randoms part 2 Flashcards
in cirrhosis the use of furosemide can lead to
hypokalemia
prerenal kindney injury from volume contraction
metabolic alkalosis (loss of H+)
non alcoholic fatty liver disease
typical pt DM–> insulin resistence –> increased peripheral lipolysis, increased TG synthesis and liver uptake of fatty acids
Ascites
> 1.1 SAAG
- cardiac or cirrhosis –> ascites
- portal HTN –> increased capillary hydrostatic pressure
breastfeeding decreases risks of?
otitis media, resp, gI, UTI infections and nec
-reduces risk of ovarian and breast cancer
DIC is seen in metastatic malignancies
like breast!
-look for decreased platelets, fibrinogen and increased INR and signs of MAHA like increased LDH, retics and bili
define oliguria
less than 400cc per day or 6 cc/hour
non seminous germ cell tumors, markers?
AFP and BHCG
seminatous markers?
bHCG
anterior mediastinal mass?
thymoma, teratoma, thyroid, terrible lymphoma
RQ protein, carbs, fat
protein 0.8
carbs 1.0
fat 0.7
middle mediastinal mass
broncogenic cyst, lymphoma
blunt abdominal trauma forming a duodenal hematoma
NG tube, most resolve on their own
acute mediastinitus
s/p cardiac surgery
-drainage, surgical debridement
axillary nerve damage
anterior shoulder dislocation
- deltoid, teres minor
- sensation over the lateral upper arm
radial nerve damage
crutches
humeral midshaft fracture
- triceps, brachioradialis, supnator, “best extenors”
- wrist drop
musculocutaneous what muscles
bicpes, brachialis, coracobrachialis
niacin is made of what?
tryptophan and serotonin
so you get a devifiency in carcinoid
pericadial tamponade on the EKG?
may show electrical alternans
ankle brachial index
nl 1- 1.3
PAD 0.4 - 0.9
Severe ischemia
progressive dysphagia of both solids and liquids at the same time
achalasia
dysohagia for solids first then liquids
esophageal cancer
gastrics ulcer and food
worse
duodenal ulcer and food
better
treat h pylori with?
ppi, clarithromycin and amoxicillin, amoxicillin can be traded for metronidazole if the patient is allergic
all variceal bleeding with ascites needs ppx for SBP
norfloxacin and TMP/SMX
hematochromatosis
fatigue, joint pain (pseudogout) erectile dysfunction and ammenorhea in women (pituitary) skin darkening bronze diabetes cardiomyopathy - dilated and restrictive
polyarteritis nodosa is associated with
hep b and c
wilsons
copper
- neurologic symptoms: psychosis, tremor, dysarthria, ataxia, seizures
- coombs negative hemolytic anemia
- renal tubular acidosis
autoimmune hepatitis antivodies
anti-smooth
fanconi anemia
- x linked
- defect in gene repair –> chromosomal breaks
- aplastic anemia (pancytopenia)
- short stature, microcephaly, abnormal thumbs, hypogonadism, hypopigmented andhyper pigmented areas
diamond black fan
- AD
- macrocytic anemia m red blood cells only
- low retic
- assoc with short stature, webbed neck, cleft lip, shielded chest and triphalangeal thumbs
wiskott-aldrich
- x linked
- thrombocytopenia, eczema and bacterial infections
chediak higashi
- decrease in granulation, chemotaxis and granuloparesis
- frequent bacteria infections, partial albinism
beckwith-wiedemann syndrome
- omphalocele or umbilical hernia
- macroglossia
- hemiphyperplasia
- assoc. with wilms tumor and hepatoblastoma
- check AFP and ab/renal US
laryngomalacia
insipiratory stridor worse in the supine position
increased laxity of the supraglottic structures
management is reassurance
respiratory distress syndrome of the newborn
risk factors: prematurity, male, perinatal asphyxia, c/s without labor
-DM –> hyperglycemia –> increased fetal insulin, insulin antagonizes cortison and block the maturation of sphinomyelin needed for surfractant in the lungs
homocytinuria
AR
- intellectual disability
- decreased lens dislocation
- thrombosis
- fair hair and eyes
neiman pick vs tay sach
both have loss of motor function, hypotonia, difficult feeding, cherry red macula , AR
but!
Neiman has hepatosplenomegaly and areflexia, sphingomyelinas deficieny
tay sachs has hyperreflexia no enlarged spleen or liver and is a b-hexosamindidase deficiency
gaucher
glucocerebrosidase deficiney
-anemia, thrombocytopenia, hepatospelnomagaly, cherry red macula, no loss of mile stones
von gierke a tyle 1 glycogen storage disease
- g-6-phosphatase deficiency
- hypoglycemia leads to SZ
- lactic acidosis, hyperlipidemia, hyperuricemia
- doll like face, thin extremities, short, protruberant abdomen
pompe tyle 2 gylcogen storage disease
- acid malatase
- floppy baby, feeding difficulties, macroglossia, heart failure, hypertrophic heart, hepatomegaly
refeeding syndrome – carbs –> insulin
insulin causes reuptake of already low Po4, K and Mg
lead poisoning
always get a venous level, dont treat if less than 45
vascular ring
- before age 1
- persistent strido that improves with neck distension
- assoc. with cardiac abnormalities
- confirm with barium contrast esophogram, bronchosopor or CT MRI with angio
acquired torticolllis
usually trauma but serious causes include retropharyngreal abscess and atlanto subluxation
-get an xray!
apgar score
appearence, pulse, grimace, activity, respiration
How to keep the PDA open
prostaglandins
how to close a PDA
indomethacin
vitamin B2 riboflavin deficiency
angular chelosis, stomatitis, glossitis, normocytic anemia, seborrheic dermatitis
