are the risk factors for bladder cancer

A

smoking, aniline dyes, cyclophosphamide.

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36
Q

what is otosclerosis and what is it associatd with

A

presents as bilateral conductive hearing loss, with a positive family history. this is overgrowth of the middle ear bones, most commonly the stapes, in which it becomes fixed to the oval window and cna no longer be pulled away by the stapedius muscle in response to sounds –loss of the stapedius reflex.

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37
Q

what is electrical alternans

A

alternating amplitudes of QRS on ECG. this is indicative of pericardial effusion and cardiac tamponade.

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38
Q

what is the classic presntation of pericardial effusion

A

cough, chest pain, tachycardia, dizziness with electrical alternans

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39
Q

what is the next appropriate step for suspected pericardial effusion

A

cardiac echocardiogram

40
Q

what is the definitive treatment for pericardial effusion

A

pericardial centesis

41
Q

what causes fatty change in the liver

A

fatty disorders like diabetes, alcohol intoxication, obesity.

42
Q

what is the difference between a sebaceous nevi and an infantile hemangioma

A

sebaceous nevi are there from birth, while hemagniomas develop over time.

43
Q

what do we watch out for with sebaceous nevi

A

can develop into cancer

44
Q

Hailey-Hailey disease

A

this is benign familial pemphigus (autosomal dominant). this usually arises in the third-fourth decades. friction areas to macerate, thicken and develop painful cracks. presents as a painful erosive skin rash. the lesions tend to come and go and leave no scars. the centers clear as the lesion spreads. heat, sweating and friction usually exacerbate the lesions.

can have malorderous drainage from secondary bacterial infections

45
Q

what differentaites hailey-hailey from pemphigus vulgaris and immune mediated blistering diseases?

A

the immunofluorescence test for antibodies is negative.

46
Q

treatment for shingles in pregnancy

A

no different than anyone else. oral acyclovir.

47
Q

what is echinococcosis

A

tapeworm infection by echinococcus granulosus.

48
Q

what is the disease course of echinococcosis

A

ingvestion of the worm egg in contaminated food with dog feces, individual will develop hydatid cysts that look like egg shells in the liver. the cysts can rupture and lead to an anaphylaxis

49
Q

what is the treatment for echinococcos

A

abendazole and possibly surgical removal is necessary

50
Q

what is a mucin positive lung tumor characterized as?

A

adenocarinoma

histologically will have glands and mucin

51
Q

what is the presentation of lung cancer

A

chronic cough, hemoptysis, hoarseness, chest pain, pericardial or plural effusion and superior vena cava syndrome

52
Q

what are the most common sites of metastasis for lung tumors

A

adrenal glands, brain, bone, and liver

53
Q

what are also common in lung cancers

A

paraneoplastic syndromes. l

54
Q

what are some paraneoplastric sydnromes

A

hypercalcemia from parathyroid hormone related peptide release. lambert-eaton myastenia syndrome, cushings syndrome, syndrome of inappropriate antidiuretic hormone release.

55
Q

what is the therapeutic range for INR

A

2-3

56
Q

what do you do for someone that is injured and is taking warfarin?

A

make sure they are hemodynamically stable and that their INR is therapeutic

57
Q

what are patients with a molar pregnancy monitored for and how>?

A

gestational trophoblastic disease. need to take the B-hCG within 48 hours of evacuation and then 1every 1-2 weeks while the level is elevated continue to take it every 6 months. OCPs and monitoring for one year is what OB says

58
Q

what is pulmonary rehabilitation

A

usually recommended for patients with COPD. a set of exercises that teaches them how to breath easier.

59
Q

what is bird fancier’s lung and how does it present

A

interstitial inflammation with some fibrosis. its also called hypersensitivity pneumonitis. a disease in which the lung parenchyma becomes inflamed as a response to environmental antigens –like bird dander.

60
Q

what is the most effective way to stop epistaxis

A

firm pressure on the cartilaginous portion of the nose for 30 min

61
Q

is hypertension to blame for epistaxis

A

not usually

62
Q

what is the next step in stopping the bleeding from epistaxis if firm pressure does not help

A

can cauterize with silver nitrate

63
Q

why must caution be taken with silver nitrite cauterization

A

because there is a risk of necrosis

64
Q

nikolsky’s sign

A

slight rubbing of the skin causes exfoliation of the outermost layer

65
Q

what is a concerning biopspy result for endometrium

A

glands with crowding and prominent nucleoli

66
Q

what is the classic triad for congenital toxoplasmosis

A

chorioretinitis, hydrocephalus, intracranial calcifications

67
Q

how does congenital syphilis present

A

jaundice and hepatosplenomegaly, nasal discharge, rash on the palms and soles, saber shins and hutchingtons incisors. sensorinerual deafnes

68
Q

how does congenital listeriosis present

A

premature birth, meningitis and sepsis, pustular skin lesions with vesicles granulomatus infantiseptica

69
Q

congenital VSV

A

IUGR, prematurity, chorioretinitis and cataracts, encephalitis, pneumonia, CNS abnormalities, hypopl;asitc limbs

70
Q

Parvovirus B19

A

fetal hydrops, aplastic anemia

71
Q

rubella congentica

A

blueberry muffin baby, IUGR, sensorineural deafness, cataracts, heart defects, hepatitis

72
Q

CMV congenica

A

jaundice, IUGR, chorioretinitis, sensorineural deafness, periventricular calcifications, microcephaly and siezures

73
Q

conegnital HSV

A

premature birth, IUGR, vesicular lesions, keratoconjunctivitis miningitis

74
Q

what do we use to treat nocturnal enuresis

A

imipramine

75
Q

what is imipramine

A

a tricyclic antidepressant

76
Q

what are clue cells and what do they represent

A

they are bacterial cells stuck to vaginal cells on a wet mount. this is indicative of garnrella vaginosis or bacterial vaginosis

77
Q

how do we treat bacterial vaginosis

A

metronidazole

78
Q

what is a side effect of the MMR vaccine

A

measles like rash on the trunk for 10-14 days after vaccination. this is benign and wil go away soon

79
Q

what is goodpasture synfdrome

A

a very serious autoimmune syndrome that causes pulmonary hemorrhage, hematuria. this is due to basement membrane antibdies

80
Q

what is a typical presentation for IgA nephropathy

A

painless hematuria after a respiratory illness. the clinical presentation is usually proteinuria, hematuria, azotemia, red blood cell casts, oliguria, hypertension

81
Q

ramelteon

A

melatonin agonist and sleep aid.

82
Q

myastenia gravis presents as

A

autoantibodies act against post synaptic nicotinic acetylcholine receptors. person that gets tired throughout the day and improves with rest. diplopika, muscle weakness and ptosis.

83
Q

what is the test to confirm myastenia

A

tensilon or edriphonium

84
Q

what is the treatment for myastenia

A

acetylcholinesterase inhibitors such as neostigmine, pyridostigmine

85
Q

what do we giev to treat cholinergic crises

A

atropine

86
Q

diamond blackfan anemia

A

aplastic anemia typically presents as a normo or macrocytic anemia

87
Q

fanconi anemia is what type of anemia

A

pancytopenic anemia

88
Q

narcolepsy presents how

A

tetrad of symptoms: cataplexy, sleep paralysis, hypenogogic hallucinations, excessive daytime sleepiness.

sudden episodes of muscle weakness ranging from slight atonia to complete paralysis and is often triggered by strong emotions like terror or crying

89
Q

when is ultrasound indicatred for breast mass

A

in all women under 30

90
Q

what are the signs of steatorrhea. what are the two sources of this

A

bulky and foul smelling stools

structural damage to the intestine (crohn’s, celiac) or pancratic/endocrine insiufficienchy

91
Q

what is the D-xylose test for?

A

to test for structural damage to the small bowels.

92
Q

if the d-xylose test is negative or normal then what do we look for?

A

endocrine insufficiency like pancreas

93
Q

what is the rule pregnancy dating with ultrasounds and LMP

A

if the LMP and ultrasound dates differ by >7 days go with the ultrasound date

94
Q

how does midgut volvulus present

A

with a lethargic infant that has been vomiting. duodenum is usually the culprit and emkergent laparotomy is required before the baby gets ischemic

95
Q

what is psittacosis

A

bacterial infection transmitted from birds gram negative bacterium. treaet with tetracyclines. presents as respiratory disease with patchy infiltrates

96
Q

what do we do for a nonreducible, painful inguinal hernia

A

surgical reduction is required because it can cause bowl strangulation

97
Q

what is steven johnson syndrome

A

a burning skin rash usually due to medication reaction.

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