Mixed Questions Flashcards
1
Q
painless abdo bleeding in 60 year old
A
ANGIODYSplasia
- dilated submucosal wins and AV malformation
2
Q
sudden onset abode pain and tenderness followed by bloody diarrhea within 24 hours
A
ischemic colitis
3
Q
if SSRI fails for depression what do you use
A
- make sure you have an adequate trail of SSRI - 6 months
- SNRI ( Venlafaxine)
- or other 1st line : Bupropion ( c/i in anorexia) , mirtazapine
4
Q
conversion disorder
A
dx. of exclusion
- neurological symptoms inconsistent when you do the exam
functional impairment
precipitated by psych stress
Treatment:
- education about disorder, CBT , physical modalities for motor symptoms
5
Q
watery diarrhea in 26 year old female - think of what?
A
laxative abuse
- ,melanosis coli - dark brown discolouration with pale patches of lymph follicles
6
Q
failure of follicle to mature - other name?
A
PCOS
7
Q
failure of mullein duct fusion
A
anatomic cause of infertility
8
Q
what complication occurs within days - months after cardiac surgery
A
PARACARDIAL EFFUSION
9
Q
x-ray findings in Pulmonary embolism
A
atelectasis
10
Q
decreased passive and active abduction flexion and rotation at the left shoulder
A
adhesive capsulitis
decrease passive and a active range of motion
11
Q
pain with abduction external rotation and subacromial tenderness
A
Rotator cuff tendinopathy
12
Q
rotator cuff tear
A
similar to rotator cuff tendiopathy but weakness with external rotation age > 40
13
Q
acute GI symptoms , forgetfulness, motor and sensory neuropathies ( stocking and glove distribution) , microcytic anemia
A
LEAD POSSIONING Labs: - anemia - elevated venous lead level - elevated since protoporphyrin level - basophilic stippling on peripheral smear
14
Q
when do you give penicillin to treat GBS
A
before onset of labour - if treated too early before labour starts - you can get bacterial regrowth
15
Q
DDX for bilious vomit in neonate
A
- meconium ileus
- hirchsprung
- malrotation
- Duodenal atresia
16
Q
mittelschmerz
A
unilateral abdo pain in young women ( days 10-14 of cycle )
- reassurance
17
Q
suspect nursemaid elbow - what do you do?
A
gently hyperpronate the right forearm
OR supination of forearm and flexion of elbow
x-ray is NORMAL
18
Q
cause of acanthuses nigicans
A
- insulin resistance
2. gastrointestinal malignancy
19
Q
multiple skin tags
A
insulin resistance
pregnancy
crowns disease ( periano)
20
Q
Porphyria cutanea tarda
A
Hep C
21
Q
sudden onset of severe psoriasis , recurrent herpes zoster , disseminated molluscs contaginosum
A
HIV infect
22
Q
severe seborrheic dermatitis
A
HIV
Parkinson disease
23
Q
Pyoderma gangrenosum
A
inflammatory bowl disease
24
Q
pneumonitis, hepatitis , gastroenteritis - in immunocompromised patient
A
think CMV
Dx: PCR
25
what type of shock is a lady who had a placenta abruption
```
HYPOVOLEMIC SHOCK
- decrease RA pressure
PCWP - decrease
Cardiac infer - decrease
after load - increase
MvO2 - decrease
```
26
if patient developed EPS on first gen antipsychotic what treatment should she go on?
Zipasidone (low risk metabolic profile)
| Olanzapine ( AVOID in diabetics - b/c weight gain and metabolic effects
27
fever cough low grade fever
bad breath and fluctuant ass in patients neck
elderly
zener's diverticulum
28
dx and ZD
contrast esophagram
Tx: surgery
29
varicella post exposure prohyplaxis
hx of immunity ( prior infection or 2 doses of vaccine)
Yes - observe
No - immunocompetent - varicella vaccine
No - immunocompetent - VZIG
30
x-ray and CT finding of PE
X-ray - hampton hump
| CT - wedge shaped pleural based opacification
31
x-ray shows widened mediastinum and barium studies show a dilated esophagus with a smooth tapering of the distal esophagus
what is it? hx of difficult swelling solid then liquid
ACHALASIA
32
possible achalasia - how to confirm Dx?
endoscopic evaluation
| can differentiate b/e achalasia and pseudoachalasia
33
MOA of clopidogrel
P2y12 receptor blocker
34
screening for lung cancer
Annual low dose chest CT in patients 55-80 with >30 pack year history - who are currently smoking or quit within the last 15 years ) - reduce cancer mortality
35
when is DEXA scan used for screening?
Women grater than or equal to 65 or at high risk using FRAX tool
36
calf is swollen tense and exquisitely tender, worse with passive extension of the knee
Compartment syndrome
- if pain is out of proportion
- clue: WORSE pain on passive stretch
37
dx of PJP
done on microscopy with specialized stains
38
best way to prevent measles spread
airborne precautions
39
macupapular rash that starts at head and spreads to body but spares palms and soles
measles
40
patient fetus has anencephaly - ROM at 35 weeks what do you do?
just let her do expectant vaginal delivery
| - the baby is non viable anyways so no point of corticosteroids
41
patient has stroke then becomes depress
its important to tell them there are treatments for depression that can help you feel better
42
causes of RDS
prematurity
maternal diabetes
male sex
prenatal asphyxia
43
treatment of bipolar disease that is not being controlled with one agent
Lithium OR valproate acid
PLUS
2nd gen antipsychotic
44
turner syndrome
increase risk for decrease bone mineral density
45
clinical of congenital hypothyroidism
```
apathy
weakness
hypotonia
large tongue
sluggish movements
```
Tx: levothyroixine
46
specific infection of dementia v.s normal aging
if patient is getting lost in familiar places
47
fibroadenoma in adolescent - what do you do?
examine after next menstrual cycle
- if decrease --> reassurance
- if increase --> ultrasound
48
renal angioblastomas ass . w/ what condition
tuberous sclerosis ( facial angiofibromas, hyper pigmentation macules, ash leaf spot)
49
incase of unilateral bloody discharge with normal mammogram
intraductal papilloma
if abnormal mammogram - pages disease
50
cause of otitis external
pseudomonas
| s. aures
51
HIV positive , water diarrhea, low grade fever, WL CD4 < 180
Cryptosporidium
52
CD4 <100 watery diarrhea, crampy diarrhea, WL, fever is rare
microsporidium isosporidium
53
water diarrhea, high fever>39 , WL Cd4<50
MAC - mycobacterium avium complex
54
frequent small volume diarrhea, hematochezia, abode pain, low grade fever , WL , Cd4< 50
Cytomegalovirus
55
whats beck triad
distended neck veins
muffled heart sounds
hypotension
56
what does cardiac tamponade cause
decrease left ventricular preload
57
when do you do surgery in patient with FAP
early 20s - does not need to be an urger surgery
58
what happens to glucose with thiazide
s/e hyperglycaemia
59
s/e of thiazides
- increase LDL and cholesterol
- hyperglycaemia
- high plasma triglycerides
- hyperurecemia
- hypokalemia
- hypomagnesemia
- hypercalcemia
60
pancytopenia in 30 year old women
SLE - due to destruction of RBC
61
HTN and undetectable plasma to renin ratio
```
primary hyperaldosteronism
(cause adrenal adenoma, bilateral adrenal hyperplasia)
```
62
what does pernicious anemia increase your risk for
gastric cancer ( increase by 2X)
63
what organism is responsible for deep wound infections following puncture wounds
Pseudomonas aeruginosa
| osteomylitis
64
ludwig angina
rapidly progressive submandibular and sublingual spaces
source of infection - most commonly an infected mandibular molar
65
test for C.diff
stool toxin testing
66
what kindly problem do patients with HSP get?
- medangial deposition of igA mediated small vessel vasculitis
67
postcholecystecomy syndrome
abdominal pain or dyspepsia ( nausea) that occurs wither postoperatively or months after cholecystectomy
68
treatment of postcholecystectomy syndrome
ERCP
69
mucopurulent urethral discharge in sexually active person who has absence of identifiable bacteria on culture or gram stain - what is Dx?
Chlamydia urethritis
| NEED Nucleic acid amplification testing
70
first treatment of BPH
alpha blockers
THEN 5 alpha reductase
71
does OCP increase or decrease risk of endometrial and ovarian cancer
DECREASE risk of both cancer
72
battery diarrhea, decrease acid secretion, flushing, lethargy, N V muscle weakness cramps
Dx and lab values
VIPOMA
- labs :
hypo Kalemia
Hypercalcemia ( increase bone resorption)
Hyperglycaemia due to increased glycogenolysis
Stool studies show secretory diarrhea with sodium and osmolal gap < 50 mmOsm/kg
73
VIPOMA location
tail of pancreas on abode ct
74
bladder cancer screening
no screening require
| - even if heavy smoker or family history
75
difference b/w acute stress disorder and adjustment disorder
Stress disorder - as// w life threatening traumatic event - get flashbacks, nightmares
Adjustment disorder - stressor or multiple terrors ex: living alone for first time, living away from home , academic stress etc. develops within 3 months
76
risk of developing what if baby has bronchiolitis
apnea ( esp if infant < 2 months)
| resp failure
77
marfanoid habits
mutation in fibrillar 1 gene
78
difference b/w marphans and homocystinuria
```
homocystinuria will also have
- Marphinoid features
PLUS
- fair skin
- intellectual disability
- thromboembolism
- LENS DISSOCIATION downward ( not upward)
```
79
PATIENT tries to give gift to doctor - what should they say
i appreciate your thank you... but i am unable to accept gifts
Exceptions to saying yes to gifts: cost, type , timing , intention of gift
If patient has a mental illness - accepting gift not appropriate b/c it may affect their judgement
80
causes of thyrotoxicosis with decrease RAIU
- painless ( silent thyroiditis)
- subacute ( deQuervain) thyroiditis
- amiodarone induced thyroiditis
- excess dose of levothyroxine
81
treatment of painless thyroiditis
propanolol - may be prescribed to control symptoms of adrenergic overstimulation - such as palpitations or tremulousness
82
what booster vaccine do you get from age 11-18
meningococcal poster vaccine ( if primary vaccine age < 16)
83
follicular thyroid cancer vs. benign follicular adenoma
- invasion of timor capsule or blood vessel - more likely follicular thyroid cancer
84
suspect Cushing disease - what do you test?
24 hour urinary cortisol excretion
Late night salivary cortisol assay
Low dose dexamethasone suppression txt
( low acuity for morning cortisol level b/c - overlap in cortisol level in normal subjects and those with cushing disease
85
chest x-ray reveals spotty calcifications along left heart border - what is dx?
constrictive pericarditis
- right heart failure with pericardial knock ( mid diastolic sound), , elevated JVP and calcifications on CXR)
86
asthma v.s COPD
look for > 12% increase in FEV1 before and after bronchodilator use
87
MOST common cause of kidney stones
calcium oxalate stones
88
calcium phosphate stones
common in :
- hyperparathyroidism
- renal tubular acidosis
89
His patient with PPD test > 5mm - what do you do?
since it is > 5mm - consider positive
do C-ray
if positive - treat active TB
if negative and No symptoms --> treat as latent TB -- 9 month of ionized and pyridoxine
90
danger of CPK levels
this is most likely due to rhabdomyolysis
high CPK levels --> acute renal tubular necrosis due to myoglubinuria
91
difference b/w axonopathy of small nerve fibers and large nerve fibers
small - with be ass/ with POSITIVE symptoms - pain, parenthesis, allodynia
Large fibers - NEGATIVE symptoms - numbness, loss of proprioception and vibration sense, diminished ankle reflexes
92
most common cause of glomerulonephritis in adults
IgA nephropathy - recurrent episodes of gross hematuria usually within 5 days of URTI
- differentiated from Post infectious GN based on earlier onset of upper res tract infection related GN and normal serum complement level
93
treatment of SVT in hemodynamic instability patient
go straight for synchronized cardioversion
if stable - could d o vagal maneuvers and adenosine
94
when do you get free wall rupture post acute MI
within 5 days to 2 weeks
- chest pain
- shock
- distant hear sounds
Echo
- pericardial effusions with tamponade
95
when do you get papillary muscle rupture
acute or within 3-5 days
- SEVERE pulmonary edema
- new holosystolic murmur r
96
inter ventricular septum rupture - when you see it
acute or within 3-5 days post MI
- chest pain
- NEW holosystolic murmur
- biventricular faliure
- shock
97
left ventricular aneurysm
up to several months post MI
- subacute heart failure
- stable angina
98
where is Eikenella bacteria found
mouth flora
- think HACEK organisms
99
CT shows CT scan with several nodular lesions with surrounding ground glass opacities in the right upper lobe
invasive aspergillosis
Train
- fever
- chest pain
- hemoptysis
Postive biomarkers 0 galactomannan , beta D glucan
100
what happens in garish Herzhiemer reaction
rapid lysis of spirochetes
- within 6-48 after initiating treatment for syphilis
-
acute fever , chills and myalgia and reach progression in secondary syphilis
101
TREATMENT of vasovagal syncope
1. reassurance
2. avoidance of triggers
3. counter pressure techniques for recurrent episodes
102
large amount of blood in urine with relative absence RBC on urine microscopy - what do you think?
myoglobinuria - caused by rhabdomyolitis - leads to acute renal failure
- you will also see HIGH potassium in labs
103
Causes of recurrent episodes of pneumonia
involving same region
1. local airway obstruction ( neoplasm, FB)
2. recurrent aspiration ( seizures, alcohol, drug use, non infections- vasculitis, BOOP)
Involving different regions of the lung
1. Immunodeficiency ( hiv, leukemia, CvID)
2. sinopulmonary disease
3. non infections
104
when do you dx. impaction of gallstone in the ileum
normally Dx preoperatively
105
acute cholecystitis is impaction of gallstone where
in the cystic duct
106
difference b/w gallstone in cystic duct vs. gallstone
Cystic duct - Upper right quadrant pain
CBD - normally by gallstone or cancer - usually has JAUNDICE
107
18 weeks pregnant and noticed to have a 7cm solid mass in ovary with hyperangrogenism symptoms - what do you do?
observation and expectant management
hyperandrogenism symptoms - with ovarian mass - think LUTEOMAS - resolves spontaneous after delivery
108
increase gastric residual volume and abdominal distention in preterm
THINK NEC
- look for pneumatosis intestinal ( intramural air and portal venous air on x-ray
109
symptoms of intracranial hypertension
nausea , vomitting
mental status exam
focal neurological
110
mass on hard palate of a young individual
think torus palatinus
- no surgery
- benign growth
111
example of selection bias
sampling bias
nonresponse bias
berkkson bias - decrease studied using only hospital based patients
prevalence bias ( Neyman bias) - exposure that happen long before disease assessment can cause study to miss disease patients that die early or recover
attrition bias - loss of study participants may cause loss of follow up bias
112
what bias is considered loss to follow up
selection bi
| ases
113
difference b/w leukemoid reaction and CML
```
Leukemoid
- WCC > 50 000
- cause- severe infection
- LAP score - high
MORE neutrophils > bands
```
```
CML
- elevated WCC > 100 000
BCR-ABL fusion
Low LAP score
Less mature neutrophils (Blast > neutrophils)
Absolute basophilia may be present
```
LAP = leukocyte alkaline phosphatase
114
3 month history of low grade fever, night sweats , productive cough and WL, skin involvement and lytic bone lesions from Wisconsin - think?
BLASTOMYCOSIS
- fungal infection near Great lakes, mississippi river and ohio river
x-ray resembles Tb and histoplasmosis
Characteristic feutre = ulcerative skin lesions and lytic bone lesions
115
best treatment for chronic venous insufficiency
LEG ELEVATION
- helps with the incompetence venous valves
then compression stockings
exercise
116
why do you get eyelid protosis in graves disease
orbital tissue expansion
117
increase intraocular pressure causes
glaucoma
118
how can hypo magnesium cause refractory hypokalemia
due to the removal of inhibition of renal potassium excretion and should be suspected in patients that is difficult to correct potassium
119
what electrolyte abnormalities can be caused by hypoalbunemia
hypocalcemia
120
treatment for a patient with a single brain metastasis
surgically accessible location and good performance status
followed by stereotactic radio surgery or whole brain radiation therapy to the tumour bed
121
patient is on insulin basal and metformin - has okay surgards in the morning but high HbA1c - what is the cause
hyperglecmic events postprandial
122
funds shows cupping of optic disc what is dx?
primary open angle glaucoma
123
what is the cause of hypoclaemia after person receives blood transfusion
calcium chelation by a substance in the transfused blood
124
meds that cause hyperkalemia
```
B-blocks
ACE inhibitors
K sparing diuretics
Digoxin
Cyclosporin
Heparin
NSAIDS
Succinylcholine
TMP/SMX
```
125
what antibiotic causes hyperkalemia
TMP/SMX
126
what drugs can be used to help prevent recurrent nephrolithiasis
thiazide diuretics
urine alkalization - with potassium citrate/ bicarbonate sale )
allopurinol ( for hyperuricosuria related stones)
127
mid ear effusion without signs of active infection
serous otitis media
| - exam will show: Dull tympanic membrane that is hypomobilic on pneumatic otoscope
128
dull tympanic membrane that is hypo mobile on otoscope
non infectious effusion
129
boss of a patient calls you to ask if he is in hospital what is your response
i can confirm that the patient is currently hospilitized and i anticipate he will be able to return to work
130
constrictive pericarditis causes
US:
- viruses, cardiac surgery, chest radiation and idiopathic causes
Developing countries - TB ( Africa, india , china )
131
what effects dose systemic sclerosis has on the esophagus
- atrophy and fibroses of the smooth muscle in the lower esophagus ( leads to decrease peristalsis and decrease tone in the lower esophagus)
132
what bacteria is in the mouth
viridian's group streptococci
133
how to tell if it is vomitting or diarrhea
diahrea - will have bicarb loss
vomitting - will have urinary chloride LOW
134
nephrotic syndrome then presents with hematuria -
think renal infarction
renal vein thrombosis is an important complication of nephrotic syndrome
MOST likely ass/ w/ membranous glomerulopathy
135
what should patients with idiopathic thrombocytopenia purport be investigated for
hep C and HIV
- treating the underlying infection can affect the platelet count
136
patients with plantar puncture wound through footwear who develop osteomyltitis - due to what organism
pseudomonas aeruginosa
137
sever burns - wat infection are you at risk of
gram negative sepsis
138
treatment of CF with S.aurea infection
vancomycin
139
most common cause of bacterial pneumonia in young children with CF
s. aures
140
tremor without any gait changes what should you think
think essential tremor eat with propranolol
141
what type of hearing loss is prescycusis
sensorineural hearing loss
142
for TB skin testing - what is considered a negative test
anything < 15mm in a otherwise healthy person - no need to get CXR
143
HIV cD4 = 80, CXR has bilateral reticulonodular opacities with hilar lymphadenopathy and elevated aminotransferase levels - what do you think
Urine histoplasma antigen
144
alcoholic hallucinations vs. delirium tremens
alcoholic hallucinosis :
- visual auditory or tactile
- intact orientation
stable vitals
Delirium tremens
- confusion, agitation , fever, tachycardia , hypertension, diaphoresis, hallucinations
145
patient has asthma attack, intubated then exulted and develops muscle weakness and hand tremor - what do you do?
do serum electrolytes - patient most likey has low K+ from a lot of beta 2 agonist
146
factor V Leiden
activated protein C resistance
147
clinical manifestation of methemoglobin
Clinical
- cyanosis
- pulse oximetry - 85%
- dark chocolate coloured blood
labs
- saturation gap
- normal PaO2
- normal A-a gradient
148
Child < 2 years UTI - what is next
usually do renal and bladder US
if hydronephrosis or scarring seen in new borns < 1 month and children age <2 years with recurrent UTI - then thats when you do a voiding cystouretrogrma
149
TB CSF findings
WBC - 5-1000
Glucose < 10
Protein > 250
150
viral CSF findings
WBC 100-1000
Glucose normal
Protein < 100
151
Management of hypernatremia
Normal saline hydration plus calcitonin
AVOID LOOP DIURETICS UNLESS VOLUME OVERLOAD
Long term - bisphosphnates
152
AKI hypternsion and systemic sclerosis - what is happening?
patient has scleroderma renal crisis which can develop 5 years after Dx
- schistocytes
Urinalysis - will show mild proteinuria
153
target cells
hemoglobinopathies (thalseemia)
| chronic liver disease
154
Spur cells
liver disease
155
Burr cells ( also known as echinocytes) - speculated appearing red blood cells with serrated edges
- liver disae
| - end stage renal disease
156
besides antipsychotics what other meds can cause acute dystonia
metoclopramide ( dopamine agonist)
157
acute limb schema - what is the cause
major cardiac sources of arterial emboli
158
most common bacteria for brain abscess
viridian's streptococci
S. aureus
- gram negative organism
159
young patient with FEVER and ring enhancing lesions n CT what do you think of ?
HIB positive? - too
If HIV negative - think brain abscess - viridians , s. acres, gram negative organisms
160
cardiac auscultation reveals ejection click followed by crescendo decrescendo systolic murmur over the left second intercostal space and widened splitting of the S2
pulmonary stenosis
| - congenital defect that remain asymptomatic until adulthood
161
patient has infective endocarditis and hx of UTI - what bacteria do you think is common for causing IE
think enterococci
162
gingival manipulation and resp tract incision or biopsy
viridian's
163
drugs that cause acute interstitial nephritis
TMP SMX
penicillins
Cephalosporin
NSAID
164
what is the most common cause of chronic MR in developed countries
MVP - from myxomatous degeneration of the mitral valve leaflet
165
when is Tdap vaccine recommended
recommended at the age of 11 and then every 10 years after that
166
when do you get HPV vaccine
age 10/11
167
ureic pericarditis
occurs in patients with renal failure
BUN > 60
TREATMENT - hemodialysis
168
elevated ALP and CB - what is diagnosis
this is indicative of cholesttasis
| - the patient should have an US of the right upper quadrant
169
what BP med should you give for patients with primary hyperaldosterone
you should give aldosterone antagonist - spirolactone , eperenone
170
anti topoisomerase - Dx
Scleroderma
Same as anti SCL 70
171
respiratory acidosis following Surgery - what is diagnosis
alveolar hypoventilation
172
what metabolic findings can hypothyroidism cause
HYPERLIPIDEMIA
hyponatremia
CK increase
increase serum transaminase
173
high calcium and hilar mass in left lung
think squamous cell carcinoma
Real: if bilateral and hypercalclemia think sarcoidosis
174
s/e of nitropurside
cyanoide toxicity
- skin: flushing, cyanosis
central nervous system: headache , altéré mental status , seziure
CV: arrhythmia
Resp: tacypnea
GI: abdo pain
Renal : metabolic acidodi from lactic acidosis / renal failure
175
bright sharply demarcated erythema at perianal area with itchiness
think perianal streptococcus infection
treat with oral penicillin or amocillin
176
what is affected with pronator drift?
pyramidal tract disease of the upper extremities
177
labs in primary hyperaldosteronism
Aldosterone pushes out K+ and saves NA
178
decrease tactile fremitus
pleural effusions
179
dullness on percussion
think consolidation of the lung
180
what type of kidney issue does amyloidosis cause
nephrotic syndrome
181
treatment of renal calculi
increase fluid intake
limit salt intake
normal dietary calcium
182
fever , back pain and focal spinal tenderness with elevated ESR - what do you do?
think patient most likely has vertebral osteomyelitis
- DO A MRI and the n CT guided needle aspiration and biopsy
if only know the history of back pain fever and focal tenderness - then do ESR and X-ray first then go into MRI
183
fixed upper airway obstruction on flow volume loop
looks like a circle without regular shape
Cause laryngeal edema - something obstructing airway
184
what type of pattern with pneumothorax and pulm edema show on flow volume loop
restrictive pattern
| - shows decrease flow volume with expiratory flow rates that are increased relative to the lung volumes
185
how does primary lymphoma of the thyroid present
rapidly progressive thyroid enlargement with compression of surrounding structures
- increase risk in a patient with Hashimotos thyroiditis
186
what do you think in a post op patient with hypotension , jugular distension and new onset right bundle branch block
massive pulmonary embolism
187
what is showed to decrease ventricular remodelling after MIR
ACE inhibitor - should start within 24 hour of MI
188
when do you do prophylaxis for MAC in HIV patients
CD 4 < 50
| give azithryomycin
189
how does mycobacterium avid complex present
these patients will have never abode pain, diarrhea, night sweats and WL
Splenmegly
ELEVATED ALK Phosphate
190
why can you get hypotension in acute pancreatitis
b/c you can get an intravascular volume loss secondary to local and systemic vascular endothelial injury
Vasodilation increase vascular permeability and plasma leak into the retroperitoneal resulting in hypotension
191
why do you get anemia in vit B 12 deficiency
defect in DNA synthesis
192
if someone has blood glycemic control of 7.5% - what is the benefit of decreasing it down to 6.5%
ONLY helps with microvascular complications
- decrease change of retinopathy
- won't change the microvascular complication - MI, Stroke
193
unilateral varicose that fails to empty when a patient is recumbent raises suspicion for
RCC
| - CT scan should be done
194
best treatment of heart block
cardiac pacing
