May 19th Flashcards
Patient with undescended testis are at risk for developing what testicular cancer(s)?
Dysgerminoma or gonadoblastoma
When do you see P aeruginosa associated osteomyelitis?
Foot puncture wound and IV drug abusers
Large mediastinal mass with elevated AFP and Beta-hCG
Nonseminomatous germ cell tumor
What are the oxygen sats and EPO levels in PV?
Normal oxygen sats and low EPO levels
What is the treatment for PV?
Phlebotomy and hydroxyurea if high risk of thrombosis
Probability of being free of a disease if the test result is negative
NPV
Patients with CAP who require hospitalization on the medical floor require treatment with what?
Fluoroquinolone or beta-lactam plus macrolide
What is the CURB-65 criteria?
Determines hospitalization; confusion, urea > 20, RR >30, BP (<90 or <60), age 65 and up; one point for each; 1-2 intermediate mortality = IP treatment; 3-4 high = ICU
What are the s/sx of malignant hypertension?
Severe HTN with retinal hemorrhages, exudates or papilledema; can develop malignant nephrosclerosis (ARF, hematuria, proteinuria) but not required for the diagnosis
Use dependence in regards to antiarrhythmic drugs is seen in what class of antiarrhythmic drugs?
Class IC - eg flecainide and propafenone
What is the treatment for anal fissures?
Stool softeners, sitz bath, topical anesthetics and vasodilators (eg nifedipine, NTG)
Narcolepsy is associated with low CSF levels of what?
Orexia-A/hypocretin-1
What is the diagnostic criteria of ascitic fluid for SBP?
> 250 PMNs, protein <1 g, SAAG >1.1, positive Cx
What are the symptoms of digoxin toxicity?
Anorexia, N/V, abd pain, confusion, fatigue, weakness, color vision alterations
What cardiac meds can increase digoxin levels?
Amiodorone, propefenone, quinidine, verapamil
Loss to follow up creates potential for what type of bias?
Selection bias (aka attrition bias)
Subject is reluctant to report an exposure due to stigma about the exposure (eg sex, drugs) leads to what type of bias?
Reporting bias
What is surveillance bias?
Exposure group undergoes increased monitoring relative to the general population; can lead to increased disease diagnoses
How is stool osmotic gap calculated?
Plasma osmolality - 2x (stool sodium + stool potassium)
What is a torus palatinus?
Benign bony growth located midline suture of the hard palate; congenital
Immunocompromised patient with fever, pleuritic CP, hemoptysis and nodules with ground glass opacities on CT scan
Invasive aspergillosis; “halo sign”
Kallmann syndrome is what type of inheritance pattern?
X linked recessive
Macrocytic anemia, craniofacial anomalies, triphalangeal thumbs
Think Diamond-Blackfan anemia
Microcytic anemia non-responsive to iron supplementation in Mediterranean origin
Beta-thalassemia
What medications are commonly used to treat acute bipolar depression?
Quetiapine, lurasidone and lamotrigine;
What murmur is heard in HOCM?
Crescendo-decrescendo systolic murmur heard best at the apex or LLSB
Early decrescendo diastolic murmur heard best on LSB (3rd/4th intercostal space)
AR
How are uric acid stones treated?
Hydration, alkalinization of urine, low purine diet; use oral potassium citrate to alkalinize the urine
How is TTP diagnosed? What is the treatment?
Hemolytic anemia + thrombocytopenia; get blood smear (see schistocytes, helmet cells); treatment: plasma exchange; glucocorticoids; can use rituximab
How is a liver abscess with E histolytica treated?
PO metronidazole; luminal agent (ie paromomycin) required to eradicate intestinal colonization; no need to drain abscess
How is a hydatid cyst dueto Echinoccus treated?
Aspiration with albendazole
How does Ehrlichiosis present?
Fever, HA, myalgias, leukopenia and thrombocytopenia
How does babesiosis present?
Anemia with intravascular hemolysis, thrombocytopenia, see maltese cross on blood smear (diagnostic)
How is babesiosis treated?
Atovaquone + azithromycin or quinine plus clindamycin (severe illness)
What is the treatment for QT prolongation?
Beta blockers + pacemaker if symptomatic (lightheadedness, palpitations)
How is hoarding disorder treated?
CBT (maybe SSRI could be used, no great evidence)
Boot shaped heart (upturning of the cardiac apex)
Tetraology of fallot
What is the treatment for bacillary angiomatosis?
Doxycycline or erythromycin
Nephrotic syndrome with dense deposits within glomerular basement membrane that stain positive for C3 but not immunoglobulins
Type II membranoproliferative disease caused by IgG antibodies to C3 convertase, leading to persistent activation of alternative complement pathway
What is treatment for Parkinson disease psychosis?
Quetiapine, clozapin, pimavanserin; haloperidol and risperidone should be avoided (worsen EPSE)
Uncal herniation results in loss of what nerve?
Ipsilateral oculomotor nerve
How is cryptococcal meningitis treated?
Amphotericin B and flucytosine
How is cancer-related anorexia/cachexia syndrome treated?
Progesterone analogues or corticosteroids
What components of spirometry measure respiratory muscle strength?
FCV and negative inspiratory force
What is Trousseau’s syndrome? What is its significance?
Migratory superficial thrombophlebitis; seen in visceral (pancreatic) cancers
Pronator drift is associated with a lesion where?
Pyramidal/corticospinal tract
New mother holding her infant with outstretched thumb now complains of pain with passive stretching of flex thumb in palm
De Quervain tenosynovitis
What is the treatment for PMS/PMDD?
SSRIs firstline; OCPs can help
