Misc. Flashcards
How can you differentiate heat stroke vs. NMS or serotonin syndrome
presents similarly, but heat stroke has bowel sounds and ARDS/DIC are unique to HS
What is the meaning of PPV and NPV?
increased PPV means that there is a higher liklihood that a positive test actually means you have a disease
What is the diff for pruritis?
Biliary disease Opiate use Renal disease Pvera Hyperthyroidism
What is the most common presentation of acute angle glaucoma?
Eye pain, redness, headache - loss of peripheral vision. eye not reactive to light
What is the presentation of optic neuritis?
Acute unlateral vision loss, pain
What is the presentation for central retinal vein occlusion? Distinguish it from other possible causes of monocular vision loss
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
What is the treatment for elevated homocysteine?
pyroxidine (vit B6), vit B12 and folate also play a role
What are the signs of Vit A toxicity?
dry skin, headache, abdominal pain, blurry vision
What are some of the changes that occur with aging that result in orthostatic hypotension?
baroceptor sensitivity loss, arterial stiffness, decreased norepi content on sympathetic nerve endings, reduced sensitivity of myocardium to sympathetic stimlation
What is on the differential for fever of unknown origin?
Rheum - GPA, RA, giant cell arteritis
Infection - TB, endocarditits, osteomyelitis, HIV (bonus: whipple, malaria, babesia, MAI)
Malignancy - leukemia, lymphoma, liver cancer, RCC
What are the common causes of secondary hyperparathyroidism?
Vitamin D deficiency, chronic kidney disease
What are the findings on fundoscopic exam of central retinal artery occlusion?
pallor of optic disc, cherry red fovea - tx with optic massage and high flow O2
How does vitreous hemorrhage present?
floaters, fundoscopic exam hard to visualize anything
What is attributable risk percent and how is it calculated?
RR-1/RR - excess risk in a population explained by exposure
What is lead time bias?
detection of disease is made at an earlier point in time while prognosis of the disease does not change
A patient presents with recurrent nasal discharge, dripping in the back of her throad following ingestion of naproxen for mennstrual cramps. this is…
asprin exacerbated respiratory disease resulting in nasal poyposis
A young patient presents with nasal obstrobction and epistaxis. This could be..
juvenile nasal angiofibroma
A pregnant woman presents with nose bleeds. this could be due to
pyogenic granulomas in the anterior septum
A patient presents with wavy lines and loss of central vision in one eye. There are new blood vessels on eye exam. This is..
wet type MD
A patient presents with progressive loss of vision in both eyes. On exam, there is patchy depigmentation in the macula. This is..
dry type MD
What are some of the treatment measures available for acute angle glaucoma?
mannitol, acetazolamide, timolol, pilocarpine to reduce intraocular pressure
What shouldn’t be given to patients with acute angle glaucoma?
mydriatic agents (atropine)
How do you calculate number needed to treat?
1/ARR (absolute risk reduction)
A bunch of kids present with heachache, nausea and vomiting at an indoor barbeque. This is..
carbon monoxide poisoning
A patient wakes up one morning to find that his eye is just spontaneously red. What is the best course of action?
subconjuctival hemorrhage - observation
A patient is suspected to have ingested acetominophen in the last 2 hours. What should be your next action?
wait two hours and obtain serum acetominophen levels
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…
quantitative beta HCG - she could have choriocarcinoma
Patients who are immobilized are at risk for hypercalcemia. True or false?
True!
A patient presents wtih decreased visual acuity and decreased brightness sensation in the setting of cafe au lait spots and freckling. This is..
an optic glioma, a complication of NF1
A patient presents suddenly with a small swelling in his eyelid - what should he do?
warm compresses
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..
dacryocystitis
What is the difference between acute angle and open angle glaucoma?
open angle - gradual onset
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?
post operative endopthalmitis - tx with antibiotic injection or vitrectomy
A diabetic presents wtih changes in vision and leg cramping after a course of respiratory illness. this is..
non ketotic hyperosmolar syndrome
A patient presents with vesicular ulcers in the cornea and dendritic ulcers. this is..
heperes keratitis
Atopic keratoconjunctivitis vs. viral vs. allergic
atopic - more severe allergy with thick discharge, corneal involvement
allergic - usually both eyes
viral - usually one eye then 2, prodrome
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??
spared eye injury due to uncovering of hidden antigens released
An HIV positive patient comes in with painless changes in vision and fundoscopy showing fluffy retinal lesions. This is..
CMV
A HIV positive patient comes in with deterioration of vision, peripheral retinal lesions and central necrosis of the retina. This is..
herpes simplex
An older gentlemen presents with difficulty reading fine print. What’s going on?
loss of elasticity of the lens = presbyopia
A patient presents with neck pain, fever, limited neck mobility and a strong dislike of opening his mouth. this could be..
retropharyngeal abscess
A patient with high blood pressure presents with bilateral hearing loss. what med that he’s on could cause this?
furosemide
A patient presents with ear pain and has been grinding his teeth at night. This is..
tempormandibular joint dysfunction
A patient presents with difficulty heraing in crownded and noisy environments but he can hear his family at home. this is.
presbycusis - inability to hear high pitched noises
A patient presents with confusion, epigastric pain and optic disc hyperema with an anion gap. this is..
methanol poisoning
A patient presetns wtih confusion, fever and very figid abdominal muscles and increased muscle tone. This is..
NMS from
A patient presents agitated combative behavior, prominant nystagmus, hallucinations. this is..
PCP
A patient presents conscious and alert after taking a substance but with a white tongue and drooling. This is likely
caustic ingestion
What is the antidote to benzo intoxication?
flumenazil
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
ethylene glycol ingestion - tx with fomepizole
A patient presetns with CNS depression, disconjugate gaze and absent ciliary reflex with no imetabolic acidosis
isopropyl alcohol poisoning
A patient presents with dorwsiness, confusion, dry mouth, dilated pupils, urinary retention. this is likely due to (and how do you tx?)
diphenhydramine poisoning - tx with physostigmine
A patient presents with bradycardia, hyptension, wheezing, confusion and AV block. This should be treate dwith…
glucagon for beta blocker toxicity
A patient presents with horizontal nystagmus, cerebellar ataxia and confusion. This is likely due to…
phenytoin toxicity
A patient consumed large amounts of lyeand presents with oropharyngeal erythema, edema. After giving saline, what is the next step?
upper GI endoscopy to eval for esophageal damage
