Set 3 Flashcards
Ash leaf spots, cardiac and kidney tumors, seizures / developmental delay?
Tuberous Sclerosis (mutation in 2 tumor suppressor genes)
Lens dissociaton associated with (2)
homocysteinuria = downward Marfan's = upward
AMS, ataxia, nystagmus and conjugate gaze palsy
Wernicke’s encephalopathy (B1 thiamine def)
Pathogenesis of statin-induced myopathy
inhibits intracellular coenzyme Q10 synthesis
Pathogenesis of RHF in COPD patient
pulmonary HTN from chronic hypoxemia –> constriction of pulmonary arterial system
What do prolonged QRS vs. prolonged QT indicate?
QRS = bradyarrhythmia (BBB) QT = tachyarrhythmia (subtype of Vtach)
Tx Dressler’s Syndrome
NSAIDs > > corticosteroids
Banana bag
Thiamine 1st then dextrose, naloxone and O2
2 causes of pulsus paradoxus
I.e. drop in SBP >10 during Inspiration
1. Cardiac tamponade
2. Severe asthma/COPD
(during inspiration blood pools in the lungs –> decreased LV preload –> decreased CO)
Complications of Strep Pharyngitis vs. Impetigo?
Strep pharyngitis can lead to PSGN, rheumatic fever, scarlet fever
Impetigo can only cause PSGN
ST depression V1 and V2
Posterior wall MI
Dx, Tx heat stroke
T >105F
Tx evaporative cooling (water spray / fans)
Tx Raynauds
Nifedipine (dihydropyridine CCB)
2 major causes of pseudotumor cerebri?
Vit. A toxicity (isotretinoin or prolonged tetracylcine use), OCPs
Tx depression WITH insomnia
Trazadone
Exudative (increased protein) effusion withOUT evidence of infection
Malignancy –> BCA or Lung MC
2 cardiac problems where Mg sulfate is the Tx
Torsades and digoxin OD
Pathogenesis of hyperprolactinemia
decreased DA in hypothalamus/tuberoinfundibular pathway –> LOSS of normal inhibition on PRL release from ANTERIOR pituitary. Hence, see increased PRL in patients on antipsychotics (DA antagonists)
Immune response elicited by Pneumoccocal polyvalent (subunit) vaccine
B cell only b/c polysaccharides* can’t be presented to T cells (peptides and proteins can be though)
Decreased grip –> nerve injured
ulnar –> INTEROSSEOUS muscles
Tx asystole or PEA
CPR –> epinephrine
DO NOT SHOCK unless in vfib or pulseless vtach
HTN, hematuria and abd mass in a young person, think? associated with? (2)
PKD (autosomal dominant)
a/w cerebral aneurysms and strokes
3 DA pathways and ass. conditions
mesolimbic - excitatory - schizophrenia (incr. DA)
tuberoinfundibular - inhibitory - hyperPRL (decr. DA)
nigrostriatal - inhibitory - parkinsonism (decr. DA)
JVD, Kussmaul’s sign, hypotension, clear lung fields and NORMAL heart sounds (not muffled)? Tx?
RHF (vs. cardiac tamponade w/ muffled heart sounds).
Tx = IVF to sustain preload and BP, avoid nitro or diuretics
What is injured with fx of supracondylar region of humerus?
median nerve and/or brachial artery
Child with syncope and hearing impairment? Tx?
QT prolongation syndrome - often + FHx
Tx BB +/- pacemaker if sx
Tx DCM
BB or CCB
decreased radial pulses that disappear with deep inspiration?
pulsu paradoxus –> cardiac tamponade
RF for AAA, oeprative criteria
RF = age >60, SMOKING, fhx, atherosclerosis
(**NOT HTN which is RF for aortic dissection)
Operate if >5.5cm, symptomatic or rapidly expanding
Tx duration of lithium for bipolar disorder
1x = 1yr
3+ x = for LIFE
Left arm is swollen pale but pulses are present, Dx? Tx? Etiology?
Subclavian vein thrombosis 2/2 indwelling central line
dx = duplex US
Tx remove line +/- anticoagulation
CD4 level prophylaxis guidelines
<50 = azithromycin for MAC
Narrow complex tachycardia
SVT
infant with persistent wheezing not responsive to inhaled bronchodilators or steroids
vascular ring causing upper airway compression
Patient with CHF or Afib develops N/V/D, vision changes, AMS and decreased appetite? 3 causes
digitoxin toxicity (precipitated by renal injury, dehydration or hypokalemia)
murmurs that increase with inspiration
Right heart murmurs bc negative intrathoracic pressure pulls blood into the RA
stones, bones, grones, psychic overtones
Hypercalcemia (primary hyperparathyroidism, malignancy)
Episodic palpitations, weakness, hypotension and tachycardia? Tx?
PSVT
Tx = vagal maneuvers, cold-water immersion, adenosine
4 CHD equivalents? When to start statins?
DM, Sx carotid artery ds, PAD, AAA
Start ASA and statin at ANY LDL level (goal <100)
Loud S1 and mid-diastolic rumble murmur
MS
F/u of pap smear LSIL
adolescent = repeat in 12mo premenopause = colpo + bx postmenopause = reflex HPV +/- colpo
<4yo with HIGH fever +/- febrile sz with a trunkal rash that spreads outward (maculopapular)
Roseola infantum/6th ds = HHV6
Tx decompensated CHF
nitro + loop diuretics
Female with normal development until 6mo then decline with hand-wringing
Rett disorder
Transient monocular vision loss
amaurosis fugax = retinal embolism (MCC carotid artery plaque)
anemia, thrombocytopenia and increased WBC (lymphs)? Tx?
CLL –> rituximab (cd20 Ab)
dizziness, palpitations, trembling and profuse sweating during exercise
hypoglycemia inducing sympathetic system
angina has CP* duh
Tx enuresis
non-med measures –> desmopressin –> imipramine
Bullous pemphigoid vs. pemphigus vulgaris
BP = tense blisters involving groin PV = fragile blisters involving oral mucosa*
2 complications of SAH
cerebral salt wasting –> increased ADH and BNP secretion causes hyponatremia
SIADH - also hyponatremia
