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IPAP > PPP ROSH- Renal/Derm > Flashcards

PPP ROSH- Renal/Derm Flashcards

1
Q

Lithium use can cause ? type of kidney issue

When is Tx by dialysis indicated

What other intervention is used to increase lithium elimination

A

Nephrogenic Diabetes Insipidus

Seizure AMS Dysrhythmia

Aggressive fluids

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2
Q

How is HyperCa Tx

Causes of high anion gap metabolic acidosis

A

Aggressive hydration, IV Bisphosphonate (Zoledronic Acid- inhibits Ca release from bones)

Na - (BiCarb + Cl): 10 +/-2:
A CAT MUDPILE:
ASA
CO/Cyanide
Acetaminophen
Theophylline
Methanol/Metformin
Uremia
DKA/Alcohol KA
Propylene glycol
Isoniazid/Ibuprofen
Lactiv acidosis
Ethylene glycol
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3
Q

What 3 meds can lead to lactic acidosis

Hyper/HypoK EKG findings

How are PTs Tx

A

Propylene glycol Metformin Salicylates

+: Bradycardia, Wide QRS, Absent P-wave, Peaked T-wave- first seen
-: Flat/inverted T-wave, U-wave- MC,

Ca chloride/gluconate
Albuterol- shifts K intracellularly
Furosemide- inc K elimination

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4
Q

? ABX can cause HyperK

Nephrotic induced protein loss can cause Pts to adopt ? blood d/o

What are the features of a naphrotic syndrome

A

TMP-SMX

Hypercoagulable- DVTs

Na dec
Albumin dec
Proteinuria >3.5g/day
Hyperlipid
Renal vein thrombosis
Orbital edema
Infections
Coagulability d/t antithrombin 3 lost in urine
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5
Q

What UA finding will be seen in Pts w/ hyperlipidemia induced by nephrotic syndromes

? med class needs to be d/c in Pts w/ pre-renal AKI

Normal pH, PaCO2 and BiCarb

A

Oval fat bodies- lipid deposit in sloughed renal tubular cells

ACEI- blunting afferent arteriole will worsen GFR

7.35-.45, 35-45, 22-26
ROME: compare pH and PCO2

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6
Q

MC type of renal Ca in adults

Only method of Tx is ?

? triad can Pts present w/

A

Renal cell carcinoma- originates in renal cortex w/ smoking doubling risk of development

Surgical resection

Flank pain, Hematuria, Palpable mass

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7
Q

Why do varicoceles occur more often on the left side

MCC of HypoCa

Expected PCO2 formula

A

Spermatic vein to L renal vein, R connects w/ IVC

Advanced CKDz; stabilized w/ Ca gluconate

pCO2= 1.5(BiCarb) + 8 +/2
Measured Co2 >Winters formula= respiratory acid
Measured Co2

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8
Q

DiGeorge Syndrome mnemonic

Stages of CKDz

A 
CATCH-22:
Cardiac abnormalities
Abnormal facies
Thymic absence/T-cell abnormality
Cleft palate
HypoCa
Chrom22

1: ≥90
2: 60-89
3: 30-59
4: 15-29
5: <15

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9
Q

How long does kidney dz need to be present to be labeled as chronic

Best method to Dx renal artery stenosis

Refractory HypoK needs to be Tx w/ ?

A

> 3mon

Gadloinium enhanced MRAngiography

Mg

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10
Q

MCC of nephrotic syndrome in adults

What med is used to Tx anemia of chronic dz

MC complication of CKDz

A

Focal segment glomerulosclerosis

Darbepoetin

HTN

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11
Q

What lab finding suggest interstitial nephritis

How is this Tx

Red Blood Cell casts suggest ? Dx

A

Eosinophiluria d/t allergic reaction to meds

D/c offending med

Acute glomerulonephritis- hematuria, proteinuria, casts, HTN, vol overload

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12
Q

MC solid renal tumor of childhood

MC electrolyte imbalance seen after laparoscopic surgery

How does post-strep glomerulonephritis present

A

Nephroblastoma- Wilms tumor

Metabolic alkalosis d/t volume contraction and gastric fluid loss

1-2wks post-strep infection w/ hematuria, HTN and periorbital edema

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13
Q

Degrees of skin burn

A

1st, Superficial- dry, red, blanches w/ pressure
2nd, Superficial partial- blisters w/ blanching
2nd, Deep partial- blisters w/ sluggish blanching
3rd, Full- waxy, dry and no blanching

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14
Q

How does Post-Strep Glomerulonephritis present

How are Pts Tx

How is Pityriasis Rosea Tx

A

Hematuria Periorbital edema HTN** d/t GAS infection

Furosemide for fluid overload

Triamcinolone acetonide, consider antihistamine (-ine)

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15
Q

Initial HyperCa d/t malignancy Tx

Prolonged Tx

How is HyperK Tx

A

NS fluids w/ loop diuretic (ide)

Bisphosphonates

Ca gluconate, Albuterol, Reg insulin, Glucose, Furosemide

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16
Q

Indications for emergency dialysis

What is the risk for rapidly correcting Na deficiency

How does pH alter K flow

A

AEIOU:
Acidosis E+ disturbance Intoxication Overloaded volume, Uremia

Central pontine myelinolysis

Acid- K moves out of cells

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17
Q

MCC of acute kidney injury in kids

What is the triad for this condition

How are Pts managed

A

HUS d/t E coli O157:H7

Schistocytes Thrombocytopenia Renal insufficiency

Monitor BUN/Cr, give Eculizumab if severe CNS involvement occurs

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18
Q

HypoMg PE finding

How is HyperMg Tx

MCC of Secondary HyperCa

A

Hyper reflexia

Dialysis, CaCl/gluconate

CKDz decreasing Vit D levels

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19
Q

How is acute hypoparathyroidism Tx

? causes kidney staghorn calculi

DI will cause ? osmolality shifts

A

Ca gluconate

Proteus mirabilis bacteria

Urine: low Na, Serum: inc Na

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20
Q

? lung condition leads to chronic respiratory acidosis

HyperK effect on heart muscle

Proteinuria and nephrotic syndrome can lead to ? type of casts

A

Pulm fibrosis

Inactivated Na channels= dec membrane excitability

Fatty

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21
Q

Where will fluid collection d/t nephrotic syndrome accumulate in non-ambulatory Pts

Microscopic oval fat bodies and maltese cross is associated w/ ? Dx

What will Pts present w/ as c/c

A

Sacrum

Nephrotic syndrome

Foamy/Suds urine

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22
Q

? lab result is highly sensitive to nephrotic syndrome

How is this Tx

Why can Pts develop DVTs

A

Lipiduria

ACEI, Fluid/Na restriction

Loss of Protein C,S and Antithrombin 3

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23
Q

? anti-hypertensive meds are c/i during HyperK

How does Fibromuscular Dysplasia present

Define Status Epilepticus

A

ACEI/ARBs

Woman <35y/o w/ HTN and abdominal bruit

Continues seizure >10min or ≥2 seizures w/out full recovery

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24
Q

How is status epilepticus Tx

? antiepileptic can cause HyoNa at therapeutic doses

How are genital warts Tx during pregnancy

A

L/D-zepam/Midazolam
Phenytoin
Phenobarbital/Propofol

Oxcarbazepine

Trichloroacetic acid at 32wks

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25
Q

Condyloma acuminata is d/t ? infection

What causes Pitryriasis Rosia

How is Histamine Fish Toxicity Tx

A

HPV 6, 11

HHV 6, 7

Diphenhydramine (antihistamine)

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26
Q

? is an absorbable material

ABCDEs of melanoma

This mnemonic is not applicable to ? melanoma lesion

A

Vicryl

Asymmetry Border irregular Color Diameter <6mm, 1/4”, Evolution

Subungual

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27
Q

Non-DM acanthosis nigricans is d/t ?

? causes Measles

How does this present/progress

A

Gastric Ca

Rubeola

High fever then rash:
3 C’s: Cough Coryza Conjunctivitis
Morbiliform rash

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28
Q

MCC of mortality from measles

What is the most life threatening complication

MC microbe from dog bites

A

Pneumonia

Subacute sclerosing panencephalitis

Pasteurella

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29
Q

? dog bite microbe can cause bacteremia/fatal sepsis

When are dog bites closed w/ primary intention

Define Pemphigus Vulgaris

A

Capnocytophaga canimorsus

Face

Bullous lesions from autoimmune (myasthenia, thymoma) origin w/ +Nikolsky sign

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30
Q

What needs to be differed in Pts w/ Pemphibus Vulgaris

MCC of skin abscess

How is this differed from cellulitis on PE and how are abscesses Tx

A

BP- >60y/o w. autoimmune induced sub-epidermal pruritic papules/tense blisters w/out Nikolsky
PV: 40-60y/o w/ flaccid blisters and mucossal involvement, +Nikolsky

Staph A- culture and Tx: Clinda/Tetracycline/TMP

Fluctulance- Clinda, TMP, Tetracycline

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31
Q

? causes HFM Dz

? is the classic derm finding during tertiary syphilis

Mnemonic and Tx for Kawasakis

A

Coxsackie A virus

Gummas

CRASH and Burn:
Conjunctivitis, non-purulent
Rash
Adenopathy
Strawberry tongue
Hand/foot swelling w/ peeling
Burning fever x 5 days
Tx: IVIG and high dose ASA
32
Q

Allergy to Amoxicillin will likely cross react w/ ? other ABX class

How are Black Widow bites Tx

How does Perioral Dermatitis present and how is it Tx

A

1st gen cephalosporin- Fa/Pha

Opioids, Benzos, Antivenom

Perioral papule/pustules w/ sparing of vermillion border; Metronidazole gel

33
Q

How is Perioral dermatitis Tx when periorbital dermatitis is also present

Define Erythema Toxicum Neonatorum presentation

What wold be seen in wright stain was performed

A

Tetracycline- doxy

2nd day of life w/ firm pale papule w/ surrounding erythematous flare

Eosinophils

34
Q

Define Kerion

How is this Tx

MC benign tumor in older Pts

A

Delayed T capitis induced hypersensitivity reaction casuing boggy plaque w/ heaped up nodules

PO griseofulvin, Steroids

SKs d/t keratotic plugging; Dx w/ shave biopsy

35
Q

? type of SK presentation indicates malignancy

SJS vs TEN body involvement

Skin infections d/t MRSA are Tx w/ ?

A

Lesser Trelat- multiple, eruptive SKs

SJS: <10%, TEN >30%

Doxy

36
Q

How does Atopic Dermatitis present by age

How is Onychomycosis Tx

Exclamation point hairs mean ? Dx

A

Infant: cheek/trunk
Peds: flexor surface
Adult: hands

Terbinafine > Itraconazole w/ LFT monitoring

Alopecia areata- Tx w/ Triamcinolone

37
Q

Hair feeling like wire brush is associated w/ ? Dx

Fixed drug eruption presentation

What can be done for Tx other than d/c offender

A

Trichotillomania

NSAID induced erythematous, edematous plaque appearing in the same location each time med is used leaving hyperpigmented macule

Diphenhydramine

38
Q

What other PE finding will be positive w/ Pemphigus Vulgaris along w/ Nikolski

How is Candidis Diaper Dermatitis Tx

Define Vitiligo and Tx

A

Asboe Hansen- lateral pressure spreads fluid into unaffected skin

Nystatin cream

Depigmentation of skin d/t destruction of melanocytes; Topical Tacrolimus, Narrow UVB therapy

39
Q

How are scabies Tx

What is the most important prognostic factor for melanoma

HS affects ? structure and AKA ?

A

5% permethrin, PO Ivermectin for residential outbreaks

Depth of lesion

Apocrine sweat glands; Acne inversa

40
Q

What causes Lichen Simplex Chronicus

Rule of 9s

This rule only applies to ? burns

A

Neurodermatitis d/t chronic itch/scratch

Head 9
Arms 9
Torso: 18 front/back
Leg: 18

2nd and 3rd degree

41
Q

? can cause a normal anion gap metabolic acidosis

Most serious complication that can arise from PCKDz

What are women at increased risk fot

A

Diarrhea

Cerebral aneurysms

Ectopics

42
Q

MC type of kidney cancer

? lab test is serially measured and tracked in Pts w/ post-streptococcal glomerulonephritis

MC type of cast

A

Renal cell carcinoma arising from epithelial cells of proximal tubules of renal cortex

Antistreptolysin O Abs

Hyaline d/t Tamm Horsfall protein from dehydration/exercise

43
Q

WBC cast mean ?

? E+ abnormality can cause hiccups

What is the only approved Tx for hiccups

A

Pyelonephritis, Nephrotic syndrome, Post-strep nephritits

HypNa/Ca

Chlorpromazine

44
Q

What other defects can be seen w/ Wilms Tumors

Muddy brown casts are associated w/ ? Dx

? ABX class can commonly cause these casts

A

Horse shoe kidney
Hypospadia
Cryptochordism

Acute tubular necrosis

Aminoglycosides

45
Q

Salicylate toxicity can cause ? acid-base disturbance

What is used to trap the ASA and enhance elimination

First line therapy for Peds w/ idiopathic nephrotic syndrome

A

Metabolic acidosis w/ respiratory alkalosis

Na bircarb

GCCS

46
Q

Define Dermatophyte presentation

What can this presentation mimic

What causes Staph Scaled Skin Syndrome

A

Ring worm: demarcated, scaling plaque w/ central clearing

Granuloma Annulare- no scaling

Ritter Dz: exotosins cleaving desmoglein 1

47
Q

Winter Green Oil poisoning

What ABG results will be seen

How is rosacea Tx

A

Salicylate toxicity: tinnitus, vertigo, vomit, diaphoresis, delerium

Resp alkalosis

Metronidazole

48
Q

? conditions are associated w/ Koebner Phenomenon

Which one of these conditions is associated w/ Hep C infections

Define Mask of Pregnancy

A

Psoriasis, Vitiligo, Lichen planus

Lichen Planus- Tx w/ topical betamethasone

Melasma- Tx w/ tretinoin (c/i in pregnancy= sunscreen)

49
Q

What are the 5 P’s of Lichen Planus

What meds can cause this

How are these Pts Tx

A

Pruritic Purple Planar Polygon Papular w/ Wickham striae (white streaks)

Furosemide Antimalarials Thiazides BBs

CCS- topical fluocinonide

50
Q

First line Tx therapy for Tinea Corpis

What other condition presents similarly and how are they differed

First line therapy for facial eczema in Peds

A

Topical clotrimazole

Granuloma annulare- no scaling

Emolients then Dapson/Hydrocortisone

51
Q

How does Erythema Multiforme present

How is this Tx

How are hives PE explained in words

A

Palm/Sole target lesions surrounded by pale halo d/t HSV infection

Steroids- if mucosal involvement + Antivirals

Raised, circumscribed erythematous plaques w/ central pallor of various sizes

52
Q

How are hives Tx

“Waxy, stuck on” appearance

What other skin condition did you confuse this with

A

Anithistamines, GCCS if angioedema is present

SKs- keratin filled pseudocysts; Initial Tx: cryo

AKs- flesh colored/yellow lesions w/ ill defined borders on sun exposed areas; Risk for SCC, Tx: 5-FU, Imiquimod, Diclofenac

53
Q

MC subtype of melanoma

How is Toxicodendron cases Tx

What type of reaction is this

A

Superficial Spreading

Ivy dermatitis w/ Pred x 21d

Type 4- Lymphocyte mediated (same as scabies)

54
Q

Etiology/Tx for Tinea pedis

Pressure ulcer staging

A

Trichophyton dermatophyte w/ topical clotrimazole or allylamines: Terbinafine/Naftifine

1: non-blanching erythema w/ intact skin
2: red wound bed (partial)
3: adipose visible (full skin loss)
4: bone/tendon/muscle visible (full tissue loss)

55
Q

Max dose of lidocaine w/out Epi

Max dose of liodcaine w/ Epi

Etiology/presentation of Scarlet Fever

A

5mg/kg

7mg/kg

GABHStrep; sandpaper, erythematous rash sparing palms/soles, circumoral pallow, strawberry tongue, Pasia lines in axilla

56
Q

? causes 5th Dz

Define Ecthyma

How is this Tx

A

Erythema Infectiosum d/t Parvo B19- Slapped cheek

Deeper, ulcerative form of impetigo

PO Cephalexin

57
Q

Alternative first line to PO Terbinafin for Onychomycosis Tx

Define Intertrigo

What causes this and how is it Tx

A

Itraonazole

Superficial inflammation of dermis where there is friction, moisture and lack of ventilation

Corynebacterium minutissimum- coral red w/ woods lamp; Tx: Erythromycin

58
Q

What are the 3 predisposing RFs for Intertrigo

How is a Kerion viewed w/ woods lamp to ID etiology

What is first and second line Tx

A

HIV Obese DM

Fluorescent green= Microsporum

1st: Griseofulvin- antifungal
2nd: Terbinafine Flu/Itr-conazole

59
Q

OTC med to reduce duration of PO HSV outbreaks

How is Lyme Dz Tx

? Tinea infection in Peds is Tx w/ systemic antifungals

A

Docosanol

Doxy, Amox- pregnancy, Neuro/Cardio Sxs- Ceftriaxone

Capitis w/ Griseofulvin

60
Q

MC bacterial infection associated w/ Erythema Multiforme

? phenomenon is seen on PE during RMSF

? other med can be used for Tx other than Doxy

A

Mycoplasma

Rumpel Leed- petechiae bleeding after BP cuff

Chloramphenicol

61
Q

Why is HSV Dx w/ Viral cultures

Kaposi Sarcoma is associated w/ ? infection

Alternative to Isotretinoin for Tx severe/resistant acne vulgaris

A

Tzanck smear can’t differ HSV from Varicella Zoster

HHV-8

Pred

62
Q

? microbe species causes tinea versicolor

Define Hutchinson Sign

How does Cutaneous Candidiasis appear on microscopy

A

Malasezzia

Herpes zoster blistering on tip of nose

Pseudohyphae

63
Q

MOA of Isotretinoin

What occurs if Sickle Pts are infected by Parvovirus B19

What occurs if pregnant Pt is infected

A

Dec skin oil, Gland size and production

Aplastic anemia

Hydrops fetalis

64
Q

How is post-herpetic neuralgia after shingles Tx

First line Tx for psoriasis

What causes Molluscum Contagiosum

A

Gabapentin, TCAs

Topical CCS

DNA poxvirus

65
Q

Only Hepatitis infection w/ DNA

How is this Tx

Best way for SLE Pts to avoid flare ups

A

Hep B

Tretinoin, LN2, Cantharidin

Sun protection

66
Q

What Pts should get the Shingles Vaccine?

How is simple cellulitis Tx

How is PCN allergic Pts Tx

A

> 50y/o regardless of chicken pox history

Cephalexin Amox/Diclox-acillin

Azith/roClinda/Erythro-mycin

67
Q

Family name of brown recluse

Family name of black widow

How is sexually transmitted Molluscum Contagiosum Tx

A

Loxosceles reclusa

Cryo, Curettage, Cantharidin/Podophyllotoxin

68
Q

Define Pilonidal abscess

How are these Tx

Define Dyshidrotic Eczema and it’s AKA

A

Embedded hair creates cavity and tract that becomes infected

InD

Dyshidrosis/Pompholyx- intense pruritis w/ deep seated “tapioca pudding” vessicles d/t excessive sweat/heat

69
Q

How is Dyshidrotic Eczema Tx

Cutaneous abscesses are best evaluated w/ ? and Tx w/ ?

What causes the purple papules seen w/ LP

A

High potency topical steroids

Culture for sensitivity- Clinda, TMP-SMX, Tetracycline

CD8 T-cells directed against basal keratinocytes in Pts w/ Hep C

70
Q

MC s/e of isotretinoin

How is head lice Tx in Peds

MCC of subungual onychomycosis

A

Dry lips/eyes

1% Permethrin, repeat in 10days

Trichophyton rubrum (fingers- C albicans)

71
Q

Define Bullous Pemphigoid

Where do these develop which is how these are ID’d on PE

This has ? MC stat

A

Chronic autoimmune blistering dz w/ itching in Pts >60

Epidermal basement membrane- no Nikolskky sign

MC blistering dz of elderly

72
Q

Define Hidranitis Suppurativa

What makes this condition worse and increase the recurrence

What would be seen on microscopy results of LP

A

Recurrent painful, erythematous nodules MC in axilla/groin d/t follicle occlusion and inflamed apocrine glands

Smoking

Homogenized dermis w/ flat dermoepidermal junction

73
Q

What two HPV strain are associated w/ cervical cancer

How is Condyloma Acuminata Tx during pregnancy

Onychomycosis does not require Tx unless ? is present

A

HPV 16, 18

Podophyllin/toxin, Imiquimod

ImmSupp- risk for cellulitis

74
Q

Slightly raise pearly lesion w/ telangiectasias is clue for ? MC skin Ca in USA

What skin lightening meds can be used for melasma

Define Rubella

A

BCC

Hydroquinone, Azelaic acid, Retinoids

German Measles- maculopapular rash, adenopathy (post-occipital/auricular) and fever

75
Q

What are the risks if pregnant Pt contacts Rubella

Gram pos cocci in chains

How is Tinea Capitis Tx

A

Cataract, Heart defect, Hearing loss

Streptococcus

PO Griseofulvin > Terbinafine

76
Q

How does T Capitis present

How are family members in contact w/ Pt Tx

Primary Tx for Acne Vulgaris

A

Patchy hair loss w/ scale and occipital adenopathy

Selenium sulfide shampoo

Topical retinoids

77
Q

Where are the 3 common sites for melanoma to mets to

A

Brain Liver Bone

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