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Medicine Flashcards

1
Q

Night/morning headaches +morning vomiting + fever

A

Brain abscess

-do head CT

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2
Q

Follicular Thyroid cancer Dx

A
  • FNA will show follicular cells
  • you need to show invasion through capsule to differentiate btwn carcinoma and a follicular adenoma
  • mets hematogenously
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3
Q

Papillary thyroid carcinoma

A
  • COMMONEST thyroid cancer
  • look for Psammoma bodies,
  • FNA shows large cells with ground glass cytoplasm, inclusion bodies in pale nuclei and central grooving. Encapsulated
  • Prognosis is really good even if there are mets
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4
Q

ITP Immune Thrombocytopenia

A

Presentation: previous viral infection (URI), petechia and bruises, bleeding (epistaxis, GI bleeds, hematuria)
-Labs: isolated thrombocytopenia and big platelets w/ nothing else
-Kids tx: just skin findings? then observe
-Bleeding? give IVIG or glucocorticoids
-Adults: Platelets >30k? observe
-

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5
Q

Pt had a heart attack and passed out. Why?

A

-b/c of some sort of ventricular arrhythmia. Probably V fib

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6
Q

Nonallergic vs allergic rhinitis

A

Nonallergic: stuffiness, congestion, postnasal drip w/ dry cough, NO identifiable triggers, perennial sx that worsen w/ season change
-tx: intranasal antihistamine or glucocorticoid
Allergic Rhinitis: pts have mainly eye sx (itching), sneezing, pale blueish nasal mucosa,
-Tx: same

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7
Q

Meds a PT should be on if they had an MI, have unstable angina or got PCI

A
  • B-Blocker
  • Aspirin
  • ACEI
  • Lisinopril
  • Clopidogrel
  • the first 4 should be used in pts to prevent an MI
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8
Q

Uric Acid stone tx

A

Potassium citrate to alkalinize the urine

-radiolucent

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9
Q

Lumbar spinal stenosis

A
  • Presents as lower back pain and pain in legs/difficulty walking.
  • Results from anything that narrows the spinal canal and compresses that nerve roots.
  • Most commonly from degenerative joint disease where disc herniation and osteophytes hurt the roots
  • Worse=standing and downhill walking (flexion (leaning back))
  • Better=uphill walking and leaning forward (less pressure on roots)
  • DX=MRI!!!! Really small spaces so yea MRI
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10
Q

Avoid sun exposure w/ this antibiotic

A

Tetracycline

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11
Q

Kidney stone dx

A

Ultrasound or NONCONTRAST CT

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12
Q

Massive pulmonary embolus sx

A

-you can see syncope and signs of right heart strain (right bundle branch block, nonspecific ST-T wave changes, hypotension, JVD), cariogenic shock causing CNS manifestations like blown pupils

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13
Q

Myasthenia Gravis tx
-Step 1?
2?
Crisis?

A

1) Pyridostigmine for all
2) if sx continue then add glucocorticoids, azathioprine, mycophenolate mofetil, and cyclosporine
Crisis: do Glucocorticoids AND IVIG or Plasmapharesis
-Infection is usually the cause of the crisis

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14
Q

CMV retinitis

A
  • does NOT hurt

- commonest ophtho complication in HIV

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15
Q

HSV retinitis

A

hurts!! Also has initial sx of keratitis and conjunctivitis

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16
Q

Tx of COPD

A
  • O2 (target is88-92%)
  • Inhaled bronchodilators (albuterol, ipratropium)
  • SYSTEMIC GLUCOCORTICOIDS
  • Antibiotics if more than one of the following: cough, increase in sputum production/weird color, or dyspnea
  • PEEP if not too bad, intubate if really bad
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17
Q

Diastolic Heart Failure

A
  • Normal ejection fraction

- Due to decreased ability of LV to fill. Usually from chronic HTN leading to a thick LV.

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18
Q

Albuminocytologic dissociation

A

Guillain-Barre

High CSF protein w/ normal cell count

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19
Q

When to use whole blood transfusion?

A

-Only when the pt is in major trauma and needs a MASSIVE transfusion. The vast majority of the time you need to choose PRBCs

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20
Q

HIV pt w/ unilateral hearing loss?

A

-Likely it’s noninfectious serous OM. Happens in HIV pts p/c of lymphadenopathy. Exam shows dull and hypomobile TM

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21
Q

Chalazion

A
  • nodular rubbery lesion that causes PAINFUL swelling.
  • If they are recurrent or persistent then they might be due to sebaceous carcinoma or basal cell so do histopathological examination.
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22
Q

Lifestyle modification for HTN tx efficacy (1 to 5)

A

1) Weight loss (10kg)
2) Dash Diet
3) Exercise
4) low sodium diet
5) DRINK 2/day for men and 1/day in women
- Notice how SMOKING has NOTHING to do with any of this crap!! It does not raise blood pressure in the long term

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23
Q

Enthesitis

A
  • pain where tendons insert into bone
  • Usually associated with HLA-B27 and most commonly ankylosing spondylitis.
  • Heel, tibial tuberosities and iliac crest pain is most common.
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24
Q

CAP

  • 3 commonest causes
  • healthy pt tx?
  • really sick old person tx?
A

Strep pneumo, H flu and Mycoplasma
Healthy: tx outpatient w/ Doxyclycline or a Macrolide
Super sick: hospitalize and tx w/ extended-spectrum fluoroquinolones (Levofloxacin or Moxifloxacin), or you could give a B-lactam w/ a Macrolide.

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25
Q

Antiphospholipid antibody syn

  • what antibody?
  • sx?
A

anti-cardiolipin

-recurrent thrombosis, loss of pregnancy, cognitive deficits, or microangipathic hemolytic anemia

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26
Q

Diastolic murmur work-up

A

ALL should be worked-up!!

-Do an echo

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27
Q

Langerhans cell histiocytosis

A
  • in bone it presents as a lytic long bone lesion w/ pain and high calcium. Associated w/ pathologic fractures. Usually in children.
  • differential is primary hyperparathyroidism (parathyroid adenoma) which can explain the lytic bone lesion, pain and hypercalcemia but this is usually in pts 50+ and not in kids.
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28
Q

Pneumocystis pneumonia

A

-in HIV pts w/ CD4 counts

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29
Q

Staph pneumonia

A

OBVIOUSLY is from IV drug users!!

-causes cavitary lesions

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30
Q

Pneumonia in a HIV pt

A
  • most likely Strep pneumo
  • presents w/ lobar pneumonia and high fever. Pleural effusion is common.
  • encapsulated organisms in general are common infections in HIV+ pts b/c they can’t fight them off
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31
Q

Lyedig cell tumor

A
  • commonest type of testicular sex cord tumor (in al age groups)
  • Lyedig cells make testosterone but can also make estrogen b/c they have aromatase. The estrogen will inhibit LH and FSH
  • Labs: high testosterone and estrogen, low FSH and LH. NO increase in AFP or B-HCG!!!
  • adults may have geinicomastia and kids may have precocious puberty
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32
Q

Yolk sac tumor

A

-increase in AFP “the yolk has lots of protein”

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33
Q

FSGS

A
  • think of FSGS if the pt is black, fat, uses heroin and/or has HIV.
  • commonest cause of nephrotic syndrome in adults
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34
Q

Membranous nephropathy

A

-associated w/ Hep B, adenocarcinoma (breast and lung), NSAIDS and SLE

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35
Q

Brain abscess

  • 3 commonest bugs (or classes)
  • what if pt has sinusitis?
  • What about hematogenous spread?
  • tx?
A
  • S. viridans (anaerobe), Staph aureus, and G- bugs
  • Sinusitis: bug is gonna be S. viridans or some other anaerobe (peptostreptcoccus)
  • Hematogenous spread: gonna be Staph aureus or or a G-
  • TX: prolonged antibiotics (4-8 week minimum!) and you should probably aspirate it and culture.
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36
Q

Complications of an MI MONTHS later? 2

A
  • ventricular aneurism: PERSISTENT (like months later) ST-segment elevation and Q waves in exact same leads as original MI. Large ones can lead to L heart failure and can dilate the mitral valve w/ regurg
  • pericarditis
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37
Q

How to prevent diabetic nephropathy?

A

Intensive HTN control (NOT GLYCEMIC CONTROL!!)

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38
Q

Antibodies for resolved Hep B infection

Antibodies for Hep B vaccination

A
  • Resolved infection: + anti-HBs and anti-HBc but neg for HBsAG
  • Immunized: + for anti-HBs. neg for anti-HBc and and HBsAG
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39
Q

What brings K+ into cells? 3

A

1) bicarb
2) insulin and glucose
3) B-2 agonists

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40
Q

Progressive Multiform Leukoencephalopathy

  • virus?
  • what shows on the CT?
  • tx/prognosis?
A
  • JC virus
  • lesions do NOT produce mass effect. Pts usually present w/ disturbances in speech, vision and gate
  • CT: multiple demyelinating (leuko… duh), non-enhancing lesions
  • No tx and life expectancy is 6 months
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41
Q

Think you have a melanoma? next step?

A
  • do excisional biopsy w/ narrow margins

- Depth of lesion is 1mm: then do 1cm margins and prog is 99% 5 year survival

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42
Q

Where did the pulmonary embolus clot come from?

A

An iliofemoral vein clot

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43
Q

Paget’s disease of the breast

A
  • ulcerating, exematous rash on the nipple
  • most of the time there will be adenocarcinoma associated w/ it.
  • Skin biopsy demonstrates large cells that are surrounded by clear halos
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44
Q

Digitalis toxicity

-arrhythmia that is most specific?

A
  • Dig will increase the ectopy of atria and ventricles. It also increases vagal tone and promotes AV block. This combo leads to…
  • Atrial tachycardia w/ AV block.
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45
Q

Pt clearly had a stroke. What do you order next?

A

CT of the head WITHOUT contrast to rule out hemorrhage

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46
Q

What do you order to dx kidney stones?

A

US if it is an option.
If not, then CT scan of abdomen WITHOUT contrast b/c this can detect both radiolucent and radiopaque stones
-Big doses of Vitamin D leads to formation of Oxalate stones
-Dietary recommendations: decrease protein and oxalate, decrease sodium, more water and more dietary Calcium (weird!)

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47
Q

Cardiac Tamponade histrory/sx/physical

A
  • recent URI, dyspnea, JVD, CLEAR lung fields, big freakin heart and NONPALPABLE PMI!
  • Beck’s triad: hypotension, JVD and muffled heart sounds
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48
Q

Vitamin K gamma carboxylates

A

Factors II, VII, IX, X, protein C and S

-don’t forget that CF pts can had a def in Vit K (fat soluble) and thus could have a deficiency in any of these.

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49
Q

Multiple System Atrophy

A

Shy-Drager Syndrome

  • Parkinsonism
  • Autonomic dysfunction (postural hypotension, abnormal sweating, bowel/bladder dsfxn, abnormal lacrimation, impotence, gastroparesis, etc..)
  • Widespread neurologic signs (cerebellar, pyramidal, lower motor neuron)
  • TX: symptomatic. Antiparkinsonism drugs don’t work
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50
Q

Interstitial cystitis

A
  • Painful bladder syndrome
  • kinda presents like endometriosis but no cervical motion tenderness, just tenderness when palpating the anterior vaginal wall.
  • associated w/ psychiatric illnesses and pain fibromyalgia
  • tx: TCAs and symptom management
  • c/c to a cystocele (will have prolapse)
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51
Q

Tick removal?

Stinger removal?

A
  • tweezers

- scrape w/ a tongue depressor

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52
Q

Pronator drift due to?

A

Upper motor neuron lesion

NOT cerebellar dsfxn!!

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53
Q

Tactile fremitus, Auscultation

  • Consolidation (lobar pneumonia)
  • COPD
  • Effusion
  • Pneumothorax
A
  • Increased, bronchial breath sounds, bronchophany, egophany, pectoriloquy
  • Decreased, decreased
  • Decreased, decreased
  • Decreased, decreased
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54
Q

Tx of solitary brain tumor at grey-white junction?

what if it is deep?

A
  • surgical resection

- whole brain irradiation. Also do this for multiple mets

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55
Q

Succinylcholine. Risk and who is it C/I in?

A
  • can cause crazy hyperkalemia which can lead to arrhythmias.
  • C/I in pts w/ hyperkalemia (could be a burn victim or rhabdo pt!)
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56
Q

Acute bronchitis clinical picture

A

-pt presents w/ a few days of a viral illness that progressed to yell sputum (sloughed epithelial cells) and some hemoptysis (infection eroded bronchial wall so that’s the bleeding… not freaking TB!). CXR will show nothing at all. Supportive care.

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57
Q

Primary biliary cirrhosis

A
  • typical pt is a middle aged female who presents w/ PRURITIS and probably fatigue.
  • Alk phos, IgM and cholesterol are high. Bump in transaminases.
  • PE shows hepaotsplenomegaly and xanthomatous lesions on eyelids, skin, tendons.
  • Anti-mitochondrial antibodies
  • increase risk of hepatobiliary malignancy
  • TX: ursodeoxycholic acid but eventually a liver transplant w/in a decade or death.
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58
Q

tx of Syphilis if non-pregnant pt has penicillin allergy?

A

PO Doxycycline for 14 days (28 days if latent)

-Remember, you can’t give doxy to preggos

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59
Q

Tx of dissecting aortic aneurism

A

B-Blocker b/c they simultaneously lower BP and HR

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60
Q

Multiple myeloma

A
  • combination of back pain, anemia, renal dsfxn, and elevated sed rate.
  • Also some pts will have hypercalcemia which will lead to things like constipation, weakness, polyurea
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61
Q

Febrile nonhemolytic transfusion rxn

A
  • commonest type
  • occurs btwn 10-6 hours after transfusion
  • due to cytokine build-up
  • no respiratory distress or shock… so it’s really not that bad
62
Q

Anaphylactic transfusion rxn

A
  • occurs w/in seconds to minutes
  • rapid onset of shock, angioedema/urticaria and respiratory distress.
  • caused by recipient anti-IgA antibodies!
63
Q

Transfusion-Related acute lung injury

A
  • occurs w/in 6hrs
  • pulm edema and respiratory distress
  • caused by donor anti-leukocyte antibodies
64
Q

Primary hypotension transfusion reaction

A
  • transient hypetension in pts taking ACE inhibitors

- b/c there are bradykinin in the donor blood and the pt doesn’t have any

65
Q

Bacterial sepsis transfusion rxn

A
  • w/in minutes to hours after transfusion

- fever, chills, septic shock, DIC

66
Q

Alcohol withdrawal tx

A

Chlordiazepoxide (benzo)

67
Q

Essential tremor tx

A

Propranolol or Primidone (an antiepileptic: may have the SE of an intermittent porphyria that manifests as abdominal pain and neurologic and psychiatric abnormalities)

68
Q

Pulm HTN tx if it is due to LV failure

A

Diuretics and ACEIs. NOT PDE-5 inhibitors

69
Q

Ascites levels of tx (4)

A

1) Sodium and water restriction
2) Spirinolactone
3) Furosamide
4) Tap dat tummy (paracentesis). Tap slowly to prevent hepatorenal syndrome and you may want to infuse albumin
- DO NOT do any kind of shunt for ascites for various reasons. Shunts are only for bleeding varices!!

70
Q

TTP

-tx?

A
  • thrombocytopenia, hemolytic anemia, renal failure, AMS and low grade fever
  • look for schistocytes on peripheral blood smear
  • most cases are idiopathic but may be associated w/ HIV or drug toxicity
    tx: plasmapheresis (plasma cell exchange)
71
Q

Dermatofibroma vs basal cell carcinoma

A

Basal Cell does NOT dimple when pinched

72
Q

Central retinal artery occlusion

A
  • sudden painless vision loss.

- Eye exam shows pallor of optic disc, cherry red fovea and boxcar segmentation of blood in the retinal veins

73
Q

Retinal detachment

A

“curtain coming down over my eye, flashes of light, floaters”

74
Q

Vitreous hemorrhage

A
  • Sudden loss of vision w/ onset of floaters
  • hard to visualize funds
  • commonly caused by diabetic retinopathy
75
Q

Pertussis prophylaxis

A

all close contacts should get a macrolide.

If less than 1mo then kid should get azythromycin

76
Q

Galstone in cystic duct clinical picture/labs

A
  • typical sx of acute cholecystitis
  • Labs will show maybe slightly elevated Alk phos (100) and transaminases (50) from passage of sludge around the stone.
  • There will be NO ICTERUS b/c the stone is not blocking the common bile duct and Bili will be NORMAL!!
77
Q

Acquired torticollis work-up and causes

A
  • Most commonly from URI, minor trauma or cervical lymphadenitis
  • Rarely from retropharyngeal abscess or atlantoaxial subluxation.
  • Get a c-spine x-ray at presentation to rule out extremely dangerous spinal fracture or dislocation
78
Q

Molluscum contagiosum

  • rash appearance?
  • why do ppl get this? who gets it?
  • what causes it?
A
  • umbilicated, firm, flesh-colored firm papules on the trunk, limbs or in the anogenital area
  • usually pts have a deficiency in cell-mediated immunity
  • pox virus
  • so pts w/ HIV get it a lot. Also it can be transmitted sexually by skin-skin contact
79
Q

Ebstain’s anomoly

A
  • Downward displacement of the tricuspid valve
  • associated w/ maternal LITHIUM use
  • tall P waves and RIGHT axis deviation
80
Q

Left axis deviation on ECG

A

Lead 1: big R waves

aVF: mostly pointing down

81
Q

Supraventricular (narrow complex) tachycardia tx

A

-adenosine. It slows AV conduction

82
Q

Echinococcus granulosis

A

Dog tapeworm

  • Sheep and dog are infected.
  • Humans get accidentally infected and larva go to Liver and then Lung.
  • You’ll see a liver cyst w/ multiple daughter cysts
83
Q

Work-up for Diarrhea in a HIV pt

A
  • do stool culture for ova and parasites as well as stool antigen test for C. dif
  • do these tests first b/c DI in a HIV pt could be like a ton of different things
84
Q

Cutaneous larva migrans

A

Dog and Cat hookworm

  • you get it after skin contact w/ contaminated soil (sand box)
  • lesions are severely pruritic, elevated, reddish-brown and migrate at several millimeters per day
85
Q

Pt had a URI a few weeks ago and now has sx of CHF.

-What caused it?

A

-pt has dilated cardiomyopathy due to a virus like Coxsackie B (commonest). Others are parvovirus B19, HHV6, adenovirus and enteroviruses.

86
Q

Alzheimer’s dz brain on MRI

A

-diffuse cortical and subcortical atrophy which is disproportionally greater in the temporal and parietal lobes.

87
Q

Afib tx if hemodynamically unstable?

-Common complication of what surgery?

A
  • Immediate DC cardioversion

- Afib is an extremely common complication of CABG!!

88
Q

Graves dz tx that can worsen ophthalmopathy?

A

-radioactive iodine therapy

89
Q

Prastatitis: dx and tx?

A
  • do a mid-stream urine catch and culture

- tx= TMP-SMX or a fluoroquinolone

90
Q

Polycythemia Veria mutation

A

JAK2 (in >95%)

-EPO levels will be LOW!!

91
Q

Normal pressure hydrocephalus

A

-GAIT IMPAIRMENT is the most prominent feature and appears the earliest. If they don’t describe a broad-based shuffling gate then the pt probably doesn’t have NPH even if they are wobbly w/ dementia and they pee on themselves

92
Q

Mucormycosis tx

A

surgical debridement and IV Amphoteracin

93
Q

Toxoplasma gondii in HIV

-what CD4 and prophylaxis

A

-CD4 counts

94
Q 
Mycobacterium avium (MAC) in HIV
-what CD4 and prophylaxis
A

-CD4 counts

95
Q

Histoplasma capsulatum in HIV

  • what CD4 and prophylaxis
  • endemic where?
A

-CD4 counts

96
Q

SIRS

A

Systemic Inflammatory Response Syndrome

  • Basically it’s sepsis w/out an actual infection
  • Temp >38.5, Pulse >90, RR >20, WBC >12,000 or >10% bands
  • Causes: severe burns, pancreatitis, autoimmune dz, vasculitis
97
Q

Purple lesions in a HIV pt

A
  • Bartonella can be the cause
  • large, pedunculate exophytic papule w/ a collarette of scale
  • can have visceral lesions as well. Ne super careful when taking the biopsy b/c they bleed a ton
98
Q

tick-borne paralysis

A

-tick needs to feed for 5-7 days before it releases the toxin. So if pt has it then do a meticulous search for the tick. Once removed, the pt will start recovering w/in an hour

99
Q

Paget’s disease is because of what cell?

A

-Osteoclast hyperfunction. Leads to a mosaic pattern of lamellar bone

100
Q

Hydroxychloroquine use and SE

A
  • Used for SLE

- SE: retinopathy

101
Q

Pt presents with changed perception of color and central scooter. Maybe field peripheral field loss. DX?

A

optic neuritis. Common in MS pts

102
Q

Morton Neuroma

A

Pain btw 3rd and 4th toes

103
Q

Ligamentous back sprain

A
  • occurs after an inciting event and is worse with movement

- hurts worse when you palpate NEXT TO the spine rather than on the spine (compression fracture)

104
Q

Pt just had a re-occlusion of a coronary artery. What lab do you order?

A

CK-MB. Returns to normal after 1-2 days

105
Q

B-blocker OD sx and tx

A
  • bradycardia, AV block, hypotension and diffuse WHEEZING.

- TX: glucagon

106
Q

Membranoproliferative glomerulonephritis

A
  • It is caused by IgG antibodies (called C3 nephritic factor) that target C3 converts of the alternative compliment pathway. This leads to persistent compliment activation which causes kidney damage.
  • Immunofluorescence is positive for C3
107
Q

Lithium toxicity

A

tremor, hyperreflexia, ataxia and seizures

108
Q

Benzo OD. Sx and tx?

A

-Pt is mainly just really freakin tired. Also slurred speech and unsteady gate.
TX: Flumazenil

109
Q

Restless leg syndrome tx

A

1st line: Iron (can be caused by Iron def), leg massage, heating pads
2nd line: Dopamine agonist (pramipexole)
3rd line: alpha-2-delta calcium channel ligands (Gabapentin)

110
Q

Pt has megaloblastic anemia and is on anti epileptic drugs. Why?

A

-some of them (phenytoin, primidone, phenobarb) inhibit folate absorption in the small intestine. So give folate.

111
Q

Mixed Essential Cryoglobulinemia

A

-palpable purpura, proteinurea and hematuria
-other sx are arthralgia, hepatomegaly and low compliment
-most pts have HEP C so check them for this!!
“Cryoglobulinemia=hep C”

112
Q

IBD colon cancer screening

A

-first colonoscopy at 8yrs after diagnosis and then YEARLY thereafter.

113
Q

Small cell carcinoma of the lung. Paraneoplastic stuff?

A

ACTH, ADH, Myesthenia Gravis (“M”uscle… DTRs preserved b/c it gets worse with repetition!!! DTRs might even be brisk), Lambert-Eaton (presynaptic calcium channels–muscle response is better to repetitive stimuli… so NO DTRs!!!!!)

114
Q

Squamous cell carcinoma of the lung makes what?

A

PTHrP

115
Q

SIADH tx (3 levels)

A

1) No sx: fluid restriction, maybe PO salt tablets and furosemide
2) Moderate sx (confusion, lethargy): 3% saline to get Na+ over 120. Then just fluid restriction
3) Severe sx (seizures, coma): just bolus hypertonic saline until sx resolve.

116
Q

Hepatorenal syndrome tx

A

Liver transplant

117
Q

Commonest predisposing factor to aortic dissection

A

Hypertension (not atherosclerosis!)

118
Q

Pill esophagitis

A
  • Tetracyclines, NSAIDs, Alendronate, Potassium Chloride, Quinidine, and Iron
  • These damage the esophageal mucosa
119
Q

Malignant otitis externa tx

A

Cipro

120
Q

Migraine tx. Acute setting and chronic?

A

Acute: Antiemetics like Prochlorperazine. Chlorpromazine or Metaclopramide. Also NSAIDs
Chronic: TCAs but they must be started EARLY in the course of the migraine to be effective.

121
Q

Opioid OD tx?

-sx?

A
  • Naloxone
  • Pupil size is not reliable b/c the pt could have ingested something else as well. RR is what you go by.
  • SX: miosis, bradycardia and hypertension (b/c it leads to histamine release)
122
Q

Dermatitis Herpetiformis tx

A

Dapsone. Also stop eating gluten

123
Q

Ca2+ channel blocker SE

A

Peripheral edema

124
Q

Polymyalgia rheumatica.

  • Sx? Who gets it?
  • Tx?
A
  • pts older than 50 get pain and stiffness in the neck, shoulders and pelvic girdle. Morning stiffness
  • elevated sed rate
  • TX: low-dose steroids
125
Q

What drug do you give for Subarachnoid Hemorrhage?

A
  • Ca2+ channel blocker

- Don’t give this for a cerebral hemorrhage.

126
Q

Cushing’s Syndrome

A

1) Ectopic ACTH (small cell lung carcinoma, pancreatic carcinoma)
2) Exogenous glucocorticoids (commonest)
3) Adrenal adenoma (will have LOW ACTH… do Adrenal CT scan)
4) Primary pigmented nodular adrenocortical hyperplasia

127
Q

Cushing’s Disease

A

-ACTH-producing pituitary adenoma

128
Q

Aspirin toxicity triad

-acid base stuff?

A
  • triad of fever, tinnitus and tachypnea
  • pts have a mixed respiratory alkalosis (so a low PaCO2) and anion gap metabolic acidosis (low Bicarb) which evens the pH out to normal.
129
Q

Weird labs in hypothyroidism?

A

-hyperlipidemia (b/c less LDL surface receptors), hypOnatremia, and high CK and transaminases.

130
Q

Idiopathic Intracranial HTN tx

A
  • Acetazolamide and maybe Furosemide

- Acetazolamide inhibits choroid plexus carbonic anhydrase and thus decreases CSF production

131
Q

Mono complications

A
  • Autoimmune hemolytic anemia

- Splenic rupture (not infarction)

132
Q

Type of gait in parkinsonism

A

Hypokinetic gait.

133
Q

Prolactinoma tx

A

-Cabergoline or bromocriptine (both dopamine agonists)

134
Q

Afib tx

  • What if pt has heart failure?
  • What is pt is decompensated?
A

B-blockers or calcium channel blockers

  • Heart failure: digoxin
  • Decompensated: cardioversion
135
Q

familial hypocalciuric hypercalcemia

A
  • AD
  • abnormal calcium-sensing cells on prathyroid gland and renal tubules. So high/high normal PTH (then high blood calcium) and low calcium in pee
136
Q

Anorexia nervosa: common findings (7)

A

1) Osteoporosis
2) high cholesterol and carotene levels
3) Cardiac arrhythmias (prolonged QT)
4) Euthyroid sick syndrome
5) anovulation, estrogen def, and amenorrhea (hypothalamic-pituitary axis dsfxn)
6) hyponatremia secondary excessive water intake
7) IUGR if they recover and can get pregnant

137
Q

Cocaine OD tx

A

Diazepam

138
Q

Aortic dissection dx

A

-transesophageal echo or CT (pick TEE if pt has kidney dz)

139
Q

Waldenstrom Macroglobulinemia

A
  • plasma cells that multiply like crazy and invade bone marrow and make IgM.
  • Major signs: hepatosplenomegaly, anemia, thrombocytopenia (so bruising and bleeding tendency), night sweats, headache and dizziness, various visual problems (from hyper viscosity… retinal engorgement), pain and NUMBNESS IN THE EXTREMITIES.
140
Q

Primary CNS lymphoma

A
  • presents as a weakly ring enhancing mass in an HIV pt that is usually SOLITARY (toxo=multiple ring-enhancing lesions on basal ganglia) and periventricular.
  • you’ll see EBV DNA in the CSF
141
Q

Cat scratch fever cause and tx

A

Bartonella henselae

-tx: PO azithromycin

142
Q

Cystinurea

  • type of crystals
  • what is the defect?
A
  • Familial defect in dibasic amino acid transporters in the intestinal brush border and kidneys.
  • will have hexagonal crystals and recurrent stones since childhood
  • positive urinary cyanide nitroprusside test
143
Q

diabetes drug that helps pts lose wt?

A

-Glucagon-Like Peptide-1 (GLP-1) agonists

144
Q

Hypernatremia tx? Mild and severe?

A 
Mild= 5% dextrose in 0.45% saline
Severe= NS. No freakin clue why
145
Q

Reactive arthritis tx

A

NSAIDs

146
Q

commonest atypical pneumonia and weird SE

A
  • Mycobacterium pneumoniae

- erythema multiforme. Also headaches and sore throat

147
Q

Bone lesions in Prostate Cancer?

A

osteoBlastic!!!! “Prostates BLAST you know what!”

148
Q

Acute cluster headache tx?

A

100% O2

149
Q

Mycophenolate tox?

A

Marrow suppression

150
Q

Azathioprine tox?

A

Dose-related diarrhea, leukopenia and hepatotox

151
Q

Cyclosporine tox?

A

-gum hypertrophy, nephrotox (commonest), glucose intolerance, malignancy (SCC), hirsutism

Step 2-General (6 decks)

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