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Pathology Review > Internal Medicine GI, Endo, Rheuma > Flashcards

Internal Medicine GI, Endo, Rheuma Flashcards

1
Q

Aluminum hydroxide side effect

Magnesium hydroxide side effect

PPI side effect

Sucralfate side effect

Bismuth side effect

A

Constipation

Diarrhea

Angioedema

Constipation

Black tarry stool, neurotoxicity

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2
Q

If unresponsive to therapy after ____ days

What test

A

ZES, 14

Secretin test

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3
Q

Dieulafoy lesion. What?

A

Large caliber arteriole in LESSER curvature

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4
Q

AST/ALT >1000

A

Viral hepatitis
Ischemic liver injury
Toxin

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5
Q

AST:ALT > 2
AST:ALT < 1

Type of liver disease

A

Alcoholic liver disease

NAFLD, chronic viral

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6
Q

Budd Chiari syndrome

Triad

Patho

A

Ab pain, hepatomegally, ascites

Venous thrombus / embolus in hepatic veins

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7
Q

ALD

Cut off for glucocorticoids

How to compute

A

Discriminant function > 32

(PT - control) + serum bilirubin

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8
Q

ALD

MELD score

A

PT INR Serum bilirubin, Serum creatinine

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9
Q

Child pugh score

A 
Bilirubin
Ascites
INR PT
Encephalopathy
Albumin
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10
Q

Spontaneous bacterial peritonitis

Value of PMN in ascitic fluid

> 2 organisms =

A

250/uL

Secondary bacterial peritonitis (perforation)

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11
Q

Hepatic encephalopathy

Is only diagnosed in ________

Usually increase in blood ______

A

Fulminant liver disease

Ammonia

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12
Q

First indication of portal hypertension

A

Splenomegaly

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13
Q

Diagnosis of acute pancreatitis

A
  1. Epigastric pain radiating to back
  2. Amylase and/or lipase x3
  3. Imaging
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14
Q

Pain medication of choice in acute pancreatitis

A

Meperidine

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15
Q

Most important intervention in pancreatitis?

A

Fluids: pNSS or Lactated ringers

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16
Q

Metabolic syndrome

A 
Central obesity
Hypertriglyceridemia
Low HDL cholesterol
Hypertension
Fasting glucose

3/5

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17
Q

Metabolic syndrome

Central obesity

A

South asians
M >90cm
F >80cm

US
M> 102
F> 88

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18
Q

Metabolic syndrome

TAG

A

Serum TG > 150mg/dL

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19
Q

Metabolic syndrome

Low HDL

A

<40 males

<50 females

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20
Q

Metabolic syndrome

Bp

A

> 130, >85

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21
Q

Metabolic syndrome

Fasting Blood glucose

A

FBS > 100

Type 2 DM

22
Q

DM diagnosis

FBS impaired

OGTT 75g

Hba1c

RBS

A

100-125 impaired fasting glucose

140-199

5.7-6.4

> 200 + polyuria polydipsia, polyphagia

23
Q

FBS, OGTT fasting time

A

At least 8 hours

24
Q

DM screening

  1. Usual start
  2. Earlier screen if?
A

> 45years every 3 years

Overweight + 1 risk factor

25
Q

DM drugs that cause

Weight loss?

Weight gain?

A

Weight loss: biguanides metformin

Weight gian: insulin secretagogues. Glip glic glim + repaglinide

26
Q

Treatment goals of DM

Hba1c
Preprandial glucose
Post prandial glucose
BP
LDL
HDL
TAG
A
  1. <7%
  2. 80-103mg/dL
  3. <180mg/dL
  4. <140/90
  5. <100 LDL
  6. > 40 mg/dL
  7. <150mg/dL
27
Q

Lab testing for DM patients

  1. Hba1c testing
  2. DM nephropathy
  3. Lipid profile , creatinine
A
  1. 2-4 times ayear
  2. Annual
  3. Annual
28
Q

Hypoglycemia diagnosis

A

<55mg/dL + symptoms

29
Q

Whipples triad

A

Hypoglycemia
Low plasma glucose
Relief of symptoms after correction

30
Q

Body hormones to prevent hypoglycemia

A
  1. Decrease insulin
  2. Incrase glucagon
  3. Increase epinephrine
31
Q

Absolute contraindication for radioactive iodine therapy.

A

Pregnancy, lactation, thyroid storm

32
Q

Most common cause of hypothyroidism

A

Iodine deficiency

33
Q

Most common cause of hypothyroidism in iodine sufficient areas

34
Q

Sick euthyroid disease lab findings

  1. TSH
  2. FT4
A
  1. Normal

2. Decreased

35
Q

Sites of DEXA scan

A
  1. Femoral neck
  2. Total femur
  3. Lumbar spine
36
Q

Screening for osteoporosis

Riskfactors present.

A 
Low BMI
Fragility fracture
Parental history of hip fracture
Current smoking
Glucocorticoid treatment
RA 
Alcohol intake
>70 in males
> 65 women
37
Q

DEXA scan values

Osteopenia
Osteoporosis

A
  1. -1 to - 2.5 SD

2. <2.5 SD

38
Q

If BMD not available

2 test available
1

A
  1. OSTA

2. FRAX

39
Q

First line pain meds for osteoarthritis?

A

Paracetamol

40
Q

Asymptomatic hyperuricemia lab value

A
  1. > 7mg/dL male

2. >6mg/dL female

41
Q

Crystals seen on synovial fluid analysis in gout.

A

Strongly negative birefringent needle shaped crystals.

42
Q

Indication for medical therapy for gout

  1. what lab value?
  2. Clinical
A

Serum uric acid >11-13 mg/dL

Tophi

43
Q

Common joint involvement in RA

A

Wrist PIP MCP

44
Q

Deformities in RA

  1. Swan neck
  2. Boutonniere
  3. Z line
  4. Hallmark of RA
A
  1. Hyperextension of PIP flexion of DIP
  2. Flexion of PIP hyperextension of DIP
  3. Subluxation of 1st MCP, extension of 1st IP joint
  4. Flexor tendon tenosynovitis
45
Q

Most frequent site of cardiac involvement in RA

A

Pleuritis/pericarditis

46
Q

Earliest finding in imaging of RA patients

A

Juxtaarticular osteopenia

47
Q

DMARD of choice in RA and its contraindication.

A

Methotrexate.

Contraindication in pregnancy

48
Q

Empiric of Septic arthritis.

  1. Gram +
  2. Gram -
  3. Pseudomonas
A
  1. Oxacillin, naficillin
  2. Cefotaxime, ceftriaxone
  3. Cefipime
49
Q

Contraindications to percutaenous liver biopsy.

A
  1. Prolonged INR

2. Significant ascites

50
Q

Criteria for DKA resolution

  1. Plasma glucose
  2. Serum HCO3
  3. Venous pH
  4. Anion gap
A
  1. <200
  2. > 15meq/L
  3. > 7.3
  4. <= 12
51
Q

Criteria for resolution of HHS

A
  1. Normal serum osmolarity

2. Improvement of mental status.

52
Q

Treatment of hypothyroidism

Drug
Monitor

A

Levothyroxine 1.6mcg/kg/day
Monitor TSH every 3-4 months if primary
Monitor t4 if secondary

Pathology Review (8 decks)

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