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PLE > Internal Medicine > Flashcards

Internal Medicine Flashcards

1
Q

Chronic Cough - first symptom frequently discounted
Dyspnea - most characteristic finding
Sputum production

A

COPD Cardinal Manifestation

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2
Q

60 % - 70 % of smoking related to

A

COPD

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3
Q

Drugs Narrow Therapeutic Index

A

Theophylline
Digoxin
Warfarin
Lithium

Mnemonic: TDWL This Drugs Were Lethal

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4
Q

Pathophysiology of COPD

A
  1. Airway Limitation and Obstruction
  2. Gas exchange Abnormality
  3. Hyperinflation
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5
Q

Conditions where dyspnea in upright position with relief in supine (Platypnea)

A

Left Atrial Myxoma

Hepatopulmonary syndrome

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6
Q

Chest thightness

A

Bronchoconstriction / Bronchial Asthma

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7
Q

Inability to take a deep breath

A

COPD

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8
Q

CHF, Obesity (diaphragm pressing), Asthma, GERD

A

Orthopnea

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9
Q

Nocturnal Dyspnea or Paroxysmal Nocturnal Dyspnea

A

CHF or Asthma

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10
Q

Acute Intermittent episodes of Dyspnea

A

Myocardial Infarction, Bronchospasm, Pulmonary Embolism

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11
Q

COPD, Interstitial Lung Disease, Chronic Thromboembolic Disease

A

Chronic Persistent Dyspnea

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12
Q

In lung palpation, decrease tactile fremitus is?

A

Effusion

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13
Q

In lung palpation, increase tactile fremitus is?

A

Consolidation

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14
Q

Pleural Effusion (large), mediastinum will shift where?

Contra or ipsi?

A

Contralateral side

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15
Q

Atelectasis (lobar obstruction), mediastinum will shift where?

Contra or ipsi?

A

Ipsilateral side

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16
Q

Most Common Adverse Reaction of drug-susceptible TB

A

Symptomatic Hepatitis

  • Jaundice, ALT 3x high

Or Asymptomatic ALT 5x high

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17
Q

Toxicity TB Meds

Red color to body secretions

A

Rifampicin

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18
Q

Rifampicin Toxicity Management

A

None. Benign condition

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19
Q

Toxicity TB Meds

Peripheral Neuropathy

A

Isoniazid

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20
Q

Isoniazid Toxicity Management

A

Take Pyridoxine

21
Q

Toxicity TB Meds

Hyperuricemia

A

Pyrazinamide

22
Q

Pyrazinamide Toxicity Management

A

If symptomatic, discontinue drug then give NSAIDs for pain

If asymptomatic, no treatment

23
Q

Toxicity TB Meds

Optic neuritis / Color Vision

A

Ethambutol

24
Q

Ethambutol Toxicity Management

A

Decrease dose in renal failure

25
Q

Most toxic TB meds

A

Pyrazinamide

*Resumption of TB meds: Rifampicin (RIF) (R), Ethambutol (EMB) (E), Isoniazid (INH) (H), Pyrazinamide (PZA) (Z)

26
Q

Size of induration of tuberculin PPD:

> 5mm

A

HIV or risk factors, close TB contact, CXR evidence of TB

27
Q

Size of induration of tuberculin PPD:

> 10mm

A

Indigent / Homeless, residents of developing nations, IV drug users, chronic illness, residents of health and correctional institutions and health care workers

28
Q

Size of induration of tuberculin PPD:

> 15mm

A

Everyone else including with no known risk factors

29
Q

Tuberculin PPD (TST) is used for

A

Screening of LATENT Tuberculosis Infection

TST - skin
IGRA - blood

30
Q

Chest Xray Findings in Pulmonary Embolism

Peripheral Wedged - Shaped density above diaphragm

A

Hamptom’s Hump

31
Q

Chest Xray Findings in Pulmonary Embolism

Focal Oligemia

A

Westermark’s sign

32
Q

Chest Xray Findings in Pulmonary Embolism

Enlarged Right Descending Pulmonary Artery

A

Palla’s sign

33
Q

Chest Xray Findings in Pulmonary Embolism

HYPERkinesis of the RV free wall with normal or HYPER

A

McConnell’s sign

34
Q

Pneumonia Risk Factor

A

C - CONFUSION
U - BUN >30mg/dl
R - RR >30 bpm
B - SBP >90 mmHg, DBP <60 mmHg

Age 65 older

35
Q

ARDS Stage

1st 7 days symptomatic with alveolar edema and neutrophil-rich leukocyte infiltration of lungs
Formation of hyaline membranes from diffuse alveolar damage

A

Exudative phase

36
Q

ARDS Stage

Day 7 - 21

Prominent Interstitial Inflammation and Early Fibrotic Phase

Also, most patient recover on this stage and usually intubated patients liberated from mech vent

A

Proliferative Stage

37
Q

ARDS Stage

> 3 weeks

Substantial Fibrosis and Bullae Formation

A

Fibrotic Phase

38
Q

NYHA Classification

No limitation

A

Class I

39
Q

NYHA Classification

With Limitation of 2 flights of stairs

A

Class II

40
Q

NYHA Classification

With Limitation of 1 flight of stairs

A

Class III

41
Q

NYHA Classification

With Limitation on rest

A

Class IV

42
Q

Dyslipidemia Drug to increase HDL

A

Fibrates - Increase incidence of gallstone, caution in CKD patient

Niacin - cause hyperuricemia and cause gout

43
Q

5 - 10 days post MI

New Onset Murmur and Pulmonary congestion 5 days post MI

A

Left Ventricular Septal Wall Rupture

Papillary muscle rupture - Acute Mitral Regurgitation

Septal rupture

44
Q

First day post MI complications

A

Heart Failure

45
Q

2-4 days post MI complications

A

Arrhythmia, Pericarditis

46
Q

Weeks to months post MI complications

A

Ventricular aneurysm

47
Q

Heart Failure with Reduced Ejection Fraction

A 
ACE inhibitors - 23% reduction in mortality - ALL class will do 
Beta Blocker - 35 %
48
Q

Beta Blockers used in HF

A

Metoprolol succinate
Bisoprolol
Carvedilol

*MsBC Heart Fails

49
Q

Pain reaches peak intensity immediately

A

Pneumothorax
Pulmonary Embolism - hypercoagulable, surgery, stasis
Aortic Dissection - sudden severe chest pain, Marfan syndrome complains of pain

PLE (5 decks)

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