Mix9 Flashcards
What bacteria is most likely cause of infective endocarditis after a tooth extraction?
Strep viridans group : Strep mutans, sanguinis, sobrinus, milleri
What are the three stages of diabetic retinopathy?
- Background/simple retinopathy - microaneurysms, hemorrhage, exudates, and retinal edema.
- Pre-proliferative retinopathy - cotton wool spots
- Proliferative/malignant retinopathy - newly formed vessels.
** Argon laser photocoagulation is suggested treatment.
What diagnostic findings on x-ray would you expect in a case of osteoarthritis?
Narrowed joint space, osteophytes, and subchondral sclerosis/cysts.
How do x-ray findings of affected joints differ in the case of gout vs pseudogout?
Gout = punched out lesions with rim of cortical bone.
Pseudogout = chondrocalcinosis (calcification of joint cartilage) due to calcium pyrophosphate dihydrate deposition.
What immunohistochemical markers are used to identify hairy cell leukemia?
Dx of hairy cell leukemia is made by IHC. Cells are positive for CD103, CD 11c, and CD25 as well as the B cell markers CD 19,20,22.
What’s the first line treatment for hairy cell leukemia?
Purine analogs like cladribine or pentostatin.
What’s the main pharmacologic treatment options for BPH?
Alpha adrenergic antagonists (terazosin, tamsulosin) with or without 5 alpha reductase inhibitors (finasteride)
How can you tell the difference between acne vulgaris vs drug induced acne?
Acne vulgaris typically displays lesions in various stages of development, and is found in the face primarily in adolescents.
Drug induced acne typically has monomorphic papules (without assoc comedomes) and involves upper back, shoulders, and upper arms.
What’s the typical presentation of disseminated gonococcal infection?
Vesiculopustular rash, tenosynovitis, and migratory polyarthralgias/septic arthritis. Most patients are febrile and skin lesions are found on distal extremities.
Rx = ceftriaxone. Add doxy or azithromycin for chlamydia.
Inflammation of the distal interphalangeal joint (DIP), morning stiffness, and dactylitis with nail involvement are all pathognomonic for this disease:
Psoriatic arthritis. Classically involves DIP. ** MCP and PIP are involved in rheumatoid arthritis.
Dactylitis = sausage fingers.
Will also likely see enthesitis (inflammation at site of tendon insertion into bone)
Current treatments = NSAIDs, methotrexate, and anti-TNFa agents.
What antidote should be offered in the case of TCA poisoning?
Sodium Bicarb. This alleviates the inhibitory action of TCAs on fast sodium channels of the myocardium, involving hypotension, and decreasing the risk of fatal ventricular arrhythmias (by shortening QRS).
Cardiac toxicity due to TCA overdose manifests as prolonged QRS (>100 msec) and ventricular arrhythmias (VTach and Vfib).
Benzos are used to treat seizures induced by TCA overdose.
Cardiac auscultation revealing an ejection click followed by crescendo-decrescendo systolic murmur over the L second intercostal space and widened splitting of S2 are pathognomonic for what valvular condition?
Pulmonary Stenosis.
What’s the most common type of nephrotic syndrome associated with Hodgkin lymphoma?
Minimal Change Disease is the most common type of nephrotic syndrome in Pt with Hodgkin’s lymphoma.
** Membranous glomerulopathy is the most common type of nephrotic syndrome assoc with malignancies.
What kind of acid base derangement would be likely in the case of salicylate toxicity?
Acute salicylate toxicity leads to respiratory alkalosis (stimulates respiratory center in medullar»_space; tachypnea) AND a metabolic AG acidosis (uncouples ox phos in mitochondria leading to anaerobic metabolism) [» low HCO3 from acid buildup]
Two acid base disorders are present. There is a primary respiratory alkalosis with respiratory compensation for metabolic acidosis. There is also a primary metabolic acidosis with metabolic compensation for resp alkalosis.
SO you develop a mixed respiratory alkalosis and anion gap metabolic acidosis and pH is near normal.
Treatment is with alkalinization of urine or dialysis.
How does the presentation differ between early vs late Takayasu arteritis? What vessel is typically involved?
Takayasu arteritis is a chronic large artery vasculitis predominantly involving the aorta characterized by mononuclear infiltrates and granulomatous inflammation of vascular media»_space; arterial wall thickening and aneurysmal dilation or narrowing/occlusion.
Initial Sx = fever, arthralgia, and weight loss. Presents as Constitutional Sx, arthralgia and dermatologic Sx.
Later Sx = arterio-occlusive manifestations (claudication, distal ulcers) esp in upper extremities. Exam findings include BP discrepancies, pulse deficits, and bruits. CXR can can show aortic dilation and widened mediastinum.
