hammer9 Flashcards
What are the symptoms of amphetamine intoxication?
Agitation, irritability, paranoia or delirium, chest palpitations and tachycardia, HTN, diaphoresis and mydriasis
What are the symptoms of heroin withdrawal?
Muscle spasms, joint pain, nausea and vomiting, diarhea, abdominal cramps, rhinorrhea, lacrimation adn sweating
What is the workup of acute bacterial prostitis? What is the treatment?
Do a mid stream urine sample. Tx - TPM-SMX or fluoroqunilones for 4-6 weeks
What are the features of adenomysis?
Dysmenorrhea, heavy mesntrual bleeding with progression to chronic pelvic pain, boggy, tender, uniformly enlarged uterus
What are findings in dermatomyositis/polymyositis?
Muscle fiber injury. Symmetrical and proximal muscle weakness. Interstitial lung disease, esophageal dysmotility, Raynaud phenomenon, polyarthritis, Skin findings like gottron papules and heliotrope rash
What are findings in Lambert-Eaton syndrome?
Proximal muscle weakness, autonomic dysfunction, cranial nerve involvement, DIMINISHED or absent DTR
Which nerve is damaged during parotid surgery? Which nerve causes jaw assymetry?
Facial nerve.V3 of trigeminal nerve
What is the treatment for Paget disease of bone? What are clinical features?
Bisphosphonates. Spinal stenosis, radiculopathy, long bone bowing, fracture, arthritis Giant cell tumor, osteosarcoma.
What are the indications to put patients on statin therapy?
Age 40 - 75 with diabetes, LDL > 190, 10 year ASCVD > 7.5, clincially significant atherosclerotic diseae
What happens to elderly patients who are predisposed to prerenal azotemia?
Intravascular volume depletion, poor renal perfusion, worsening of GFR and renal function.
What is the diference between trichomoniasis and bacterial vaginosis in terms of inflammation and erythema?
Trichomoniasis has inflammation. Both have pH > 4.5, only candida has normal pH.
What are clinical findigns of hereditary hemochromatosis?
Chondrocalcinosisi pseudogout, chronic arthopathy, diabetes, liver disease.
What are the inheritance mode and findings in osteogenesis imperfecta?
Blue sclerae, hearing loss, recurrent fractures, opalescent teeth. Autosomal dominant and norma intelligence
What are lab findings (Ca, P, PTH) in osteomalacia 2/2 vitamin D deficiency?
low Ca, low P, increased PTH
What are the risk factors for milk/soy protein induced colitis? Clinical features? Treatment and prognosis?
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.
Which organisms cause osteomyelitis in children with sickle cell?
Salmonella and staph aureus
What is the workup of secondary hypogonadism in males?
Serum prolactin, transferrin, MRI
What are the findings in optic neuritis?
Central scotoma, afferent pupillary defect, changes in color perception and decreased visual acuity.
What are ECG, imaging and JVP findings in constrictive pericarditis?
nonspecific or afib or low voltage QRS, imaging shows pericardial thickening and calcification. JVP shows prominent x and y descents.
What are teh CT brain findings in Alzhemier with MMSE
Diffuse cortical and subcortical atrophy which is greater in the temporal and parietal lobes
What are teh symptoms and imaging findings in frontotemporal dementia?
Mute, immobile, incontinent. Marked atrophy of frontal and temporal lobes on CT.
What is the murmur of tricuspid regurgitation and what makes it louder?
Holosystolic and gets louder with inspiration
What are teh two major causes of acute pancreatitis and what is the first step in diagnosis?
Gallstones and chronic alcohol use. Abdominal ultrasound
What is the etiology and treatment for patietns with febrile neutropenia (
Pseudomonas, pip-tazo
What is the major cause of duodenal ulcers and how is it treated?
H.pylori or NSAIDS. Acid suppression and antibiotic eradication therapy.
What is the progression of acne treatment?
- Topical retinoids, salicylic 2. topical antibiotics 3. Oral antibiotics 4. oralisotretinoin
Who should get tetanuspdipteria toxoid vaccine? tetanus immune globulin?
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
Where do neuroblastomas arise adn what are teh imaging and lab findings?
Neural crest cells. Most commonly in abdomen, calcifications and hemorrhages are seen and elevated serum adn urine catecholamines adn their metabolites (HVA and VMA)
What is the best way to prevent prenatal conjuctivitis from chlamidya?
Maternal prenatal testing.
What is the presentation adn imaging findings of progressive multifocal leukoencephalopathy?
HIV patints with focal neurological signs and multiple non-enhancing lesions with no mass effect. Stroke in HIV patinets
What is the most common congenital GI tract anomaly in children and what does it usually present with? Tx?
Meckel diverticulum presentign between epidodes of telescoping. Surgical resection.
What sign is specific for renovascular hypertension? What are other signs implicated?
Presence of an abdominal bruit. Resistant HTN and diffuse atherosclerosis, assymetic kidney size, recurrent flash pulmonary edema and elevation in serum creatinine > 30%
What are teh best treatment for cancer induced anorexia/cachexia?
Progesterone analogues such as megesterol acetate and medroxyprogesterone acetate
What is the presentation of prepatellar bursitis? which organism is implicated?
Anterior knee pain, tenderness, erythema and localized swelling in repetitive kneeling. 2/2 staph aureus
What are early findings in Alzheimer?
memory loss, visuospatal deficits (getting lost), landuage difficulties, cognitive impairement
What are late findings of Alzhemier disease?
Neuropsychiatric halluciations, dyspraxia, lack of insight regarding deficits, non cognitive neurologic deficits, urinary incontinence
What is the imaging findings of advanced ovarian cancer and what is the management?
Pelvic mass and ascites. Exploratory laparotomy.
What are nasal polyps often associated with and what kind of symptoms do they cause?
Chronic rhinosinusitis, asthma, aspirin induces bronchospasm. Cause symptoms of bilateral nasal obstruction, nasal discharge and anosmia.
Which meds are used to treat acromegaly and what are their mechanisms?
Cabergoline to inhibit GH release
Octeorotide to inhibit GH release
Pegvisomant inhibits IGF release from the liver, is a GH receptor antagonist
What hormone is usually cosecreted with Growth hormone? Which CCB increases its level?
Prolactin. Verapamil
Which medications cause hyperprolacintoma?
Antipsychotics, methyl dopa, metoclopromide, opioids, TCAs and Verapamil
What is the presentation in men and women with high prolactin?
Women have galactorrhea, amenorrhea, infertility and men have ED and decreased libido
What four tests are done prior to getting an MRI for prolactin? Treatment?
TFT, pregnancy test, BUN/Creatinine, LFTs. Treatment is with Cabergoline preferred over bromocriptine
Which process is elevated during hypothyroidism?
Menstrual flow
When do you replace thyroid hormone? When do you test for antithyroig per oxidase/antithyroglobulin?
When TSH is very high more than double with normal T4. When TSH is less than double
Which is the only case in hyperthyroidism where TSH is elevated and where RAIU is elevated?
Pituitary adenoma. Graves.
What is the treatment for acute hyperthyroidism or thyroid storm?
Propranolol to block peripheral conversion. Methimazole and PTU. Iodinated contrast material to block peripheral conversion and release. Steroids.
What is the treatment for Graves opthalmopathy?
Steroids, radiation for those not responding, de compressive surgery for severe cases.
What is the management of a thyroid nodule?
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.
