GP Flashcards

1
Q

Diagnosis of Diabetes

A

Clinical symtoms (polyuria, polydipsia, unexplained weight loss) + random glucose or 2 hr 75 g glucose test >11 mmol/l + fasting glucose >7 mmol/l

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2
Q

Rapid Acting Insulin

A

Lispro, aspart, or glulisine

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3
Q

Long Acting Insulin

A

Insulin detamir (Levemir) lnsulin glargine (Lantus)

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4
Q

5 causes of Secondary Hypertension

A

CHAPS - Cushings, Hyperaldosteronism, Aortic Coarctation, Pheochromocytoma, Stenosis of the renal artery

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5
Q

Female Athlete triad

A

ammenorhea, eating disorder, osteoporosis

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6
Q

Treatment of chalmidya and gonorrhea

A

Gonorreha - ceftraixone 125 mg IM single dose and chlamidya - doxycline 100 mg BID 7 DAYS or azithromycin 1 g orally

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7
Q

Warfarin therapy indications

A

first episode DVT with transient risk factors: 3 months first episode DVT with ongoing risk factors - consider indefinite therapy first episdoe with no identifiable risk factors - 6-12 months or indefinite recurrent - indefinite

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8
Q

Treatment of acute sinusitis

A

symptoms improving within 5 days - symptomatic moderate symptoms that persist for more than 5 days - corticosteroids severe and resistant to corticosteroids - clarithromycin

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9
Q

Impotence

A

Inability to achieve or maintain an erection

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10
Q

Min number of sperm needed for pregnancy

A

1 million

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11
Q

Treatment of cluster headaches

A

abortive - oxygen, triptans, octreotide, dihyrdoergotamine prophylaxis - verapmail, ergotamine, prednisone, indomethacin

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12
Q

Hypercholestermia and HTN

A

beware that statins and verapamil together can lead to rhabdomyolysis and verapamil inhibits cytochrome p450 that normally breaks down statins

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13
Q

Treatment of V tachycardia

A

Amiodarone

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14
Q

Most common fractured bone in lower leg in children

A

Tibia

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15
Q

Prevntion of contrast induced nephropathy

A

Hydration with sodium bicarbonate

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16
Q

Indications for tonsillectomy

A

Recurrent, confirmed bacterial tonsillitis (>4 times/year), irrespective of the type of bacteria Compliations of acute tonsillitis such as peritonsilar abscess or septicaemia originating from the tonsils Peritonsillar abscess in a patient <40 years of age Suspected malignancy including marked asymmetry or ulceration Airway obstruction caused by sleep apnea, tonsils or disorder of dental occlusion Chronic tonsillitis is a relative indication – if causing bad breath, sore throat, gaggin and symptoms do not decrease with follow up

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17
Q

Treatment of athletes foot

A

Before putting on anti-fungals need to diagnose by taking a culture of scrappings - terbinafine 250 mg once/day for 12 weeks or itroconazole 200 mg bid 1 week/month for 3 months

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18
Q

Best initial therapy for acute cardiogenic pulmonayr edema

A

LMNO Loop Diuretics Morphine (venous dilation decreases preload) Nitrates Oxygen

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19
Q

Rhinitis medicamentosa

A

If you use decongestants for more than 3 days you get a rebound congestion on drug withdrawal. When used for several months, these agents can cause a rhinitis that is difficult to treat

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20
Q

Xerosis

A

pathologic drying of the that is especially common in the elderly and exacerrabated by winter and low humidity

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21
Q

Treatment of central vs nephorgenic DI

A

Central - vasopressin or desmopressin Nephrogenic - diuretics

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22
Q

Complications of nasogastric feeding

A

Diarrhea (most comon) - add anti-diarrheal agents to feed, aspiration, ucleration of nasal and esophageal tissues leading to strictures

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23
Q

Breast cancer incidence

A

1 in 9 will be diagnosed and 1 in 27 will die from breast cancer

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24
Q

Match elevated ACE elevated methylmanionic acid reduced haptoglobin elevated protoporphyrin

A

elevated ACE - sarcoidosis elevated methylmanionic acid - vitamin b12 deficiency reduced haptoglobin - hemolytic anemia elevated protoporphyrin - lead poisoning or iron deficiency

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25
Q

Preferred antibiotics for anerobic infection in the mouth

A

Clindaymycin or amoxicillin

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26
Q

Treatment of acne

A

Mild - topical benzoyl peroxide and/or topical antibiotics (erythromycin, clindamycin Moderate - Tetracycline, Doxycycline, erythromycin Severe - Oral isoretinoin (Accutane)

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27
Q

Causes of acanthosis nigricans

A

DM2 Obesity Familial Drung induced Malignant (gastric cancer) PCOS

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28
Q

Preferred site for emergent airway entry is

A

Through cricothyroid membrane above the cricoid cartilage. Note that during controlled circumstances, the preferred site would be the between the tracheal rings or thyroid isthmus

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29
Q

Patients taking isoniazid should also take what

A

Vitamin B6 (Pyridoxine) otherwise can result in coma, seizures, pins and needles sensation

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30
Q

Medical Management of Aortic Dissection

A

Beta blocker to decrease BP to 110 mmHg followed by nitroprusside

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31
Q

Thrombolytics contraindications

A

Severe hypertension Stroke within the preceeding 2 months Active bleeding Surgery within the preceeding 2 months Neoplasms or vascular abnormalities

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32
Q

Thrombolytics contraindications

A

Severe hypertension Stroke within the preceeding 2 months Active bleeding Surgery within the preceeding 2 months Neoplasms or vascular abnormalities

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33
Q

Secondary causes of osteoporosis

A

Decreased BMI Corticosteroids Vitamin D deficiency Excessive alcohol Hypogonadism

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34
Q

Differential Diagnosis for Hematuria

A

Generalized Medication - anti- coagulants Hemoglobinopathies - Anemia Leukemia Localized Neoplasm Infection - Tuberculosis, UTI Trauma Stones Glomerulonephritis

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35
Q

Casue of rheumatic Fever

A

Group A beta hemolytic streptococcus

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36
Q

Radical Prostatecomy

A

Prostate, seminal vesicles and ampula of vas deferens are removed

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37
Q

Investigations and treatment for BPH

A

Ix: Urine fr microscopy and culture, U&E to assess renal function, PSA. Urine flow test to see flor and urinary volume against time. U/S to assess urinary bladder volume and upper tract dilatation. Transrectal ultrasound and biopsy if BPH suspected. Voiding diary to see how bothersome symptoms are to patients

Tx:

Conservative - watchful waiting if symptoms are mild

Medical - alpha blockers which relax the prostatic smooth muscle tone increasing urinary flow and helping with obstructive symptoms. Side effect: Postural hypotension

5 alpha reductase inhibitors which block the conversion of testosterone to the more potent dihydrotestosterone

Surgical - Transurethral resection of the prostate (TURP) - patient palced in lithomy position and a resectoscope placed through urethra and diathermy is used to cut away the prostate. Diathermy is also used to minimize bleeding. Three way cathether is used to irrigate the bladder until the fluid is no longer blood stained

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38
Q

[Complications of TURP

A

General vs Specific

Early vs late

Early : Septic shock, bleeding and transurethral syndrome (absorption of hypotonic irrigation leading to electrolyte abnormalities 0 hyponatremia, fluid overload and hemolysis, brain edema. Treat transurethral syndrome with fluid restriction, diuretics and close observation. Note that saline solution cannot be used as it limits the use of diathermy

Late: Secondary hemmorhage, urethral strictures, impotence (65-80% experience retrograde ejaculation), recurrent prostatic growth and recurrent symptoms

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39
Q

Causes of bladder outlet obstruction

A

Urethral stricutres due to trauma, catherization or STI’s

BPH

Prostate cancer

40
Q

Complications of BOO

A

Infections

Urinary stasis

Acute painful urinary retention

Chronic painless urinary retention

Hydronephrosis

Bladder calculi

Renal impairment

41
Q

Treatment of Ca. P

A

Early - Radical prostatectomy, brachytherapy

Advanced - Medical - LHRH agonists, anti-androgens

Surgical - TURP

42
Q

How do you differentiate between kidney and spleen

A

Kidney

  • ballatable (place one hand on the abdomen - keep still and the other on the renal angle - raise)
  • moves vertically down on inspiration
  • resonant to percussion due to overlying colon

Spleen

  • Notch
  • Moves towards the right iliac fossa on inspiration
  • Dull to percussion
43
Q

Course of the ureter and sites of obstruction by stone

A

  1. Start at renal pelvis at L1/2 (12th rib), trabel down along the line of transverse processes towards the sacroiliac joint (where they cross over the iliac vessels). Travel downwards towards the ischial spines and then forward to the bladder.
  2. Common sites of obstruction are the pelviureteric junction, sacroiliac junction where theureter crosses the iliac vessels and the vesicoureteric junction
44
Q

Treatment of ureteral stones

A

conservative - <4mm 90% pass, <7 mm 50% will mass

surgical - < 2 cm in size or in the upper third of kidney = Extracorporeal Shock Wave Lithotripsy and if that fails urethrescope

>2 cm = percutaneous removal

Stone in the lower third of kidney = ureteroscopy

45
Q

DDx Dysuria

A

Infectious: cystitis, uretheritis, prostatits, epididymitis, orchitis, cervicitis, vulvovaginitis, vestibulitis, perineal inflammation/infection, TB

Neoplasm: RCC, UCC, Penis, Prostate, BPH, Vaginal/vulva

Calculi: Bladder, kidney, ureteral stone

Inflammatory: drug side effects, autoimmune, seronegative arthropathies, interstitial cystitis, pelvic pain syndrome

Hormonal: Endometeriosis, hypogonadism

Trauma: Catheter insertion, post-coital cystitis

Psychogenic: Somatization, MDD, stress

Other: Foreign body, contact sensitivity

46
Q

Acute vs Chronic retention

A

Acute - medical emergency, pain and anuria with normal bladder volume, can lead to bladder rupture, immediate catherization needed

Chronic - assymptomatic, greatly increased bladder volume with detrusor hypertrophy and atony (later), intermittent catherization

47
Q

Casues of Urinary Retention

A

Outflow obstructioon

  • bladder neck/urethra - stone, neoplasm, clot, foreign body
  • prostate - BPH, prostate cancer, prostatitis
  • urethra - stricture, phimosis, traumatic disruption

Bladder innervation

  • stroke, DM, post pelvic surgery, spinal cord (disc herniation, MS, injury)

Pharmacologic

  • antihistaimes, anticholingerics, narcotics, antihypertensives (methyldopa)
48
Q

Differential Diagnosis for Lumps in the Neck

A

Based on anatomical region: Posterior triangle

    • cystic hygroma (cysts of watery fluid)
  • dermoid cysts (cystic teratoma found at sites of embryological fusion)

Anterior triangle

  • branchial cyst (retained elements of branchial cyst, lined wiht sq. epithelium, filled with cholesterol)
  • branchial fistual/sinus
  • chemodectomas (carotid body tumors that arise in front of the SCM)

Midline

  • Goitre - diffusely swollen (graves, hashimoto, subacute thryoiditis, iodine deficiency, ingestion of goitrogens)

multiple nodules(cysts, adenomas) solitary nodule (cyst, tumor), adenomas, malignant tumors (follicular, papillary, lymphoma, anaplastic, medullary)

  • parathyroid adenoma (very rarely is it a palpable neck lump)
49
Q

Complications of Thryoid Surgery

A

Acute hemmorhage - LIFE THREATENING as it can casue airway compression. Intubate and remove sutures to evacuate hematoma

Recurrent laryngeal nerve damage - unilateral leads to voice horaseness, bilateral leads to airway obstruction requiring tracheostomy

Damage to the parathyroid glands - either due to their poor blood supply or inadvertent ecision producing hypocalcemia resulting in tetany (Trousseau’s, Chvostek’s)

Hypothyroidism

50
Q

Discuss the staging of melanoma

A

Breslow thickness - dept of tumor in millimeters and give a good indication of prognosis

<0.76 99% survival over a 5 year period

  1. 76-1.50 - 90%
  2. 51-4.0 - 70%

>4 - <50%

The Clark level refers to how deep the tumor has penetrated into the layers of the skin.

Level I: confined to the epidermis (top-most layer of skin); called “in situ” melanoma; 100% cure rate at this stage
Level II: invasion of the papillary (upper) dermis
Level III: filling of the papillary dermis, but no extension in to the reticular (lower) dermis
Level IV: invasion of the reticular dermis
Level V: invasion of the deep, subcutaneous tissue

51
Q

Define Hemoptysis and what are the main Causes of Hemopytsis

A

Hemoptysis is defined as >100-600 ml of blood in a24 hour period. The causes listed below can cause erosion of an artery or capillary in the pulmonary circulation and expectoration of blood. The greatest danger in massive hemptysis is not exsanguination but aspiration due to airway flooding with blood.

Main causes of hemoptysis include bronchits, bronchietasis, malignancy, TB, pneumonia, lung abscess, vasculitis, PE

Treatment: Bronchoscopy to identify site of bleeding followed by pulmonary arterial catherization

52
Q

Causes of Esophageal Perforation and Signs of Esophageal Perforation

A

Signs - widened mediastinum, penumomediastinum, crackling sound under the sternum,

Casues: Instruemnt induced, medication induced (KCl) or caustic injury (pills dont pass immediately into the stomach - important to take pills upright and with fluids) , Barrets esophagus, Esophageal ulcer rupture, Boerhave syndrome (increased esophageal pressure, decreased intrathoracic pressure from chronic and excessive coughing, vomiting)

53
Q

Leriche syndrome

A

Triad of symmetric atrophy of bilateral lower extremities, impotence and hip, thigh and buttock claudication due to aortoiliac occlusion

54
Q

Radiological signs of

esophageal rupture

acute pancreatitis

perforated duodenal ulcer

A

esophageal rupture - penumomediastinum, mediastinal widenining, creptius under sternm

acute pancreatitis - left pleural effusion

perforated duodenal ulcer - air under diaphgragm

55
Q

Define Episadias, hypospadias, peyronie’s disease

A

Episadias = abnormal urethral opening on the dorsal surface of the penis

Hypospadias = abnormal urethral opening on the ventral surface of the penis

Peyronie’s disease = fibrosis of the penis shaft causes an a bend upon erection

56
Q

Casues of priapism

A

Low flow: leukemia, durg (prazosin), sicke cell disease, impotence treatment gone wrong

High flow: pudendal artery fistula from trauma

57
Q

Causes of impotence

A

Vascular - decreased blood flow (test with papverine/PGE1 vascular injections)

Endocrine: decreased testosterone

Anatomic: Peyronies disease or other structural abnormality of erectily apparatus

Medications: Clonidine

Psychogenic: depression, anxiety

Neurologic: damage to nerves, DM, MS

58
Q

DDx for RIF Mass

A

Acute Appendicitis

Cecal tumor

Soft tissue tumor (sarcoma)

Lymph node mass

TB

Actinomycosis

Transplant kidney

Iliac anneurysm

59
Q

Causes of exopthalmos

A

Bilateral - Graves

Unilateral - Graves, tumors of the eyes (neurofibroma, granuloma, dermoid, optic nerve glioma), cavernous sinus thrombosis, pseudotumors of the orbit

60
Q

Cardiac Tamponade

A

Accumulation of 100-200 ml of fluid in the stiff pericardial sac. Triad: Hypotension, Elevated jugular veins and Tachycardia. CXR shows small pleural effusion with normal cardiac sillhoute without tension pneumothorax

61
Q

Signs on CXR of aortic injury from blunt chest trauma

A

Widened mediastimun

Left sided Hemothorax with right leaning mediastinum

Disruption of cardiac contours

62
Q

Signs on CXR of esophageal rupture

A

Pneumomediastinum, pleural effusion

Diagnosis is confirmed with water soluble contrast esophagography

63
Q

Signs of Mycoardial Contusion

A

Sternal fracture

New arrtyhmia

Tachycardia

64
Q

Signs of Diaphragmatic Rupture

A

Abdominal pain referred to the shoulder, loss of diaphragmatic contours and diaphragmatic contents above diaphragm

65
Q

Signs of Bronchial Rupture

A

Pneumothorax that does not resolve with chest tube placement, pneumomediastinum and subcutaeneous emphysema

66
Q

Triad of chronic pancreatitis and clinical features

A

Triad = inflammation, pancreatic cell loss (necrosis), fibrosis

Clinical features = abdominal pain, DM, steatorrhea

67
Q

DDx for epigastric pain

A

Gastritis/PUD

Perforated viscus

Acute cholecystitis

SBO

Ruptured AAA

Mesenteric ischemia/infarction

Biliary colic

Inferior MI/pneumonia

68
Q

Cause of recurrent largyneal nerve palsy voice hoarseness

A

vocal cord abduction and adducion can occur with phonation but not with inspiration

69
Q

Contraindications for lap cholecystectomy

A

Absolute Generalized abdominal sepsis
Major bleeding disorders
Late pregnancy

Relative Morbid Obesity
Choledocholithiasis
Obstructive jaundice
Acute gallstone pancreatitis
Intra-abdominal malignancy

70
Q

Complications of lap cholecystectomy

A

(1) Conversion to open procedure (5%)
(2) Common bile duct / hepatic duct damage
(3) Cystic duct leak
(4) Bleeding
(5) Biloma
(6) Post-operative shoulder tip pain
(7) Retained bile duct stones
(8) Late hernia formation at port sites

71
Q

Zenkers diverticulum

A

Outpouching of the pharynx between the upper border of the cricopharyngeus muscle and the lower border of the inferior cosntrictor muscle of the pharynx. Corresponds to a weak area called Killian’s dehiscence. Pharygenal pouches are caused by peristaltic activity pumping against resistance from uncoordinated muscle spasm. Though the deficit occurs posteriorly, swelling usually bulges to hte left side of the neck.

72
Q

Causes and management of esophageal perforation

A

Causes: Trauma during endoscopy, foriegn body, spontaneous rupture from forceful vomitting (Boerhaaves sydnrome), ingestion of corrosive agents

Ix: CXR, CT, Contrast swallow

Tx: NG tube + antibiotics + PPI’s. Srugery to debride the mediastinum and placement of a T tube within the esophagus to provide drainage and formation of a controlled esophago-cutaneous fistula

73
Q

Nissen fundoplication

A

Involves mobilizing the fundus of the stomach and wrapping around the lower end of the esophagus creating a high pressure area designed to prevent reflux

74
Q

Define Peptic ulceration

A

Ulcer formation associated with acid and can occur at several sites namely duodenum (commonest), stomahc, esophagus, jejunum (Zollinger Ellsion syndrome), Meckels diverticulum (if there is ectopic gastric mucusa)

Can present with pain, dyspepsia, bleeding (acute or chronic), perforation, penetration, obstruction

75
Q

Complicatroins of Peptic Ulcer Surgery

A

Early: Hemorrhage, Duodenal Stump leakage, failure of the stomach to empty and billous vomitting (occurig in 10% of patients)

Late: Dumping syndrome (early - right after meal; late - 1-2 hrs after meal), postvagotomy diarrhea, biliary vomitting, anemia (due to lack of intrisinc factor, vitamin B12 and iron), osteomalacia (due to lack of Vitamin D and calcium), recurrent ulceration and malignancy, alklaine gastritis, Blind loop syndrome (proliferation of bacteria in the long blind end loop leading to anemia, malnutrition and weight loss)

76
Q

DDx of upper GI bleeding

A
77
Q

Management of upper GI bleed

A

2 large IV cannula (14G) for fluid resuscitation

Blood sent for urgent cross match for 4 units, CBC, U&E, clotting (note that intestinal absorption will lead to an elevated urea level)

Urinary catheter to monitor urine output

IV PPI’s and coagulopathies todecrease pH

Endoscopy to determine source of bleeding - injection of adrenaline, endoscopic band ligation, injection sclerotherapy

If endoscopic measures fail, open surgery

78
Q

Presenting complaints for Meckels diverticulum

A

Presents similar to appendicitis, bleeding (most common complication in tennagers), volvulus or intussception

79
Q

Complications of large blood transfusions

A

Dilutionl thrombocytopneia

DIC (mismatched blood or patients underlying condition)

Coagulation factor dilution or consumption (esp 5, 8)

Hyperkalemia (due to storage)

Hypomagnesemia (occurs as it binds to citrate)

Ctrate toxicity (Citrate binds to Ca and Mg)

Acidosis/Alkalosis

Impaired O2 delivery with left shift of the dissociation curve

Hypothermia from lack of warming blood

80
Q

Ways of assessing hydration status

A

Urine outout (most reliable)

Skin turgor

HR

Sunken eyeballs

mucus membranes

Capillary refill time

81
Q

Treatment of anatomic snuffbox fracture

A

Non-displaced

  • long arm thumb spica cast with hte wrist in in neutral position for 6 weeks followed by a short arm spica splint for an additional 6 weeks until union evident. After immobilization, active ROM exercises to the forearm, wrist and thumb should be performed 6-8 times daily. A wrist and tumb spica splint with the wrist in neutral position should be worn between exercise sessions and at night

Displaced

  • ORIF amd then short arm thumb spica for 8-12 weeks until union evident. At 4 months - dynamic wrist flexion and extension. At 6 months - patient uses hand normally
82
Q

Contraincations for use of succinycholine in rapid sequence intubation

A

Hyperkalemia is an absolute contraindication. Not to be used in patients with burns (due to rhabdomylysis), tumor lysis syndrome, demyelinating disorders (Guillian Barre)

83
Q

Define Proteinuria and what are its causes

A

Normal protein excretion <150 mg/dl, consisting of albuin <30mg/dl of albuin. Rises to >300 mg/dl

Causes: Glomerular or tubular disease

DM

amyloidosis

HTN

interstitial nephritis

heavy metals

mutliple myeloma

pregnancy

CCF

84
Q

Nephrotoxic drugs for which dose adjustment is needed

A

Aminoglycosides

Lithium

Digoxin

Ethambutol

Cephalosporins

Tetracycline

Procainamide

Sulfamethoxazole

85
Q

CABG - which arteries are most commonly blocked and where are grafts taken from?

A

CABG - LAD, RCA, Left circumflex artery

Grafts taken from internal mammary/thoracic and great saphenous vein

86
Q

Definition of Pulsus paradoxus and conditions that cause it

A

Drop in systolic pressure of >12mmHg due to increase in venous return during inspiration which decreases left ventricular filling and decreases systolic pressure .

Cardiac causes: Cardiac tamponade and pericaditis

Non-cardiac causes: Pneumothorax and Severe asthma

87
Q

Describe lesion

A

Umbilicated, flesh colored , firm, dome shaped papules on the trunk. limbs and genital areas are characterized of a rash caused by molluscum contangiosum. This is an infectious rash that can be transmitted by skin to skin transmission and by sexual contact. It is caused by the pox virus, people with immunodeficiency are at increased risk of developing this condition. Rash is non-pruritic

88
Q

DDx of Postural Hypotension

A

Drugs (vasodilators, alpha adrengergic antagonists)

Hypovolemia (dehydration, bleeding)

Addisons disease

Hypopituitarism

Autonomic (DM, Shy Drager syndrome)

Idiopathic (with age in the elderly)

89
Q

Define apex beat

A

The most inferolateral point of visible or palpable pulsation of the chest wall due to movement of the apex of the heart. It corresponds to the point of maximal impulse. Note that the real apex (anatomical) is below it. The apex is felt as the heart assumes a more spherical shape on contraction and moves closer to the chest wall

90
Q

Causes of bilateral hilar lymphadenopathy

A

Infection - TB, mycoplasma

Sarcoidosis

Malignancy - Lymphoma, carcinoma, mediastinal tumors

Organic dust disease

Extrinsic allergic alveolitis

Histocytosis x

91
Q

DDx granulomatous diseases

A

Infection - Bacteria - TB, cat scratc Fungi- Cryptococcus

Autoimmune - primary biliary cirrhosis, granulomatous orchitis

Vasculitis - GCA, Takayasu’s arteritis, Polyarteritis nodosa

Organic dust disease (eg silicosis, berylosis)

Idiopathic - Chrons, Sarcoidosis, De Quervains thryoiditis

Extrinsic allergic alveolitis

Histiocytosis X

92
Q

Causes of cor pulmonale

A

Lung disease - asthma, COPD, bronchiectasis, pulmonary fibrosis, lung resection

Pulmonary vascular disease - PE, pulmonary vasculitis, sickle cell disease, parasite infestation, pulmonayr HTN

Thoracic cage abnormality - kyphosis, scoliosis, thoracoplasty

Neuromusuclar disease - MG, motor neuron disease, poliomyelitis

Hypoventilation - sleep apnea, enlarged adenoids in childnre

Cerebrovascular disease

93
Q

Causes of Hypoglycemia

A

Postprandial Hypoglycemia - Idiopathic, alimentary hyperinsulism (previous gastrectomy)

Fasting Hypoglycemia

  • Secondary to overutilization of glucose (insulinoma, exogenous insulin (sulfonylureas), drugs like quinine and pentamidine
  • Secondary to imparied glucose production (hormone deficiency (hypopituitarism, adrenal insuficiency), substrate deficiency (malnutiriton), drugs (EtOH, salicyclate toxicity), enzyme defects, cirtical illness, autoimmune hypoglycemia
94
Q

Motivational Strategies for Behavioural Change

A

Pre-Contemplation

Contemplation

Preparation

Action

Maintenance

Relapse

95
Q

Complications of knee replacement

A

Intra-operative - fracture of the tibia or femur

Immediate - vascular injuries - superifcial femora, popliteal and genicular vessels

Early - DVT, PE, Peroneal nerve palsy, Infection,, fat embolism

Late - infection, loosening, periprosthetic fractures, patellar instability/fracture/disruption of extensor mechanisms

96
Q

Signs of rhabomyolisis

Treatment of rhabdomylosis

A

Eleveated creatinine phoshokinase, red blood cells on dipstick but no actual RBC on microscopy, high K

Manitol and alkalinize urine