hammer20 Flashcards
Which cancer is common in patients exposed to asbestos? What worsens the risk?
Bronchiogenic carcinoma.
What are CT findings in peritoneal mesothelioma?
Nodular peritoneal thickening with moderat to severe ascites
What is the presenation of vertebral osteomyelitis? What does evaluation include? What is the imaging modality of choice?
Fever, backpain and focal spinal tenderness. Evaluation includes blood culture and inflammatory markers (ESR and CRP). MRI
What is the main measure of association in case control studies?
Exposure odds ratio
What is the treatment for newborns with ABO incompatability?
Can develop neonatal jauncide, treat with phototherapy
Which seizure type has an aura? Which seizure types have automatisms?
Partial seizures. Complex parital seizures.
Which seizure type can have deja vu and No loss of consciousness?
Simple partial seizures
What is the presentation of peptic ulcer diseae?
Epigastric pain, nausea, early satiety in association with food. Melena which is a common cause of PUD.
What contraceptives are contraindicated in pregnancy? What are other contraindications to these meds? What is the best substitute?
All hormone containing contraceptives. Migraine, smoker, >160/100, history of thromboembolic disease, stroke, breast cancer, major surgery with immobilization. Copper IUD
What is the most reliable sign for vertebral osteomyelitis? What else is elevated? Best test?
Tenderness to gentle percussion. ESR and CPK. MRI. Suspect in drug users
What is the pathophysiology and presentation of lacunar strokes?
Microatheroma formation and lipohyalinosis in small penetrating arteries of teh brain. Pure motor hemiparesis since they often affect internal capsule.
What is a common sideeffect of methotrexate?
Macrocytic anemia, nausea, stomatitis, rash, hepatotoxicity, interstitial lung disease, alopecia and fever
What is the CSF findings of Viral encephalitits? Treatment?
Elevated white count with a lymphocytic predominance, normal glucose and elevated protein concentration. Start acyclovir
How is PEEP calculated? Plateau pressure?
PEEP is calculated with end expiratory hold maneuver. Plateay pressure is sum of elastic pressure and PEEP
What is teh criteria for diagnosing ADHD?
Inattention, impuslivity and hyperactivity in 2 or more settings
What should you administer with Thiamine in Wernicke patients?
Glucose
What medication is administered to bipolar patients who have renal dysfunction?
Valproate instead of Lithium
What is the management of patients with BPH?
Do urine culture and recal exam to assess for UTI and hematuria. Patients with life expectance > 10 years should have PSA.
What is the presentation of aplastic crisis in sickle cell patients?
Acute severe anemia (pallor, weakness, functional murmur), sudden drop in hemoglobin with a very low retic count (
What is the presentation and biopsy findings in HSP?
palpable purpura, arthralgias, abdominal pain and renal disease. IgA deposition in the mesangium
Which nerve is injured in midshaft fracture of humerus?
Radial nerve
What is unique about ischemic hepatic injury?
Occurs in the setting of hypotension with massive increases in AST and ALT with MILDER associated increases in total bilirubin and alkaline phosphatase.
What is the most common etiology of Mallory-Weiss teat?
Sudden increase in abdominal pressure from forceful weritching, Mucosal tear (longitudinal laceration) in esophagus or stomach, Risk factors are hiatal hernia and alcoholism.
What are long term neurologic sequale associated with bacterial meningitis? Which portion of the brain is affected?
hearing loss, loss of cognitive function (2/2 neuronal loss in the dentate gyrus of the hippocampus), seizures, mental retardation, spasticiy
What is the immediate treatment and long term treatment for panic attack?
Immediate - Benzodiazepine. Long term - SSRI/SNRI &/or cognitive behavioral therapy
What are the LH levels in gonadotropin independent (peripheral) precocious puberty? What can cause it?
Low. Late onset non classic CAH (21 hydroxylase deficiency).
What is the first test when you observe hypokalemia in a person taking diuretic?
Measure plasma renin activity and aldosterone concentration
What are the clinical features in silent thyroditis? Diagnostic test findings?
Mild brief hyperthyroid phase, mildly enlarged gland, spontaneous recovery,. Positive TPO antibody, low radioiodine uptake.
What is the presentation of Herpes Zoster opthalmicus?
Dendriform corneal ulcers and a vescular rash in the trigeminal distribution
What are the most common causes of secondary digital clubbing?
Lung malignancies, CF, R-L cardiac shunts
What is the presentation of ADPKD?
Multiple renal cysts and intermittent flank pain, hematuria, UTIs and nephrolithiasis
What is the distinction between case control and retrospective cohort studies?
Case control determines outcome first and looks for associated risk factors. Retrospective cohort checks risk factors first then determines outcomes.
What is the management of BPP 6/10? BPP 8/10? How often do gestational hypertensives require monitoring?
Repeat in 24 hours. Repeat in a week. Weekly BPPs starting at 32 weeks.
What is the inheritance, clinical presentaiton, comorbidities and prognosis of myotonic muscular dystrophy?
AD expansion of CTG trinucleotide repat in DMPK gene on chromosome 19q 13.3 . Onset at age 12-30. Facial weakness, hand grip, myotonia, dysphagia.
What is the comorbidities and prognosis of myotonic muscular dystrophy?
Arrhythmias, cataracts, balding, testicular atrophy/infertility. Death from respiratory or heart failure
What is the comorbidities and prognosis of Duchenne vs Becker muscular dystrophy?
Duchenne - scoliosis, cardiomyopathy (death @ 20-30 from respiratory or HF)
Becker - cardiomyopathy (death @ 40-50 from HF)
What is the common complication of glucocorticoid use in patients presenting with groin pain?
Osteonecrosis (avascular necrosis) of the femoral head.
What is the management of patients with acute arterial occlusion?
Anticoagulation with IV heparin
What is the management of patients with acute low back pain?
Moderate activity plus NSAIDS. Physical therapy is persistent pain (6-12 weeks or longer)
What CD4 count for Toxoplasmosis? Treatment?
CD4
What is the most common cause of health care associated infective endocarditis?
Staph infection
What is the most common cause of community acquired infective endocarditis?
Streptococcal infection
What is the most common cause of dental care associated infective endocarditis?
Viridians group strep (S mitis, S oralis, S mutans, S sanguinis, S milleri)
What malignancy can hereditary hemochromatosis lead to?
Cirrhosis which can increase risk for hepatocellular carcinoma
What are the symptoms and treatment for diabetic gastroparesis?
Anorexia, nausea ,vomiting, early satiety. Prokinetic agents (metoclopramide, erythromycin, cisapride)
What is the presentation of congenital aromatase deficiency?
Prevents conversion of androgens to estrogens. It causes gestational maternal virilization and virilization of XX fetusus. Also high levels of FSH/LH
What is the presentation of neonatal tetanus?
Infants born to unimunized mothers, frequently following umbilical stump infection. Neonates present with poor sucking and fatigue, followed by rigidity, spasms and opisthotonus
When is endometrial biopsy indicated?
- Women > 45 and all post menopausal women,
2. women
What organism causes CF before 20 years? after 20 year old?
Staph aureus. Pseudomonas.
What is the etiology of plantar warts?
HPV infection. Can be painful when walking or standing.
