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hammer30 Flashcards

1
Q

What are the electrolyte abnormalities in RTA4? What is the etiology?

A

Hyponatrima, hyperkalemia, hypercholeremia, non anion gap metabolic acidosis. DIabetes, primary adrenal insufficiency, renal insuficiency and NSAIDS

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2
Q

What is the presentation and most common etiology of SVC syndrome?

A

Dyspnea and edema of upper face, neck ,chest. Lung cancer

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3
Q

Which antibody is specific for dermatomyositis?

A

Anti Jo 1

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4
Q

What are the findings in acalculos cholecystitis? What are risk factors?

A

New onset RUQ pain, elevated WBC, Elevated LFTs (elevated alk phos). Long illness and TPN

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5
Q

Which patients have germinal matrix hemorrhage?

A

Premature infants with hydrocephalus

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6
Q

What do you use to treat GBS in patients allergic to penicillinanaphylacticaly?

A

Vancomycin. If mild allergy, use Cefazolin

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7
Q

What should you suspect when Ca levels drop rapidly after parathyroidectomy?

A

Hungry bone syndrome (metabolic)

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8
Q

What is the most common cardiac defect in infants of diabetic mothers?

A

Asymmetric septal hypertrophy presenting with low BP, weak pulse, prolonged cap refill. Will improve byitself

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9
Q

What is first and second line treatment of hyperemesis gravidum (HEG)?

A

Pyridoxine-doxylamine. Promethazine and/or ondansetron.

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10
Q

What is the presentation of femoral pseudoaneurysm?

A

Cool lower extremities, absent DP pulses, pulsatile groin mass usually after femoral catheterization

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11
Q

What should you worry about in silicosis patients?

A

30X risk of TB

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12
Q

What is the first step after discovering prolactinoma?

A

MRI to assess tumor

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13
Q

What is the first step after discovering gastroparesis?

A

ENdoscopy

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14
Q

What is the histologic presentation and elevated markers of embyonic carcinoma?

A

Sheets of undifferentiated cells with scant cytoplasm, indistinct cell borders, crowded nuclei, Elevated serum AFP

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15
Q

What is the histologic presentation and elevated markers of choriocarcinoma?

A

Cytotrophoblastic and syncitiotrophoblastic cells resembling papillary villi. Serum bHCG

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16
Q

What is the histologic presentation and elevated markers of seminoma?

A

Large round clear cells with centrally placed nuclei and obvious nucleoli resembling primary spermatocytes. placental alkaline phosphatase

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17
Q

What is the histologic presentation and elevated markers of yolk sac carcinoma?

A

Looks like glomeruli (Schiller Duval bodies)

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18
Q

What is the treatment for patients with hyperkalemia and EKG changes?

A

IV calcium gluconate

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19
Q

What is the first step in managing patients with acute pulmonary edema?

A

100% Oxygen

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20
Q

What is the presentation of acute laryngotracheobronchitis (viral croup)

A

<3 yo, barking cough, inspiratory stridor

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21
Q

What is the treatment of PID in pregnant women?

A

IV clindamycin and gentamycin

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22
Q

What prophylaxis for malaria to Africa travellers?

A

Mefloquine (contraindicated in cardiac and neuropsychiatric patients) or doxycycline.

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23
Q

What vaccines for COPD patients?

A

Pneumococcal and influenza vaccine

24
Q

When do you attempt external cephalic version?

A

Breech presentation after 36 weeks

25
Q

Treatment for acute COPD exacerbation?

A

Systemic steroids, inhaled albuterol and ipratropium, antibiotics against Strep and HIB

26
Q

What is the treatment for emphysematous cholecysttis which can also reflect sound waves 2/2 air presence?

A

Chloecystectomy followed by IV ciprofloxacin and metronidazole

27
Q

What is the imaging modality of choice in AAA in an obese patient or patient with bowel gas?

A

Abdominal CT with contrast

28
Q

What are the indications for hemodyalysis?

A

Potassium > 6.5, profound metabolic acidosis < 7.1, signs of uremia, ams, pericarditis, refractory fluid overload

29
Q

What are the symptoms of Pyridoxine (Vitamin B6 deficiency) and what hematologic disorder is it associated with?

A

Glossitis, angular chelitis, peripheral neuropathy, sideroblastic anemia with low MCV and high serum ferritin. Myelodysplastic syndrome.

30
Q

What are the findings of IgA heavy chain type disease? What is seen in serum electrophoresisi?

A

Abdominal mass and malabsorption syndomre. Decreased gamma and broad alpha 2 and beta chains.

31
Q

Which class of BP medications are useful in treating patients with multiple BP risk factors who are undergoing non cardiac surgery?

A

Betablockers particularly (which is mied alpha and beta blocker) labetalol

32
Q

What are the findings of membranous nephropathy in imaging? Most common etiologies?

A

subepithelial intramembranous IgG and C3 deposits. Chronic infections and drugs.

33
Q

What are the findings of membranoproliferative glomerulonephritis? Which is common etiology?

A

Thickened basement membrane with dense deposits and mesangial cell proliferation. Classic train track and Hep C.

34
Q

When does a dirty wound require a tetanus vaccine?

A

If last one was more than 5 years ago. If it is clean, can wait upto 10 years.

35
Q

What is the recommnede surveillance in ulcerative colitis patients?

A

Annual Colonoscopy with multiple biopsies starting 8 years from diagnosis

36
Q

What is the presentation of Whipple disease and treatment?

A

Diarrhea, arthralgia, endocarditis, CNS dysfunction. Penicillin, ampicillin, TMP/SMX or doxycylcine

37
Q

What are EKG findings of supraventricular tachycardia? Treatment steps?

A

Sinus Tachy > 100 and P waves before QRS complexes. 1. Vagal maneuvers such as Carotid massage (contraindicated if b/l carotid stenosis) .2 Valsalva 3. Drug therapy

38
Q

What are presenting symptoms and signs of good prognosis in juvenile rheumatoid arthritis?

A

Morning stiffness, joint pain and lethargy. Positive Anti Nuclear Antibody

39
Q

What is the treatment for infants with poorly formed loose stools?

A

May have low bile acids 2/2 excretion in stool. Use MC triglycerides instead of long chain because they don’t require bile for absorption

40
Q

What are the two common sites for endometriosis?

A

Ovaries followed by cul-de-sac

41
Q

What is the presentation adn treatmetn of nevus sebaceous?

A

Hamartomatous warty area on scalp . Excise at early age 2/2 malignancy concerns

42
Q

What is the best initial test in subclavian steal syndrome?

A

Measure BP in both arms b/c there is a 15 - 20 mm Hg difference. There are also neurologic signs since the subclavian steals from the vertebral artery.

43
Q

What is the presentation of polyarteritis nodosa? What diseases is it associated with?

A

Constitutional symptoms, arthritis, abdominal pain worsened by eating, CNS changes, skin nodules. Spares lungs. Bx shows focal necrotizing arteritis. Hepatitis B and C.

44
Q

What is second line treatmetn for animal bites?

A

Clindamycin plus (doxicycline or fluoroquinoone or TMP/SMX)

45
Q

Which infections are associated with Reiter’s syndrome?

A

Chalmidya, Yersinia, Salmonella, Shigella, Campylobacter. Treat underlying infection particularly Chlamidya with doxycycline.

46
Q

What is the characteristics and treatmetn of ALS?

A

Upper (motor cranial nuclei) and lower (anterior horn cells of spinal cord) motor neuron deficits. Riluzole

47
Q

What test is done in patietns with coronary disease if the baseline EKG has abnormalities?

A

Stress echo or exercise thallium test

48
Q

How do hepatic adenomas appear on sulfur colloid liver scan? Why? How many of turn malignant?

A

Appear Cold because of lack of Kuppfer cells. 10-15%. Rupture has 20% mortality rate.

49
Q

What are risk factors for cholangiocarcinoma?

A

PSC, chronic parasitic infections, IBD especially UC, chronic cholecystitis, chronic pyogenic cholangitis

50
Q

What is the initial treatmetn for ankylosing spondylitis?

A

NSAIDS such as Indomethacin. TNF alpha antagonists (Etanercept, Inflximab, aldalimumab) are used in advanced disease

51
Q

What is the difference between moderate and severe placental abruption?

A

Moderate - fetal tachycardia, decreased variability, mild/late decelerations, moderate bleeding
Severe - knife like uterine pain with severe bradycardia, severe late deceleration, or fetal death. DIC in 10 - 20 % of cases.

52
Q

What is the initial treatment and EKG finding for Wolf Parkinson White?

A

Procainamide or Amiodarone. Short PR, delta wave and wide QRS.

53
Q

What are the hormone abnormalities in Klinefelter syndomre?

A

Low testosterone, increased FSH and LH

54
Q

What is a subsitiute med if there is HIT?

A

Lepiuridin

55
Q

What are common symptoms in order of frequency in Premenstrual dysphoric disorder?

A
  1. Bloating 2. Breast tenderness 3. Headaches
56
Q

What is the workup of asymptomatic hematochezia in a person < 45 years?

A

Ansocopy and flexible sigmoidoscopy because source is usually distant colon, rectum or anus

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