May8th Flashcards
What is seen on ECG in posterior Mi?
ST depression in leads V1-V3, ST elevation in leads I and aVL (LCX); ST depressions in leads I and aVL (RCA)
When do you seen congenital heart block?
Primarily in neonatal lupus - presents with bradycardia, erythematous annular rashes on scalp and periorbital region
Infant with central cyanosis and single S2 heart sound?
Transposition of great arteries or truncus arteriosus (truncus arteriosis is associated with DiGeorge and has a systolic ejection murmur)
What cardiac defect is commonly seen in trisomy 18 (Edward syndrome)?
VSD
Central cyanosis with 24 hours of life, single S2 and narrow mediastinum on XR
Transposition of the great vessels; note: can have a murmur (PDA or VSD), but may not if have PFO
Whta is the MOA of tamsulosin in treating renal calculi?
Tamsulosin is an alpha 1 antagonist that relaxes ureteral muscle and decreases intraureteral pressure
What is bethanechol?
Cholingergic agent used to treat urinary retention or atonic bladder
What is oxybutynin? What is it used for?
Anticholinergic; inhibits cholinergic input during bladder filling; improves bladder capacity; used to treat overactive bladder (detrusor instability)
Angiodysplasia is associated with what diseases?
Advanced renal disease, von Willebrand diease, and aortic stenosis
What is the pathophysiology of flail chest?
> /= 3 contiguous ribs fracture in >/= 2 locations —> flail chest segment
What is felodipine?
CCB
What are the features of sleep terrors?
Panicked scream, terror, autonomic arousal, unresponsive to comfort; little to no dream recall; most common in children ages 2-12
Caroid pulse with dual upstroke in young African American male with FH of sudden cardiac death in brother
Hypertrophic cardiomyopathy / HOCM
What is the genetic inheritance of Friedreich ataxia?
Autosomal recessive trinucleotide repeat (GAA) - abnormality in frataxin protein
How is minimal change disease treated?
Corticosteroids
What are the cardiovascular consequences of acromegaly?
Concentric myocardial hypertrophy; mitral and aortic regurg; CVD is leading cause of death in patients with acromegaly
What are the indications for delivery in PPROM?
> /= 34 weeks gestation, patients <34 weeks gestation with signs of infection or fetal compromise
What antibodies are seen in primary biliary cholangitis?
Anti-mitochondrial antibodies
What bone is most commonly fractured in an epidural hematoma?
Sphenoid bone
What is the pathophysiology of HUS?
Preceding diarrheal illness, resulting in Shiga toxin release —> endothelial damage —> thrombocytopenia / platelet activation —> microthrombi formation —> MAHA
What is the most common cause of AA amyloidosis?
Rheumatoid arthritis
Rheumatoid arthritis causes what kind of amyloidosis?
AA
Why does supplemental oxygen not improve cyanosis or pulse ox in methemoglobin?
Methemoglobinemia results in ferric Hgb, which has poor oxygen affinity
What is the treatment for methemoglobinemia?
Methylene blue; acts as an electron acceptor for NADPH
What is dimercaprol used for?
Lead poisoning
What is fomepizole used for?
Treatment of ethylene glycol or methanol ingestion; inhibits alcohol dehydrogenase
What is the treatment for cholinergic toxicity?
Pralidoxime + atropine
How is cyanide toxicity treated?
Hydroxocobalamin or sodium thiosulfate; can use nitrites to induce methemoglobinemia
How does cyanide inhibit the ETC?
Inhibits cytochrome oxidase A3; binds ferric iron, inhibiting reduction to ferrous iron and blocking ATP from oxidative phosphorylation