Rosh Material #2 Flashcards
ohio or mississippi river valley
bird/bat droppings
histoplasmosis
permanent pacemaker is the definitive tx for which two AV blocks
mobitz type II
third degree
what is this showing
second degree type II (mobitz II)
prophylaxis tx for PJP if sulfa allergy
dapsone
opportunistic HIV infxns and associated prophylaxis
PJP -> bactrim
myobacterium TB -> isoniazid + pyridixoine
toxoplasmosis -> bactrim
MAC -> azithromycin
indications for prophylaxis for opportunistic HIV infxns
PJP: < 200
toxoplasmosis: < 100
MAC: <50
rose bengal stain
sjorgen’s
salivary gland bx findings of sjorgen’s
mononuclear cell infiltration
what surgical procedure is an alternative to cipro to eradicate the carrier state for carriers of salmonella
cholecystectomy
common cause of osteomyelitis in kids w. SSA
salmonellosis
pathophys of alpha thalassemia
two or more of the four alpha-globin chain genes fails to fxn
only independent rf for mesothelioma
asbestos
presenation of mesothelioma
-20-40 yrs after exposure
-insidious onst SOB, unilateral, nonpleuritic cp
-fatigue/weakness
-weight loss
2 CXR findings of mesothelioma
pleural thickening
pleural effusion
describe fluid w. mesothelioma related pleural effusion
exudative
hemorrhagic
dx for mesothelioma
-VATS bx (video assisted thorascopic surgery)
pharm for SAH
nimodipine (decreases vasospasm)
CSF findings of SAH
xanthochromia (yellow/pink)
vs
gross blood
lung ca screening guidelines for smokers/past smokers
annual low dose CT for:
50-80 yo w. 20 ppy smoking hx
OR
have quit w.in past 15 yr
d/c when pt has not smoked x 15 yrs or has limited life expectancy
lupus pernio
bilat hilar adenopathy
noncaseating granulomas
sarcoidosis
desmopressin is effective in treating which type of diabetes insipidus
central
indication for mechanical valve replacement over biprosthetic
<50 yo who can take warfarin
what is this showing
superficial thrombophlebitis
3 types of thrombophlebitis
-superficial phlebitis: pain/inflammation, (-) thrombus
-superficial thrombophlebitis: pain/inflammation, (+) thrombus
-superficial vein thrombosis
tx for thrombophlebitis
-elevation/warm compress
-NSAIDs
-compression
-ambulation
-anticoagulation
3 signs of metastatic gastric carcionma
left supraclavicular node (virchow)
left axillary node (irish)
periumbilical node (sister mary joseph)
management of sliding hiatal hernia
asymptomatic: lifestyle
symptomatic: ppi
management of paraesophageal hiatal hernia
asymptomatic: conservative
symptomatic: surgery
classificaitons of post MI complications
mechanical
mural thrombosis
pump failure
pericarditis
recurrent MI
conduction abnl’s
3 mc types of post MI mechanical complications
free wall rupture
VSD
acute mitral valve regurgitation
post MI free wall rupture mc occurs _ after an MI
24-48 hr
hallmark presentation of post MI free wall rupture
cardiac tamponde 24-48 hr post MI
timeline of post MI free wall rupture and VSD
-free wall rupture: 24-48 hr (up to 2 weeks)
-VSD: 10 days
what is this showing
anterior mediastinal neoplasm -> thymoma is mc
pharm tx for MG
-chronic: cholinesterase inhibitors:
neostigmine
pyridostigmine
-acute: plasmapheresis, IVIG
4 mc paraneoplastic d.o
MG
pure red cell aplasia
immunodeficiency
thymoma-associated multiorgam autoimmunity
sx of MG
-ocular or generalized muscle weakness
-dysarthria
-dysphagia
-ptosis/diplopia worse at the end of the day/after exertion
3 conditions associated w. MG
thymoma
thyroid dz
autoimmune d.o
mcc and affected valve of infective endocarditis: non IVDU vs IVDU
IVDU: staph, tricuspid
non IVDU: staph vs strep viridans, mitral
2 indications for valacyclovir w. bells palsy
-presence of herpetic vesicles in the external ear canal
-grade IV severity
causes of pneumoconiosis and associated luing findings
asbestos: shipping, construction, plumbing, mechanic -> lower lobe
berylliosis: aerospace, dentist, IT, fluorescent bulbs -> upper lobe
byssinosis: cotton
silicosis: quarries, sandblasting, mines/drilling -> upper lung
talc: ceramics, cosmetics, plastics/rubber/paint -> upper lobe
hard metal (cobalt): diamond polishing, cobalt -> lower lobe
what types of pneumoconiosis are assocaited w. upper upper lobe findings
coal dust
beryllium
talc
silica
what 2 types of pneumoconiosis are associated w. lower lobe findings
hard metal (cobalt)
asbestos
how to remember upper vs lower lobe pneumoconiosis
-asbestos: from the roof, affects the base
-silica, coal: from the base (earth), affect the roof (upper lobes
rapid correction of acute hypernatremia may cause:
rapid correction of acute hyponatremia may cause:
rapid correction of hypernatremia -> cerebral edema
rapid correction of hyponatremia -> osmotic demyelination syndrome
bp management of acute aortic dissection
esmolol
vs
labetalol
g6pd is caused by
reduction in glutathione levels in rbc
name 2 meds that are used for abd cramping in IBD
dicyclomine
hyoscyamine
tx for myocarditis
similar to CHF:
furosemide
ACEI
bb if EF < 40%
+/- abx
sx of stroke based on location
ACA: apraxia, contralateral LE paralysis
MCA: contralateral UE paralysis, aphasia
PCA/VBI: LOC, n/v, CN dysfxn, ataxia, visual agnosia
mcc complication of pckd
ESRD
3 conditions that cause increased serum solutes
hyperglycemia
IVIG
mannitol administration
3 rf for idiopathic pulmonary fibrosis
-smoking
-exposure to stone, metal, wood, organic dusts
-GERD
early vs late PE findings of pulmonary fibrosis
early: crackles
late: clubbing
what is this showing
diffuse ST elevation -> pericarditis
pharm for AVNRT (mcc of paroxysmal SVT)
adenosine
diltiazem
metoprolol
extraintestinal manifestations of UC
pyoderma gangrenosum
erythema nodosum
ankylosing spondylitis/sacroileitis
arthritis
uveitis
liver dz
kidney dz
primary sclerosing cholangitis
bx findings of UC vs crohn’s
UC: crypt abscesses, crypt branching
Crohn’s: granulomas
recs for lipid panel screening for men w. no other CVD rf
lipid profile beginning at age 35
management of IBD, acute vs chronic
acute: prednisone
chronic: mesalamine
opportunistic infxns associated w. CD4 counts that Rosh wants us to know
<250: esophageal candidiasis
<200: PCP PNA
<100: cerebral toxoplasmosis, cryptococcosis
<50: MAC
TSH range goal for pt’s w. PMH thyroid ca
0.1-2.0
which alzheimer’s med is neuroprotective
memantine -> NMDA agonist
most impotant rf for prostate ca
older age
2 PSA indications for urology referral
> 4
rapidly rising
management of prostate ca
localized: obs, EBRT, brachytherapy, prostatectomy
recurrent/metastatic: androgen deprivation
femal w. recurrent DVTs and adverse pregnancy outcomes
antiphospholipid abs syndrome
painless weakness of the proximal muscles
polymyositis
what 2 lab abnl’s are associated w. sarcoidosis
elevated ACE
hypercalcemia
IV management of HTN emergency (2)
labetalol
nicardipine
cholinergic agonist that is approved for dry mouth caused by sjorgen syndrome
cevimeline
core regimen for PVD/PAD
ASA
cliostazol
rosuvastatin
smoking cessation
structured exercise
f/c, worsening of lesions, tender LAD, hyperventilation, and hypotn w.in 24 hr after receiving tx for spirochete infxn (ex syphilis)
jarisch herxheimer rxn
tx for harisch herxheimer rxn
APAP vs ibuprofen
t/f: a fasely high ABI may indicate severely hardened, non compressible leg vessels
t!
causes of normal anion gap metabolic acidosis
diarrhea
renal tubular acidosis
adrenal insufficiency
ckd
intestinal/pancreatic/biliary fistula
hypoaldosteronism
meds
5 meds associated w. normal anion gap metabolic acidosis
spironolactone
prostaglandin inhibitors
sulfas
cyclosporin
pentamidine
what age should AAA screening be done
one time US at 65 yo
gs imaging for the initial dx and staging of bladder ca
cystoscopy
4 rapid sequence intubation induction agents
etomidate
ketamine
midazolam
propofol
which RSI agent is best for respiratory failoure due to asthma
ketamine (bronchodilatory effects)
the rash of SLE mc affects the _ surfaces of the hands and arms
extensor
sx of acute adrenal insufficiency
dehydration, hypotn, shock
n/v, wt loss, anorexia
acute abdomen
hypoglycemia
fever
hyponatremia, hyperkalemia, azotemia, hypercalcemia
hyperpigmentation
initial tx for MG
pyridostigmine
