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medicine 1 Flashcards

1
Q

audible S4, think…

A

aortic stenosis

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2
Q

pulsus parvus et tardus

A

diminished (amplitude) and delayed (upstroke) of carotid pulse

in aortic stenosis

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3
Q

exercise stress test or echo for syncope?

A

echo 1st, prior to exercise stress test

echo- for cardiomyopathy, valvular heart dz (eg. aortic stenosis)

exercise stress test: for known coronary dz (contraindicated in aortic stenosis)

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4
Q

acute arterial limb ischemia (6 P’s) post-MI is from thrombus or embolus?

A

embolus

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5
Q

what intervention post-STEMI can improve CV outcomes and overall mortality?

A

restore coronary blood flow with:

  • primary percutaneous intervention
  • fibrinolysis
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6
Q

etiologies of pericarditis

A

viral

autoimmune (SLE)

uremia (renal failure)

post MI

  • early: peri-infarction pericarditis
  • late: dressler syn
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7
Q

bounding pulses seen in

A

aortic regurgitation

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8
Q

aortic regurg is systolic or diastolic murmur?

A

diastolic

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9
Q

strongest predictors of AAA expansion/rupture

A

**smoking
large aneurysm diameter
rate of expansion

others: age, family hx, white, atherosclerosis

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10
Q

abrupt onset of tachycardia that resolves with cold water immersion. think…

A

supraventricular tachycardia-

more specifically, atrioventricular nodal reentrant tachycardia

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11
Q

how does cold water help SVT?

A

vagal maneuver

increase parasympathetic tone –> slow AV conduction and increase refractory period

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12
Q

wilson disease symptoms

A

hepatic (liver failure, cirrhosis, chronic hepatitis)

neuro (parkisonism, abnl gait, dysarthria)

psych (depression, personality changes)

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13
Q

wilson disease treatment

A

chelators (d-pencillamine, trientine)

zinc - interferes with Cu absorption

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14
Q

zencker diverticulum presentation

A

> 60 yo male

halitosis
dysphagia
regurgitation
neck mass

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15
Q

where is zencker diverticulum

A

above upper esophageal sphincter

with posterior herniation between crichophryngeal muscle

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16
Q

what causes zencker diverticulum

A

sphincter dysnfunction and dysmotility

17
Q

diagnosis and treatment of zencker diverticulum

A

dx: barium esophogram
tx: surgery- excision or cricopharyngeal myotomy

18
Q

how to improve steatorrhea in patients with chronic pancreatitis?

A

pancreatic enzyme supplementation

19
Q

acute pancreatitis treatment

A

resolves in 4-7 days

supportive care, IVF, analgesics

20
Q

elevated alk phosphatase and positive AMA. think…

A

primary biliary cholangitis (autoimmune)

21
Q

primary biliary cholangitis symptoms

A

pruritus, fatigue

jaundice, hepatomegaly, steatorrhea, xanthelasma

22
Q

primary biliary cholangitis treatment

A

ursodeoxycholic acid

  • decreases biliary injury by hydrophobic bile acids
  • increases biliary secretion
  • anti-inflammatory
23
Q

urinary outflow obstruction symtpoms

A

flank pain

low urinary output with periods of post-obstructive diuresis

–> potassium wasting –> weakness

24
Q

is there screening for bladder cancer?

A

no

25
Q

what is this: bladder pain, worse with filling, relief with voiding. frequency and urgency. also dyspareunia.

A

interstitial nephritis

26
Q

how does acyclovir cause crystal-induced acute kidney injury?

A

acyclovir excreted into urine but has low urine solubility –> precipitates –> renal obstruction

–> AKI within 24-48 hours

27
Q

symptoms of aut dom `polycystic kidney disease

A

intermittent flank pain and mass
hematuria
UTIs
nephrolithiasis

28
Q

workup of BPH

A
  1. UA and PSA
  2. if significant symptoms or risk factors, test Cr
  3. if Cr elevated, do renal US to r/o hydronephrosis
29
Q

most sensitive test for diabetic nephropathy

A

random urine for microalbumin/Cr ratio

30
Q

multiple peptic ulcers and diarrhea. think…

A

zollinger-ellison (excess gastrin can cause ulcers and inactivate pancreatic enzymes)

31
Q

first degree relative with colon cancer should make patient get screened when

A

age 40 or 10 years before diagnosis

32
Q

what type of blood should be given to patient with low Hgb from upper GI bleed?

A

packed RBC

33
Q

when is fresh frozen plasma given

A

severe coagulopathy (DIC, liver dz) with active bleeding

34
Q

when are platelet transfusions given

A

<10,000 or <50,000 + bleed

35
Q

when is whole blood transfusion given

A

severe hemorrhage

36
Q

standard of care for pateints with FAP

A

annual c-scopes starting in childhood

elective proctocolectomy

screen for upper GI tumors

37
Q

diarrhea, weight loss, and apthous ulcers. think…

A

Crohn’s

38
Q

how is BUN/Cr ratio increased in someone with upper GI bleed?

A

increased urea production (from Hgb breakdown)

increased urea absorption (from hypovolemia)

39
Q

can IBS diarrhea have mucous?

A

yes

surgery (22 decks)

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