Random4 Flashcards
1
Q
normal jugular venous pressure?
A
2
Q
normal jugular venous pressure?
A
3
Q
teardrop shaped growths on vulva vestibule - think?
A
genital warts from HPV (condyloma acuminata)
4
Q
condyloma acuminata caused by?
A
HPV
5
Q
cluster of pink/skin-colored smooth teardrop lesions on vulva - think?
A
condyloma acuminata (genital warts) from HPV
6
Q
condyloma lata is from?
A
2ndary syphilis
7
Q
teardrop shaped growths on vulva vestibule - think?
A
genital warts from HPV (condyloma acuminata)
8
Q
condyloma acuminata caused by?
A
HPV
9
Q
cluster of pink/skin-colored smooth teardrop lesions on vulva - think?
A
condyloma acuminata (genital warts) from HPV
10
Q
genital warts treat?
A
small :tricholoroacetic acid or prodophyllin
large: excision or fulguration (electric current)
11
Q
condyloma lata is from?
A
2ndary syphilis
12
Q
flat velvety lesions on vulva think?
A
condyloma lata (syphilis)
13
Q
condyloma lata look?
A
flat velvety lesions on vulva
14
Q
single fleshy lesion on labia majora – think?
A
vulvar cancer
15
Q
white thin wrinkled skin over labia + itchy - think?
A
lichen sclerosus
16
Q
hyperkeratotic, erosive, or papulosquamous lesions in middle aged women w/ pruritus, soreness, and vag discharge – think?
A
vulvar lichen planus
17
Q
when pregnent pt has chronic HTN when?
A
systolic >140 and/or diastolic >90 PRIOR to conception or 20wks gestation
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
19
Q
new onset of elevated pressure >20 weeks gestation w/ no end organ issues?
A
gestation HTN
20
Q
inc fetal risk w/ primary HTN preg are (4)?
A
- IUGR (asymmetric)
- Perinatal mortality
- Preterm delivery
- Oligohydramnios
21
Q
treatment for benzodiazepine intoxication?
A
Flumazenil
22
Q
Flumazenil treats what intoxication?
A
Benzodiazepine
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
24
Q
inc maternal risk w/ primary HTN are? (5)
A
- superimposed preeclampsia
- postpartum hemorrhage
- gestational DM
- Abruption
- C-section
25
beta blocker intoxication symp and treat w/?
- bradycardia + hypOtension + whezing
| - glucagon
26
nL pupil size in bright light ?
2-4 mm
27
dilated pupil is ?
4-8mm
28
drowsiness + slurred speech + unsteady gate -- what intoxicated w/?
- alcohol
| - benzos
29
glucagon used for what intoxication?
Beta-blocker inxociation
30
beta blocker intoxication symp and treat w/?
- bradycardia + hypOtension + whezing
| - glucagon
31
what meds can cause extrapyramidal side effects?
those that block dopamine (D2) receptors.
- 1st gen Antipsychotics (ie halperidol)
- Some 2nd gen antipsychotics (ie risperidone)
- antiemetics (ie metoclopramide)
32
what may help w/ tardive dyskinesia?
clozapine
33
Extrapyramidal symps?
- acute dystonia (torticollis)
- Akathisia (restlessness)
- parkinsonism (tremor, rigidity, bradykinesia)
- Tardive dyskinesia
34
severe rigidity + mental status change + high fever + autonomic instability + psych meds - think?
neuroleptic malignant syndrome
35
treatment of akathisia (2)?
- propranolol
| - lorazepam (benzo)
36
treatment of extrapyramidal symp -- > parkinsonisms? (2)
- benztropine
| - Amantadine
37
what may help w/ tardive dyskinesia?
clozapine
38
lead pipe rigidity - think?
neuroleptic malignant syndrome
39
severe rigidity + mental status change + high fever + autonomic instability + psych meds - think?
neuroleptic malignant syndrome
40
hereditary angioedema due to?
C1 inhibitor deficiency
41
rapid onset of non-inflammatory edema of face, limbs, and genitalia, laryngeal edema, colicky abdominal pain w/ no evidence of hives (urticaria) -- think?
Hereditary angioedema
abdominal pain due to edema of intestines
42
c1 inhibitor deficiency or dysfuntion -->?
hereditary angioedema
43
immune hemolytic anemia and Rh hemolytic disease of new born what kind of hypersensitivity?
Ab mediated (type II)
44
C1 q levels differ how and why in hereditary vs acquired angioedema?
- Hereditary: C1q levels are normal
| - Acquired: LOW c1q levels
45
cafe-au-lait spots, bilateral acoustic neuromas, cataracts - think?
neurofibromatosis type 2
46
what is elevated in hereditary angioedema?
C2b and bradykinin
47
serum sickness what type of hypersensitivity?
Immune complex mediate (type III)
48
immune hemolytic anemia and Rh hemolytic disease of new born what kind of hypersensitivity?
Ab mediated (type II)
49
cafe-au-lait spots, macrocephaly, feeding problems, short stature, and learning disabilities, lish nyhan spots- think?
Neurofibrimatosis 1
50
cafe-au-lait spots, bilateral acoustic neuromas, cataracts - think?
neurofibromatosis type 2
51
newborn w/ large flank masses + resp distress + flattened ears/nose + small jaw -- think?
Autosomal recessive polycystic kidney disease
flattened ears/nose and small jaw = Potter faces
52
Potter faces - think? is?
- flattened ears/nose
- micgrognathia (small jaw) from oligohydramnios
Think: Autosomal recessive polycystic kidney disease
53
kid w/ pertussis how to treat household contacts?
- Macrolide for all household contacts
| REGARDLESS of vax status
54
myopathy is?
disease of muscle --> muscle weakness
55
what med associated w/ pyloric stenosis?
erythromycin use in babies
56
erythromycin associated w/ what GI complication?
pyloric stenosis if used in pts
57
when acellular pertussis vaccine given?
5 doses!
| 2,4,6, 15-18mo and 4-6yo
58
myotonia is?
inability to relax muscles after strenuous effort
59
myopathy is?
disease of muscle --> muscle weakness
60
myotonic dystrophy is inherited how?
Autosomal dominent
61
mytonic m. dystrophy cause?
expansion of CTG trinucleotide repeat on DMPK gene
62
comorbidities w/ duchenne?
- scoliosis
| - cardiomyopathy
63
comorbidity w/ becker MD?
cardiomyopathy
64
comorbidities w/ myotonic m. dystrophy? (4)
- arrhythmias
- cataracts
- balding
- testicular atrophy/infertility
65
Duchenne and Becker inherited how?
X-linked recessive deletion of dystrophin gene
66
mytonic m. dystrophy cause?
expansion of CTG trinucleotide repeat on DMPK gene
67
hazard rate is?
the change of an event occuring in 1 of the study groups during a set period
68
hazard ratio is?
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
Hazard ratio
event more likely to occur in control group
| treatment likelihood/control likelihood
70
hazard ratio >1 means?
event more likely to occur in the treatment group
| treatment likelihood/control likelihood
71
confidence interval contains 1 means?
no significant difference between the 2 groups
72
Delta wave is?
upsloping just before QRS complex
73
Electrical alternans found on EKG in what cardiac case ?
Pericardial effusion
74
QRS complexes who amplitudes vary from beat to beat - is?
Electrical alternans
| think pericardial effusion
75
f waves found?
F wave = flutter wave
Dx for atrial fluter
76
most common skin malignancy in gen pop?
basal cell carcinoma
77
Delta wave is?
upsloping just before QS complex
78
main cause of exertional heat stroke?
inadequate/failure of thermoregulation
- fluid and salt levels may contribute, but does not cause
79
squamous cell carcinoma common in?
Immunosuppresed pts (ie organ transplant)
80
pearly, flesh/pink colored nodule w/ telangiectatic vessels - think?
basal cell carcinoma
81
most common skin malignancy in gen pop?
basal cell carcinoma
82
immunosuppressed pt + multiple, discrete, flesh--red colored papules of varying size w/ slight central umbilication -- think?
Disseminated cryptococcosis
83
heat exhaustion vs heat stroke?
Exhaustion: inability to maintain adequate CO due to dehydration
Stroke: failure of thermoregulation
84
main cause of fever?
cytokine activation during inflammation
85
main cause of malignant hyperthermia?
uncontrolled efflux of Ca from sarcoplasmic reticulum
| rare autosomal dom disorder, pts receive halothane and succinylcholine for anesthesia --> hyperthermia
86
heat exhaustion cause by?
inadequate Na and H2O replacement during physical activity
87
Heat exhaustion is?
inability to maintain adequate cardiac output
88
heat exhaustion vs heat stroke?
Exhaustion: inability to maintain adequate CO due to dehydration
Stroke: failure of thermoregulation
89
baker's cysts dev bc?
excessive fluid production by inflamed synovium --> accumulates in popliteal bursa
- associated w/ RA, OA, cartilage tears
90
resting tremor is?
low amplitude and freq tremor that dec w/ voluntary movement (so most pronounced when resting)
seen w/ parkinson's disease
91
Resting tremor associated w/?
parkinson's disease
92
which tremor is relieved w/ alcohol?
Essential tremor
93
parkinson disease due to?
loss of dopaminergic neurons in the basal ganglia
94
Intention tremors associated w/?
Cerebellar dysfunction
95
what tremor asociated w/ cerebellar dysfunction?
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
physiological tremors are what type?
postural (inc w/ sustained m. tone --> ie holding arms outstretched)
97
which tremors are worsened by emotional or physical stress or caffeine?
physiologic tremors
98
physiological tremor amp and freq?
low amplitude
| high freq
99
resting tremor amp and freq?
low amp
| low freq
100
physiological tremors are what type?
postural (inc w/ sustained m. tone --> ie holding arms outstreched)
101
which tremors are worsened by emotional or physical stress or caffeine?
physiologic tremors
102
substernal discomfort, left sided neck pain, diaphoresis, SOB that can wake a person up at night -- concern for?
acute coronary syndrome (ie MI, ischemia, etc)
103
during acute MI what new heart sound may be heard?
S4
| atrial gallop; due to atria contracting and forcing blood into stiff ventricle
104
associated w/ S4? (4)
- HTN hear disease
- AS
- HOCM
- Acute MI
105
S3 nL in what pop? (3)
- kids
- young adults
- pregnancy
106
associated w/ S3? (3)
- Heart failure
- Restrictive cardiomyopathy
- High output states
107
nL pop to hear S4?
healthy OLDER adults
108
sharp pleuritic pain hurts worse w/ inspiration or coughing and dec when pt sits up and leans forward -- think?
Acute pericarditis
109
"ejection type systolic murmurs" - talking about what?
flow of bld across aortic and pulmonic valves
110
pulsus paradoxus found w/? (5)
- MAIN: Cardiac tamponade
- severe asthma
- COPD
- hypovolemic shock
- occasionally constrictive pericarditis
111
best imaging for acoustic neuromas?
MRI w/ gadolinium
112
sharp pleuritic pain hurts worse w/ inspiration or coughing and dec when pt sits up and leans forward -- think?
Acute pericarditis
113
post ictal acidosis treatment?
Should be transient and self resolves w/in 60-90 minutes
114
cardiac and vascular response to dopamine?
Dopamine is:
- positive inotrope (inc contraction strength)
- vasoconstrictor
115
best imaging for acoustic neuromas?
MRI w/ gadolinium
116
high anion gap metabolic acidosis post grand mal seizure - likely cause?
lactic acidosis
117
post ictal acidosis treatment?
Should be transient and self resolves w/in 60-90 minutes
118
proptosis is?
bulging of eye
119
flash pulm edema in MI setting - treat?
furosemide
120
what indicates an MI pt that would NOT receive beta blockers?
- Bradycardia
| - Decompensated CHF (ie flash pulm edema)
121
if left untreated hypERthyroidism maj effect?
- Bone loss --> osteoporosis, hyperCalcemia, and hypercalciuria
122
proptosis is?
bulging of eye
123
fetal hyperthyroidism seen w/ what thyroid disease?
Graves disease
| - TSH receptor Ab cross the placenta affecting fetal thyroid
124
carotid pulse w/ dual upstroke - thinkn?
HOCM
125
systolic ejection murmur along L sternal border w/ strong apical pulse - think?
HOCM
126
valsalva inc what murmurs (2)?
HCM
| MVP
127
standing inc what murmurs?
HCM
| MVP
128
Squatting inc what murmurs (3)?
AR
MR
VSD
129
Squatting dec what murmurs (2)?
HCM
| MVP
130
handgrip --> what?
inc afterload
| inc BP
131
handgrip inc what murmurs? (3)
AR
MR
VSD
132
What maneuvers inc preload? (2)
- Squatting from standing (inc afterload too)
| - Passive leg raise
133
blunt trauma + pneumomediastinum + persistent pneumothorax + subQ emphysema - think?
Bronchial rupture (usually R)
134
what maneuvers dec preload (3)?
- valsalva (straining phase)
- Abrupt standing
- Nitro admin
135
What maneuvers inc afterload? (2)
- Hand grip
| - Squatting (from standing; also inc preload)
136
What maneuvers inc preload? (2)
- Squatting from standing (inc afterload too)
| - Passive leg raise
137
cerebellar gait?
ataxic: staggering, wide based gait
can see swaying side to side and impaired tandem gait
138
foot drop due to issue w/?
common peroneal nerve
| L5 radiculopathy
139
peroneal neuropathy due to?
compression of the nerve at the lateral aspect of the fibula
140
peroneal neuropathy associated w/
sensory loss over dorsum of food
141
vestibular gait?
unsteady fall to one side
vertigo
142
gait apraxia/frontal gait?
Magnetic (freezing): start and turn hesitation
143
when do you see gait apraxia?
- frontal lobe issue
| - NPH
144
parkinson gait?
short steps, shuffling
145
vestibular gait?
unsteady fall to one side
vertigo
146
Corrected Ca = ?
Corrected Ca = (measured total Ca) + (0.8*[4 g/dL - serum albumin in g/dL])
