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ACP > GIM - Intro > Flashcards

GIM - Intro Flashcards

0
Q

Filipino:

A

Gout, disseminated coccidioidomycosis

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1
Q

Heart sounds: plop

A

Atrial myxoma

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2
Q

Caucasian, Northern Europe:

A

PMR, temporal arteritis, pernicious anemia

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3
Q

SE Asian

A

TB, rheumatic HD

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4
Q

Japanese

A

Gastric ca, moya-moya (arteries of circle of Willis blocked by constriction and blood clots, resulting in TIAs, recurrent strokes and haemorrhages)

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5
Q

Berry aneurysm

A

Saccular aneurysm, occurs at the point where the cerebral artery departs from the circular artery (at the circle of Willis) at the base of the brain. Prone to rupture and bleed

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6
Q

PPD test

A

Mantoux, purified protein derivative

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7
Q

Least effect on dopaminergic system amongst antipsychotics

A

Quetiapine

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8
Q

Opioids and CCBs can give a patient this urination abnormality

A

Urinary retention

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9
Q

Overflow incontinence: PVR >

A

> 100 cc

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10
Q

Bladder detrusor innervation (to squeeze)

A

Parasympathetic (=cholinergic) - at level S1S2

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11
Q

Bladder internal sphincter innervation to hold

A

Sympathetic

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12
Q

2 mechanisms of urge incontinence:

A
  1. Loss of CNS inhibition of detrusor parasympathetic squeeze
  2. Over active detrusor
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13
Q

If detrusor is underactive, this urination abnormality occurs

A

Retention and overflow incontinence

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14
Q

Causes of detrusor underactivity

A
  1. Weakening is detrusor from chr obstruction - blockage below
  2. Meds (TCAs, opioids, antocholinergics - Benadryl)
  3. Peripheral neuropathy - DMT2, PD, mechanical damage to the detrusor nerves (spinal stenosis, disc herniation, tumor etc)
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15
Q

Leser-Trelat sign

A

Sudden onset of seborrheic keratosis (paraneoplastic - NHL, GI malignancies)

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16
Q

Vibrio infection

A

Eating raw shellfish eg. in Lousiana

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17
Q

Ecthyma gangrenosum - vesicles, pustules, evolving to necrotic ulcers - painful

A

Pseudomonas aeruginosa

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18
Q

Ascending sporothrichoid infection - ascending nodular lymphangitis

A
  1. Sporotrichosis - gardening
  2. Mycobacterium marinum - fish tank, water
  3. Nocardia - soil
  4. Leishmaniasis - Texas
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19
Q

Chickenpox in adults

A 
Cellulitis, sepsis
Pneumonia !!
Encephalitis
Predisposes to TSS
Reye sy (in pts on Aspirin; hypoglycaemia + brain edema + hepatic failure)
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20
Q

Transmission rates: HBV, HCV, HIV?

A

HBV>HCV>HIV

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21
Q

Indications for steroids in pts w mononucleosis:

A
  1. Impeding airway obstruction
  2. Liver failure
  3. Aplastic anemia
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22
Q

Contact sports makes you prone to obtain this bug

A

MRSA

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23
Q

Malignant external otitis (w cranial nerve involvement) in diabetic pts - aBx coverage?

A

Broad w double pseudomonas coverage - high mortality (15%!!) Hospital admission

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24
Q

Negative predictive value of normal CTPE

A

98%

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25
Q

Case control study design

A

Subjects are enrolled on the basis of disease status (ill or not) and then look for exposure/factors. Single disease study

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26
Q

Observational cohort study

A

Subjects are enrolled on the basis of exposure within a well defined population. This can be prospective or retrospective. For single exposure studies

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27
Q

Asthma presentation w intermittent pulmonary infiltrates & Tx

A

Allergic bronchi pulmonary aspergillosis - Tx: prednisone

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28
Q

Lambert-Eaton myasthenia sy ass w this malignancy

A

SCLC

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29
Q

Wernicke’s encephalopathy -Tx

A

Thiamine, then glucose

30
Q

INO clinical presentation

A

Weak adduction of affected eye, nystagmus w abduction of contra lateral eye

31
Q

INO pathology and causes

A
  • Brainstem abnormality 2ry to lesion in medial longitudinal fasciculus in the pons or midbrain
  • Causes: MS, brainstem infarct, syphilis, cancer, hepatic encephalopathy, head trauma, Wernicke’s encephalopathy
32
Q

3rd nerve palsy

A

Ipsilateral ptosis & normal or large/blown pupil (pupil reaction may be delayed + extraocular muscle impairment: looking down and outwards; cannot look inwards and up)

33
Q

Myasthenia gravis - eye presentation

A

Ptosis (fatiguability), no pupil change

34
Q

Syphilis eye finding

A

Argyl-Robertson pupil: accommodates but does not react to light
No ptosis

35
Q

Horner’s syndrome - oculists pathetic palsy

A

Ptosis, myosis (small pupil on the same side), anhydrosis
Enophtalmos - loss of innervation to the orbicularis muscle
All ipsilateral

36
Q

Charcot Marie Tooth - hereditary motor and sensory neuropathy

A

AD - autosomal dominant

37
Q

Color blindness

A

X-linked recessive

38
Q

NF-1

A

Autosomal dominant

39
Q

Haemophilia A

A

X-linked recessive

40
Q

Cystic fibrosis

A

Autosomal recessive

41
Q

Cystic fibrosis incidence and carrier status

A

Incidence 1/2000

Carriers 1/20

42
Q

Cystic fibrosis & sterility

A

Women not sterile, but decreased fertility 2ry to thick cervical mucus
Men sterile 2ry to absence of vas deferents

43
Q

Klinefelter sy

A

47 XXY or mosaics

44
Q

Klinefelter sy & cancer risk

A

Gynecomastia w increased risk of breast ca

? Increased risk of testicular ca

45
Q

Autosomal dominant conditions

A

Polycystic KD,
Familial hyperchol, Familial hyperTG,
Hereditary non-polyposis colorectal ca (HNPCC), Peutz-Jeghers sy,
Charcot-Marie-Tooth (hereditary motor and sensory neuropathy), Huntington’s,
NF-1, tuberous sclerosis,
AIP, BRCA 1&2 mutations

46
Q

X-linked recessive

A 
Color blindness
Haemophilia A&B
G6PD
Duchenne's muscular dystrophy
Fabry's disease - alpha galactozidase A deficiency
47
Q

Autosomal recessive

A 
CF, hemochromatosis,
Alpha-1 antiripsin deficiency
Sickle cell anaemia 
Thalassemia
Tay-Sachs disease - hexoseaminidase deficiency
Albinism
48
Q

When to evaluate AAA emergently for Sx?

A

If acute pain

49
Q

Dermatitis herpetiformis -clinical picture

A

Herpetiform rash, young adults or teens,associated w gluten sensitive enteropathy

50
Q

Dermatitis herpetiformis - skin Bx

A

IgA-deposition

51
Q

Dermatitis herpetiformis Tx

A

Dapsone and gluten-free diet

52
Q

Acrodermatitis enteropathica - causes

A

Zinc deficiency 2ry to inborn error or nutritional

53
Q

Common side effect of Dapsone

A

Haemolytic anemia (20-30%)

54
Q

Falsely high HbaA1c

A

Fe/B12/folate deficient anemia

Some Hb-variants (sickle cell and S-Beta thalassemia)9

55
Q

Mess having mortality benefits in CHF

A

BB, ACEI, spironolactone, hydralazine

+ nitrate

56
Q

Constrictive pericarditis causes

A 
Radiation
Cardiac Sx
SLE-RA
TB
Malignancy
Histoplasmosis
Viral/Idiopathic pericarditis
57
Q

Falsely low HbA1c

A

Haemolytic anemia
Hbopathies
Renal failure (RBC lifespan is significantly reduced with. The subsequent increased rate of hbturnover leads to decr exposure time to ambient glucose that in turn lowers the extent of non-enzymatic binding of glucose to haemoglobin)
Phlebotomy/haemorrhage (transfusion)

58
Q

Meralgia paraesthetica

A
  • thigh lateral paresthesia
  • Entrapment of lateral femoral cutaneous nerves (no objective motor or sensory findings)
  • Causes: obesity, tight clothes, RF: DMT2
59
Q

Small cell lung ca can cause hypoNa, hypoglycaemia, Cushing sy but not:

A

HyperCa

60
Q

Malignant hypercalcaemia

A
  • Breast ca (prostaglandins>bone lysis)
  • Squamous cell ca, renal ca (PTHrp)
  • lymphoma: 1,25 -OH-VitD
  • myeloma: cytokines
61
Q

Paraneoplastic manifestations of renal cell ca

A
  • Sudden onset varicocele (2%) - retro peritoneal pathology causing spermatic vein compression: non-reducible
  • fever (20%) (hepatoma can too)
  • erythrocytosis (3%, most commonly anemia)
  • non-metastatic liver dysfunction (15%)
62
Q

When not to use HCTZ?

A
  • gout
  • increased creat
  • pt on Lithium
63
Q

Meds increasing Lithium levels

A

HCTZ, ACEIs

64
Q

Finasteride - 5alpha-reductase inhibitor effects

A

Effects in 6-12 months to reduce symptomatic progression of BPH (bleeding from bladder varices and obstruction)

65
Q

PSA is not a recommended screening test in this age group

A

> 70

66
Q

Probenecid effect

A

Increases uric acid excretion, only works if renal function is good

67
Q

Livedo reticularis - doesn’t come and go; associated with

A

Increased thrombosis and stroke risk, thus, may warrant A/C in pts with positive anti-phospholipid ABs

68
Q

Livedo reticularis can be seen in:

A

SLE, primary anti-phospholipid sy, atheromatous emboli sy, PAN

69
Q

Skin lesions in reactive arthritis

A

Keratodermia blenorrhagicum
Circinate balanitis - hyperkeratotic lesions on penis
Keratodermia
Nail changes resembling psoriasis

70
Q

Seroderma renal crisis Tx

A

ACEI

71
Q

Fibromyalgia

A

Young women with

  • sleep disturbance
  • soft tissue aches/tender points
  • ache worse in the am
72
Q

Constrictive pericarditis clinical picture

A

Elevated JVP, as cites, pericardial knock, Kussmaul sign (paradoxical rise of JVP in inspiration), hepatosplenomegaly

ACP (6 decks)

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