PANCE questions Flashcards
Skin, SVR, and CO in early septic shock
Increase CO with warm, flushed skin
Decreased SVR
Gram + cocci in pairs
Strep pneumonia
Gram - oxidase + S shaped rod
Campylobacter
Initiating event for pregnancy induced hypertension
Placental ischemia
One risk factor for developing hydatiform moles
Nutritional deficiency
Meigs Syndrome
- Benign ovarian tumors (fibromas)
- Ascites
- Pleural effusion
- Young women
U/L sharply marginated red scaly rash on breast with vesicles
Paget’s Disease
Which vitamin can be associated with molar pregnancy?
Vitamin A (Retinol)
3 main things with Kleinfelter Syndrome
- Gynecomastia
- Testicular atrophy
- Infertility
Aspergillis
- Thick brown sputum
- Eosinophilia
- Increase IgE
Kimmelstiel Wilson Lesion
- Patients with diabetic nephropathy
- Biopsy shows nodules of pink hyaline material
G + non-spore forming rod
Listeria
Increase risk of listeria in…how do you contract it?
- Increase risk in newborns, elderly, immunocompromised
- No lunch meat in pregnant patients
Nummular eczema
- Pruritic
- Coin-shaped lesions seen on dorm of hands, feet, extensor surfaces
Is TCAs anticholinergic or cholinergic?
They have anticholinergic properties
CXR shows rib notching and “3” sign
Coarctation of aorta
Residual volume, FVC, and FEV1 in patients with emphysema
- Increase in residual volume (increase lung volume)
- FVC and FEV1 decreased
Pericardial knock
Constrictive pericarditis
Difference between constrictive pericarditis and restrictive CM (like amyloidosis)
- Both have diastolic dysfunction
- RCM will have myocardial dysfunction
- Constrictive pericarditis will have thickened pericardium
Speckled myocardium seen with
Amyloidosis
Sail sign or post fat pad sign in adults indicates
Radial head fracture
Intertrigo
Candida infection; “beefy red”
Minimal Change Disease
- Causes Nephrotic syndrome in children
- Maltese cross
- Prednisone DOC to treat
Pupils in cholinergic toxicity
Constricted (SLUDD-C)
Is atropine anticholinergic or cholinergic?
Anticholinergic
Is Erlichiosis gram - or +?
Gram - that destroys RBCs
Morulae
Tetrad inclusions seen within RBCs
Babesiosis
“Butterfly” appearance on CT in cerebral hemisphere
Glioblastoma
Tumor that occurs in convexities of hemispheres and attach to dura
Meningiomas
Hemangiomas
Retinal involvement + Von Hippel Lindau Syndrome
Hantavirus
Rodents are vectors; prodromal febrile phase with myalgias
Bipolar II
MDD + hypomania
Not significant impaired social function
Treatment of choice in unstable patient with presumptive ectopic pregnancy
Laparotomy
Hemophilia A treatment (2)
- Factor VIII
- Cryoprecipitate
Two treatments for NMS
Dantrolene and Bromocriptine (dopamine agonists)
CXR for hypersensitivity pneumonitis
Diffuse nodular densities
Test of choice for diagnosis of infant hearing loss
Auditory evoked potentials
What do fibroblasts produce
Collagen
Kidney disorder associated with URI
IgA nephropathy
MC location for osteomyelitis in children and adults
Children = long bones Adults = spine
If albumin levels are low, which lab value should you check next?
Calcium, since approximately 50% of Ca is protein bound
Kussmaul’s sign, what is it caused by
- An increase in CVP during inspiration
- Caused by severe R sided HF
- Frequent finding in patients with constrictive pericarditis or RV infarction
What does methotrexate inhibit
Dihydrofolate reductase
When should strabismus be gone in infants?
By 6 months of age
PE finding for emphysema (tactile fremitus, percussion)
- Distant heart sounds
- Decreased tactile fremitus
- Hyperresonant to percussion
What med can decrease effectiveness of OCPs
Rifampin
Mechanism for meniscus tear
Axial loading and rotation
Most sensitive test to detect rhabdomyolysis
Serum creatinine kinase
What is rhabdo a complication of?
Serious complication of seizures and hyperthermia related to drug abuse
Increase cold agglutinin test
Mycoplasma pneumoniae
Small grayish vesicles and punched out ulcers on posterior pharynx
Coxsackie
What drug can be used to prevent migraine HA
Propranolol
When does grasp and moro reflex disappear?
Grasp at 2-3 mon
Moro at 5-6 mon
Intraarticular injection of hyaluronic acid can be used to treat
OA of the knee
Methotrexate is contraindicated in patients with
Hepatic insufficiency; used to tx RA
EKG findings for LAE and RAE
LAE = wide P waves RAE = tall P waves
What does proliferative retinopathy (neovascularization) increase the risk of
Vitreous hemorrhage
Which diabetic meds have highest risk of hypoglycemia
Sulfonylureas (ex. Glipizide)
Pes anserine bursitis
Medial knee pain with point tenderness inferior and medial to the patella
Brown pigmentation on the LE is seen with
Chronic venous insufficiency
SQ red tender nodules is seen with
Erythema nodosum
What eye defect can long term oral corticosteroid use cause?
Glaucoma
Radiograph view to see scotty dog fracture
Oblique view
Spondylolysis
Tzank smear tests for
Herpes virus
Tests for syphilis
FTA-ABS (absorption serum test)
Best screening test used for evaluation of SLE
ANA
Rebound hypertension with abrupt withdrawal of what htn med?
Clonidine
Base of thumb pain is seen with RA or OA?
OA; typically spared in RA
What valvular abnormality is seen with acute MI?
Mitral regurgitation
Treatment for patient with acute bacterial prostatitis and urine retention
Suprapubic catheter
What lab value should you routinely test for patients taking lithium?
TSH (causes hypothyroidism)
Abx treatment for patient with chronic bacterial prostatitis
Levofloxacin or Bactrim
Two disorders that show Heinz bodies
Alpha thalassemia and G6PD
Lab values and PE for patient with primary biliary cirrhosis
-Jaundice, pruritus, fatigue
+ AMA, increase Alk phos and GGT
What antibody is positive for patient with autoimmune hepatitis
Anti smooth muscle antibodies
What is primary sclerosing cholangitis associated with, and what lab value is positive?
Associated with IBD (UC)
Positive P-ANCA
“Adult” hemoglobin (HgbA) has what chains
2 alpha and 2 beta chains
Hgb values for patient with beta thalassemia major
- No beta chains
- Decreased Hgb A synthesis
- Increased HgbA2 and Hgb F synthesis (due to making up for decreased Hgb A)
Treatment for acute exacerbation of multiple sclerosis
IV high dose corticosteroids
What is tx to prevent progression of multiple sclerosis
Beta interferon or glutiramer acetate
CXR and spirometry results for bronchiestasis
- Bronchial wall thickening (“tram track” airways)
- Obstructive pattern (decreased FEV1, decreased FEV1/FVC)
Subclinical hypothyroidism lab results
Increase TSH (because it shows up first), normal T3/T4
What is a ST elevation MI equivalent
LBBB
Wide QRS complex with broad, slurred R wave in V5/V6 with deep S wave in V1
MC cause of bacterial meningitis in patients <18y, and treatment
N meningitidis
Tx = IV Pen G
Boas sign
R shoulder pain seen with acute cholecystitis
Etiology and treatment for infective endocarditis
Staph aureus
IV Vancomycin
Treatment for ITP in children and adults
Children = IVIG Adults = corticosteroids
Increase risk factor for Hirsprung’s
Increase in children with Down’s syndrome
Aganglionic
Triple therapy for H pylori
PPI + Amoxicillin + Clarithromycin
Best diagnostic test for pituitary adenoma
MRI of sella tunica (pituitary gland)
Acute interstitial nephritis clinical presentation, labs, and etiology
MC caused by drugs (like PCN)
-Fever, eosinophilia, artralgia, maculopapular rash
RBC casts
glomerulonephritis
WBC casts
acute interstitial nephritis
How long for treatment for first event idiopathic DVT
At least 6 months therapy
Two main lab work side effects of lithium
Hypothyroid
Hyperparathyroid
What skin condition can cause negative Nikolsky sign
Bullous pemphigoid
Side effects of Clozapine (Clozaril)
- Agranulocytosis
- Myocarditis
- EPS symptoms
- QT prolongation
Cat scratch disease etiology
Bartonella
HPV diagnosis with application of
Acetic acid
Treatment of acute bronchiolitis
Supportive with humidified O2
Ulcers with peripheral venous disease
Medial malleolus ulcer with uneven ulcer margins
Two pathognomic findings for dermatomyositis
Gottran’s papules
Purple heliotrope rash around eyelids
Two treatments for nephrogenic DI
Indomethacin and Hydrochlorathiazide
Treatment for central DI
Desmopressin
What can cause an aplastic crisis in patients with sickle cell patients?
Parvovirus B19 infection
CN V sensory function
Corneal reflex with cotton wisps
What should a 13 month old infant with sickle cell disease receive
Folic acid and Penicillin V
What is associated with chronic use of phenytoin
Osteomalacia
What is a side effect of Bleomycin
Pulmonary fibrosis
Granular casts
Chronic renal disease
What can an anorectal abscess turn into?
Anorectal fistula
NASH
- Comes from metabolic syndrome (pt with DM, hypertriglyceridemia, htn, obesity)
- Resembles alcoholic hepatitis but in alcoholic AST/ALT is >2 and with NASH it is <1
Infants with severe combined immunodeficiency (SCID)
- Infant with hx of recurrent respiratory infections and diarrhea, FTT
- Skin changes and FH is suggestive of an X-linked immune deficiency
What vaccines can infant with SCID have/not have?
- No live vaccines
- Can have pneumococcal vaccine PCV 13
Vitamin C deficiency
- Scuvry
- Bleeding tendencies, impaired wound healing, swollen gums
- Splinter hemorrhages
What will staph aureus look like on blood agar, and what is it positive for?
- Grape-like clusters, enterotoxins
- Coagulase and mannitol positive
- Shows yellow colonies on blood agar