Rosh Material #1 Flashcards
1
Q
pleural effusions cause _ tactile fremitus
A
decreased
2
Q
what sx is typically only present in pt’s w. an exudative pleural effusion
A
chest pain
3
Q
mcc of transudative vs exudative pleural effusion
A
transudative: CHF
exudative: 1. infxn, 2. malignancy, 3. PE
4
Q
_ criteria is used to differentiate btw transudative and exudative pleural effusion
A
light
5
Q
transmission cycle for lyme dz
A
white-footed mouse -> ixodes scapularis -> human
6
Q
what tick borne illness causes RBC hemolysis and is diagnosed w. thick and thin smear
A
babesiosis
7
Q
what tick borne illness causes a biphasic fever
A
colorado tick fever
8
Q
what tick born illness causes a centripetal rash (greatest concentration on trunk, fewest on distal extremities)
A
RMSF
9
Q
describe tick paralysis
A
ascending flaccid paralysis
10
Q
what tickborne illness causes ulcers, LAD, conjunctivitis, and PNA
A
tularemia
11
Q
list the cause of the following tick borne illnesses:
babesiosis:
colorado tick fever:
ehrlichiosis:
lyme dz:
RMSF:
tick paralysis:
tularemia:
A
babesiosis: babesia
colorado tick fever: orbvirus
ehrlichiosis: rickettsia like coccobacilli
lyme dz: spirochete borellia burgdorfi
RMSF: rickettsia rickettsii
tick paralysis: demacentor spp.
tularemia: francisella tularensis
12
Q
what 3 tick borne illnesses are treated w. doxy
A
ehrlichiosis
lyme dz
RMSF
13
Q
tx for tularemia
A
streptomycin
14
Q
tx for babesiosis
A
atovaquone
+
azithromycin
15
Q
what tick borne illness is deadly in asplenic pt’s
A
babesiosis
16
Q
_ is pathognomonic for lyme dz
A
bilat facial palsy
17
Q
tx for temporal arteritis: no vision loss vs vision loss
A
no vision loss: high dose prednisone
vision loss: IV methylprednisolone + high dose ASA
18
Q
temporal arteritis is associated w. what condition
A
polymyalgia rheumatica
19
Q
management of SIADH: asymptomatic vs symptomatic
A
asymptomatic: fluid restriction + 2 g Na tablets
symptomatic: 3% hypertonic saline 100 mL over 10 min
20
Q
what is this showing
A
rat bite erosions -> gout
21
Q
what is this showing
A
white lines of chondrocalcinosis -> pseudogout
22
Q
joint mc affected by pseudogout
A
knee
23
Q
what causes pseudogout
A
calcification of cartilage from buildup of calcium pyrophosphate crystals
24
Q
mc rf for aortic dissection
A
htn
25
what are the steps in TB infxn
1. tubercle (macrophage accumulation)
2. regional LAD
3. ghon complex formation
4. ranke complex
26
3 phases of TB
primary: asymptomatic
latent: asymptomatic
reactivation: fever, night sweats
27
light criteria for exudative pleural effusion
presence of one:
-pleural fluid pro > 0.5
-pleural fluid LDH:serum LDH > 0.6
-pleural fluid LDH > 2/3 UNL of normal LDH
28
2 bx findings of parkinsons
lewy bodies in substantia nigra
decrease in dopaminergic neurons in substantia nigra
29
sjorgen's increases risk for what 2 diseases
lymphoma
ILD
30
test indicated for RA pt's who require intubation/sedation
cervical spine XR
31
management of SVT: stable vs unstable
stable: cold stimulus to face, valsalva, stimulate gag reflex
unstable: **1. adenosine**, 2nd line: procainamide, amiodarone, bb, 3. cardioversion
32
office based management of hemorrhoids
-rubber band ligation: healthy pt, grade I, II, III, or internal
-sclerotherapy: anticoagulants/antiplatelets, immunocompromised, portal htn
-excision: actively thrombosed external
33
contraindication for office based procedures for hemorrhoids
grade IV internal
34
pericardial knock on cardiac auscultation
kussmaul sign
pulsus paradoxus
constrictive pericarditis
35
4 causes of restrictive cardiomyopathy
amyloidosis
sarcoidosis
hemochromatosis
tropical endomyocardial fibrosis
36
paradoxical increase in JVP that occurs during inspiration
kussmaul sign -> constrictive pericarditis
37
tx for constrictive pericarditis
pericardiectomy
38
bloody diarrhea, crampy abd pain, tenesmus
UC
39
which IBD is associated w. increased colon ca risk
UC
40
advanced prostate ca is associated w. PSA levels >
40
41
tx for coccidioidomycosis
-at risk (HIV/organ transplant): fluconazole vs itraconazole
-meningitis, first trimester pregnancy, failed azole: amphotericin B
42
2 derm manifestations of coccidioidomycosis
erythema nodosum
erythema multiforme
43
stages of de quervain thyroiditis
1. hyperthyroid
2. euthyroid
3. hypothyroid
4. euthyroid (recovery)
44
etiology of de quervain's thyroiditis
viral URI
45
dx/tx for de quervain thyroiditis
dx: clinical
tx: naproxen vx steroids, propranolol (anxiety)
46
presentation of blastomycosis
1. pna - mc
skin: verrucous lesions - mimic scc
osteomyelitis
47
blastomycosis is endemic in the (2)
midwest
southern states
48
gs dx for cor pulmonale
right heart cath
49
dx for acromegaly
**1. serum IGF1 - gs**
2. unequivocal: r.o acromegaly
3. equivocal: oral glucose suppression test
50
PE findings of acromegaly
increased head/glove/shoe size
coarse facial features
oily skin
visual field defects
DM
51
symptomatic management of sjorgens
1. artificial tears/saliva
2. cyclosporine drops
3. oral cholinergics: pilocarpine
52
CSF findings of MS
oligoclonal IgG bands
53
what is lhermitte sign
spinal electric shock sensation w. neck flesion
54
3 PE findings of MS
-marcus gunn pupil (afferent pupillary defect)
-lhermitte sign
-impaired bilat eye adduction (bilat internuclear ophthalmoplegia)
55
main med to know for MS tx
glatiramer acetate - interferon beta-1a
56
what gene is associated w. CML
BCR-ABL1 (philadelphia)
57
conditions associated w. HLAB27
**pair:**
psoriatic arthritis
ankylosing spondylitis
IBD
reiter's syndrome
58
pharm for acute angle closure glaucoma
topical timolol
topical apraclonidine - alpha agonist
pilocarpine - miotic
acetazolamide - cah inhibitor
59
the HOCM murmur is increased w.:
and relieved w.:
increased: valsalva, standing
relieved: squatting, trendelenburg
60
2 genetic conditions associated w. MVP
marfan
ehlers danlos
61
2 PE findings associated w. MVP
scoliosis
pectus excavatum
62
t/f: MVP requires f/u w. cardiology before a pt can participate in sports
f!
can be a normal finding in healthy, think, young women
63
2 sx of prolactinoma
amenorrhea
impotence
64
hallmark sx of dressler syndrome (post MI syndrome)
pleuritic cp radiating to the back -
worse w. lying down
improved w. leaning forward
65
3 PE finding of post MI syndrome
pericardial friction rub
persistent low grade fever
leukocytosis
66
3 rf for dermatomyositis
female
40-60 yo
occul malignancy
67
sx of dermatomyositis
insidiou, painless proximal m weakness
rash
dysphagia
68
PE findings of dermatomyosistis
heliotrope rash
gottron papules
mechanic's hand
shawl sign/v-sign
photodistributed poikiloderma
i honestly have no idea what most of these are #sacrificiallamb
69
what abs are associated w. dermatomyositis
anti Jo-1 abs
70
what is this showing
short PR interval
delta wave
wide QRS
**WPW**
71
mcc of WPW
accessory conduction pathway (bundle of kent)
72
definitive tx for WPW
radiofrequency ablation
73
progression of colon polyps to malignant
1. hyperproliferation
2. adenomatous polyps
3. dysplasia (pre cancer)
4. adenocarcinoma
5. invasive cancer
74
indication for repeat scan 5 years after first colonoscopy
tubular adenomas < 10 mm
75
4 indication for colonoscopy 3 years after first scan
>/= 3 polyps
tubular adenomas > 10 mm
villous adenomas
high grade dysplasia
76
progressive tender weakness of 3 mos duration
polymyositis
77
2 abs associated w. polymyositis
anti-Jo
anti-SRP
78
bb are contraindicated in what type of angina
prinzmetal
79
mainstay of tx for prinzmetal angina (2)
ccb
nitrates
80
mc route of infxn for prostatitis
ascending urethral spread
81
lab characteristics of anemia of chronic dz
low: serum iron, TIBC
high vs normal: ferritin
82
order of tx for BPH
1. alpha blockers
2. 5 ART inhibitors
3. TURP
83
tx for venous insufficiency
1. leg elevation
2. compression therapy
3. ulcer care
4. ablation
84
2 rf for plyarteritis nodosa
male age 40-60
hep B infxn
85
starburst livedo - painful violaceous plaques surrounded by livedo reticularis
pathognomonic for polyarteritis nodosa
86
small vessel vasculitides to know
hypersensitivity vasculitis
henoch schonlein purpura
goodpasture
granulomatosis w. polyangitis
87
3 medium vessel vasculitides to know
polyarteritis nodosa
behcet dz
microscopic polyangitis
88
2 large vessel vasculitides to know
giant cell arteritis
takayasu arteritis
89
what 2 conditions are associated w. palpable purpura
-hypersensitivity vasculitis -> isolated palpable purpura
-henoch schoenlein purpura -> palpable purpura w. abd pain, hematuria, n/v/d
90
cough
hemoptysis
glomerulonephritis
goodpasture
91
sinusitis
pulmonary infiltrates
nephritis
granulomatosis w. polyangitis
92
skin ulcers
nephritis
mesenteric ischemia
polyarteritis nodosa
93
recurrent painful oral and genital ulcers
uveitis, iritis, or optic neuritis
behcet dz
94
pulmonary infiltrates
nephritis
microscopic polyangitis
95
large vessel vasculitis
finger ischemia
arm claudication
takayasu arteritis
96
cardiomegaly w.o pulmonary congestion
pericardial effusion
97
order of tx for hemochromatosis
1. phlebotomy
2. erythrocytapheresis
3. iron chelation - deferoxamine
4. dietary changes
98
4 complications of hemochromatosis
liver dysfxn
hypogonadism
arthralgias/arthritis
cardiomyopathy
99
3 causes of superior vena cava syndrome
mediastinal tumors
thrombosis
aortic aneurysm
100
4 PE findings of superior vena cava syndrome
facial swelling
plethora (purple skin)
upper extremity swelling
JVD
101
mcc of secondary htn in adults
renal artery stenosis
102
3 causes of renal artery stenosis
fibromuscular dysplasia
atherosclerosis
kidney transplant
103
what are the 3 normocytic anemias
anemia of chronic dz (early)
hemolytic
aplastic
104
fx mc associated w. multiple myeloma
vertebral
105
crest syndrome is associated w.
scleroderma
calcinosis of skin
raynaud
esophageal dysmotility
sclerodactylyl
telangiectasia
106
what is this showing
multifocal atrial tachy
| at least 3 different p wave morphologies
rate 100-180
irregular
107
3 causes of MAT
COPD
hypoxia
pulmonary htn
108
tx for MAT
O2
rate control
109
meds that cause drug-induced SLE
**hipps:**
hydralazine
INH
procainamide
phenytoin
sulfonamides
110
recommended contraception for pt's w. SLE
progestin only due to higher thromboembolic risk
111
labs associated. w SLE
flares: low complement
antidsDNA abs
anti smith
antiphospholipid
112
abs associated w. drug induced SLE
anti histone abs
113
tx for SLE
-steroids
-hydroxychloroquine
-cyclophosphamide, mycophenolate, mofetil, azathriprine, rituximab
114
which heart sound is always pathologic
S4
115
which heart sound is associated w. right sided heart failure
S3
116
empiric tx for HAP
cefepime
levofloxacin
vanco
117
what rash is associated w. RMSF
maculopapular eruption on palms and soles
118
what dementia is associated w. early age onset, changes in behavior/personality, and social conduct - ex. impulsivity, criminal behavior, inappropriate sexual advances, child like sense of humor, lashing out at pets, primal reflexes, binge eating, and eating inedible objects
frontotemporal
119
first line tx for erosive esophagitis
ppi
120
5 causes of atrial flutter
COPD
PE
thyrotoxicosis
mitral valve dz
etoh
121
pathophys of a flutter
single excitable electrical focus in the left or right atrium
122
metabolic syndrome criteria
**any 3 of the following:**
-abdominal obesity
-TG >/= 150
-HDL < 40 (w), <50 (m)
-BP >/= 130/85
-FBG >/= 100 OR on meds for hyperglycemia
123
harsh midsystolic crescendo-decrescendo murmur radiating to the left shoulder
pulmonic stenosis
124
what is carvallo sign
pansystolic murmur that becomes louder during inspiration -> tricuspid regurgitation
