Rapid review Flashcards
Abdominal pain, ascites, hepatomegaly
Budd-Chiari syndrome (posthepatic venous thrombosis)
Bounding pulses, wide pulse pressure, diastolic heart murmur, head bobbing
Aortic regurgitation
Chest pain, pericardial effusion/friction rub, persistent fever following MI
Dressler syndrome (autoimmune-mediated post-MI fibrinous pericarditis, 2 weeks to several months after acute episode)
Golden brown rings around peripheral cornea
Wilson disease (Kayser-Fleischer rings due to copper accumulation)
Lucid interval after traumatic brain injury
Epidural hematoma (middle meningeal artery rupture)
Periorbital and/or peripheral edema, proteinuria (> 3.5g/ day), hypoalbuminemia, hypercholesterolemia
Nephrotic syndrome
Rapidly progressive limb weakness that ascends following GI/upper respiratory infection
GBS
Rash on palms and soles
Coxsackie A, 2° syphilis, Rocky Mountain spotted fever
Swollen gums, mucosal bleeding, poor wound healing, petechiae
scurvy (vit C deficiency)
Systolic ejection murmur (crescendo-decrescendo)
Aortic stenosis
Anti–glomerular basement membrane antibodies
Goodpasture syndrome (glomerulonephritis and hemoptysis)
Antimitochondrial antibodies (AMAs)
1° biliary cirrhosis (female, cholestasis, portal hypertension)
Basophilic nuclear remnants in RBCs
Howell-Jolly bodies (due to splenectomy or nonfunctional spleen)
Basophilic stippling of RBCs
Lead poisoning or sideroblastic anemia
“Delta wave” on EKG, short PR interval, supraventricular tachycardia
Wolff-Parkinson-White syndrome (Bundle of Kent bypasses AV node)
“Honeycomb lung” on x-ray or CT
Interstitial pulmonary fibrosis
Necrotizing vasculitis (lungs) and necrotizing glomerulonephritis
Granulomatosis with polyangiitis (Wegener; PR3-ANCA/ c-ANCA) and Goodpasture syndrome (anti–basement
membrane antibodies)
Ring-enhancing brain lesion on CT/MRI in AIDS
Toxoplasma gondii, CNS lymphoma
Carcinoid syndrome
Octreotide
Acute gastric ulcer associated with CNS injury
Cushing ulcer ( intracranial pressure stimulates vagal gastric H+ secretion)
Acute gastric ulcer associated with severe burns
Curling ulcer (greatly reduced plasma volume results in sloughing of gastric mucosa)
Holosystolic murmur
VSD, tricuspid regurgitation, mitral regurgitation
Winters formula
PCO2 = 1.5 [ HCO3] + 8 … +/-2
PW is diagnosed by the presence of a short PR interval and a delta wave in sinus rhythm, it is important to be able to make the diagnosis of WPW with atrial fibrillation when presented with an ECG such as this one.
In WPW with atrial fibrillation, drugs that slow AV nodal conduction increase the number of impulses that go down through the bypass tract and actually increase ventricular rate in this setting. Only drugs that slow conduction down the bypass tract are indicated.
Procainamide slows conduction down bypass tracts in WPW
These three criteria
Wide complex tachyarrhythmia
Irregularly irregular rhythm
Varying widths of the QRS complexes-> should prompt consideration of preexcited atrial fibrillation or atrial fibrillation in a patient with an accessory conduction pathway.
Tx: ibutilide or procainamide
_____ is a Class III antiarrhythmic drug that prolongs refractoriness of both the AV node and accessory pathway and acutely terminates atrial fibrillation or flutter.
Ibutilide
_____ is a Class Ia antiarrhythmic that increases refractoriness of atrial and ventricular myocardium without any AV nodal-blocking effect. It can also be effective for acute termination of preexcited atrial fibrillation, and even when it fails to terminate the atrial fibrillation, it usually slows the ventricular rate due to decreased conduction and increased refractoriness in the accessory pathway.
Procainamide
Although ____ may slow conduction through the accessory pathway with chronic administration, it does not slow accessory pathway conduction with acute IV administration, and its β-blocking properties make it a primarily AV nodal-blocking agent in the acute setting, making it a nonpreferred agent in preexcited atrial fibrillation.
amiodarone
Auto-PEEP ventilator waveform. Expiratory flow fails to return to a baseline of zero flow (red line), and pressure gradually increases (blue line).
