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step 2 ck - IM mix > IM mix UWQ - may30th 2021 > Flashcards

IM mix UWQ - may30th 2021 Flashcards

1
Q

chemotherapy at risk for opportunistic pathogens?

A

gram-negative bacillus Pseudomonas aeruginosa.

-> ecthyma gangrenosum

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2
Q

Pyoderma gangrenosum

sym?

A

neutrophilic dermatosis

-> seen with IBD and arthropathies.

dev rapidly –> begin as a cutaneous papule/nodule–> quickly matures into a painful, purulent ulcer with violaceous borders.

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3
Q

lose weight to achieve and maintain a healthy weight.

rx?

A

each 10 kg (22 lb) of weight loss can lower blood pressure by ~6 mm Hg;

-> weight loss is one of the most effective nonpharmacologic interventions

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4
Q

Pain in the groin, buttock, or lateral hip (trochanteric) region and can radiate to the lower thigh or knee.

  • > mild pain and brief stiffness with prolonged rest <30 mins
  • .> worst pain usually occurs with activity and weight bearing

dx?
XR finding?

A

osteoarthritis of the hip

x-ray:
loss of joint space, osteophyte formation, and subchondral sclerosis.

loc: 
Knees
Hips
DIP joints
1st carpometacarpal joint
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5
Q

Lower back pain

rx?

A

acute <4 weeks: moderate exercise, NSAIDS

subacute/ chronic >12 wks:
exercise rx, TCA, duloxetine

secondary prevention: exercise therapy, education

Vs/ back brace not useful for preventing LBP

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6
Q

high dose drug prolong use>3 month

Constitutional symptoms (eg, fever, malaise)

Arthralgias
Serositis (eg, pleuritis, pericarditis)

Rash (less common compared with SLE)

Dx?
rx induced?

A

Drug-induced lupus erythematosus

procainamide, hydralazine, penicillamine

Others:
minocycline,
TNF-α inhibitors (eg, etanercept, infliximab),
isoniazid

RF: slow acetylator status

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7
Q

Hypertrophic osteoarthropathy

sym?

A
  • > underlying lung disease (eg, adenocarcinoma, chronic pulmonary infection)
  • > arthralgia.
  • > skin thickening and digital clubbing
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8
Q

Microscopic polyangiitis and granulomatosis with polyangiitis
(wegener)

-> necrotizing, small-vessel vasculitides

sym?
lab?

A
  • > acute-onset fever
  • > tracheopulmonary disease.
  • > rhinosinusitis, hematuria, and rash (eg, palpable purpura)
  • > saddle nose , hearing loss
    lab: c-ANCA: PR3+, MPO+
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9
Q

Osteogenesis imperfecta

A

defective formation of type 1 collagen,

  • > bone, tendons, ligaments, skin, teeth, and sclera.
  • > childhood with fragility fractures, short stature, impaired hearing, blue sclera
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10
Q

osteomalacia

-> fatigue, bone pain, and hypophosphatemia

lab?

Asso with: celiac dx, CKD, Chronic liver dx, bypass surgery

A 
↑ Alkaline phosphatase
↑ PTH
↓ Serum calcium & phosphorus
↓ urinary calcium
↓ 25 OH-D levels

X-rays: thinning of cortex with reduced bone density

-> reduced mineralization of the osteoid matrix

Bilateral & symmetric pseudofractures (Looser zones)

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11
Q

amiloride

moa?
sym?
rx?

A

potassium-sparing diuretic that blocks the epithelial sodium channel (ENaC) in the renal collecting system.

sym:
hyperkalemia
met acidosis

rx: switch rx -> CCB recheck in 1-2 wks

severe hyperkalemia rx:
IV ca + insulin + glc

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12
Q

Goodpasture syndrome)

sym?
hx?

A

hx:
anti–glomerular basement membrane (anti-GBM) disease

renal bx: formation of antibodies to the alpha-3 chain of type IV collagen

-> linear IgG deposition along the glomerular basement membrane IF

sym:
1. renal : pnuria <3.5g/day, hematuria
2. resp: hemoptysis , SOB

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13
Q

PCP

sym?

A

HIV patients with CD4 counts <200/mm3.

  • > Fever, dyspnea, and nonproductive cough
  • > Fatigue, weight loss, and chills
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14
Q

acute-onset, severe headache

vomiting, photophobia, neck stiffness, and lethargy

dx?

Rx?

A 
subarachnoid hemorrhage (SAH) 
-> ruptured saccular aneurysm
isolated CN palsies -> sign of a compressing aneurysm:
Oculomotor nerve (CN III) palsy
->  pupillary dilation:  loss of PNS,  ptosis and down and out due to loss of somatic innervation.

Full or partial oculomotor nerve palsy: enlarging or ruptured aneurysm of the adjacent PCA

Dx: CT angiography

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15
Q

Cavernous sinus thrombosis

sym?

A

fever, headache, and periorbital swelling.

-> palsy of ICA, CNs III, IV, and VI , V1, v2 resulting in ophthalmoplegia.

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16
Q

JC virus reactivation
untreated AIDS

dx?

A

Progressive multifocal leukoencephalopathy

MRI:
asymmetric white matter lesions;
no enhancement/ edema

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17
Q

Community acquired pneumonia (CAP)

  • > pulmonary parenchymal infection, focal consolidation
    sym: develop acutely and include fever, cough, pleuritic chest pain, and dyspnea.
  • > Tachycardia, tachypnea, focal crackles (right lower lobe)

dx?

A

> caused by bacterial (majority), viral (30%), or fungal pathogens.

-> strep pneumonia

dx: CXR
- > Symptomatic treatment alone insufficient due to the risk of secondary bacterial pneumonia

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18
Q

chronic pancreatitis

CT: pancreatic atrophy and calcifications

RF: smoking + Etho

rx?

A

destruction of acinar and islet cells
-> pancreatic exocrine insufficiency.

Pancreatic secretion is stimulated by cholecystokinin (CCK).

Normally, pancreatic enzymes breakdown CCK-releasing protein, thereby limiting CCK release.

pancreatic insufficiency, pancreatic enzyme deficiency

  • > release of high volumes of CCK
  • > pancreatic hyperstimulation

rx:
Pancreatic enzyme supplementation, lipase, protease, and amylase

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19
Q

obstructed pancreatic duct

dx?

A

Endoscopic retrograde cholangiopancreatography (ERCP) with sphincterotomy and/or stent placement

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20
Q

burning or itching of the lids, discharge (which may be associated with crusting of the eyelashes in the morning),

  • > often a foreign body sensation in the eye
  • > scaling at the lid margin

Dx?

A

Blepharitis

-> inflammation at the eyelid margin, usually most prominent at the opening of the meibomian glands.

Asso with:
seborrheic dermatitis

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21
Q

Allergic conjunctivitis

sym?

A

conjunctival edema

-> prominent (often with papilla formation)

primarily at the conjunctivae rather than lid margin,

Asso with:
seasonal allergies or other atopic disorders.

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22
Q

TCA overdose

  • > anticholinergic effects (eg, hyperthermia, flushed skin, dilated pupils, decreased bowel sounds)
  • > seizures
  • > cardiac toxicity (eg, prolonged QRS interval, hypotension)

antidopt?

A

Hypotension is treated with isotonic saline boluses;
refractory hypotension may require vasopressors (eg, norepinephrine)

->IV NaHco3:
decreases the incidence of ventricular arrhythmia

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23
Q

anticholinesterase toxicity

sym?
antidopt?

A

Atropine and pralidoxime

sym:
- > cholinergic toxicity

-> bradycardia, miosis, and salivation.

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24
Q

Hyperkalemia
-> peaked T waves, followed by lengthening of the PR and QRS intervals, and eventually resulting in a sine wave.

-> Bradycardia and muscle weakness

rx?

A

Calcium gluconate

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25
Q

Systemic sclerosis:

severe hypertension and acute renal failure

-> scleroderma renal crisis

Thrombocytopenia and microangiopathic hemolytic anemia

rx?

A

renal ischemia
-> activation of the renin-angiotensin-aldosterone system (RAAS).

rx: ACEi

elevated serum creatinine level is not a contraindication for ACE inhibitors

Hemodialysis
-> Urgent indications hyperkalemia, volume overload with respiratory impairment

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26
Q

multiple sclerosis

-> neurologic symptoms (eg, weakness, incontinence)

rx?

A

interferon beta-1a

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27
Q

MDD

-> anhedonia, feelings of worthlessness, weight loss, low energy, impaired ability to think) accompanied by memory impairment

rx?

A

depression-related cognitive impairment

rx:
- > selective serotonin reuptake inhibitors (eg, escitalopram)

-> psychotherapy.

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28
Q

AD

rx?

A
  • > Cholinesterase inhibitors (eg, donepezil)
  • > NMDA receptor antagonist memantine

treatment of dementia (eg, Alzheimer disease)

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29
Q

-> congenital narrowing of the descending aorta, just distal to the left subclavian artery.

creates a proximal arterial pressure load affecting the upper body

dx?

A

Coarctation of the aorta

  • > Congenital
  • > Acquired (rare) (eg, Takayasu arteritis)
  • > hypertension
  • > continuous murmur
  • > S4

CXR:
notching of the posterior third of the third to eighth ribs
-> bony erosion due to enlarged intercostal arteries.

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30
Q

Upturning of the cardiac apex (“boot-shaped heart”)

dx?

A

tetralogy of Fallot due to pulmonic stenosis and consequent right ventricular hypertrophy.

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31
Q

Diffuse vascular calcifications

dx?

A

premature ATS with advance renal failure

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32
Q

Prominent right atrial contour

dx?

A

Ebstein congenital abnormality

-> apical displacement of the tricuspid valve with atrialization of the right ventricle

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33
Q

MM

-> back pain, normocytic anemia, and arm pain

Hx?
dx?

A

Osteolytic lucent lesion

Dx:
serum pn electrophoresis , M spike

bone marrow biopsy confirm

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34
Q

warning signs consideration of early imaging:

  1. Neurologic findings: Seizure, changes in consciousness, specific deficits
  2. Differences compared to prior headaches: Change in frequency, intensity, characteristics
  3. Other: New at age >40, sudden onset, trauma, present on awakening

Dx?

A

Dx: MRI

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35
Q
  • > lymphoplasmocytic malignancy
  • > excessive production of monoclonal IgM antibody.

sym:
- > hyperviscosity syndrome (diplopia, tinnitus, headache, dilated/segmented funduscopic findings),

-> neuropathy (electric sensation), infiltrative disease (hepatosplenomegaly, anemia, thrombocytopenia)

dx?

A

Waldenstrom macroglobulinemia (WM

dx: monoclonal spike (M-spike) of IgM
- > bone marrow biopsy showing >10% clonal B cells

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36
Q

Multiple myeloma (MM)

lab?

A

monoclonal IgG, IgA, or light chains

-> CRAB
bone pain

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37
Q

Psoriatic arthritis (PsA)

sym?

X-ray:
narrowing of the proximal phalanx with erosion of the distal phalanx (pencil-in-cup deformity) and new bone formation

A

cyclical/episodic
–> rather than chronic/slowly progressive.

  • > Prolonged (>30 min) morning stiffness and pain lessen, not worsen, with activity.
  • > involves the DIP and PIP joints;
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38
Q

AR

RF?
sym?

Backflow from aorta into LV → ↑ LV end-diastolic volume

LV initially compensates with eccentric hypertrophy → ↑ SV & CO
–> bring ventricular closer to chest wall -> pounding snesation and pounding in left decubitus position

Eventual LV dysfunction → ↓ SV & CO → heart failure

A
  1. Congenital bicuspid aortic valve
    Postinflammatory (eg, rheumatic heart disease, endocarditis)
  2. Aortic root dilation (eg, Marfan syndrome, syphilis)

sym:
Decrescendo diastolic murmur

Widened pulse pressure (↑SBP & ↓DBP)

Rapid rise-rapid fall (“water-hammer”) pulsation

Abrupt carotid distension & collapse, “pistol-shot” femoral pulses

39
Q

constrictive pericarditis

sym?
dx?

etio: 
idiopathic 
viral pericarditis (>40%)
radiation therapy (~30%)
cardiac surgery (~10%)
 connective tissue disorders

eg. TB

A

impairs ventricular filling during diastole,

  • > decreased cardiac output (fatigue and dyspnea on exertion)
  • > venous overload (elevated JVP, ascites, and pedal edema).
  • > Kussmaul’s sign, lack of the typical inspiratory decline in central venous pressure, pericardial knock (early heart sound after S2)
  • > Sharp x and y descents on central venous tracing.

Pericardial calcification

40
Q

normal thyroid function with an estrogen-induced

lab?

A

-> increase in T4-binding globulin (TBG), transthyretin, and albumin.

increase the level of TBG by decreasing its catabolism and increasing its synthesis in the liver.

  • > more TBG binds more TH
  • > TH production inc to maintain a euthyroid state;
  • > slight elevation in total T4 level

Only the free (ie, unbound) thyroid hormones are biologically active

41
Q

ankylosing spondylitis (AS)

Rx?

A

Nonpharmacologic
measures:
Exercise (postural exercises, ROM/stretching exercises)
Physical therapy

Initial treatment:

  1. NSAIDs (eg, ibuprofen, naproxen)
  2. COX-2 inhibitors (eg, celecoxib)

Rx fails:
1. TNF-α inhibitors (eg, etanercept, infliximab)

  1. Anti–IL-17 antibodies (eg, secukinumab)
42
Q

prevent rejection in patients with allogeneic transplants

rx?

A

Mycophenolate

43
Q

cluster headaches

rx?

A

100% o2 + sumatriptan

44
Q

hereditary hemochromatosis

sym?
rx?

elevated iron studies.

Diagnosis: genetic analysis of HFE mutations

A
  • > hepatic fibrosis and cirrhosis
  • > skin pigmentation (sun-exposed areas, scars, genitalia),
  • > diabetes mellitus (“bronze diabetes”),
  • > arthropathy
  • > hypogonadism (diminished libido, erectile dysfunction [ED])

Serial phlebotomy to deplete excess iron stores

-> reduce the risk for cirrhosis and HCC.

45
Q

Hemolytic anemia due to intravascular erythrocyte trauma

lab?

A

schistocytes or helmet cells

Intravascular erythrocyte destruction-> free hemoglobin in the serum (hemoglobinemia) + urine (hemoglobinuria)

-> increased serum lactate dehydrogenase

Haptoglobin is a serum protein that binds free hemoglobin -> excess amount of free hemoglobin in the serum decreasing the level of haptoglobin

46
Q

deep venous thrombosis (DVT)

wells score?
dx?
rx?

A

Patients with a score ≥2 (eg, pitting edema, calf swelling >3 cm compared to the other leg) more likely to have DVT

dx: compression ultrasonography
rx: anticoagulation

47
Q

Medications for osteoporosis?

A
  1. Bisphosphonates
    (eg, alendronate,
    risedronate)
    -> First-line treatment for most patients
2. Selective estrogen
receptor modulators
(eg, raloxifene)
-> Less effective
-> May lower risk of breast cancer
-> Increased risk of DVT, hot flashes, endometrial ca, uterine sacroma
48
Q

Rx induce EPS ?

sym?
moa?
rx?

A

metoclopramide
prochlorperazine

moa:
DA antagonist

sym:
EPS : ADAPT
acute dystonia
-> muscle spasm/ stiffness , oculogyric crisis, laryngeal dystonia

akathisia
parkinsonism
tartive dyskinesia

rx:
benzotropine (antiAch rx) / diphenhydramine

49
Q

aprepitant

moa?

A

sub P NK1 receptor antagonist

50
Q

self induce vomiting
diuretics overuse

lab?

A

Loss HCl-
hypochloremic

met alkalosis
ph>7.45
hco3 >24
low urine chloride < 20

51
Q

persistent diarrhea

RTA

lab?

A

severe hypokalemia

low Ph ( met acidosis)
low Hco3
non-AG met acidosis
52
Q

MC community-acquired bacterial meningitis?`

dx?
rx?

A

Streptococcus pneumoniae

dx:
Blood cultures + lumbar puncture.

Rx:

  • > third-generation cephalosporin (eg, ceftriaxone), -> vancomycin,
  • > dexamethasone (to reduce inflammatory morbidity)
53
Q

atelectasis

BS?
percussion?
tactile fremitus?

A

-> BS: dec
-> percussion: dull
-> tactile: dec
mesiastinal shift: towards

54
Q

Bacterial pneumonia

BS?
percussion?
tactile?

A

BS: inc

percussion: dull
tactile: inc

mediastinal shift: none

55
Q

Lymphoma / sarcoidosis

sym?

A

-> bilateral hilar lymphadenopathy

56
Q

Raising the cut-off point ?

sens?
spec?

A

increasing the inclusion criteria) of a screening test:

  • > increase in specificity (SpIN)
  • -> TN/TN+ FP
  • > decrease in sensitivity (SnOUT)
  • -> TP/TP+FN
  • -> higher cut off pt : dec TP, dec FP

** TP close to =1
FP : 1- specificity =

57
Q

Bells pasly, unilateral facial paralysis

sym?
rx?
dx?

A

sym:
- > acute (over the course of hours) and progressive
- > within 3 weeks.
- > auricular pain or dysacusis (distortion of sound)

rx:
- > prednisone
- > corneal protection strategies

dx: NOT needed if classic presentation!!!

58
Q

pre-renal azotemia ( renal hypoperfusion)

lab?

A

inc BUN/Cr > 20:1

inc Urea absorption

-> systemic hypovolemia / impaired CO

59
Q

erectile dysfunction

rx?

A

PDE-5 inhibitor ( sildenafil)

etio: CVD

** not remove current medication

60
Q

Pneumothroax

etio?
sym?

A

PEEP vent: alveolar damage, pneumothroax, hypotension

–> sudden SOB, tachycardia, hypotension, tracheal deviation

-> unilateral absence BS, impaired ventricular filing

61
Q

Atelectasis

sym?

A

cough , dyspnea dec PaO2 stats

-> NO hypotension cuz not compression mediastinum

62
Q

pul embolism

sym?

A

sudden-onset SOB , tachypnea, hypoxia, hypotension

63
Q

cardiac tamponade

sym?

A

beck’s traid:

hypotension, elev CVP, muffled heart sound

etio: build up of fluid around heart compressing

** NOt have unilateral absence BS

64
Q

high output HF

sym?

A
  • > dec SVR –> inc CO
  • > brisk ocarotid upstroke
  • > widened pulse pressure

etio:
1. bypass SVR -> AV fistula

  1. inc peripheral vessels -> morbid obesity (MC); paget dx
  2. vasodilation unmet metabloism demands in tix -> hyperthyroidism, sever anemia, thiamine def

sym:
- > eccentric LVH -> inc VR + venous hydrostatic pressure inc
- > peripheral edema
- > pul edema

65
Q

Dual antiplatelet therapy

moa?

A

DAPT with ASA
-> P2y12 receptor blockers : clopifogrel, prasugrel , ticagrelor

additional rx:

  • > beta blockers
  • > ACEI
  • > statins
  • > aldosterone antagonist
66
Q

apixaban

mao?

A

FXa inhibitor

rx: DVT + PE

67
Q

chlorpheniramines

moa?

asso with allergic rhinitis

A

postnasal drip, asthma, GERD induce
–> chronic cough >8 wks

moa:
reduce H1 receptors –> blocking histmine relase mast cells
–> blocking nasal secretion

** inhaled corticosteroids: dec airway inflammation

68
Q

mucosal neuroma

risk for?

A

MEN2B

-medullary thyroid ca
- pheochromocytoma
- marfanoid habitus
mucosal neuroma

69
Q

Tuberous sclerosis

sym?

A

HARMOTOMS

  • > seizures
  • > ash-leaf sopts
  • > facial angiofibromas
  • > shagren patches
70
Q

hereditary hemorrhagic telangiectasis ( osler weber rendu syn)

sym?

A
  • > AVM
  • > massive hemoptysis, GI bleeding
  • > mucosal telangiectasias
71
Q

acute otitis externa

etio?
moa?
sym?
rx?

A

“swimmers ear”

-> water exposure
-> trauma
foreign bodies ( earbuds, hearing aid)

etio: pseduomonas , s. aureus

sym:
- > otalgia, pruritus, discharge, hearing loss
- > pain with auricle manipulation
- > ear canal erythema, edema, debris

rx: topical fluroquinolone

72
Q

otitis media with effusion

sym?

A

ear pain + fullness
-> drainage in presence TM perforation

-> less common

73
Q

osmotic / sevretory diarrhea

stool osm gap?
moa?
lab?

A

osmotic diarrhea: moa: nonabsorbed Osm active solute

  • > polyethylene glycol, sorbitol, lactose
  • > inhibits water resorption
  • -> SOG > 125

lab:
SOG = 290 - 2 x (stool Na + stool K)

<50 secretory diarrhea -> toxin ( v. cloria , hormones, CF, bile acid, postsurgical bowel resection)
–> persistent while fasting at night

50-125 indetermin

> 125 Osmotic diarrhea ( lactose intolerance)
–> after ingestion

74
Q

SIADH
Sq call Ca ( inc ADH)

lab?
rx?

A

inc ADH –> inc water reabsorption

  • > high Urine Na
  • > low renin, low aldo

-> euvolemic hyponatremia ( diluted by excess water reabsorption)

lab:

  • > serum osm < 290 ( diluted by water)
  • > urine Osm >100 ( more concentrated )
  • > high urine Na >25 (concentrated with water all reabsorbed)

rx:

  • > fluid restriction
  • > hypertonic saline (3%) -> careful infusion
  • -> <8 mEq/L over 24 hours avoid Osmotic demyelination syn
75
Q

DI central

lab?
rx?

A

low ADH -> losing water

  • > low ADH
  • > low urine Na ( diluted urine with excess water)
  • > polyuria, polydypsia

rx: desmopressin ( ADH analong)

76
Q

BZD

se?

A

occur within a hour after ingestion:
paradoxical agitation -> in elderly

-> taper off

77
Q

PEEP effects?

decomp LHF with cardiogenic pul edema

  • S3, crackles, hypoxemia
A

PEEP effects: 5-20cm H2O

  • > inc Intrathoracic pressure -> drop in VR to RH
  • -> dec RV preload ( dec CVP)
  • -> inc RV afterload (PCP) compresses alveolar capillaries
  • -> dec LV preload (less blood voln returning to LA)
  • -> dec MAP thru baroreceptor effects by lowering adrenergic tone-> dec neurohormonal activation
  • -> dec LV transmural pressure
  • -> dec LV afterload
  • -> inc PaO2, LV performance, CO
  • -> inc end-organ O2 delivery + survival
78
Q

primary polydipsia

lab?

A

etio:
schizo, excess water intake

excess hypoNa -> excess ADH secretion

hyponatremia and dilute urine with urine osmolality <100 mOsm/kg.

significant hyponatremia can develop confusion, lethargy, psychosis, and seizures

79
Q

MDD with psychotic features

sym?
rx?

A

MDD in which the patient develops psychotic symptoms during a depressive episode.

rx:

  • > combined antidepressant and antipsychotic
  • > electroconvulsive therapy
  • -> faster response in elderly patients unable to eat/ dink with suicidal thoughts
80
Q

Persistent complex bereavement disorder (complicated grief)

sym?

A

intense yearning for the deceased that persists for at least 6 months to a year after the loss.

-> It is not associated with psychotic features.

81
Q

Spironolactone and eplerenone

A

mineralocorticoid receptor antagonists (MRAs)

82
Q

chi-square test

testing?

A

relationship between 2 categorical variables. –> qualitative (gps/ categories)

  • > categorical INdependent variable (eg, exposure or intervention)
  • > 2 groups and a categorical dependent variable (eg, outcome).
83
Q

Two-sample t-test

A
  • > Compares the MEAN of a quantitative variable of 2 independent groups
  • -> quantitative ( # value )

eg. comparing serum ferritin concentrations (ie, quantitative variable) in male and female patients ( qualitative -gps)

84
Q

correlation analysis

testing?

A
  • > correlation coefficient to describe the LINEAR relationship between 2 quantitative variables
  • > evaluating the linear relationship between stress level and irritability score
85
Q

Exercise-associated postural hypotension

sym?
moa?

A
  • > sudden decrease in VR after cessation of exercise, which fails to meet increased cardiac demand.
  • > collapse (with no loss of consciousness) immediately after completion of exercise.
86
Q

Exertional hyponatremia

sym?

A
  • > excessive fluid intake (weight gain).
  • > confusion, headache, and swollen hands after prolonged heat exposure
  • > seizure, collapse.
87
Q

Phencyclidine intoxication

sym?

A
  • > psychosis in addition to combative behavior
  • > delirium: hallucinating immediately
  • > dissociative symptoms,
  • > ataxia
  • > nystagmus
88
Q

Alcoholic hallucinosis

sym?
time frame?

A

Visual, auditory, or tactile; intact orientation; stable vital signs

time:
12-48 hrs

rx: BZD

89
Q

Delirium tremens

sym?
time frame?

A
  • > Confusion, agitation, fever, tachycardia, hypertension, diaphoresis, hallucinations
    time: 48-96 hr
90
Q

Acute bacterial prostatitis

sym?
dx?
rx?

A

sym:

  • > perineal pain: Lower UTI
  • > systemic symptoms (eg, fever, chills, acute illness),
  • > tender, swollen prostate on digital rectal examination

dx: U/C
rx: 6 wks of AB (eg, trimethoprim-sulfamethoxazole, fluoroquinolone

91
Q

Roux-en-Y gastric bypass

complication sym?

dx?
rx?

A
  • > stomal (anastomotic) stenosis
  • > progressive narrowing of the GJ anastomosis that leads to obstruction of gastric pouch outflow.

dx:

  • > esophagogastroduodenoscopy (EGD),
  • > balloon dilation can be performed to open the narrowing.
92
Q

Acute nitrofurantoin-induced pulmonary injury

sym?

A

->
hypersensitivity that can present with fevers, shortness of breath, dry cough, and erythematous rash

-> begin 3-9 days from medication initiation

XR: bil basilar opacities, pleural effusion (unilateral)

93
Q

AIN

sym?

A

fever, eosinophilia

-> nonsp sym , n/v

94
Q

RCC

sym?

A
  • > ASX
  • > flank pain, hematuria, abd renal mass
  • > varioceles fails to emply -> tumor ob gonadal vein
  • > inc EPO: polycythemia asso with anemia

dx:
- > abd CT scan

step 2 ck - IM mix (5 decks)

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