- Primary hyperparathyroidism - pituitary adenoma - pancreatic tumors (especially gastrinomas)

- medullary thyroid cancer - pheochromocytoma - Primary hyperparathyroidism

- medullary thyroid cancer - pheochromocytoma - mucosal neuromas/ marfanoid habitus

Internal Medicine Flashcards by Charlene Omekwu

Korsakoff syndrome is a potential complication of Wernicke encephalopathy that is characterized by __________, ________, ________, and _______.

retrograde and anterograde amnesia with preserved long term memory, confabulation, lack of sight and apathy

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___________________ often cause feminization (eg, gynecomastia) due to the production of estrogen by tumor cells.

Leydig cell testicular tumors

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In patients with alcoholic cirrhosis, ____________ can reduce liver inflammation, fibrogenesis, and portal pressure, which can lead to the resolution of ascites and, ultimately, improved survival.

Cessation of alcohol use

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____, ______ and _______ accounts for >90% of chronic cough in non smokers who do not have pulmonary disease

Post nasal drip, GERD and asthma

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For patients with suspected post nasal drip initial empiric treatment includes ___________ or _________

Oral first-generation antihistamine (eg chlorpheniramine) or combined antihistamine-decongestant (eg brompheniramine and pseudoephedrine)

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_______ is characterized by a painful, red eye with tearing and decreased visual acuity.

Anterior uveitis

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_______________ in children typically presents with an erythematous, tender, warm lymph node as well as possible fever and fluctuance

Acute, unilateral cervical lymphadenitis

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________ is an intensely pruritic rash characterized by small erythematous papules and burrows in the axillae, periumbilical area, genitalia and interdigital web spaces

Scabies

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The first line treatment of scabies is ________ or _______

Topical 5% permethrin or oral ivermectin

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Hematuria in the setting of direct penile trauma concerning for _________ and should prompt ____________

Urethral injury

Retrograde urethrography

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___________ is a small-vessel vasculitis that commonly presents with palpable purpura (leukocytoclastic vasculitis), arthralgias, fatigue, peripheral neuropathy, liver involvement and renal disease

Mixed cryoglobulinemia

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____________ is the most common cause of dementia in the western world. It is characterized initially by gradual memory loss, language difficulties, and apraxia, followed by impaired judgment and personality and behavioral changes.

Alzheimer’s disease

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Type 1 MEN

Primary hyperparathyroidism
pituitary adenoma
pancreatic tumors (especially gastrinomas)

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Type 2A MEN

medullary thyroid cancer
pheochromocytoma
Primary hyperparathyroidism

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Type 2B MEN

medullary thyroid cancer
pheochromocytoma
mucosal neuromas/ marfanoid habitus

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Milk-alkali syndrome is caused by excessive intake of _____ and ____

excessive intake of calcium and absorbable alkali

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clinical findings seen in milk-alkali syndrome include ______, _______ and ________

symptomatic hypercalcemia, metabolic alkalosis and acute kidney injury

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_________ should be suspected in patients with AIDS who have CD4 counts<50/mm3; frequent small-volume, bloody stools and abdominal pain.

Cytomegalovirus colitis

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The preferred initial treatment for uncomplicated BPH includes _________

alpha-1 blockers e.g. terazosin, tamsulosin

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______ is characterized by hypertension, mild hypernatremia, metabolic alkalosis and suppressed plasma renin activity

Primary hyperaldosteronism

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In patients with suspected stroke, ___________ is the initial diagnostic test of choice

noncontrast CT scan of the head

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________ is an effective and rapid method used to abort an acute cluster headache without major side effects

providing 100% oxygen

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______________ is a common manifestation of systemic sclerosis that typically presents with progressive dyspnea and often leads to right ventricular enlargement and right-sided heart failure.

Pulmonary arterial hypertension

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________________ is a common manifestation of systemic sclerosis that results from intimal hyperplasia of the pulmonary arteries.

Pulmonary arterial hypertension

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First-line treatment for essential tremor is ________________, especially if the patient is also hypertensive.

propranolol

__________ causes pruritic, erythematous plaques with a greasy scale that predominantly affect the scalp and face.

Seborrheic dermatitis

_____________ is the initial treatment of choice.in patients with persistent tachyarrhythmia (narrow or wide complex) associated with clinical or hemodynamic (hypotension, cardiogenic shock, signs of ischemia, acute heart failure)

Immediate synchronized cardioversion

A pt after gastric bypass procedure presents with bloating, flatulence and watery diarrhea; malabsorption and nutritional deficiencies most likely as__________

Small intestinal bacterial overgrowth

Methamphetamine use is associated with cardiomyopathy. T/F

True

Dobutamine is a potent inotropic agent with a strong affinity for _________ receptors and a weak affinity for _____ and _____ receptors.

Strong affinity for beta 1 receptors and weak affinity for beta 2 and alpha 1 receptors

Dobutamine stimulates increased myocardial contractility leading to _____, _____ and ____

Improved EF, reduced Left ventricular ESV and symptomatic improvement of decompensated HF

Initial test for a patient with suspected acute stroke is ______

Head CT Scan without contrast

____________ is characterized by a recurrent, pruritic, vesicular rash that primarily affects the palms, soles, and sides of the digits.

Dyshidrotic eczema (acute palmoplantar eczema)

______ is a large artery vasculitis that I’d most common in young Asian women

Takayasu arteritis

A young Asian woman presents with c/o initial symptoms of fever, arthralgias and weight loss and later features of blood pressure discrepancies and claudicationof upper extremities. Diagnosis?

Takayasu arteritis

Abortive treatment for migraine | 5

- NSAIDs eg, naproxen - Acetaminophen - Ergotamine eg, dihydroergotamine - Triptans eg, sumtriptan - Antiemetics eg, metoclopramide, prochloperazine

Preventives therapy for migraines

- Topiramate - Divalproex sodium - Tricyclic antidepressants - Beta blockers (eg, propanolol)

_______ and ______ are indicated in patients with severe asthma unresponsive to maximal medical therapy and who have signs of impending respiratory arrest

Endotracheal intubation and mechanical ventilation

Signs of ________ includes altered mental status, minimal aeration, hyoercarbia and worsening hypoxemia

Respiratory failure

Patients with cocaine-associated chest pain should be treated initially with ________________

Intravenous benzodiazepines

A personal history of recurrent kidney stones from childhood, a positive family history for nephrolithiasis and a positive cyanide-nitroprusside test raises suspicion for diagnosis

Cystinuria

Ecthyma gangrenosum is a rapidly progressive cutaneous disorder seen most commonly in immunocompromised patients with __________________.(pathogen) Lesions begin as painless red macules, quickly progress to pustules/bullae, and then form "punched-out" gangrenous ulcers.

Pseudomonas aeruginosa bacteremia/sepsis.

Suspect____________ in a young woman with obesity who comes with a headache that is suggestive of a brain tumor, but with normal neuroimaging and elevated CSF pressure.

idiopathic intracranial hypertension (pseudotumor cerebri

The most significant complication of pseudotumor cerebri is _____________

Blindness

Treatment of idiopathic intracranial hypertension includes ______ and _______

Weight reduction and acetazolamide

________ or _________ may be performed to prevent blindness in idiopathic intracranial hypertension

Shunting or optic nerve sheath fenestration

Differential diagnosis for polyuria and dilute urine........ (3)

Central or nephrogenic diabetes insipidus or primary polydipsia

wernicke encephalopathy triad

encephalopathy gait ataxia ocular dysfunction

________test can differentiate between DI and primary polydipsia

The water deprivation test

___________ should be suspected in patients with conjunctival erythema and thick, purulent eye discharge that reaccumulates within a few minutes after wiping.

Bacterial conjunctivitis

_______ is the most common etiology of bacterial conjunctivitis in adults.

Staph aureus

one of the earliest findings in macular degeneration is ___

distortion of straight line such that they appear wavy

______ is the most common cause of blindness in industrialized nations

macular degeneration

on ophthalmology examination _________ is a common lesion seen in the macula

drusen deposit

CSF analysis (WBC, Glucose, protein) for normal:

WBC: 0-5 Glucose: 40-70 Protein: <40

CSF analysis (WBC, Glucose, protein) for bacterial meningitis

WBC count: >1000 Glucose: <40 Protein: >250

CSF analysis (WBC, Glucose, protein) for tuberculosis meningitis

WBC count: 5-1000 Glucose: <10 Protein: > 250

CSF analysis (WBC, Glucose, protein) for viral meningitis

WBC count: 10-500 Glucose: 40-70 Protein: <150

______ is commonly characterized by mental status changes, respiratory depression and mioisis

Opioid Intoxication

Topical glucocorticoid eyedrops and systemic glucocorticoids can raise____________, leading to open-angle glaucoma (OAG).

intraocular pressure (IOP)

________ is usually characterized by insidious loss of peripheral vision, and some patients with steroid-induced ________ may develop central blurriness due to corneal edema.

Open-angle glaucoma (OAG) | OAG

Intracranial Pressure can be measured with_________

Tonometry

______________ is characterized by inflammation and degeneration of the plantar aponeurosis (deep plantar fascia), a thick, fibrous band that extends from the calcaneus to the toes and supports the longitudinal arch of the foot. It presents with chronic pain at the sole of the foot that is worse with weight bearing.

Plantar fasciitis

Indication for cervical spine imaging: (6)

- high-energy mechanism of injury - neurologic deficit - spinal tenderness - altered mental status - intoxication - distracting injury

The presence of a single vertebral fracture in a patient with blunt trauma is an indication to image the entire spine. T/F

True

___ is sensitive and accurate for diagnosing thoracolumbar spine injury

CT scan

__________ is an endemic mycosis of the desert southwest that causes community-acquired pneumonia (fever, chest pain, cough, lobar infiltrate) often accompanied by arthralgias, eythema nodosum and erythema multiforme

Coccidioides

_______ is characterized by the acute onset of hypertension and acute kidney injury in a patient with systemic sclerosis

scleroderma renal crisis

The mainstay therapy of a patient with systemic sclerosis who presents with acute onset of hypertension and acute kidney injury is ____

ACEi eg, typically captopril

patients with _______ typically have pleuritic chest pain, a pericardial friction rub, and diffuse ST-segment elevations on ECG < 4 days post MI

peri-infarction pericarditis

_____ is the best form of photoprotection

sun avoidance

sunscreen with sun protective factor______ should be applied how?

>/= 30 should be applied liberally 15=30 minutes prior to sun exposure and reapplied every 2 hours or after swimming

_____________ is a complication of mediastinal irradiation and an important cause of right heart failure. It should be suspected in patients with progressive peripheral edema, elevated jugular venous pressure, hepatomegaly, and ascites.

constrictive pericarditis

___________ causes injury to the upper aerodigestive tract and most commonly presents with pain, dysphagia, and oropharyngeal erythema and ulcerations. It does not cause alterations in consciousness.

A caustic ingestion

__________ can manifest as central nervous system stimulation (eg, headache, insomnia, seizures), gastrointestinal disturbances (eg, nausea, vomiting), and cardiac toxicity (arrhythmia).

theophylline toxicity

sudden death post MI. CAUSE?

fatal arrhythmia---V.fib

new systolic murmur 2-7 days after MI

Papillary muscle rupture

The most severe consequences of methanol intoxication are

Vision loss and coma

Post concussive syndrome

Headache, confusion, amnesia, difficulty concentrating or with multitasking, mood alteration, vertigo, sleep disturbance and anxiety following traumatic brain injury of any severity

What should be given to patients that present to the ED with chest pain and suspected ACS?

Aspirin ASAP

Painful sensorimotor polyneuropathy, skin lesions (hypo- and hyperpigmented, hyperkeratotic), pancytopenia and mild transaminase elevation in a pt with possible environmental exposure warrants suspicion of

Arsenic toxicity

Difference between autoimmune hemolytic anemia and hereditary spherocytosis

Negative family history and positive Coombs test suggests AIHA while positive family history and negavitice Coombs test suggest HS

Typical lab findings seen in osteomalacia

Hypocalcemia Hypophosphatemia Elevated alkaline phosphatase

Define orthostatic hypotension

Defined as a postural decrease in blood pressure by 20mmHg systolic or 10mmHg diastolic that occurs on standing.

_______________ is the most common end-organ complication of CMV in those with advanced AIDS

Cytomegalovirus (CMV) retinitis

First line therapy for chemotherapy related diarrhea

Oral hydration and anti diarrheal eg, loperamide

Reversal of warfarin toxicity

Vitamin K Prothrombin complex concentrate Fresh frozen plasma

A type of optic neuropathy characterized by loss of peripheral vision associated with enlarged optic cup and increased cup/disc ratio (> 0.6)

Open-angle glaucoma

6 causes of normal anion gap metabolic acidosis

``` Diarrhea Fistulas (eg, pancreatic, ileocutaneous, etc.) Carbonic anhydrase inhibitors Renal tubular acidosis Ureteral diversion ( eg, ideal loop) Iatrogenic ```

initial therapy of patients with pulmonary edema and hypoxemia due to acute decompensated heart failure includes

aggressive intravenous diuresis, oxygen supplementation, and possibly assisted ventilation.

How does obstructive uropathy presents

Flank pain Low volume voids with or without occasional high-volume voids And if bilateral renal dysfunction

Define acute liver failure

Acute onset of severe liver sever liver injury with encephalopathy and impaired synthetic function (defined as INR >/= 1.5) in a patient without cirrhosis or underlying liver disease

Transport proteins that thyroid hormone is bound to

Thyroxine-binding protein Transthyretin Albumin

_____________ are the most appropriate diagnostic tests for acute hepatitis B infection as they are both elevated during initial infection and ___________ will remain elevated during the window period.

HBsAg and anti-HBc | anti-HBc

Treatments of Graves’ disease

Anti thyroid drugs Radioactive iodine Thyroidectomy

Peri-infarction pericarditis can be prevented by

Early coronary reperfusion therapy

First line treatment of mycoplasma pneumonia is

Azithromycin

Preferred therapy for symptomatic Paget disease of bone

Bisphosphonates

Bone loss associated with anemia, renal insufficiency and hypercalcemia suggests _________

Multiple myeloma

First line treatment of mycoplasma pneumonia is

Azithromycin

Preferred therapy for symptomatic Paget disease of bone

Bisphosphonates

Bone loss associated with anemia, renal insufficiency and hypercalcemia suggests _________

Multiple myeloma