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Med 1 Flashcards

1
Q

2 hour cutoff for impaired glucose tolerance

A

140

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2
Q

preDM indication for metformin

A

impaired FG and Impaired glucose tolerance

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3
Q

tx DKA vs HHS

A

DKA: insulin drip
HHS: IV fluids

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4
Q

statin indication if no DM

A

if 10 yr risk>7.5%

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5
Q

cutoff hyperlipidemia

A

total cholesterol 200

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6
Q

LVH with EKG

A

S1 + R5 = >35

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7
Q

QT cutoff math

A

70 bpm, qt<.4

for every 10 bm, subtract .02

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8
Q

vitamin D cutoff

A

30

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9
Q

t wave inversion =

A

ischemia

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10
Q

q’s in V1-V4

part of heart and artery

A

anterior

LAD

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11
Q

q’s in I, AVL, maybe 5 or 6

heart and artery

A

lateral

circumflex coronary artery

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12
Q

q’s in II, III, AVF

heart and artery

A

inferior leads = inferior

RCA or descending branch.

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13
Q

large R, ST depression in V1,V2

heart and artery

A

posterior

RCA

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14
Q

normal PR

A

less than .2 (less than 1 big box)

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15
Q

normal QRS

A

less than .12 (3 boxes)

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16
Q

Saag cutoff and significance

A

1.1

Greater is portal htn.

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17
Q

2 types microscopic colitis

A

Lymphatic and collagenous.

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18
Q

Sensitivity =

A

Tp/sick

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19
Q

Specificity =

A

Tn/healthy

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20
Q

Lrs of 2,5,10 increase dz by

A

15, 30, 45

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21
Q

Stage 2 htn (2)

A

Greater than 160 sys or 100 dia

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22
Q

Sirs (4) include number necessary

A 
2 of:
Fever
WBC
Tachypnea or paco2 less than 32
Tachycardia
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23
Q

Sepsis (2)

A

Sirs + source of infection

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24
Q

Severe sepsis

A

Sepsis + hypotension or lactic acidosis

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25
Q

Septic shock

A

Severe sepsis despite aggressive fluids

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26
Q

If rta, urine gap is

A

A positive number.

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27
Q

Osm equation

A

2Na + glucose/18 + BUN/2.8

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28
Q

Osm gap normal

A

10

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29
Q

Osm gap significance

A

Alcohols

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30
Q

Normal range for blood osm

A

275-295

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31
Q

Cutoff urine k for hypokalemia investigation

A

20

Above suggests renal losses

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32
Q

Migraine prophylaxis tx

A

Propranolol if more than 2 a week.

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33
Q

RTA type 1

location
urine pH
tx

A

distal tubule
>5.5
bicarb

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34
Q

RTA type 2

location
tx

A

proximal tubule

thiazide

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35
Q

RTA type 4
hallmark
tx

A

hyperkalemia (classically hyporeninemic hypoaldosteronemic diabetic)
fludrocortisone

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36
Q

Cutoff for concerning PSA velocity

A

Greater than .75

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37
Q

P waves change shape

More than vs less than 100

A

More than 100 = multifocal atrial tachycardia

Less than 100 = wandering pacemaker

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38
Q

20 to 40 BPM with wide qrs

A

Ventricular escape

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39
Q

Pause than long qrs

A

Ventricular escape

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40
Q

No p wave or p wave inverted following.

A

Junctional rhythm

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41
Q

Tachycardia like sinus 160 to 200

A

Svt

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42
Q

Tactile fremitus (2)

A

Increased if lobar

Decreased if effusion

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43
Q

side effect of niacin besides pruritis (2 labs)

A

+glucose

+uric acid

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44
Q

side effect fibrates

A

+myositis with statins

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45
Q

side effect cholestyramine

A

flatus and abd. cramping

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46
Q

problem with ezetimibe.

A

well tolerated and nearly useless

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47
Q

normal R wave progression in precordial leads

A

gets bigger 1-5

interrupted in RVH. V1 R ends up being bigger than S. V6 S wave ends up being bigger than R.

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48
Q

2 drugs you may NOT use in hypertrophic cardiomyopathy but you may use in dilated cardiomyopathy.

A

Digoxin and spironolactone.

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49
Q

5 indications for dialysis

A

Aeiou

Acidosis
Electrolytes
Intoxication
Overload
Uremia
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50
Q

Metabolic acidosis

Determining appropriate resp compensation

A

Appropriate pco2 = 1.5hco + 8

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51
Q

3 work ups for acid base

A

Check ag
Check compensation
Check delta gap

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52
Q

Strep pneumo vaccines before and after 65.

A

Before equals one dose plus another 5 years later. After 65 is just one dose.

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53
Q

pleural fusion analysis

2 labs

A

in exudate or pseudoexudate
protein >3
LDH>200

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54
Q

pleural fusion analysis

transudate vs pseudoexudate (CHF)

A

cholesterol <50 is the hallmark of true transudates

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55
Q

Lab difference in primary vs secondary hyperPTH

A

2 has low calc, high phosphate.

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56
Q

Electrolyte that parallels vitamin d

A

Calcium

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57
Q

Ca normal value range

A

8.4 to 10.2

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58
Q

Normal phosphorus range

A

3.0 to 4.5

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59
Q

Find out 24 hour urine protein quickly

A

Urine albumin/creatinine ratio

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60
Q

Calculating delta gap

A

Corrected hco3 (25) should = hco3 actual + delta anion gap

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61
Q

Expected renal compensation for a respiratory acid base disorder (2)

A

HCO3 up 1 down 2

Acute up 1 per 10 mmhg co2 up. Down 2
Chronic up 4 per 10 mmhg co2

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62
Q

2 side effects acetazolamide

A

Hypokalemia

Metabolic acidosis

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63
Q

Cutoff for concerning K level in urine

A

20

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64
Q

tx acute ex CHF

A

LMNOP (Loop diuretics, Morphine, Nitrates, Oxygen, Positioning/Pressors

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65
Q

Use of spironolactone in chf (what classes of chf)

A

Class 3 or 4 only

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66
Q

Urine na >40 type of arf

A

Postrenal

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67
Q

Fena cut offs (3)

A

Less than 1 prerenal
Greater than 2 renal
Greater than 4 postrenal

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68
Q

Rbc casts

A

Glomerulonephritis

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69
Q

recurrent sinopulmonary infections in adults
normal # B cells, decreased output of B cells (abs)
+giardiasis, risk of lymphoma

A

CVID

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70
Q

tx CVID

A

IVIG

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71
Q

hypomagnesemia causes
gland disorder
lyte change

A

hypoPTH

+Ca renal loss

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72
Q

2 CV changes with hypercalcemia

A

short QT

HTN

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73
Q

test to locate pheochromocytoma outside of adrenals

A

MIBG scanning

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74
Q

criteria for O2 use in COPD (2)

A

pO2 below 55
sat below 88%

60 and 90 if right sided heart failure signs

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75
Q

pneumonia pathogen associated with hoarseness

A

Chlamydophila

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76
Q

tx of wpw

A

procainamide

NOTHING to slow AV node

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77
Q

SVT 1st tx

A

carotid massage

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78
Q

electrical alternans association

A

tamponade

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79
Q

if you suspect pe, 1st step

A

give heparin

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80
Q

2 pressures w/pulmonary wedge pressure

pulmonary htn vs chf

A

pwp normal if pulmonary htn

high if chf

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81
Q

low glucose in transudative effusion

A

RA

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82
Q

Persistent ST elevation 1mo after MI + systolic MR murmur?

A

ventricular wall aneurysm

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83
Q

cannon a-waves (2)

A

vfib or 3rd degree heart block

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84
Q

best prognostic indicator COPD

A

FEV1

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85
Q

acute clubbing in COPD

A

lung malignancy

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86
Q

asthma person with normalizing (lower going up) pco2

A

danger. intubate.

87
Q

thermophillic actinomyces with patchy lower lobe inflitrates

A

hypersensitivity pneumonitis (farmer’s lung)

88
Q

lung cancer with peripheral cavitation and distant mets

A

large cell

89
Q

antimitochondrial ab

A

pbc

90
Q

dx of prinzmetal’s angina

A

ergonavine stimulation test

91
Q

SEM louder w/ valsalva, softer w/ squatting or handgrip.

A

HOCM

92
Q

old smoker with COPD

pneumonia pathogen

A

H. flu

tx with 2nd, 3rd gene cephalosporins

93
Q

HAART started (2, cd4 count and viral load)

A

CD4 less than 350
Or
Viral load greater than 55k

94
Q

aids drug w/pancreatitis

A

didanosine

95
Q

HS rash, fever, n/v, muscle aches, SOB in 1st6wks. D/C and never use again! AIDS drug

A

abacavir

96
Q

AIDS drug

Nephrolithiasis and hyperbilirubinemia

A

indinavir

97
Q

Sleepy, confused, psycho AIDS drug

A

efavirenz

98
Q

AIDS patient with MS-like presentation

A

PML (JC polymoma virus)

99
Q

paralysis, ileus, ST depression, U waves.

A

hypokalemia

100
Q

most common cause type 1 & 2 RTA (1 each)

A

lithium

myeloma

101
Q

electrolytes in types 1 & 2 RTA (1)

A

hypoK

102
Q

tx for RTA types 1,2,4

A

bicarb
diuretic
fludrocortisone

103
Q

main problem in type 1 or 2 RTA (2)

A

type 1 cannot excrete H+

type 2 cannot reabsorb HCO3

104
Q

definition ARF

A

greater than 25% or 0.5 rise in creatinine over baseline.

105
Q

confusion, pericarditis, itchiness, increased bleeding

A

uremia

106
Q

nephritis 1-2 days vs 1-2 weeks after infection

A

Berger’s

Post SC GN

107
Q

Cardiac patient s/p ticlopidinew/ renal failure, MAHA, ↓plts, fever and AMS.

A

TTP

108
Q

tx TTP

A

plasmaphoresis

don’t give platelets

109
Q

neurologic and renal symptoms, fever, thrombocytopenia,

and microangiopathic hemolytic anemia

A

TTP

110
Q

substance increased in B12 anemias

A

methylmalonic acid

111
Q

2 bleeding factors not made by liver

A

8, vWF

made in endothelium

112
Q

thrombotic skin necrosis with hemorrhage

following administration of warfarin is a sign of

A

protein C or S deficiency

113
Q

acute tx (2) for gout

A

Indomethacin + colchicine (steroids if kidneys suck).

114
Q

anti-RNP

A

MCTD

115
Q

thyroid cancer:

Spreads via blood, must surgically excise whole thyroid!

A

follicular (but papillary is most common type)

116
Q

size cutoff for excising adrenal nonfunction nodule

A

6 cm

117
Q

Sestamibi scan.

A

used to locate parathyroid adenomas

118
Q

EEG 3 Hz spike-and-wave.

A

absence

tx: ethosuccimide

119
Q

EEG triphasic bursts

A

CJD

120
Q

EEG diffuse background slowing

A

delirium

psychosis has no EEG change

121
Q

EEG hypsarrhythmia

A

infantile spasms

tx with ACTH

122
Q

test of choice for GERD

A

24 pH monitoring

123
Q

best test for zollinger-ellison syndrome

A

secretin stimulation test

124
Q

toxicity of carbepenems

A

seizures

125
Q

hallmark high lab of PCP

A

LDH

126
Q

most common EKG change in PE

A

nonspecific ST-T changes.

more common than S1Q3T3

127
Q

definition ARDS

A

pO2/FIO2 ratio below 200

FIO2 of room air = .21 or the fraction of oxygen

128
Q

migratory superficial thrombophlebitis

name and sign of?

A

Trousseau’s Syndrome

Pancreas or other cancer

129
Q

5 days - 3 months post-MI

persistent ST-segment elevation and deep Q waves in same leads

A

ventricular aneurysm

130
Q

vitamin that reduced morbidity, mortality in measles

A

vitamin A

131
Q

umbilicated vesicular rash over atopic dermatitis

A

eczema herpeticum

132
Q

main side effect of lamotrigine (and 2 indications)

A

bipolar and epilepsy

major side effect = rash

133
Q

prevention of chlamydial conjunctivitis vs gonococcal (ophthalmia neonatorum) to neonates

A 
chlamydia = prenatal testing
gonoccal = erythromycin
134
Q

phenelzine, class

A

MAO inhibitor (anti-depressant)

135
Q

HIV-related nephropathy

A

FSGS

136
Q

Case control vs retrospective cohort

A

Case control. Have group look back on risk factors

ret cohort. Review past records to study incidence

137
Q

blood abnormality with obstructive sleep apnea

A

polycythemia

138
Q

most serious side effect of hydroxyxhloroquine

A

retinopathy

get eye exam q6 mo.

139
Q

D-dimer cutoff for excluding PE

A

500

140
Q

elderly patient with anemia, renal failure and hypercalcemia

A

multiple myeloma

141
Q

rapidly progressing dementia

sharp complexes on EEG

A

Creutzfeld-Jacob dz

142
Q

D-xylose test

A

test for small bowel malabsorption (celiac, for example), esp. proximal small bowel

143
Q

dacrocystitis

A

infection of lacrimal sac

144
Q

chalazion vs hordolum

A 
chalazion = hard painless nodule (granuloma or meibomian gland)
hordeolum = abscess of upper/lower eyelid
145
Q

first calculaton with hypernatremia, hypokalemia

A

aldosterone/renin ratio

146
Q

tx of chorioamniotis (2)

A 
abx
delivery (NOT C-SECTION)
147
Q

diabetic patient with sudden vision loss with floaters

A

vitreous hemorhage

148
Q

most significant reversible cause pancreatic cancer

A

smoking

149
Q

drug for hairy cell leukemia

A

cladribine (purine analog)

150
Q

electrolyte contraindication for succinylcholine

A

hyper K (or risk for hyper K = burn/crush, etc

151
Q

antidote for mg toxicity

A

ca gluconate

152
Q

angular chelisos, glossitis, anemia, seborrheic dermatitis

vitamin deficiency?

A

B2 riboflavin

153
Q

cheilosis w/ mood changes (irritability, confusion, depression)

vitamin deficiency?

A

B6 pyridoxine

154
Q

fena greater than 2?

less than 1?

A

greater than 2 = ATN

less than 1 = prerenal

155
Q

1 risk factor for emphysematous pyelonephritis

A

DM

156
Q

tx of duodenal hematoma from blunt abdominal injury

A

suck and drip

157
Q

most common cause of Guillian Barre Syndrome

A

campylobacter jejuni infection

158
Q

criteria for SBP dx or peritonitis

A

WBC above 250

159
Q

most common location choriocarcinoma metastasis

A

lungs

160
Q

tx for HIV needles stick

A

immediate 3 drug therapy

161
Q

etiology of lytic lesions in cancers

A

+PTHrP

162
Q

cutoff of gestational age with lung immaturity requiring investigation

A

less than 34 weeks

163
Q

2 types of monitoring if on amiodarone

A

hepatic

thyroid

164
Q

hallmark rhythm of digitalis toxicity

A

atrial tachycardia

due to +ectopy and +vagal tone

165
Q

risk if asymptomatic UTI not treated in pregnant pt

A

becomes pyelonephritis

166
Q

pseudocyesis

A

fake pregnancy, a conversion disorder

167
Q

what to do if find a diastolic murmur on PEx

A

work it up!

168
Q

protein cutoff for transudates vs exudates

A

+ than 3 g/dl (>.5 of serum) in exudates

169
Q

LDH in exudates vs transudates

A

+ than 200 IU/L (>.6 or serum) in exudates

170
Q

pH cutoff for exudates

A

acid in exudates (below 7.2)

171
Q

class of medications to + appetite in hospice care

A

progesterone analogs

172
Q

tx for fibromuscular dysplasia

A

angioplasty w/stent placement

173
Q

GGT and ferritin levels in alcoholic liver dz (2)

A

increased

174
Q

HCM maneuver to increase murmur

A

decrease preload (make LV smaller) = valsalva

175
Q

pain on palpation of heels, iliac crests, tibial tuberositios

A

enthesitis

(inflammation of tendon attachments) - common feature of ankylosing spondylitis

176
Q

2 side effects lithium

A

nephrogenic diabetes insipidus

hypothyroidism

177
Q

cor pulmonale

A

isolated right heart failure, typically due to lung dz

178
Q

anatomical location where DHEAS is produced (specific for)

A

adrenals

179
Q

traveler w/pneumonia and hyponatremia

or liver disfunction, AMS, diarrhea too

A

legionella

180
Q

initial tx of SIADH (if not severe enough for hypertonic IVF)

A

fluid restriction

181
Q

Ab diff. in Waldenstom’s macroglobinuria vs multiple myeloma

A

IgM in Waldenstrom’s

IgG or IgA in MM

182
Q

besides IgM, other hallmark of Walderstrom’s

A

hyperviscosity

183
Q

liver dz assoc with ulcerative colitis

A

PSC

184
Q

hallmark of histology of IBD

A

neutrophilic cryptitis

185
Q

artery and nerve at risk with supracondylar humerus fx

A

brachial artery, median nerve

186
Q

tx of anti-phospholipid ab

A

LMW heparin

187
Q

2 causes of exertional syncope besides vtach

A

outlet obstruction:

aortic stenosis
hypertrophic cardiomyopathy

188
Q

ACTH levels and cortisol levels in adrenal insufficiency (caused bu abruptly stopping steroids)

A

both low

189
Q

contraindication for raloxifene

A

hypercoagulation (hx of DVT)

190
Q

timing of ETOH withdrawl

A

1-2 days

191
Q

toxicity with prolonged or high doses nitroprusside

A

cyanide

192
Q

inheritance of hypertrophic cardiomyopathy

A

AD

193
Q

sequelae for CF in adulthood as males

A

infertility (no vas)

194
Q

renal artery stenosis effect on aldersterone

A

a form of secondary hyperaldosteronism

195
Q

colonoscopy scheduled for UC

A

8 years after dx, then 1-2 years after

196
Q

immunosupressant that gives hepatotoxicity, diarrhea, leukopenia

A

azathioprine

197
Q

side effect mycophenolate

A

bone marrow suppression

M = Marrow

198
Q

malaria prophylaxis if pregnant

A

mefloquine

199
Q

type of poisoning with almond scent

A

cyanide

200
Q

type of test for HIV screening

A

Ab and Ag

RNA only for +suspicion w/negative test

201
Q

Antidote for anticholinergic meds

A

Physostigmine

202
Q

electrolyte causing refractory hypoK in an alcoholic

A

Hypomagnesemia

203
Q

if a relative risk =4, what is the attributable risk %

A

75%

RR-1/RR

204
Q

biggest cause of B12 deficiency

A

pernicious anemia

205
Q

MCHC level in spherocytosis

A

increased

206
Q

medical tx of prolactinoma

A

cabergoline (dopamine agonist)

207
Q

cutoff for hypertensive urgency

A

180/120

malignant htn is end-organ damage

208
Q

tx for electrical abnormalities in TCA overdose

A

sodium bicarb

209
Q

sx of retinitis in HIV pt (HSV vs CMV)

A

CMV retinitis is painless

210
Q

abd. pain on one side, fever, gross hematuria

A

Renal Vein Thrombosis

211
Q

Renal Vein thrombosis most associated w/what glomerular pathology?

A

membranous

212
Q

COPD home O2 requirements include SaO2 less than 88 and Ht, PaO2 cutoffs are?

A

55!
Ht >55
PaO2

213
Q

kussmaul’s sign

A

rise in JVP on inspiration. Sign of RHF

214
Q

area of pathology in each of these:
lambert-eaton syndrome
myasthenia gravis
dermatomyositis

A

pre-synaptic membrane
post-synaptic membrane
muscle fibers

Step 2 CK (12 decks)

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