Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Internal Medicine > IM Essentials > Flashcards

IM Essentials Flashcards

1
Q

Listeria monocytogenes: gram stain

A

gram + rods

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

L. monocytogenes meningitis tx

A

ampicillin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Common groups infected w/L. monocytogenes meningitis

A

-elderly-neonates-immunocompromised

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Most sensitive/specific test for HSV encephalitis

A

Cerebrospinal fluid polymerase chain reaction assay is the most sensitive and specific test for the diagnosis of herpes simplex encephalitis.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

S. pneumo: gram stain

A

gram + diplococci

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

S. pneumo meningitis empiric therapy

A

-vanc + 3rd gen. ceph (e.g. ceftriaxone)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Imaging in suspicion of stroke

A
  1. Non-contrast CT Head ==> r/o hemorrhagic stroke2. MRI if CT negative
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Important medication in resolving acute ischemic stroke

A

-aspirin vs. clopidogrel

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Dx testing suspected subarachnoid hemorrhage

A
  1. CT w/out contrast2. if neg. ==> lumbar puncture-RBCs or xanthochromia indicate signs of SAH
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Method of estimating GFR

A

-equation-based calculation of GFR-CKD-EPI (CKD epidemiology collaboration)-Cr clearance overestimates GFR (because some is excreted), but approximates true GFR in patients w/out kidney disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Histology in rapidly-progressing glomerulonephritis

A

-most commonly crescentic glomerulonephritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

glomerulonephritis characteristics

A

-nephritic syndrome- ==> hematuria, oliguria, HTN, acute kidney failure- ==> pyuria, hematuria, cellular/granular casts+/- proteinuria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Examples of nephrotic syndromes

A

-MCD-FSGS-membranous glomerulonephropathy==> edema, hypoalbuminemia, proteinuria, bland sediement (no casts, RBCs, leuks)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

MCD disease type

A

nephrotic syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

FSGS disease type

A

nephrotic syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Membranous disease type

A

nephrotic syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Dysmorphic erythrocytes or acanthocytes on urine micro ==>

A

-glomerular hematuria-indication of glomerulonephritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Evaluation/work-up with glomerular hematuria

A
  1. urine protein-cr ratio/serum cr measurement2. serum complement3. hepatitis panel4. blood cx5. ANA, ANCA, anti-GBM, antistreptolysin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Evaluations of hematuria

A

repeat UA>40yo ==> lower/upper urinary tract workup

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Evaluation of sustained, isolated proteinuria

A
  1. split urine collection ==> r/o orthostatic proteinuria2. imaging vs. kidney biopsy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Tx of rhabdomyolysis

A

rapid NS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Lab findings in rhabdo

A

-serum CK > 5000-blood on urine dip w/out sig. hematuria (myoglobin from m. breakdown)- ==> hypocalcemia, hyperphosphatemia, hyperkalemia, hyperuricemia, metablic acidosis-AK

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Serum osmolality concentration

A

serum osm = 2[Na] + [BUN]/2.8 + [glucose]/18

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Types/categories of hypo-osmolol hyponatremia

A

-hypovolemic-euvolemic-hypervolemic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Causes of hyperosmolal hyponatremia

A

-extreme hyperglycemia-exogenously administered solutes: mannitol or sucrose

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Cuases of isosmotic hyponatremia

A

-glycine-sorbitol-pseudohyponatremia (lab artifact w/hyperglobulinemia or severe hyperlipidemia)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Tx of symptomatic hyponatremia 2/2 SIADH

A

-3% (hypertonic) saline-NS ==> excretion of most of infused sodium and retention of water ==> positive water balance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Causes of SIADH

A

-antidepressants-xx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Tx of significant hypernatremia

A

correct water deficit w/5% dextrose

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Potential causes of nephrogenic diabetes insipidus

A

-medications (for example, lithium)-hypokalemia-hypercalcemia-sickle cell disease and trait-amyloidosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Tx of nephrogenic DI

A

-adequate water intake-salt restriction-thiazide diuretic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Sodium polystyrene use/characteristics

A

-cation exchange resin-removes K from body ==> use in long-term control of hyperkalemia-slow onset; not useful in acute setting-contraindicated in pt.s w/recent bowel surgery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Characteristics of refeeding sydnrome

A

-occurs during reintro of nutrition after period of (relative) starvation==> hypophosphatemia, hypokalemia, and hypomagnesemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Tx of hypoparathyroidism

A

calcium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Tx of acute hypercalcemia

A

normalization of intravascular volume with saline will improve delivery of calcium to the renal tubule and aid in excretion of calcium.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Urine anion gap (UAG)

A

Urine anion gap (UAG) = ([urine sodium] + [urine potassium]) – [urine chloride]Normal = 30-50

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Type 2 RTA characteristics

A

-Type 2 (proximal) RTA = defect in regenerating bicarbonate in the proximal tubule-normal anion gap metabolic acidosis-hypokalemiaglycosuria (w/normal plasma glucose)-low-molecular-weight proteinuria-kidney phosphate wasting-urine pH is less than 5.5 -no nephrocalcinosis/nephroliths

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Type 1 RTA characteristics

A

-Hypokalemic distal (type 1) renal tubular acidosis-normal anion gap metabolic acidosis-hypokalemia-urine pH > 6.0-nephrocalcinosis**no ability to excrete H+ ions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Possible causes of type 1 RTA

A

-autoimmune: Sjögren syndrome, systemic lupus erythematosus, or rheumatoid arthritis-drugs: lithium or amphotericin B-hypercalciuria-hyperglobulinemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Expected compensation in respiratory alkalosis

A

PCO2 decrease by 10 ==> HCO3 decrease by 2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Expected compensation in respiratory acidosis

A

**predicted increase in the serum bicarbonate level is calculated as 1 mEq/L (1 mmol/L) for each 10 mm Hg (1.3 kPa) increase in Pco2 (acute) **4 mEq/L (4 mmol/L) for each 10 mm Hg (1.3 kPa) increase in Pco2 (chronic).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

Evaluation of metabolic alkalosis

A
  1. clinical assessment of volume status and blood pressure; hypovolemic = “saline-responsive”2. measurement of urine sodium and chloride levels can help distinguish the various causes.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

Urine chloride use in evaluation of metabolic alkalosis

A

-low urine chloride levels ( vomiting vs. decreased effective arterial blood (diuretics or low cardiac output)-high urine chloride levels (>15 mEq/L [15 mmol/L]) ==> diuretics vs. (rare) genetic tubular disorder (Bartter syndrome or Gitelman syndrome)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

Compensation in metabolic acidosis

A

Winter’s formula:Expected Pco2 = (1.5 × [HCO3] + 8) ± 2 = 26 ± 2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

Calculation of corrected bicarbonate in AG metabolic acidosis

A

-Corrected [HCO3] = measured [HCO3] + (measured anion gap – 12)-if corrected serum bircarb deviates from expected then there is another metabolic process in play

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

Correction in metabolic alkalosis

A

Pco2 would be expected to increase by 0.7 mm Hg (0.09 kPa) for each 1 mEq/L (1 mmol/L) increase in the serum bicarbonate level

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

FENa use

A

-distinguish source of AKI-prerenal vs. infrarenal vs. postrenal-xx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

Evaluation of AKI

A

-Kidney imaging, typically US, considered in all patients w/ AKI esp. w/ risk factors for obstruction are present-FENa can be useful, but is variable in obstruction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

Tx for acute pericarditis

A
  1. NSAIDs/antiinflamatory meds + observation/supportive ==> most cases resolve w/in 24 hours2. steroids only if other anti-inflam contraindicated or refractory cases (==> increase risk recurrence)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

Tx of pituitary apoplexy

A
  1. glucocorticoids2. neurosurgery/tumor removal
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

Thyroid d/o w/low RAIU

A

-subacute/lymphocytic thyroiditis ==>1. hyperthyroid x weeks2. hypothyroid x weeks3. euthyroid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

TSH goal in hypothyroidism

A

0.1 - 2.5

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

Hypothyroid in preg.

A

-levothyroxine dose need increases by 30-50%-test/increase dose in first semester followed by repeat testing in 2-4 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

Testing in incidental adenoma

A

Nearly 10% of adrenal incidentalomas are functional, and testing is usually necessary to identify functional tumors secreting catecholamines, cortisol, or aldosterone.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

Screening in T1DM

A
  1. lipid panel @ puberty2. urine albumin-creatinine ratio @ 10yo+ AND dx of DM1 for 5 or more years3. dilated funduscopic examination @ 10 years of age or older AND dx with type 1 diabetes for 3 to 5 years.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

Dx of DM

A

-A1c > 6.5-Fasting Gluc > 120If results of two different diagnostic tests for diabetes mellitus are discordant, the test that is diagnostic of diabetes should be repeated.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

Modifiable risk factors for osteoporosis

A

-adequate amounts of both calcium and vitamin D-regular exercise-cessation of cigarette smoking-avoidance of alcohol abuse

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

Contraindication to oral bisphosphonates and alternative therapies

A

-GERD==> IV bisphosphonates (zoledronic acid)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

Who should receive osteoporosis therapy?

A
  1. dx of osteo via DEXA/fragility fx OR2. (FRAX) risk of major osteoporotic fracture over the next 10 years is 20% OR3. risk of hip fracture over the next 10 years is 3% or greater
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

Outpatient vs. Inpatient management of diverticulitis

A

-most ==> outpatient + oral abx (metro + cipro-hospitalization/IV abx are generally reserved for patients with evidence of peritonitis, those with significant comorbidities, or those who cannot tolerate oral intake.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

Indications of upper endoscopy in dyspepsia

A

-symptom onset after age 50 years-anemia-dysphagia-odynophagia-vomiting-weight loss-fhx of upper gastrointestinal malignancypersonal history of peptic ulcer disease, gastric surgery, or gastrointestinal malignancy-abdominal mass or lymphadenopathy on exam

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

Characteristics of gilbert syndrome

A

Gilbert syndrome is a common and frequently incidentally discovered cause of indirect (unconjugated) hyperbilirubinemia that usually does not require evaluation or treatment.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

Acute viral hepatitis presentation

A

-elevations of liver aminotransferase levels-increased direct hyperbilirubinemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

Elevated alk phos ==>

A

cholestatic pattern of liver injury

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

Primary biliary cirrhosis presentation

A

-PBC = immune-mediated cause of chronic liver inflammation-elevated serum alkaline phosphatase and bilirubin levels disproportionately higher than the aminotransferase elevation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

Hep C therapy

A

-peginterferon + ribavirin-addition of an NS3/4A protease inhibitor for patients with genotype 1 hepatitis C virus.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

Management of chronic hep B

A

-as long as no elevation in LFTs ==> monitor-serial LFTs q3-6mo.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

Immune-tolerant hep B

A

-immune-tolerant, identified by the presence of a circulating viral level in the absence of markers of liver inflammation-typically occurs in patients born in hepatitis B–endemic areas such as Southeast Asia or Africa in whom HBV was likely acquired perinatally

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q

Dx of SBP

A

In patients with cirrhosis and ascites, an ascitic fluid neutrophil count of ≥250/µL (250 × 106/L) is diagnostic for spontaneous bacterial peritonitis.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
70
Q

Anemia of inflammation lab values

A

-Inflammatory cytokines ==> decrease transferrin saturation and calculated serum total iron-binding capacity (TIBC) levels-ferritin = acute phase reactant ==> serum ferritin levels tend to increase-Serum ferritin levels less than 100 to120 ng/mL (100-120 µg/L) may reflect co-existing iron deficiency in patients with inflammatory states.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
71
Q

Iron deficiency anemia lab values

A

-decreased transferrin saturation-increased calculated serum TIBC levels-decreased serum ferritin levels

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
72
Q

Most sensitive/specific test for dx of B12 deficiency

A

An elevated serum methylmalonic acid level is more sensitive and specific for diagnosing cobalamin (vitamin B12) deficiency than a low serum vitamin B12 level.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
73
Q

Indications of IV iron

A

Parenteral iron, either intramuscular iron dextran or intravenous iron sucrose, is reserved for patients receiving dialysis or for patients who cannot absorb or tolerate oral iron replacement.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
74
Q

Management of acute chest syndrome

A
  1. empiric broad-spectrum antibiotics2. supplemental oxygen3. pain medication4. avoidance of overhydration5. bronchodilators as needed5. **erythrocyte transfusion for persistent hypoxia despite supplemental oxygen
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
75
Q

Criteria for acute chest syndrome

A

-sickle cell disease-new infiltrate on a CXR that involves at least one lung segment AND 1+: -chest pain-temperature less than 38.3°C (100.9°F)-tachypnea-wheezing/cough/labored breathing-hypoxia relative to baseline

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
76
Q

Presentation of thrombotic thrombocytopenic purpura

A

-(TTP) = abnormal activation of platelets and endothelial cells, deposition of fibrin in the microvasculature, and peripheral destruction of erythrocytes and platelets-microangiopathic hemolytic anemia-thrombocytopenia-peripheral smear = schistocytes.

77
Q

Dx of immune thrombocytopenic purpura

A

-isolated thrombocytopenia or thrombocytopenia and anemia from bleeding-otherwise normal peripheral blood smear-absence of additional organ dysfunction

78
Q

microangiopathic hemolytic anemia ==> elevated ___?

A

LDH

79
Q

Elevated LDH ==> ?

A

hemolysis

80
Q

Peripheral smear in warm autoimmune hemolytic anemia

A

spherocytes

81
Q

Coagulation lab values in TTP vs. DIC

A

-DIC ==> abnormal coagulation-TTP ==> normal coags

82
Q

Platelet clumping on peripheral smear ==> ?

A

-pseudothrombocytopenia = lab artifact- ==> repeat CBC

83
Q

Tx of ITP

A

-asx + platelets > 30-40,000 ==> repeat/f/u CBCs-sx OR platelets steriods

84
Q

Tx of PCV

A

Phlebotomy and aspirin are the initial treatments for patients with polycythemia vera.

85
Q

Indications of hydroxyurea in PCV

A

-increased risk for thrombosis: -age older than 60 years OR-history of a previous thrombotic event

86
Q

Dx of AML

A

peripheral blood smear showing myeloblasts that contain Auer rods

87
Q

MGUS presentation

A

-asx-serum monoclonal (M) protein level of less than 3 g/dL (30 g/L)-

88
Q

AL amyloidosis characteristics

A

-AL amyloid = deposition of monoclonal light chains1. nephrotic-range proteinuria w/worsening kidney fxn2. restrictive cardiomyopathy3. hepatomegaly4. neuro = symmetric distal sensorimotor neuropathy, carpal tunnel syndrome, and autonomic neuropathy with orthostatic hypotension5. Periorbital purpura and macroglossia

89
Q

Asymptomatic multiple myeloma

A

-Asymptomatic (smoldering) multiple myeloma = serum M protein level of 3 g/dL (30 g/L) or more OR-10% or more of clonal plasma cells on bone marrow examination-absence of myeloma-related end-organ damage

90
Q

Tests for determination of monoclonal protein production

A
  1. serum protein electrophoresis2. urine protein electrophoresis combined with immunofixation
91
Q

decreased anion gap + anemia + proteinuria, + hypercalcemia + kidney failure ==> dx?

A

multiple myeloma

92
Q

Milk-alkali syndrome labs

A

-hypercalcemia-metabolic alkalosis

93
Q

Timing of screening/testing for inherited thrombophilia

A

-factor V Leiden and the prothrombin gene mutation (PTG2021A) can be done at any time-antithrombin, protein C, protein S, and dysfibrinogenemia testing may be altered during acute thrombotic events and their treatment ==> wait until AFTER completion of tx

94
Q

Pes anserine bursitis presentation

A

-overuse/running-antero-medial pain-worse w/stair climbing & @ night

95
Q

IT band pain location

A

lateral knee

96
Q

PF pain syndrome presentation

A

-women

97
Q

Medical therapy for kidney stones

A

-stones

98
Q

Most common cause of obscure small intenstinal bleeding in older pt.s & dx

A

-angiectasia-dx w/tech-99 scan

99
Q

cough + SOB + glomerulonephritis ==> dx?

A

-Granulomatosis with polyangiitis (formerly known as Wegener granulomatosis) -systemic necrotizing vasculitis- ==> upper and lower respiratory tract sx and pauci-immune glomerulonephritis

100
Q

Tx of Bell’s Palsy

A

prednisone

101
Q

Typical joints of OA

A

DIPPIP1st MCP joint

102
Q

Presentation of pseudogout

A

-Ca-pyrophosphate dihydrate deposition disease-osteoarthritis-like arthritis in atypical joints (e.g. metacarpophalangeal joints)- AND chondrocalcinosis (calcification of cartilage)

103
Q

Solar lentigo vs. Lentigo meligna

A

-lentigo meligna = slow-growing melanoma-Solar lentigines = brown macules/patches in elderly fair-skinned persons in sun-damaged areas-SL = benign, usually more homogeneous pigmentation and lighter color-in equivocal cases, a biopsy is indicated.

104
Q

acute pancreatitis course/management

A
  1. bowel rest, opioids, iv fluids2. mild/mod ==> sx improvement @ 72-96H ==> resume PO3. severe = no improvement ==> CT scan + can consider NJ feedings
105
Q

Factors that affect BNP value

A

-increased by: kidney failure, older age, and female sex-decreased by: obesity

106
Q

Lambert-Eaton myasthenic syndrome (LEMS) characteristics

A

-autoimmune neuromuscular dz that is classically associated with small cell lung cancer-autoantibodies that target voltage-gated calcium channels @ NMJ- ==> proximal muscle weakness, autonomic symptoms, and loss of reflexes

107
Q

Normal response of HIV counts to HAART

A

-effective therapy x 24 wks ==> resistance/genotyping + consult ID specialist

108
Q

TMP-SMX prophylaxis in HIV

A

-@ CD4

109
Q

Hypersensitivty pneumonitis presentation

A

-inflammatory lung disease that is also called extrinsic allergic alveolitis-esults from exposure to airborne allergens that cause cell-mediated immunologic sensitization-Most patients who are exposed to an inhalational antigen have symptoms within 4 to 12 hours.

110
Q

Mitral stenosis murmur

A

opening snap followed by a diastolic murmur that is accentuated with atrial contraction. S1 is usually loud, and S2 may be variable in intensity.

111
Q

daily fever + salmon-colored rash + arthritis +multisystem involvement ==> dx?

A

adult-onset Still disease

112
Q

Labs in Still disease

A

-markedly elevated serum ferritin -leukocytosis-thrombocytosis-elevated erythrocyte sedimentation rate-anemia-abnormal liver chemistry tests

113
Q

Memantine: MOA, use

A

-N-methyl-D-aspartate receptor antagonist-first-line treatment of moderate to advanced Alzheimer disease

114
Q

Presentation/cause of delayed hemolytic transfusion rxn

A

-@ 5 to 10 days after transfusion ==> anemia, jaundice, and fever-cause = new alloantibody formation against non-abo antigen-tend to occur more frequently in sickle cell pt.s who receive multiple transfusion

115
Q

Risk factors for pseudomonal PNA

A

-smoking and chronic lung disease-broad-spectrum antibiotic use in the previous month-recent hospitalization-malnutrition-neutropenia-glucocorticoid use

116
Q

Tx/coverage for suspected pseudomonal PNA

A

-dual therapy: β-lactam and an aminoglycoside-e.g. pip-tazo + amikacin

117
Q

Blood products used with risk of anaphylaxis

A

“washed” erythrocytes/platelets

118
Q

γ-Irradiation of erythrocytes purpose

A

-minimize the incidence of graft-versus-host disease -eradicates any lymphocytes present in the transfusion when given to an immunocompromised recipien

119
Q

leukoreduction of erythrocytes purpose

A

decreases the incidence of febrile nonhemolytic transfusion reactions, CMV transmission, and alloimmunization

120
Q

Stage IA vs. IB NSCLC

A

1A 3cm tumor

121
Q

Tx of metastatic prostate cancer

A

-androgen deprivation-chemical (GnRH agonist) vs. surgical castration

122
Q

Tx of asx hyperuricemia

A

no tx needed

123
Q

Management of lesions suspicion for melanoma

A

excisional biopsy

124
Q

Indications for further workup of acute diarrhea

A

-bloody stools-diarrhea in pregnant, elderly, or immunocompromised patients-hospitalization-employment as a food handler-recent antibiotic use-volume depletion-significant abdominal pain

125
Q

Lung Cancer Screening

A

individuals age 55 to 79 years who have a 30-pack-year or greater smoking history either as current smokers or as former smokers who have quit within the past 15 years.

126
Q

Tx for resolving sx of ischemic stroke

A

aspirin

127
Q

Aortic regurgitation murmur

A

grade 2/6 high-pitched blowing diastolic decrescendo murmur is heard to the left of the sternum at the third intercostal space

128
Q

Features and tx of severe C. diff

A

-fever-leukocytosis-oral vancomyocin +/- IV metronidazole

129
Q

Indications for noninvasive positive pressure ventilation in COPD exacerbation

A

-moderate to severe dyspnea, -moderate to severe acidosis (pH 25/min

130
Q

Exclusion criteria for NNPV in COPD exacerbation

A

-respiratory arrest-cardiovascular instability (hypotension, arrhythmias, and myocardial infarction)-AMS -high aspiration risk/copious secretions-recent facial or gastroesophageal surgery-craniofacial trauma-fixed nasopharyngeal abnormalities-burns-extreme obesity

131
Q

Indication for intubation in COPD exacerbation

A

-Severe acidosis (pH 35/min

132
Q

Anticoagulants to avoid in advanced kidney disease

A

-LMWH

133
Q

Optimal medical therapy in severe systolic heart failure

A

-ACE-B-blocker-spiro

134
Q

Predictors of poor prognosis in acute pancreatitis

A

-APACHE II score-markers of hemoconcentration: elevated blood urea nitrogen, serum creatinine, or hematocrit levels-multiple medical comorbid, age > 70yrs, BMI > 30

135
Q

Polymyalgia rheumatica presentation

A

-hip and shoulder girdle stiffness and pain-elevated inflammatory markers-closely associated w/GCA ==> if any sx ==> temporal a. biopsy

136
Q

Prophylactic tx of tumor lysis syndrome

A

-aggressive hydration + diuresis -allopurinol and rasburicase- if necessary, hemodialysis before initiation of antineoplastic therapy.

137
Q

CURB-65 criteria

A

ConfusionUrea > 20RR > 30BP ward3 criteria ==> consider ICU

138
Q

Indications for endocarditis prophylaxis

A

-prosthetic cardiac valve-history of infective endocarditis-unrepaired cyanotic congenital heart disease-congenital heart disease repair with prosthetic material or device within the last 6 months-palliative shunts and conduits-cardiac valvulopathy in cardiac transplant recipients

139
Q

Tx of Raynauds

A

dihydropyridine ca-channel blocker (amlodipine)q

140
Q

Characteristic findings in hodgkin lymphoma

A

-B sx: fever, weight loss, night sweats-lymphadenopathy-Reed sternberg cell: abundant pale cytoplasm and two or more oval lobulated nuclei containing large nucleoli

141
Q

Tx of fibromuscular dysplasia

A

revascularization with kidney angioplasty

142
Q

Tx of early-stage large B-cell lymphoma

A
  1. abbreviated course of chemotherapy2. immunotherapy: rituximab2. involved-field radiation therapy
143
Q

Lymphangioleiomyomatosis classic presentation

A

young woman w/emphysema or chylothorax or tuberous sclerosis

144
Q

Respiratory bronchiolitis-associated interstitial lung disease characteristics

A

micronodular disease that causes mild symptoms and typically presents in active smokers with subacute progressive cough and dyspnea.

145
Q

Churg-Strauss syndrome presentation

A

-vasculitis that typically occurs in patients with a history of asthma-peripheral eosinophilia-perinuclear antineutrophil cytoplasmic antibody (pANCA).

146
Q

Microscopic polyangiitis presentation

A

-involves small arterioles and may be associated with glomerulonephritis and purpuric skin lesions-no immune deposits in the skin -positive p-ANCA titer.

147
Q

Polyarteritis nodosa

A

-small- to medium-vessel vasculitis -may be associated with renal artery involvement and hypertension-Purpura with skin biopsy findings of immune deposits is not a characteristic cutaneous feature.

148
Q

Goal of pressors

A

-maintain MAP > 65-MAP = [(2xdbp) + sbp]/3

149
Q

Tx in high grade carotid stenosis

A

carotid endarterectomy

150
Q

de Quervain tenosynovitis presentation

A

-inflammation of the abductor pollicis longus and extensor pollicis brevis tendons-associated with repetitive use of the thumb -also assoc. w/ pregnancy, RA, and calcium deposition disease. -pain on the radial aspect of the wrist that occurs when the thumb is used to pinch or grasp. -Examination: localized tenderness @ distal radial styloid process + pain with resisted thumb abduction and extension.

151
Q

Prevention of migraines

A

-b-blcokers-TCAs-anticonvulsants

152
Q

SVC syndrome initial w/u

A

biopsy to guide tx

153
Q

Ventricular interdependence/”to-and-fro diastolic motion of the ventricular septum” ==> dx?

A

constrictive pericarditis

154
Q

Constrictive pericarditis presentation

A

Dyspnea, pedal edema, clear lung fields, and jugular vein engorgement with inspiration

155
Q

initial tx in uncomplicated cystitis

A

-TMP-SMX-nitrofurantoin

156
Q

abx to avoid in kidney disease

A

aminoglycoside

157
Q

burning distal extremity pain + sensory loss ==> dx?

A

-small-fiber peripheral neuropathy==> glucose tolerance testing

158
Q

Tx of severe sx of PVCs

A

b-blockers

159
Q

Stage III colon cancer tx

A
  1. surgery/resection2. adjuvant chemo: 5-fluorouracil and leucovorin x 6 mo.
160
Q

Tx of recurrent gout w/hyperuricemia

A

allopurinol + colchicine

161
Q

Indication for PPX tx in migraine

A

sx > 10 days/month (limit of use of triptan)

162
Q

Threshold for thoracentesis for pleural effusion

A

-unexplained- > 1cm - ? loculated

163
Q

Late complication of gastric bypass

A

-Small intestinal bacterial overgrowth - ==> diarrhea, bloating, and features of malabsorption

164
Q

Characteristics of Acral lentiginous melanoma

A

unevenly darkly pigmented patch that most often arises on the palmar, plantar, or subungual surfaces

165
Q

Ca-channel blocker to add for HTN in heart failure

A

amlodipine

166
Q

Criteria for exudative pleural effusion

A
  1. pleural fluid total protein–serum total protein ratio greater than 0.52. pleural fluid lactate dehydrogenase level greater than two thirds of the upper limit of normal (or a pleural fluid–serum lactate dehydrogenase ratio >0.6)
167
Q

Workup in suspected CLL?

A

flow cytometry

168
Q

PFTs in respiratory m. weakness

A

-reduced total lung capacity-increased residual volume

169
Q

Cholangitis presentation

A

-fever, jaundice, and altered mental status-abdominal pain is usually present

170
Q

Management of cholangitis

A
  1. broad-spectrum antibiotics directed against gram-negative bacteria, enterococci, and gut anaerobes2. ductal decompression = urgent endoscopic retrograde cholangiopancreatography
171
Q

Synovial fluid in inflammatory arthritis

A

synovial fluid leukocyte count greater than 5000/µL (5 × 109/L)

172
Q

Churg-Strauss sx/presentation

A

-antecedent asthma, allergic rhinitis, or sinusitis-eosinophilia, migratory pulmonary infiltrates-purpuric skin rash-mononeuritis multiplex-fever, arthralgia, and myalgia-kidney disease- (+) pANCA

173
Q

Tx of essential tremor

A
  1. Lifestyle changes: getting enough sleep and reduction of caffeine2. Meds: β-blockers (such as propranolol) or anticonvulsants (such as primidone)
174
Q

Prostate cancer monitoring s/p remission

A

serial DRE + PSA q6-12 mo.

175
Q

Tactile fremitus

A

increased ==> consolidationdecreased ==> pleural effusion

176
Q

Indications for surgical intervention for spinal osteo

A
  1. abscess drainage2. removal of an orthopedic implant3. stabilization of the spine.
177
Q

Signs/sx of CAP that persist after a course of abx ==> dx?

A

cryptogenic organizing pneumonia

178
Q

Indications for valve replacement in endocarditis

A

endocarditis complicated by heart failure, abscess, severe regurgitation, or hemodynamic derangements ==> urgent surgery w/out waiting for response to abx

179
Q

LeMierre syndrome presentation

A

-fever, leukocytosis, sore throat-unilateral neck tenderness-multiple densities on CXR (septic emboli)

180
Q

Treatment of Lemierre syndrome

A

-abx that cover streptococci, anaerobes, and β-lactamase-producing organisms. -Penicillin with a β-lactamase inhibitor (eg, ampicillin-sulbactam, piperacillin-tazobactam, ticarcillin-clavulanate) OR-carbapenem

181
Q

Positive skin TB test

A

-5mm @ HIV+, recent contacts, CXR w/evidence of past TB, immunosuppresed-10mm @ recent from high-risk country, IVDUs, high-risk settings-15mm @ everyone else

182
Q

Management of calcium oxalate stones

A

increased dietary calcium intake and avoidance of oxalate-rich foods such as rhubarb, peanuts, spinach, beets, and chocolate

183
Q

Contraindication to B-blockers in management of MI

A

heart failure, systolic blood pressure of less than 90 mm Hg, bradycardia (

184
Q

Mitral valve prolapse murmur

A

The auscultatory feature of mitral valve prolapse is a midsystolic click followed by a late systolic murmur. Performing the Valsalva maneuver and standing from a squatting position move the click-murmur complex closer to S1.

185
Q

Management of acute afib

A

The acute management of atrial fibrillation in symptomatic but hemodynamically stable patients includes rate control with a β-blocking agent, such as metoprolol, or a calcium channel blocker, such as diltiazem.

186
Q

Adenosine: MOA, use

A

-Adenosine = IV agent that transiently blocks atrioventricular nodal conduction-tx of supraventricular tachycardia (whne dependent on the av node) -may be used to break the reentrant rhythm in atrioventricular nodal reentrant tachycardia, or orthodromic atrioventricular reciprocating tachycardia.

187
Q

first-line treatment for a hemodynamically stable ventricular tachycardia

A
  1. intravenous antiarrhythmic agent such as amiodarone, procainamide or sotalol2. lidocaine can be used as a second-line agent.
188
Q

Multifocal atrial tachycardia characteristics

A

Multifocal atrial tachycardia is characterized on electrocardiograms by three or more P wave morphologic patterns and variable P-R intervals.

189
Q

Characteristics of Lyme carditis

A

Lyme carditis is manifested by acute-onset, high-grade atrioventricular conduction defects that occasionally may be associated with myocarditis.

Internal Medicine (4 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions