Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

2019 ABIM > Nov 21, 2019 > Flashcards

Nov 21, 2019 Flashcards

1
Q

When should you suspect blood transfusion associated graft-v-host

A

Donor lymphocytes attack host tissue in immunocompromized or close HLA matched patients

4-30 days post transfusion have erythematous/maculopapular rash

Anorexia, Abd pain, hepatomegaly, liver dysfunction, diarrhea

Pancytopenia from bone destruction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is the mortality rate of blood transfusion associated graft-v-host disease?

A

80-90%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is the decision point cut off size for pulmonary nodules in low to intermediate risk individuals?

A

8mm or >

FDG-PET or biopsy

<8mm

if 5-7mm serial CT

if 4 or less and intermediate risk then serial CT otherwise no follow up

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

PPx CD4 cutoffs

A

<200

PCP

<150

Histoplasma capsulatum

<100

Toxoplasma gondii

VZV

Any close contact with infective person and no hx of prior disease or negative antibody

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

PPx for PCP in HIV

A

CD4 <200 or Oropharyngeal candidiasis or hx of PCP

TMP/SMX or

Dapsone; Atovaquone; Pentamidine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

PPx for Toxoplasma in HIV

A

CD4 <100 & Positive IgG antibody

TMP/SMX or

Dapsone + Pyrimethamine + Leucovorin; Atovaqone +- Pyrimethamine + Leucovorin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

PPx for Histoplasma capsulatum in HIV?

A

CD4 < 150 & endemic area

Itraconazole

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

PPx for VZV in HIV?

A

If exposed with no prior hx of disease or negative ab

Give VariZIG or IVIG within 4 days of exposure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Antibodies in Drug-Induced Lupus?

A

DNA-histone complex

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

DNA-histone complex associated condition?

A

Drug induced lupus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Ab in SLE?

A

dsDNA

Sm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Antibodies in systemic sclerosis?

A

RNA polymerase II and III

Scl-70/anti-topoisomerase I

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

RNA polymerase II and III as well as Scl-70/anti-topoisomerase I are associated with?

A

Systemic Sclerosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Ab in MCTD?

A

RNP (ribonucleoprotein) ie Anti-U1-RNP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

RNP (ribonucleoprotein) ie Anti-U1-RNP Ab is associated with?

A

MCTD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Ab in Sjogren’s

A

SS-A/Ro, SS-B/La

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

SS-A/Ro, SS-B/La Asoociated with?

A

Sjogren’s

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Ab associated with Limited scleroderma?

A

Centromere

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Centromere Ab associated with?

A

Limited scleroderma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Ab associated with Polymyositis/Dermatomyositis?

A

Aminoacyl-tRNA synthetases (Jo-1)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Aminoacyl-tRNA synthetases (Jo-1) associated with?

A

Polymyositis, Dermatomyositis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Ab associated with Microscopic polyangiitis?

A

Myeloperoxidase

23
Q

Myeloperoxidase Ab associated with?

A

Microscopic polyangiitis

24
Q

Ab associated with Granulomatosis with polyangiitis (Wegener’s)

A

C-ANCA Proteinase 3 (PR3)

25
Q

C-ANCA Proteinase 3 (PR3) associated with?

A

Granulomatosis with polyangiitis (Wegener’s)

26
Q

Diagnostic criteria for MCTD?

A

Serologic Anti-U1-RNP ab

+ 3 or more of:
Swollen hands or fingers

Myositis or myalgia

Synovitis

Raynaud’s

27
Q

Most common cause of death in MCTD?

A

Pulmonary HTN

28
Q

What form of MCTD has the worst prognosis?

A

Those with scleroderma and polymyositis symptoms

29
Q

Ab associated with cutaneous systemic sclerosis?

A

Anti-DNA Topoisomerase

30
Q

Anti-DNA Topoisomerase is associated with?

A

systemic sclerosis

31
Q

Ab associated with microscopic polyangiitis?

A

P-ANCA, ie Myeloperoxidase (MPA)

32
Q

P-ANCA, ie Myeloperoxidase (MPA) is associated with?

A

Microscopic polyangiitis

33
Q

What is the treatment for Toxicodendron dermatitis?

A

(Poison ivy/oak) 2 weeks of therapy

Topical mid to high potentcy corticosteroids if early disease

Oral pred at 1mg/kg/day for severe or in cases with facial/periocular involvement or widespread disease

34
Q

What are the features of Systemic Sclerosis?

A

Systemic: Fatigue, Weakness

Skin: Telangiectasia, sclerodactyly, digital ulcers, calcinosis cutis

Extremities: Arthralgias, contractures, myalgias

GI: Esophageal dysmotility, dysphagia, dyspepsia

Vascular: Raynaud phenomenon

ANA, Anti-topoisomerase I (Anti-Scl-70) and anticentromere

35
Q

What are common complications of systemic sclerosis?

A

Lung: Interstitial lung disease, PAH

Kidney: HTN, Scleroderma renal crisis (oliguira, thrombocytopenia, MAHA)

Cardiac: Myocardial fibrosis, pericarditis, pericardial effusion

36
Q

Ab associated with RA?

A

Anti-CCP and RF

37
Q

Anti-CCP and RF associated with?

A

RA

38
Q

Antimitochondrial Ab (AMA) associated with?

A

Primary Biliary Cirrhosis

39
Q

Ab associated with Primary Biliary Cirrhosis?

A

Antimitochondrial Ab (AMA)

40
Q

What two carbapenems have better outcomes in ESBL?

A

Imipenem and Meropenem

41
Q

Causes of Hyperhidrosis?

A

Idiopathic

EtOH abuse

Opiod withdrawal

Hyperthyroidism

DM/Hypoglycemia

Menopause

Antidepressants

Insulin/oral hypoglycemics

SERM’s

Niacin

42
Q

How do you treat hyperhidrosis?

A

Topical aluminum chloride solution

Iontophoresis (Palms and soles)

Botulinum toxin

43
Q

Diagnostic criteria for pericarditis?

A

2 or more:

Typical chest pain

Pericardial friction rub

ECG changes (diffuse ST elevation, PR depression)

New or worsening pericardial effusion

44
Q

Diagnostic criteria for myopericarditis?

A

Definite pericarditis diagnosis

AND

Elevated cardiac enzymes

New depressed left ventricular function

Imaging (MRI) showing myocarditis

45
Q

Causes of pericardidis and myopericarditis?

A

Viral

Idiopathic

Bacteria

Fungi

Autoimmune (Lupus)

Neoplasm

ESRD

Post-cardiac injury (Dressler)

46
Q

How do you treat uncomplicated myopericarditis?

A

ie normal EF and no arrhythmias?

NSAIDS

+

Colchicine

Treat any identified underlying cause

47
Q

Clinical features of Microscopic colitis?

A

Watery, non-bloody diarrhea with fecal urgency and incontinence

Abdomial pain, fatigue, wt loss, arthraligas

Commoonly affects middle-aged women

48
Q

Diagnosis of microscopic colitis?

A

Normal CSP with biopsy of:

Collagenous colitis subtype: Thickented subepithelial collagen band

Lymphocytic colitis subtype: High levels of intraepithelial lymphocytes (20 or > for every 100 epi), focal cryptitis can be seen

49
Q

What are potential triggers for microscopic colitis?

A

Smoking

NSAIDs

PPIs

SSRIs

Ranitidine

50
Q

What is the treatment for microscopic colitis?

A

Stop possible triggers

Anti-diarrheal agents

Oral budesonide in persistant cases

51
Q

Causes of acute severe anemia in sickle cell?

A

Splenic sequestration crisis (children before autosplenectomy)

Aplastic crisis (Infection with B19, EBV, Strep pneumo, Salmonella)

Hyperhemolytic crisis (unclear etiology though may be due to multiple transfusions)

52
Q

Diagnostic criteria for MM?

A

Monoclonal protien in serum or urine (alternatively can use serum free light chain)

10% or greater clonal plasma cells in bone marrow or soft tissue/bone plasmacytoma

End-Organ damage (CRAB)

53
Q

Senile Purpura

A

Older adults due to vessel fragility from years of sun related damage

Ecchymotic lesions with occasional hyperpigmentation due to hemosiderin deposition

54
Q

Depression medication duration?

A

Single episode, 6months after control of symptoms then taper

Recurrent, chronic (2 or more years), severe (suicide) - 1-3 years following remission

Highly recurrent 3 or more lifetime episodes, severe/chronic MDD - Consider lifetime

2019 ABIM (5 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions