Set 22 Flashcards
How does MRI differ from CT imaging?
MRI - no ionizing radiation, better at looking at soft tissues (brain, SC, ligaments, cartilage), caution with metal objects (e.g. pacemaker). Bones = gray
CT - uses ionizing radiation (bad for pregnant women), better at bone detail, recognition of blood, no problem with metal objects. Bones = white
A 45-year-old woman presents to the ER with complaints of chest pain, a racing heart beat, and dizziness. Examination reveals a heart rate of 120 beats/minute, blood pressure of 116/74, and 20 respirations/minute. The patient is diaphoretic and anxious. An initial EKG reveals ventricular tachycardia with shifting sinusoidal waveforms. What is this classic EKG finding? What are the possible causes of this patient’s condition?
Torsades de pointes: polymorphic ventricular tachycardia characterized by shifting sinusoidal waveforms on ECG (aka polymorphic vtach, variable amp vtach). Can progress to ventricular fibrillation. Long QT interval predisposes to torsades de pointes. Caused by drugs, decreased K+, decreased Mg2+, congenital long QT sydromes. Treatment includes magnesium sulfate.
Some Risky Meds Can Prolong QT: Sotalol, Risperidone (antipsychotics), Macrolides, Chloroquine, Protease inhibitors (-navir), Quinidine (class Ia, III), Thiazides
A patient of yours with recent complaints of weakness, pallor, craving for ice chips and tachycardia has a history of chronic hemorrhoids. What do you immediately suspect is the cause of this patient’s anemia and how do you treat it?
Pica: craving of nonfood substances (ice chips). Iron deficiency anemia. Hemorrhoids is a flag for rectal bleeding as a cause of deficiency.
What enzymes do obligate anaerobes lack?
Catalase
Superoxide dismutase
[Anaerobes “Can’t Breathe Air” Clostridium, Bacteroides, Actinomyces]
What embryological structural abnormalities might account for multiple miscarriages? What structures arise from the paramesonephric ducts? What other name is given to the paramesonephric ducts?
A bicornuate uterus results from incomplete fusion of the paramesonephric ducts (vs. complete failure of fusion, resulting in double uterus and vagina). Can lead to anatomic defects —> recurrent miscarriages
Paramesonephric = Mullerian ducts: develops into female internal structures - fallopian tubes, uterus and upper portion of the vagina (lower portion from urogenital sinus). Mullerian duct abnormalities result in anatomical defects that may present as primary amenorrhea in females with fully developed secondary sexual characteristics (indicator of functional ovaries)
What is the antidote for digoxin toxicity?
Digoxin immune Fab (DigiFab)
What are some of the circumstances in which information is HIPAA-exempt, meaning that your health information can be shared with another party?
Child abuse
Birth or death
Reporting of state mandated reportable illness
Public health disease surveillance
State sponsored disease intervention activities
Schools (vaccination status)
Hydatidiform mole is the most common precursor of what ovarian germ tumor? What tumor marker is monitored after the dilation and curettage of a hydatidiform mole?
Choriocarcinoma
Abnormal form of pregnancy in which a non-viable fertilized egg implants in the uterus and fails to come to term. Cystic swelling of chorionic villi and proliferation of chorionic epithelium (only trophoblast)
Monitor B-hCG
You are reading a research article about the prostate specific antigen test, and it mentions that the PSA blood test is associated with a high false positive frequency. In your own words, explain what false positive means.
Test is positive even though the disease is NOT present
A young woman complaining of easy bleeding and menorrhagia was referred by her OB/GYN for work- up of her bleeding disorder. Your preceptor tasks you with determining the cause of the patient’s condition. Compare the clinical findings of platelet disorders to those of coagulation factor defects.
Platelet disorder: Prolonged bleeding time, normal PT and PTT. Microhemorrhage: mucous membrane bleeding, epistaxis, petechiae, purpura
Coagulation factor defect: Bleeding time normal, PT and PTT prolonged. Major hemorrhage: hemarthrosis, intracranial hemorrhages
