NBME 6 Flashcards
if someone is getting peritoneal dialysis then has a fever… what do you think of
peritonitis so get a gram stain to figure out what is causing the infection
what nerve causes the eyes reactivity to light
cranial nerve 2- optic nerve
what to think of when you have cramping abdominal pain with distention and n/v
small bowel obstruction
what to think of when you have hyperactive bowel sounds and pneumobilia (gas in the biliary system)
gallstone ileus
what to do if pt has potassium level > 6.5
give calcium gluconate before they have an arrhythmia and die
patient struggles to let go of something once they grasp it
myotonic muscular dystrophy
CTG repeat- cataracts, toupee, gonads small
pt presents with horners syndrome, ipsi face and temp loss, vestibular sings, vertigo, diplopia, diminished gag reflex and cerebellar probs, what do you think of
PICA infarct which comes off of the vertebral artery
pregnant pt presents with diarrhea/blood in stool and weird rash, what do you think of
IBD
possible Ulcerative Colitis
patient has hallucinations and weird movements (vermicular movements of the tongue and bilateral writhing motions)
huntingtons chorea
young pt gets sick a lot with infections and has lots of pus and PMNs found with infections
chronic granulomatous disease
- deficiency of NAPDH Oxidase
- trap bacteria but cant kill it (impaired phagocytic oxidative metabolism)
hilar lymphadenopathy with fever plus recent travel
think TB
post-partum pt presets with high cholesterol, lethargy, boredom, sleep and memory issues, hypernatremia, and weight gain
thyroid issue
any sort of abdominal bruit
renal artery stenosis likely due to atherosclerosis
what type of casts do you expect with dehydration
hyaline casts
what do you think of when you hear widened pulse pressure in adults vs babies
adult –> aortic regurg
baby –> PDA
-close the PDA with indomethacin
-keep it open with PGE1 (alprostadil)
why do glucocorticoids increase wbc and pmns
glucocorticoid-induced demargination and storage pool release of segmented neutrophils
second most common cause of constrictive pericarditis
radiation therapy comes after viral/idiopathic
how to tell the difference b/w bacterial and cryptococcal meningitis
CSF glucose will be low in both but wayyyy lower in bacterial meningitis
-bacterial will also present with higher fever (103+) and more toxic appearing pt
lady with increased calcium and hx of cancer… what do you do
increased risk of cervical spine compression so be sure to decompress the spinal cord and use a cervical stabilizer
compare and contrast polymyalgia rheumatica and fibromyalgia
polymyalgia rheumatica
- proximal stiffness > pain (normal strength), fever malaise, weight loss
- associated with giant cell arteritis (increased inflammatory markers)
- rapid response to steroids
fibromyalgia
- chronic, widespread musculoskeletal pain with tender points and a little stiffness, poor sleep, cognitive dysfunction
- treat with regular exercise, antidepresants, neuropathic pain agents
proximal muscle weakness with endomysial inflammation and CT8-T cells
-usually on the shoulders
polymyositis
little baby has a problem with heart, liver, and muscles (no splenomegaly) what do you think of?
pompe disease
-lysosomal acid alpha-1,4-glucosidase deficiency
*if they have splenomegaly then think of GM1 gangliosidosis
severe fasting hypoglycemia with increased glycogen in the liver, gout, and hepatomegaly
increased lactate: Von Gierke disease (glucose-6-phophatase deficient)
normal lactate: Cori disease
muscle cramps and myoglobinuria and pt has a second-wind phenomenon when exercising due to increased muscular blood flow
McArdle disease (myophosphorylase deficiency) -muscle cant break down glycogen
