Level 2 CE Flashcards
Damage to the ___ of the brachial plexus, most commonly seen with thoracic outlet syndrome or trauma, would cause numbness/pain in the fourth and fifth digits.
lower trunk brachial plexus
The median nerve innervates what muscles?
LOAF: lumbricals (first and second) opponens pollicis abductor pollicis brevis flexor pollicis brevis.
Presenting sx of tender adenopathy and linear excoriations on the arm with social history of pets (dog, cat, bird) suggest infection from what organism?
cat-scratch disease caused by Bartonella henselae.
Gram-negative bacterium causing fever, chills, headache, muscle aches, and a dry cough in humans, especially with social history related to birds.
Birds are the natural reservoir for Chlamydia psittaci. The organism is a gram-negative bacterium that causes fever, chills, headache, muscle aches, and a dry cough in humans.
Dx of postterm pregnancy rests on establishment
of ___.
the correct gestational age
In otherwise healthy pt w clear microadenoma causing Cushing syndrome, tx of choice: __.
transsphenoidal resection of the adenoma
Five major causes of metabolic alkalosis:
Loop diuretics vomiting renal insufficiency hyperaldosteronism (aka Conn syndrome) antacids
pH, pCO2, and HCO3 findings in a pt with metabolic alkalosis?
- pH elevated (basic)
- pCO2 elevated (respiratory compensation)
- Bicarb > 28 (elevated)
Pt presents with asymptomatic hypercalcemia. What is first test to run, and what is indicated if elevated?
serum parathyroid hormone; if elevated, indicates dx of primary hyperparathyroidism, which is caused by parathyroid adenoma.
The MCC of hypercalcemia are hyperparathyroidism and __.
squamous cell carcinoma, usually of the lung.
Pt w HIV presents with red/purple papules and plaques in the hard palate of the mouth and lower extremities. Dx/etiology/tx?
Kaposi sarcoma, HHV-8.
Biopsy to confirm.
Start on antiretrovirals.
Pt presents with ear pain, itching, and pain with mvmt of tragus/pinna. Dx and etiology?
Otitis externa
Pseudomonas
Pt presents w ear pain following URI. Exam reveals bulging, erythematous tympanic membrane. Dx/MC etiology/tx?
Otitis media;
S pneu, H influ, M cata
Tx: amoxicillin; if mild, may observe for 48-72 hours.
Two possible sequelae of untreated otitis media:
mastitis and cholesteatoma
Pt with ear discharge and hearing loss. Exam shows retraction pocket on tympanic membrane.
Dx/Cx/Tx?
- cholesteatoma
- keratin accumulation
- surgical removal
Elderly pt with increasing difficulty reading. Fundoscopy reveals yellow deposits clustered around macula in both eyes. Dx?
dry age-related macular degeneration
Presents as progressive loss of central vision.
Elderly pt with dry age-related macular degeneration has yellow deposits of extracellular material called ___ around the macula.
drusen
Wet age-related macular degeneration is characterized by __.
growth of abnormal blood vessels into the subretinal space. These disorganized, leaky vessels lead to abnormal fluid or blood collections, causing rapid vision loss.
Central vision loss is (rapid/slow) in (dry/wet) age-related macular degeneration.
rapid in wet
slow in dry
Visual distortion of straight lines (as detected in an Amsler grid) is a cardinal sign of (vision ds) __.
wet age-related macular degeneration
Vitamin __ deficiency results in inadequate production of __, which facilitates vision in low-light conditions.
rhodopsin
HTN, w or wo hypokalemia, is the hallmark of excess ___ secretion.
aldosterone
HTN and hypokalemia are the hallmarks of excess aldosterone secretion.
___ sign is increased pain and involuntary hip/knee flexion with passive neck flexion.
Brudzinski’s sign
meningitis
___ sign: increased neck pain and resistance to knee extension when hip flexed to 90 degrees.
Kernig’s sign
meningitis
