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Medicine > osmosis review > Flashcards

osmosis review Flashcards

1
Q

what is erythrasma

A

usually presents as sharply demarcated erythematous plaques or brown scaly patches of skin that is more common in people that are obese and have diabetes. itchy and uncomfortable.

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2
Q

what is the causal organism for erythrasma

A

corynebacterium minutissimum

gram positive bacillus

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3
Q

what is the treatment for erythrasma

A

topical benzoyl peroxide, oral erythromycin and topical clindamycin

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4
Q

what is a confirmational test for erythrasma

A

woods lamp shows distinct coral red appearance

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5
Q

what is lipodermatosclerosis

A

inflammatory condition of the subcutaneous tissue associated with chronic venous insufficiency and obesity. i

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6
Q

how does lipodermatosclerosis

A

thickening of the skin, scaling, redness, pain and bowling pin shape to the lower leg. the fibrosing region is inflexible and allows the edema to pool in the feet and above the ankle

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7
Q

what is the most common cause of epididymitis in sexually active patients under the age 35.

A

chlamydia or gonorrhea

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8
Q

what is the treatment for epididymitis

A

ceftriaxone and doxycycline

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9
Q

what disorders does arsenic exposure cause

A

squamous cell carcinoma of the skin, angiosarcoma of the liver and lung cancer

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10
Q

what is the treatment for non-hodgkins lymphoma

A 
CHOP therapy 
cyclophosphamide 
hydroxydaunorubicin 
oncovin (vincristine) 
prednisone 
rituximab is added for b cell origin
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11
Q

what is the therapy for Hodgkins lymphoma

A

(A)driamycin (also known as doxorubicin/(H)ydroxydaunorubicin, designated as H in CHOP)
(B)neomycin
(V)inblastine
(D)acarbazine (similar to (P)rocarbazine, designated as P in MOPP and in COPP)

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12
Q

what is pontiac fever

A

legionellosis that resembles influenza and it often goes unreported and clears spontaneously

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13
Q

what is legionella pneuophilla

A

causal organism for legionaires and pontiac and this is a gram negative bacterium

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14
Q

what is borrelia lymphocytoma

A

bluish-red nodular swelling in the context of disseminated lyme disease (dizziness, joint pain, palpitations

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15
Q

what is the first line treatment for lyme in adults and children

A

doxycycline and amoxicillin

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16
Q

what is the most common cause of death in marfan syndrome

A

aortic dissection

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17
Q

what causes urge incontinence

A

detrusor muscle overactivity

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18
Q

what is the treatment for urge incontinence

A

nonpharmacologic methods such as lifestyle modification (fluid restriction, avoidance of caffeine), bladder retraining, and pelvic floor muscle (PFM) exercise.

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19
Q

what SSRI is safe for breastfeeding

A

paroxetine

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20
Q

Which inflammatory bowel disease is associated with noncasseating granuloma

A

crohns

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21
Q

Which inflammatory bowel disease is associated with ankylosing spondylitis

A

ulcerative colitis

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22
Q

what are the causes of acute pancreatitis

A 
I GET SMASHED
idiopathic
gallstones
ethanol
trauma
steroids 
mumps viral infection
autoimmune 
scorpion sting
hypertriglyceridemia
ERCP trauma
drugs --sulfa drugs or reverse transcriptase inhibitors
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23
Q

what is telogen effluvium

A

when the body undergoes a sudden shock such as pregnancy or childbirth it can cause noticable but temoory hair loss

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24
Q

what is the first line treatment for psoriasis

A

topical steroids

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25
Q

what is the second line therapy for psoriasis

A

UVB light therapy

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26
Q

what is the third line therapry for psoriasis

A

PUVA or psoralen and ultraviolet light

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27
Q

what is the most common cause of PID

A

chlamydia 5:1 to gonorrhea

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28
Q

what is the PID that causes perihepatic adhesions

A

fitz-hugh-curtis

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29
Q

what is the most life threatening consequence of toxic epidermal necrosis

A

sepsis.

although dehydration is also an important cause of mortality

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30
Q

what is the most important lab to monitor in a burn patient for administration of fluids

A

urine output

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31
Q

what is the cause of endogenous cushings

A

elevated cortisol due to increased stimulation of the adrenals by the pituitary stalk secreting ACTH.

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32
Q

what test works for diagnosing exogenous cushings

A

dexamethasone suppression test

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33
Q

what is fanconi syndrome

A

proximal convoluted tubules dysfunction leading to loss of phosphate and potassium causing polyuria, polydipsia, dehydration

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34
Q

what is hyper-IgE syndrome of Job syndrome

A

inherited syndrome that causes immunodeficiency. presents with atopic dermatitis, coarse facies, staph abscesses, increased IgE and retained primary teeth.

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35
Q

what must be done in boorehave’s syndrome

A

first figuring it out that it is, then CT scan, then surgery. CT is important for aiding the disangosis and planning the intervention

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36
Q

what is the best way to reverse warfarin

A

immediate reversal of the warfarin effect can be accomplished by IV delivery of factors II, VII, IX and X
or prothrombin complex concentrates

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37
Q

what is the treatment for hyperemesis gravidarum

A

IV saline with thiamine and potassium

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38
Q

what is typically elevated in choriocarcinoma and can males have this?

A

rare form of testicular cancer, but yes males can have this. BhCG

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39
Q

what is elevated in yolk sac tumor and can males have this

A

yes, very rare form of testicular cancer. usually elevated AFP

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40
Q

what is elevated in seminoma

A

usually no markers are elevated

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41
Q

what is epidymititis-orchitis

A

This when trauma causes the testicle to swell rapidly and the scrotum becomes enlarged, tender and red. it can be very painful.

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42
Q

what is autoimmune thyroiditis

A

this is hashimotos and is the most common cause of hypothyroidism. commonly presents with antibodies to thyroglobulin or thyroid peroxidase. histology shows hurtle cells with lymphoid germinal centers

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43
Q

Vibrio vulnificus

A

a gram-negative rod bacteria present in marine environments. Infection may occur either via ingestion, typically from raw or undercooked shellfish, or by infecting open wounds with the bacteria through contact with contaminated water. The ability to cause wound infections distinguishes Vibrio vulnificus from Vibrio parahaemolyticus.

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44
Q

what is the most specific test for autoimmune hepatitis

A

Anti-smooth muscle antibody is most specific test for autoimmune hepatitis.

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45
Q

what is a Pyogenic granulomas

A

benign polypoid capillary hemangiomas that can ulcerate and bleed. They are associated with trauma as well as hormonal changes during pregnancy

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46
Q

what is gauchers disease

A

result of mutations in the gene encoding the protein for glucocerebrosidase, causing an accumulation of glucocerebrosides, and ultimately leading to pancytopenia, hepatomegaly, splenomegaly, and, classically, the “Erlenmeyer flask” sign on long bone radiographs

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47
Q

what is the proper management for a person that had a TIA

A

these people are at high risk for a stroke. they need a stroke work up. look at carotids and MRI. anti platelets also necessary

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48
Q

what does high does of allopurinol do?

A

put patients at a greater risk for developing serious cutaneous drug reactions, including Steven-Johnson Syndrome (SJS), Toxic Epidermal Necrolysis (TEN) and Drug-induced hypersensitivity (DIHS).

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49
Q

what is the most important thing for diagnosing alcoholic liver disease

A

AST/ALT>2, elevated gamma-glutamyl and juandice

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50
Q

what is Neutropenic enterocolitis

A

a life-threatening condition that involves transmural inflammation of the cecum. It is also known as ileocecal syndrome or typhlitis. It occurs in patients who are myelosuppressed, most commonly due to cytotoxic chemotherapy. The immediate management should be the same as any suspected bowel obstruction with bowel rest, nasogastric tube insertion, and IV fluids.

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51
Q

what causes elephantitis

A

Wuchereria bancrofti is a form of filariasis. owing to lym­phatic obstruction in the presence of an inflammatory reac­tion to the adult filarial worms. It is spread by the bite of a mosquito

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52
Q

The prognosis for melanoma is most strongly correlated with

A

he depth of invasion, Breslow thickness, at the time of discovery.

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53
Q

what is the treatment and course for bacterial vaginosis

A

Treatment is with a 7 day course of oral metronidazole

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54
Q

what is the PRSS-1 gene

A

gene implicated in hereditary chronic pancreatitis

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55
Q

what is CADASIL

A

Cerebral Autosomal Dominant Arteriopathy with Subcortical Infarcts and Leukoencephalopathy (CADASIL) is an autosomal dominant leukodystrophy. It is characterized by migraine with aura, subcortical ischaemic events on MRI, dementia, mood disturbances, and ataxic hemiparesis as a result of ischaemic strokes.

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56
Q

How does HIV-ASssociated neurocognitive disorder present

A

pectrum of disorders encompassing HIV-associated dementia and encephalopathy. MRI shows symmetric, periventricular hyperintensity.

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57
Q

how does progressive multifocal leukencephalopathy present

A

Histopathology shows a diagnostic triad of demyelination, abnormal astrocytes, and enlarged, infected oligodendrocytes. neurological deficits such as altered mental status, motor impairment, ataxia, and visual disturbances. Lesions are non-enhancing, asymmetrical, and preferentially located in the periventricular and subcortical white matter areas

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58
Q

how is PML diagnosed

A

brain biopsy

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59
Q

Branchial cleft cysts

A

are congenital anomalies due a persistent cervical sinus during development. The 2nd cleft is most common and most likely presents as a lateral neck mass anterior to the sternocleidomastoid muscle. hey often swell after an infection and may become infected and swell.

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60
Q

what is the triad of diabetes, liver failure, and pseudogout

A

this is hereditary hemachromatosis

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61
Q

what is the prophylaxis for neutropenic fever

A

antipseudomonals (cefepime, zosyn (piperacillin/tazobactem) and meropenem)

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62
Q

what is the first imaging study for erythema nodosum and why

A

CXR because the two most common causes are sarcoidosis and TB

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63
Q

what is type I cryoglobninemia

A

lymphoproliferative or hematologic; typically asymptomatic, hypervicosity with thrombosis, can present with livedo reticularis and Purpura. COMPLEMENT NORMAL

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64
Q

type II/III cryoglobinemia

A

associated with HCV.HIV SLE, causes arthralgia, fatigue, HTN, glomerulonephritis, dyspnea, pleurisy, palpable Purpura. LOW COMPLEMENT C4

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65
Q

what pneumonia is associated with COPD

A

Hemophilus influenza

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66
Q

what pneumonia is associated with alcoholism/diabetes

A

klebsiella

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67
Q

what pneumonia is associated with poor dentition and aspiration

A

anaerobes

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68
Q

what pneumonia is associated with young and healthy patients

A

mycoplasma

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69
Q

what pneumonia is associated with hoarseness

A

chlamydia pneumonia

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70
Q

what pneumonia is associated with contaminated water, air-conditioning, ventilation systems

A

lengionella

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71
Q

what pneumonia is associated with birds

A

chlamydia psittaci

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72
Q

what pneumonia is associated with animals giving birth and farming

A

coxiella burnetti

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73
Q

what is patellofemoral pain syndrome and what usually causes it

A

this is weakness in the knee that is worse when sitting for long periods or climbing stairs, can feel like buckling. This is typically caused by vests medialis obliquus

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74
Q

what is the PSA/staging for low risk

A

less than 10 or T1c/T2a

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75
Q

when are abdominal AA treated?

A

when they are above 4cm they should be treated or expanding at a rate greater than 0.3 cm annually

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76
Q

what drugs are associated with drug-induced lupus

A

hydralazine, isoniazid, procainamide

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77
Q

what is the most specific test for drug-induced lupus

A

anti-histone antibodies

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78
Q

what does small cell lung cancer look like

A

tends to occur centrally in larger airways with neuroendocrine differentiation and cells resembling lymphocytes

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79
Q

what is cerebral autosomal dominant Arteriopathy with Subcortical Infarcts and Leukoencephalopathy

A

is an autosomal dominant leukodystrophy resulting in progressive degeneration of vascular smooth muscle cells. It is characterized by migraine, dementia, mood disturbances and ataxic hemiparesis due to ischaemic strokes, occuring in the absence of traditional cardiovascular risk factors.

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80
Q

what can exacerbate pustular psoriasis

A

cig smoking

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81
Q

which type of infections cause acute glomerulonephritis

A

GAS skin and pharyngeal infections

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82
Q

which type of infections cause acute rheumatic fever

A

pharyngeal infections

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83
Q

what is the best form of ventilation for CHF

A

postive pressure ventilation

84
Q

what drugs should CHF patients be on?

A

ACEi/ARB and beta blockers.

either carvedilol, bisopropolol or sustained release metoprolol

85
Q

what is gestational hypertension

A

BP over 140/80 after 20 weeks gestation. it is not accompanied by other signs of preeclampsia

86
Q

what is the familial melanoma gene

A

CDKN2A

87
Q

what is the purified protein test

A

TB test.

88
Q

what can TB do in the eye?

A

cause vision changes and pain due to infection of the choroid

89
Q

what type of cataract does Cushing’s syndrome cause

A

posterior sub capsular cataract

90
Q

what is the typical age related cataract

A

nuclear sclerotic cataract

91
Q

what is sezary syndrome

A

T cel lymphoma that is more likely to manifest as widespread erythroderma and present with atypical lymphocytes. involves mature CD4 lymphocytes. More likely to have lympohadenopathy

92
Q

what is mycosis fungicides

A

Extremely similar to sezary syndrome, but doe snot usually have lymphadenopathy or widespread erythroderma

93
Q

what is tertiary hyperparathyroidism

A

usually due to long standing secondary hyperparathyroidism and when the parathyroids have become autonomous, secreting parathyroid hormone indeterminate of the level of calcium

94
Q

what is the haplotype for asian populations that contraindicates carbamazepine treatment due to SJS/TEN

A

HLA-B*1502

95
Q

what is the definition of asymptomatic bacteriuria

A

greater or equal to 100,000 CFU/mL

96
Q

what are the risk factors for asymptomatic bacteriuria

A

diabetes, history of UTI, multiparty

97
Q

what are the common organisms for asymptomatic bacteriuria

A

E coli, klebsiella, enterobacter, group B strep.

98
Q

what are the first line treatments for asymptomatic bacteriuria

A

cefalexinw, amoxicillin, nitrofurantoin, fosfomycin

99
Q

what is the difference between neurogenic and vascular claudication

A

vascular is relieved by rest and independent of positioning. Neurogenic claudication does not improve with rest and is usually more responsive to repositioning

100
Q

what is the best way to measure nitric oxide levels

A

measure the serum thiocyanate levels.

101
Q

what is the most definitive test for myasthenia

A

electromyography

102
Q

when do you see acidophilic bodies on liver biopsy

A

typically during hepatocyte apoptosis, due to viral infection

103
Q

what is allergic bronchopulmonary aspergillosis

A

is a condition caused by a hypersensitivity reaction against Aspergillus fumigatus. This condition is most common among patients with asthma or cystic fibrosis. Major findings include eosinophilia, elevated serum concentration of total IgE, and bronchiectasis.

104
Q

what is the presentation of gestational trophoblastic neoplasia

A

vaginal bleeding and pulmonary symptoms with elevated bHCG

105
Q

when can PML happen to crohns patients

A

when they are severely immunocompromised on natalizumab

106
Q

what is the most common type of abdominal aneurysm

A

splenic artery

107
Q

what is cyclic vomiting syndrome and what is the treatment

A

is a condition characterized by discrete episodes of intractable vomiting with periods of weeks or months without any symptoms. Abortive treatment for cyclic vomiting episodes includes anti-emetics such as ondansetron, and prophylaxis includes anti-migraine drugs such as sumatriptan and amitryptiline.

108
Q

what is leukovorin prescribed for

A

for synergistic activity with 5-FU or with methotrexate.

109
Q

what is the SE for 5FU

A

pancytopenia. watch blood counts

110
Q

what is the CD4 count in HIV to prophylax for toxoplasmosis

A

<100

111
Q

How is PID treated

A

OUTPATIENT unless complicated with IM ceftriaxone and doxycycline

112
Q

what is complicated PID

A

Indications for hospitalizations are pregnancy, non-adherence to therapy, inability to take oral medications due to nausea and/or vomiting, as well as complicated PID with abscess formation.

113
Q

what test should Neve rbe ordered for Boerhaave

A

endoscopy

114
Q

what is the test to diagnose and then confirm borehaave

A

CXR and ct scan

or gastrogaffin studhy

115
Q

what is the treatment for PCP if allergic to TMPSFX

A

pentamidine or dapsone

116
Q

what does lichen sclerosis look like and what does it put you at risk for

A

white thin atrophic skin usually involving the vulva. it usually itches and becomes excopritated. puts at risk for squamous cell carcinoma

117
Q

what happens top ferritin in iron deficiency anemia

A

it is classically decreased. it is the most sensitive for iron stores. when low, true iron deficiency anemia.

118
Q

how to diagnose non small cell lung cancer from a CXR

A

look for the golden S sign off the pleura

119
Q

what causes an inverted T wave

A

Increased intracranial pressure due to intracranial hemorrhage can lead to T wave inversions appearing on an electrocardiogram. Other causes of T wave inversions include certain types of cardiomyopathy (apical or yamaguchi type), other severe central nervous system disorders that increase intracranial pressure, acute coronary ischemia, massive pulmonary embolisms, and Wellens’ syndrome.

120
Q

what EKG changes occur in hypomagnesemia

A

prolonged QT intervals.

121
Q

what are the two most common causes of acute pancreatitis

A

1) gallstone disease

2) alcoholism

122
Q

If someone on warfarin is put on antibiotics why should their dose of warfarin be reduced

A

because antibiotics can kill the normal flora that make vitamin K in the gut and this could increase bleeding risk

123
Q

what is the most important step in management of anaphylaxis

A

epinephrine administation

124
Q

what is the preferred rehydration therapy for burn victims

A

lactated ringers

125
Q

what is the gold standard for diagnosing necrotizing faciitis

A

surgical exploration and biopsy’

126
Q

what is Fomepizole udsed fo

A

methanol or ethylene glycol poisoning

127
Q

what is nutcracker syndrome

A

Nutcracker syndrome occurs when the left renal vein gets compressed by the superior mesenteric artery (SMA) and the abdominal aorta (AA). Try to imagine the SMA and the AA as a nutcracker, cracking the “nut” of the left renal vein. In the CT scan image, the red arrow points to the left renal vein that is compressed.

128
Q

what is a good prognostic indicator for squamous cell carcinoma histology

A

keratin pearls

129
Q

what is a Christmas tree cataract

A

this is a cataract that looks like it has small flecks in it and is associated with myotonic dystrophy.

130
Q

what is used to treat hypertension in the setting of aortic dissection

A

beta blockers, such as propranolol

131
Q

what is anti-ccp

A

this is anti-cyclic citrulinated peptide. this is highly associated with rheumatoid arthritis.

132
Q

what is the presentation of mumps

A

fever, orchitis, parotitis

often presents with aseptic meningitis

133
Q

Since insulin is low in type II DM what can be measured to determine insulin use>

A

C-peptide. if its low, with poor glucose function, then insulin should be initiated.

134
Q

what happens when someone with protein C deficiency gets warfarin

A

they have warfarin skin necrosis.

135
Q

what is the treatment with warfarin skin necrosis

A

discontinue warfarin, administer vitamin K and heparin

136
Q

what is the definition of first degree heart block

A

is asymptomatic. It is characterized by PR-interval prolongation on ECG. To diagnose the condition, the patient’s PR-interval must be greater than 200ms (five small boxes, or one large box).

137
Q

what is the definition of second degree type 1

A

This is also known as Mobitz I or Wenckebach. It is characterized by a progressive prolongation of the PR-interval on successive beats, followed by a dropped QRS-complex. The condition is usually asymptomatic but can cause fatigue, exercise intolerance, and syncope.

138
Q

what is the definition of second degree type 2

A

This is also known as Mobitz II. It is characterized by intermittently conducted P-waves (dropped QRS-complexes) that are not preceded by progressive prolongations of the PR-interval. There is usually a fixed number of non-conducted P-waves for every successfully conducted QRS-complex (e.g. 2:1, 3:1).

139
Q

third degree heart block

A

This is a condition in which the electrical impulse generated by the sinoatrial node is not propagated to the ventricles. The ECG in the question shows this condition clearly. As the ventricular rate is approximately half the atrial rate, this rhythm at first glance appears to be second-degree AV block (type 2) with 2:1 conduction.

140
Q

what is gastric volvulus

A

when the stomach twists on its own mesentery. There are two types. Organoaxial (more common in adults) and mesenteroaxial (more common in children).

141
Q

how does diabetes affect the skin

A

Xerosis reduces the elasticity and causes a breakdown making it more susceptible to infection

142
Q

what are the symptoms of mercury poisoning

A

sweating, leg pain, visual field deficits, renal failure

143
Q

how do we differentiate primary and secondary adrenal insufficiency

A

aldosterone levels will be decreased in primary insufficiency, while they will be normal in secondary (pituitary insufficiency)P

144
Q

what are the risk factors for mesenteric ischemia

A

increased age, atrial fibrillation, previous MI

145
Q

what is giant cell arteritis and the treatment

A

causes unilateral headache and jaw claudication, is often associated with polymyalgia rheumatica, an inflammatory condition that presents with aching and morning stiffness of the proximal joints. Due to the possible complication of permanent blindness, patients with suspected GCA should be treated immediately with glucocorticoids.

146
Q

when does concentric hypertrophy occur

A

in the context of chronic hypertension due to the increased afterload

147
Q

what is the underlying cause of amarosis fugax

A

atherosclerosis

148
Q

how does henock-shonlein purpura present

A

classic clinical triad of palpable purpura petechia in dependent areas, migratory arthritis, and abdominal pain.

149
Q

what is osteosclerosis and what is the most common cause

A

a type of osteopetrosis characterized by hardening of bone and an elevation in bone density. One of the most common causes of osteosclerosis is prostate cancer metastases to the axial skeleton.

150
Q

what is acute tubular necrosis and what are the causes

A

condition commonly related to episodes of significant hypotension leading to renal hypoperfusion, leading to necrosis of proximal convoluted tubule epithelium. Muddy brown casts in the urine are virtually pathognomonic.
Acute Tubular Necrosis (or ATN), secondary to renal ischemia that resulted from his injury/hemorrhage.

151
Q

what is Lichen sclerosis

A

Lichen sclerosis results in epidermal thinning and dermal fibrosis, resulting in a white patch and chronic inflammation that can be extensive enough to constrict the vaginal orifice. It is associated with an increased risk of squamous carcinoma.

152
Q

what material are staghorn calculi most commonly made of

A

struvite

153
Q

what are the available treatments for psoriasis

A

topical retinoids, light therapy, immunosuppressants, methotrexate and biologicals like taltz. usually do NOT use steroids because this can make it worse when removed and other treatments are more effective

154
Q

what organs are removed in a whipple procedure

A

head of the pancreas, duodenum, proximal jejunum, gallbladder, common bile duct, distal stomach

155
Q

what is included in the treatment of TB if peritoneal TB is suspect

A

addition of corticosteroids for a few months may reduce the incidence of late complications

156
Q

what is the causal organism for esophageal achalasia

A

Trypanosoma cruzi

157
Q

what is the treatment for MS exacerbation

A

IV methylprednisolone and oral prednisone

158
Q

What can happen when there is long standing osteomyelitis or chronic infection

A

This increase in inflammation due to chronic inflammation can lead to squamous cell carcinoma

159
Q

what is the definition of leukomoid reaction

A

characterized by an increased white blood cell count exceeding 50,000/mm3 and an increase in early neutrophil precursors in blood serum.

160
Q

how do you differentiate between CML and leukomoid

A

A hallmark differentiating feature from chronic myeloid leukemia (CML) is the increased activity of leukocyte alkaline phosphatase, patients with CML, will have low leukocyte alkaline phosphatase.

161
Q

what are the benign benign of calcification

A

diffuse, mental/complete, popcorn, laminated/concentric

162
Q

what is the presentation of hypersensitivities pneumonitis

A

alveolar inflammation in response to allergen exposure. Common findings are lymphocytosis and imaging with ground-glass opacities in addition to symptoms of fever, chills, shortness of breath, cough, and malaise.

163
Q

what are the radiological findings of celiac disease

A

imaging and biopsy of the GI mucosa show a characteristic blunting of distal duodenal and jejunal villi. This is often associated with a compensatory “jejunization” of the ileum to enhance nutrient absorption.

164
Q

what type of hypersensitivity is allergy to bee stings

A

type I

165
Q

give examples of type II hypersensitivity and what causes

A

graves and good pastures. molecular mimicry.

166
Q

what type of hypersensitivity is poison ivy what is another example

A

type IV delayed hypersensitivity

PPD test

167
Q

what do you do for someone that is status and Benzos are not working to control seizures

A

Induce sedation with propofol and intubate

168
Q

what are brown tumors and what are they associated with

A

hyperparathyroidism
Osteitis fibrosa cystica is a rare manifestation in severe cases that is characterized by the appearance of brown tumors on X-ray.

169
Q

what is the difference between membranoproliferative I and II

A

The location of the immune deposits leads to subdivision of MPGN into two types. MPGN I (primary/idiopathic) is characterized by subendothelial deposits, and MPGN II (dense deposit disease) is characterized by deposits within the glomerular basement membrane (GBM).

170
Q

how does decompression sickness usually present (the bends)

A

The most key part of the diagnosis here is the acute-onset of symptoms (i.e., joint pain, hypoxemia, shortness of breath, and fatigue) in the context of a recent training dive. Decompression sickness is a pressure-related injury that results from dissolved gasses coming out of solution into nitrogen bubbles

171
Q

the most appropriate first treatment for the bends is what

A

oxygen administration

172
Q

which arthritis involves the metacarpalphalangeal joints

A

rheumatoid

173
Q

which arthritis involves the proximal interphelangeal joints

A

Both rheumatoid and osteoarthritis

174
Q

which arthritis affects the distal phalangeal jointsd

A

psoriatic

175
Q

what is gitelmans syndrome

A

an autosomal recessive condition of the renal tubules in which the distal convoluted tubule is unable to reabsorb sodium chloride. As the sodium chloride wasting causes a diuretic effect, these patients experience mild hypovolemia, which causes the release of aldosterone and renin. Accordingly, this leads to dumping of potassium and hydrogen ions in an effort to reabsorb more water. Laboratory serum studies may show hypokalemia, metabolic alkalosis, hypomagnesemia, and hypocalciuria.

176
Q

what syndrome is similar to gitelmans but less severe?

A

bartters syndrome

177
Q

what causes hepatic angiosarcoma

A

working with PVC or VCM

178
Q

what is the best diagnostic test for boerhaave syndromes

A

water-soluble contrast esophageal

179
Q

what is the AIRE gene mutation syndrome

A

history of increased otitis media and respiratory infections as well as what seems to be a chronic Candida infection should immediately be considered a possible immunosuppressed patient. Most likely the patient has chronic mucocutaneous candidiasis, which is commonly caused by mutation in the autoimmune regulator syndrome. Chronic mucocutaneous candidiasis is an immune disorder of T cells that is characterized by chronic infections with Candida albicans.

180
Q

what is important to exclude in hyperemesis gqavidarum

A

molar pregnancy. need ultrasound and B-HCG

181
Q

what is the presentation of amniotic fluid embolus

A

characterized by hypotension, hypoxemia, and coagulopathy (disseminated intravascular coagulation

182
Q

what is the only way to confirm the diagnosis of Adenomyosis

A

hysterectomy and hstoligica evaluation s

183
Q

what is cholelithiasis

A

more commonly known as gallstones, is a common condition that is generally asymptomatic.

184
Q

what is choledocholithiasis

A

refers to gallstones within the common bile duct (CBD). Patients with CBD stones present with abdominal pain and elevated hepatic enzymes in a cholestatic pattern, but do not demonstrate Murphy’s sign and are initially afebrile. Symptoms associated with choledocholithiasis include right upper quadrant abdominal or epigastric pain, nausea, and vomiting.

185
Q

what is acute cholecystitis

A

Acute cholecystitis presents with colicky right upper quadrant pain, fever, and leukocytosis. Patients with cholecystitis usually present with a positive Murphy’s sign.
this is inflammation that typically follows cystic duct obstruction

186
Q

what is the gold standard for diagnosing bacterial meningitis

A

CSF culture. this is the most specific

187
Q

what drugs are used to control hypertension in pregnancy

A

nifedipine, labedelol, hydralazine

188
Q

what murmurs are the most serious and require follow up every time, usually with echo

A

diastolic murmurs need to be followed up. these usually indicate a valvular insufficiency

189
Q

what are the treatments for asymptomatic bacteruria in pregnant patients

A

cephalexin,

190
Q

what is the antibody associated with scleroderma

A

anti-topoisomerase

191
Q

what is the anticardiolipin associated with

A

this antiphospholipid syndrome

192
Q

what is ANCA associate with

A

wegeners and others vasculitis

193
Q

what are the best ways to reduce gouty attacks

A

reduce alcohol consumption, low fat diets, decrease fish and red meats, diuretic use, and weight loss

194
Q

what does diphenhydramine toxicity look like

A

this has anticholinergic properties with antihistamine properties. there will dry mouth, dilated pupils, herthermia, urinary retention, decreased bowel sounds.

195
Q

what is the first line treatment for women with female pattern hairloss and what is this pattern of loss

A

at the vertex with loss at the midline. there is follicular miniaturization. topical minoxidil is the first line treatment.

196
Q

when do you use finasteride or spironolactone o women with hairloss

A

when they have excess androgens and symptoms of excess hair like hirsutism

197
Q

what is the difference between urate crystals and calcium pyrophosphate crystals

A

calcium crystals are fat and rhomboid, uric acid are long and thin.

198
Q

can orthostatic hypotension result in LOC

A

yes. very commonly

199
Q

what is the normal hearing test resutls

A

air conducts greater than bone. when bone conduction is greater than air conduction then that’s the ear with conductive hearing loss.

200
Q

when you see C diff what should come to mind

A

healthcare settings, antibiotic use, watery, foul-smelling diarrhea, bloody stool is atypical.

201
Q

when you see C perfrigens in the context of diarrhea, what should you think

A

common cause of toxin-0mediated, food-borne illness diarrhea with non-bloody diarrhea.

202
Q

when you see rotavirus

A

think common cause of.nonbloody diarrhea and vomiting in children, but can occur in adults.

203
Q

What is the difference between nocardia and actinomyces

A

actinomyces: gram positive, branching rods that are anaerobic. treatment with penicillin G.
nocardia: grampositive, branching rods, disseminated infections. aerobic, treat with TMP-SMX

204
Q

what heart murmur is usually heard in Marfan syndrome and why

A

aortic root dilation frequently leads to chronic aortic regurgitation identified as an early decrescendo diastolic murmur.

205
Q

what is the stain for cryptococcal meningitis

A

india ink

206
Q

pustular lesions after swimming or at the gym

A

this is most likely gram negative folliculitis and caused by pseudomonas this is self limited and will go away with hygiene

Medicine (14 decks)

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