hammer34 Flashcards
How does metronidazole cause flushing?
Blocks aldehyde dehydrogenase and leads to buildup of acetaldehyde causing a disulfiram reaction.
When is the recommended screening for breast cancer?
> 40 anually or biannually
When is the recommended lipid panel screening?
20-45 if CAD risk factors are present or >45 if CAD risk factors are present
What is acute promyelocytic leukemia associated with?
DIC with elevated D-dimer
What is the presentation of autoimmune hepatitis type 1?
Anti smooth muscle antibodies. Most common type of the disease. It can occur at any age. About half the people with type 1 autoimmune hepatitis have other autoimmune disorders, such as celiac disease, rheumatoid arthritis or ulcerative colitis.
What is the presentation of autoimmune hepatitis type 2?
Anti liver/kidney microsomes. Most common in children and young people.
What is the treatment for unstable vs stable torsade de pointes?
FOr stable - Magnesium sulfate IV, for unstable, unsynchronized cardioversion
What are fundoscopic findings in MS?
1/3 Papillitis and 2/3 normal
What is the mainstay treatment for UC?
Topical mesalamine (5ASA) if not, topical /oral corticosteroids, oral azithioprine, IV corticosteroids and TNF inhibitors
What is management for pregnant woman who was in a car accident but with normal signs nad normal fetal HR?
Have to do electronic fetal monitoring
What is the treatment for acute cocaine induced chest pain?
IV nitroglycerin aspirin and IV benzodiazepines such as diazepam,
Which complements are associated with recurrent gonorrhea infection? SLE? Recurrent encapsulated bacteria infections?
C5 - C9 (MAC).
SLE - C1q
C2 or C3
What steps have to be taken for pregnant patients with mitral stenosis during the second stage of labor?
Use forcep or vaccum assisted delivery to prevent excessive maternal valsalva and tachycardia
Why is buproprion contraindicated in anorexia nervosa?
Decreases seizure threshold
What is the best way to screen for scoliosis?
Forward bending or Adams test
Lab values in gallstone pancreatitis?
Elevated ALT, acute pancreatitis, elevated lipase
Which vessel is occluded when pure motor or pure sensory defect is present?
Posterior limb of internal capsule 2/2 lacunar infarct
What are the findings in vitamin D resistant rickets?
Rickets, low phosphate, slow growth, normal Ca, elevated PTH, vitamin D and alk phos
What is DLCO in emphysema vs chronic bronchitis?
Emphysema has low DLCO and chronic bronchitis has normal DLCO
What structure is compressed in Cushing’s triad?
Brainstem
What is the presentation of neonatal listeriosis?
Neonatal amnionitis, Granuloma with central necrosis, mothers have flu like symptoms. Gram positive bacilli
What is the treatment for pheochromocytoma?
Phenoxybenzamine to block alpha receptors and beta blockers in that order.
What is the most specific test for chronic pancreatitis?
Secretin stimulation test will show no bicarb rich pancreatic fluid
What is RTA Type 2 associated with?
Lytic bone lesions such as from multiple myeloma and carbonic acid anhydrase inhibitor (acetazolamide) use
What is the presentation of Dubin Johnson? What are T-bili and conjugated bili levels?
Jaundice with infections, pregnancy and birth control pills. Associated with defect in secretion of conjugated bilirubin into bile. Total bili is 2 -5 with half being conjugated.
At what levels of fetal scalp pH is repeating indicated and immediate delivery indicated?
7.2 - 7.25 repeating indicated in 15-30 mins
< 7.2 - immediate delivery indicated
What is the most likely outcome of periventricular necrosis 2/2 bleeding of choroid plexus?
Spastic di/quadri plegia
What is the MRI findings of MS? What is transverse myelitis?
Periventricular hyperintensity in T2 weighted images. Total loss of power and reflex below the level of the lesion
What is the treatment for PSGN? What are the EM findings?
Supportive treatment. Subepithelial humps.
What are sideeffects of prochloroperazine and treamtnet?
Extrapyramidal effects caused by this anti emetic med. Parkinson meds such as Benztropine
What is the presentation of brain stem gliomas?
Neck stiffness proceeding to torticollis
What is the presentation of Yersinia entercolitis?
RLQ pain plus diarrhea
What is the difference in managemenet between mentus anterior vs posterior in normal pregnant contraction patient?
Mentus posterior needs c section while anterior can have regular vaginal delivery.
What is the interpretation of the booster effect in TB?
Happens in people who have had prior TB infections so that when PPD is repeated, the induration gets larger and the second PPD is the true result.
What is needed to see oocysts in cryptosporidum diarrhea?
Acid fast stain. Bx shows spores on the tips of the infected villi.
What is the rate of vertical transmissionin untreated mothers, antiretroviral therapy alone, or antiretroviral therapy plus scheduled c-section?
25%, 8 %, 2 %
What is the most common complication of mumps in prepubertal children?
Meningioencephalomyelitis
What vessels cause hemorrhage in diverticulosis?
Single arteriole weakened by outpouchings of colon
What nerve is damaged if there is decreased sensation of lower chin and jaw?
Inferior alveolar nerve (branch of third trigeminal nerve) that passes through the mandibular foramen
What are common causes of nephrotic syndrome?
DM, Lupus, Hepatitis, toxins, amyloidosis
What is the pathophysiology of Kallman syndrome?
Congenital gonadotropin releasing hormone deficiency
When is immediate cholecystectomy required vs cholecystectomy in 24-48 hours?
IF fever is progressive fever, intractable pain, perforation, suspected gangrene or perforation
What are Right side EKG findings in R sided infarcts
ST elevation in V4 so give IV fluids
What is the major cause of morbidity and death in PV?
Acute thrombosis
Describe pyogenic granuloma
Rapidly enlarging, red, vascular papule with collarette of scale that is benign and bleeds easily
What is the age to screen for diabetes?
> 45
How do NSAIDS induce bronchospasm?
Increasing the production of leukotrienes and blocking prostaglandin and prostacyclin production by inhibiting cyclooxygenase
What is the most common valvular disease?
MVP
What is the treatment of infantile spasms 2/2 Tuberous sclerosis?
ACTH
What are the hematologic parameters in Glanzman thrombasthenia?Bernard Soulier?
Increased bleeding time. Normal response to risoctecin but decreased response to ADP and epinephrine. Opposite of GT
What tests should you do in nephrotic syndrome?
Hepatitis
What is the difference in Na levels in DI vs psychogenic polydipsia/
Na is high in DI and low in psychogenic polydipsia.
Which antibody presence is helpful in Juvenile Rheumatoid Arthritis?
Positive ANA
