HARDEST TO REMEMBER STUFF Flashcards
Target LDL in a patient with diabetes
70
The most common cause of HTN in young people
Men: alcohol
Women: OCPs
Flat-topped papules (6 Ps)
Lichen Planus (possibly autoimmune but sometimes there are triggers)
Headache, weakness, and polyuria; exam reveals hypertension and tetany, labs show hypernatremia, hypokalemia and metabolic acidosis
Primary hyperaldosteronism (Conn’s syndrome or bilateral adrenal hyperplasia)
“Dewdrops on a rose petal,” “teardrops”
Primary varicella (chickenpox)
Why are B blockers contraindicated in diabetics?
They can mask symptoms of hypoglycemia
The percentage of cases within 2 SDs of the mean
95.4%
Diagnostic modality when US is equivocal for cholecystitis
HIDA scan
Diarrhea organisms:
- Most common
- Recent antibiotic
- Camping
- Traveler’s
- Church picnics/mayo
- Uncook hamburgers
- Fried rice
- Poultry/eggs
- Raw seafood
- AIDS
- Psuedoappendicitis
- Most common: campylobacter
- Recent antibiotic: C diff
- Camping: giardia
- Traveler’s: ETEC
- Church picnics/mayo: S aureus
- Uncook hamburgers: E coli O157H7
- Fried rice: Bacillus cereus
- Poultry/eggs: Salmonella
- Raw seafood: Vibrio, HAV
- AIDS: Isospora, Cryptosporidium, MAC
- Psuedoappendicitis: Yersinia
Charcot’s triad
RUQ pain, jaundice, fever/chills–ascending cholangitis
- Pure RBC aplasia?
- Anemia associated with absent radii and thumbs, diffuse hyperpigmentation, cafe au lait spots, microcephaly, macrocytic anemia, and pancytopenia (congenital marrow failure)?
- Diamond-Blackfan anemia
- Fanconi’s anemia
HUS triad?
Anemia, thrombocytopenia, and acute renal failure
Treatment for TTP
Plasmapheresis, corticosteroids, antiplatelet drugs. Platelet transfusion is contraindicated.
A late, life threatening complication of CML
Blast crisis (fever, bone pain, splenomegaly, pancytopenia)
Auer rods on blood smear
AML
Treatment for neonatal meningitis
Amp and gent
Treatment for meningitis in infants
Cefotaxime (or ceftriaxone?) and vancomycin
Ring enhancing brain lesions on CT with seizures
Taenia solium (cysticercosis)
Organism associations:
- Branching rods in oral infection
- Painful chancroid
- Raw pork and skeletal uscle cysts
- Sheepherders with liver cysts
Organism associations:
- Branching rods in oral infection: actinomyces (penicillin)
- Painful chancroid (haemophilus ducreyi)
- Raw pork and skeletal muscle cysts (trichinella spiralis)
- Sheepherders with liver cysts (echinococcus granulosus)
A 55 year old man who is a smoker and a heavy drinker presents with a new cough and flulike symptoms. Gram stain shows no organisms. Silver stain shows gram - rods.
Legionella pneumonia (listeria is meningitis in neonates and elderly)
Endocarditis:
IV drug user
Dental procedures
Prosthetic heart valve
Endocarditis:
IV drug user–S aureus
Dental procedures-Strep viridans
Prosthetic heart valve-S aureus or Staph epidermidis
An 11 year old obese AA boy presents with sudden onset of limp.
SCFE (legg-calve-perth is age 4-10). Diagnose with AP and frog leg lateral XRs
Treatment for guillain barre
Plasmapharesis or IVIG–avoid steroids
What % lesion is indication for carotid endarterectomy
70% if stenosis is symptomatic (60% if nonsymptomatic in men)
A 6 year old girl presents with a port wine stain in the V1 distribution as well as with mental retardation, seizures, and ipsilateral leptomeningeal angioma
Sturge-Weber syndrome. Treat symptomatically.
Hyperphagia, hypersexuality, hyperorality, and hyperdocility
Kluver Bucy Syndrome (amygdala)
Antibiotics with teratogenic effects
Tetracycline, fluoroquinolones, aminoglycosides, sulfonamides
Cause of amenorrhea with normal prolactin, no response to estrogen progesterone challenge, and a history of D and C
Asherman’s syndrome (intrauterine adhesions)
Indications for medical treatment of ectopic pregnancy
Patient stable, unruptured,
MOA of danazol, clomiphene, leuprolide
Danazol: estrogen antagonist
Clomiphene: Inhibits estrogen receptors in hypothalamus
Leuprolide: GnRH agonist
Most common cause of bloody nipple discharge
Intraductal papilloma
Paget’s disease of the breast
Underlying ductal carcinoma in situ
Most common cause of infertility
Endometriosis
A newborn with a posterior neck mass and swelling of the hands
Turner syndrome
A 5 month old girl has decreased head growth, truncal discoordination, and decreased social interaction
Rett’s disorder. Loss of milestones.
Med to avoid in patients with PTSD
Benzos (due to high addiction potential)
A violent patient has vertical and horizantal nystagmus
PCP intoxication
Honeycomb patter on CXR. Treatment?
Diffuse interstitial pulmonary fibrosis. Supportive care; steroids may help.
Treatment for SVC syndrome
Radiation
“doughy” skin
Hypernatremia
First line treatment for hypercalcemia
IV hydration (loop diuretics can be used for refractory cases if euvolemic)
Treatment of SIADH
Fluid restriction, demeclocycline if refractory
Treatment for malignant hypertension
Nitroprusside
A burn patient presents with cherry red flushed skin and coma. SaO2 is normal, but carboxyhemoglbin is elevated. Treatment?
Treat CO poisoning with 100% O2
Method of calculating fluid repletion in burn patients
Parkland formula: 24 hour fluids=4xkgx%BSA
Acceptable urine output
30 cc/hr in a stable patient, 50 cc/hr in a trauma patient
Barbiturate antidote
Urine alkalinization, dialysis, activated charcoal
Cyanide antidote
Hydroxycobalamin, amyl nitrate, sodium nitrate, sodium thiosulfate
Digitalis antidote
Normalize K+ and anti digitalis Fab
Iron antidote
Deferoxamine
Methanol/ethylene glycol antidote
Fomepizole or ETOH
Methemoglobin antidote
Methylene blue
Salicylates antidote
Urine alkalinization, dialysis, activated charcoal
TCA antidote
Sodium bicarb for QRS prolongation; diazepam or lorazepam for seizures; cardiac monitoring for arrythmias
tPA antidote
Aminocaproic acid
Black widow bite
Calcium gluconate (also used for hyperkalemia to stabilize heart)
Vitamin A deficiency
Night blindness, dry skin
Vitamin B2 (riboflavin) deficiency
Angular stomatitis, cheilosis, corneal vascularization
Vitamin B5 (Pantothenate) deficiency
Dermatitis, enteritis, alopecia, adrenal insufficiency
Vitamin B6 (pyridoxine) deficiency
Convulsions, hyperirritability, peripheral neuropathy
Vitamin B12 deficiency
Macrocytic and megaloblastic anemia, neuro symptoms (subacute combined degeneration and others), glossitis
Vitamin C deficiency
Scurvy (swollen gums, bruising, anemia, poor wound healing
Vitamin E deficiency
Increased fragility of RBCs
Biotin deficiency
Dermatitis, enteritis. Can be caused by ingestion of raw eggs or antibiotic use
Magnesium deficiency
Weakness, muscle cramps, exacerbation of hypocalcemic tetany, CNS hyperirritability leading to tremors, choreoathetoid movement
Selenium deficiency
Keshan disease (cardiomyopathy)
Zinc deficiency
Alopecia, skin lesions, abnormal taste, impaired wound healing
Anti-CCP
Rheumatoid arthritis
Anticentromere
CREST
Antinuclear/anti-Scl-70/Antitopoisomerase I
Scleroderma
Antihistone
Drug-induced SLE
Anti-Jo-1
Polymyositis/dermatomyositis
Antimitochondrial
PBC
c-ANCA
Vasculitis, especially Wegener’s
p-ANCA
Vasculitis, especially microscopic polyangiitis
Anti smooth muscle
Autoimmune hepatitis
Tumor marker in Breast cancer
CA-15-3 and CA-27-29
Tumor marker in ovarian cancer
CA-125
Tumor marker in pancreatic cancer
CA-19-9
Tumor marker in colon cancer
CEA
Tumor marker in HCC
AFP
Tumor marker of neural cest origin
S-100
Tumor marker of haircy cell leukemia
TRAP
Fatty casts
Nephrotic syndrome
Broad/waxy casts
Chronic renal failure
Endometritis Treatment
Clinda + Gent
Meningitis Treatment
Neonates: Amp + Gent
1 month-60 years: Vanc+3rd gen ceph
60 years and on: Vanc+3rd gen ceph+amp (for listeria
Chorioamnionitis
Amp+Gent
Induction of P450s
Quinidine, Barbiturates, St John’s wort, phenytoin, rifampin, griseofulvin, carbamazepine
Inhibition of P450 enzymes
Cimetidine, ketoconazole, INH, grapefruit, erythromycin, sulfonamides, acetaminophen(?)
Difference between MM and Waldenstroms
Waldenstroms is a hyperviscosity syndrome with elevated levels of IgM
Anemia, renal failure, bone pain, hypercalcemia, infections, elevated monoclonal M proteins
Multiple Myeloma
Bone tumor XR appearances
Osteosarcoma: codman’s triangle, sunburst pattern
Ewing’s Sarcoma: Onion skinning
Giant Cell Tumor: Soap bubble
Chediak-Higashi
AR disorder that leads to a defect in neutrophil chemotaxis/microtuble polymerization. Syndrome of partial oculocutaneous albinism, peripheral neuropathy, and neutropenia
Job’s syndrome
FATED: coarse facies, abscess (staph aureus), retained primary teeth, hyper IgE, dermatologic
C1 esterase deficiency
Recurrent angioedema
Terminal complement deficiency
Recurrent Neisseria infections
Symptoms of lead/Chelation for lead
Irritability, HA, hyperactivity or apathy, anorexia, intermittent abdominal pain, constipation, intermittent vomiting, and peripheral neuropathy
EDTA
Hyperkalemia antidote
Calcium Gluconate (cardiac stabilizer)
