Set 7 Flashcards
IBD, hypotension, tachycardia, leukocytosis, fever? Dx?
MC toxic megacolon (vs. abscess but no cardio sx)
Dx = abd xray
8 drugs that cause HYPERkalemia
nonselective BB, ACEI/ARB, Spironolactone, cyclosporine, digoxin, NSAIDs, heparin, succinylcholine
painful eye, erythema, visual disturbances, severe HA, b/l periorbital edema and cranial nerve deficits (ocular)
cavernous vein thrombosis (2/2 orbital cellulitis)
UTI in indwelling catheter with ALKALINE urine pH
alkaline, think proteus mirabilus (produces urease)
Tx TIA
start ASA +/- dipyridamole
immediate complication (w/in 3days) of SAH, Tx?
vasospasm –> tx = dihydropyridine CCB
palatal ulcers, HSM, pancytopenia in patient from missouri
disseminated histoplasmosis
50 yo w/ dysphagia and neck mass when eating? Tx?
zenker’s diverticulum (above UES)
tx = excision and cricopharyngeal myotomy
D-xylose test used for…(2), how to differentiate
tests for intactness of GI mucosa –> Celiac d/s and bacterial overgrowth. If pt improves after abx, then it was bacterial overgrowth
fever + abrupt onset sharply demarcated w/ raised borders, red, edematous tender skin lesions?
erysipelas, MCC GAS > s aureus
group a strep =
strep pyogenes
Mallory bodies
inclusion bodies in hepatocytes, MCC alcoholic hepatitis»_space;> PBC, NASH, Wilsons and HCCA
SE cyclophosphamide (2)
hemorrhagic cystitis, bladder cancer
pleural effusion in cirrhotic ascites patient? Tx?
hepatic hydrothorax 2/2 small diaphragmatic defects
Tx = thorocentesis, salt restriction, diuretics, TIPS last resort
Best tx for young parkinson’s patient with tremor as main sx
trihexyphenidyl (anticholinergic)
drugs precipitating G6PD deficiency hemolytic episode (6)
“hemolysis IS PAIN”
Isoniazid, Sulfonamides, Primaquine, Aspirin, Ibuprofen, Nitrofurantoin
Prussian blue detects… used often for…
detects iron, often used to dx hemolysis
E- abnormalities in alcoholics
low K, Mg, phos (low mg causes refractory low k)
management of cold hand without radial pulse
immediate heparin and sgy consult for embolectomy
pain b/w 3rd and 4th toes that is reproduced with palpation and makes a clicking sensation? Tx?
Morton neuroma = mechanically* induced degenerative neuropathy seen in runners
Tx = orthotics +/- steroid injections, last resort sgy
3 drugs for tx gastroparesis
metoclopramide (DA antagonist)
bethanechol (anti-muscaranic)
erythromycin (motilin inducer)
SE methotrexate (3), routine testing, prophylaxis
SE = mouth ulcers, hepatotoxic, myelosuppressive
CBC q3mo, prophylaxis = folate
PAS positive, 2 diseases?
whipple’s = foamy macrophages in intestinal LP
alpha-1 AT deficiency = globules in liver
Tx heparin and warfarin reversal
heparin = protamine sulfate warfarin = FFP 1st then vit K
no meconium in first 48 hrs, 2 ddx and ass. d/s?
hirschsprungs –> Downs
meconium ileus –> CF
5 dx criteria metabolic syndrome?
3+ needed: abd obesity (>40in or 35in) fasting BG >100 BP> 13/80 TG>150 HDL (<50 female)
AST and ALT in alcoholics
AST: ALT 2:1
<500
40 yo with rash on palms, soles and trunk. 2 ddx, differentiate b/w them? Tx?
RMSF = periph–>central. Tx doxy or chloramphenicol in prengancy)
secondary syphilis = central–>periph. Tx IV benzathine PCN weekly x3
Causes of pancreatitis “get smashed”
Gallstones, Ethanol, Trauma, Steroids, Mumps, Autoimmune ds, Scorpion sting, Hypercalcemia/triglyceridemia, ERCP, Drugs
Tx cryptococcal meningitis in AIDs?
amphotericin B + flucytosine
Spherocytes on blood smear, 2 ddx? differentiate?
Hereditary spherocytosis = negative direct coombs
AIHA = positive direct coombs
After pt travels to mexico 2mo ago, develops watery diarrhea and liver abnormalities? Tx?
Amebic abscess (E. histolytica) Tx ORAL metronidazole. only drain if that FAILS
earliest manifestations of alzheimers vs NPH vs Lewy Body
Alzheimer = memory+visuospatial
NPH = gait
Lewy Body = visuospatial
metoclopramide MoA, uses and SEs?
a DA antagonist used for anti-emetic, promotility and allodynia but it is NOT (for whatever reason) an antipsychotic like other DA antagonists
SE = EPS
Severe dysesthesia, hemianesthesia and athetosis
thalamic nucleus (VPL nucleus transmits SENSORY)
Criteria for mild vs. severe pre-eclampsia
both >20wks gestation
Mild = >140/90, proteinuria >0.3g/d, +/- edema
severe = >160/110, >5g/d, oliguria, transaminitis, thrombocytopenia, pulmonary edema
Tx mastitis
- dicloxacillin or cephalosporin + analgesics
- continue to breast feed from BOTH breasts
Tx hypernatremia
no AMS = oral free water
mild/moderate AMS = IV D5W or 1/2NS 12mEq/d
severe = same but at rate of 1mEq/hr
if HYPOVOLEMIC –> always use NS (or isotonic solution) to restore perfusion 1st
small bleeds at gray-white matter jxn?
DAI
ddx osmolar gap MA, tx?
methanol (eye problems), ethanol, ethylene glycol (causes hypocalcemia and ca-oxalate stones)
Tx = fomepizole +/- sodium bicarb
clear, abundant stringy cervical mucus, which phase of cycle?
ovulatory/follicular/proliferative –> ferning on slide, pH >6.5. Allows penetration by sperm (vs thicker, acidic luteal phase that is hostile)
3 drug classes causing hyperkalemia
ACEI, NSAID, K-sparing diuretics
digital clubbing and acute-onset arthropathy? a/w? Dx?
hypertrophic osteoarthropathy, often a/w lung cancer, TB, bronchiectasis or emphysema –> Get CXR
Tx TCA OD? MoA?
Sodium bicarb –> alleviates depressant effect on sodium channels which narrows the QRS and prevents arrhythmia
FSGS a/w 4 populations
blacks, obese, IVDU, HIV
menstrual/lower ab pain 2 weeks into cycle, ddx?
Mittelschmerz - midcycle pain 2/2 ovulation
ovarian torsion –> medical emergency! (N/V, adnexal mass, radiating pain)
congenital HIV prevention?
Ziduvodine through pregnancy/labor, and give to baby for 6 wks. –> better also C-section, no breast feeding
W/u hirsuitism in pregnancy
US:
no mass–> CT abd to look for adrenal mass
b/l cystic mass –> theca lutein cysts, r/o high BhCG
-b/l solid mass –> pregnancy luteoma, benign
unilateral solid mass –> surgery to r/o malignancy
Sign of MgS overdose in pre-eclampsia, tx?
hyporeflexia, RR8, abnormal VS
Tx = calcium gluconate and d/c MgS
Lower abd pain that radiates, at onset of period, dx? MoA? Tx?
primary dysmenorrhea 2/2 increased prostaglandin breakdown of endometrium. Tx NSAIDs or OCPs
