march 28 Flashcards
what is avoidant/restrictive food intake disorder?
dislike of eating due to the sensory experience or a fear of consequences of eating (choking, vomiting)
does increasing the afterload increase or decrease the murmur of HOCM?
decreases it (increases LV volume which decreases the intensity of the murmur)
what are the two types of breath holding spells?
cyanotic
pallid
what triggers a pallid breath holding spell?
usually occur after minor trauma (from pain or fear -> slowed heart rate)
what causes a cyanotic breath holding spell?
vigorous crying -> breathholding -> LOC
how do you calculate a corrected sodium level in a patient with DKA?
observed sodium + 2x mEq/L for every 100mg/dL glucose they are over 100 mg/dL
what kind of saline should a patient with DKA receive?
isotonic (0.9%)
-even if they have hyponatremia it may be pseudohyponatremia
how do you assess respiratory function in a patient with GBS who is stable?
monitor via spirometry
A patient with GBS undergoes spirometry to monitor lung function. When you should intubate?
If their FVC declines to less than 20 mL/kg
clinical features of eosinophilic esophagitus?
- dysphagia
- chest/epigastric pain
- reflux/vomiting
- food impaction
- associated atopy
what causes the leukopenia and thrombocytopenia in a patient with SLE?
immune mediated destruction (autoantibodies)
what acid base disturbance is commonly seen in laxative abuse?
metabolic alkalosis
findings on colonoscopy from laxative abuse?
melanosis coli
what is melanosis coli?
dark brown discolouration of the colon with pale patches that occurs from laxative abuse
path of drug induced immune mediated hemolytic anemia?
Drug coats erythrocytes -> igG binding -> splenic destruction of RBCs
when can a baby start rolling?
4-6 months
what murmur is common in ankylosing spondylitis?
aortic regurgitation
what is a framing bias?
when a diagnositc approach is influenced by context & presentation of information (influenced by previous notes)
what is critic illness neuropathy?
neuropathy that occurs after severe sepsis and presents with severe, diffuse, symmetric muscle weakness
why may secretory diarrhea occur after bowel resection?
this can result in unabsorbed bile acids reaching the colon, which then directly stimulate luminal ion channels
which cells degenerate in amylotropic lateral sclerosis?
UMNs (in the primary motor cortex) and LMNs (in the anterior horn)
where does the degeneration occur in poliomyelitis?
anterior horn cells
A patient is given D-xylose and his urinary excretion is low, what does this mean?
The patient was unable to absorb the d-xylose across the intestinal wall (where it would then get excreted in the urine)
What diseases results in low d-xylose absorbtion (and thus urine levels)?
celiac disease
what can cause a false POSITIVE d-xylose absorption test?
- small intestinal bacterial overgrowth (ferment the dxylose before its absorbed)
- impaired glomerular filtration
- delayed gastric emptying
what is imipramine?
TCA
can a single negative fecal occult blood test completely rule out GI bleeding?
no
treatment of viral (or idiopathic) pericarditis?
NSAIDS + colchicine
in which patients with viral pericarditis do you treat with steroids?
if the patient has an NSAID contraindication or the colcichine/NSAID therapy fails
most common cause of erysipalas?
strep pyogenes (group A streptococcus)
what is a choroid plexus papilloma?
a rare, benign, slow growing choroid plexus tumour that produces CSF
treatment of a symptomatic choroid plexus papilloma?
resection (they rarely recur)
what is tacchycardia mediated cardiomyopathy?
when chronic tacycardia (could be from afib, flutter, ventricular tacchycardia, etc) results in structural changes in the heart (and myocardial dysfunction)
how do you treat tacchycardia medated cardiomyopathy?
rate and rhythym control - potentially reversible
path of huntingtons disease?
loss of GABAergic neurons in the caudate and putamen
which bone tumour has a moth eaten appearance?
ewing sarcoma
onion skinning is characteristic of which bone tumour?
ewing sarcoma
how long should most antidepressants be discontinued before starting an MAOi?
2 weeks (to prevent serotonin syndrome)
how long must fluoxatine be stopped before starting an MAOi?
5 weeks (long half life)
