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Internal Medicine > MedStudy Board-style Q+A's > Flashcards

MedStudy Board-style Q+A's Flashcards

1
Q

Younger, intermittent dysphagia, solids not liquids, not progressive

A

Schatzki ring, do EGD

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2
Q

Rectal bleeding with cramps

A

Ischemic colitis, do flex-sig

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3
Q

Chronic diarrhea + GERD + Ulcers

A

Zollinger-Ellison syndrome, check gastrin level off PPI

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4
Q

Familial polyposis coli- what surveillance?

A

Scope any rectum remaining after surgery, also EGD for gastric or proximal small bowel malignancies

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5
Q

Common cause pill esophagitis

A

doxycycline. Rx supportive measures

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6
Q

Older with watery diarrhea, mild cramping, abdominal pain

A

Microscopic colitis, dx with colonoscopy with biopsy

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7
Q

Younger, recurrent severe GI bleeds, negative scopes

A

Meckel’s diverticulum; dx nuc med scan; rx surgery

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8
Q

Hospitalized pt with MSOF, on TPN, US shows thickened GB wall with surrounding fluid, no stones

A

Acalculous cholecystitis; place percutaneous cholecystostomy tube

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9
Q

Hep C with normal LFT’s- what rx?

A

No rx at this time

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10
Q

Gastric bleed with visible vessel- rx?

A

Endoscopic rx with heater probe to the vessel

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11
Q

Food poisoning: Chinese restaurant, fried rice; 4-6 hours after, diarrhea, vomiting

A

B. cereus

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12
Q

Food poisoning: food left out at a picnic, mayonnaise

A

Staph aureus

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13
Q

Food poisoning: fast food hamburgers

A

E. coli 0157:H7

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14
Q

Lung mass, draining cutaneous lesion, budding yeast

A

Ohio/Mississippi basins: Blastomycosis
Southwest: Coccidioidomycosis
Rx itraconazole, amphoB if severely ill

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15
Q

Treatment Pulmonary Arterial Hypertension

A

Warfarin, oxygen, calcium channel blockers, oral endothelin receptor antagonists, PDE inhibitors, prostacyclin analogues

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16
Q

Causes decreased DLCO

A

Emphysema, interstitial inflammation and fibrosis, edema, infections; also reduced capillary lung volumes as in pulmonary hypertension, pulmonary embolism; anemia (unless corrected for hgb count)

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17
Q

Drugs that interact with theophylline and can elevate levels causing toxicity

A

cipro, cimetidine, erythromycin, propranolol, tetracycline

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18
Q

Necrotizing pneumonia that is contagious (possible bioterrorism)

A

Yersinia pestis (plague pneumonia)

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19
Q

Cause of pleural effusion glucose < 30

A

Rheutoid arthritis pleural effusion

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20
Q

Best test if suspect tuberculous effusion

A

Pleural biopsy

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21
Q

Fever, malaise, headache, sore throat, nonproductive cough; sore throat seen 2-3 weeks prior to pneumonia

A

Chlamydophila pneumoniae (formerly Chlamydia) rx macrolide or doxycycline

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22
Q

Definition severe persistent asthma

A

continual symptoms, frequent exacerbations, nighttime symptoms, limited activity, FEV1 or PEF 30%

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23
Q

Calculate A-a gradient; normal A-a gradient

A

A-a gradient = 149 - (PaO2 + 1.25 x PaCO2);

Normal < 0.3 x age (years)

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24
Q

Neurofibromatosis-2 associated with what tumor?

A

vestibular schwannoma

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25
Q

Neurofibromatosis-1 associated with what tumor?

A

optic glioma

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26
Q

Tuberous sclerosis associated with what tumor?

A

Giant cell tumors

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27
Q

Turcot syndrome and nevoid basal cell carcinoma syndrome associated with what tumor?

A

medulloblastoma

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28
Q

von Hippel-Lindau syndrome associated with what tumor?

A

hemangioblastoma

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29
Q

Treatment of hypercalcemia of malignancy

A

IV hydration, bisphosphonate, diuresis

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30
Q

Cell types ovarian cancer old vs younger

A

Older- epithelial; Younger- germ cell, more treatable

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31
Q

Cell type testicular cancer

A

Germ cell > 95% of time; do not do transscrotal resection

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32
Q

Side effect alkylating agents

A

infertility

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33
Q

What chemorx cause capillary leak syndrome?

A

IL-2, GM-CSF

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34
Q

derived from bark of the western yew tree

A

Paclitaxel

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35
Q

Which causes more nausea and nephrotoxicity: carboplatin or cisplatin?

A

cisplatin

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36
Q

Stages CLL

A 
0- lymphocytosis
1- + LAD
2- + HSM
3-  anemia
4- thrombocytopenia
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37
Q

Side effects 5FU

A

GI toxicity and mucositis

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38
Q

Side effects methotrexate

A

mucositis and diarrhea

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39
Q

Side effects vincristine

A

neurotoxicity

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40
Q

Side effects vinblastine

A

myelotoxicity

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41
Q

Basal cell ca facts

A

Related to sun exposure
Can be inherited
Locally aggressive
Uncommonly seen black skin

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42
Q

Features Gorlin syndrome (nevoid basal cell carcinoma syndrome)

A 
Autosomal dominant
Numerous basal cell carcinomas
Palmar and plantar pits
Cysts of mandible
Bifid ribs
agenesis of the corpus callosum
hypertelorism
Generally good prognosis
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43
Q

Concussion recommendations

A

Grade I- no amnesia or LOC- ok return after 20 minutes
Grade II amnesia but no LOC out x 1 week
2nd concussion out one month
3rd concussion out for season

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44
Q

Coma with pinpoint pupils- dx?

A

opiate overdose or pontine infarct

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45
Q

Sx Creutzfeldt-Jacob disease

A

Rapidly progressive dementia
myoclonus (precipitated by sudden noises or startle)
Pyramidal, extrapyramidal, cerebellar signs

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46
Q

Anticonvulsant that is only could for absence seizures

A

Ethosuximide

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47
Q

Encephalitis with personality changes/encephalopathy dx

A

viral meningitis- HSV (usually 1 except in neonates) or WNV

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48
Q

Rx active TB

A

4-drug therapy x 2 months then INH+RIF x 4 months

INH, RIF, Pyrazinamide, and either ethambutol or streptomycin

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49
Q

Upper lobe predominant lung diseases

A

Silicosis
Ankylosing spondylitis
Eosinophilic granuloma

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50
Q

What agent will effectively bronchodilate and not be blunted by beta-blockade?

A

Ipratropium

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51
Q

Lower lobe predominant lung diseases

A

Rheumatoid fibrosis
Asbestosis
Connective tissue diseases e.g. SLE

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52
Q

Sarcoidosis and berylliosis both cause non-caseating granulomas. How to differentiate?

A

Lymphocyte transformation test on BAL lymphocytes or blood;

positive = berylliosis

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53
Q

Clinical features silicosis

A 
Mining, stone cutting, quarrying, construction, glass manufacturing, sand-blasting
Restrictive lung function
"Eggshell calcification" of hilar nodes
Increased risk TB, lung cancer
Associated with scleroderma, RA
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54
Q

Clinical features coal worker’s pneumoconiosis

A

Similar PFT findings to silicosis

No eggshell calcifications or increased TB or lung cancer risks

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55
Q

Clinical features berylliosis

A

Exposure to electronics, nuclear material, ceramics

Bilateral hilar LAD similar to sarcoid

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56
Q

Byssinosis

A

Related to exposure to impurities in cotton, flax, and hemp dusts
after > 10 years exposure, often “first day of work week”
associated with gm neg exotoxin

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57
Q

What is CD4 cutoff in HIV pt at which you are concerned for MAI/MAC?

A

CD4 < 50

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58
Q

Treatment latent TB?

A

INH 9 months

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59
Q

Appropriate ventilator settings for asthma

A

You want prolonged expiratory phase, therefore:

low rate, low tidal volume, high flows

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60
Q

Clinical features of Hand-Schuller-Christian syndrome?

A

Lytic bone lesions
DI
exophthalmus
On lung bx look for eosinophilic granulomatosis

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61
Q

Clinical features Loeffler’s syndrome

A

Pulmonary infiltrates
Peripheral eosinophilia
Due to Ascaris or other worm migrating through the lung

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62
Q

Light’s criteria

A

Exudate if:
pleural:serum protein > 0.5
pleural:serum LDH > 0.6
pleural LDH > 2/3 upper limit of normal for serum LDH

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63
Q

Adenosine deaminase in pleural fluid

A

TB related effusion

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64
Q

Elevated triglycerides in pleural effusion

A

Chylous effusion from disruption of thoracic duct

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65
Q

Rx mild RA

A

ASA or other NSAID

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66
Q

Crystals gout

A

strongly negatively birefringent needle-like

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67
Q

Crystals pseudogout

A

weakly positive birefringent rhomboid; precipitated by infection, trauma, surgery

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68
Q

Clinical features drug-induced lupus

A

Procainamide can cause
+ anti-histone antibodies
Serositis, fever are common
Rash, CNS, renal involvement are rare

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69
Q

Eosinophilic fasciitis

A

scleroderma-like condition with eosinophilia and skin thickening (sparing the hands) that frequently starts after vigorous exercise
Unlike scleroderma, which always involves hands, causes Raynauds, + ANA, synovitis

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70
Q

In dermatomyositis, what autoantibody indicates possible pulmonary fibrosis?

A

Anti-Jo-1

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71
Q

Rx Behcets with retinal vasculitis

A

Thalidomide
Methotrexate
Colchicine

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72
Q

c-ANCA associated with

A

Wegeners; think if sinusitis and vasculitis

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73
Q

p-ANCA associated with

A

microscopic polyangiitis

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74
Q

anti-GBM associated with

A

Goodpastures

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75
Q

Rx sicca symptoms of sjogren’s

A

Artificial tears and saliva and secretagogues such as pilocarpine or cevimeline

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76
Q

SLE: what antibodies associated with increased disease activity and nephritis?

A

anti-dsDNA and low complement levels

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77
Q

SLE: 17-30% positive what antibody?

A

anti-Sm

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78
Q

SLE: what antibody 100% for drug-induced but 25% of not drug-induced?

A

anti-histone

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79
Q

SLE: what antibody suggests better prognosis?

A

anti-U1 RNP

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80
Q

SLE: what antibody associated with complete heart block and neonatal lupus?

A

anti-Ro/SS-A

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81
Q

PPD: Positive at 5mm

A

Immunosuppressed such as HIV or organ transplant
Close contact with documented case
Fibrotic changes on CXR consistent with prior TB

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82
Q

PPD Positive at 10mm

A

High risk with normal immunity: Health care workers, IV drug users, prisoners, homeless

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83
Q

PPD Positive at 15

A

People with no risk factors

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84
Q

How to calculate pressure gradient across a valve?

A

modified Bernoulli equation
4 v squared
v = velocity of flow

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85
Q

Heart sound: pulmonary htn

A

Widely split S2 (delayed emptying RV)

86
Q

Heart sound: severe AS

A

Either only P2, or paradoxical splitting 2nd sound

87
Q

Paradoxical splitting S2

A

severe AS, permanent pacemaker, LBBB

88
Q

Heart sound: ASD

A

fixed split S2

89
Q

CXR findings rheumatic mitral stenosis

A

pulmonary vascular redistribution
large left atrium
normal sized left ventricle
calcified nodules from previous pulmonary hemorrhages

90
Q

People from tropical environments develop what a decade earlier?

A

valvular disease from rheumatic fever

91
Q

What is unique about congenital pulmonic stenosis?

A

Only right-sided heart sound to become softer on inspiration

92
Q

Commonest abnormality at autopsy of young athlete

A

Hypertrophic cardiomyopathy

93
Q

Features of apical hypertrophic cardiomyopathy?

A

Asians
Usually but not always autosomal dominant
No obstruction or murmur
Prominent voltage anterior or lateral leads
Atrial fibrillation is common due to elevated LV end-diastolic pressures

94
Q

Cardiac tamponade: cath tracings

A

elevated and equalized diastolic pressure

95
Q

Cardiac tamponade: H+P findings

A

History: carcinoma of lung or breast, lyphoma with dyspnea
Physical: hypotension, elevated neck veins with single rapid x descent, pulsus parodoxicus (arterial BP inspiratory fall > 10mmHG)

96
Q

Post-splenectomy organisms

A

Strep pneumo
H. influenzae
N. Meningitidis

97
Q

Meningococcemia: screen for ?

A

CH50 (terminal compliment deficiency

98
Q

Pophyria cutanea tarda associated with what?

A

HCV
Vesicles of the skin, increased pigmentation, increased fragility, milia formation
Increased liver cirrohsis and cancer

99
Q

Rash of syphilis

A

Diffuse maculopapular rash trunk, head, neck, palms, soles;

Classically “round, nickel and dime-sized lesions”

100
Q

Pyoderma gangrenosum

A

Leg ulceration hypersensitivity reaction to IBD, RA, multiple myeloma, other inflammatory disorders

101
Q

Guttate psoriasis

A

hundreds of 2-5mm scaly red papules trunk and extremities, moderately pruritic
often after strep throat

102
Q

Acute fatty liver of pregnancy

A

Late pregnancy with nausea, vomiting, liver dysfunction

103
Q

Live vaccines that shouldn’t be given during pregnancy:

A

MMR
Typhoid
polio
yellow fever

104
Q

Antibiotics to avoid during pregnancy

A

Cipro
Tetracycline
Doxycycline

105
Q

Treatment syphilis in pregnancy

A

PCN-

even if highly allergic, desensitize her

106
Q

Pregnant pt with new onset atrial fibrillation and pulmonary edema

A

mitral stenosis secondary to rheumatic fever

107
Q

Tetralogy of Fallot

A

large VSD
right ventricular outflow tract obstruction
overriding aorta
RVH

108
Q

Characteristics and rx of fibromuscular dysplasia

A

Sudden onset htn in young, caucasian female
renal bruit (30%)
hypokalemia (htn is mediated by stimulation of renin, aldosterone)
renal arteriography “beaded appearance” of renal artery
Rx ace-i or ARB, consider surgery or angioplasty

109
Q

EKG: Right axis deviation

A

I: negative
aVF: positive

110
Q

EKG: Normal axis

A

I: positive
aVF: positive
or
aVF: negative and II: positive

111
Q

EKG: Left axis deviation

A

I: positive
aVF: negative
II: negative

112
Q

EKG: classic PE findings

113
Q

Indications for mitral valve replacement

A

Severe MR with symptoms or asymptomatic with LV systolic dimension > 55mm

114
Q

Arkansas, tick-bite, lymphadenopathy

A

Francisella tularensis (tularemia)

115
Q

Missouri, pancytopenia, tick exposure

A

ehrlichiosis

116
Q

Dx cryptosporidium

A

acid fast stain of stool or stool antigen

won’t grow in culture

117
Q

Malaria-like severe hemolytic anemia in splenectomized pt

A

Babesiosis

118
Q

Dx amebic liver abscesses

A

do serology

119
Q

When and what to start for HIV?

A

HAART @ CD4 < 350:
tenofovir, emtricitabine, efavirenz
If CD4 < 200 add TMP/SMX for PCP prophylaxis

120
Q

EtOH, sepsis, oysters, gulf water

A

Vibrio vulnificus

121
Q

Toxic shock with + blood cx: strep or staph?

122
Q

Young person with hearing loss

123
Q

Arizona, fever, inguinal lymphadenopathy

124
Q

Mississippi river valley, AIDS, pancytopenia, palatal ulcer

A

histoplasmosis

125
Q

Isolated Bell’s palsy can be presentation of ?

A

Lyme disease

126
Q

Febrile neutropenia indications for vanco?

A

Hypotension/shock
Suspected IV catheter infection
Known MRSA colonization or resistant pneumococcus
Mucositis

127
Q

nonspecific symptoms: weight loss, diarrhea, arthropathies, skin hyperpigmentation

A 
Trophermyma whippleii (Whipple disease)
Dx bx lymph node or endoscopic and PAS staining; 
Rx bactrim or ceftriaxone or chloramphenicol
128
Q

Contraindications for breast-feeding

A

Active untreated TB, maternal HIV

129
Q

HAGMA: D-lactic acidosis

A

Short bowel syndrome- increased carbs to colon, increased L and D lactate, but L lactate is metabolized.

130
Q

dDx AG metabolic acidosis

A 
lactic acidosis
renal failure
ketosis
ingestions
D-lactic acidosis
131
Q

Steps of acid-base

A

1) pH
2) AG- ? HAGMA present?
3) Assess delta HCO3 vs AG to assess for NAGMA or metabolic alkalosis
4) Assess respiratory compensation: 15 + HCO3 should = CO2

132
Q

HAGMA: Renal failure

A

Increase ammonia (BUN)

133
Q

HAGMA: Ketoacidosis

A

diabetic
EtOH
starvation

134
Q

HAGMA: Lactic acidosis

A

drugs
toxins
circulatory compromise

135
Q

HAGMA: Ingestions

A

salicylates
methanol
ethylene glycol

136
Q

What eye drops do not use with hyphema?

137
Q

Horner pupil

A

sympathetic denervation
Ipsilateral ptosis and anhidrosis
Normal responses to pupillary light, topical dilators and constrictors

138
Q

AIDS with retinopathy

A

CMV retinitis

139
Q

HIV + with good CD4 count (not AIDS)

A

HIV retinopathy

140
Q

Renal complications of multiple myeloma

A

Nephrotic syndrome, usually due to secondary amyloidosis
Myeloma kidney- renal failure w/o proteinuria
Fanconi syndrome

141
Q

Fanconi syndrome

A 
Proximal, Type II RTA
Hypokalemia
Phosphaturia
Uricosuria
Glycosuria
Aminoaciduria
142
Q

Bartter’s, Gitleman’s, Liddle’s cause:

A

hypokalemia with metabolic alkalosis
Bartters and Gitleman’s = normotensive
Liddle’s = hypertensive

143
Q

Hyperparathyroidism in ESRD

A

Control phosphorus level (< 5.5), can use calcium to bind but need to keep Ca x Phos < 60-70
O/W sevelamer binds phos w/o affecting Ca
If Ca and Phos both ok control hyperpara with 1,25 vit D (calcitriol) or zemplar or hectorol

144
Q

dDx NAGMA

A

RTA
Diarrhea
Carbonic anydrase inhibitors
TPN

145
Q

Type 1 RTA: findings/mechanism

A

Distal
Urine pH > 5.5
Serum K+: Low-nl
Decreased H+ secretin distal tubule

146
Q

Type 1 RTA: Causes

A

Autoimmune (SLE, Sjogrens, RA)
Hereditary hypercalciuria
Drugs (amphotericin B, lithium)

147
Q

Type 2 RTA: findings/mechanism

A 
Proximal
Urine pH < 5.5 (high initially)
Serum K+: Low-nl
Fanconi's
Decreased resorption of HCO3 in proximal tubule
148
Q

Type 2 RTA: Causes

A 
Multiple myeloma
Acetazolamide
Ampho B
Heavy metals
Amyloidosis
149
Q

Type 4 RTA: findings/mechanism

A

Distal
Urine pH < 5.5
Serum K: high
Decreased cation exchange distal

150
Q

Type 4 RTA: causs

A 
Diabetic nephropathy
Chronic interstitial nephritis
NSAIDS
Ace-i
Obstructive uropathy
Spironolactone
151
Q

Red cell casts

A

Very specific for glomerulonephritis

152
Q

White cell casts

A

pyelonephritis

153
Q

Granular casts

A

nonspecific, often ATN

154
Q

Waxy casts

A

advanced renal disease

155
Q

hyaline casts

A

do not indicate disease, seen with concentrated urine

156
Q

Nephritic syndrome urine findings

A 
"Active sediment"
variable protein
red cells
white cells
red, white, and granular casts
157
Q

Nephrotic syndrome definition

A

> 2.5gm proteinuria/day
hypoalbuminemia and hypogammaglobulinemia
hypercoaguable
hyperlipidemia

158
Q

Nephritic
Low complement
Primarily kidney

A

Post-infectious glomerulonephritis (check strep antigen titers)
Membranoproliferative glomerulonephritis

159
Q

Lithium toxicity symptoms

A 
Ataxia
muscle weakness
nausea/vomiting
diarrhea
tinnitus
polyuria
mental status changes
160
Q

Drugs which decrease lithium excretion

A

ACE inhibitors
Thiazides
Diuretics

161
Q

Wernicke aphasia

A

Lesion posterior temporal gyrus of dominant hemisphere
Right superior quadrantanopia
Poor repitition
Fluent speech output

162
Q

Nephritic
Low complement
Systemic

A 
SLE (can cause anything type of glomerular disease- nephritic or nephrotic)
Endocarditis
Cryoglobulinemia (usually due to HCV, MM, or waldenstrom macroglobulinemia)
163
Q

Neprhitic
Normal complement
Primarily kidney

A

IgA nephropathy

Alport syndrome

164
Q

Membranoproliferative glomerulonephritis

A

(idiopathic or SLE, cryos, HCV, HBV); basement membrane dz on bx, “tram tracking”

165
Q

IgA nephropathy

A

AKA mesangial proliferative GN
worldwide most common GN
Hematuria concurrent with viral illness or exercise
Only dx with biopsy
Prognosis tied to creatinine, BP, degree of proteinuria

166
Q

Alport syndrome

A

Nephritic-normal complement-primarily kidney
AKA hereditary (x-linked) nephritis
chronic
associated with nerve deafness, congenital eye probs (lens, retinas, corneas)
dx renal biopsy

167
Q

Nephritic
Normal complement
Systemic

A

Anti-GBM disease
Vasculitides
TTP/HUS

168
Q

Anti-GBM disease

A

when associated with pulmonary hemorrhage known as Goodpasture’s
Not vasculitis- no weight loss or fevers
Dx biopsy or serum anti-GBM antibodies

169
Q

Vasculitides that cause acute glomerulonephritis

A 
Wegener's
microscopic polyangiitis
PAN
Churg-Strauss
HSP
170
Q

RPGN

A 
Rapidly progressive glomerulonephritis
Can have features of any cause nephritic syndrome
Crescents on biopsy
Goodpastures
Lupus
Wegener's
Immune-complex dz
171
Q

Nephrotic

Primarily kidney

A

Minimal change disease
Focal and segmental glomerulosclerosis
Membranous nephropathy

172
Q

MCD associated with:

A

Drugs: NSAIDS, lithium, sulfa
Lymphoma
Inhaled and contact allergies

173
Q

MCD findings

A

Urine sediment with oval fat bodies with “maltese crosses”
Dx renal bx- “no change”
Responds to steroids
Best prognosis of nephrotic syndromes

174
Q

Bactrim can cause what in the elderly?

A

Hyperkalemia

175
Q

High AG and osmolal gap acidosis

A

ethylene glycol

methanol

176
Q

Osmolal gap but not AG acidosis

A

isopropyl alcohol

177
Q

Calculated osmolar gap =

A

2[Na+] + glucose/20 + BUN/3

178
Q

Risk factors for thyroid cancer

A 
FMH thyroid cancer
H/o neck radiation
Anterior neck pain or dysphagia
Respiratory obstruction
New nodule age < 20 or > 60
Vocal cord paralysis
Nodule firm, fixed, or growing or accompanied by LAD
179
Q

Medullary thyroid cancer associated with what mutation?

A

Ret-proto-oncogene (RET)

180
Q

Causes of high RAI uptake:

A 
Graves
Iodine deficiency
Hot nodules
Toxic multinodular goiter
Elevated B-HCG
TSH secreting pituitary tumor
181
Q

Causes of low RAI uptake:

A

Hashimoto thyroiditis
Other thyroiditites: subacute, postpartum, radiation, amiodarone-induced
Thyroid suppressive meds
Iodine excess
Ectopic thyroid tissue (struma ovarii)
Absent thyroid gland (surgery or radioablation)

182
Q

Klinefelter syndrome

A 
Small and fibrotic testes
47, XXY with Barr body
Gynecomastia and poor social skills
Normal arm span
High LH and FSH because testes won't respond
183
Q

Kallman syndrome

A

Increased arm span
Normal genotype
Impaired smell
LH and FSH low or undetectable

184
Q

Clinical course of DI after pituitary surgery

A

First DI (initial stunning)- dilute urine
Then cells die and ADH store is released so SIADH and concentrated urine
Then ADH gone so back to DI

185
Q

Adrenal steroid pathways

A

Cholesterol –> Progesterone, 17OH progesterone, DHEA-S
Progesterone –> 11-doxycorticosterone –> aldosterone
17OH progesterone –> 11-deoxycortisol –> cortisol
DHEA –> testosterone

186
Q

Excess mineralocorticoids cause:

A

Hypertension, hypokalemia, alkalosis

187
Q

Schmidt syndrome

A

Combination of hypothyroidism and adrenal insufficiency

Give steroids first

188
Q

Pseudoprolactinoma

A

Can be caused by hypothyroidism- usually prolactin level is < 200

189
Q

How to dx acromegaly

A

Check GH levels after a glucose load
High glucose normally would suppress GH
or check IGF-1 level

190
Q

Cushings disease : DXMZ suppression

A

Does not suppress with low-dose, but does with high dose

191
Q

What is nephrogenic DI?

A

DI (inability to concentrate urine) that does not respond to exogenous vasopressin (problem is in the kidneys)

192
Q

Features of TTP

A 
Mental status changes
Thrombocytopenia
Hemolysis
Renal dysfunction
Fever
associated with mitomycin C
Rx plasmapheresis
193
Q

Which type of AML is associated with DIC?

194
Q

MDS findings

A

Hypercellular bone marrow with dysplasia in all lines

Microcytic, pseudo-Pelger-Huet cells

195
Q

Secondary thrombocytosis

A

caused by iron-deficient anemia

196
Q

Diseases associated with splenomegaly

A

CML
CLL
hairy cell leukemia
Lymphoma

197
Q

CLL

A

associated with AIHA and ITP

198
Q

Philadelphia chromosome

A

better prognosis with CML

worse with ALL

199
Q

Iron low
TIBC low
Ferritin high
Iron sat low or normal

A

anemia chronic disease

200
Q 
Normal PT
normal or elevated PTT
Normal CBC
Elevated bleeding time
Abnormal RIPA
A

von Willebrand disease

201
Q

abnormal PT

Normal PTT

A

Labs vit K deficiency and FVII deficiency

202
Q

normal PT and PTT, platelets, and bleeding time

A

Labs F XIII

203
Q

pancytopenia
large spleen
dry tap

A

Hairy cell leukemia

204
Q

Auer rods

205
Q

normal PT

abnormal PTT

A

Labs F VIII

206
Q

abnormal PT and PTT

207
Q

Microcytic and slightly hypochromic red cell w/o significant anemia or hemolysis

A

alpha-thalassemia trait

208
Q

normal PT
abnormal PTT
no bleeding

A

Labs F XII

209
Q

Progressive dysphagia to solids and liquids

A

achalasia or scleroderma

210
Q

Progressive dysphagia to solids first, then liquids

A

cancer or stricture

211
Q

Intermittent dysphagia to solids

A

webs or rings

212
Q

Organophosphate poisoning

A

DUMBELS

defection, urination, miosis, bronchospasm/bradycardia, emesis, lacrimation, salivation, + fasciculations and weakness

Internal Medicine (3 decks)

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