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Random4 Flashcards

1
Q

normal jugular venous pressure?

A
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2
Q

normal jugular venous pressure?

A
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3
Q

teardrop shaped growths on vulva vestibule - think?

A

genital warts from HPV (condyloma acuminata)

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4
Q

condyloma acuminata caused by?

A

HPV

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5
Q

cluster of pink/skin-colored smooth teardrop lesions on vulva - think?

A

condyloma acuminata (genital warts) from HPV

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6
Q

condyloma lata is from?

A

2ndary syphilis

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7
Q

teardrop shaped growths on vulva vestibule - think?

A

genital warts from HPV (condyloma acuminata)

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8
Q

condyloma acuminata caused by?

A

HPV

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9
Q

cluster of pink/skin-colored smooth teardrop lesions on vulva - think?

A

condyloma acuminata (genital warts) from HPV

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10
Q

genital warts treat?

A

small :tricholoroacetic acid or prodophyllin

large: excision or fulguration (electric current)

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11
Q

condyloma lata is from?

A

2ndary syphilis

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12
Q

flat velvety lesions on vulva think?

A

condyloma lata (syphilis)

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13
Q

condyloma lata look?

A

flat velvety lesions on vulva

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14
Q

single fleshy lesion on labia majora – think?

A

vulvar cancer

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15
Q

white thin wrinkled skin over labia + itchy - think?

A

lichen sclerosus

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16
Q

hyperkeratotic, erosive, or papulosquamous lesions in middle aged women w/ pruritus, soreness, and vag discharge – think?

A

vulvar lichen planus

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17
Q

when pregnent pt has chronic HTN when?

A

systolic >140 and/or diastolic >90 PRIOR to conception or 20wks gestation

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18
Q

Chronic HTN w/ superimposed preeclampsia is?

A

Chronic HTN and 1 of following:

  • new onset proteinuria/worsening proteinuria >=20wks
  • sudden worsening of HTN
  • Signs of end organ damage
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19
Q

new onset of elevated pressure >20 weeks gestation w/ no end organ issues?

A

gestation HTN

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20
Q

inc fetal risk w/ primary HTN preg are (4)?

A
  • IUGR (asymmetric)
  • Perinatal mortality
  • Preterm delivery
  • Oligohydramnios
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21
Q

treatment for benzodiazepine intoxication?

A

Flumazenil

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22
Q

Flumazenil treats what intoxication?

A

Benzodiazepine

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23
Q

Chronic HTN w/ superimposed preeclampsia is?

A

Chronic HTN and 1 of following:

  • new onset proteinuria/worsening proteinuria >=20wks
  • sudden worsening of HTN
  • Signs of end organ damage
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24
Q

inc maternal risk w/ primary HTN are? (5)

A
  • superimposed preeclampsia
  • postpartum hemorrhage
  • gestational DM
  • Abruption
  • C-section
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25
Q

beta blocker intoxication symp and treat w/?

A
  • bradycardia + hypOtension + whezing

- glucagon

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26
Q

nL pupil size in bright light ?

A

2-4 mm

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27
Q

dilated pupil is ?

A

4-8mm

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28
Q

drowsiness + slurred speech + unsteady gate – what intoxicated w/?

A
  • alcohol

- benzos

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29
Q

glucagon used for what intoxication?

A

Beta-blocker inxociation

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30
Q

beta blocker intoxication symp and treat w/?

A
  • bradycardia + hypOtension + whezing

- glucagon

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31
Q

what meds can cause extrapyramidal side effects?

A

those that block dopamine (D2) receptors.

  • 1st gen Antipsychotics (ie halperidol)
  • Some 2nd gen antipsychotics (ie risperidone)
  • antiemetics (ie metoclopramide)
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32
Q

what may help w/ tardive dyskinesia?

A

clozapine

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33
Q

Extrapyramidal symps?

A
  • acute dystonia (torticollis)
  • Akathisia (restlessness)
  • parkinsonism (tremor, rigidity, bradykinesia)
  • Tardive dyskinesia
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34
Q

severe rigidity + mental status change + high fever + autonomic instability + psych meds - think?

A

neuroleptic malignant syndrome

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35
Q

treatment of akathisia (2)?

A
  • propranolol

- lorazepam (benzo)

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36
Q

treatment of extrapyramidal symp – > parkinsonisms? (2)

A
  • benztropine

- Amantadine

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37
Q

what may help w/ tardive dyskinesia?

A

clozapine

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38
Q

lead pipe rigidity - think?

A

neuroleptic malignant syndrome

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39
Q

severe rigidity + mental status change + high fever + autonomic instability + psych meds - think?

A

neuroleptic malignant syndrome

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40
Q

hereditary angioedema due to?

A

C1 inhibitor deficiency

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41
Q

rapid onset of non-inflammatory edema of face, limbs, and genitalia, laryngeal edema, colicky abdominal pain w/ no evidence of hives (urticaria) – think?

A

Hereditary angioedema

abdominal pain due to edema of intestines

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42
Q

c1 inhibitor deficiency or dysfuntion –>?

A

hereditary angioedema

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43
Q

immune hemolytic anemia and Rh hemolytic disease of new born what kind of hypersensitivity?

A

Ab mediated (type II)

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44
Q

C1 q levels differ how and why in hereditary vs acquired angioedema?

A
  • Hereditary: C1q levels are normal

- Acquired: LOW c1q levels

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45
Q

cafe-au-lait spots, bilateral acoustic neuromas, cataracts - think?

A

neurofibromatosis type 2

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46
Q

what is elevated in hereditary angioedema?

A

C2b and bradykinin

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47
Q

serum sickness what type of hypersensitivity?

A

Immune complex mediate (type III)

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48
Q

immune hemolytic anemia and Rh hemolytic disease of new born what kind of hypersensitivity?

A

Ab mediated (type II)

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49
Q

cafe-au-lait spots, macrocephaly, feeding problems, short stature, and learning disabilities, lish nyhan spots- think?

A

Neurofibrimatosis 1

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50
Q

cafe-au-lait spots, bilateral acoustic neuromas, cataracts - think?

A

neurofibromatosis type 2

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51
Q

newborn w/ large flank masses + resp distress + flattened ears/nose + small jaw – think?

A

Autosomal recessive polycystic kidney disease

flattened ears/nose and small jaw = Potter faces

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52
Q

Potter faces - think? is?

A
  • flattened ears/nose
  • micgrognathia (small jaw) from oligohydramnios

Think: Autosomal recessive polycystic kidney disease

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53
Q

kid w/ pertussis how to treat household contacts?

A
  • Macrolide for all household contacts

REGARDLESS of vax status

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54
Q

myopathy is?

A

disease of muscle –> muscle weakness

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55
Q

what med associated w/ pyloric stenosis?

A

erythromycin use in babies

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56
Q

erythromycin associated w/ what GI complication?

A

pyloric stenosis if used in pts

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57
Q

when acellular pertussis vaccine given?

A

5 doses!

2,4,6, 15-18mo and 4-6yo

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58
Q

myotonia is?

A

inability to relax muscles after strenuous effort

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59
Q

myopathy is?

A

disease of muscle –> muscle weakness

60
Q

myotonic dystrophy is inherited how?

A

Autosomal dominent

61
Q

mytonic m. dystrophy cause?

A

expansion of CTG trinucleotide repeat on DMPK gene

62
Q

comorbidities w/ duchenne?

A
  • scoliosis

- cardiomyopathy

63
Q

comorbidity w/ becker MD?

A

cardiomyopathy

64
Q

comorbidities w/ myotonic m. dystrophy? (4)

A
  • arrhythmias
  • cataracts
  • balding
  • testicular atrophy/infertility
65
Q

Duchenne and Becker inherited how?

A

X-linked recessive deletion of dystrophin gene

66
Q

mytonic m. dystrophy cause?

A

expansion of CTG trinucleotide repeat on DMPK gene

67
Q

hazard rate is?

A

the change of an event occuring in 1 of the study groups during a set period

68
Q

hazard ratio is?

A

chance of an event occuring in a TREATMENT group compared to the chance of that event occurring in the CONTROL group during a set period

69
Q

Hazard ratio

A

event more likely to occur in control group

treatment likelihood/control likelihood

70
Q

hazard ratio >1 means?

A

event more likely to occur in the treatment group

treatment likelihood/control likelihood

71
Q

confidence interval contains 1 means?

A

no significant difference between the 2 groups

72
Q

Delta wave is?

A

upsloping just before QRS complex

73
Q

Electrical alternans found on EKG in what cardiac case ?

A

Pericardial effusion

74
Q

QRS complexes who amplitudes vary from beat to beat - is?

A

Electrical alternans

think pericardial effusion

75
Q

f waves found?

A

F wave = flutter wave

Dx for atrial fluter

76
Q

most common skin malignancy in gen pop?

A

basal cell carcinoma

77
Q

Delta wave is?

A

upsloping just before QS complex

78
Q

main cause of exertional heat stroke?

A

inadequate/failure of thermoregulation

  • fluid and salt levels may contribute, but does not cause
79
Q

squamous cell carcinoma common in?

A

Immunosuppresed pts (ie organ transplant)

80
Q

pearly, flesh/pink colored nodule w/ telangiectatic vessels - think?

A

basal cell carcinoma

81
Q

most common skin malignancy in gen pop?

A

basal cell carcinoma

82
Q

immunosuppressed pt + multiple, discrete, flesh–red colored papules of varying size w/ slight central umbilication – think?

A

Disseminated cryptococcosis

83
Q

heat exhaustion vs heat stroke?

A

Exhaustion: inability to maintain adequate CO due to dehydration

Stroke: failure of thermoregulation

84
Q

main cause of fever?

A

cytokine activation during inflammation

85
Q

main cause of malignant hyperthermia?

A

uncontrolled efflux of Ca from sarcoplasmic reticulum

rare autosomal dom disorder, pts receive halothane and succinylcholine for anesthesia –> hyperthermia

86
Q

heat exhaustion cause by?

A

inadequate Na and H2O replacement during physical activity

87
Q

Heat exhaustion is?

A

inability to maintain adequate cardiac output

88
Q

heat exhaustion vs heat stroke?

A

Exhaustion: inability to maintain adequate CO due to dehydration

Stroke: failure of thermoregulation

89
Q

baker’s cysts dev bc?

A

excessive fluid production by inflamed synovium –> accumulates in popliteal bursa
- associated w/ RA, OA, cartilage tears

90
Q

resting tremor is?

A

low amplitude and freq tremor that dec w/ voluntary movement (so most pronounced when resting)

seen w/ parkinson’s disease

91
Q

Resting tremor associated w/?

A

parkinson’s disease

92
Q

which tremor is relieved w/ alcohol?

A

Essential tremor

93
Q

parkinson disease due to?

A

loss of dopaminergic neurons in the basal ganglia

94
Q

Intention tremors associated w/?

A

Cerebellar dysfunction

95
Q

what tremor asociated w/ cerebellar dysfunction?

A

low freq (3-4 even lower than PD) INTENTION tremor (inc at end of intentional movement that is visually directed [ie reaching for something])

96
Q

physiological tremors are what type?

A

postural (inc w/ sustained m. tone –> ie holding arms outstretched)

97
Q

which tremors are worsened by emotional or physical stress or caffeine?

A

physiologic tremors

98
Q

physiological tremor amp and freq?

A

low amplitude

high freq

99
Q

resting tremor amp and freq?

A

low amp

low freq

100
Q

physiological tremors are what type?

A

postural (inc w/ sustained m. tone –> ie holding arms outstreched)

101
Q

which tremors are worsened by emotional or physical stress or caffeine?

A

physiologic tremors

102
Q

substernal discomfort, left sided neck pain, diaphoresis, SOB that can wake a person up at night – concern for?

A

acute coronary syndrome (ie MI, ischemia, etc)

103
Q

during acute MI what new heart sound may be heard?

A

S4

atrial gallop; due to atria contracting and forcing blood into stiff ventricle

104
Q

associated w/ S4? (4)

A
  • HTN hear disease
  • AS
  • HOCM
  • Acute MI
105
Q

S3 nL in what pop? (3)

A
  • kids
  • young adults
  • pregnancy
106
Q

associated w/ S3? (3)

A
  • Heart failure
  • Restrictive cardiomyopathy
  • High output states
107
Q

nL pop to hear S4?

A

healthy OLDER adults

108
Q

sharp pleuritic pain hurts worse w/ inspiration or coughing and dec when pt sits up and leans forward – think?

A

Acute pericarditis

109
Q

“ejection type systolic murmurs” - talking about what?

A

flow of bld across aortic and pulmonic valves

110
Q

pulsus paradoxus found w/? (5)

A
  • MAIN: Cardiac tamponade
  • severe asthma
  • COPD
  • hypovolemic shock
  • occasionally constrictive pericarditis
111
Q

best imaging for acoustic neuromas?

A

MRI w/ gadolinium

112
Q

sharp pleuritic pain hurts worse w/ inspiration or coughing and dec when pt sits up and leans forward – think?

A

Acute pericarditis

113
Q

post ictal acidosis treatment?

A

Should be transient and self resolves w/in 60-90 minutes

114
Q

cardiac and vascular response to dopamine?

A

Dopamine is:

  • positive inotrope (inc contraction strength)
  • vasoconstrictor
115
Q

best imaging for acoustic neuromas?

A

MRI w/ gadolinium

116
Q

high anion gap metabolic acidosis post grand mal seizure - likely cause?

A

lactic acidosis

117
Q

post ictal acidosis treatment?

A

Should be transient and self resolves w/in 60-90 minutes

118
Q

proptosis is?

A

bulging of eye

119
Q

flash pulm edema in MI setting - treat?

A

furosemide

120
Q

what indicates an MI pt that would NOT receive beta blockers?

A
  • Bradycardia

- Decompensated CHF (ie flash pulm edema)

121
Q

if left untreated hypERthyroidism maj effect?

A
  • Bone loss –> osteoporosis, hyperCalcemia, and hypercalciuria
122
Q

proptosis is?

A

bulging of eye

123
Q

fetal hyperthyroidism seen w/ what thyroid disease?

A

Graves disease

- TSH receptor Ab cross the placenta affecting fetal thyroid

124
Q

carotid pulse w/ dual upstroke - thinkn?

125
Q

systolic ejection murmur along L sternal border w/ strong apical pulse - think?

126
Q

valsalva inc what murmurs (2)?

127
Q

standing inc what murmurs?

128
Q

Squatting inc what murmurs (3)?

129
Q

Squatting dec what murmurs (2)?

130
Q

handgrip –> what?

A

inc afterload

inc BP

131
Q

handgrip inc what murmurs? (3)

132
Q

What maneuvers inc preload? (2)

A
  • Squatting from standing (inc afterload too)

- Passive leg raise

133
Q

blunt trauma + pneumomediastinum + persistent pneumothorax + subQ emphysema - think?

A

Bronchial rupture (usually R)

134
Q

what maneuvers dec preload (3)?

A
  • valsalva (straining phase)
  • Abrupt standing
  • Nitro admin
135
Q

What maneuvers inc afterload? (2)

A
  • Hand grip

- Squatting (from standing; also inc preload)

136
Q

What maneuvers inc preload? (2)

A
  • Squatting from standing (inc afterload too)

- Passive leg raise

137
Q

cerebellar gait?

A

ataxic: staggering, wide based gait

can see swaying side to side and impaired tandem gait

138
Q

foot drop due to issue w/?

A

common peroneal nerve

L5 radiculopathy

139
Q

peroneal neuropathy due to?

A

compression of the nerve at the lateral aspect of the fibula

140
Q

peroneal neuropathy associated w/

A

sensory loss over dorsum of food

141
Q

vestibular gait?

A

unsteady fall to one side

vertigo

142
Q

gait apraxia/frontal gait?

A

Magnetic (freezing): start and turn hesitation

143
Q

when do you see gait apraxia?

A
  • frontal lobe issue

- NPH

144
Q

parkinson gait?

A

short steps, shuffling

145
Q

vestibular gait?

A

unsteady fall to one side

vertigo

146
Q

Corrected Ca = ?

A

Corrected Ca = (measured total Ca) + (0.8*[4 g/dL - serum albumin in g/dL])

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