S2 RR_1 Flashcards
Classic ECG finding in atrial flutter
Sawtooth P waves
Definition of unstable angina
Angina is new worsening or occurs at rest
Antihypertensive for a diabetic patient with proteinuria.
ACEI
Beck’s triad for cardiac tamponade.
Hypotension distant heart sounds and JVD
Drugs that slow AV node transmission.
beta-blockers digoxin calcium channel blockers
Hypercholesterolemia treatment that causes flushing and pruritus.
Niacin
Treatment for atrial fibrillation.
Anticoagulation rate control cardioversion
Treatment for ventricular fibrillation.
Immediate cardioversion
Autoimmune complication occurring 2-4 weeks post-MI.
Dressler’s syndrome: fever pericarditis inc’d ESR
IV drug use with JVD and holosystolic murmur at the left sternal border. Treatment?
Treat existing heart failure and replace the tricuspid valve
Diagnostic test for hypertrophic cardiomyopathy.
Echocardiogram (showing thickened left ventricular wall and outflow obstruction)
A fall in systolic BP of > 10 mmHg with inspiration.
Pulsus paradoxus (seen in cardiac tamponade)
Classic ECG findings in pericarditis.
Low-voltage diffuse ST-segment elevation
Definition of hypertension.
BP > 140/90 on three separate occasions two weeks apart
Eight surgically correctable causes of hypertension.
Renal artery stenosis coarctation of the aorta pheochromocytoma Conn’s syndrome Cushing’s syndrome unilateral renal parenchymal disease hyperthyroidism hyperparathyroidism
Evaluation of a pulsatile abdominal mass and bruit.
Abdominal ultrasound and CT
Indications for surgical repair of abdominal aortic aneurysm.
> 5.5 cm rapidly enlarging symptomatic or ruptured
Treatment for acute coronary syndrome.
Morphine O2 sublingual nitroglycerin ASA IV beta-blockers heparin
What is the metabolic syndrome?
Abdominal obesity high triglycerides low HDL hypertension insulin resistance prothrombotic or proinflammatory states
Appropriate diagnostic test? A 50-year-old male with angina can exercise to 85% of maximum predicted heart rate.
Exercise stress treadmill with ECG
Appropriate diagnostic test? A 65-year-old woman with left bundle branch block and severe osteoarthritis has unstable angina.
Pharmacologic stress test (e.g. dobutamine echo)
Signs of active ischemia during stress testing.
Angina ST-segment changes on ECG or dec’d BP
ECG findings suggesting MI.
ST-segment elevation (depression means ischemia) flattened T waves and Q waves
A young patient has angina at rest with ST-segment elevation. Cardiac enzymes are normal.
Prinzmetal’s angina
Common symptoms associated with silent MIs.
CHF shock and altered mental status
The diagnostic test for pulmonary embolism.
V/Q scan
An agent that reverses the effects of heparin.
Protamine
The coagulation parameter affected by warfarin.
PT
A young patient with a family history of sudden death collapses and dies while exercising.
Hypertrophic cardiomyopathy
Endocarditis prophylaxis regimens.
Oral surgerym amoxicillin; GI or GU proceduresampicillin and gentamicin before and amoxicillin after
The 6 P’s of ischemia due to peripheral vascular disease.
Pain pallor pulselessness paralysis paresthesia poikilothermia
Virchow’s triad.
Stasis hypercoagulability endothelial damage
The most common cause of hypertension in young women.
OCPs
The most common cause of hypertension in young men.
Excessive EtOH
Stuck-on appearance.
Seborrheic keratosis
Red plaques with silvery-white scales and sharp margins.
Psoriasis
The most common type of skin cancer; the lesion is a pearly-colored papule with a translucent surface and telangiectasias.
Basal cell carcinoma
Honey-crusted lesions.
Impetigo
A febrile patient with a history of diabetes presents with a red swollen painful lower extremity.
Cellulitis
+ Nikolsky’s sign.
Pemphigus vulgaris
- Nikolsky’s sign.
Bullous pemphigoid
A 55-year-old obese patient presents with dirty velvety patches on the back of the neck.
Acanthosis nigricans. Check fasting blood sugar to rule out diabetes
Dermatomal distribution.
Varicella zoster
Flat-topped papules.
Lichen planus
Iris-like target lesions.
Erythema multiforme
A lesion characteristically occurring in a linear pattern in areas where skin comes into contact with clothing or jewelry.
Contact dermatitis
Presents with a herald patch Christmas-tree pattern.
Pityriasis rosea
A 16-year-old presents with an annular patch of alopecia with broken-off stubby hairs.
Alopecia areata (autoimmune process)
Pinkish scaling flat lesions on the chest and back. KOH prep has a spaghetti-and-meatballs appearance.
Pityriasis versicolor
Four characteristics of a nevus suggestive of melanoma.
Asymmetry border irregularity color variation large diameter
Premalignant lesion from sun exposure that can lead to squamous cell carcinoma.
Actinic keratosis
Dewdrop on a rose petal.
Lesions of 1Á varicella
Cradle cap.
Seborrheic dermatitis. Treat with antifungals
Associated with Propionibacterium acnes and changes in androgen levels.
Acne vulgaris
A painful recurrent vesicular eruption of mucocutaneous surfaces.
Herpes simplex
Inflammation and epithelial thinning of the anogenital area predominantly in postmenopausal women.
Lichen sclerosus
Exophytic nodules on the skin with varying degrees of scaling or ulceration; the second most common type of skin cancer.
Squamous cell carcinoma
The most common cause of hypothyroidism.
Hashimoto’s thyroiditis
Lab findings in Hashimoto’s thyroiditis.
High TSH low T4 antimicrosomal antibodies
Exophthalmos pretibial myxedema and dec’d TSH.
Graves’ disease
The most common cause of Cushing’s syndrome.
Iatrogenic steroid administration. The second most common cause is Cushing’s disease
A patient presents with signs of hypocalcemia high phosphorus and low PTH.
Hypoparathyroidism
Stones bones groans psychiatric overtones.
Signs and symptoms of hypercalcemia
A patient complains of headache weakness and polyuria; exam reveals hypertension and tetany. Labs reveals hypernatremia hypokalemia and metabolic alkalosis.
1Á hyperaldosteronism (due to Conn’s syndrome or bilateral adrenal hyperplasia)
A patient presents with tachycardia wild swings in BP headache diaphoresis altered mental status and a sense of panic.
Pheochromocytoma
Should alpha- or beta-antagonists be used first in treating pheochromocytoma?
alpha-antagonists (phentolamine and phenoxybenzamine)
A patient with a history of lithium use presents with copious amounts of dilute urine.
Nephrogenic diabetes insipidus (DI)
Treatment of central DI.
Administration of DDAVP decreases serum osmolality and free water restriction
A postoperative patient with significant pain presents with hyponatremia and normal volume status.
SIADH due to stress
An antidiabetic agent associated with lactic acidosis.
Metformin
A patient presents with weakness nausea vomiting weight loss and new skin pigmentation. Labs show hyponatremia and hyperkalemia. Treatment?
1Á adrenal insufficiency (Addison’s disease). Treat with replacement glucocorticoids mineralocorticoids and IV fluids
Goal hemoglobin A1c for a patient with DM.
< 7.0
Treatment of DKA.
Fluids insulin and aggressive replacement of electrolytes (e.g. K+)
Why are beta-blockers contraindicated in diabetics?
They can mask symptoms of hypoglycemia
Bias introduced into a study when a clinician is aware of the patient’s treatment type.
Observational bias
Bias introduced when screening detects a disease earlier and thus lengthens the time from diagnosis to death.
Lead-time bias
If you want to know if race affects infant mortality rate but most of the variation in infant mortality is predicted by socioeconomic status then socioeconomic status is a what?
Confounding variable
The number of true positives divided by the number of patients with the disease is what?
Sensitivity
Sensitive tests have few false negatives and are used to rule (in or out?) a disease.
Out
PPD reactivity is used as a screening test because most people with TB (except those who are anergic) will have a +PPD. Highly sensitive or specific?
Highly sensitive for TB
Chronic diseases such as SLEhigher prevalence or incidence?
Higher prevalence
Epidemics such as influenzahigher prevalence or incidence?
Higher incidence
Cross-sectional surveyincidence or prevalence?
Prevalence
Cohort studyincidence or prevalence?
Incidence and prevalence
Case-control studyincidence or prevalence?
Neither
Describe a test that consistently gives identical results but the results are wrong.
High reliability low validity
Difference between a cohort and a case-control study.
Cohort studies can be used to calculate relative risk (RR) incidence and/or odds ratio (OR). Case-control studies can be used to calculate an OR
Attributable risk?
The incidence rate (IR) of a disease in exposed - the IR of a disease in unexposed
Relative risk?
The IR of a disease in a population exposed to a particular factor … the IR of those not exposed
Odds ratio?
The likelihood of a disease among individuals exposed to a risk factor compared to those who have not been exposed
Number needed to treat?
1 / (rate in untreated group - rate in treated group)
In which patients do you initiate colorectal cancer screening early?
Patients with IBD; those with familial adenomatous polyposis (FAP)/hereditary nonpolyposis colorectal cancer (HNPCC); and those who have first-degree relatives with adenomatous polyps (< 60 years of age) or colorectal cancer
The most common cancer in men and the most common cause of death from cancer in men.
Prostate cancer is the most common cancer in men but lung cancer causes more deaths
The percentage of cases within one SD of the mean? Two SDs? Three SDs?
68% 95.5% 99.7%
Birth rate?
Number of live births per 1000 population
Fertility rate?
Number of live births per 1000 women 15-44 years of age
Mortality rate?
Number of deaths per 1000 population
Neonatal mortality?
Number of deaths from birth to 28 days per 1000 live births
Postnatal mortality?
Number of deaths from 28 days to one year per 1000 live births
Infant mortality?
Number of deaths from birth to one year of age per 1000 live births (neonatal + postnatal mortality)
