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marrow Flashcards

1
Q

Rapid X descent
With absent y

Rapid y descent

A

CARDIAC TAMPONADE

CONSTRICTIVE PERICARDITIS

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2
Q

Absent x descent

A

Severe TR

even dominant v wave present

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3
Q

Pulsus paradoxus
Sbp > 10 falls with inspiration

Seen in

( OH 20 sbp 10 dbp )
(Hills sign in AR — LL sbp > Ul by minimum of 20)

A

Cardiac tamponade

Copd

Tension pneumothorax

Obstructive pneumothorax

Massive Pulmonary embolism

Hemorrhagic shock

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4
Q

Electrical alter and

low amp qrs

Pulsus paradoxus

A

CARDIAC TAMPONADE

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5
Q

S3 S4

Diastolic
Bell low pitched
At apex in lt lateral position 
Summation gallop
Sounds like Galloping horse

s3 can be physiological
S4 always pathological

A

S3 due to rapid vent filling vent gallop

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6
Q

Increased rate monomorphic VT

A

vent flutter

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7
Q

Schilling test

A

CO 58 is used as radio radio labelled cobalamin

10 percent excretion and above is normal

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8
Q

Paradoxical disinhibition

A

Seen with BZD

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9
Q

Mcc of spinal fracture in Ankylosing spondylitis is

A

Cervical

Not sacral

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10
Q

Severe AR criteria

A

Volume > 60 ml

Jet width > 65 % of LV outflow

Width > 6mm

Orfice > 0.3cm sq

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11
Q

Cardiac donors

Cat 1 - brought dead

Cat 2 - death inmed after into hosp - cpr in ambulance

A

Cat 3 - ICU awaiting cardiac arrest planning withdrawal of support

Cat 4- ICU sudden arrest after brain death

Cat 5— ICU unexpected sudden arrest

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12
Q

Aortic aneurysms
Mc sites

1.ASC aorta

MC is Media degeneration ( also for aortic dissection )
- mar fans ehler turner HTN , vasculitis

Syphilis —- asc aorta and arch

Spondyloarthropathies

A

2.
TB - thoracic

Trauma ,
degenerative ( aging , atherosclerosis , smoking )

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13
Q

Operative repair of aneurysm

Statins ,, BB , ACE used for medical management

A

Desc aorta if > 5.5cm
Growth 1cm/yr

Asc aorta if > 5.5
Growth 0.5cm/ yr

In marfan if > 4 cm

If less serial follow up with Usg

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14
Q

Aortic dissection

A

3 rd trimester pregnancy

CO A

medial degeneration

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15
Q

Seizures

RP

CATARCT

A

Ushers syndrome

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16
Q

Behecet

E nodosum

Rec thrombosis

Painful oral ulcers heal without scar

A

Cogan syndrome

Aortitis

Interstitial keratitis

Vestibulo auditory symptoms
Treatment is steroid

17
Q

Lung cancers
Primary osteoarthropathy asso with all lung cancers and cirrhosis and brectasis
Mc with adenocarcinoma

Scc - hyper pth - hyper ca
Small cell CA- SIADH , LEMS , Cushing

A

Adenoca harbours EGFR mutation

Geftinib erlotinib — tyrosine kinase inhibitors of EGFR pathway of adenoca

Imatinib tki for cml gist

18
Q

P jitovici
Xray reticulonodular pattern with hiv or wt loss etc background

Prophylaxis if prev inf or candidiasis or cd4<200

Ldh elevated , sputum histo is diagnostic

A

cotrim, or aerosolised pentamidine

Treatment cotrim doc
severe iv pentamidinie doc
steroids if po2 < 70

Other drugs leucovorin dapsone

19
Q

Nocardiosis

Nodular cavitation On xray
And Headaches

Mc extra pulm complication
Subacute Brain abcess

Gram positive bacilli

A

DOC cotrimoxazole

20
Q

Restrictive pathology
fvc more decreased

Obstructive pathology fev1 more decreased

PAH -DLCO more decreased

A

AIP - diffuse alveolar damage

Ground glassing- NSIP ( homogenous ),AIP (all othr ild patchy)

Lower lobes — asbestosis and sarcoid
upperlobes - LCH , all pneumoconiosis
Smoking — LCH ,desqumtv, RB ILD

21
Q

LCH vs LAM
LCH - young male smokers
LAM - young female nonsmoker TSC

Both cysts nodules
Spont pneumothx
Chylous effus

Lam -pulm lymphangiomyomatosis

A

ABPA - criteria 1)eosinophilia>500

2) Elevated Ig E>1000
3) positive skin test , IG E and Ab against asp fum

Coughs sputum casts
Central BE
Hypersen to asp in Asthmatics /CF

22
Q

Pneumoconiosis except asbestosis —- UL

BE EXCEPT ABPA- LL

ILD NSIP except AS -LL

A

Be

Usually LL

central in ABPA and CF

UL In ABPA , TB

23
Q

Lower lobe lung involvement

Asbestosis ( all other pneumocon UL )

NSIP and all ILD
RA, scleroderma (CTD ) ,and drugs-ILD
Except AS

A

Upper lobe

TB
SARCOIDOSIS
pneumoconiosis , AS

LCH
ABPA ( BE involving UL , never BE UL)

radiation

24
Q

Mononeurotis multiplex

PAN
2 nd Mc compl of churg Strauss

Asym painful sens motor post viral illness

A

Sle causing drugs

Anti TB

Anti arrhythmics

Anti thyroid drugs

Lithium , HCQ , hydralazine ,sulfonamides

25
Q

SLE

most cmn cns ab -glutamate ab
Ribosomal p for psychosis

Most specific ab smith however it lacks sensitivity

A

Sle lung

Mc is pleurisy

Interstit fibrosis
Shrunken lung
Alveolar h’age

26
Q

Cardiac sle

Mc pericarditis
Most severe are myocarditis , MI
MOST specific libman sacks

SLE rash scaling + , never carcinoma

Arthritis - symmetric small jt non deforming

A

Sle renal
Most common - class 4
Class 1 minimal mesangial only on IF immune depositis
Class 2 mesangipproliifrtv - prolif, imm deposits
Class 3 focal ( endoth,Mesang..prolif)
Class 4 diffuse, wireloop, crescents, subendo immune deposits
Class 5 memb lupus subepith deposits
Class 6 advanced sclerosing - sclerosis >90 %

27
Q

Mcc death in chronic SLE

Accelerated atherosclerosis and MI

In fisrt decade of illness
Causes of death are nephritis and infection

A

Ab - chorea in SLE - APLA

APLA pregnancy
Heparin and aspirin
Steroid ineffective
IVIG prevents abortions

APLA 2.5 to 3.5 INR to be maintained

28
Q

Extra articular manifestations of RA

Mc is subcutaneous nodules

Others : sjogren
Pleuritis , ILD
Pericarditis , MR
Felty syndrome , lymphoma DLBCL

A

Mc c death: CVS

Mc hemat :N N anemia
Mc cerv spine c1/2 involved

Earliest is periarticular osteopenia

Hypoandrogenism , mononeurotis mplx

29
Q

SIADH causes

asthma , pneumothorax, PP ventilation

Acute porphyria

Neoplasms( non cns also) , trauma ( closed and penetrating ) , vascular , thrombosis , infections

SSRI and other antidep
, Vincristine , high dose oxytocin,

A

Nephrogenic DI causes

Hypercalcemia , hypokalemia

Cns causes and all other - trauma , inf, vascular, granulomarous ( sarcoid / histiocytosis ) except MS

Demeclocycline ( used for treating chronic SIADH), lithium, rifampin, ampho, aminoG, foscarnet

MS causes SIADH not DI
Uric acid low in SIADH

30
Q

Siadh treatment
Acute symp : iv infuse hypertonic saline
TOlvapatan

Chronic fluid restrict <500ml/day
vaptans doc
Demeclocycline
Fludrocort

A

DI

treatment
Low salt diet
Desmoprwssin /

thiazides
Amiloride
Indomethacin

31
Q

Ild Mc in women

A

Worst ild is AIP

32
Q

Silicosis hrct

Acute : crazy pavemnt , secondary PAP

Chronic upper lobe nodules - simple
Complicated - nodules coalaesce
Progressive massive fibrosis , egg shell calcifications

A

Silicosis increased risk ofTB

Pulm alveolar macrophage dysfunction

33
Q

Phaeo

adrenal with men 2 : epinephrine

Adrenal with VHL : NE

Extra adrenal : NE

A

VHL

no skin involvement

Cbllr ( CNS ) and retinal -hemangioblastoma

pheao , RCC , pancreas- Tumors

(Visceral cysts, cafe au l,Stroke, Cad)

34
Q

Phaeo

Seen in 
MEN 2
VHL 
NF1 
paraganglioma syndrome
A

Treatment of cushings

Ketoconazole

Mitotane used in adrenocortical ca, adrenolytic property )

Cyproheptadine
Metyrapone

35
Q

Type 1 DM :
HLA DR 3, 4 , CTLA4
Chr 6

Type 2 no HLA
Calpain 10
Chr 2 - insulin resistance

A

MODY - 11 types
Type 3 MC
Rx - Sulf ureas

Mono genic DM
types 1,3,5 - HNF mut
Type 2 - glucokinase mutation
Type 4- IPF1 mut

36
Q

MEONS

CARNEY
COWDEN
MC CUNE
VHL
NF1
Jaw hyper pth tumor
A

EPO increased in

RCC
HCC
CBLLAR HEMANGIOBLASTOMA - VHL

37
Q

Diabetes seen in

Turner , Kline , downs , prader, Laurence moon biedel

Friedrichs

Myotonic dystrophy

Hemochromatosis , cystic fibrosis , (exocrine pancreas defect)

Acromegaly hyperthyroidism

A

Metformin
No monitoring
no hypoglyc
Wt loss

Contraindi
hepatic and renal failure
Alcoholics

Side effects
Lactic acidosis , b12 def

38
Q

New blood group discovered in India

A

P null

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