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IM > Misc. > Flashcards

Misc. Flashcards

1
Q

How can you differentiate heat stroke vs. NMS or serotonin syndrome

A

presents similarly, but heat stroke has bowel sounds and ARDS/DIC are unique to HS

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2
Q

What is the meaning of PPV and NPV?

A

increased PPV means that there is a higher liklihood that a positive test actually means you have a disease

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3
Q

What is the diff for pruritis?

A 
Biliary disease
Opiate use
Renal disease
Pvera
Hyperthyroidism
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4
Q

What is the most common presentation of acute angle glaucoma?

A

Eye pain, redness, headache - loss of peripheral vision. eye not reactive to light

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5
Q

What is the presentation of optic neuritis?

A

Acute unlateral vision loss, pain

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6
Q

What is the presentation for central retinal vein occlusion? Distinguish it from other possible causes of monocular vision loss

A

Associated with coagulopathy, fundus exam shows blood and thunder appearence (retinal hemorrhage, cotton wool spots). sudden painless loss of vision
Glaucoma - headache, pain
Optic neuritis - also acute, but painful
A auroras fugax - temporary loss of vision
Anterior uveitis - eye is painful and red

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7
Q

What is the treatment for elevated homocysteine?

A

pyroxidine (vit B6), vit B12 and folate also play a role

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8
Q

What are the signs of Vit A toxicity?

A

dry skin, headache, abdominal pain, blurry vision

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9
Q

What are some of the changes that occur with aging that result in orthostatic hypotension?

A

baroceptor sensitivity loss, arterial stiffness, decreased norepi content on sympathetic nerve endings, reduced sensitivity of myocardium to sympathetic stimlation

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10
Q

What is on the differential for fever of unknown origin?

A

Rheum - GPA, RA, giant cell arteritis
Infection - TB, endocarditits, osteomyelitis, HIV (bonus: whipple, malaria, babesia, MAI)
Malignancy - leukemia, lymphoma, liver cancer, RCC

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11
Q

What are the common causes of secondary hyperparathyroidism?

A

Vitamin D deficiency, chronic kidney disease

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12
Q

What are the findings on fundoscopic exam of central retinal artery occlusion?

A

pallor of optic disc, cherry red fovea - tx with optic massage and high flow O2

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13
Q

How does vitreous hemorrhage present?

A

floaters, fundoscopic exam hard to visualize anything

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14
Q

What is attributable risk percent and how is it calculated?

A

RR-1/RR - excess risk in a population explained by exposure

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15
Q

What is lead time bias?

A

detection of disease is made at an earlier point in time while prognosis of the disease does not change

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16
Q

A patient presents with recurrent nasal discharge, dripping in the back of her throad following ingestion of naproxen for mennstrual cramps. this is…

A

asprin exacerbated respiratory disease resulting in nasal poyposis

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17
Q

A young patient presents with nasal obstrobction and epistaxis. This could be..

A

juvenile nasal angiofibroma

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18
Q

A pregnant woman presents with nose bleeds. this could be due to

A

pyogenic granulomas in the anterior septum

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19
Q

A patient presents with wavy lines and loss of central vision in one eye. There are new blood vessels on eye exam. This is..

A

wet type MD

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20
Q

A patient presents with progressive loss of vision in both eyes. On exam, there is patchy depigmentation in the macula. This is..

A

dry type MD

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21
Q

What are some of the treatment measures available for acute angle glaucoma?

A

mannitol, acetazolamide, timolol, pilocarpine to reduce intraocular pressure

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22
Q

What shouldn’t be given to patients with acute angle glaucoma?

A

mydriatic agents (atropine)

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23
Q

How do you calculate number needed to treat?

A

1/ARR (absolute risk reduction)

24
Q

A bunch of kids present with heachache, nausea and vomiting at an indoor barbeque. This is..

A

carbon monoxide poisoning

25
Q

A patient wakes up one morning to find that his eye is just spontaneously red. What is the best course of action?

A

subconjuctival hemorrhage - observation

26
Q

A patient is suspected to have ingested acetominophen in the last 2 hours. What should be your next action?

A

wait two hours and obtain serum acetominophen levels

27
Q

A patient presents with irregular bleeding 8 weeks post partum, an enlarged uterus and pelvic pain as well as chest pain and hemoptysis. You should obtain…

A

quantitative beta HCG - she could have choriocarcinoma

28
Q

Patients who are immobilized are at risk for hypercalcemia. True or false?

A

True!

29
Q

A patient presents wtih decreased visual acuity and decreased brightness sensation in the setting of cafe au lait spots and freckling. This is..

A

an optic glioma, a complication of NF1

30
Q

A patient presents suddenly with a small swelling in his eyelid - what should he do?

A

warm compresses

31
Q

A patient presents with pain and swelling over the inner aspect of her right eye with tenderness and redness in the medial canthus as well as purulant discharg.e this is..

A

dacryocystitis

32
Q

What is the difference between acute angle and open angle glaucoma?

A

open angle - gradual onset

33
Q

After cataract surgery, a patient presents with pain and decreased visual acutiy and exam reveals swollen conjunctiva. What is this and what is the tx?

A

post operative endopthalmitis - tx with antibiotic injection or vitrectomy

34
Q

A diabetic presents wtih changes in vision and leg cramping after a course of respiratory illness. this is..

A

non ketotic hyperosmolar syndrome

35
Q

A patient presents with vesicular ulcers in the cornea and dendritic ulcers. this is..

A

heperes keratitis

36
Q

Atopic keratoconjunctivitis vs. viral vs. allergic

A

atopic - more severe allergy with thick discharge, corneal involvement
allergic - usually both eyes
viral - usually one eye then 2, prodrome

37
Q

A patient who had penetrating injury and loss of vision in one eye starts experiencing changing vision in the other eye with floaters. What’s happening??

A

spared eye injury due to uncovering of hidden antigens released

38
Q

An HIV positive patient comes in with painless changes in vision and fundoscopy showing fluffy retinal lesions. This is..

A

CMV

39
Q

A HIV positive patient comes in with deterioration of vision, peripheral retinal lesions and central necrosis of the retina. This is..

A

herpes simplex

40
Q

An older gentlemen presents with difficulty reading fine print. What’s going on?

A

loss of elasticity of the lens = presbyopia

41
Q

A patient presents with neck pain, fever, limited neck mobility and a strong dislike of opening his mouth. this could be..

A

retropharyngeal abscess

42
Q

A patient with high blood pressure presents with bilateral hearing loss. what med that he’s on could cause this?

A

furosemide

43
Q

A patient presents with ear pain and has been grinding his teeth at night. This is..

A

tempormandibular joint dysfunction

44
Q

A patient presents with difficulty heraing in crownded and noisy environments but he can hear his family at home. this is.

A

presbycusis - inability to hear high pitched noises

45
Q

A patient presents with confusion, epigastric pain and optic disc hyperema with an anion gap. this is..

A

methanol poisoning

46
Q

A patient presetns wtih confusion, fever and very figid abdominal muscles and increased muscle tone. This is..

A

NMS from

47
Q

A patient presents agitated combative behavior, prominant nystagmus, hallucinations. this is..

A

PCP

48
Q

A patient presents conscious and alert after taking a substance but with a white tongue and drooling. This is likely

A

caustic ingestion

49
Q

What is the antidote to benzo intoxication?

A

flumenazil

50
Q

A patient presents with flank pain, hematuria, high osmolar gap and increased anion gap metabolic acidosis with calcium oxalate crystals in urine. This is likely

A

ethylene glycol ingestion - tx with fomepizole

51
Q

A patient presetns with CNS depression, disconjugate gaze and absent ciliary reflex with no imetabolic acidosis

A

isopropyl alcohol poisoning

52
Q

A patient presents with dorwsiness, confusion, dry mouth, dilated pupils, urinary retention. this is likely due to (and how do you tx?)

A

diphenhydramine poisoning - tx with physostigmine

53
Q

A patient presents with bradycardia, hyptension, wheezing, confusion and AV block. This should be treate dwith…

A

glucagon for beta blocker toxicity

54
Q

A patient presents with horizontal nystagmus, cerebellar ataxia and confusion. This is likely due to…

A

phenytoin toxicity

55
Q

A patient consumed large amounts of lyeand presents with oropharyngeal erythema, edema. After giving saline, what is the next step?

A

upper GI endoscopy to eval for esophageal damage

IM (24 decks)

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