MISCELLANEOUS REVIEW 1-10 Flashcards
Abdominal pain, diarrhea (non-bloody), weight loss…usually chronic…WITH PAPULOVESICULAR RASH…also presents with bloating, fatigue, and weakness
celiac sprue!
associated with gluten intolerance
dermatitis herpetiformis
can also present from vitamin deficiency secondary to fat malabsorption leading to osteoporosis (form vit d deficiency), easy bleeding (vit k def) and megaloblastic anemia (vit b12 and folate)
Types of neuropathies associated with DM
femoral neuropathy
diabetic polyneuropathy
meralgia paresthetic
Mononeuropathy commonly associated wth DM; unilateral decerased motor strength of leg and decreased sensation
femoral neuropathy
symmetric and distal limb sensory and otor deficitis
diabetic polyneuropathy
meralgia paresthetic
paresthesias but no motor defecit
Women who use low dose estrogen oral contraceptives have 50% lower risk of cancer of the….
OVARY
inflammatory disorder ours in elderly patients (self limiting).
Main feature if hip and shoulder/muscle pain as well as pelvis
also presents with systemic symptoms like malaise, fever, depression, weight loss, fatigue
polymyalgia rheumatica
Labs for polymyalgia rheumatica
ESR usually elevated
Treatment for polmyalgia rheumatica
Corticosteroids (until disease is over, self limiting; resolved usually in 1-2 years
Refeeding syndrome is characterized by potentially fatal shifts in fluids and electrolytes that ay occur in malnourished patients receiing artifical feeding. What electrolyte abnormality is is assocaited with
hypophosphatemia
how to reduce risk of oral candidiasis in patients with asthma inhaler
metered dose and spacer
When to be proceed with layrngoscopy for hoarseness
if hoarseness persists for 3 months or more
most common cause of right heart failure
LEFT HEART FAILURE
also myocarditis, pulmonic stenosis, and VSD
Infectious mononucleosis management
-NOT ANTIVIRALS (NO BENEFIT)
- supportive therapy (hydration, NSAIDS, throat sprays)
-
How to manage hypercalcemia of malignancy
- FLUID REPLACEMENT FIRST WITH NORMAL SALINE
- once patient is euvolemic, PAMIDRONATE is the mainstay of treatment
Myomectomy vs fibroid embolization for symptomatic uterine fibroids
myomectomy - for those who wish to become pregnant in future, but needs general anesthesia and blood transfusion more likely
embolization - shorter hospitalization, less time off work, no general anesthesia required, blood transfusion unlikely to be needed
Black leopard spotting on colonic mucosa
melanosis coli - benign condition resulting form abuse of antrhaquinon laxatives such as cascara, senna, or aloe
Valsalva usually decreases length and intensity of most murmurs except for
murmur of hypertropic obstructive cardiomyopathy and mitral valve prolapse (NOT INSUFFICIENCY)
Overweight 12 year old male presents with left hip pain that gradually starts after playing tennis (no injury recalled). He is now walking with limp (afebrile, limited internal rotation)
slipped capital femoral epiphysis
if fever? - think septic artrhtis
If a patient or nursing home resident is losing weight or has suffered acute change in ability to perform ADL, what is an option for nutrition?
PEG tube (percutaneos endoscopic gastrostomy)
this is very uncomfortable and agitating so restraints may need to be used
What is a high risk patient for colon cancer and when should they start being screened for colon cancer?
patient with a first degree relative diagnosed before age 60 or at least two relatives with colon cancer (regardless of age)
should start screening at 40 or 10 years before earliest age that relative was diagnosed…then rescreened
What drugs can cause pleurisy?
HYDRALAZINE
Pharmacologic therapy for WPW
Procainamide
avoid digoxin, adenosine, or CCBs like verapamil or amlodipine since they can bring about vfib
Which antibiotic is contraindicated in 2nd and 3rd trimesters of pregnancy for tooth discoloration of fetus
doxycycline
Patients should be screened for TB before starting which gout treatment?
anti tumor necrosis factor inhibiting agents like infliximab! which is used if methotrexate doesn’t control disease…risk of reactivating TB
Cautious gait with visual impairment
wide stance, abducted arms and legs, “walking on ice”, trying to avoid falls
Presentation of influenza and when to initiate treatment
sudden onset fever, malaise, myalgias, rhinitis, cough, sore throat, headache
if you suspect clinically, START TREATMENT IMMEDIATELY