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Medicine Flashcards

1
Q

Complications of acute pancreatitis:

A

Pleural effusion, ARDS, Ileus, renal failure

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2
Q

SBP dx via:

A

Temp >100, ascitic fluid with PMN count >250, SAAG > 1.1

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3
Q

Factitious diarrhea 2/2 laxative abuse has following lower GI endoscopy findings:

A

Brown discoloration of colon and shiny lymph follicles/pale patches

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4
Q

GI bleeding will ??? BUN/Cr ratio

A

Increase

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5
Q

Steatorrhea 2/2 ZES occurs via?

A

Inactivation of pancreatic enzymes due to increased stomach acid production (gastrin producing pancreatic tumor)

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6
Q

Dx tests for acute Hep B infection?

A

HBsAg and anti-HBc

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7
Q

Active esophageal varices bleeding med? Non bleeding varices med for ppx?

A

Octreotide. Beta blockers

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8
Q

Triad of Pellagra:

A

Diarrhea, dermatitis, dementia

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9
Q

Pellagra is deficiency of ???

A

Niacin

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10
Q

Lab findings of every chronic inflammatory dz?

A

Anemia and reactive thrombocytosis

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11
Q

Gallstone med for pts with symptomatic/functional GB and poor surgical candidate

A

Ursodeoxycholic acid (also used to tx PBC)

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12
Q

Wilsons dz is aka ???

A

Hepatolenticular degeneration

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13
Q

Hx of travel, bloody diarrhea and liver cyst: due to what organism?

A

Entamoeba histolytica

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14
Q

Hx of dog contact, liver cyst with eggshell calcifications. Likely organism?

A

Echinococcus granulosus (hydatid cyst)

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15
Q

Hyperpigmented nodule that dimples in center when pinched around edges. Most commonly on LE. Dx?

A

Dermatofibroma

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16
Q

Sensorineural hearing loss that occurs with aging

A

Presbycusis

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17
Q

Pt with epigastric pain, vision loss, optic disc hyperemia, and increased anion gap metabolic acidosis. Likely poison?

A

Methanol intoxication

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18
Q

??? damages the eyes, ??? damages the kidneys

A

Methanol; Ethylene glycol

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19
Q

Tx of organophosphate poisoning?

A

Atropine

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20
Q

Pt with HA, N/V, Ab pain, confusion, and PINKISH-RED skin hue. Likely poisoning?

A

Carbon monoxide

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21
Q

Ethylene glycol tx?

A

Fomepizole or ethanol

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22
Q

Tx of diphenhydramine overdose?

A

Physostigmine

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23
Q

Pt with hallucinations, agitation, pupillary dilation, vertical nystagmus. Likely poisoning?

A

Phencyclidine intoxication

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24
Q

Vomiting and non bloody diarrhea devoid of fecal leukocytosis in absence of fever is highly indicative of ???

A

VIRAL gastroenteritis

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25
Q

Suspect a GI bleed when pt has anemia, elevated ???, and normal ???

A

BUN; Cr

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26
Q

Asterixis and increased DTRs are signs of ???

A

Hepatic encephalopathy

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27
Q

These meds can precipitate hepatic encephalopathy?

A

Benzos

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28
Q

Pt presents with appendicitis symptoms and bloody diarrhea. Stool exam reveals gram negative coccobacilli on CIN agar and serotype 0:3. Likely organism?

A

Yersinia enterocolitica

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29
Q

Acute alcoholic hepatitis tx?

A

Steroids, IVF, enteral nutrition

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30
Q

Underlying cause of Wilsons dz?

A

Decreased copper excretion

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31
Q

What electrolyte abnormalities are hallmark of refeeding syndrome?

A

HYPOkalemia, HYPOphosphatemia, and HYPOmagnesemia. All due to increased insulin

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32
Q

Dx test of choice for PUD/H.Pylori?

A

Serologic testing for antibodies

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33
Q

Tx of H.Pylori?

A

PPI and either 1) clarithromycin & amoxicillin, or 2) clarithromycin & metronidazole

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34
Q

Tx of SBP?

A

3rd gen cephalosporins like cefotaxime

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35
Q

Fe deficiency anemia has ??? iron/ferritin; ACDz has ??? iron/ferritin

A

Low/low; low/high

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36
Q

T or F: Dx of contact dermatitis via serum IgE

A

False. Patch testing is correct test

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37
Q

Pt falls, presents with externally rotated and shortened leg. Likely Dx?

A

Femoral neck fracture

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38
Q

SJS vs TEN: ??? involves 30% BSA and 2 mucosal sites

A

SJS; TEN

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39
Q

Generally, ??? affects extensor surfaces, and ??? affects flexor surfaces

A

Psoriasis; eczema

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40
Q

Hypopigmented/scaley macules with hyphae on KOH prep. Tx is selenium sulfide. Dx?

A

Tinea versicolor via Malassezia furfur

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41
Q

Fungal infection forming scaly circular patches with central clearing. Tx with ketoconazole, terbinafine, miconazole. Dx?

A

Tunes corporis. Via trictophyton dermatophyte

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42
Q

If suspecting melanoma, evaluate via ??? biopsy

A

Excisional

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43
Q

Blistering skin lesions and nodular liver. Liver bx significant for intracellular crystals. Dx?

A

Porphyria cutanea tarda

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44
Q

Tx of refractory/fistulizing Crohns dz?

A

Infliximab IV; a TNF alpha antibody

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45
Q

Confirm pancreatitis with ???

A

Abdominal CT (shows calcifications)

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46
Q

Ranson criteria 0 hours from onset of pancreatitis:

A

Age >55, WBC >16000, Glucose >200, LDH >350, AST >250

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47
Q

Ranson criteria for 48 hours after onset of pancreatitis:

A

Ht fall by >10%, BUN increase by >5, calcium

48
Q

Foul smelling, fatty diarrhea that is nonbloody, onset after camping. Dx? Tx?

A

Giardia, Metronidazole

49
Q

Pt returns from Caribbean trip and develops fevers, polyarthralgia, lymphopenia, thrombocytopenia. Likely Dx?

A

Chikungunya

50
Q

Cat scratch fever is caused by ??? and tx with ???

A

Bartonella henselae, azithromycin

51
Q

Sex worker with fever, chills, tenosynovitis, polyarthralgia, and PUSTULAR lesions on trunk/extremities. Cultures are negative for organisms. Likely Dx?

A

Disseminated gonococcal infection

52
Q

Neuroimaging CT shows ring enhancing lesions. Dx is toxoplasmosis: tx now? Ppx?

A

Sulfadiazine and pyrimethamine; TMP-SMX

53
Q

Tx of cryptococcal meningitis?

A

Amphotericin B with flucytosine

54
Q

Pt is scheduled for splenectomy, vaccination against encapsulated organisms should be given when?

A

2 wks before or after splenectomy

55
Q

Pt with cough, has pulmonary nodules with cavitations. Culture yields branching/filamentous PARTIALLY acid fast bacteria. Dx? Tx?

A

Nocardia; TMP-SMX

56
Q

Tx of CMV? Tx of HSV?

A

Ganciclovir or Foscarnet; acyclovir or valcyclovir

57
Q

Drug of Choice for human and dog bites?

A

Amoxicillin-clavulanate

58
Q

Pt over 65 with loss of CENTRAL vision. Dx?

A

Age related macular degeneration

59
Q

Painful glaucoma that is an emergency?

A

Closed angle glaucoma

60
Q

Loss of visual acuity 2/2 lens opacification. Pts c/o glare and difficulty driving at night. Dx?

61
Q

Sudden, transient/temporary monocular vision loss 2/2 retinal ischemia from a cholesterol emboli. Dx?

A

Amaurosis fugax (“curtain falling down”)

62
Q

CMV retinitis presents when CD4 is

A

Yellow-white patches of retinal opacification and retinal hemorrhages

63
Q

Fundoscopy of HSV retinitis reveals:

A

Pale, peripheral retinal lesions and central necrosis of retina

64
Q

Central retinal vein occlusion has classic “blood and thunder” appearance on fundoscopic exam:

A

Optic disc swelling, retinal hemorrhages and dilated veins, cotton wool spots.

65
Q

Central retinal artery occlusion is described on fundoscopic exam as:

A

Optic disc pallor, cherry red fovea, boxcar segmentation of blood in retinal veins

66
Q

Age related decrease in lens elasticity that leads to difficulty with near vision. Dx?

A

Presbyopia

67
Q

Inflammatory changes in medial region of eye, near lacrimal sac*

A

Dacrocystitis

68
Q

Strict vegetarian with anemia and neurologic complications(memory loss, dementia, irritability, loss of vibration/proprioception in LE) due to ???

A

Vitamin B12 deficiency

69
Q

Most common cause of malignancy-associated SIADH?

A

Small cell lung cancer

70
Q

Cavitary lung lesions and hypercalcemia. Dx?

A

Squamous cell carcinoma

71
Q

Pt with new onset seizures and CT scan shows cysts with scolices. Dx? Tx?

A

Neurocysticercosis by T. Solium worm. Prednisone, phenytoin, albendazole

72
Q

Tx for young pt with atypical or “walking” PNA?

A

Macrolide (erythromycin, clarithromycin, or azithromycin) or doxycycline

73
Q

What organism can causes concurrent fever, PNA symptoms, gastroenteritis and neuro symptoms?

A

Legionella

74
Q

CMV vs. HSV esophagitis:

A

CMV ulcers- large/shallow/linear
HSV ulcers- small/deep/circular
*both will have multinucleated giant cells with nuclear inclusions

75
Q

First line tx of impetigo?

A

Topical mupirocin

76
Q

Test of choice to Dx MS?

77
Q

Pronator drift is a specific finding for ??? damage

78
Q

??? presents in young, obese women with HA, vision changes, and pulsatile tinnitus. Also papilledema and elevated opening pressure during LP. Tx?

A

Idiopathic intracranial HTN (pseudotumor cerebri). Acetazolamide

79
Q

Alcoholic pt with AMS, gait instability, nystagmus, conjugate gaze palsy. Dx?

A

Wernicke’s encephalopathy 2/2 thiamine deficiency

80
Q

What has greatest accuracy in confirming Dx of Parkinson’s dz: PE, imaging, or labs?

A

Physical exam: want 2/3 of rest tremor, rigidity, bradykinesia

81
Q

Pt with parkinsonism and autonomic dysfunction. Dx?

A

Shy-Drager syndrome (multi system atrophy)

82
Q

Suspect ??? In an HIV pt with focal neurologic signs and multiple NON-enhancing lesions in white matter, with no evidence of mass effect

A

Progressive multifocal leukoencephalopathy

83
Q

Acute exacrbations of MS are tx with?

A

Corticosteroids

84
Q

??? cause HA, hypothyroidism, adrenal failure, and diabetes insipidus due to mass effect on hypothalamus

A

Craniopharyngiomas

85
Q

Tx of pulmonary HTN 2/2 LV dysfunction?

A

Loop diuretic + an ACE inhibitor or an ARB

86
Q

Hypoxia in pts with PNA occurs due to an increase in ???

A

Alveolar-arterial oxygen gradient

87
Q

Meds that trigger bronchoconstriction in pts with asthma?

A

Aspirin and beta blockers

88
Q

Management of Pts with a persistent tachyarrhythmia and hemodynamic instability? Same but hemodynamically stable?

A

Immediate sync DC cardioversion.

Vagal maneuvers or IV adenosine

89
Q

Most beneficial therapy to reduce progression of diabetic nephropathy?

A

Strict BP control, target is 130/80

90
Q

Target BP for DM pts?

91
Q

Pts with hypoalbuminemia can have decreased ???

A

Serum calcium

92
Q

All DM pts age 40-75 should be on ??? to decrease risk for CAD

93
Q

Pt with low T3, normal T4 and TSH, presenting during an acute/severe illness. Dx?

A

Sick euthyroid syndrome (aka low T3 syndrome)

94
Q

CSF analysis of GBS patient?

A

High Protein, normal glucose/WBC/open press

95
Q

Empiric ABX tx of bacterial meningitis in an infant?

A

Ampicillin and gentamicin (be a GENT and AMP kids defense)

96
Q

Mono characteristic features (4):

A

Lymphadenopathy, pharyngitis with tonsillar exudate, Splenomegaly, subclinical hepatitis (LFTs)

97
Q

SIADH: ??? serum sodium, ??? urine

A

Low; highly concentrated (hi spec grav)

98
Q

??? Is a consequence of rapid Overcorrection of hyponatremia with hypertonic Saline.

A

Central Pontine Myelinoysis

99
Q

Opioid inTOXICication:

A

Pupillary constriction, respiratory depression , hypotension/Bradycardia

100
Q

Opioid toxicity tx?

101
Q

NFB type 2: involves 2 ??? and defect in ??? 22, and has classic NFB skin finding of ???

A

Ears/Schwannomas; chromosome; cafe au lait spots

102
Q

NMS presents with:

tx:

A

AMS, hyperthermia, HTN/tachycardia, rigidity. Tx:BROMOCRIPTINE

103
Q

NMS is caused by deficiency in dopamine, which is seen:

A

By antipsychotic meds or withdrawal of dopaminergic meds

104
Q

Test of choice in Dx of Cushing’s syndrome?

A

24 hr urine cortisol

105
Q

Most reliable way to difftiate bwn pituitary and ectopic ACTH secretion?

A

Inferior petrosal sinus ACTH

106
Q

Etiology of exophthalmos in Graves dz?

A

TSH ab activate fibroblasts and T lymphocytes to deposit GAG

107
Q

Gas gangrene from Clostridium perf., which is an ??? gram ??? rod

A

Anaerobic ; Positive

108
Q

Cellulitis lacks signs of ??? production, and usually caused by ??? and ???

A

Gas; strep pyo & staph aureus

109
Q

??? presents with Parkinsons, urogenital dysfunction, and orthostatic hypotension

A

Multiple System Atrophy

110
Q

Pt with CKD: best DM med? Worst DM med?

A

Glipizide (repaglinide/meglitinide if sulfa allergy); metformin (lactic acidosis)

111
Q

MEN 2A or Sipple’s syndrome classic presentation:

A

Medullary thyroid carcinoma, pheochromocytoma, HPTH

112
Q

Blood on UA, but absence of RBCs on microscopy: suspect??

A

Myoglobinuria (likely 2/2 Rhabdomylosis)

113
Q

AFib most commonly caused by ectopic foci within ???

A

Pulmonary veins

114
Q

Atrial flutter commonly involves a reentrant circuit around the ???

A

Tricuspid annulus

115
Q

Initial DMARD of choice of pts with active RA?

A

Methotrexate

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