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Step 2 > Set 7 > Flashcards

Set 7 Flashcards

1
Q

IBD, hypotension, tachycardia, leukocytosis, fever? Dx?

A

MC toxic megacolon (vs. abscess but no cardio sx)

Dx = abd xray

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2
Q

8 drugs that cause HYPERkalemia

A

nonselective BB, ACEI/ARB, Spironolactone, cyclosporine, digoxin, NSAIDs, heparin, succinylcholine

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3
Q

painful eye, erythema, visual disturbances, severe HA, b/l periorbital edema and cranial nerve deficits (ocular)

A

cavernous vein thrombosis (2/2 orbital cellulitis)

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4
Q

UTI in indwelling catheter with ALKALINE urine pH

A

alkaline, think proteus mirabilus (produces urease)

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5
Q

Tx TIA

A

start ASA +/- dipyridamole

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6
Q

immediate complication (w/in 3days) of SAH, Tx?

A

vasospasm –> tx = dihydropyridine CCB

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7
Q

palatal ulcers, HSM, pancytopenia in patient from missouri

A

disseminated histoplasmosis

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8
Q

50 yo w/ dysphagia and neck mass when eating? Tx?

A

zenker’s diverticulum (above UES)

tx = excision and cricopharyngeal myotomy

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9
Q

D-xylose test used for…(2), how to differentiate

A

tests for intactness of GI mucosa –> Celiac d/s and bacterial overgrowth. If pt improves after abx, then it was bacterial overgrowth

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10
Q

fever + abrupt onset sharply demarcated w/ raised borders, red, edematous tender skin lesions?

A

erysipelas, MCC GAS > s aureus

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11
Q

group a strep =

A

strep pyogenes

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12
Q

Mallory bodies

A

inclusion bodies in hepatocytes, MCC alcoholic hepatitis&raquo_space;> PBC, NASH, Wilsons and HCCA

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13
Q

SE cyclophosphamide (2)

A

hemorrhagic cystitis, bladder cancer

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14
Q

pleural effusion in cirrhotic ascites patient? Tx?

A

hepatic hydrothorax 2/2 small diaphragmatic defects

Tx = thorocentesis, salt restriction, diuretics, TIPS last resort

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15
Q

Best tx for young parkinson’s patient with tremor as main sx

A

trihexyphenidyl (anticholinergic)

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16
Q

drugs precipitating G6PD deficiency hemolytic episode (6)

A

“hemolysis IS PAIN”

Isoniazid, Sulfonamides, Primaquine, Aspirin, Ibuprofen, Nitrofurantoin

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17
Q

Prussian blue detects… used often for…

A

detects iron, often used to dx hemolysis

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18
Q

E- abnormalities in alcoholics

A

low K, Mg, phos (low mg causes refractory low k)

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19
Q

management of cold hand without radial pulse

A

immediate heparin and sgy consult for embolectomy

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20
Q

pain b/w 3rd and 4th toes that is reproduced with palpation and makes a clicking sensation? Tx?

A

Morton neuroma = mechanically* induced degenerative neuropathy seen in runners
Tx = orthotics +/- steroid injections, last resort sgy

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21
Q

3 drugs for tx gastroparesis

A

metoclopramide (DA antagonist)
bethanechol (anti-muscaranic)
erythromycin (motilin inducer)

22
Q

SE methotrexate (3), routine testing, prophylaxis

A

SE = mouth ulcers, hepatotoxic, myelosuppressive

CBC q3mo, prophylaxis = folate

23
Q

PAS positive, 2 diseases?

A

whipple’s = foamy macrophages in intestinal LP

alpha-1 AT deficiency = globules in liver

24
Q

Tx heparin and warfarin reversal

A 
heparin = protamine sulfate
warfarin = FFP 1st then vit K
25
Q

no meconium in first 48 hrs, 2 ddx and ass. d/s?

A

hirschsprungs –> Downs

meconium ileus –> CF

26
Q

5 dx criteria metabolic syndrome?

A 
3+ needed:
abd obesity (>40in or 35in)
fasting BG >100
BP> 13/80
TG>150
HDL (<50 female)
27
Q

AST and ALT in alcoholics

A

AST: ALT 2:1

<500

28
Q

40 yo with rash on palms, soles and trunk. 2 ddx, differentiate b/w them? Tx?

A

RMSF = periph–>central. Tx doxy or chloramphenicol in prengancy)

secondary syphilis = central–>periph. Tx IV benzathine PCN weekly x3

29
Q

Causes of pancreatitis “get smashed”

A

Gallstones, Ethanol, Trauma, Steroids, Mumps, Autoimmune ds, Scorpion sting, Hypercalcemia/triglyceridemia, ERCP, Drugs

30
Q

Tx cryptococcal meningitis in AIDs?

A

amphotericin B + flucytosine

31
Q

Spherocytes on blood smear, 2 ddx? differentiate?

A

Hereditary spherocytosis = negative direct coombs

AIHA = positive direct coombs

32
Q

After pt travels to mexico 2mo ago, develops watery diarrhea and liver abnormalities? Tx?

A 
Amebic abscess (E. histolytica)
Tx ORAL metronidazole. only drain if that FAILS
33
Q

earliest manifestations of alzheimers vs NPH vs Lewy Body

A

Alzheimer = memory+visuospatial
NPH = gait
Lewy Body = visuospatial

34
Q

metoclopramide MoA, uses and SEs?

A

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

35
Q

Severe dysesthesia, hemianesthesia and athetosis

A

thalamic nucleus (VPL nucleus transmits SENSORY)

36
Q

Criteria for mild vs. severe pre-eclampsia

A

both >20wks gestation
Mild = >140/90, proteinuria >0.3g/d, +/- edema
severe = >160/110, >5g/d, oliguria, transaminitis, thrombocytopenia, pulmonary edema

37
Q

Tx mastitis

A
  • dicloxacillin or cephalosporin + analgesics

- continue to breast feed from BOTH breasts

38
Q

Tx hypernatremia

A

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

39
Q

small bleeds at gray-white matter jxn?

A

DAI

40
Q

ddx osmolar gap MA, tx?

A

methanol (eye problems), ethanol, ethylene glycol (causes hypocalcemia and ca-oxalate stones)
Tx = fomepizole +/- sodium bicarb

41
Q

clear, abundant stringy cervical mucus, which phase of cycle?

A

ovulatory/follicular/proliferative –> ferning on slide, pH >6.5. Allows penetration by sperm (vs thicker, acidic luteal phase that is hostile)

42
Q

3 drug classes causing hyperkalemia

A

ACEI, NSAID, K-sparing diuretics

43
Q

digital clubbing and acute-onset arthropathy? a/w? Dx?

A

hypertrophic osteoarthropathy, often a/w lung cancer, TB, bronchiectasis or emphysema –> Get CXR

44
Q

Tx TCA OD? MoA?

A

Sodium bicarb –> alleviates depressant effect on sodium channels which narrows the QRS and prevents arrhythmia

45
Q

FSGS a/w 4 populations

A

blacks, obese, IVDU, HIV

46
Q

menstrual/lower ab pain 2 weeks into cycle, ddx?

A

Mittelschmerz - midcycle pain 2/2 ovulation

ovarian torsion –> medical emergency! (N/V, adnexal mass, radiating pain)

47
Q

congenital HIV prevention?

A

Ziduvodine through pregnancy/labor, and give to baby for 6 wks. –> better also C-section, no breast feeding

48
Q

W/u hirsuitism in pregnancy

A

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

49
Q

Sign of MgS overdose in pre-eclampsia, tx?

A

hyporeflexia, RR8, abnormal VS

Tx = calcium gluconate and d/c MgS

50
Q

Lower abd pain that radiates, at onset of period, dx? MoA? Tx?

A

primary dysmenorrhea 2/2 increased prostaglandin breakdown of endometrium. Tx NSAIDs or OCPs

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