Miscellaneous 3 Flashcards
clinical features of secondary syphilis
- maculopapular rash on trunk and extremities
- patchy hair loss
- diffuse LAD
- hepatitis, uveitis
- often don’t have history of genital lesion
toxoplasma vs. PML
- 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
Management of recurrent UTI
- postcoital or daily prophylactic abx
first line meds for migraine ppx
- topamax
- depakote
- TCAs
- beta blockers
Management of secondary parkinsonism from dopamine receptor antagonists
- switch to a low risk agent (anticholinergics don’t work well)
Initial management of WPW
- exercise ECG OR EP study (either can identify patients at risk of sudden cardiac death)
Measles clinical features
- “3 Cs” - cough, conjunctivitis, coryza
- koplik spots (white lesions on an erythematous base)
Initial step in management of suspected measles
- airborne isolation (measles is highly infectious)
Initial management of atrial flutter with RVR
Ablation (high success rate in atrial flutter)
Management of dysphagia after a stroke
- modified barium swallow (oropharyngeal dysphagia common after CVA and other neurologic injury. Oropharyngeal dysphagia is best evaluated with a modified barium swallow)
Management of patient with severe AS requiring emergent surgery
- surgery with invasive hemodynamic monitoring (ensures adequate intravascular volume, preload, and SVR)
Management of GERD during pregnancy
Initial: lifestyle modification + antacids
Subsequent: PPI’s OR H2RAs
Treatment of mild to moderate pulmonary hypertension in COPD
- just treat COPD (pulmonary vasoactive medications have not been shown to relieve PH associated with COPD)
- no need for RH cath
CSF pattern in GBS
- albuminocytologic dissociation (high protein with normal (very low) WBC count)
Systemic sclerosis clinical features
- Raynaud’s
- GI: acid reflux, esophageal dysmotility, dyspepsia
- skin findings: telangiectasia, digital ulcers, calcinosis cutis
antibodies positive in systemic sclerosis
- antitopoisomerase
- anticentromere
general term for antibodies in myositis
- antisynthetase antibodies
Management of serotonin syndrome
First line: benzos
Second line: cyproheptadine
Presentation of isopropyl alcohol ingestion
- AMS + elevated osmolar gap + normal anion gap + ketonuria-ketonemia
methanol ingestion clinical features
- visual dysfunction + CNS depression
brugada syndrome clinical features + EKG features
- syncope + SCD
- ST elevations + RBBB
Lab features of infective endocarditis
- leukocytosis
- elevated ESR
- decreased complement levels
Chronic constipation evaluation
IF alarm features – TSH, serum calcium before dietary modification
Treatment options for traveler’s diarrhea
- quinolones
- azithromycin
- rifaximin
Red flags for elder abuse
- unexplained traumatic injuries
- pressure ulcers
- abrupt changes in financial status or ability to pay
- malnutrition
Electrolyte abnormalities commonly associated with hypomagnesemia
- hypocalcemia, hypokalemia
initial workup of suspected SVC syndrome
- CT chest
IPF clinical features
- nonproductive cough, progressive dyspnea + Right sided heart failure + pHTN + crackles
- clubbing
Only intervention that has been shown to improve survival in patients hospitalized with acute MI
PCI
NMS clinical features + causes
- fever + muscle rigidity + autonomic instability
- starting antipsychotics OR withdrawing dopamine agonists (either cause dopamine deficiency) (PD patients who stops taking carbodopa, levodopa)
Key feature of renal labs in multiple myeloma
- discrepancy between amount of proteinuria on dipstick and quantitative proteinuria
What is a peak pressure?
Measures the resistance to flow air delivered by ventilator and the amount of pressure needed to inflate the lung
Typical cause of increased peak pressure
mucous plug (need to suction)
Initial workup of cushing syndrome + caveat
- low-dose overnight dexamethasone suppression test
* can’t use if on OCP because OCP increase total cortisol, resulting in a false positive
GCA management
- steroids
* aspirin (reduce risk of TIA and CVA)
Other features of schistosomiasis
- urticarial lesions, angioedema
- eosinophilia
Hip osteoarthritis features
- morning stiffness + **groin pain + pain radiating to knee
occult hip fracture clinical features
- severe and acute pain with internal and or external hip rotation
AE of black cohosh
- hepatic injury
AE of St. John’s wort
- hypertensive crisis
AE of kava
- severe liver damage
indications for PrEP
- high risk sexual behaviors or *IVDU
Ogilvie syndrome clinical features
- marked colon dilation without evidence of obstruction (autonomic nervous system dysfunction)
Ogilvie syndrome treatment
- supportive, serial abdominal exams, NG tube decompression, NPO
Vocal cord dysfunction clinical features and question stem
- 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
workup of suspected vocal cord dysfunction
- repeat spirometry with flow-volume loop
Management of Graves during pregnancy
- PTU during first trimester
* methimazole during second and third trimesters
Sequelae of membranous nephropathy know
- VTE (renal vein thrombosis that can embolize, PE)
calcium and phos levels in secondary hyperparathyroidism from vitamin D deficiency
- PTH decreases urinary calcium excretion and increases urinary phos excretion, which normalizes serum calcium but lowers serum phos
Interstitial cystitis clinical features
- chronic pelvic pain + pain relieved with voiding
hydroxychloroquine and pregnancy
- safe for use and associated with improved outcomes in SLE
Initial workup of SLE
- check for antiphospholid antibodies at time of diagnosis of SLE in all patients, regardless of pregnancy or miscarriage history
Methanol toxicity
- AGMA + retinal toxicity
Isopropyl alcohol toxicity presentation
- elevated osmolar gap but NO increased anion gap metabolic acidosis
treatment of methanol toxicity
fomepizole
P falciparum malaria treatment
artemisinin
P vivax, ovale, or p malariae treatment
artemisnin + primaquine (also need to treat liver forms)
what are the SGLT2 inhibitors?
the -flozins
- canagliflozin
- dapagliflozin
- empagliflozin
Afferent pupillary defect
Swinging light test – swinging light to unaffected eye causes only mild constriction of affected eye
malignant otitis externa
- severe infection of external ear canal also commonly seen in uncontrolled diabetics but due to a bacterial infection
pancreatic pseudocyst management in asymptomatic patient
Repeat imaging in 3-6 months
Type 1 cryoglobulinemia association
- heme diseases – plasma cell dyscrasia and **CLL
timing of peripartum cardiomyopathy
- last month of pregnancy + up to 6 months postpregnancy
other term for labyrinthitis
vestibular neuritis (synonymous)
mixed cryoglobulinemia complement levels
- C4 low
- C3 normal or mildly decreased
GLP-1 agonist drugs
exenatide, lixisenatide, liraglutide, albiglutide, dulaglutide, and semaglutide
DPP-4 inhibitor drugs
sitagliptin, saxagliptin, linagliptin, and alogliptin
keratosis pilaris presentation
- dry, rough patches and tiny bumps, often on the upper arms, thighs, cheeks or buttocks (similar to my upper arms)
GDMT steps
Step 1: ARB + beta-blocker + diuretic
Step 2: Aldactone
Step 3: SGLT2 inhibitor
chlamydia presentation
dysuria, discharge
When Rh immunoglobulin is indicated + timing of administration
- 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.
bronchial breath sounds indicate
consolidation or compression of the lung
Indications for ICD in HOCM
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
Classic presentation of reactivation TB
- upper lobe predominance with cavitation
age cutoff where EGD is required for dyspepsia
60
HCM vs athlete’s heart
HCM = eccentric + greater than 15 mm in thickness
when to think about coronary artery dissections
- otherwise, healthy young women
when to recheck TTE after STEMI
3 months
Initial treatment of acute lumbosacral radiculopathy
- short course of NSAIDS
- PT if no improvement
sweet syndrome medical term
acute febrile neutrophilic dermatosis
sweet syndrome clinical features
fever + an elevated white blood cell count + tender, red, well-demarcated papules and plaques that show dense infiltrates by neutrophil granulocytes on histologic examination.
