Round Two Flashcards
ECK has T wave inversions in leads V4-V6. Spouse died 5 days ago. What will confirm dx?
Dx: takutsubo cardimyopathy (LV dyskinesia mimicing acute coronary syndrome dt excess catecholamine release)
Test: repeat EKC 1-4wks later, showing physiologic ventricular wall motion
Test to dx CAD
excercise stress test.
Dx and test:
Asx in childhood, hallmark cardiac finding is a wide fixed, split S2 heart osund that may be accompanied by a systolic ejection murmur at LUSB (dt increased pulmonary blood flow)
ASD
Echo shows the defect
Murmur that improves with Valsalva (innocent childhod murmur), musical/vibratory
Murmur that worsens with Valsalva. Crescendo descrescendo systolic ejection murmur at LLSB.
Hypertrophic cardiomyopathy
The three SSRIs safe for tx of depression during pregnancy.
Avoid which?
Fluoxetine, sertraline, citalopram
(Cit Flu Sert)
Avoid paroxetine
chlamdia testing guidelines
all sexually active Females or pregnant females less than 24
define threatened v. inevitable abortion v. incomplete
cervix and tisse
Threatened - cervix CLOSED, vaginal BLEEDING
Inevitable - cervix DILATED, no tissue seen through os
Incomplete - cervix DILATED, YES TISSUE through os
First line tx for premature ejaculation (time to ejaculate less than 1min, loss of control, anxiety in patient or partner) - MOA
SSRI
Name the SSRI suffixes (3)
- tine (paroxetine, fluoxetine)
- line (sertraline)
- pram (citalopram, escitalopram)
Anemia of chronic disease: MCV? Fe? Ferritin? TIBC?
MCV - low
Fe - low
Ferritin - high
TIBC - normal
IDA: MCV? Fe? Ferritin? TIBC?
MCV - low
Fe - low
Ferritin - high
TIBC - high
Thalassemia: MCV? Fe? Ferritin? TIBC?
MCV - low
Fe - normal
Ferritin - normal
TIBC - normal
A microcytic anemia with normla iron studies
(inadequate production of alpha and beta Hb chains)
Hemochromatosis (triad: cirrhosis, increased skin pigmentation, hyperglycemia dt iron deposits in pancreas) MCV? Fe? Ferritin? TIBC?
MCV - normal
Fe - high
Ferritin - high
TIBC - low
iron overload
Ferritin and TIBC trends
opposite
Ferritin is how much Fe is IN THE CELL, so TIBC is how much it wants more.
Tx for aphthous ulcers
a corticosteroid - triamcinolone
Corneal abrasion in a contact lens wearer. What bug is MC and what drug is given to tx?
Pseudomonas aeruginosa
give a fluoroquinolone or aminoglycoside - ciprofloxacin
Corneal abrasion in a non-contact lens wearer. What bug is MC and what drug is given to tx?
polymyxinB/TMP ophthalmic drops
CHARGE associtation
Coloboma Heart defects choanal Atresia Restricted growth Genital hypoplasia Ear anomalies and deafness
VACTERL association
Vertebrae anomalies (fused or missing) Anal atresia Cardiac defects Tracheo-Eophageal fistula Renal abnormalities Limb abnormalities
RADS - predominant cell responsible for airway infiltration in RADS
neutrophil
Why is edema present in DM patients with nephrotic sydnrome?
Urinary loss of major protiens including albumin causes decreased protein content in serum, dropping intravescular oncotic pressures, and leaking fluid into interstitial space. So edema ensues.
Dx and diagnostic test:
Infant with bilious, nonbloody, nonprojectile vomiting wihtin first d-mo of life. PRogressiv eintolerance and FTT.
Dx of infants with a malrotation of the gut
Test: upper GI barium contrast - proximal duodenal dilation followed by “bird’s beak” obstruction and then spiral or corkscrew duodenal configuration.
What does excessive alcohol use do to cause anemia?
Siderolastic anemia - heme synthesis dusrupted causing iron to accumulate in mitochondira, causing BM to produce ringed sideroblasts (nucleated RBC precursors),
DM retinopathy dx by fluorescein angiography or fluorescein staining?
angiography
thiazides and lithium can cause what lab abonormality?
hyperCa
who should be screened for alcohol abuse?
all adults
What neumococcal and meningococcal vaccines are given to asplenic if vaccination hx unknown?
PCV13 if unknown
PPolysaccharide if known
MCV3 less than 55
Mpolysaccharide 56+
Hib if uncertain/not received
A woman had a cesarean birth for first child. She wants TOLAC. What do you tell her?
risk of maternal dath significantly decreased by TOLAC compared to elective repeat cesarean delivery.
Target HbA1c for elderly population with multiple comorbidities and less than 10y to live.
8.0
