Incorrect Questions Flashcards
1
Q
acute MI on ECG
A
new development of ST-segment elevation or depression or the development of new T-wave changes such as hyper acute T waves or T wave inversions in two contiguous leads
2
Q
posterior wall infarct ECG leads
A
V1-V4
3
Q
posterior wall infarct vessels
A
left coronary artery
- circumflex branch
right coronary artery
- posterior descending branch
4
Q
posterior wall ECG findings
A
tall R waves
ST-segment depression
upright T waves
5
Q
inferior wall infarct ECG leads
A
II, III, aVf
6
Q
inferior wall infarct vessels
A
right coronary artery
- posterior descending branch
7
Q
inferior wall ECG findings
A
T-wave inversion
ST-segment elevation
8
Q
lateral wall infarct ECG leads
A
I, aVl, V5, V6
9
Q
lateral wall infarct vessels
A
left coronary artery
10
Q
lateral wall infarct ECG findings
A
ST-segment elevation
11
Q
septal wall infarct ECG leads
A
V1 and V2
12
Q
septal wall infarct vessels
A
left anterior descending artery
- septal branch
13
Q
septal wall infarct ECG findings
A
R wave disappears
ST-segment rises
T-wave inverts
14
Q
anterior wall infarct ECG leads
A
V2-V4
15
Q
anterior wall infarct vessels
A
left anterior descending artery
- diagonal branch
16
Q
anterior wall infarct ECG findings
A
poor R-wave progression
ST-segment elevation
T-wave inversion
17
Q
what causes neck stiffness (meningismus) after subarachnoid hemorrhage
A
breakdown of blood products within CSF
18
Q
what is meningismus
A
neck stiffness indicating inflammation of the meninges
19
Q
multiple endocrine neoplasia type 2
A
pheochromocytoma
thyroid carcinoma
hyperparathyroidism
20
Q
cells for medullary thyroid cancer
A
thyroid parafollicular cells
21
Q
what do thyroid parafollicular cells secrete
A
calcitonin
22
Q
Atrial natriuretic peptide
A
seen in cardiac amyloidosis
23
Q
ß-amyloid
A
accumulates in neurofibrillary tangles in Alzheimer’s disease
24
Q
immunoglobulin light chain
A
amyloidosis associated with multiple myeloma
25
tuberous sclerosis genetics
autosomal dominant neurocutaneous disorder
26
presentation of tuberous sclerosis
```
infants present with convulsive seizures (infantile spasms)
developmental delay
abnormal skin findings:
- angiofibromas (sebaceous adenomas)
- ash-leaf spots best seen on Wood lamp
- shagreen patches
CNS: periventricular tubers
heart: rhabdomyoma
regina: mulberry tumors, phakomas, Regina hamartomas
kidneys: angiomyolipomas
```
27
most common kidney finding in tuberous sclerosis
angiomyolipomas
28
diagnosis of allergic dermatitis
patch testing
29
cells involved in allergic dermatitis
T cells, NOT IgE
30
O'Brien's test is for
superior labral anterior to posterior tear
31
O'Brien's test
passively flex patient's shoulder to 90° then internally rotate shoulder
32
positive O'Brien's test
pain and/or clicking when arm is in full internal rotation, but not when arm is in neutral rotation
33
Speed test for
irritation of the long head of the biceps tendon
34
α-1 antitrypsin deficiency (A1AD)
inherited condition characterized by genetic defect that causes configurational change in α-1 antitrypsin molecule that prevents its release from hepatocytes
35
what does α-1 antitrypsin do
protects lung tissue from damage by proteases
36
ancestry for α-1 antitrypsin deficiency
Northern European
37
presentation of α-1 antitrypsin deficiency
emphysema - unchecked proteases cause damage to alveolar walls
liver disease
38
extra pulmonary manifestations of A1AD
```
necrotizing panniculitis
vascular disease
vasculitis (c-ANCA positive)
inflammatory bowel disease
glomerulonephritis
```
39
common pathogens in meningitis for <1month
streptococcus agalactiae
escherichia coli
listeria monocytogenes
40
common pathogens in meningitis for 1 month to 23months
```
streptococcus pneumonias
neisseria meningitidis
S. agalactiae
haemophilus influenza
E. coli
```
41
common pathogens in meningitis for 2 years to 50 years
N. meningitidis
| S. pneumoniae
42
common pathogens in meningitis for > 50 years
S. pneumonias
N. meningitides
L. monocytogenes
Aerobic gram-negative bacilli
43
empiric antibiotic treatment for meningitis <1 month
ampicillin + cefotaxime
OR
ampicillin + aminoglycoside
44
empiric antibiotic treatment for meningitis 1 month to 23 months
vancomycin + third-generation cephalosporin
45
empiric antibiotic treatment for meningitis 2 years to 50 years
vancomycin + third generation cephalosporin
46
empiric antibiotic treatment for meningitis >50 years
```
vancomycin
+
ampicillin
+
third-generation cephalosporin
```
47
why ceftriaxone for meningitis
provides good penetration into CSF
| effective against most major causes of adult meningiits
48
why vancomycin for meningitis
increasing resistance of some bacteria to ß-lactams
49
why ampicillin for meningitis
increased risk of listeria in patients over 50
50
descriptions suspicious for malignancy in breast cancer
"linear branching micro calcifications"
| "grouped irregular micro calcifications"
51
descriptions suspicious for benign breast changes
"vascular/skin calcifications"
"rim calcifications"
"large and coarse calcifications"
"smooth round and oval calcifications"
52
what is the next best step for suspected malignancy in breasts without a palpable mass?
stereotactic core biopsy
53
when is stereotactic core biopsy indicated?
non-palpable masses diagnosed on mammography
54
HELLP syndrome
Hemolysis
Elevated Liver
Low Platelets
55
Risk factors for HELLP syndrome
```
African American
extremes of age
multiple gestations
molar pregnancy
renal disease
chronic hypertension
```
56
another name for colonic pseudo-obstruction
Ogilvie syndrome
57
what is pseudo-obstruction
acute dilation of the colon with signs and symptoms of mechanical bowel obstruction without an actual mechanical or anatomic obstruction of flow
58
signs/symptoms of pseudo-obstruction
```
abdominal distension
abdominal pain
nausea/vomiting
constipation
bowel sounds, hypoactive
abdominal tenderness, mild
abdominal tympani
```
59
who commonly gets pseudo-obstruction
severely ill or post surgical patients with certain medications (calcium channel blockers, narcotics, α-2 antagonists) and/or electrolyte imbalances (hypocalcemia, hypokalemia)
60
diagnosis of Ogilvie syndrome
clinical history and physical exam, abdominal radiography
61
abdominal x-rays in Ogilvie syndrome
colonic dilation, usually from cecum to splenic flexure
62
management of Ogilvie syndrome
```
urgent NG decompression via NG tube
strict NPO
IV fluid resuscitation
labs to evaluate electrolyte abnormalities
abdominal imaging
```
63
complications of Ogilvie syndrome
colonic ischemia and/or perforation
64
sideroblastic anemia
acquired disease caused by an abnormality in iron metabolism
65
acquired causes of sideroblastic anemia
```
lead
drugs
- isoniazid, alcohol, chloramphenicol
collagen vascular disease
neoplasm
```
66
labs in sideroblastic anemia
microcytic
hypo chromic
increased ferritin and iron
TIBC normal or elevated
67
peripheral smear of sideroblastic anemia
anisocytosis
target cells
poikilocytosis
occasional siderocytes
68
what is pathognomonic for sideroblastic anemia
siderocytes
69
what are siderocytes
hypo chromic red blood cells which have coarse basophilic granules visible via Wright or Wright-Giemsa stain
70
missed abortion
death of a fetus before 20wks with complete retention of products of conception and a closed cervical os
71
physiologic changes in pregnancy related to thyroid hormones
TBG increases
TSH no change
T4, total increases
T4, free no change
72
treatment for acute RV infarction
isotonic IV fluids (increase preload, cardiac output, and Pressure)
aspirin
cardiac catheterization
73
initial treatment of acute pericarditis
NSAIDs plus colchicine
74
gram stain of strep pyogenes
gram-positive cocci in chains
75
what is Peutz-Jeghers syndrome
autosomal dominant mutation in a tumor suppressor gene (STK11)
76
characteristic findings of PJS
2 of:
- 2 or more Peutz-Jeghers-type hamartomatous polyps of the GI tract
- mucocutaneous hyperpigmentation of the mouth, lips, nose, eyes, genitalia, and fingers
- family history of PJS
77
most commonly increased GI cancer risks in patients with PJS
colorectal
gastric
small bowel
pancreatic
78
most commonly increased extra intestinal cancer risks in patients with PJS
```
breast
ovary
cervix
Sertoli cell tumor of the testis
lung
thyroid
```
79
diphyllobothrium latum
cestode (tapeworm) from fish
acquired from ingesting infective larvae in fish, usually freshwater or spend most life in freshwater
larvae killed by flash freezing
causes vitamin B12 deficiency
80
most common causes of diphyllobothrium latum
salmon, trout, whitefish, herring, cod, freshwater squid, mackerel, and red snapper
81
sudden-onset severe chest pain that is ripping or tearing in nature, HTN, inter-arm pressure difference, asymmetric pulses
aortic dissection
82
aortic dissection - ascending
anterior chest
83
aortic dissection - aortic arch
neck and jaw
84
aortic dissection - descending
inter scapular area
85
mycosis fungoides
mc type of cutaneous T-cell lymphoma, a non-Hodgkin lymphoma
86
cutaneous T-cell lymphoma
malignant disease of helper T-cells within he skin and lymph nodes
87
clinical features of cutaneous T-cell lymphoma
initially, scaly plaques along with an erythematous, pruritic rash (often mis-dx)
may then progress to tumor stage with at least one tumor (lesion >5mm from skin)
88
threes phases of mycosis fungoides
1 - patches (nonspecific dermatitis-like patches)
2 - plaques (pruritic plaques and lymphadenopathy)
3 - tumors (likely to ulcerate)
89
tx of mycosis fungoides
topical (radiation, photochemotherapy, photodynamic therapy, and laser surgical excision)
90
back/flank pain, dark or cloudy urine, fever, and urinary incontinence or increased frequency
renal papillary necrosis (RPN)
91
u/a in renal papillary necrosis (RPN)
necrotic tissue that has sloughed from the kidneys
92
CT RPN
anatomical defects - medullary ring shadows and/or hydronephrosis
93
risk factors for RPN
acetaminophen or NSAID use, sickle cell anemia (s/t ischemia of kidneys), urinary tract obstruction, and diabetes
94
tx RPN
supportive
95
CT hepatic hemangioma
well-defined hypotenuse mass with typical filling pattern for hemangioma - peripheral nodular enhancement followed by complete opacification on delayed images
96
risk factors for anal cancer
HPV, receptive anal intercourse, and smoking
97
mc type of anal cancer
squamous cell carcinoma
98
liver cirrhosis immunization recommendations
HepA, HepB, influenza, and pneumococcal polysaccharide vaccine 23
99
res ipsa loquitur
'the thing speaks for itself'
- no direct evidence of physician's negligence
- requires the accident must be of a kind which ordinarily does not occur in the absence of someone's negligence and the patient did not contribute to the accident
100
muscle strength grading
Grade 0 = no muscle movement
Grade 1 = trace muscle contraction but no joint movement
Grade 2 = joint and muscle movement with gravity and resistance eliminated
Grade 3 = joint and muscle movement against gravity, but not resistance
Grade 4 = joint and muscle movement against gravity and resistance, but less than normal
Grade 5 = normal joint and muscle movement against gravity and resistance
101
radial nerve palsy
C5-T1
most often fx at mid-humerus or compression of nerve by crutches
paralysis of wrist extensors, digits, and forearm supinators ('wrist drop')
102
axillary nerve injury
C5-C6
fx of surgical neck of humerus
motor of deltoid and sensory overlying deltoid
103
long thoracic nerve injury
serrates anterior
| winged scapula
104
median nerve injury
pronation, flexion of the hand at wrist joint, and thumb opposition
'ape hand' deformity
105
ulnar nerve injury
fx of medial epicondyle
| pinpoint pain, loss of sensation over medial hand, decreased grip strength
106
hydrosalpinx
collection of fluid inside Fallopian tube and is almost always a complication of acute salpingitis/pelvic inflammatory disease
107
pelvic ultrasound of hydrosalpinx
sausage-like, cystic lesions filled with clear fluid
108
radioactive iodine uptake scan in dequervain thyroiditis
decreased uptake
| d/t stored hormones being released from the inflamed gland, not from overproduction
109
Grave's disease antibody
thyroid-stimulating hormone receptor antibody (TRAb)
110
kallman syndrome
hypogonadotropic hypogonadism and impaired ability to smell
111
lab findings in Kallman syndrome
low LH, low FSH, low testosterone, progesterone, and estrogen
112
lichen planus
immune-mediated skin disorder in middle aged adults
five p's : pruritic, purple, polygonal, and papules or plaques
commonly found on ectremities
113
viewing of lichen planus
fine white lines (Wickham striae)
114
TCA toxicity
CNS depression, coma, seizures, cardiac dysrhythmias, and respiratory depression
115
mc EKG findings in TCA toxicity
sinus tachycardia
prolonged PR interval
widening of QRS complex
QTc interval prolongation
116
what can be used to reduce incidence of PUD associated with NSAIDs
misoprostal - prostaglandin
117
arsenic poisoning
```
acute = GI symptoms - watery diarrhea, abdominal pain, and vomiting
chronic = polyneuropathy and skin pigmentation changes
```
118
tx arsenic poisoning
chelation therapy with dimercaprol (BAL) to speed excretion
119
mc hematologic complication with nephrotic syndrome
venous thrombosis and pulmonary embolism
120
rib movements
ribs 1-5: pump handle
ribs 6-10: bucket-handle
ribs 11-12: caliper
121
muscles used for rib tx
```
rib 1: anterior scalene
rib 2: posterior scalene
ribs 3-5: pectoralis minor
ribs 6-9: serratus anterior
ribs 11-12: quadrates lumborum
```
122
odds ratio
determining the different levels of risk attributable to the exposure
123
calculation of odds ratio
```
= ad/bc
a = exposure & disease
b = exposure & no disease
c = no exposure & disease
d = no exposure & no disease
```
124
LVH on ekg
increased in amplitude of QRS complexes and left deviation
125
causes of LVH
uncontrolled htn, cvd, aortic stenosis, and aortic insufficiency
126
tx LVH
if reversible, target cause of disease
| ex: HTN? tx ACE-i, ARB, direct renin inhib, CCBs
127
minor pelvic fx
located within pubic rami
128
consider minor pelvic fx in pt with:
leg length discrepancy, abnormal positioning of leg, focal bony tenderness of hip or pelvis, reluctance to move leg, and inability to lift leg
129
granulomatosis with polyangiitis
necrotizing vasculitis that primarily affects lungs and kidneys
130
nephritic syndrome
hematuria, oliguria, and mild proteinuria
131
granulomatosis with polyangiitis
rhinitis and hemoptysis
positive c-ANCA
cxr: interstitial lung disease, infiltrates, cavitary nodules
IF negative for antibodies
132
contact dermatitis (diaper)
erythema and maceration on convex skin surfaces that are in direct contact with the diaper
133
comedonal or noninflammatory acne
multiple open and closed comedones and small papules and pustules without significant erythema or inflammation
134
tx comedonal acne vulgars w/o inflammatory component
topical retinoid
135
topical retinoid MOA
reduce follicular hyper proliferation resulting in reduced follicular occlusion and reduced comedones formation
136
four main pathogenic factors of acne
1. increased sebum production (triggered by presence of androgens)
2. follicular hyper proliferation (excessive keratinization which blocks the sebum from exiting the follicles)
3. proliferation of Cutibacterium acnes, part of the normal skin lora, within the sebum-clogged follicles
4. inflammation (trigged by proliferation of C. acnes)
137
Galeazzi fracture
fx of distal third of the radius in conjunction with dislocation of the distal radioulnar joint
138
nerve affected in Galeazzi fx
anterior interosseous nerve (branch of the median nerve) is damaged
-> paralysis of the flexor policies longs and flexor digitorum profundus -> loss of ability to pinch between the thumb and index finger
139
tricuspid stenosis murmur
significant diastolic pressure gradient -> low pitched diastolic rumble heard at lower left sternal border that enhances with insporation
mc cause is rheumatic fever
140
what can be used to increase breast milk production
metoclopramide, dopamine antagonist
141
hx of travel to tropical/subtropical, eosinophilia, pruritic skin lesion f/b transient cough and later GI
parasites
| Strongyloides stercoralis
142
Echniococcus granulosus
'hydatid cysts'
mc - lung, liver, and CNS
chest pain, hemoptysis and HA or disorientation d/t increased ICP
NO GI
143
onchocerciasis volvulus
transmitted by blackfly, common in africa
'river blindness'
dx: skin snip test and microscopic exam, slit lamp
144
Schistosoma haematobium
'swimmer's itch'
fever, urticaria, nausea, and abdominal pain
mc cause of squamous cell carcinoma of the urinary bladder
145
trypanosoma brucei
African trypanosomiasis, or African sleeping sickness
no GI manifestations
fever, malaise, chancre at site of tsetse fly bite f/b meningoencephalitis and daytime somnolence
146
Strongyloides stercoralis
penetrate skin in foot from soil
penetrate colonic mucosa, travel hematogenously to other organ systems -> hyper infection syndrome in immunocompromised host
pneumonitis, abdominal apin, severe fever, meningitis/encephalitis
147
radial head somatic dysfunction muscle energy
physician supinates the arm to move the radial head anterior while the patient resists by pronating the arm
148
pulmonary fibrosis
chronic inflammation of the lung parenchyma -> fibroblast activation and proliferation
slow onset with dyspnea on exertion, chronic cough, wheezing, and chest pain
149
physical exam of pulmonary fibrosis
inspiratory rales
| signs of right heart failure: elevated JVD, S3 heart sounds, RV heave, digital clubbing
150
pulmonary fibrosis on xray
reticular, nodular, or ground-glass pattern
| severe: cystic space in the lung periphery d/t destruction of lung parenchyma
151
causes of pulmonary fibrosis
idiopathic, irritation with cigarettes, medications (amiodarone), environmental allergens, environmental pollutants, recurrent aspiration, and reflux
152
pulmonary fibrosis PFT
decreased diffusion capacity
153
management of fibromyalgia
duloxetine, milnacipran, and pregabalin
154
eligibility for mechanical thrombectomy
initiated within 6hrs of symptom onset, imaging without hemorrhage and minimal signs of ischemic change
155
thiazide diuretics
hydrochlorothiazide and chlorthalidone
156
Henoch Schonlein Purpur (HSP)
inflammation of small to medium blood vessels
157
fever, palpable purpura on LE and buttocks, migratory polyarthritis of large joints, glomerulonephritis, abdominal pain in peds pt
Henoch-Schonlein Purpura
| aka IgA vasculitis
158
IgA nephropathy
primary glomerulonephritis
| recurrent episodes of macroscopic hematuria, mild flank pain, and low-grade fever
159
peds pt with tuberculosis
several days to weeks of fever, cough, night sweats, and weight loss
cxr - hilar adenopathy
foreign born, visited endemic area, or adult contact
160
iodine deficiency
hypothyroidism goiter
161
tx actinic keratoses
5-FU in diffuse areas
| cryo for isolated lesions
162
pancreas posterior chapman's point
between transverse process of T7 and T8 on right
163
pancreas anterior chapman's point
7th ICS right
164
complication of acute diverticulitis
pneumaturia
165
number needed to treat
1/absolute risk reduction
ex:
0. 8% -> 1/0.008 = 125
166
Berger's disease
presents within days of URI
| caused by deposition of IgA antibody in glomerulus
167
trichuris trichiura
whipworm
| diarrhea, mucus or bloody, worse at night, abdominal pain
168
brugia malayi
filarial nematode transmitted by mosquitoes
| inhabits lymphatics -> lymphadenitis and lymphedema
169
dipylidium caninum
dog tapeworm, transmitted to humans via flea ingestion
| asymptomatic, but can have abdominal pain or diarrhea
170
enterobius vermicularis
pin worm, common nematode in children
| intense pruritus of ani, particularly at night
171
loa loa
African eye worm
transmitted by chrysoprase fly
soft tissue swelling sand ocular migration
172
TB pleural effusion
lymphocytes >80%, greatly increased total protein
adenosine deaminase <40 r/o TB
glucose is low (30-50)
173
CHF pleural effusion
transudative bilateral
174
rheumatoid arthritis pleural effusion
extremely low glucose (< 30)
| *extremely low glucose also found in empyema and malignancy*
175
lymphoma pleural effusion
chylothorax = white and milky pleural fluid with TG > 110
176
PE pleural effusion
bloody
| *bloody also seen in malignancy*
177
dawn phenomenon
result of early morning growth hormone secretion
| GH is an antagonist to insulin, so may cause hyperglycemia in the middle of the night and early morning
178
initial step in management if pt has increased morning glucose
measure blood glucose again at 3am prior to making any change to insulin regimen
179
inability to tolerate oral intake and obstipation in first few days after an abdominal operation
postoperative ileus
normal intestinal structure on CT
self-limited
180
positively skewed distribution
mean > median
| mean, median > mode
181
bimodal distribution
two distinct modes
182
negatively skewed distribution
mean < median, mode
183
normal (gaussian) distribution
classic symmetric bell curve
| mean = median = mode
184
management for isolated cleft lip in otherwise healthy infant
surgically manage at 3-6mo of age
185
SAAG > 1.1
portal HTN likely to be cause of ascites
| may be portal vein thrombosis, cirrhosis, or CHF
186
diagnostic test to confirm thoracic outlet syndrome
arteriography
187
superficial thrombophlebitis
localized extremity pain and redness
cordlike area of induration, erythema
tx: NSAIDs, elevation, heat, and support stockings
188
hypersensitivity pheumonitis PFT
decreased diffusing capacity of the lungs for carbon monoxide
189
hypersensitivity pneumonitis cause
associated with bird or pigeon breeding
190
generalized weakness, easy fatiguability, depression, HTN, recurrent episodes of pseudo gout, nausea, vomiting, and abdominal pain
hypercalcemia
191
pt < 5y/o with fever, bull formation, and sheetlike desquamation of the skin
staph scalded skin syndrome
192
chi-square
best statistical test for analyzing studies where results are 2 proportions
193
tx of narrow QRS tachycardia in unstable pt
sedation and synchronized cardioversion
194
chronic urticaria
antihistamines- diphenhydramine or cetirizine
195
Creutzfeldt-Jakob disease
rapidly progressive dementia accompanied by at least 2 of the four findingS:
- myoclonus
- visual or cerebellar disturbance
- pyramidal/extrapyramidal dysfunction
- akinetic mutism (lack of motor activity)
196
tests in CJD
EEG: sharp wave complex
MRI: putamen and head of caudate
CSF: elevated protein, normal glucose, no cells
197
biopsy in CJD
gliosis (increased size and number of astrocytes)
neuronal loss
spongiform change (tissue replaced with vacuoles)
abnormal protein buildup (using prion protein immunoperoxidase)
198
myxoma
mc primary tumor of heart in adults
| connective tissue in right or left atria
199
symptoms of myxoma
weight loss, fatigue, dyspnea, syncope
| ball-valve obstruction of mitral valve -> 'tumor plop' with early diastolic thud f/b diastolic murmur
200
diagnostic test of choice for diverticulitis
CT scan
201
treatment of neuroleptic malignant syndrome
bromocriptine
202
tx cyanide poisoning
from sodium nitroprusside
| hydroxocobalamin - binds cyanide to facilitate urinary excretion
203
altered mental status, autonomic hyperactivity, seizures, and tactile/visual hallucinations
delirium tremens - lorazepam tx
204
folliculitis
pruritic, erythematous pustules
| staph aureus
205
Ewing sarcomas
primary malignant bone tumors affecting children and adolescents
206
Ewing sarcoma xray
destructive lesion with a periosteal reaction causing layers of reactive bone to form, giving a so-called 'onion-skin' appearance
207
bone pain, skeletal deformities, hearing loss, elevated alk phos, enlargement of skull, jaw, or clavicle
Paget disease of the bone
208
Paget disease of bone xray
thick bone cortices with bony deformities
| prominent radimdense peripheral contours of vertebrae common
209
fat embolism
```
respiratory changes (dyspnea, tachypnea, cough, hypoxia)
neurologic abnormalities (mental status change)
petechial rash 1-3d after insult
```
210
serum glucose >600, bicarb >/= 15, serum pH >/= 7.30; no ketonuria, profound dehydration, alteration of consciousness
Hyperglycemic Hyperosmolar State (HHS)
| effective serum osmolality >320
211
polyarteritis nodosa
necrotizing arteritis of medium-sized vessels
| affects skin, cardiovascular, renal/mesenteric, and nervous systems
212
derm manifestations of polyarteritis nodosa
livedo reticular, subcutaneous nodules, digital gangrene, and ulcers
213
polyarteritis nodosa test
hepatitis B
| negative p-ANCA
214
polyarteritis nodosa findings
dermatologic
hypertension caused by renal artery involvement
abdominal pain assoc with meals d/t mesenteric ischemia
215
dx polyarteritis nodosa
biopsy or mesenteric angiography
216
cariogenic shock
causes increased pulmonary capillary wedge pressure and JVD
cxr & lung: pulmonary congestion
low cardiac output, high systemic vascular resistance (SVR)
217
neurogenic shock
disruption of autonomic nervous system control over vasoconstriction
peripheral vasodilation -> warm, flushed skin
low cardiac output, pulmonary capillary wedge pressure, AND SVR
218
septic shock
hx recent infection
peripheral vasodilation -> warmed, flushed skin
decreased SVR -> increased cardiac output
low pulmonary capillary wedge pressure
219
hypovolemic shock
trauma, diarrhea, vomiting, GI bleeding, SBO, or burns
decreased preload -> decreased cardiac output -> increase SVR to compensate
low pulmonary capillary wedge pressure
220
H&P cardiogenic shock
MI, CHF, chest pain.
| cold clammy skin, JVD, and pulmonary congestion
221
H&P hypovolemic shock
History of fluid loss
| Cold clammy skin, pallor
222
H&P septic shock
Recent infection, fever, leukocytosis, warm flushed skin
223
H&P anaphylactic shock
inciting exposure
224
H&P neurogenic shock
severe CNS trauma or hemorrhage
