Medicine 4 Flashcards by Alee Perkins

How to diagnose a rotator cuff tear

MRI

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Involved site in myasthenia Gravis

Acetylcholine receptor in postsynaptic membrane

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Involved site in lambert Eaton

Presynaptic membrane voltage gated calcium channels

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Involved site in dermatomyositis/polymyositis

Muscle fiber injury

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Methotrexate can cause a ___ anemia

Macrocytic

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Long term glucocorticoid use can do what to the femoral head

Osteonecrosis

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Screening test for sle

Antinuclear antibodies

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Osteonecrosis is common in people with what blood dz?

Sickle cell

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Carpal tunnel syndrome is diagnosed with

Nerve conduction studied

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Is dermatomyositis often associated with malignancy?

Yes

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Imaging for suspected malignancy in low back?

X-ray

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Achilles tendinopathy is associated with what abx?

Fluoroquinolones

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Raynaud’s phenomenon is associated with what antibody?

Antinuclear antibody

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Rhomboid shaped crystals are associated with

Pseudogout

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Person with young kids and joint pain, think

Parvo b 19

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Metastatic disease to the bone is ___ at night

Worse

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Numbness or pain between 3 and 4 toes, clicking sensation when palpating space between 3 and 4 toes while squeezing the metatarsal joints

Morton neuroma

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Dx of septic arthritis?

Synovial fluid analysis

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Tx of fibromyalgia

Amitriptyline or other anti depressants

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In Paget’s disease of the bone, serum calcium is ___, serum phosphorus is ___, alk phos is ___ and urine hydroxyproline is ____

Normal normal high high

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Triad of polyarthralgia, tenosynovitis and painless vesiculopustular skin lesions indicate

Disseminated gonococcal infection

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Define presbycusis

Sensorineural hearing loss

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Cyclophosphamide is related to what kind of cancer?

Bladder carcinoma

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Three causes of gout other than idiopathic

Myelo/lymphoproliferative disorders, tumor lysis syndrome, hypoxanthine guanine phosphoribosyl transferase deficiency

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Ra most commonly affects which part of the spine

Cervical

Lateral epicondylitis is the same as

Tennis elbow

Is hypercalcemia associated with gout or pseudogout

Pseudogout

Muffled “hot potato” voice and deviated uvula are suggestive of a

Peritonsillar abscess

First line treatments for Alzheimer’s cognitive sx

Cholinesterase inhibitors such as donepezil

Why do you get primary metabolic acidosis in cardiogenic shock?

Fall in co and arterial hypoxemia leads to tissue hypoxia and fall in plasma bicarb due to rise in lactic acid, leading to metabolic acidosis

What acid base disorder do you get in cardiogenic shock?

Primary metabolic acidosis

What bone cancer is generally in male teens/young adults?

Osteosarcoma

Carriers of the retinoblastoma tumor suppressor gene are predisposed to what kind of bone disease?

Osteosarcoma

Osteosarcoma usually presents at what site on the bone?

Distal femur Or proximal tibia

Fever, purulent sputum, fatigue, foul smelling breath and cavitary lesion with air fluid level. Think

Lung abscess

Can gas cause arthritis

Yes

Episode of massive Hematemesis and shock. First step in tx?

Rapid infusion of 0.9% isotonic saline

Unfortunate side effect of ipratropium

Bladder outflow obstruction

Side effect of treatment of hemophilia with replacement factor viii

Developing antibodies against fvIII (fvIII inhibitors)

Nephrotic syndrome is associated with ____albuminemia and edema

Hypo

Uncontrolled htn is associated with ___uria

Proteinuria

What is labyrinthitis

Inflammation of the inner ear resulting in vertigo and tinnitus, usually is a single attack or diminishes over three to six weeks

Best lab for giant cell arteritis

Esr (or crp)

Tx of giant cell arteritis

High dose steroids

If you suspect restless leg, what do you do first?

Get a ferritin. It’s associated with iron def anemia.

Two treatments for restless leg

Ropinirole and pramipexole, dopamine agonists

Criteria for screening for lung cancer

30 pack year hx, age between 58 and 79

How to screen for lung cancer

Low dose chest ct (cxr is worthless)

Which drugs do you use for chronic gout

Allopurinol and probenecid

Which drugs can you use for a gout flare? Which of these are contraindicated with a high creatinine?

Prednisone, indomethacin, colchicine. Indomethacin and colchicine contraindicated with high creatinine

Tx of community acquired mrsa

Bactrim or doxy

Spider bite or football player =___ until proven otherwise

Mrsa

Side effect of nifedipine

Peripheral edema esp in women

Lupus is associated with what kind of chest pain?

Pleuritic

When do you get a non contrast head ct

When you suspect bleeding in brain

Do migraines change in frequency

Yes

If you have papilledema, change in neuro exam, Aphasic, one side gets weak or visual changes, which imaging do you get?

Head mri

Workup of hepatic encephalopathy

Tap then because sbp is such a common cause, repeat CBC, bmp, lfts, ask about alcohol

Causes of hepatic encephalopathy

Sbp, bleed, alcohol, noncompliance

Tx of sbp

Cefataxime or ceftriaxone

Tx of hypervolemia in cirrhosis

Furosemide 40 and spironolactone 100

Sbp bugs

Gnrs esp klebsiella, proteus, and E. coli

Don’t pull off more than ___ liters in paracentesis

What goes into a meld score

Creatinine, bili, sodium, inr, dialysis

Anti smooth muscle looks for what kind of hepatitis

Autoimmune

Oft missed reason for sob

Anemia

Risk factors for calciphylaxis

Warfarin use, esrd, hyperparathyroid

Tx of calciphylaxis

Dialysis, phosphate binders, sodium thiosulfate

Exquisitely tender nodules on fatty parts eg panus, think

Calciphylaxis

Where does psoriasis show up usually?

Extensor surfaces

Side effect of amiodarone

Pulm fibrosis

Empiric coverage of pneumonia in an aids pt who has ivdu/risk of Mrsa

Vanco

In delirium, medications should be used as a

Last resort. Get a sitter first/make it a relaxing environment.

What role do tcas (eg amitryptyline) have in migraines?

Preventative

Serious side effect of citalopram

Hyponatremia esp in the elderly

Crohns increases your risk for what kind of cancer?

Bowel adenocarcinoma

What kind of pain can a pe cause

Pleuritic chest pain

How can pes cause a pleural effusion?

By increasing the interstitial fluid in the lungs as a result of ischemia or through the release of vasoactive cytokines

Tx of latent tb

Isoniazid for nine months

First line for bph incontinence?

Tamsulosin | Finasteride might not work for 6-12 months

How do you treat community acquired Mrsa

Bactrim or doxy

AFP is associated with what kind of cancer

Hcc

First thing to check in restless leg

Ferritin

Side effect of chlorthalidone

Makes gout worse

Pathophys of dka

Occurs when lipid breakdown generates a surplus of acidic ketones bodies

Criteria to dx dka

1. Blood glucose above 250 2. Bicarb less than 15 3. Ph less than 7.35 4. An increased anion gap

Three main abnormalities of dka

Hyperglycemia, ketosis, metabolic acidosis