Mix15 Flashcards
MCC of sepsis in SCD:
S pneumo (NOT Staph)
Rx for neonatal thyrotoxicosis from maternal anti-TSH R
Methimazole + BB. Generally self resolving after 3 mo
maternal anti-TSH R Ab (Graves) pass into placenta and bind baby’s TSH-R. Present as low birth weight infant w/tachy, warm/moist skin, and poor feeding/irritability.
Most likely cause of hearing loss in an AIDS patient:
Serous otitis media. Presents with dull hypomobile tympanic membrane. Due to auditory tube dysfunction from HIV lymphadenopathy or obstructing lymphoma.
Etiology of vulvar SCC:
Persistent HPV infection and chronic inflammation. Unifocal friable plaque or ulcer on labia majora that causes persistent vulvar irritation and/or pain.
Mammo screening guidelines:
Biennial for women 50-74
Why do you get ^ BUN in prerenal AKI?
Hypovolemia»_space; decreased renal BF»_space; activation of RAAS»_space; ^ resorption of Na and H2O»_space; passive reabsorption of urea
** kidneys don’t show actual injury (unless its prolonged and leading to ATN), so urine sediment in AKI is typically bland.
How do you differentiate Parkinsons Disease Dementia from Lewy Body Dementia?
By time to onset. PDD is diagnosed when parkinsonism predates cognitive changes by 1 year. In LBD though, the cognitive changes happen at the same time as parkinsonism.
Why do you use normal saline for initial correction of low BP in hypovolemic hypernatremia instead of free water or D51/2NS?
Don’t use hypotonic solutions because they quickly exit the intravascular system and lower serum sodium [ ] too rapidly
acute diffuse noninflammatory hair loss w/hair shafts easily able to be pulled out:
telogen effluvium. generally triggered by stressful event, is self limiting but may take up to a year to resolve
Which happens sooner after birth, gonorrhea or chlamydial conjunctivitis?
Gonorrhea (day 2-5) - purulent discharge. Rx = CTX IM
Chlamydia (day 5-14) - mucopurulent dc. Rx = Ertyhro PO
Pathophys of HIV assoc dementia:
macrophage mediated signaling pathway»_space; neuronal dysfunction. Subacute onset w/increasing apathy and impaired attention. May have subcortical dysfunction (basal ganglia, nigrostriatal) with slowed movement and problems with smooth limb movement.
Hawthorne bias:
subject of study changes behavior because they are aware they are under observation.
MOA of quetiapine:
2nd gen antipsych
MOA of fluphenazine:
high potency 1st gen
MOA of ziprasidone:
2nd gen antipsych
1st line Rx options for asymptomatic bacteruria:
Cephalex, amoxicillin-clavulanate, nitrofurantoin, fosfomycin
Azathioprine is a purine analog that is converted to 6-MP. Acts by inhibiting purine synth. The major toxicity of azathioprine is:
dose related diarrhea, hepatotoxicity, and leukopenia.
Major toxicity of mycophenolate:
Bone Marrow suppression
Cyclosporine and tacrolimus are both IL-2 transcription inhibitors. Cyclosporine is unique in that it causes ___ and ____ in addition to the following side effects shared with tacrolimus: Hyper K, glucose intolerance, nephrotoxicity, HTN, and tremor
hirsutism and gum hypertrophy.
Felty syndrome
Advanced RA with neutropenia and splenomegaly
Rx for neurocysticercosis:
albendazole (antiparasitic), corticosteroid (brain inflammation), and antiepileptic (phenytoin) for seizure
Effects of pregnancy on thyroid hormone levels;
Estrogen increases serum TBG levels, requiring an increase in the amount of thyroid hormone to saturate the binding sites. hCG stimulates TSH R to ^ thyroxine production. Total thyroid hormone levels ^ with a minimal increase in free T4 levels
13 mo old kid with erythematous, nonblanching rash on trunk and lower extremities. Developed fever, lethargy, and pos brudzinski sign. Dx and Rx?
Dx = meningococcal meningitis (Neisseria meningitis).
Rx = Penicillin and 3rd gen ceph
Pain, watering, and redness in the eye with vesicles and dendritic ulcers in the cornea:
Herpes simplex keratitis
Recommended dietary changes for Pt with Ca oxalate stones;
- Increase fluid intake
- Decrease sodium intake.
- Normal dietary Ca2+ intake
** Increased sodium enhances Ca2+ excretion. Low sodium intake promotes Na+ and Ca2+ reabsorption through effects on the medullary concentration gradient. Reabsorption of Na+ and Ca2+ is coupled by CaSR in TAL.
Respiratory distress and signs of noncardiogenic pulmonary edema within 6 hrs of receiving a blood transfusion:
TRALI (transfusion related acute lung infection) due to donor anti-leukocyte Ab.
Fever, flank pain, hemoglobinuria, and renal failure in a patient 1 hr after receiving a blood transfusion:
Acute hemolytic transfusion rxn due to ABO mismatch.
Bone conduction > air conduction on side of decreased hearing. Weber lateralizes to affected side:
Conductive hearing loss (stapes footplate becomes fixed to oval window)
Air conduction > bone conduction in both ears. Weber lateralizes away from affected side:
Sensorineural hearing loss (i.e. acoustic neuroma, Meneire’s, ototoxic drugs)
What is metoclopramide used for?
Prokinetic drug that can be used to treat diabetic gastroparesis. Presents with symptoms of anorexia, nausea, vomiting, early satiety, postprandial fullness.
