misc

Question 1

CHF patients should be on what two meds to reduce mortalitly?

Answer 1

ACE/ARB and Beta-blocker

Question 2

if CHF pt cannot use ACE (black, allegic), use what instead?

Answer 2

hydralazine with nitrates

Question 3

four main categories of causes o fCHF

Answer 3

1 mycoardial injury or chemo

2. chornic presre overload (HTN, AS)
3. chornin volume overload (MR)
4. Infilatrative diseases

Question 4

CHF with EF >40% = wjat tue pf dysfunction?

Answer 4

diastolic (stiff ventricles = decr filling)

Question 5

four goals of acute AF tx

Answer 5

1 hemodynamic stability
2 rate control with IV Beta-blockers (if stable)
3. anticoag
4. cardioversion (if unstable)

Question 6

CHADS2 score

Answer 6

CHF, HTN, Age >= 75, Diabetes, Stroke

Question 7

Avoid what meds in WPW with AF

Answer 7

beta blockers, verapamil, or other AV nodal blocking agents because they paradoxically increase ventricular rate

Question 8

tx WPW with afib with what?

Answer 8

procainamide - slows the propagation through accessory pathway, not through AV node

Question 9

muddy brown casts

Answer 9

ATN

Question 10

RBC casts

Answer 10

golmerulonephritis

Question 11

WBC casts

Answer 11

interstitial nephritis and pyelonephritis

Question 12

Fatty casts

Answer 12

nephrotic syndrome

Question 13

Broad and waxy casts

Answer 13

Chronic renal failure

Question 14

3-hz spike and wave

Answer 14

absence seizure

Question 15

triphasic bursts on EEG

Answer 15

creutzfeldt jakob

Question 16

diffuse background slowing on eeg

Answer 16

delerium

Question 17

if neg, r/o SLE

Answer 17

ANA

Question 18

most sensitive for SLE

Answer 18

anti-dsDNA

anti-Smith

Question 19

anti-histone

Answer 19

drug induced lupus

Question 20

anti-ro (SSA) or anti-la (SSB)

Answer 20

sjogren’s

Question 21

anti-centromere

Answer 21

CREST

Question 22

anti-scl-70

anti-topoisomerase

Answer 22

systemic sclerosis

Question 23

mixed connective tissue disease

Answer 23

anti-RNP

Question 24

WBC 5k-50k in joint tap:

crystals v. no crystals

Answer 24

crystals: gout and pseudogout (rhomboid, birefringement, Ca)

no crystals - RA, ank spond, SLE, reiters

Question 25

WBC 200-5k in joint tap =

Answer 25

OA, hypertrophic osteoarthropathy, trauma

Question 26

TIBC =

Ferritin =

Answer 26

TIBC = carrying capacity (decr in ACD)
Ferritin = storage (decr in IDA)

Question 27

1-2d after runny nose, sore throat, cough pt gets hematuria

Answer 27

IgA nephropathy

Question 28

what’s wrong with PT and PTT in TTP/HUS

Answer 28

nothing - differentiates from DIC (has decr plts and fibrinogen, but everything else is increased)

Question 29

a nephrotic pt develops flank pain - think what

Answer 29

renal vein thrombosis dt peeing out clotting factors

Question 30

tx of MCC’s of meningitis

Answer 30

vanc and ceftriaxone

Question 31

tx of MCC of meningitis in old and young

Answer 31

AMPicillin for LYSteria

Question 32

MCC of pna in healthy young person

Answer 32

mycoplasma pna (Cold agglutinin) (marcrowlide)

Question 33

cause of pna in old smoker w/ copd

Answer 33

h flu

Question 34

cause of pna in person hospitalized w/i 3mo

Answer 34

pseudomonas kleb, e coli, MRSA

Question 35

tx of MCC of pna

Answer 35

M, FQ, 3rd ceph (ceftriaxone)

Question 36

looks like MS in a HIV+ pt

Answer 36

PML - JC polymyomavirus

Question 37

s/s of meningitis in HIV+

Answer 37

crypto

Question 38

elevated alk phos and GGT

elevated alk phos and normal GGT

Answer 38

elevated GGT = obstruction (IBD==> PSC)

normal GGT = paget’s