High Yield Monday

Question 1

Systolic-diastolic bruit in upper abdomen

Answer 1

Pt likely has renal artery stenosis

- see resistant HTN

Question 2

Descending aortic aneurysm risk factors:

Answer 2

Smoking
HTN
Hypercholesterolemia

Question 3

What do vagal measures do?

• carotid sinus massage
• cold water immersion
• valsalva maneuver

Answer 3

Increase parasympathetic tone in the heart
- slow conduction through AV node

Can terminate AVNRT (most common form of PSVT)

Question 4

Reflex syncope

• causes
• types of response

Answer 4

Pee/poop/cough

• think cardioinhibitory response
• think vasodepression response
• or think mixed

Question 5

Factors contributing to orthostatic hypotension?

Answer 5

Loss/decrease of

• baroreceptor sensitivity
• arterial stiffness
• NE content of sympathetic nerve endings
• sensitivity of myocardium to sympathetic stimulation

Question 6

A-fib is normally caused by abnormality in?

Answer 6

Pulmonary veins

- site of ectopic foci that causes AF

Question 7

Epistaxis and claudication…

- what have in common?

Answer 7

Can both be caused by coarctation

• high pressure to the head
• low pressure to the LE

Question 8

Sarcoid manifests where?

Answer 8

Lungs - obviously
Skin lesions
Eye lesions
Bilateral hilar adenopathy
Joint lesions

Question 9

What is erythema nodosum?

Answer 9

Painful, erythematous nodules
- often on lower legs
- red or pigmented
(sarcoid, fungal infections)

Question 10

What is sacroidosis?

Answer 10

Multi-system
Granulomatous disorder
Non-caseating granulomas

Question 11

Where do you see sarcoid beyond lungs, skin and eyes?

Answer 11

Liver - hepatomegaly
Spleen - splenomegaly
Lymph nodes - hilar, paratracheal,
Joint - polyarthritis (bilateral ankle joints)

Question 12

Acute uveitis
Acute polyarthritis
Erythema nodosum

Answer 12

Sarcoid - the granulomatous disease

(non-caseating)

Question 13

Hilar adenopathy
Migratory polyarthralgia
Erythema nodosum
Fever

Answer 13

Lofgren syndrome
- seen in women

Men may have bilateral ankle arthritis w/out the EN

Question 14

Most common electrolyte imbalance in sarcoid?

Answer 14

Calcium
 - stones
 - hypercalcemia
 - hypercalciuria
Calcium deposition can lead to CKD/ESRD

Question 15

What kind of kidney dysfunction is caused by sarcoid?

Answer 15

Interstitial nephritis

• normal glomeruli
• noncaseating granulomas

Question 16

What kind of GN can sarcoid cause?

Answer 16

Membranous
Proliferative/crescentic
FSGS

Question 17

Causes of Erythema Nodosum?

Answer 17

IBD
Sarcoid
TB
Leprosy
Histo / Blasto / Coccidio