Medicine Flashcards
what heme illness chromosome 22
CML: BCR-ABL
pt with clinical features of Ankylosing spondylitis, next best test to confirm dx?
X ray of SI joints
patient with kidney biopsy with intimal thickening nad luminal narrowing or renal arterioles with evidence of sclerosis–MCC?
HTN
when vaccinate patients undergoing splenectomy?
14 days before or after surgery
Tactile fremitus increase or decrease in pleural effusion?
Decrease!
who is at risk of anaphylaxis s/p transfusion?
pts who are IgA deficient because they have anti-IgA IgG antibodies
definitive dx of Wegener’s
bx of site of active disease
Thyroid cancer that spreads via lymph and has psammoma bodies
Papillary
The cancer that spread via blood, have to excise the whole thyroid
Follicular
Associate with and MEN2, amyloid and calcification
Medullary
What type of cancer does Hashimoto’s predispose to
Thyroid lymphoma
First best test for pheochromocytoma
urine and plasma free metanephrines
First best test for primary aldosteronism
Plasma aldosterone to renin ratio
First best test for adrenocortical carcinoma
urine 17-ketosteroids
First test for cushing syndrome
Overnight one mg dexamethasone test
Management of a less than five centimeter and nonfunctional adrenal nodule
Observing CT scans every six months
Management a greater than 6 cm or functional adrenal module
Surgical excision
how dx suspicious nodules for hyperPTH?
FNA or sestamibi
breast cysts that are painful and change with menses, dx?
fibrocystic change
mgmt fibrocystic change
restrict caffeine, take vit e, wear a supportive bra
mgmt DCIS
Excision With clear margins or simple mastectomy of multiple lesions [ no node sampling] and adjuvant radiation therapy
mgmt LCIS
More often bilateral. Consider bilateral mastectomy only if positive family history hormone sensitive or prior history of breast cancer
Mgmt IDC or lobular carcinoma
If small and away from nipple, can do a lumpectomy with axillary node sampling. Adjuvant radiation therapy. Chemo if node positive. Tamoxifen relaxes an estrogen receptor positive
Or
Modified radical mastectomy with axillary node sampling without adjuvant radiation therapy
Management for Paget’s disease of the breast
Mammogram to find the mass
Management of basal cell carcinoma
Shaver punch fancy that surgical removal Mohs
Management of squamous cell carcinoma
Excisional biopsy at Edge of lesion, then wide local excision. Can use radiation for tough locations
Management of melanoma
Treatment with excision, 1 cm margin if less than one millimeter thick, 2 cm margin if 1-4 mm thick. 3 cm margin if >4 millimeter thick
Sarcoma typically spread first
lungs, hematogenously
treatment for oral squamous cell cancer
XRT or radical dissection
tx laryngeal cancer
laryngoscope laser or resection
MC salivary gland tumor?
pleomorphic adenoma, benign but recurs
Dx diaphragmatic hernia prenatally, mgmt?
plan delivery at hospital with ECMO, let lungs mature 3-4 days and then do surgery
Baby is born w/ respiratory distress w/ excess drooling.
•Best diagnostic test?
TE-Fistula
Place feeding tube, take xray, see it coiled in thorax
Gastroschisis assoc with other disease?
not usually
Defect lateral (usually R) of the midline, no sac.
gastroschisis, see high maternal AFP
assoc with congenital umbilical hernias?
Assoc w/ congenital hypo-thyroidism. (also big tongue)Repair not needed unless persists past age 2 or 3.
complications of pyloric stenosis
Hypochloremic, met alkalosis
tx pyloric stenosis
Immediate surg referral for myotomy
2wk old infant w/ bileous vomiting. The pregnancy was complicated by poly-hydramnios. dx? assoc with
Intestinal atresia or annular pancreas
assoc with downs
1 wk old baby w/ bileous vomiting, draws up his legs, has abd distension.
Malrotation and volvulus*Ladd’s bands can kink the duodenumDoesn’t rotate 270 ccw around SMA
A 3 day old newborn has still not passed meconium.
–DDX? (name 2)
Meconium ileus-consider CF if +FH*gastrograffin enema is dx & txHirschsprung’s-DRE explosion of poo. bx showing no ganglia is gold standard
A 5 day old former 33 weeker develops bloody diarrhea
NEC
A 2mo old baby has colicky abd pain and current jelly stool w/ a sausage shapend mass in the RUQ
Intussusception*Barium enema is dx and tx
Hyperacute Rejection-
Vascular thrombosis w/in minutes
–Caused by preformed antibodies
Acute Rejection-
Organ dysfunction (incrGGT or Cr depending on organ) w/in 5days –3mo. Due to T-lymphocytes.
–Technical problems common in Liver 1stcheck for biliary obstruction w/ U/S then check for thrombosis by Doppler.
–In heart, sxscome late, so check ventricular bxperiodically.
–Txw/ steroid bolus and antilymphocyteagent (OKT3)
Chronic Rejection
Occurs after years. Due to T-lymphocytes.
–Can’t treat it. Need re-transplantation.
Merperidine: side effects
Norperidine metabolite can lower seizure threshold esp in pts w/ renal failure.
Succinylocholine side effects
Can cause malignant hyperthermia, hyperK (not for burn or crush victim
Rocuronium side effects
Sometimes allergic rxn in asthmatics
Halothane side effects
Can cause malignant hyperthermia (dantroline Na), liver toxicity.
risk with raloxifene?
increases risk of DVT
MC heart defect in Downs
complete AV septal defect
treatment for extrapyramidal side effects
Benztropine or antihistamines
Abx for human bite
Amoxicillin-clavulonate
pt with back pain with red flags or sciatica, next step in mgmt
ESR and plain films
what type of thyroid cancer does mantle radiation predispose to?
papillary
HTN predisposes to what kind of intracerebral hemorrhage
basal ganglia
Contralateral hemiparesis and hemisensory loss, homonymous hemianopsia, gaze palsy
Basal ganglia hemorrhage
what is cardiac index, how is it changed in heart failure?
= cardiac output / body surface area, decreased in heart failure because of decreased forward flow
what type of anemia does lead poisoning cause?
microcytic
what does an inspiratory hold measure?
pulmonary compliance
patient who recently travelled to mexico with fever, double vision and painful swelling around his eyes, pain in neck and jaw muscles, eosinophilia–dx?
trichinellosis
pt with chondrocalcinosis, mild hepatomegaly and DM–dx?
hemochromatosis
leukocyte alkaline phosphatase score is usually high in what condition?
leukomoid reactions
strongest influence on long-term prognosis s/p STEMI is what?
time to return of coronary blood flow
what GI disorder that causes flatulance and malabsorption can be seen in patients with systemic sclerosis
SIBO
best mgmt of patient with fulminant liver failure
put on transplant list ASAP
pt with pancreatitis who likely has gallstones: what imaging modality
RUQ US!
how long do patients with mono have to avoid contact sports?
at least 3 weeks
treatment for spinal epidural abscess
abx and emergent spinal decompression
methimazole side effect
agranulocytosis
pt with sickle cell with nocturia?
hyposthenuria
-can’t concentrate urine, 2/2 blood sickling in vasa recta
73 yo man recently started on amitriptyline with ab pain and suprapubic tenderness
do a urinary cath, likely urinary retention 2/2 amitriptyline
patient with RBC casts, proteinuria, palpable purpura, low complement, anti-HCV positive
dx?
mixed essential cryoglobulinemia
tx of patient with SIADH who is symptomatic
hypertonic saline
1st step in mgmt of patient with suspected variceal hemorrhage
volume resuscitation, IV octreotide and Abx
what are the best lifestyle modifications to decrease HTN?
weight loss (#1) DASH diet
pt with upper body edema and weight loss and plethoric, dark appearance, what should you think of?
SVC syndrome
cancer pt with pain who hasn’t taken narcotics, first line pain med?
short acting morphine
patient s/p stroke with hemianesthesia and athetosis: location of stroke?
thalamus
AIDS patient with widespread pale, peripheral lesions and central necrosis of the retina: dx?
HSV
CMV retinitis is PAINLESS
immigrant with weight loss, fever, cough, nausea and adrenal calcs bilaterally: dx
TB
MCC adrenal insufficiency in developing countries
what cranial nerve is responsible for corneal sensation?
trigeminal
ddx tinea corporis from secondary syphilis
tinea corporis: ring-shpaed scaly patches with central clearing and distinct borders
secondary syphilis is usually maculopapular and involves palms and soles
mgmt of premature atrial beats
observation
benign
L sided varicocele that fails to empty when the patient is recumbent: consider what diagnosis?
RCC
Dx: mediastinal mass with elevated bHCG and AFP
nonseminomatous germ cell tumors
first degree heart block mgmt?
if no QRS prolongation: no further eval
if QRS eval: conduction delay below AV node, need electrophys workup
do rimantadine and amantadine work against flu b?
no, only flu A
HA, fever, periorbital edema, vomiting: what should you worry about?
cavernous sinus thrombosis
ddx orbital cellulits, CST cellulitis extends beyond the orbital septum
facial swelling, bilateral lower-extremity edema, massive proteinuria, nephrotic syndrome
dx?
AA Amyloidosis
Colchicine for preventation and treatment
propylthiouracil (PTU) and methimazole (MMI) MC side effects
agranulocytosis
discontinue if pt has a fever and sore throat or WBC count less than
idiopathic intracranial hypertension Tx
Acetazolamide is first
inhibits choroid plexus carbonic anhydrase
what labs look at before starting someone on BP meds
UA
EKG
chemistry panel
lipid profile to risk stratify
genetic inheritance of HOCM
AD
hydatid cyst, what organism
echinococcus granulosus
pt with WPW who develops AFib–tx?
procainamide!
diabetic pt with elevated LFTs and normal serology, hepatic fullness: Dx?
NASH, 2/2 insulin resistance
pt with dysarthria and R hand weakness, likely etiology of stroke?
HTN
CURB-65
Confusion
Uremia (BUN >20)
Tachypnea RR >30
HYPOtension, BP 65
HIT immune mediated?
YES: type 2: antibodies against heparin-platelet factor 4 complexes
HOCM mitral valve abnormality
abnormal mitral leaflet motion
malignancy associated ACTH production associated with what kind of cancer?
SCLC
how monitor HBV infection
ALT and HbEAg q 3-6 months
pt with an unexplained elevated CK level, next best test?
TSH
treatment for Sanford type B aortic dissection
Labetalol
do NOT give Heparin
MC complication with TPN
central line infection
Pt with non-Hodgkins lymphoma with painless ulcer on foot, recently had chemo: best tx?
anti-pseudomonal PCN because patient is immunosuppressed
CSF WBC 25 PMNs 5% Glucose 65 RBC 700 Protein 120
Dx?
HSV encephalitis
CSF WBC 1100 PMNs 80% Glucose 12 RBC 200 Protein 300
Dx?
Low glucose, elevated protein, PMNs
Acute bacterial meningitis
CSF WBC 120 PMNs 10% Glucose 10 RBC 100 Protein 80
Dx?
Lymphs, decreased glucose, increased protein
Chronic bacterial meningitis due to TB
1 cause of spinal stenosis
OA of the spine
pseudoclaudication
lower extremity pain that occurs with walking and does not improve with sitting or resting (this is how you differentiate it from true caludication)
MCC is spinal stenosis which is usually 2/2 OA
what kind of hormone is ACTH
polypeptide hormone
causes of labor protraction
power
passenger
pelvis
define labor arrest
once true labor has begun
no change in dilation over 2 hours or no change in descent in over 1 hour
tx = augment labor, then C section
active phase of labor, definition and times
3-4 cm to full dilation
dilated >1cm and hour
thoracentesis with > 4gm protein, dx?
TB
patient with cancer who has headache worse when they lean forward: dx?
SVC syndrome
what level BUN in pts with uremia?
100 mg/dL
diabetic moms: what risk to fetal lungs?
increased risk of respiratory distress because insulin causes cellular hypertrophy at the expense of cellular maturation
what ABI values suggest peripheral arterial dz
0.4-0.9
Calcium 14.1, phos 2.8 in old man with recent lethargy and weight loss
hypercalcemia of malignancy
anti-mitochondrial antibodies
associated with PBC
anti-smooth muscle antibodies
associated with autoimmune hepatitis
tx neurogenic bladder
cholinergic agonist ex. bethanechol
tx urge incontinence
muscarinic antagonist
oxybutynin
SAAG cutoff for portal HTN
1.1
pt with CHF sx s/p URI
myocarditis, can cause dilated cardiomyopathy
unilateral upper lobe infiltrate and hilar adenopathy DX
TB
A Fib associated with what thyroid dz
hyperthyroidism
poor prognostic indicator for astrocytomas
anaplasia
MC presentation of CLL
lymphocytosis and painless LAD
smudge cells
assoc with ITP and Autimmune hemolytic anemia
tx CLL
Rituximab, anti CD 20
who needs abx prior to dental procedures
prosthetic heart valves
prior history of un-repaired congenital heart dz
history of infective endocarditis
best way to increase fertility in overweight PCOS patients
weight loss
pancreatic cancer pt with elevated TBili and pruritis – tx?
endocopic stent placement
ursodeoxycholic acid only works in patients with INTRAhepatic bile duct obstruction
multiple myeloma causes what kind of renal damage
renal tubule damage due to toxic effect of light chain casts
tx for agitation due to delirium
haldol
NOT benzos, those increase delirium
LGSIL and positive or uknown HPV status
colpo and bx
LGSIL and negative for HPV 16 and 18
repeat cotesting in 1 year (preferred)
OR
colposcopy and biopsy
vaginal normal ph
3.8-4.2
vaginal irritation and pH of 4, dx?
Candida
BV and Trich elevate pH
pt s/p MI who has a new holosystolic rupture
rupture of IV septum
characteristics of DIC
thrombocytopenia
decreased fibrinogen
increased INR
breast cancer screening recs
q 2 yrs over 50 yo
cremasteric reflex: what is it? when useful?
elevation of testes in response to touching inner thigh
absent in almost all pts with testicular torsion
pain relief with elevation of testicle associated with what dx?
Prehn’s sign
assoc with epididymitis
Pancost tumor, what association?
SMOKING
not TB since TB doesn’t cause tumors!
MCC AR
aortic root dilation or bicuspid aortic valve
CSF
nml WBC
elevated portein
nml glucose
GBS
presentation of oral herpes in a kid?
herpes gingivostomatitis
vesicular eruptions on the anterior oral mucosa and perioral region, kids are sick with a fever
ovalo macrocytes and PMNs with reduced segmentation are associated with what illness?
myelodysplastic syndrome
impetigo: bug, tx and MC complication
Staph A and group A strep
topical mupirocin
post-strep glomerulonephritis
what drug hasten COPD exacerbation recovery
glucocorticoids
chemo pt with WBC of 600, s/p transfusion 1 week prior dx?
bacterial infxn
tx of diabetic ulcer that isn’t gangrenous but invades muscle
debridement
mgmt DKA in kids
1: 10mL/kg isotonic fluid over one hour
2: insulin + isotonic fluids with K supplementation
Efavirenz side effect
insomnia, vivid dreams
lamivudine side effect
hepatotox
initial tx of urge incontinence
bladder training
more freq urination
leukocytoclastic vasculitis aka
HSP
tx Barthoin gland abscess
I and D
what migraine meds do you NOT want to use together
ergots and triptans
KD tx
IVIG and ASA
cause of carpal tunnel in hypothyroidism
accumulation of matrix substance
cause of carpal tunnel in pregnancy
accumulation of fluid
cause of carpal tunnel in RA
tenosynovial inflammation
women at what weeks gestation are candidates for steroids
24-34 weeks
kid with a 3-day fever followed by blanching, eryhtematous macular rash, dx?
roseola infantum HHV-6
Tx for DIC
plasmapheresis
what does sotalol predispose to?
torsades
what complication is common s/p coil for SAH
rebleed in first 24 hours
vasospasm 3 days out
mgmt of pt with NSCLC with a single brain met
resect the met
tx Lewy body dementia
Rivastigmine or other Ach-ase inhibitors
MC bug causing brain abscess s/p URI
viridans group strep
Stroke location:
unilateral motor impairment
no sensory or cortical deficits
no visual field abnormalities
Posterior limb of internal capsule, lacunar infarct
Stroke location:
contralateral somatosensory and motor deficit
conjugate eye deviation Toward side of infarct
homonymous hemianopsia
aphasia (dominant hemisphere)
hemineglect (non-dominant hemisphere)
MCA
Stroke location
- contralateral somatosensory adn motor deficit, predominantly in lower extremity
- abulia (lack of will or initiative)
- dyspraxia, emotional disturbance, urinary incontinence
ACA
Stroke location
- alternate syndromes with contralateral hemiplegia and ipsilateral CN involvement
- possible ataxia
vertebrobasilar system lesion supplying the brainstem
site of hemorrhage
contralateral hemiparesis and hemisensory loss
homonymous hemianopsia
gaze palsy
basal ganglia
site of hemorrhage
no hemiparesis
facial weakenss
ataxia and nystagmus
occipital headache and neck stiffness
cerebellum
site of hemorrhage
deep coma and total paralysis within minutes
pinpoint reactive pupils
Pons
etiology of normal pressure hydrocephalus
decreased CSF absorption
treatment for restless leg syndrom
Dopamine agonist like pramipexole
best diagnostic test for delirium in edlery
UA and serum electrolytes
what is pronator drift specific for?
UMN lesion
fixed dilated pupil: what type of injury to CN III
compression, can also cause parasympathetic injury.
due to P Comm aneurysm or uncal herniation
Down and out pupil in a diabetic: what type of injury
ISCHEMIC injury to somatic fibers
normal light and accomodation reflexes
best med to treat parkinson’s tremor
trihexyphenidyl (anticholinergic)
what neuro test can you do in a brain dead pt
deep tendon reflexes because relate to spinal cord not brain
patient has parkinsonism, autonomic dysfunction and diffuse neuro signs
dx?
multiple system atrophy
aka Shy Drager
Tx: IV volume expansion, anti-parkinsons drugs
Ddx: Familial Dysautonomia: autonomic dysfunction in jewish kids with severe orthostatic hypotension
Tx for Lambert Eaton
plasmapheresis + immunosuppressive drug tx
what type of drug is Selegine
MAO-B used to treat Parkinsons
bilateral trigeminal neuralgia can be the first sign of what illness?
MS
intense ipsilateral retroocular pain and Horner’s = what dx?
Cluster HA
tx acute cluster HA attack
100% O2 and subQ sumatriptan
tx opiod OD / delerium
naloxone
medulloblastoma: infra or supra tentorial
supra
when do endarterectomy
stenosis greater than 70%
Ddx Werdnig Hoffman vs. infant botulinum
WHD: hypotonic at birth, affected by 6 months, + family history since AR. supportive tx
Botulism: often s/p honey, supportive tx and watch respiratory status
tx organophosphate poisoning
Atropine and Pralidoxamine
cause of charcot joint
nerve damage!
Tx of hepatic encephalopathy
supportive tx first: K, electrolyte disturbances, albumin. Then lactulose to get rid of some of the ammonia
TIPS is for complications of portal HTN, not hepatic encephalopathy!
AIDS patient with exophytic purpuric skin rash , and liver lesions that hemorrhage on bx
Bartonella
tx: ABX
who gets PPSV23 first before PCV13?
heart or lung dz
diabetes
smoking
chronic liver disease
get PPSV23 first, then PCV 13 and PPSV23 at age 65
dense, patchy lung infiltrates + abdominal tenderness in a patient who had a bone marrow transplant
CMV
what tx for beta thal minor?
none
patient with pale, voluminous, greasy and foul smelling stools
ddx
pancreatic insufficiency MCC 2/2 alcohol abuse
bile salt dysfunction
impaired intestinal epithelium
side effect of bactrim
hyperkalemia
urinary retention from anticholinergic drugs is a result of what?
detrusor inactivity
what drug to stimulate appetite in cancer patients
progesterone analog
mgmt of Hep C in pregnancy
give Hep A and B vaccine
side effect of isoniazid
acute hepatitis`
drugs of choice for hypercalcemia of malignancy
bisphosphonates like zolendronic acid or pamidronate
treatment of dermatitis herpetiformis
dapsone
side effect of HCTZ
hyperglycemia
increased LDL cholesterol
plasma triglycerides
hypoK, hypoNa, increased Ca
how ddx chlamydia vs. gonorrhea urethritis in men
gram stain
won’t see chlamydia, will see neisserria
name 3 causes of increased BUN/Cr ratio
renal failure
GI bleed
steroid administration
symmetric and circumferential narrowing of the esophagus with dysphagia for solids, no weight loss: DX
stricture
tiotroprium and ipratroprium are what kinds of drugs?
muscarinic antagonist
next step if FAST inconclusive
DPL
mgmt of hypercalemia if >14
normal saline and calcitonin
NO furosemide unless CHF bc can worsen volume depletion
hepatojugular reflex reflects what?
failing R heart
do pts with sickle cell trait have findings on a peripheral smear?
NO
heinz bodies, what dz
oxidated hemoglobin from G6PD
tx for diabetic gastroparesis
metoclopramide
what do WBC casts indicate?
interstitial nephritis and pyelo
what do broad and waxy casts indicate?
chronic renal failure
tx for TCA toxicity
if QRS >100, give sodium bicar
when prophylax HIV patients against MAC
CD4
next best step Gastric adenocarcinoma found on bx
CT scan for staging
Hep C is associated with what skin disorder?
porphyria cutanea tarda
tx cellulitis
nafcillin or cefazolin
mgmt hyperplastic colon polyps
non-neoplastic
no further workup
what abx can cause acute renal failure
aminoglycosides: amikycin, gent, tobra
tx acute vs chronic prostatitis
acute: bactrim or cipro x4-6 weeks
chronic: cipro
gum hypertrophy in a transplant pt, what drug?
cyclosporine
diarrhea, leukopenia and hepatotox in a transplant pt, caused by what drug?
azathioprine
bone marrow suppression in a transplant pt, drug cause?
mycophenolate
erythematous lesions with sandpaper texture: dx?
actinic keratoses
Ddx for anterior mediastinal mass
thymoma
teratoma
thryoid neoplasm
terrible lymphoma
what vaccinations do HIV positive pts need?
Hep A and B
flu
pneumococcus
what bug causes erysipelas
Group A beta hemolytic strep
pyoderma gangrenosum is associated with what illness?
IBD, esp crohn’s
what do you have to test for before starting a patient on methotrexate?
hep B
hep C
TB
best test to demonstrate volume depletion
elevated BUN: Cr ratio (not Hct, because that could actually be elevated in a dehydration state due to hemoconcentration)
tx for type IV RTA
Fludrocortisone
tx for Goodpasture’s nephritic
plasmapheresis to get off excess antibodies
who gets amyloid nephrotic syndrome
tx?
pts with chronic inflammatory diseases like RA, IBD
tx is transplant bc otherwise it recurs
Aspirin leads to what acid base disorder? what’s the pH?
respiratory alkalosis and then anion gap metabolic acidosis (lactate)
pH is close to 7.40
what electrolyte changes would you see in a patient with Addison’s
hyper K (bc no aldo) hypo Na (because no mineralcorticoids)--look this up
carotid endarterecomy recommended with carotid stenosis of what levels?
symptomatic men and women: 70-99% stenosis
men with asymptomatic stenosis of 60-99%
most important prognostic indicator in acute liver failure
PT
bradycardia, hypotension, wheezing, hypoglycemia, delirium, seizures, cardiogenic shock: dx? tX?
BB overdose
tx: IV fluids and atropine, then IV glucagon if profound or refractory hypotension
how dx C Diff
stool toxin
RA drug that can cause oral ulcers
methotrexate
1st line tx for OA
acetaminophen
what kind of drug is ondansetron
serotonin antagonist
how treat anemia of chronic disease
treat underlying illness
MC complication of peptic ulcer dz
hemorrhage
tx febrile neutropenia in a cancer pt
pip-taxo, cefepime, meropeneum
need an anti-pseudomonal
Dx Hep B tests during window period
HBsAg and Anti-HBc
all patients with chronic liver dz should be immunized against
Hep A and B
patient with h/o asthma or chronic rhinosinusitis with nasal polyposis: dx?
aspirin-exacerbated respiratory disease
pseudo-allergic drug reaction
what kind of kidney injury does acyclovir cause
renal tubular obstruction
2/2 crystals that precipitate
pt with MGUS, next step
skeletal survey to rule out multiple myeloma
abnormal D xylose test indicates what illness
Celiac
Cause of systemic HTN in throtoxicosis
hyperdynamic circulation from increased myocardial contractility and HR
Meniere’s is a dz of what part of the ear?
INNER ear
MC underlying valve abnormality associated with patients with infective endocarditis?
MR
dendritic corneal ulcer is due to what
VZV
how ddx methanol vs. ethylene glycol poisoning
both cause AGMA with increased serum osms
methanol–> blurry vision
ethylene glycol–> kidney damage (stones)
tx for ethylene glycol poisoning
Fomepizole
treatment for Hep B
Tenofavir or entecavir
osteomalacia: what pathophys?
impaired osteoid matrix mineralization
how does acute pancreatitis cause hypotension
increased vascular permability
is it okay to practice procedures on dead patients?
yes as long as you get family’s permission
patient with a painful red eye and opacification and ulceration of the cornea
contact lens associated keratitis, mostly due to pseudomonas or serratia
medical emergency, broad spectrum Abx
MC site of spinal arthritis in RA
C-spine
middle ear effusion without an acute infection: dx?
serous otitis media
sx: dull tympanic membrane, hypomobile
L hemipleiga
R ptosis and eye deviation to R and down: what kind of stroke?
Webber’s aka PCA paramedian branch stroke to midbrain
Falling to the left
R ptosis and eye deviation to R and down: what kind of stroke?
Benedikt’s
PCA or paramedian branches of basilar artery to tegmentum of midbrain
pure motor or pure sensory stroke
basal ganglia lacunar stroke
ex: clumsy hand syndrome, ataxic hemiparesis
toxo treatment
sulfadiazine and pyrimethamine
meningitis vaccine: what age?
booster?
11-12
16-21
unilateral motor deficit
mild dysarthria
no visual, sensory or higher cortical dysfunction
pure motor hemiparesis
lacunar infarct in the posterior limb of the internal capsule
unilateral numbness, parasthesias, and hemisensory deficit involving the face, arm, trunk and leg
pure sensory stroke
stroke int eh VPL nucleus of the thalamus
weakness that is more prominent in the lower extremity, along with ipsilateral arm and leg incoordination
ataxic-hemiparesis
lacunar infarct in the anterior limb of the internal capsule
hand weakness, mild motor aphasia, no sensory abnormalities
dysarthria clumsy hand syndrome
lacunar stroke at the basis pontis
hemisensory loss with severe dysesthesia of the affected area: lesion in what side of the brain?
thalamus
medical tx for descending aortic dissection
labetalol NOT nifedipine