II Flashcards
clinical features glucagonoma
necorylytic migratory erythema-- with central clearing DM GI symptoms weight loss ataxia, dementia
Neuroleptic malignant syndrome cause
1st gen antipsychotics
cause of death with anaerobic infection in mouth from teeth
asphyxiation
need to intubate
digital clubbing and COPD
hypertrophic OA
sudden onset arthropathy
need CXR for underlying cause
hydatid cyst
echinococcus granulosus
dogs-tapeworm that makes cyst in liver, calcified
Tx for migraine
prochloperazine
NDAIDs or Triptans
clinical features of thyroid storm
fever high tachycardia HTN agitation delirium goiter lidlag tremor nausea vomiting diarrhea
acute Tx thyroid storm
beta blocker
PTU with iodine
glucocorticoids
next step in finding a painless hard testicular mass
take it out
Amyloidosis in kidneys can be secondary to
inflammatory arthritis chronic infections IBD malignancy vasulitis
acute Tx cluster HA
100% O2
meds that inc theophylline (COPD) toxicity
ciprofloxacin
healthy patient gets venous trhomboembolism out of blue, next step after anticoag therapy
CT chest abdomen and pelvis to look for cause– malignancy
tick borne illness looks like malaria
asplenic patient with jaundice
babebiosis
do giemsa stain and thin blood smear
Tx babesiosis
quinine-clindamycin
atovaquone-azithromycin
signs of zenker diverticulum
dysphagia, coughing, regurg, halitosis, neck mass
causes of zenkers diverticulum
sphincter dysfunction and esophageal dysmotility
rubella vs measles
rubellas rash is quick head to toe. measles is drawn out and with higher fever
necrotic nasal septum with maxillary infection
what bacteria
rhizpous, mucormycosis
vaccines for asplenic patients
pneumococcal, haemophilus, meningococcal
and before operations take penicillin
also penicillin 3-5 years post splenectomy
Dx for toxic megacolon
XR of colonic distention + >3:
- fever>38
- HR >120
- Neutrophils 10.500
- Anemia
must have 1:
- volume depletion
- altered sensorium
- electrolyte disturbances
- hypotension
bacteria in urinary tract that canc ause infective endocarditis
enterococcus
signs chikungunya
high fevers, polyathralgias
HA myalgias, conjunctivitis, maculopapular rash
lymphopenia, thormbocytopenia and inc liver enzymes
Whipples disease
chronic malabsorptive diarrhea non deforming arthritis lymphadenopathy damage to eye CNS and myocardium Tropheryma whippelii small intestine Bx shows PAS + macrophages
cause of ipsilateral ataxia
cerebellar tumor
patient walking with legs wide apart
feet lifted higher than usual and have a foot drop
tabes dorsalis
how is the gait in a hemiparesis patient
will swing leg in semi circle with it extended and affecte arm is adducted
waddling gait
due to affected gluteal muscles
seen in muscular dystrophy
Trichinellosis
abdominal pain, nausea, vomiting diarrhea
then up to 4 weeks later
myositis, feer, subungal splinter hemorrhages, periorbital edema
eosinophila and maybe increased CPK
Acute mitral regurg
probably papillary muscle rupture
increased left atrial pressure
endopthalmitis
most commonly postoperative within 6 weeks surgery
pain and decreased visual acuity, swollen eyelids and conjunctiva, hypopyon, corneal edema and infection
when do you not take away beta blockers, Ca channels in nitrates for a stress test
when they have known CAD
symptoms signs of gestational trophoblastic disease
irregular vaginal bleeding, enlarged uterus, pelvic pain
malignant forms of gestational trophoblastic disease
invasive gestational trophoblastic neoplasia and choriocarcinoma
most common place for mets of a choriocarcinoma
lungs
have SOB and dyspnea
Dx lab for choriocarcinoma
beta hCG
Cause of death in someone with acromegaly
congestive cardiac failure from high GH and IGF-I !!!!!!! strokes colon CA renal failure adrenal failure
lab clues for legionella pneumonia
hyponatremia
hepatic dysfunction
hematuria and proteinuria
sputum gram stain many neutros, few microorganisms
ichthyosis vulgaris
gradual progression to dry scaly skin
hereditary or acquired
all over limbs with horny plates
what causes the hypoxemia in penumonia
increase in alveolar arterial oxygen gradient
warfarin inhibits what
vit K dependent clotting factors II VII IX X and protein C and S
paresthesias in someone who receieved blood transfusion
the citrate in the transfused blood chelates Ca
most common cause of disappearing bile ducts
primary biliary cirrhosis
most common causes of acute liver failure
acute viral hepatits, acetominophen toxicity or ischemic hepatopathy
elevated serum protein with normal albumin
multiple myeloma
amyloidosis
waldenstroms macroglobulinemia
monoclonal gammopathy of undetermied significance
how to differentiate multiple myeloma from monoclonal gammopathy of undetermined significance
MM >10% plasmacells in bone marrow and >3 g/ml protein
MGUS is opposite.
how to Dx esophgeal perforation
water soluble esophagram
elderly with smudges cells
CLL
skin signs of sarcoidosis
erythema nodosum and eveitis
what type of cardiac failure is caused by AV fistual
high output because shunting blood increasing preload
