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UW Wrong Answers > IM UW 2 > Flashcards

IM UW 2 Flashcards

1
Q

Pt w/recent travel to Southeast Asia a yr ago. Now has nonpainful nonparticipating skin lesion on upper arm that began 2 months ago. Numbness and tingling in fingers + thickened tender lunar nerve at elbow. Dx? Tx? How do you dx?

A

Dx w/ full thickness skin biopsy of lesion = leprosyTx: dapsone and rifampin

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2
Q

Why do blood transfusion pets experience parethesias?

A

Hypocalcemia! Whole blood contains citrate anticoagulant this causes ca & mg to chelate reducing plasma levels causing parethesias

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3
Q

Tx of essential tremor

A

Tremor regardless of movement. Tx: Propanolol > pirimidone/toprimate > benzo

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4
Q

Tx of pagets of the bones?

A

Optimize vitamin D and calcium intake and then add BISPHOSPHONATES

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5
Q

37 F from Cambodia w left sided weakness 2h, progressive exertions dyspnea, nocturnal cough, occasional hemoptysis, episodes of palpations and irregular hearts beat. Dx? Explain…

A

Sweetie probably had rheumatic fever when she was younger causing mitral stenosis leading to increased left atrial pressure causing dilation resulting in episodes of a fib causing her stroke

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6
Q

Cause of trigeminal neuralgia

A

Compresssion of trigeminal nerve root

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7
Q

PML sx (JC virus)

A

Slowly progressive confusion, ataxia, seizures, white matter lesions of the brain WITHOUT enhancements or edemaVs toxo = ring enhancing lesions with edema

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8
Q

Pt that is in ICU after trauma. Hypotension tx w/aggressive IVF and vasopressin. What are they at risk for?

A

NE induced vasodpasm causing ischemia and necrosis of digits

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9
Q

What is spare eye injury?

A

Immune mediated injury to one eye after trauma to the office at five. Do to uncovering of hidden antigens. Presents as. PeriLimbal flush, uveitis papillary edema, blindness, floaters

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10
Q

Strongest RF for stroke?

A

HTN

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11
Q

Small vessel lipohyalinosis of the brain?

A

Aka fucking hyalin thickinging of a microatheroma in a small artery of the brain that has the potential to cause a stroke

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12
Q

Side effects of elevated Ca in MM?

A

Fatigue, depression and CONSTIPATION

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13
Q

Can you get HIT with enoxaparin?

A

Yes!! This is LMWH!! It will increase ur risk of thrombosis

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14
Q

Pt tx for asthma exacerbation and recovers. Next morning has trouble moving arms and weakness + tremor. Dx?

A

Pt received b2 agonist for asthma to and likely reduced serum K levels by driving them into cells causing hypokalemka

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15
Q

CT scan of Alzheimer’s brain would show…

A

Diffuse cortical and subcritical atrophy that is disproportionally greater in the temporal and parietal lobes

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16
Q

Car crash in elderly shows weakness in upper Body > lower (usually) dx?

A

Central cord syndrome I fix the upper body more than the lower body because the CST fibers in the cervical spine or closer to the central canal. May also see loss of PIT.

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17
Q

Common side effects of methotrexate?

A

Oral ulcers, acute rise in serum transaminases, alopecia, pulmonary tox, bone marrow suppression(anemia, leukopenia, thrombocytopenia)

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18
Q

Antibiotics used for acne?

A

Minocyclin or doxycycline(teeth discoloration, GI stuff, phototoxicity, inhibition of bone grows in children)

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19
Q

Melancytic Nevis vs melanoma

A

Melanoma will have: ABCDE = asymmetry, uneven boarders, color variability, >=6mm diameter and evolve in size. Nevis will not have that shit.

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20
Q

Pt w/stiff neck, shoulders and hips for the last 3 months that last 1-2h in the morning. No other sx. Elevated ESR. Tx?

A

Polymyalgia Rheumatica!!! Tx w/ LD prednisone

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21
Q

What is Kussmauls sign? When would you usually see it? Tx?

A

Increased JVD with inspiration usually a sign of RV failure. Seen with RV infarct(2,3,aVF). DO NOT GIVE BB. For RV infarct you need to increase preload = IVF bolus

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22
Q

Person with BPH is given amitriptyline for somthing. 8 days later has abdominal pain. What could of happened?

A

Anticholinergic fx of amitrypt caused urinary retention! Due to dec detrusor contraction and preventing urethral sphincter relaxation

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23
Q

Sx of cyanide toxicity with nitroprusside.

A

Used to tx HTN emergency. Look for pt that initially improved with nitro and followed by acute neurological changes(AMS, coma, seizures) in a pt w/ renal insufficiency.

24
Q

TB tx plan? When do you stop INH?

A

4 drugs for 2months(INH, RIF, EMB, PZA) then 2 for 4m(INH and RIF)— stop INH when live enzymes >100. Mild elevations are okay! <100

25
Q

How do you treat myasthenic crisis?

A
  1. Intubate2. Stop ACh-inhibitors
26
Q

Males prolactinoma vs testicular dz?

A

Both: decreased libido, dec body hair, dec testosterone and sperm countTesticular: increased LH/FSHProlactinoma: dec LH/FSH

27
Q

PH, GLU & WBC assoc with bacterial invasion of pleural space?

A

PH < 7.2 = anaerobic GLUcose < 60 = consumptionWBC > 50,000 = high protein due to cell destruction!This is an infection! But gram stain usually beg due to low bacterial count. Tx w/ abx + drainage

28
Q

PH, GLU & WBC assoc with sterile exudate of pleural space?

A

PH >= 7.2GLUcose >= 60WBC <= 50000Gram stain neg to w/ abx prophylacticly

29
Q

MC vein to get a PE from?

A

Thigh! (Iliac, femoral and poplitea) calf veins usually go away on their own

30
Q

What is the Jarisch-Herxheimer reaction?

A

6-8hr are initiating syphillis tx presents with fever, chill, myalgias an rapid progression to 2nd syphillis! This is due to destruction of the bug and will resolve in 48hr. Tx by giving support

31
Q

Test with the highest sensitivity for HF?

A

BNP>400 = HF

32
Q

Can steroids cause myositis?

A

Yes!!! cK and ESR will be normal!

33
Q

Drug for gastroparesis? What do they use in the hospital for acre exacerbation?

A

MetoclopramideIV erythromycin for acute

34
Q

What is Aspirin exacerbated respiratory distress(AERD)?

A

Person taking asa develops. Asthma chronic rhinosinusitis with nasal polyps, bronchospasms or nasal congestion, physical exam shows gray nasal masses.Tx by removing polyps

35
Q

Looks like PCP but doesn’t show up on tox screens and lasts a lot longer…..drug?

A

Bath Salts

36
Q

Pt w/fever, HA, confusion some icterus and rev smear shows fragmented cells. Platelets are low(44). Dx? Tx?

A

TTP = PLASMA exchange *do not exchange platelets they will just get destroyed

37
Q

Vomiting will cause……acidosis/alkalosis? why? How will urine be different?

A

metabolic alkalosis due to excessive vomiting up Cl = increase aldo = NaCl absoption, Na ab and H exc = worsens alkalsos + low serum Cl makes bicarb exc difficult.urine = Low Cl and Na bc body is trying to replace this! with other diseases like ACTH, primary aldo, cushing you wont see low urine Cl

38
Q

Diarrhea will cause….acidosis/alkalosis? what are you losing in stool?

A

Metabolic Acidosis! Losing: Na, Cl, K, HCO

39
Q

why is there an increased risk of athrosclerosis with neophroic syndrome?

A

decrease protein means the liver starts throwing all sorts of crap into the blood stream including lipids = accelerating atherosclerosis. Also increased risk of coagulation due to loss of Antithrombin 3

40
Q

Patiented with B12 deficiecny are at an increaed risk of….(what cancer?)

A

gastric cancer

41
Q

What is the most common nephrotic syndrome in the overall population? #2?

A

FSGS =1membraneous =2

42
Q

Which Nephrotic syndrome is associated with adenocarcinomas of the lung & SLE?

A

membraneous nephropathy

43
Q

which nephrotic syndrome is associated wtih heroin used, HIV, obesity?

A

FSGS

44
Q

when is the answer frontrotemporal dementia?

A

when shit involves behavior more. like the lady is now eaing shit or big personality changes

45
Q

What live vac can you give to a person with HIV only if CD > 200?

A

MMR

46
Q

Acalculous cholecystitis

A

Seen in acute inflammmatuin of gallbladder in absence of stones. Hospital patients who are very ill(trauma, burns, intubation, shock,etc) tx like normal

47
Q

Milk-alkali syndromeSx? Tx?

A

Caused by excessive calcium carbonate use(like someone taking ca for osteoporosis) resulting in hypercalcemia(stones,moans, ab overtones) = constipation, neuro sx, polydip, polyuria, AKI, metabolic alk, hypo P & MgTx: stop agent, IVF + Furosemide

48
Q

Common places to find pseudogout?

A

Knees and ankles

49
Q

Alcoholic cerebellar degeneration vs wernicke encephalopathy

A

Both >10 yrs if alcohol use that dmgs purkinje cells in the cerebellar vermis = loss of trunca coordination w/ wise gait and postural instability(abnormal heel and shin but normal finger nose) Wernicke will have all ^ and oculomotor dysfunction(horizontal nystagmus) and encephalopathy

50
Q

Tight control of A1C will decrease —

A

Microvascular(nephropathy and retinopathy)

51
Q

When would you see clinic jerks with suncopal episode?

A

Prolonged cerebral hypoxia

52
Q

Hypo—

A

Na

53
Q

Pulses parvus & tardus vs bounding pulses. Which do you see with AS ? Which with AR?

A

Bounding pulses with aortic regurgitatePulses parvus & tardus(decreased amplitude and upstroke) with stenosis

54
Q

What drug should be avoided in glaucoma?

A

Atropine! Anticholinergic

55
Q

Vitiligo is associated with what AI disorder?

A

Hashimoto thyroidiitis, graves

56
Q

Common sx of graph vs host

A

Macular papular rash and forming palms, soles, and face. Intestines may have blood part of diarrhea, abnormal liver function test. Basic pathophysiology mech involves host major and minor HLA antigens by donor T cells and a consequent cell mediated response

57
Q

What drug class can cause hyponatremia and SIADH in elderly?

A

SSRI

UW Wrong Answers (13 decks)

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