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MJ- Internal Med EOR > Rosh 2 > Flashcards

Rosh 2 Flashcards

1
Q

What med is contraindicated in inferior wall STEMI

A

nitroglycerin

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2
Q

ultrasound findings are concerning for testicular cancer- what is the next step in diagnosing/

A

radical inguinal orchiectomy

(testicular biopsy CI due to risk of seeding into scrotum)

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3
Q

serum markers for seminoma testicular cancer

A

HCG and LDH

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4
Q

serum markers for nonseminoma testicular cancer

A

HCG and alpha-fetoprotein

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5
Q

Which condition commonly coexists with polymyalgia rheumatica?

A

giant cell arteritis

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6
Q

symmetric aching/stiffness about the shoulders, hip girdle, neck, and torso

A

Polymyalgia rheumatica

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7
Q

triad of:

GRADUAL ipsilateral hearing loss

ataxia

tinnitus

(also: ipsilateral sensorineural hearing loss in the high tones and a poor word discrimination score- c/o not being able to talk on the phone in that ear)

Meniere’s is LOW tones

A

Vestibular schwannoma

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8
Q

vestibular schwannomas affect what nerve

A

CN VII (facial)

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9
Q

what nerve injury causes foot drop

A

common peroneal

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10
Q

tx for BPH

A
  • Alpha blockers (urethral relaxation, rapid sx relief): Tamsulosin
  • 5 ∝ reductase (REDUCE THE SIZE) inhibitors shrink an enlarged prostate: Finasteride
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11
Q

Obstructive vs restrictive lung disease:

FEV1/FVC= <0.8

A

obstructive= <0.8

restrictive= normal

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12
Q

tx for chronic, stable angina

A

lifestyle modifications

statin

antihypertensive (BB)

antiplatelet therapies

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13
Q

MCC tricuspids stenosis

A

rheumatic heart dz

(almost always occurs with mitral stenosis)

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14
Q

What are Signs of more serious cardiac disease heard on auscultation

A

S4

grade >3/6 intensity

any diastolic murmur

fixed splitting of S2

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15
Q

what is seen on ekg in pericarditis

A

PR depression (I, II, III, aVF, aVL, V2-V6)

PR elevation (aVR)

diffuse ST-segment elevation (concave)

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16
Q

What is the minimum time s/p cardioversion should someone with A.fib be anticoagulated for

A

at least 4wks

(may be lifelong depending on CHADVASC score)

17
Q

what is the most specific finding for myocardial ischemia during exercise stress test

A

2 mm downsloping ST-segment depression

18
Q

pericardial knock

A

pericarditis

19
Q

in patients with a myocardial infarction, which four drugs have been shown to decrease mortality?

A

ASA

BB

ACE

Statin

20
Q

tx for endocarditis in an IV drug abuser w/ native valve

A

vanco + Ceftriaxone or cefepime

21
Q

What 2 conditions LOWER BNP

A

Obesity

pericardial constriction

22
Q

What is commonly hypertrophied in mitral stenosis

A

Right ventricular hypertrophy

(b/c MS causes “pressure backup” into pulmonary circulation and ultimately back to the right ventricle–> R vent hypertrophy +/- R HF)

(long standing MS can lead for L atrial dilation–> A.fib)

23
Q

decrescendo diastolic blowing murmur at left sternal border w/ WIDE PULSE PRESSURE

water hammer pulse

A

AORTIC REGURG

24
Q

medical tx for STABLE pts w/ WPW that have antidromic (widecomplex) tachycardia

A

procainamide

25
Q

medical tx for STABLE pts w/ WPW that have orthodromic (narrow complex) tachycardia

A

adenosine

26
Q

MC causative organism of endocarditis:

Tricuspid (IVDU) vs mitral valve

A

Tricuspid (IVDU)= S. aureus

Mitral= Strep viridans, S. aureus

27
Q

what is a serious complication of Kawasaki disease

A

coronary artery aneurysm

28
Q

Those with surgically repaired tetralogy of Fallot, with right ventricular pressure > ____ mm Hg or cardiomegaly, should not participate in rigorous or contact sports

A

> 50

(if RV pressure <50, no restrictions recommended)

29
Q

Which of the following antiarrhythmic medications is contraindicated in the setting of coronary artery or structural heart disease?

A) Amiodarone

B) Dofetilide

C) Dronedarone

D) Flecainide

A

D) Flecainide

(increased risk of polymorphic ventricular tachycardia)

30
Q

Which of the following medications has the greatest impact on reducing mortality in patients presenting with acute coronary syndrome?

A) Morphine

B) Beta blocker

C) Aspirin

D) Nitroglycerin

A

ASA

31
Q

Stanford type A aortic dissections involve what part of the aorta?

Stanford type B?

A

Type A= Ascending

Type B= Descending

MJ- Internal Med EOR (4 decks)

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