Rando Flashcards
What causes Restless Leg syndrome?
Iron deficiency anemia
Tx - pramipexole
What is actinic keratosis associated with?
Increases risk for squamous cell carcinoma
AK is caused by light exposure
most common transfusion reaction in 1-6 hours post transfusion?
febrile non hemolytic transfusion reaction
Tx - stop infusion and tyl
Formula for PPV
True Positive/(True positive+false positive)
Preggo
Progressively worsening HA that feels like intracranial fullness
Now FNDs
C/f central venous sinus thrombosis
Heparinize
significant smoking hx
erythrocytosis
Hematuria
Dx?
Renal Cell Carcinoma
Should get a CT - enhancing kidney mass, thick irregular walls of septa
Biggest RF’s for breast CA in a male?
BRCA mutation
Klinefelter syndrome
Fatal complications of neonatal polycythemia
apnea hyper viscosity hypoglycemia hyperbili respiratory compromise
Which type of MI is preload dependent?
R sided (II, III, aVF)
post partum c-section pt with fever
uterine tenderness
purulent vag discharge
dx and tx?
Post partum endometritis
Tx - Clinda + gent
Need aerobe and anaerobe coverage
higher risk with c-section
Preggo has intrapartum fever
Dx and Tx?
Chorio - an intrapartam uterine infection
Tx - Amp + gent
How do you dx biliary atresia in a kiddo?
First two months of life
jaundice babe
direct bili is >20% of total bill
if direct bill is low, more likely breast feeding jaundice
When is amiodarone indicated for a fib?
If they have recurrence of fib with RVR despite beta blockade
Aox0 pt with hematemesis. What ya do next?
Intubate. aspiration risk too high
cirrhosis + hematemesis
Tx?
IV octreotide and egd
decreases elevated portal pressure
IF pt has esophageal varies, what can prevent future bleeds?
Beta blockers (nadolol, propanolol)
EGD
Band ligation
alpha blocker med
tamsulosin
some inhalation increases risk of?
supraglottic edema
When is Rhogam given during prenatal care
@ 28 wk and <72 hours after delivery if babe is Rh+
what does asymmetry in a funnel plot suggest?
publication bias
Preggo
R flank pain that radiates to labia
Dx?
npehrolithzasis
Get an ultrasound
What happens to a kidney after long term NSAID use?
Papillary necrosis
Can have an acute presentation with hematuria, pyuria, proteinuria, and renal colic
chronic injury presents with frank proteinuia and elevated Cr
US - Mild pelvicalyceal dilation
Tx - avoid NSAIDs
when the survival benefit of a screening test is over estimated because it detects a disproportionate number of slowly progressive or benign cases
Length-time bias
What do you do with an adult that has persistent ear syx despite abx, decongestant and antihistamines?
Need a nasal endoscopy to r/o nasopharyngeal mass blocking the Eustachian tube
Preggo Itchy skin over abdomen Then gets urticarial papule and plaques around umbilicus Can mature in bull Mucos membranes spared. Dx?
Pemphigoid gestationis
autoimmune dz in 2nd or 3rd trimester
Tx - topical corticosteroid
Neutropenic patient
in ICU develops eye pain, photosensitivity
On exam - glistening white mound like lesions with vitreous haze
Dx?
Candida endophthalmitis
Risk is increased when central line present
Tx - Vitrectomy and systemic amphotericin B
What is the difference between mortality rate and case fatality rate?
Mortality rate - death rate in a population
Case fatality rate - number of patients that die form a specific disease
Hair loss with clean margins and complete hair loss in the middle. scalp is clean. Dx?
Alopecia areata
Recurrence is common
Tx - scalp injection of steroids
What two meds should PAD receive?
ASA + statin
Regardless of lipid panel results
When should PAD pts be on a supervised exercise program?
Any pt that has intermittent claudication
30-45 min of supervised walking 3x/wk for 3 months
Goal is to improve how far they can walk w/o pain
Can add cilostazol BID to help with six
trauma pt has brisk reflexes. Which electrolyte is off?
Hypocalcemia
Why do girls get uterine cramps during periods?
Excess prostaglandins causing uterine contractions
NSAIDs help
What type of study can be used to identify the source of an outbreak
Case-control
compare ill to a non ill control to determine what the exposure was
What should you think about for someone that was treated for Graves and keeps ending increases in levothyroxine doses?
Consider reasons for malabsorption of levothyroxine
Older lady constant urine lof
think overflow incontinence
Formula for Relative risk
Risk in group of interest/risk in other group
Formula for attributable risk?
(risk in exposed - risk in unexposed)/risk in exposed
If you suspect rectal prolapse, what do you do next?
Get a surgery c/s
When is conjunctivitis no longer contagious?
When the discharge goes away
Tx for H. pylori
PPI
Clarithromycin
Amoxicillin
+/- bismuth
What to do with someone with persistent GERD syx despite H. pylori testing?
Stool test for H. pylori or urea breath test
what recs do you give someone with a cerclage?
no exercise
Pancreatic lesion in head of pancreases, what next?
Endoscopic ultrasound and bx to dx cyst vs. malignancy
How do you interpret albumin in ascites?
Serum Alb - Ascites Alb
If >1.1 –> port HTN/cirrhotic stuff
<1.1 –.> not cirrhotic stuff
What is the pathophys behind HIT?
Autoantibodies against heparin platelet factor IV complexes
Tx - stop heparin. Consider direct thrombin inhibitor (agratroban)
Tx of tine versicolor
TOP Ketoconazole
Tx for cocaine induced CP and EKG changes
IV benzo + nitroglycerine
IF not symptomatic improvement and EKG persistently elevated consider a Cath
Lichen sclerosis increases risk of?
vulvar cancer
bx anything that looks suspicious
What happens if you give a WPW adenosine?
a fib with RVR d/t accessory pathways
Most common cause of unilateral nipple discharge?
Papilloma
Need a mammon’s and ultrasound
Tx for hidradenitis suppurativa?
Mild TOP clinda
Moderate po tetracyclines (doxy)
Severe TNG alphas
when is tpa indicated after a PE?
Hemodynamic instability
Right heart strain
Large clot burden
R heart thrombus*Hold AC
When do preggos get Tdap?
Third trimester
If lead level is increased what is the kiddo at risk of?
Neurobehavioral impairment
Unilateral Conjunctivitis constricted pupil Blurred vision Eye pain Rash on shins
Anterior uveitis
Sarcoid is most common cause
(rash = erythema nodosum)
angioedema is associated with?
ACEI
Switch to ARBs because they do not affect the kinin system
Tx of Touretts in a kid that fails Behavioral therapy?
Risperidone, aripiprazole
What can be a complication of re-perfusion?
Compartment syndrome
Tx for urge incontinence
Caused by detrusor m. overactivity
Tx - bladder training, timed voids, weight loss, smoking cessation, avoid caffeine/alcohol
If they fail - oxybutynin and tolterodine
can consider botox or tibial n. stimulation
How do you dx CO poisoning?
Measure Carboxyhemoglobin
How to dx Duchenne muscular dystrophy?
CK and genetic testing
palpable purpura
Fatigue
Arthralgias
Mixed cryoglobulinemia
Associated with HepC
Confirm dx with serum cryoglobulin levels
