May 2nd Flashcards
What are the clinical features of Felty syndrome?
RA, neutropenia, splenomegaly
How is Felty syndrome diagnosed?
Anti-CCP and RF are positive, increased ESR, peripheral smear and bone marrow bx to r/o other causes
Eyelid xanthelasma is associated with what biliary disease?
Primary biliary cholangitis
What is a pharmacological therapy for primary biliary cholangitis?
Ursodeoxycholic acid
What is the most common cause of death in dialysis patients?
CVD - 20% MI, 60% sudden cardiac death
Beriberi results in what type of cardiomyopathy?
Dilated cardiomyopathy
Concentric LV hypertrophy is seen in what cardiomyopathy?
Restrictive cardiomyopathy
What are the causes of restrictive cardiomyopathy?
Infiltrative (eg sarcoid, amyloid), storage disease (hemochromatosis) or endomyocardial fibrosis, idiopathic
What drugs can cause folate deficiency?
MTX (supplement with leucovorin), TMP, and phenytoin (decreased absorption in gut)
What are the clinical features of mycoplasma pneumoniae?
HA, malaise, fever, and INCESSANT DRY COUGH; can have pharyngitis and macular/vesicular rash; subclinical hemolytic anemia (cold agglutinins), WBC usually normal
Patient with SOB, cough, dullness to percussion with increased breath sounds
Lobar pneumonia causing lung consolidation
Dimorphic RBCs, increased serum iron concentration and decreased TIBC in patient receiving RIPE therapy
Sideroblastic anemia due to pyridoxine def resulting in impairment of protoporphyrin synthesis
What are the clinical manifestations of chronic arsenic toxicity?
Sensorimotor neuropathy with burning and painful hypersensitivity in stocking glove distribution, distal weakness, hyporeflexia, hypo- and hyper-pigmentation of the skin (earlier) and hyperkeratosis and scaling of the soles and palms (later); can also see Mees lines (horizontal striation of fingernails)
What is the treatment for arsenic poisoning?
Dimercaprol and DMSA
What is a nonstress test fetal surveillance?
External fetal HR monitoring
What is a biophysical profile?
Nonstress test plus US assessment of amniotic fluid volume, fetal breathing movement, fetal movement, fetal tone
What is a contraction stress test?
External fetal HR during spontaneous or induced uterine contractions
What is the next best step in evaluating a nonreactive nonstress test?
Biophysical profile or contraction stress test (CST contraindicated in contraindications to labor - eg placenta previa, prior myomectomy)
What is a normal amniotic fluid volume on a biophysical profile?
Single fluid pocked >/=2x1 cm or amniotic fluid index >5
What is an aborting submucous myoma?
A uterine leiomyomata that prolapses into the vagina; can cause labor-like pain and prolonged bleeding
Fundoscopic exam reveals elevated retina with folds
Retinal detachment
Sudden loss of vision and onset of floaters, fundus is hard to visualize/details obscured, floating debris is seen and a dark red glow on fundoscopy
Vitreous retinal hemorrhage
Recurrent pneumonia, atopy (asthma and eczema) and anaphylactic reaction during blood transfusion
Ig A def
How much should HCO3- decrease in a respiratory alkalosis?
Bicarb down 2 mEq/L for every 10 mmHg change in PaCO2
What are the signs/symptoms of neuroleptic malignant syndrome?
Mental status change, rigidity, fever and autonomic dysregulation (abnormal VS, sweating)
What are the s/sx of serotonin syndrome?
Mental status change, autonomic instability, tremor, hyperreflexia, and myoclonus
What is the mechanism by which diphenhydramine can cause urinary retention?
Anticholinergic - leads to impaired detrusor muscle contraction, and to a less extent impaired internal sphincter relaxation
What are the s/sx of lithium toxicity?
Tremor, hyperreflexia, ataxia, seizures, vomiting and diarrhea
