rapid review Flashcards
antihypertensive for diabetic pt with proteinuria
ACEi
antihypertensive for diabetic pt with proteinuria
ACEi
beck’s triad
cardiac tamponade
- hypoT
- distant heart sounds
- JVD
HOCM murmur
systolic ejection
lateral sternal border
increases with Valsalva
aortic insufficiency murmur
diastolic decrescendo low pitched blowing best heard sitting up increases with handgrip
indications for surgical repair of AAA
> 5.5cm
rapidly enlarging
symptomatic
ruptured
target LDL in pt with diabetes
silent MI sx
CHF
shock
altered mental status
derm: “stuck on”
seborrheic keratosis
pearly papule, translucent, telangeictasias
BCC
flat topped papules
lichen planus
anogenital thinning and inflammation
lichen sclerosus
exohytic nodules with varying scaling or ulceration
SCC
hypocalcemia, hyperphosphatemia, low PTH
hypoparathyroidism
- headache, weakness, polyuria
- exam with HTN and tetany
- hypernatremia, hypokalemia, metabolic alkalosis
1ary hyperaldo
weakness, nausea, vomiting, weight loss, new skin pigmentation
Addison’s/1ary adrenal insufficiency
MC diarrhea organism
Campylobacter
MC diarrhea organism
Campylobacter
beck’s triad
cardiac tamponade
- hypoT
- distant heart sounds
- JVD
HOCM murmur
systolic ejection
lateral sternal border
increases with Valsalva
aortic insufficiency murmur
diastolic decrescendo low pitched blowing best heard sitting up increases with handgrip
indications for surgical repair of AAA
> 5.5cm
rapidly enlarging
symptomatic
ruptured
target LDL in pt with diabetes
silent MI sx
CHF
shock
altered mental status
derm: “stuck on”
seborrheic keratosis
pearly papule, translucent, telangeictasias
BCC
flat topped papules
lichen planus
anogenital thinning and inflammation
lichen sclerosus
exohytic nodules with varying scaling or ulceration
SCC
hypocalcemia, hyperphosphatemia, low PTH
hypoparathyroidism
- headache, weakness, polyuria
- exam with HTN and tetany
- hypernatremia, hypokalemia, metabolic alkalosis
1ary hyperaldo
weakness, nausea, vomiting, weight loss, new skin pigmentation
Addison’s/1ary adrenal insufficiency
why no BBs in diabetics?
mask hypoglycemia sx
MC diarrhea organism
Campylobacter
camping diarrhea
Giardia
mayonnaise diarrhea
S aureus
uncooked hamburger diarrhea
E coli O157:H7
fried rice diarrhea
B cereus
raw seafood diarrhea
vibrio, HAV
ring enhancing lesions + seizures
cysticercosis
pseudoappendicitis?
yersinia
tx hepatic encephalopathy
decrease protein intake
lactulose
rifaximin
drug induced hepatitis
TB mx
acetaminophen
tetracycline
hernia with highest incarceration risk?
femoral
absent radii and thumbs, diffuse hyperpig, cafe au lait, microcephaly, pancytopenia
Fanconi’s anemia
lab findings in DIC
increased fibrin split products and D dimer
decreased platelets, fibrinogen, hematocrit
AML subtype assoc with DIC
M3
tx with ATRA (retinoic acid)
tumor lysis electrolyte abnormalities?
decreased Ca
increased K
increased P
increased uric acid
is risk of postinfectious glomerulonephritis affected by treatment?
nope
fever, cough, night sweats in pt from Arizona
Coccidio
tx with ampho B
causes meningitis in neonates
GBS, E coli, Listeria
tx amp and gent
causes meningitis in infants
pneumococcus, meningococcus, H flu
tx cefotax and vanc
gamma globulins in CSF
MS
pruritic papule –> black eschar
cutaneous anthrax
tx PCN G or cipro
PCP prophylaxis: when and what?
CD4
MAI prophylaxis: when and what?
CD4
ring enhancing lesions + seizures
cysticercosis
lung infection partially acid fast weakly gram +
nocardia
sheepherders with liver cysts
echinococcus
smoker and drinker with cough and flulike symptoms, silver stain with gram - rods
legionella PNA
endocarditis of prosthetic valve
S aureus or Strep epi
tx postpartum hemorrhage
uterine massage –> oxytocin
test for ankylosing spondylitis
HLA B27
infections assoc with Reiters
Chlamydia
campylobacter, shigella, salmonella, ureaplasma
needle shaped negatively birefringent
gout
rhomboid shaped positively birefringent
pseudogout
wrist drop, loss of thumb abduction
radial nerve damage
humeral fracture
normal direction of nystagmus in cold water test
toward opposite ear
sources of mets to brain
lung breast skin kidney GI
confusion, confabulation, ophthalmoplegia, ataxia
Wernicke’s
given thiamine before glucose
indication for carotid endarterectomy
70-99 if symptomatic
steroids in Guillan Barre?
no
hyperphagia, hypersexuality, hyperoralitiy, hyperdocility
Kluver Bucy
amygdala
3rd tri bleeding
placental abruption
placenta previa
complete mole karyotype?
46XX
sx of abruption
continuous, painful bleeding
sx of previa
limited, painless bleeding
MCC of postpartum hemorrhage
uterine atony
tx postpartum hemorrhage
uterine massage –> oxytocin
amenorrhea with nl prolactin, no response to estrogen-progesterone challenge, history of D&C
Asherman’s syndrome
newborn with posterior neck mass and hand swelling?
Turner’s
MCC of bloody nipple discharge
intraductal papilloma
screening of strong family hx of ovarian ca?
CA-125 and TVUS annually
mx for urge incontinence?
oxybutinin or metaproterenol
MCC of female infertility
endometriosis
type of breast ca that increases future risk of invasive carcinoma in both breasts?
LCIS
kid with nontender abdominal mass with elevated VMA and HVA
neuroblastoma
MCC of TEF
esophageal atresia with distal TEF
can’t past NG tube
how to r/o shaken baby
optho
CT
MRI
MC 1ary immunodeficiency
selective IgA
chronic respiratory infections, negative nitroblue tetrazolium test
CGD
eczema, thrombocytopenia, high IgA
Wiskott Aldrich
4 mo with life-threatening Pseudomonas infx
Bruton’s X-linked agammaglobulinemia
sx of Reyes?
mental status change, emesis, liver dysfunction
increased risk of what cancer with RB?
osteosarcoma
6mo vaccinations
HBV DTaP Hib IPV PCV rota
MC pathogen in croup
parainfluenza type 1
newborn with posterior neck mass and hand swelling?
Turner’s
galactorrhea, impotence, menstrual dysfunction, decreased libido
dopa antagonist SEs
mother is angry at husband and yells at child
displacement
pedophile enters monastery
reaction formation
woman calmly describes grisly murder
isolation
10 yo in hospital starts wetting bed
regression
how long to dx schizophrenia?
6 mos (1-6 = schizophreniform)
atypical antipsychotic SEs?
weight gain
type 2 DM
QT prolongation
mx to avoid in PTSD
benzos
feeling outside of or detached from body?
depersonalization disorder
Light’s criteria
exudative if:
- p/s protein >0.5
- p/s LDH >0.6
causes of exudative effusion
malignancy TB infection PE pancreatitis
causes of transudative effusion
CHF
liver or kidney dz
protein losing enteropathy
honeycomb pattern on CXR?
diffuse interstitial pulmonary fibrosis
tx: supportive, steroids
tx of SVC syndrome
radiation
cancer assoc with hypercalcemia
SCC
tx SIADH
fluid restriction, demeclocycline
cancer highly related to cigarettes
SCLC
sequelae of asbestos?
fibrosis
pleural plaques
bronchogenic ca
mesothelioma
silicosis increases infection risk with what?
TB
RTA with abnl H+ secretion, nephrolithiasis
type I
RTA with abnl HCO3 and Rickets
II
elevated EPO
elevated HCT
normal O2 sat
RCC or EPO-producing tumor
doughy skin means what?
hypernatremia
MCCs of hypercalcemia
malig, hyperPTH
tx of moderate hypercalcemia
IV hydration and lasix
MC nephrolithiasis
ca oxalate
MC nephrotic syndrome
membranous glomerulonephritis
MC glomerulonephritis
IgA nephropathy
RBC casts in urine sediment
nephritic syndrome
waxy casts and maltese crosses
nephrotic syndrome
eosinophils in urine
allergic interstitial nephritis
drowsiness, asterixis, nausea, pericardial friction rub
uremia
tx SIADH
fluid restriction, demeclocycline
testicular ca with bHCG and AFP
choriocarcinoma
MC testicular cancer
seminoma = germ cell tumor
radiosensitive!
MC bladder ca histology
transitional cell
acid-base prob in salicylate ingestion
metabolic acidosis and respiratory alkalosis
systemic diseases causing nephrotic syndrome
DM
SLE
amyloidosis
elevated EPO
elevated HCT
normal O2 sat
RCC or EPO-producing tumor
tx malignant HTN
nitroprusside
tx SVT
stable: carotid massage or vagal stim
unsuccessful: adenosine
causes of drug-induced SLE
INH penicillamine hydral procainamide chlorpromazine methyldopa quinidine
macrocytic megaloblastic anemia
b12 defic if neurologic sx
folate if not
tx of CO poisoning
100% O2 or hyperbaric if severe/pregnant
how to r/o urethral injury
retrograde cystourethrogram
parkland formula
24h fluids = 4 * kg * %BSA
