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OBGYN, PSYCH, PEDS > IM 2 > Flashcards

IM 2 Flashcards

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1
Q

compare CML to LR

A

LR has HIGH alk phsophatase score, greater proption fo late neutrophil precursors, lack of absolute basophilia

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2
Q

tx of hepatic encephalopathy

A

lactulose

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3
Q

AMS, nystagmus and ataxia in alcoholic

A

thiamine deficiency with wernicke encephalopathy

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4
Q

why glucagon in tx of BB or CCB OD

A

incrased cAMP, corrects refractory hypotension if pt doesn’t initially respond to atropine and fluid boluses

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5
Q

phenytoin toxicity

A

horizontal nystagmus, ataxia, N/V, AMS

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6
Q

old person on a medication with recent addition and now new sx

A

think medication interaction

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7
Q

isolated thyrombocytopneai, mucocutaneous bleeding, easy bruising, IgG autoantibodies against platelet membrane glycoproteins

A

ITP

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8
Q

ADAMTS13

A

TTP = thrombocytopenia + MAHA

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9
Q

degeneration of GABA producing neurons in caudate nucleus and putamen

A

HD

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10
Q

rectangular, envelope-shaped calcium oxalated crystals in pt with AMS

A

eythlene glucol poisoning

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11
Q

pt presents with concern of dropping left face. how to differentiate peripheral vs central nerve lesions?

A 
central = upper facial muscles are spared due to compensation from the unaffected hemisphere
peripheral = bell palsy = weakness of the entire half of the face
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12
Q

screening and dx test for MM

A 
screen = serum or urine protein electrophoresis, free light chain analysis
diagnosis = BM biopsy
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13
Q

following MI, develops sx of HF, refractory angina, ventricul arrythmias, functional MR, mural thrombus and ECT shows persistent ST elevation and deep Q waves

A

ventricular aneurysm, late MI complication

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14
Q

presentation of MR after MI

A

due to papillary muscle rupture, 2-7 days post MI, presents dramatically with acute, severe MR (hypotension, pulmonary edema, cardiogenic shock)

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15
Q

what are untreated hyperthyroid pts at risk of?

A

rapid bone loss from increased osteoclastic activity, cardiac tachyarrhythmias, including afib

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16
Q

microcytic anemia, HTN, neprhopathy, hyperuricemia, basophillic stippling on peripher smear

A

lead toxicity, tx is EDTA chelation

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17
Q

anti-TPO antibodies

A

Hashimoto’s thyroiditis; also associated with increased risk of miscarriage

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18
Q

anti-mitochondrial Ab

A

primary biliary cholangitis

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19
Q

phenytoin can lead to megaloblastic anemia and gingival hyperplasia due to impaired absorption of _____

A

folic acid

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20
Q

vitamin B1

A

thiamine

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21
Q

HIV pt with severely advanced disease (CD4<100) and lung symptoms

A

progressive disseminated histoplasmosis; get urine or serum histoplasma antigen assay

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22
Q

fevers, chills, malaise, weight loss, cough, dypsnea, mucocutaneous lesions, LAD in pt with HIV

A

disseminated histoplasmosis; tx is amphotericin

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23
Q

HTN, mild hypernatremia, metabolic alkalosis, suppressed plasma renin activity

A

primary hyperaldosteronism

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24
Q

how to distinguish benzos from opioid OD

A

benzo = lack of severe respiratory depression and pupillary constriciton

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25
Q

leaning on elbows, decreased sensation over the 4th and 5th fingers, weak grip

A

ulnar entrapment

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26
Q

antiGBM

A

goodpasture’s syndrome

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27
Q

hemolysis (elevated bili and LDH), cytopenias, hypercoagulable state (venous thrombosis), flow cytometry with absence of CD55 and CD59

A

paroxysmal noctural hemoglobinuria

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28
Q

____ is an impt cause of RHF, characterized by progressive peripheral edema, scites, elevated JVP, pericardia knock, and pericardial calcifications

A

constrictive pericarditis

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29
Q

middiastolic sound

A

pericardial knock

30
Q

fever, generalized muscle rigidity, autonomic instability, mental status changes

A

neuroleptic malignant syndrome - typically due to dopamine antagonists

31
Q

why infxns in MM

A

hypogammaglobulinemia

32
Q

in what cond’ns should hospitalized pts be taken off metformin

A

acute renal failure, liver failure, or sepsis; all increase risk of lactic acidosis

33
Q

monotherapy for bipolar

A

lithium, valproate, quetiapine, lamotrigine

34
Q

recommended therapy for severe bipolar

A

dual therapy = lithium/valproate + second generation like quetiapine/lamotrigine

35
Q

first line tx for mania

A

olanzapine (antipsychotic), lithium, valproate (anticonvulsant mood stabilizer)

36
Q

this antipsychotic can be administered IM and has acute onset of action, making it ideal for tx of acutely manic/behavioral agitationJJj pts

A

olanzapine

37
Q

these two rxs can be used for tx of drug-induced parkinsonism (type of EPS)

A

benztropine and amantadine

38
Q

what type of EPS does propranolol tx

A

akathisia

39
Q

what class of psychiatric rx can lead to galactorrhea, menstrual irregularities and infertility?

A

antipsychotics (block dopamine 2 receptors, leading to resultant prolactin increase)

40
Q

name some antipsychotics

A

haloperidol, fluphenazine, risperidone, paliperidone, aripiprazole

41
Q

MUDPILES

A 
Methanol
Uremia
DKA
Paraldehyde
Isoniazide
Lactic acidosis
Ethylene glycol (anti-freeze; see crystals)
Salicylates
42
Q

Non Gap Acidosis

A

Diarrhea (poop out bicarb = metabolic acidosis)
Abuse/overuse of diuretics
RTA

43
Q

numbness, prolonged QT

A

hypocalcemia

44
Q

bones, stones, groans, shortened QT

A

hypercalcemia

45
Q

what to check if concerned about CO poisoned?

A

carboxyhemoglobin, tx is 100% O2

46
Q

young person who clots

A

Factor V Leiden

47
Q

normal platelets but increased bleeding and PTT

A

vWD

48
Q

tx of burns, doesn’t penetrate eschar, can cause leukopenia

A

silver sulfadiazene

49
Q

this topical rx for burns also doesn’t penetrate eschar, but causes hypokalemia and hyponatremia

A

silver nitrate

50
Q

of the three topical tx for burns, this one does penetrate eschars

A

mafenide `

51
Q

what will kill you from electrical burn

A

arrhytmia, look at EKG

52
Q

urine + for blood but no RBCs

A

myoglobinuria, MUST CHECK K in evaluation of rhabdo as arrhtyhmia can kill you

53
Q

GCS < 8

A

intubate

54
Q

trauma, blood at urethra, high-riding prostate

A

evaluate with retrograde urethrogram, followed by retrograde cystogram if negative.

55
Q

bugs of nec fasc

A

strep and clostridium

56
Q

POD 3-5 with fever

A

pneumonia, UTI

57
Q

POD 1 with fever

A

atelectasis, nec fasc, malignant hyperthermia

58
Q

POD 7 with fever, salmon colored fluid from incision

A

dehiscence, return to OR

59
Q

post gyn surgery with unexplained fever

A

think about thrombophlebitis, given heparin and abx

60
Q

is a person with a crhonic ulcer at risk of squamous cell carcinoma due to continual skin remodeling?

A

yes

61
Q

popcorn calcification in lung

A

hamartoma, benign

62
Q

what do we give octreotide for

A

carcinoid, VIPoma, bleeding varices

63
Q

RUQ pain, high bili and alk phos

A

choledocolithiasis

64
Q

large hydatid liver cyst + eosinophilia

A

echinococcus, albendazole and surgery to remove entire cyst (the other liver cyst with entamoeba histolytica you do not drain/do surgery)

65
Q

IBD that involves terminal ileum, can mimmic appendicitis, skip lesions, transmural inflammation, fistulae, biopsy with granulomas

A

chrons

66
Q

IBD with continuous lesions, associated with pANCA, increased risk of colon cancer and primary sclerosing cholangitis, tx with colectomy

A

UC

67
Q

get this test if pt with known vascular disease c/o butt, thigh and calf pain with walking

A

ABI, nl is < 1

68
Q

pituitary adenoma, parathyroid hyperplasia, pancreatic

islet cell tumor.

A

MEN 1

69
Q

neck mass anterior to SCM

A

brachial cleft cyst

70
Q

what type of rx to avoid in pt with BPH

A

anticholinergics, make urinary retention worse

OBGYN, PSYCH, PEDS (8 decks)

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