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hammer9 Flashcards

1
Q

What are the symptoms of amphetamine intoxication?

A

Agitation, irritability, paranoia or delirium, chest palpitations and tachycardia, HTN, diaphoresis and mydriasis

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2
Q

What are the symptoms of heroin withdrawal?

A

Muscle spasms, joint pain, nausea and vomiting, diarhea, abdominal cramps, rhinorrhea, lacrimation adn sweating

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3
Q

What is the workup of acute bacterial prostitis? What is the treatment?

A

Do a mid stream urine sample. Tx - TPM-SMX or fluoroqunilones for 4-6 weeks

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4
Q

What are the features of adenomysis?

A

Dysmenorrhea, heavy mesntrual bleeding with progression to chronic pelvic pain, boggy, tender, uniformly enlarged uterus

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5
Q

What are findings in dermatomyositis/polymyositis?

A

Muscle fiber injury. Symmetrical and proximal muscle weakness. Interstitial lung disease, esophageal dysmotility, Raynaud phenomenon, polyarthritis, Skin findings like gottron papules and heliotrope rash

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6
Q

What are findings in Lambert-Eaton syndrome?

A

Proximal muscle weakness, autonomic dysfunction, cranial nerve involvement, DIMINISHED or absent DTR

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7
Q

Which nerve is damaged during parotid surgery? Which nerve causes jaw assymetry?

A

Facial nerve.V3 of trigeminal nerve

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8
Q

What is the treatment for Paget disease of bone? What are clinical features?

A

Bisphosphonates. Spinal stenosis, radiculopathy, long bone bowing, fracture, arthritis Giant cell tumor, osteosarcoma.

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9
Q

What are the indications to put patients on statin therapy?

A

Age 40 - 75 with diabetes, LDL > 190, 10 year ASCVD > 7.5, clincially significant atherosclerotic diseae

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10
Q

What happens to elderly patients who are predisposed to prerenal azotemia?

A

Intravascular volume depletion, poor renal perfusion, worsening of GFR and renal function.

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11
Q

What is the diference between trichomoniasis and bacterial vaginosis in terms of inflammation and erythema?

A

Trichomoniasis has inflammation. Both have pH > 4.5, only candida has normal pH.

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12
Q

What are clinical findigns of hereditary hemochromatosis?

A

Chondrocalcinosisi pseudogout, chronic arthopathy, diabetes, liver disease.

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13
Q

What are the inheritance mode and findings in osteogenesis imperfecta?

A

Blue sclerae, hearing loss, recurrent fractures, opalescent teeth. Autosomal dominant and norma intelligence

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14
Q

What are lab findings (Ca, P, PTH) in osteomalacia 2/2 vitamin D deficiency?

A

low Ca, low P, increased PTH

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15
Q

What are the risk factors for milk/soy protein induced colitis? Clinical features? Treatment and prognosis?

A

Family hx of allergies, eczema or asthma. Presents ate age 2 - 8 weeks with regurgitation or vomiting, +/- painless bloody stools, +/- eczema. Elimination, inititation of hydrolyzed formula in formula fed infants. Spontaneous resolution by age 1 year.

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16
Q

Which organisms cause osteomyelitis in children with sickle cell?

A

Salmonella and staph aureus

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17
Q

What is the workup of secondary hypogonadism in males?

A

Serum prolactin, transferrin, MRI

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18
Q

What are the findings in optic neuritis?

A

Central scotoma, afferent pupillary defect, changes in color perception and decreased visual acuity.

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19
Q

What are ECG, imaging and JVP findings in constrictive pericarditis?

A

nonspecific or afib or low voltage QRS, imaging shows pericardial thickening and calcification. JVP shows prominent x and y descents.

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20
Q

What are teh CT brain findings in Alzhemier with MMSE

A

Diffuse cortical and subcortical atrophy which is greater in the temporal and parietal lobes

21
Q

What are teh symptoms and imaging findings in frontotemporal dementia?

A

Mute, immobile, incontinent. Marked atrophy of frontal and temporal lobes on CT.

22
Q

What is the murmur of tricuspid regurgitation and what makes it louder?

A

Holosystolic and gets louder with inspiration

23
Q

What are teh two major causes of acute pancreatitis and what is the first step in diagnosis?

A

Gallstones and chronic alcohol use. Abdominal ultrasound

24
Q

What is the etiology and treatment for patietns with febrile neutropenia (

A

Pseudomonas, pip-tazo

25
Q

What is the major cause of duodenal ulcers and how is it treated?

A

H.pylori or NSAIDS. Acid suppression and antibiotic eradication therapy.

26
Q

What is the progression of acne treatment?

A
  1. Topical retinoids, salicylic 2. topical antibiotics 3. Oral antibiotics 4. oralisotretinoin
27
Q

Who should get tetanuspdipteria toxoid vaccine? tetanus immune globulin?

A

Severe or dirty wounds who received a booster > 5 years and those with minor clean wounds who received a booster > 10 years ago. TIG for dirty wound and unclear/incomplete immunization history

28
Q

Where do neuroblastomas arise adn what are teh imaging and lab findings?

A

Neural crest cells. Most commonly in abdomen, calcifications and hemorrhages are seen and elevated serum adn urine catecholamines adn their metabolites (HVA and VMA)

29
Q

What is the best way to prevent prenatal conjuctivitis from chlamidya?

A

Maternal prenatal testing.

30
Q

What is the presentation adn imaging findings of progressive multifocal leukoencephalopathy?

A

HIV patints with focal neurological signs and multiple non-enhancing lesions with no mass effect. Stroke in HIV patinets

31
Q

What is the most common congenital GI tract anomaly in children and what does it usually present with? Tx?

A

Meckel diverticulum presentign between epidodes of telescoping. Surgical resection.

32
Q

What sign is specific for renovascular hypertension? What are other signs implicated?

A

Presence of an abdominal bruit. Resistant HTN and diffuse atherosclerosis, assymetic kidney size, recurrent flash pulmonary edema and elevation in serum creatinine > 30%

33
Q

What are teh best treatment for cancer induced anorexia/cachexia?

A

Progesterone analogues such as megesterol acetate and medroxyprogesterone acetate

34
Q

What is the presentation of prepatellar bursitis? which organism is implicated?

A

Anterior knee pain, tenderness, erythema and localized swelling in repetitive kneeling. 2/2 staph aureus

35
Q

What are early findings in Alzheimer?

A

memory loss, visuospatal deficits (getting lost), landuage difficulties, cognitive impairement

36
Q

What are late findings of Alzhemier disease?

A

Neuropsychiatric halluciations, dyspraxia, lack of insight regarding deficits, non cognitive neurologic deficits, urinary incontinence

37
Q

What is the imaging findings of advanced ovarian cancer and what is the management?

A

Pelvic mass and ascites. Exploratory laparotomy.

38
Q

What are nasal polyps often associated with and what kind of symptoms do they cause?

A

Chronic rhinosinusitis, asthma, aspirin induces bronchospasm. Cause symptoms of bilateral nasal obstruction, nasal discharge and anosmia.

39
Q

Which meds are used to treat acromegaly and what are their mechanisms?

A

Cabergoline to inhibit GH release
Octeorotide to inhibit GH release
Pegvisomant inhibits IGF release from the liver, is a GH receptor antagonist

40
Q

What hormone is usually cosecreted with Growth hormone? Which CCB increases its level?

A

Prolactin. Verapamil

41
Q

Which medications cause hyperprolacintoma?

A

Antipsychotics, methyl dopa, metoclopromide, opioids, TCAs and Verapamil

42
Q

What is the presentation in men and women with high prolactin?

A

Women have galactorrhea, amenorrhea, infertility and men have ED and decreased libido

43
Q

What four tests are done prior to getting an MRI for prolactin? Treatment?

A

TFT, pregnancy test, BUN/Creatinine, LFTs. Treatment is with Cabergoline preferred over bromocriptine

44
Q

Which process is elevated during hypothyroidism?

A

Menstrual flow

45
Q

When do you replace thyroid hormone? When do you test for antithyroig per oxidase/antithyroglobulin?

A

When TSH is very high more than double with normal T4. When TSH is less than double

46
Q

Which is the only case in hyperthyroidism where TSH is elevated and where RAIU is elevated?

A

Pituitary adenoma. Graves.

47
Q

What is the treatment for acute hyperthyroidism or thyroid storm?

A

Propranolol to block peripheral conversion. Methimazole and PTU. Iodinated contrast material to block peripheral conversion and release. Steroids.

48
Q

What is the treatment for Graves opthalmopathy?

A

Steroids, radiation for those not responding, de compressive surgery for severe cases.

49
Q

What is the management of a thyroid nodule?

A

Perform TFT, if tests are normal biopsy. If nodules are greater than 1 cm, biopsy. If TSH is low, do iodine 123 scintigraphy and if nodule is hot, treat, if it is cold FNA.

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