Sep 2023 Flashcards
Theophylline Toxicity S/S
HypoK+
Nausea
Muscle weakness
Quinolones & Macrolides reduce clearance - Toxicity
IIH Rx
Acetazolamide
Weight loss
2nd line: Topiramate
Finasteride M.O.A.
5-alpha reductase Inhibitor
Reduce DHT
Gout flare Rx in CKD ?
Steroids (short course)
Colchicine C/I
NSAIDs C/I
Lower UTI (Females) Rx ?
Fosphomycin 3 Gram Stat
Meronum (Severe Infection)
Trimethoprim Use ?
Uncomplicated UTI (sensitivity known)
Glycogen storage Dz (type 5)
Mcardle’s disease ?
Aerobic/weight lifting causes rhybdomyolysis
abnormal dark urine
(myoglobinuria)
High CK
Uncontrolled HTN (post pregnancy) Dx:
H/O pre-eclampsia
(headache, HTN, seizues)
CT brain: multiple areas of white matter inattenuation (esp posterior lobe)
Etyhlene Glycol ABGs:
High anion gap metabolic acidosis.
Normal anion gap cause?
Increase HCO3 loss (GI/Kidney)
Familial hypercholesterolemia Dx ?
“Chol > 7.5”
“LDL > 4.9”
“Xanthoma” in pt or 1st/2nd degree relative
DNA Evidence of genetic defect
Venous ulcer lower limb Rx ?
Tripple layer bandaging
if ABPI < 0.8 (Refer to vascular surgeon)
Granulomatosis with polyangitis
(Wegner’s) Dx ?
cANCA (+)
Metastatic Malignant melanoma Rx ?
Nivolumab
RPGN causes ?
Goodpasteur syn
Granulomatosis with polyangitis (Wegner’s)
Microscopic polyangitis
CIDP Dx and Rx ?
Dx:
(1) Symmetrical upper and lower limb weakness
(2) less severe sensory symptoms
Rx:
(1) steroids & IVIG
(2) (azathioprine steroid sparing)
CD maintenance therapy ?
Azathioprine
other 1st line: Mercaptopurine
Pseudohyponatremia Dx ?
Marked increase TG
alongwith hypoNa+
Hypothyroid associated HypoNa+
Dx ?
Confusion
Drowsiness
relative bradycardia
Raise TG/Chol
HypoNa+
Water Deprivation test
Indication ?
To Dx
DI (hyperNa+)
SIADH
Dx ?
(1) Na+ (Low)
(2) S/osmolarity (low)
Next step ???
Urine Osmolarity
Urinary Na+ (low in Polydipsia)
Toxoplasmosis MRI ?
Increase intensity in occipital lobe
PML MRI ?
Multiple high intensity focal lesions
(periventricular & subcortical)
*Memory loss
Urge incontinence
Rx ?
(1) Life style / bladder training
(2) Anti-cholinergic (Oxybutynin/tolteradine)
TTP Rx ?
Plasma exchange
Parkinon’s Dx in young age Rx ?
Ropinarole
(few motor fluctuations)
Aspirin overdose (less than 1hr)
Rx ?
Activated charcoal (125 - 500 mg/kg)
Gastric lavage (> 500 mg/kg)
hidradenitis suppurativa
Dx ?
Rx ?
Dx:
Nodules and pus discharge in axilla
Rx:
Clindamycin (Topical)
Doxycycline (PO)
Yersenia Enterocolitica
Dx ?
Rx ?
Dx:
Undercooked meat, fever, muscle pain, diarrhea, pain abdomen
Rx:
TMP-SMX
Gaucher’s dz:
Dx ?
Rx ?
Foam cells
Imiglucerase
DM medication that reduce Kidney stone formation ?
Empa
SU abuse causing Hypoglycemia
Dx ?
Urine SU level
Odontoid neck fracture Dx ?
(Known case of ankylosing spondylitis)
X-rays neck
Cervical Spondylosis
Dx ?
age related ppt by RTA leads to
Neck pain/nerve injury - pressure on C7 nerve root (loss of sensation)
cervical myelopathy
Dx ?
spinal cord compression in neck
leads to
B/L symptoms (loss of motor skills)
Latent TB
Dx ?
CXR - Normal
Mantoux test (+)
Next step ?
Quantiferon test
Peritoneal Dialysis peritonitis
Rx ?
Vanco (gram + cover)
Meronum (gram - cover)
both intra-peritoneal
MM
Dx ?
Collapse of multiple vertebrae
Immunoglobulin electrophoresis
Primary membraneous GN (nephrotic syn)
auto-antibodies ?
Phospholipase A2 receptor Ab
Retinitis pigmentosa
Dx ?
B/L peripheral loss of vision
(tunnel vision)
Night blindness
DKA
Mx ?
IV sodium chloride
Fixed-rate insulin infusion 0.1U/kg/Hr
(add 10% dextrose once glucose < 14mmol/L)
Deranged RFTs in weeks (3months post renal transplant)
cause?
macrolides (like clarithromycin) increase ciclosporin exposure - renal damage rapidly
cat scratch Dz
Cause ?
Rx ?
bartonella henselae
Azithro
starting ACE-i
how much reduce GFR is expected in 1 week post use ?
25%
DVT in young female
Increase APTT
Anti-cardiolipin Ab (–)
Dx ?
Anti-beta2 glycoprotein 1 Ab (+)
cause of Anti-phospholipid Ab syn
Pons stroke features ?
ipsilateral facial/abducent N palsy
contra-lateral body motor loss
Hemochromatosis
Rx (1st line vs 2nd line) ?
1st line: Venesection
2nd line:desferrioxamine
renal transplant patient
induction of immunosuppression ?
Basiliximab (IL-2 monoclonal Ab)
Alzheimer’s Dz
Rx ?
Initial Rx vs where failed to achieve impact ?
Donapezil
Rivastigmine
Galantamine
………………..
Manatine (next step from acetylcholinesterase inhibitor)
Tertiary hyperparathyroidism
Dx ?
Creat - High
Phosphate - High
PTH - High
Ca - High slightly
Keratocanthoma
Rx ?
surgical Excision
(indistinguish from squamous cell CA)
Tocilizumab
Anti-IL6
Rituxmab
Anti-CD20
Ustekinumab
anti-IL10
Graves Dz
Dx ?
Isotope scan - diffuse symmetrical uptake
SVC Syn
short term Rx ?
Dexa
Moluscum contagiosum
Dx ?
Rx ?
Pox virus (share towel hotel)
Podophyllotoxin
Carbamazepine toxicity d/t diltiazem use. cause ?
CYP34A inhibition
