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Miscellaneous 3 Flashcards

1
Q

clinical features of secondary syphilis

A
  • maculopapular rash on trunk and extremities
  • patchy hair loss
  • diffuse LAD
  • hepatitis, uveitis
  • often don’t have history of genital lesion
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2
Q

toxoplasma vs. PML

A
  • CD4 count less than 100 in toxo, less than 200 in PML

- lesions with mass effect and edema in toxo, no mass effect or edema in PML

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3
Q

Management of recurrent UTI

A
  • postcoital or daily prophylactic abx
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4
Q

first line meds for migraine ppx

A
  • topamax
  • depakote
  • TCAs
  • beta blockers
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5
Q

Management of secondary parkinsonism from dopamine receptor antagonists

A
  • switch to a low risk agent (anticholinergics don’t work well)
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6
Q

Initial management of WPW

A
  • exercise ECG OR EP study (either can identify patients at risk of sudden cardiac death)
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7
Q

Measles clinical features

A
  • “3 Cs” - cough, conjunctivitis, coryza

- koplik spots (white lesions on an erythematous base)

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8
Q

Initial step in management of suspected measles

A
  • airborne isolation (measles is highly infectious)
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9
Q

Initial management of atrial flutter with RVR

A

Ablation (high success rate in atrial flutter)

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10
Q

Management of dysphagia after a stroke

A
  • modified barium swallow (oropharyngeal dysphagia common after CVA and other neurologic injury. Oropharyngeal dysphagia is best evaluated with a modified barium swallow)
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11
Q

Management of patient with severe AS requiring emergent surgery

A
  • surgery with invasive hemodynamic monitoring (ensures adequate intravascular volume, preload, and SVR)
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12
Q

Management of GERD during pregnancy

A

Initial: lifestyle modification + antacids
Subsequent: PPI’s OR H2RAs

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13
Q

Treatment of mild to moderate pulmonary hypertension in COPD

A
  • just treat COPD (pulmonary vasoactive medications have not been shown to relieve PH associated with COPD)
  • no need for RH cath
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14
Q

CSF pattern in GBS

A
  • albuminocytologic dissociation (high protein with normal (very low) WBC count)
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15
Q

Systemic sclerosis clinical features

A
  • Raynaud’s
  • GI: acid reflux, esophageal dysmotility, dyspepsia
  • skin findings: telangiectasia, digital ulcers, calcinosis cutis
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16
Q

antibodies positive in systemic sclerosis

A
  • antitopoisomerase

- anticentromere

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17
Q

general term for antibodies in myositis

A
  • antisynthetase antibodies
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18
Q

Management of serotonin syndrome

A

First line: benzos

Second line: cyproheptadine

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19
Q

Presentation of isopropyl alcohol ingestion

A
  • AMS + elevated osmolar gap + normal anion gap + ketonuria-ketonemia
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20
Q

methanol ingestion clinical features

A
  • visual dysfunction + CNS depression
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21
Q

brugada syndrome clinical features + EKG features

A
  • syncope + SCD

- ST elevations + RBBB

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22
Q

Lab features of infective endocarditis

A
  • leukocytosis
  • elevated ESR
  • decreased complement levels
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23
Q

Chronic constipation evaluation

A

IF alarm features – TSH, serum calcium before dietary modification

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24
Q

Treatment options for traveler’s diarrhea

A
  • quinolones
  • azithromycin
  • rifaximin
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25
Q

Red flags for elder abuse

A
  • unexplained traumatic injuries
  • pressure ulcers
  • abrupt changes in financial status or ability to pay
  • malnutrition
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26
Q

Electrolyte abnormalities commonly associated with hypomagnesemia

A
  • hypocalcemia, hypokalemia
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27
Q

initial workup of suspected SVC syndrome

A
  • CT chest
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28
Q

IPF clinical features

A
  • nonproductive cough, progressive dyspnea + Right sided heart failure + pHTN + crackles
  • clubbing
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29
Q

Only intervention that has been shown to improve survival in patients hospitalized with acute MI

A

PCI

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30
Q

NMS clinical features + causes

A
  • fever + muscle rigidity + autonomic instability
  • starting antipsychotics OR withdrawing dopamine agonists (either cause dopamine deficiency) (PD patients who stops taking carbodopa, levodopa)
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31
Q

Key feature of renal labs in multiple myeloma

A
  • discrepancy between amount of proteinuria on dipstick and quantitative proteinuria
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32
Q

What is a peak pressure?

A

Measures the resistance to flow air delivered by ventilator and the amount of pressure needed to inflate the lung

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33
Q

Typical cause of increased peak pressure

A

mucous plug (need to suction)

34
Q

Initial workup of cushing syndrome + caveat

A
  • low-dose overnight dexamethasone suppression test

* can’t use if on OCP because OCP increase total cortisol, resulting in a false positive

35
Q

GCA management

A
  • steroids

* aspirin (reduce risk of TIA and CVA)

36
Q

Other features of schistosomiasis

A
  • urticarial lesions, angioedema

- eosinophilia

37
Q

Hip osteoarthritis features

A
  • morning stiffness + **groin pain + pain radiating to knee
38
Q

occult hip fracture clinical features

A
  • severe and acute pain with internal and or external hip rotation
39
Q

AE of black cohosh

A
  • hepatic injury
40
Q

AE of St. John’s wort

A
  • hypertensive crisis
41
Q

AE of kava

A
  • severe liver damage
42
Q

indications for PrEP

A
  • high risk sexual behaviors or *IVDU
43
Q

Ogilvie syndrome clinical features

A
  • marked colon dilation without evidence of obstruction (autonomic nervous system dysfunction)
44
Q

Ogilvie syndrome treatment

A
  • supportive, serial abdominal exams, NG tube decompression, NPO
45
Q

Vocal cord dysfunction clinical features and question stem

A
  • describe patient diagnosed without asthma without typical symptoms (nighttime symptoms or response to beta-agonists and steroids)
  • throat tightness, choking sensation, dysphonia, inspiratory wheezing, *psychosocial triggers
46
Q

workup of suspected vocal cord dysfunction

A
  • repeat spirometry with flow-volume loop
47
Q

Management of Graves during pregnancy

A
  • PTU during first trimester

* methimazole during second and third trimesters

48
Q

Sequelae of membranous nephropathy know

A
  • VTE (renal vein thrombosis that can embolize, PE)
49
Q

calcium and phos levels in secondary hyperparathyroidism from vitamin D deficiency

A
  • PTH decreases urinary calcium excretion and increases urinary phos excretion, which normalizes serum calcium but lowers serum phos
50
Q

Interstitial cystitis clinical features

A
  • chronic pelvic pain + pain relieved with voiding
51
Q

hydroxychloroquine and pregnancy

A
  • safe for use and associated with improved outcomes in SLE
52
Q

Initial workup of SLE

A
  • check for antiphospholid antibodies at time of diagnosis of SLE in all patients, regardless of pregnancy or miscarriage history
53
Q

Methanol toxicity

A
  • AGMA + retinal toxicity
54
Q

Isopropyl alcohol toxicity presentation

A
  • elevated osmolar gap but NO increased anion gap metabolic acidosis
55
Q

treatment of methanol toxicity

A

fomepizole

56
Q

P falciparum malaria treatment

A

artemisinin

57
Q

P vivax, ovale, or p malariae treatment

A

artemisnin + primaquine (also need to treat liver forms)

58
Q

what are the SGLT2 inhibitors?

A

the -flozins

  • canagliflozin
  • dapagliflozin
  • empagliflozin
59
Q

Afferent pupillary defect

A

Swinging light test – swinging light to unaffected eye causes only mild constriction of affected eye

60
Q

malignant otitis externa

A
  • severe infection of external ear canal also commonly seen in uncontrolled diabetics but due to a bacterial infection
61
Q

pancreatic pseudocyst management in asymptomatic patient

A

Repeat imaging in 3-6 months

62
Q

Type 1 cryoglobulinemia association

A
  • heme diseases – plasma cell dyscrasia and **CLL
63
Q

timing of peripartum cardiomyopathy

A
  • last month of pregnancy + up to 6 months postpregnancy
64
Q

other term for labyrinthitis

A

vestibular neuritis (synonymous)

65
Q

mixed cryoglobulinemia complement levels

A
  • C4 low

- C3 normal or mildly decreased

66
Q

GLP-1 agonist drugs

A

exenatide, lixisenatide, liraglutide, albiglutide, dulaglutide, and semaglutide

67
Q

DPP-4 inhibitor drugs

A

sitagliptin, saxagliptin, linagliptin, and alogliptin

68
Q

keratosis pilaris presentation

A
  • dry, rough patches and tiny bumps, often on the upper arms, thighs, cheeks or buttocks (similar to my upper arms)
69
Q

GDMT steps

A

Step 1: ARB + beta-blocker + diuretic
Step 2: Aldactone
Step 3: SGLT2 inhibitor

70
Q

chlamydia presentation

A

dysuria, discharge

71
Q

When Rh immunoglobulin is indicated + timing of administration

A
  • All RhD negative mothers, regardless of fetal blood type
  • at about 28 weeks gestation (third trimester), and again shortly after delivery in the case of an RhD positive or RhD unknown baby.
72
Q

bronchial breath sounds indicate

A

consolidation or compression of the lung

73
Q

Indications for ICD in HOCM

A

1) history of cardiac arrest, VF, or VT
2) sudden death in one or more first-degree relatives
3) **LV wall thickness greater than 30 mm
4) unexplained syncopal eent

74
Q

Classic presentation of reactivation TB

A
  • upper lobe predominance with cavitation
75
Q

age cutoff where EGD is required for dyspepsia

A

60

76
Q

HCM vs athlete’s heart

A

HCM = eccentric + greater than 15 mm in thickness

77
Q

when to think about coronary artery dissections

A
  • otherwise, healthy young women
78
Q

when to recheck TTE after STEMI

A

3 months

79
Q

Initial treatment of acute lumbosacral radiculopathy

A
  • short course of NSAIDS

- PT if no improvement

80
Q

sweet syndrome medical term

A

acute febrile neutrophilic dermatosis

81
Q

sweet syndrome clinical features

A

fever + an elevated white blood cell count + tender, red, well-demarcated papules and plaques that show dense infiltrates by neutrophil granulocytes on histologic examination.

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