Jeff's cards Flashcards
Alexander the Great refused to let his troops eat fish due to this toxin;
Most common fish food poisoning in tropical coastal regions
Ciguatera toxin
Sxs: GI –> neuro
Fish + histamine
Sombroid
Red tide + fish toxin
Saxitoxin
Pufferfish (fugu) toxin
Tetrodotoxin
Cyanide toxicity Tx
Inahled?
IV?
Amyl nitrite
Sodium thiosulfate
TCA toxicity
Na bicarb
Bitter almond
Garlic
Cyanide
Arsenic
methgb toxicity Tx
methylene blue
ethylene glycol toxicity Tx
ethanol or fomepizole
organophosphate toxicity Tx
atropine; pralidoxime
BZO toxicity Tx
flumazenil
osmolar gap & ketosis w/o sig met acidosis
isopropyl alcohol
pt on a beta blocker goes into anaphylactic. shock refractory to epi
glucagon
lactic acidosis, AMS, on nitroprusside drip
cyanide
decompression sickness
accumulation of nitrogen gas
nomogram for acetaminophen toxicity
modified Rumack-Matthew nomogram
salicylate toxicity Tx
alkalinization of urine
carbon monoxide poisoning with coma
hyperbaric chamber
electrolyte abnormality a/w MDMA (ectasy)
hyponatremia
antivenom rxn (1-2 weeks)
serum sickness
cholinergic toxicity
SLUDGE: salivation, lacrimation, urination, diarrhea, gastric emptying
BBB: bronchospasm, bradycardia, bronchorrhea
2 alcohols that cause high AG
methanol, ethanol
alcohol that doesn’t cause high AG. Why?
isopropyl alcohol (converted to acetone–neutral compound)
lithium toxicity Tx
HD
anticholinergic toxicity
red as a beet, dry as a bone, mad as a hatter, blind as a bat
NMJ disease, improves with use
Lambert Eaton
yellow tint in CSF
xanthochromia
prion disease, PNG
Kuru
1 inherited peripheral neuropathy
Charcot-Marie-Tooth
impaired short term memory with confabulation, normal cognition
Korsakoff
ipsilateral weakness, contralateral loss of pain/temp
Brown-Sequard
wernickes triad
nystagmus
encephalopathy
ataxia
Charcot’s triad (for MS)
scanning speech, intention tremor, nystagmus
Stroke like symptoms following seizure
Todd’s paralysis
miners of this element get PD
manganese
test for NPH
Miller-Fischer test (remove 30 cc CSF and walk again)
plexus in achalasia
Auerbachs
plexus in Hirshsprungs
Meyers
protein found in Lewy Bodies
synuclein
Cushings reflex (triad)
HTN, bradycardia, irregular respirations
rapidly progressive dementia with startle myoclonus. CSF protein
CJD.
14-3-3
acute memory loss lasting minutes w/o LOC
transient global amnesia
auditory symptoms a/w Bell’s palsy
hyperacusis
Tx for spasmodic torticollis (cervical dystonia)
Botox injections
Parkinsons + dysautonomia + ataxia + corticospinal tract signs
Multiple system atrophy
pupil with consenual but not direct response to light. eponym
afferent pupillary defect (Marcus Gunn pupil)
1 malignant eye tumor
melanoma
1 presentation of MS
optic neuritis
corkscrew conjunctival vessels
sickle cell disease
glaucoma dx criteria (3)
progressive loss of peripheral vision, high IOP, abnormal cup/disc ratio
pseudotumor cerebri Tx
acetazolamide
Daily spiking fevers (quotidian), arthritis and an evenescent “salmon-colored” rash
Adult stills disease
Pain at at the elbow is reproduced with the extension of the wrist against resistance
Lateral epicondylitis (Tennis elbow)
RA index finger abnormality
boutonniere deformity (PIP hyperflexion with DIP hyperextension)
proximal muslce weakness and elevated CK levels in a patient on chronic treatment for gout
colchicine myopathy
seronegative spondyloarthropathies
Reactive arthritis, IBD-associated, Psoriatic, Ankylosing spondylitis
TNF alpha inhibitors (3)
Infliximab
Ertanercept
Adalimumab
Felty’s syndrome (3)
neutropenia, splenomegaly, RA
stridor and hoarseness in a patient with RA is a signal for involvement of this joint. Tx?
Cricoarythenoid synovitis (steroids!)
2 large vessel vasculitidies
Giant cell arteritis, Takayusu arteritis
active Hep B and vasculitis
PAN (polyarteritis nodosa)
low complement levels in these 2 vasculitidies
Cryoglobulinemia, SLE vasculitis
antibody associated with the absence of interstitial lung disease in patients with scleroderma
anti-centromere
autoantibodies associated with interstitial lung disease, arthritis, and a hyperkeratotic rash on the hands
Antihistidyl-tRNA synthetase
Test for lacrimal function in patients with dry eyes
schirmer test
pain localized to the distal radius and a positive Finkelstein’s test
De Quervain’s tenosynovitis
Most common extra-articular manifestation of ankylosing spondylitis
acute anterior uveitis
candlewax appearance on back x-ray
DISH (diffuse idiopathic skeletal hyperostosis)
Autoimmune disorders that comprise Mixed connective tissue disorder (3)
Antibody?
SLE, scleroderma, polymyositis
anti-U1 RNP (spliceosomal component)
Idiopathic inflammatory myopathy that most commonly affects older men
Inclusion body myositis
2 types of arthritis that affect the DIP joints
OA (Heberden’s nodes), psoriatic arthritis
class of drugs is the treatment of choice in patients with HTN crisis with scleroderma
ACE-I
Connective tissue disease in which wide mouthed colonic diverticuli are pathagnomonic
scleroderma
Antibody associated with neonatal lupus (congenital heart block)
Anti-SSA (Ro)
most specific autoantibody for SLE
Anti-Smith or anti-ds-DNA
Pulmonary complication of sjogren’s syndrome predisposing to lymphoma
Lymphocytic interstitial pneumonia
Apthous stomatitis, uveitis, genital ulcers
bechets syndrome
Primary biliary cirrhosis antibody
Antimitochondrial
Goodpasture’s syndrome antibody
Anti-glomerular basement membrane
Antibody associated with drug induced lupus
anti-histone antibody
Familial Mediterranean fever Tx
colchicine
most common glycogen storage disease which can be associated with pain and weakness after exercise
McArdle’s disease
HLA antigen is associated with aggressive rheumatoid arthritis
HLA DR4
RA also associated with DR1
Wegners Ab
C-ANCA (anti-PR3)
Acute colonic pseudo-obstruction
Ogilvie’s syndrome
common hereditary form of colon cancer (not FAP)
Hereditary Non-polyposis colorectal cancer (Lynch syndrome)
Stress ulcers associated with severe burns or trauma due to ischemia of the gastric mucosa
Curlings ulcers
pain out of proportion to abdominal exam findings in an elderly patient
Ischemic bowel (Mesenteric ischemia)
Most sensitive and specific test to diagnose acute cholecystitis
HIDA scan
Most sensitive and specific test to diagnose acute cholecystitis
Neutropenic enterocolitis
intestinal obstruction and pneumobilia
gallstone ileus
narrowing of the extra-hepatic bile duct from mechanical compression by a gallstone impacted in the cystic duct
Mirizzi’s syndrome
skin condition a/w IBD (but activity does not correlate with disease activity)
Pyoderma Gangrenosum
esophageal webs and iron deficiency anemia
Plummer Vinson syndrome
Gastrointestinal polyps and pigmented macules around mouth and lips
Peutz-Jeghers’ disease
Drug used to treat bleeding associated with hereditary hemorrhagic telangiectasia
Combination estrogen/progesterone
Lights criteria
Protein (Effusion/serum) ratio greater than 0.5.
LDH (effusion/serum) ratio greater than 0.6.
Effusion LDH >2/3 upper limit lab reference range of serum LDH
TST threshold for tx in pt planning to take infliximab
5mm
Class of drugs causing regression of polyps in familial adenomatous polyposis
NSAIDs
Fe/TIBC percent consistent with hemochromatosis
45%
monoclonal antibody reduces disease activity in both MS and Crohns disease
natalizumab, an alpha-4 integrin antagonist
Minimum Child-Pugh and MELD (Cr, INR, total bili) scores to consider liver transplantation
7 & 10
Hepatotoxic mushroom
Amanita phalloides
patient with hemochromatosis develops abdominal pain, fever, and diarrhea (bloody)
Yersinia enterocolitica
hepatic mass has been associated with the use of OCP
Hepatocellular adenoma
Most common cause of osmotic diarrhea
lactase deficiency
Associated with Fundal involvement of gastritis
pernicious anemia
Associated with antral involvement of gastritis
H. pylori
5 components of child pugh classification
Ascities, encephalopathy, bilirubin, albumin, PT
Charcot’s triad
Reynaulds pentad
RUQ pain, jaundice, fever/chills
AMS, hypotension
Pancreatitis: periumbilical region
Cullen’s sign
1 cause of liver failure in the US
acetaminophen toxicity
Finding on colonoscopy in patient abusing laxatives
melanosis coli
acute hepatic or chronic biliary infection caused by eating watercress
Fasciola hepatica
Urine lab used to aid in the diagnosis of intestinal carcinoid tumor
5-HIAA (5-Hydroxyindoleacetic Acid)
Antibody associated with ulcerative colitis
P-ANCA
Screening tests for HCC indicated in Hep B
AFP & hepatic US Q6mos
male patient with neuronal hearing loss and renal insufficiency
Alport Syndrome
Path of kidneys in patients with diabetic nephropathy
Kimmelstiel-Wilson nodules
RTA is assoicated with nephrolithiasis
Type I RTA (distal)
Winter’s formula
PCO2 = [1.5(HCO3 + 8) +/- 2
patient with nephritic syndrome who presents with flank pain, frank hematuria and acute worsening of their renal function
Renal vein thrombosis
5 causes of low complement GN
post infectious SLE cryoglobulinemia MPGN endocarditiis
acute renal failure, eosinophilia and livedo reticularis
cholesterol emboli syndrome
Most likely cause of hyperkalemia in diabetic patients with mild to moderate renal insufficiency
Type IV RTA
Most common cause of acute glomerulonephritis
IgA nephropathy (Berger’s disease)
BB that improve mortality in HFrEF
carvedilol
metoprolol succinate
bisoprolol
goal SBP w/in 1 hr aortic dissection
<120
a/w bicuspid aortic valve & Turner syndrome
aortic coarctation
hand finding pathogneumonic for Dermatomyosis
Gottron’s papules
Ears + saddle nose
relapsing polychondritis
pain, numbness, tingling in the forefoot, aggravated by high heels
mortons neuroma
vitamin that reduces falls in the elderly
vit D
normal time threshold for “get up and go”
<10 secs
distinguish factor deficency from factor inhibitor
Mixing study
least common MPN
primary myelofibrosis
gold standard HIT Dx
serotonin release assay
characterized by lack of CD 55 & CD 59 on RBCs
Paroxysmal Nocturnal Hematuria
max TIMI score
7
cause of STEMI in young F with Raynauds
coronary vasospasm
fibro-fatty infiltration of the RV
Arrhythmogenic RV dysplasia
septal shudder and bounce on echocardiography
Constrictive pericarditis
atopy, recurrent food impaction and esophageal rings, furrows, plaques, or strictures
Eosinophilic esophagitis
Immunological cause of false-negative IgA anti-tTG antibody test for celiac disease
IgA deficiency
nausea, early satiety, and bloating in patient with systemic sclerosis
Gastroparesis (accept delayed gastric emptying)
Eponym for perihepatitis and pelvic inflammatory disease
Fitz-Hugh Curtis syndrome
peritoneal carcinomatosis of unknown primary are treated for this cancer
ovarian
histological scoring system for patients with biopsy proven prostate cancer
gleason score
eponym for gastrointestinal metastases to ovary
Krukenberg tumor
BRAF mutation is specific for this endocrine cancer
Papillary thyroid cancer
association with spoon nails
iron defcy anemia
Irradiated blood prevents this fatal transfusion-related complication
Graft vs Host disease (GVHD)
elevated homocysteine and normal methylmalonic acid levels
Folate deficiency
intracytoplasmic inclusion associated with ehrlichiosis
Morulae
Etiological agent responsible for cat scratch disease
Bartonella henselae
skin lesions in animal hide workers
Cutaneous anthrax
Most likely malarial agent causing an 8% RBC parasitemia rate
P. falciparum
Scoring system to predict risk of stroke at 2, 7, and 90 days after TIA
ABCD2
Dementia presenting with early personality changes, fixation, disinhibition and emotional lability
Frontotemporal dementia
noninflammatory, nonatherosclerotic carotid artery stenosis in a young woman
Fibromuscular dysplasia
ulcerative impetigo
Ecthyma
develops after infection with β-hemolytic Streptococcus
Guttate psoriasis
Eponym describing the ability to laterally extend bullae by application of pressure
indirect Nikolsky sign
Split urine collection (daytime and nighttime) used to diagnose this condition
Orthostatic proteinuria
Multiple myeloma type typically associated with low anion gap
IgG myeloma
Eponym for renal carcinoma, CNS hemangioblastomas and retinal angiomas
von Hippel-Lindau disease
Eponym for criteria used to diagnose acute rheumatic fever
Jones criteria
nonarthritic lateral hip pain that worsens with direct pressure
trochanteric bursitis
test that measures forward spine flexion
Schober test
cutaneous sarcoidosis characterized by red indurated papules, plaques, or nodules on the central face
lupus pernio
