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BOREDs High Yield for ME > June 10-20 > Flashcards

June 10-20 Flashcards

1
Q

What are medications that can cause lithium toxicity?

A

Anything that decreases Renal Perfusion

Thiazide diuretics, NSAIDs, ACE inhibitors

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2
Q

A patient comes in to the ED c/o worsening N/V/D with associated confusion and agitation. She has a hx of bipolar disorder that has been controlled with treatment. She has recently had a flare up of tension headaches and has been taken ibuprofen for the headaches. What is the best course of action for this patient?

A

IV hydration

She has sx of lithium toxicity

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3
Q

What tracts are affected with a subacute combined degeneration?

A

Dorsal Column: Loss of position and vibration sense

Spinocerebellar tract: ataxia

Lateral corticospinal tract: Spastic paresis

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4
Q

What is the mutation in X-linked agammaglobulinemia and what does it cause on a cellular level?

A

BTK gene mutation

Impaired B cell maturation and Ig production

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5
Q

An 8 month old male is brought to the pediatrician by mother. She states that the patient has had recurrent sinopulmonary infections and has had “gastric issues all his life”. On examination, the patient has smaller than normal tonsils.

On serology, the patient has decreased B cells and normal T cells. What do you suspect?

A

X linked agammaglobulinemia

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6
Q

What are the sx of X liked agammaglobulinemia?

A

Recurrent sinopulmonary infections

Chronic enteroviral infection

Small or absent lymphoid tissue

On serology, there will be decreased Igs and B cells

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7
Q

What bacteria commonly cause septic abortions?

A

Enterobacteriaceae
Group A strep
Staph aureus

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8
Q

What are the clinical manifestations of a septic abortion?

A

Fever
Lower abdominal pain
Malodorous purulent cervical discharge
Tender uterus with dilated cervix

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9
Q

Which infectious agents can cause reactive arthritis?

A 
Chlamydia 
Salmonella 
Shigella
Yersinia 
Campylobacter 
Cdiff
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10
Q

What are the symptoms of reactive arthritis?

A 
Oligoarthritis 
Dactylitis 
Enthesitis 
Conjunctivitis, anterior uveitis
Urethritis, cervicitis, prostatitis
Oral ulcers
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11
Q

A pregnant woman comes in with HTN, RUQ pain, and N/V.

Labs show elevated liver enzymes, low platelets, and signs of anemia with some proteinuria, what do you suspect?

A

HELLP syndrome

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12
Q

What is the MOA of metformin?

A

Inhibits the mitochondrial glycerophosphatase dehydrogenase

Upregulates AMP activated protein kinase

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13
Q

What are the metabolic effects of metformin?

A

Decreased hepatic glucose production (gluconeo)

Decreased intestinal glucose absorption

Increased peripheral glucose uptake

Decreased lipogenesis

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14
Q

What are the adverse effects of metformin?

A

Diarrhea
Lactic Acidosis
Vitamin B12 def

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15
Q

How do bulk forming laxatives ease constipation?

A

Binds luminal water and decreases the consistency of the stool

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16
Q

What are the side effects of bulk forming laxatives?

A

Flatulence and abdominal distension

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17
Q

What is the MOA of osmotic laxatives?

A

Draws water into the lumen

Can cause electrolyte issues and bloating

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18
Q

How do the surfactant laxatives work?

A

Decreases stool surface tension and lets water enter the stool

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19
Q

What kind of laxatives activates enteric nerves in the myenteric plexus to stimulate peristalsis?

A

Stimulant laxatives

20
Q

Which types of laxatives are the following? Polyethylene glycol, magnesium hydroxide, lactulose

A

Osmotic laxatives

21
Q

What type of laxative is docusate? How does she work?

A

Surfactant laxative

Decreases stool surface tension which allows water to enter the stool

22
Q

Bisacodyl and senna are examples of what kind of laxative? What are the common side effects?

A

Stimulant laxatives

Can cause abdominal cramping and electrolyte issues

23
Q

What is the chloride channel agonist laxative?

A

Lubriprostone

24
Q

What is methylnaltrexone?

A

It is a peripherally acting mu opioid receptor antagonist

25
Q

What medications are known for causing QT prolongation?

A

Macrolides and fluoroquinolones

Antimetics

Azoles

Antipsychotics, TCAs, methadone

Quinidine: Class IA
Dofetilide: Class III

26
Q

What would you expect to see on the physical examination of someone who has bulemia?

A 
Hypotension 
Tachycardia 
Dental enamel erosion 
Dorsal hand calluses 
Parotid gland swelling
27
Q

Prochlorperazine and metoclopramide are examples of what anti-emetic?

A

Dopamine receptor antagonist

Used for chemotherapy induced emesis

28
Q

What are the neurokinin 1 receptor antagonists?

A

Aprepitant

Fosaprepitant

29
Q

What are the clinical features of acute adrenal insufficiency

A 
hypotension and shock 
N/V
abdominal pain 
Fever 
Generalized weakness
30
Q

How do you treat acute adrenal insufficiency

A

hydrocortisone and dexamethasone

Rapid IV volume repletion

31
Q

What do the toxins of Cdiff effect?

A

Toxins A and B disrupt the cytoskeleton integrity and stimulate inflammation

Forms pseudomembranes

32
Q

What two organsims toxins act by inactivating EF2 via ribosylation and inhibits protein cell synthesis

A

Corynebacterium diphtheria

Pseudomonas aeruginosa

33
Q

What does the pertussis toxin do?

A

Disinhibits adenylate cyclase via Gi ADP riboslyation increasing cAMP production in the host cell

Causes increased histamine sensitivity and phagocyte dysfunction

34
Q

How does the cholera toxin work?

A

Activates adenylate cyclase via Gs ADP ribosylation

Increases cAMP production in the host cell

Secretory diarrhea, dehydration, and electrolyte imbalances

35
Q

What are the most common pathogens causing nosocomial bloodstream infections?

A

Coagulase negative staphylococci
Staph aureus
Enterococci
Candid species

36
Q

What are the effects of persistent pulmonary hypertension of the newborn?

A

Abnormal persistence of elevated fetal pulmonary vascular resistance

Right to left shunting across ductus arteriosus

37
Q

What are the risk factors for persistent pulmonary hypertension of the newborn?

A

Lung hypoplasia

Meconium aspiration syndrome

Infection

38
Q

What are the clinical examination findings in an infact with persistent pulmonary hypertension of the newborn?

A

Decreased postductal relative to preductal oxygen saturation

Respiratory distress and cyanosis

Prominent S2

39
Q

What are medications that increase the methadone effect?

A

Fluconazole, voriconazole, ketoconazole

Cipro, clarithromycin

Cimetidine

Fluvoxamine

40
Q

What antiseizure medications block NA channels?

A

Phenytoin

Carbamazepine

41
Q

What antiseizure medication blocks Na channels and increases GABA levels?

A

Valproic acid

42
Q

What antiseizure drugs increases GABA a action?

A

Benzodiazepine

Phenobarbital

43
Q

What antiseizure medication modulates GABA and glutamate release?

A

Levetiracetam

44
Q

what antiseizure medication blocks T type Ca channels

A

Ethosuximide

45
Q

What enzymes require biotin as a cofactor?

A

Pyruvate carboxylase

Acetyl CoA carboxylase

propionyl CoA carboxylase

BOREDs High Yield for ME (6 decks)

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