Set 4 Flashcards
OCPs decrease the risk of what? Increase?
Decrease = Endometrial, ovarian Increase = VTE, HTN
Arrhythmia caused by digoxin toxicity
Atrial tachycardia w/ AV block (increased ectopy and increased vagal tone)
Autism vs. Child Disintegrative Disorder
Autism ALWAYS manifests before 3yo
CDD displays normal development until ~2yo followed by LOSS of PREVIOUSLY acquired skills in 2+ areas (language, social, bowel/bladder, motor) with ENSUING autistic features
Young healthy person suddenly dies, ddx?
HCM –> tx BB or CCB
QT prolongation snydrome –> tx BB +/- pacemaker if sx
Jervell-Lange Nielson
torsades + hearing impairment + fhx
Ca2+, Phos, vit D and PTH levels in secondary hyperPTH
Increased = Phos and PTH decreased = vit d and Ca2+
Tx DKA
IV NS or** 1/2NS+K (if hypokalemic BEFORE insulin, must use 1/2NS with K+ to make isotonic)
then insulin
Trigeminal nerve palsy and limb ataxia, wheres the lesion?
lateral pons
Dx, Tx hypertensive encephalopathy
BP > 180/120
Tx nitroprusside and labetolol
Jugular venous tracing letters / meaning
a,c,x,v,y a- atrial contraction c- ventricular contraction x down- RA relaxation v- valve closed and RA filling y down- blood flows from RA to RV
2mo vaccinations (6)
Hep B(2), rotavirus, TDaP, Hib, Pneumococcal, Inactivated polio
pure motor stroke
Lacunar infarct (posterior limb of IC)
Tx CML
imatinib
7 tocalytics
B-agonist --> terbutaline or ritodrine MgS nifedipine indomethacin nitroglycerin oxytocin ANTagonist progesterone
Tx aortic regurg
decrease afterload = nifedipine or ACEI
Tx EPS
diphenhydramine, bezontropine or triheyphenidyl (anticholinergics)
Bullae and ulcers w/ central necrosis in an immunocompromised patient
pseudomonas - erythema gangrenosum
Tx depression with insomnia AND decreased appetite
mirtazapine (TCA) good in old folks
contralateral paralysis and loss of touch/vibration/proprio and tongue deviating to the IPSilateral side, wheres the lesion?
Medial medullary syndrome
Systolic murmur that disappears with squatting
MVP (squatting increases venous return)
severe / refractory HTN and muscle weakness, dx? Tx?
Conn’s Syndrome aka Primary hyperaldosteronism (hypoK causes weakness)
Tx = spironolactone
MCC death in MI patients
Vfib –> defibrillate
ispilateral limb ataxia, contralateral eye deviation and paralysis, wheres the lesion?
Medial Pons
Drugs for Tx of parkinson’s
DA agonists = levodopa/carbidopa, bromocryptine, amantadine
anticholinesterase = benztropine
MAO-B inhibitor = selegeline
Loss of contralateral pain/temp, ipsilateral loss of face pain/temp, difficulty swalling, cerebellar ataxia and horner’s syndrome
Lateral medullary syndrome aka Wallenberg, 2/2 PICA stroke
SE terbutaline
B1 = tachycardia / increased SV B2 = vasodilation and bronchodilation
Narrow QRS with P waves buried in beggining of QRS (ie not discernable)? Tx?
AVNRT aka paroxysmal SVT (rentry causes simultaneous atrial and ventricular contraction)
stable = carotid massage/valsalva, adenosine
unstable = cardiovert
TB pleural effusion vs. epyema
TB = VERY high protein (>4), LYMPHOCYTIC leukocytosis, glucose midly low
empyeme = VERY low glucose, frank prurulence and PMN dominant leukocytosis
3 MCC foot drop
peripheral neuropathy
L5 radiculopathy
common peroneal nerve damage (fibula neck fx)
Tx chronic stable angina
1st BB then +/- CCB
Nitrates used acutely
kid, holosystolic murmur at LLSB and apical diastolic murmur
VSD
Effect of chronic steroid use on muscles
steroid-induced myopathy = painless* proximal muscle weakness LE before UE
improves after d/c steroids
systolic and diastolic abdominal bruit
think RAS
bilateral hip, thigh buttock claudication, impotence, symmetric atrophy BLE
aortoiliac occusion causing chronic ischemia
Second line mood stabilizers
carbemazepine or valproate
Tx hypertriglyceridemia
fibrates (fenofibrate or gemfibrozil) = LPL stimulators that increase HDL, decrease TG
Dx criteria ARDS
acute onset
PaO2/FiO2 <18
lifestyle mods for decreasing HTN in order of effectiveness (5)
weight loss > DASH diet > low salt diet/exercise > decrease alcohol intake
electrical alternans suggests
pericardial effusion
Dx spontaneous bacterial peritonitis
paracentesis w/ >250PMN, protein >1, glucose <50, LDH greater than serum
3 tests before starting Lithium
Creatinine, TSH/T4, BhCG
Tx vtach
stable = amiodarone (2nd line lidocaine, procainamide) unstable = cardiovert
nerve most often damaged in mastectomy / effect
long thoracic nerve –> winged scapula
prominant x and y descents on JVP w/ early heart sounds following S2
constrictive pericarditis (TB if outside US, viral in US) early heart sound = pericardial knock
Which type of bilirubin causes pruritus
direct (conjugated) bc conjugated bilirubin is water-soluble and thus floats freely in blood (unconjugated is bound to albumin)
Live vaccines for HIV patients?
ONLY MMR and varicella if 200
Medication given after gastric bypass
ursodeoxycholic acid x6mo to prevent gallstones 2/2 rapid weight loss inducing increased [bile]
Hepatomegaly, CHF, DM and testicular atrophy
hemochromatosis
Tx overflow incontinence
timed voids, double voids, intermittent cath or BETHANECHOL (cholinergic agonist)
pericaridits in CKD patient? Tx?
uremic pericarditis (BUN>60) Tx hemodialysis