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Internal medicine > Random mix > Flashcards

Random mix Flashcards

1
Q

Most common cause of death in dialysis patients

A

Cardiovascular disease

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2
Q

Eye dysfunction in NF T1

A

Optic giloma

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3
Q

Associated neoplasms of Lynch syndrome

A

Colorectal
Endometrial
Ovarian

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4
Q

MEN1 associated neoplasms

A

Parathyroid adenomas
pituitary adenomas
pancreatic adenomas

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5
Q

Initial symptomatic treatment for hyperthyroidism

A

Propranolol

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6
Q

When to use PTU?

A

Treat hyperthyroidism in cases when radio ablation is contraindicated (pregnancy)

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7
Q

Cause of pulmonary edema in the setting of aortic dissection

A

Aortic regurg

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8
Q

Chronic rhino sinusitis, asthma, aspirin or NSAID induced bronchospasm

A

Aspirin-Exacerbated respiratory disease.

Nasal polyps
Bilateral nasal obstruction, discharge and anosmia

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9
Q

Causes of renal transplant dysfunction early post-op

A

Ureteral obstruction, acute rejection, cyclosporine toxicity, vascular obstruction, acute tubular necrosis

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10
Q

What test to get if patient has hypertension and hypokalemia

A

plasma aldosterone/renin ratio

Suspicion of primary hyperaldosteronism

If PAC/PRA >20

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11
Q

Amiloride

A

potassium-sparing diuretic

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12
Q

Common causes of hyperkalemia

A

acute or chronic kidney disease
medications
Disorders impairing the renin-angiotensin axis

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13
Q

Aspirin intoxication acid-base disorder

A

mixed respiratory alkalosis and metabolic acidosis

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14
Q

Exertional heat stroke vs. heat exhaustion

A

Exertional heat stroke- thermoregulation failure

Heat exhaustion- inadequate fluid and salt replacement W/ NO CNS dysfunction

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15
Q

Pathophys of nephritic syndrome

A

primary damage to glomeruli

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16
Q

Causes of nephritic syndrome

A 
Poststrep glomerulonephritis
IgA nephropathy
Lupus
MPGN
rapidly progressive glomerulonephritis
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17
Q

Anasarca, pulmonary and facial edema, hypertension, abnl UA with proteinuria and hematuria

A

Nephritic syndrome

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18
Q

Painful nodules in the armpit that progress to abscesses

A

Hidradenitis suppurativa

inflammatory occlusions of folliculopilosebaceous units

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19
Q

Treatment for uric acid kidney stones

A

alkalization of urine (potassium citrate)

Low-purine diet

Allopurinol

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20
Q

AKI acid/base disturbance

A

Non-anion gap metabolic acidosis (impaired acid excretion)
OR
Anion gap acidosis (retention of unmeasured uremic toxins)

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21
Q

Criteria for ATN

A
  • BUN:Cr::20:1
  • Urine osm 300-350
  • Urine Na >20
  • FENa >2%
  • Muddy brown casts
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22
Q

Muddy brown casts

A

ATN

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23
Q

RBC casts

A

Glomerulonephritis

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24
Q

WBC casts

A

Interstitial nephritis and pyelo

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25
Q

Fatty casts

A

Nephrotic syndrome

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26
Q

Broad and waxy casts

A

Chronic renal failure

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27
Q

Drugs that cause acute interstitial nephritis

A

Penicillins
TMP-SMX
Cephalosporins
NSAIDs

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28
Q

Common complication of nephrotic syndrome

A
  • Coagulopathy (renal vein thrombosis)
  • Protein malnutrition
  • iron-resistant microcytic hypo chromatic anemia
  • Vit D deficiency
  • decreased thyroxine levels
  • Increased susceptibility to infection
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29
Q

Progression of DM kidney injury

A
  1. glomerular hyperfiltration
  2. Glomerular BM thickening
  3. Mesangial expansion
  4. nodular sclerosis
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30
Q

Treatment for kidney stones

A

hydration, analgesics and alpha blockers

relaxes ureteral muscle

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31
Q

URI 4 days ago, young male, gross hematuria

A

IgA nephropathy

normal serum complement

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32
Q

Timing of post infectious GN

A

10-21 days

-children

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33
Q

Post infectious GN labs

A
  • Low C3

- Elevated anti-streptolysin O or anti-DNAse B

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34
Q

Most common cause of ascites

A

Cirrhosis

Hep C and Alcoholic liver dz

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35
Q

Level of G6PD activity during attack

A

may be normal

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36
Q

Most common cause of spontaneous deep intracerebral hemorrhage

A

Hypertensive vasculopathy

Most frequently effecting basal ganglia, cerebellar nuclei, thalamus and pons

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37
Q

Cause of subarachnoid hemorrhage

A

berry aneurysms

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38
Q

Treatment of metabolic alkalosis

A

Normal saline

determine if responsive or not

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39
Q

Causes of saline resistant metabolic alkalosis

A
  • primary hyperaldo
  • Cushing’s syndrome
  • severe hypokalemia (
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40
Q

fever, chills and malaise w/in 1-6 hrs of transfusion

A

febrile non hemolytic transfusion.

can be avoided by leukoreduction.

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41
Q

decrescendo early diastolic murmur

A

aortic regurgitation

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42
Q

Most common causes of aortic regurg

A

Developed countries-biscupid valve

Developing countries- rheumatic heart disease

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43
Q

sensitive lab test for hypovolemia in pt on diuretics

A

BUN/Cr ratio

looking for (>20:1) pre renal azotemia

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44
Q

Young obese female with headache and normal neuroimaging and elevated CSF

A

Pseudotumor cerebri

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45
Q

Treatment for pseudo tumor cerebri

A

weight reduction and acetazolamide

Shunting or opt nerve sheath fenestration to prevent blindness

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46
Q

Diagnosis of myasthenia gravis

A

Bedside edrophonium test, ice pack test

  • Ach receptor antibodies
  • CT scan of chest for thymoma
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47
Q

physical exam findings in renovascular disease

A

resistant HTN
asymmetric renal size
abdominal bruit

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48
Q

Localized pain on anteromedial tibia after trauma with neg callous stress test

A

pes anserinus pain syndrome

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49
Q

Location of coccidioides

A

southwest

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50
Q

autoantibodies to RBCs + pallor, jaundice, splenomegaly

positive coombs test

A

Autoimmune hemolytic anemia

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51
Q

Peripheral vision loss, cupping of optic disc

A

open angle glaucoma

tx: timolol drops

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52
Q

Effects of IGF-1

A

excessive growth of bone and soft tissue

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53
Q

Leading cause of death in acromegaly

A

cardiovascular

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54
Q

Hypertension, palpable bilateral abdominal masses and microhematuria

A

AD polycystic Kidney disease

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55
Q

Common complication of ADPKD

A
  • intracranial berry aneurysm
  • hepatic cysts (most common!)
  • valvular heart dz
  • colonic civerticula
  • abdominal wall inguinal hernia
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56
Q

rapid onset hirsutism

A

Androgen secreting neoplasm

test for testosterone and DHEAS

  • elevated T w/ nl DHEAS (OVARIAN)
  • elevated DHEAS (ADRENAL)
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57
Q

rapid onset hirsutism w/ elevated testosterone and nl DHEAS

A

OVARIAN TUMOR

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58
Q

Rapid onset hirsutism with elevated DHEAS

A

Adrenal tumor

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59
Q

what insulin for DKA?

A

regular insulin IV

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60
Q

Goals of treatment of DKA

A
  1. restore intravascular volume (NS)
  2. correction of hyperglycemia (regular insulin)
  3. correction of electrolytes (K+)
  4. treatment of precipitating factors like infection
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61
Q

Treatment for hypercalcemia

A

Severe (>14)- NS+calcitonin

Bisphosphonates for long term

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62
Q

Characteristics of HHS

A

Hyperglycemia
increased serum osm
little or no ketonemia or acidosis
gradual onset

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63
Q

cause of milk-alkali syndrome

A

excess intake of calcium and absorbable alkali.

Thiazide, ACE I, NSAIDs

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64
Q

Anti-TPO and anti-thyroglobulin antibodies

A

Hashimoto’s

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65
Q

positive urinary cyanide nitroprusside test

A

cystinuria

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66
Q

UA with hexagonal crystals

A

cystinuria

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67
Q

AL amyloidosis associated conditions

A

multiple myeloma

Waldenstrom macroglobulinemia

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68
Q

AA amyloidosis associated conditions

A

RA
IBD
chronic infection (osteomyelitis, TB)

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69
Q

Flank pain, low-volume voids +/- occasional high vol voids, renal dysfunction

A

Obstructive uropathy

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70
Q

Eye injury with contact lens

A

ulcers

Keratitis–Pseudomonas

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71
Q

Hip pain, limited internal rotation and abduction, normal XR and inflammatory markers.

A

Osteonecrosis (aseptic necrosis) of femoral head

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72
Q

Causes of hypercalciuria

A

idiopathic, hyperPTH, dehydration, prolonged immobilization

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73
Q

Cause of nephrolithiasis in pts with Crohn

A

Increased absorption of oxalate

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74
Q

NNT

A

1/ARR

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75
Q

Primary medication for COPD

A

anti-cholinergic (ipratropium and tiotropium)

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76
Q

Bright red, firm, friable, exophytic nodules in HIV pt

A

Bacillary angiomatosis

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77
Q

Signs of oropharyngeal dysphagia

A

difficulty initiating swallow, coughing, choking, nasal regurgitation

78
Q

Diagnosis of oropharyngeal dysphagia

A

video fluoroscopic modifica barium swallow

79
Q

Chalazion

A

painful swelling that progresses to nodular rubbery lesion on eyelid

80
Q

beta-D-Glucan test

A

test for fungi

81
Q

post-transplant pt with respiratory failure, dry cough, and fever

A

PCP

82
Q

Indications for carotid endarterectomy

A

Men: 60-99% stenosis if asymp
Women: 70-99% stenosis

83
Q

Cause of bullies pemphigoid

A

IgG autoantibodies against hemidesmosome and BM

84
Q

First line treatment for Bullous pemphigoid

A

High-potency topical glucocorticoid (clobetasol)

85
Q

Risk factors for idiopathic intracranial hypertension

A

Overweight women of childbearing age

medications (tetracyclines, hypervitaminosis A, isotretinoin)

86
Q

Treatment for acute MS exacerbation

A

glucocorticoids (IV methylprednisolone)

Or plasmapheresis if steroids do not work

87
Q

Treatment for metastatic bone cancer

A

Bisphosphonates (zoledronic acid)

88
Q

Use dependence with antiarrhymitcs

A

enhanced pharmacologic effects of a drug during faster heart rates.

89
Q

Highly use dependent antiarrhythmic

A

Class 1 (flecanide) and class 4 (CCB)

leads to widened QRS

90
Q

pain in groin that radiates to thigh. Worse with activity. decreased internal and external rotation of hip. No redness or warmth or tenderness to joint.

A

Osteoarthritis

91
Q

Osteonecrosis pain

A

Constant

92
Q

Cutaneous larva migrans source

A

walking barefoot on beach

Hookworm larvae

93
Q

Diseases associated with vitiligo

A

autoimmune disorders (SLE, thyroid, pernicious anemia, addison disease)

94
Q

Clinical features of glucocorticoid-induced myopathy

A

progressive proximal msk weakness and atrophy w/o pain

Nl ESR and CK

95
Q

Most common pulmonary complication of scleroderma

A

interstitial fibrosis

96
Q

trihexylphenidyl

A

anticholinergic med for parkinsons and drug induced EPS

97
Q

Pt with NSTEMI with pulmonary edema needs

A

IV furosemide

98
Q

Pt with NSTEMI with unstable sinus bradycardia

A

IV atropine

99
Q

Pt with NSTEMI with persistent severe pain

A

IV morphine

100
Q

Pt with NSTEMI w/ pain, hypertension, or HF

A

IV nitro

101
Q

Tx for SVT

A

adenosine or vagal maneuvers

102
Q

Fourth heart sound causes

A

Ventricular hypertrophy

Acute MI

103
Q

Association with cryoglobulinemia

A

hep C

IgM against anti-hepatitis C virus IgG

104
Q

ADAMTS13

A

Thrombi thrombocytopenic purpura

105
Q

urine positive for prussian blue stain

A

hemosiderin

106
Q

diagnosis of obstructive ureterolithiasis

A

US or spiral CT

107
Q

Test for EBV

A

heterophiles antibody test

108
Q

most common thrombophilia

A

Factor V Leiden

Activated protein C resistance

109
Q

RBC casts, proteinuria and low serum C3

A

post-strep GN

110
Q

inflammatory arthritis, splenomegaly, ulcerating skin lesions and neutropenia

A

Felty syndrome

common in pts w/ RA

111
Q

isolated elevated alk phos

A

Paget’s disease of the bone

Normal Ca and phos

elevated bone turnover markers: procollagent type 1 N propertied, urine hydroxyproline

112
Q

travel diarrhea >2wks

A

Cryptosporidium, cystoisosporia, cyclospora, giardia

113
Q

clinical manifestations of waldenstrom macroglobulinemia

A

Hyperviscosity syndrome (diplopia, tinnitus, HA), Neuropathy and hepatosplenomegaly, anemia, thrombocytopenia

114
Q

elevated IgM with hepatosplenomegaly

A

Waldenstrom macroglobulinemia

115
Q

elevated IgG, IgA and hypercalcemia

A

Multiple myeloma

116
Q

elevated IgM with no end organ effects

A

MGUS

117
Q

Are deep diabetic wounds mono microbial or polymicrobial

A

Poly

118
Q

Treatment for symptomatic SIADH

A

Hypertonic saline

Vaptains

119
Q

Middle aged woman with widespread pain, fatigue and cognitive/mood disturbances

A

Fibromyalgia

120
Q

Treatment for Fibromyalgia

A

Exercise w/ aerobic conditioning

121
Q

Fever, severe focal spinal pain, neurologic deficits

A

spinal abscess

122
Q

Causes of hypokalemia

A
  • increased entry into cells
  • renal potassium wasting
  • GI loss
123
Q

Effect of beta-adrenergic agonists on potassium

A

Shift potassium into cells

Hypokalemia

124
Q

Fixed, dilated pupil that is “down and out” with no accommodation

A

compression of CNIII

125
Q

Ptosis and down and out gaze with normal light and accommodation reflexes

A

diabetic CN III neuropathy

126
Q

Test with high sensitivity for CHF

A

BNP

127
Q

Dipyridamole and adenosine use in diagnosis of CAD

A

Coronary vasodilators

lead to coronary steal

128
Q

unexplained elevation of serum CK and myopathy

A

Hypothyroid

polymyositis

129
Q

cause of secondary bacterial pneumonia

A

S. aureus

130
Q

Tx for TTP

A

plasma exchange

131
Q 
Thrombocytopenia
Hemolytic anemia
Renal insufficiency 
Neurologic changes
Fever
A

Thrombotic thrombocytopenic purpura

Normal PT

132
Q

Drop in plts >50% or new thrombus w/in 5-10 days of heparin initiation

A

HIT

133
Q

Recurrent infection, osteolytic bone lesions, weight loss, fatigue

A

Multiple myeloma

134
Q

Multiple myeloma labs

A

normocytic anemia
renal insufficiency
-hypercalcemia

135
Q

Indications for HAV vaccine

A

Chronic liver dz
Men who have sex with men
IV drug users

136
Q

Indication for HPV vaccine

A

all pts age 11-26

137
Q

Complications of mono

A

autoimmune hemolytic anemia (IgM cold agglutinin ab) and thrombocytopenia

138
Q

Treatment for HBV

A

Entecavir and tenofovir

139
Q

Groin pain on weight bearing, pain on hip abduction and internal rotation.

A

Avascular necrosis

140
Q

Treatment for urge incontinence

A
  • bladder training
  • kegels
  • antimuscarinic drugs (oxybutynin)
141
Q

Treatment for SVT causing hemodynamic instability

A

Synchronized cardioversion

142
Q

Middle 28 yo woman with difficulty swallowing, weakness worse in evenings, and severe dyspnea

A

Myasthenia crisis

143
Q

Precipitating factors for myasthenic crisis

A

Infection or surgery, Pregnancy, tapering immunosuppressive drugs, Medications (ahminoglycosides, BB)

144
Q

Signs and symptoms of myasthenic crisis

A

ptosis, diplopia
fatiguable chewing, dysphagia, nasal speech
proximal limb weakness
respiratory muscle weakness

145
Q

Effect modification

A

external variable positively or negatively impacts effect of a risk factor on the disease of interest

146
Q

Treatment for Guillain-Barre

A

IV immunoglobulin OR plasmapheresis

147
Q

Diagnosis of Guillain-Barre

A

LP w/ elevated protein and nl WBC

148
Q

elderly pt with dramatic leukocytosis (primarily lymphocytes), hepatosplenomegaly, lymphadenopathy and anemia/thrombocytopenia

A

CLL

149
Q

Diagnosis of CLL

A

Flow cytometry

150
Q

Best initial treatment for migraine

A

Prochlorperazine (IV antiemetic) PLUS NSAIDs

151
Q

Papule with indented center everywhere but palms and soles

A

Molluscum contagiosum (Poxvirus)

consider testing for HIV

152
Q

Salvage therapy

A

treatment for a disease when standard therapy fails

153
Q

Neoadjuvant

A

treatment given before standard therapy

154
Q

Timing of gait impairment in NPH

A

early

155
Q

Episodic vertigo, sensorineural hearing loss, tinnitus

A

Meniere disease

156
Q

Initial test for lupus

A

ANA

157
Q

Most common cause of lower Gi bleed

A

Diverticulosis (bleeding most commonly from right colon)

painless

158
Q

OSA effect on kidneys and electrolytes

A

kidneys increase bicarb reabsorption and decrease Cl reabsorption to compensate for metabolic alk

159
Q

what part of spine effected by RA

A

Cervical

160
Q

Young pt with chronic back pain that improves with NSAIDS

A

inflammatory process

Consider AS

161
Q

Most common extraarticular manifestation of ankylosing spondylitis

A

Anterior uveitis (iritis)

also look for dactylitis

162
Q

treatment for febrile neutropenia

A

anti-pseudomonad agent (cefepime, meropenem, pip/tazo)

163
Q

Which test to use to test for syphilis

A

Nontreponemal (VDRL) (more false neg rates)

FTA-ABS (highest sensitivity)

164
Q

Asymmetric resting tremor 4-6 Hz associated with rigidity

A

first presentation of Parkinson’s dz.

165
Q

Treatment for younger pts with parkinson’s and mainly a tremor

A

Trihexyphenidyl

166
Q

Causes of chronic cough

A
  • upper-airway cough syndrome (postnasal drip)
  • asthma
  • GERD
167
Q

treatment of upper-airway cough syndrome

A

Chlorpheniramine

blocks H1 receptors, histamine release from mast cells, limits secretory response to inflammatory cytokines

168
Q

Vaccines for pts post splenectomy and timing

A

PCV13, meningococcal, H influenza type B

14 days before or after splenectomy

169
Q

Treatment for aspiration pneumonia

A

Clindamycin
Metronidazole + amox
Amox/clavu
Carbapenem

170
Q

Brain death characteristic findings

A

absent cortical and brain stem functions

171
Q

Does brain death eliminate DTR?

A

NO spinal cord might still work

172
Q

when to get booster meningococcal vaccination

A

age 16-21 if vaccinated pre 16th b-day

173
Q

Live attenuated vaccines

A
  • polio (PO)
  • measles/mumps/rubella
  • rotavirus
  • nasal influenza
  • yellow fever
  • varicella
174
Q

hypertension, bradycardia, respiratory depression

A

Cushing reflex

brainstem compression

175
Q

Brown-Sequard syndrome effect on pain

A

contralateral loss of pain and temp

176
Q

first line for chemo induced n/v

A

ondansetron

177
Q

Treatment for botulism

A

equine serum heptavalent botulinum antitoxin

178
Q

Cause of osteomyelitis by puncture wound

A

Pseudomonas aeruginosa

179
Q

5-HIAA tests for…

A

carcinoid

180
Q

treatment for carcinoid

A

octreotide

181
Q

episodic flushing and wheezing, diarrhea, valvular heart disease with tricuspid regurg

A

Carcinoid syndrome

182
Q

treatment for chronic low back pain

A

exercise therapy
intermittent NSAIDs
maybe TCAs or duloxetine

183
Q

Diagnosis of pancreatic cancer

A

US

then CT

184
Q

Treatment for hairy cell leukemia

A

Cladribine

185
Q

Antibiotic treatment for human bites

A

Amox/clauv

186
Q

Treatment for ALS

A

Riluzole (glutamate inhibitor)

187
Q

Treatment of graves dz

A

thyroidectomy

radioactive iodine W/ steroids if eye issues

188
Q

Treatment for acute glaucoma

A

mannitol, acetazolamide, timolol, pilocarpine

189
Q

Medications to avoid with acute glaucoma

A

atropine

190
Q

how to diagnose parkinson’s

A

Physical exam

Tremor, rigidity, bradykinesia, postural instability

Internal medicine (2 decks)

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