Random Flashcards
If DQ2 & DQ8 negative, what can you NOT have?
Celiac
What physical exam finding is consistent with constrictive pericarditis?
Rapid X and Y descent
The absence of what three clinical signs can help rule out meningitis?
fever, stiff neck, AMS
Define LR
LR = probability of finding in patient with disease/probability of finding in patient without disease
LRs are a stable measure of a diagnostic test that is based on both the sensitivity AND specificity of the test. They provide an alternative way of describing the performance of a diagnostic test. They can be used to calculate the post-test probability of disease after a positive or negative test.
Define Cincinnati Pre Hospital Stroke Score
Acute facial paresis, arm drift, abnormal speech. LR for ≥1 finding = 5.5. Absence of all 3 findings LR = 0.39
If received BCG in past, what can be done to rule out latent TB?
Interferon gamma release assay
Name the ECOG categories
0 - no restriction
1 - limitation of strenuous activity, normal activity OK
2 - OK for self care, no work activity, up > 50% waking hrs
3 - limited self care, in bed > 50% of waking hrs
4 - bed ridden
A murmur is described as: a mid-systolic click with late systolic murmur. What happens when heard with patient standing/valsalva?
Classic for MVP, on standing preload drops, decrease in LV filling, therefore exaggerating MVP murmur. Click will be earlier, and murmur longer.
What is the best test to rule out aortic dissection (and LR for bonus points)?
Normal CXR, LR -0.3
Pt. with severe, symptomatic AS. Risk of surgery calculated to have >50% mortality. Prooceed to surgery?
No. Offer TAVR (2012 ACCF/AATS/SCAI/STS guidelines)
Which of the following, if present, does not increase the probability that this is malaria? Headache, dyspnea, jaundice, splenomegaly, fever. And what has the highest LR
Dyspnea LR +0.11. headache LR + 1.8, Fever LR +5.1 and splenomegaly LR + 6.5
Most common bacterial and viral cause of traveller’s diarrhea?
E. coli, rotavirus
What are the components of the HIT score?
thrombocytopenia, thrombosis, timing, causes (none)
How do you calculate NNT?
1/ARR
What are the components of the CAM score?
AIDS acute onset and fluctuation, inattention, disorganized thought, somnolence/AMS
Management of Goodpasture’s?
steroids, cyclophosphamide, plasmapheresis
What finding suggests infected ulcer?
Pain LR 11
Criteria for LVH (Sokolow)?
Sum of S wave in V1 and R wave in V5 or V6 ≥3.5 mV (35 mm) and/or R wave in aVL ≥1.1 mV (11 mm) (sometimes ≥1.3 mV [13 mm] is used)
In patients with egg allergy, what type of influenza vaccine is contraindicated?
live attenuated as its safety has not been studied. CDC does say egg-based vaccines OK
What two organs need to be monitored every six months for those on amiodarone?
hepatic (ALT/AST) & TFT Q6M
Criteria for Still’s
4 major: fever, arthralgia, maculopap rash, high WBC
5 minor: sore throat, LAD, HSM, LFTs, neg RF and ANA
Need 5 criteria, with at least 2 major
Absolute contraind. to lysis in STEMI?
h/o intracranial hemo., ischemic stroke w/i 3/12, cere. vasc. abn/cere. malig., s/sx of ao. dissection, bleeding diathesis/act. bleeding, closed head/facial trauma w/i 3/12
Relative contraind. to lysis in STEMI?
chronic, severe HTN OR BP>180 - 110 on pres., ischemic CVA >3/12, dementia, intracran. path., CPR>10min, major sx w/i 3/52, internal bleeding 2-4/52, act. PUD, noncompress. vasc. punc., preg, warfarin, prior expo. STK
Barrett’s with no dysplasia, what dose PPI?
Regular dose
What is the acceptable rise in creatinine with ACE-I?
25-30%
Beta blockers are not recommended in what group as monotherapy in HTN w/o other compelling indications?
> 60 years old
ACE-I are not recommended in what group as monotherapy in HTN w/o other compelling indications?
Blacks
A delayed hemolytic transfusion reaction occurs when and is thought to be due to what incompatibility?
Anywhere from 3-21 days post, and Rh or Kidd incompatibility
MEN1 tumors?
parathyroid, pituitary, pancreas
MEN2a tumors?
parathyroid, medullary thyroid, pheochromocytoma
MEN2b tumors?
medullary thyroid, pheochromocytoma, mucosal and gastrointestinal neuromas
What is the recommended treatment for syphilis?
long acting benzathine penicillin G 2.4 mill U SQ * 1
NMS symptoms?
FARM - fever, auto instab, rigid, MS change
Medically managed NSTEMI, EF 50%. What will decrease mortality: nitrate, plavix, smoking cessation, spiro?
Plavix, spiro if EF decreased/CHF
What are the landmarks of the spinal cord?
cord ends at L1-2, L4 cauda ends
What is true about the MOCA compared to MMSE?
More sensitive (LR 9.6), both specific
What is most suggestive of hyperaldo?
Hypokalemia
Class I indications for MV surgery for MR?
Severe + symptomatic (acute or chronic)
Severe + asymptomatic + LVEF 30-60% and/or LVESD > 40
Young man, mass, + bHCG +AFP?
non-seminoma
Young man, mass, + bHCG
seminoma
What are the biochemical - serum and urinary of Barter’s?
hypokalaemia, alkalosis, normal to low blood pressures, and elevated plasma renin and aldosterone. high urinary potassium and chloride despite low serum values
Gitelmans affects which transporter?
NaCl (like a thiazide diuretic)
