Questions Flashcards
What is the next best step after establishing the diagnosis of myasthenia gravis?
Chest X-ray to r/o thymoma
Who always gets a statin accoring to current guidelines?
Diabetic ages 40-75
Shiny tongue with vitalligo
Pernicious anemia– Ab against intrinsic factor
HIV pts with a CD4 of <50 require prophylaxis for what infection? With What Abx?
Mycobaterium Avium Complex (MAC)
Azithromycin
Loss of the gallbladder ducts is commonly seen in what disorder?
Primary biliary cirrhosis
Chemotherapy
GVHD
CMV
Hodgkin disease
Treatment for ethylene glycol poisoning
Ethanol or fomepazole (alcohol dehydrogenase inhibitor)
Explain type II HIT
Type II HIT is the result of heparin binding to platelet factor 4.
The heparin-PF4 complex then binds IgG. This leads to activation of platlets and sequestion of the patelets by the spleen.
This causes thrombosis and thrombocytopenia
Most common cause of PNA in nursing homes
S. pneumonia
Equation to calculate osmolar gap
2xNa + BUN/2.8 + Glucose/18
How much fluid given to burn patient
4mL per 1% burn
(rule of 9s)
Most common EKG abnormality seen in hypothermia
J point elevation
Common side effect of hydroxychloroquine
retinopathy
Causes of AKI with acyclovir treatment
Acyclovire when given IV can chrystallize in the urine causing obstructive uropathy
Give this to treat epiglottitis…what to give close contacts
Ceftriaxone
give close contacts Rifampin
Gray highly vascular membrane on the pharynx of a sick child…dx? Tx?
Diptheria
Tx with antitoxin
Signs of vitamin B2 (riboflavin) deficiency
Chelosis
Arrythmia most specific for digoxin tox
atrial tachycardia with AV block
Combination of nephrotic syndrome, hepatomegaly, palpable kidneys and ventricular hypertrophy is suggestive of…
Secondary amyoldosis (AA)
tx: colchicine
Vitamin B3 (niacin) deficiency
4D’s
Dermatitis
Diarrhea
Dementia
Death
Which type of dementia is associated with alterations in level of consciousness and EPS
Lew body dementia
Calculation to adjust Ca for albumin
Serum Ca - ( 0.8 (4 - albumin))
Mnemonic to remember gravity and parity
F-PAL
Full term
Pre term
Abortions
Living Children
Most commonly induced HIV nephropathy
Focal segmental glomerulosclerosis
Commone side effect of statin
elevated transaminases
Myositis
Side effects of niacin
elevated glucose, uric acid and pruritis
Side effects of fibrates
Elevated rate of myositis when used with statins
Side effects of cholestyramine
flatus and abdominal cramping
Common side effects of CCB
Edema
Constipation
ST elevation in V2-V4 corresponds to ischemia here
Anterior wall MI= high mortality
Which leads correspond to inferior wall MI?
ST elevations in II, III, aVF
Ho long does CK-MB stay elevated in a patient post MI? Why is this important to know?
1-2d
It is most specific for re-infarction because Tropnins stay elevated for 10-14d
Describe the S4
Late diastolic murmur heard when an atria contracts against a stiffened ventricle
Describe S3
Low frequency
Early Diastole, just after the S2 in early diastole
Normal in young people
Indicates elevated ventricular diastolic filling pressures
may be first clinica sign of CHF
Initial teo drug therapy in CHF
ACEi or ARB with a diuretic (loop)
Spironolactone is given for anti-aldosterone effect not diuretic effect
What treatments are shown to have a mortality benefit in systolic dysfunction?
ACEi/ARB
B-blocker
Spironolactone
Hydralazine/nitrate
implatable defib
This drug shows clear benefit in CHF with diastolic dysfunction
B-blocker
Best INITIAL therapy for CHF with pulmonary edema
Loop diuretic
All left sided murmurs will increase on expiration except for these two
HOCM
Mitral valve prolapse
Pulsations in the nail bed, BP in legs 40mmHg higher than arms, and a wide pulse pressure are all signs of this
Aortic regurgitation
Which manuveurs improve MVP murmur? Why?
Anything that increases LVEDV becuase the valve will be more stretched out and less likely to “snap” backwards
Most commom cause of hypertrophic cardiomyopathy
Hypertention
Erythematous papules and plaques that are present on the face, extremities and perineum in patients with glucagonomas
Necrolytic migratory erythema
Treatment of choice for uncomplicated cystitis in a female
Nitrofurantoin or tmp/smx
Treatment of choice for complicated UTI in female
Fluroqinnolones
Abx of choice for a neonate <1yo for pertussis prophylaxis
Azithromycin
NOT erythromycin due to pyloric stenosis
Best choice Abx for human bite patient
Amoxicillin-clavulanate
Isloated alk phos incidentally discovered in elderly patient. Most like Dx?
Paget disease of bone
Early 20s African American female with slow onset dry scaly skin diffusely with horns and plaques
Icthyosis Vulgaris
Hosimoto patients are at high risk for this malinancy
Thyroid lymphoma– rapidly enlarging gland with donut sign
Needs core bopsy for dx
Discuss CAH

Durring which week is external eversion indicated in a patient with a breech presentation?
Not until the 37th week
An HIV patient presents with non-specific symtoms of malaise, fever, cough, abdominal pain and aches. Their alkphos is elevated. CD4 is <50.
Most likely Dx?
What prophylactic drug would have prevented this?
MAC- Disseminated mycobaterium complex
Axitromycin would have prevented