Simulation 11_2023 Flashcards
SIADH is caused by?
Caused by: increased ADH secretion by neurohypophysis or ectopic areas. Ectopic secretion is more common, coming from neoplasias.
- Drugs liks: morphine, carbamazepine, haloperidol, TCA, SSRI, cancer drugs
Endopthalmitis is? Presents with? Is most frequently the subtype
It is a bacterial or fungal infection of the eye, particularly of the vitreous.
Presents with conjunctival, corneal edema, hypopyon, decreased vision and pain.
Most frequent subtype is exogenous post-op. (within 6 weeks of surgery)
what muscles are involved in polymyositis and dermatomyositis?
acute or subacute, symmetrical and diffuse muscular weakness, with a preference for the proximal muscles of the extremities (pelvic and shoulder girdle) of the trunk and neck.
In severe cases; dysphagia dur to esophagus and pharynx involvement
T/F polymyositis or dermatomyositis can be associated with neoplasia?
T
lung, ovarian, breast, GI and myeloproliferative
What are complication of sinusitis?
Meningitis
Subdural empyema
cervenous sinus thrombosis
What is the mechanism of action of Ezetimibe
It inhibits the NPC1L1 protein.
Ezetimibe, a drug used in dyslipidemia, inhibits the absorption of exogenous cholesterol in a specific manner by inhibiting the NPC1L1 protein present at the apical level of enterocytes.
Examples of phosphorus chelators
sevelamer carbonate (Renvela©)
Magnesium hydroxide + aluminum hydroxide, more commonly known by the name of Maalox©
Sucroferric oxy-hydroxide (Velphoro©)
Ferric citrate (Fexeric©)
What is the Sarin classification
used for the description of esophageal varices
What pathological condition are the Dallas criteria diagnostic of?
acute myocarditis - is anatomic/pathological staging following endomyocardial biopsy
What is a long term complication of hemodialysis?
amyloidosis: bc accumulation of B proteins that common filters don’t remove
immunosuppression
CV death: is the leading cause of death in dialysis pts
Sarcopenia
T/F In the vast majority of cases, small perforations of the tympanic membrane heal spontaneously,
T
What are the most frequent fracture locations in the case of osteoporosis in the spine
The last dorsals D8-12 and the first lumbar L1-3.
Stewart-Treves syndrome
Is angiosarcoma arising on lymphedema.
Most common on women post lymphadenectomy after breast cancer
A gastric tumor that invades the peritoneum and adjacent structures is classified as:
T4B
(if it only infiltrated peritoneum it would have been T4A)
Lidocaine facts
is a local anesthetic
class of amino-amides
is metabolised at the liver level through a process of oxidative alkylation
has a low risk of inducing cardiotoxicity
like all local anaesthetics, it blocks the generation and propagation of nerve fiber impulses in a reversible manner, targeting the pharmacological action sodium channels of neuronal membranes
RECIST criteria
is a set of published rules that define when tumors in cancer patients improve (“respond”), stay the same (“stabilize”), or worsen (“progress”) during treatment.
Which hormones can typically be increased by the use of antipsychotic medications?
prolactin
What is the main cause of erectile dysfunction?
vascular
In electrical burns, respiratory arrest occurs above:
“20-50 milliamps”
above 2 amps the patient goes into cardiac arrest
How many tender points must be positive for evoking pain to be fibromyalgia?
11/18
Löffler’s cardiomyopathy
it is determined by the infiltration of eosinophilic leukocytes. It is a rare restrictive cardiomyopathy,
Eye infections
The patient with conjunctival inflammation and watery secretion in the context of an upper respiratory tract infection presents the typical features of viral conjunctivitis. The majority of cases this is caused by adenovirus, a frequent infection especially in settings such as primary schools. Symptoms are typically self-limiting and last a few days. In rare cases, bacterial superinfection can be observed with the appearance of pain and purulent secretions. Bacterial conjunctivitis is treated with topical antibiotic therapy, typically erythromycin (answer D), however uncomplicated viral conjunctivitis can be managed symptomatically with warm or cold gauze to relieve symptoms. Answer B: anti-viral therapy is used in case of herpetic keratitis, which would appear with pain, red eye, visual loss, corneal opacity and corneal ulcers. Answer C: Prednisolone eye drops are approved for inflammatory ocular and allergic conditions. Answer E: olapatadine eye drops, is indicated for allergic conjunctivitis.
Degree of ascites
mild (1): dx only with US
moderate (2): by a moderate and symmetrical increase in abdominal circumference
severe/tense: (3) significant increase in abdominal circumference
from 1-3 based on amount of effusion in the abdominal cavity
definitive diagnosis of pulmonary thromboembolism
CT angiography
(initial diagnostic approach to pulmonary thromboembolism includes history, physical examination, chest x-ray, arterial blood gas analysis, and ECG )
African, blood in urine, hypereosinophilia. What is suspect?
Bladder bilharzia, schistosomiasis.
Gotten due to contact with contaminated water
TX: Praziquantel
T/F obesity is not a RF for osteoporosis
t
microcytoma is diagnosed with Schwarz-Bartter syndrome
syndrome of inappropriate ADH secretion
PRES
The acronym PRES means Posterior Reversible Encephalopathy Syndrome associated with cerebral edema
Needs MRI no contrast for diagnosis
Most frequent causes of neonatal meningitis are
Group B streptococci or Gram-negative bacilli or Listeria.
What antibiotic therapy would you set immediately after performing a lumbar puncture in suspect of neonatal meningitis
Ampicillin + cefotaxime.
Intrathecal methotrexate prophylaxis is typical of the treatment of which oncohaematological disease?
acute lymphoblastic leukemia.
Among the following neoplasms, Melanoma is the least radiosensitive.
T
Which pharmacological agents is indicated in the case of vago-mediated atrial fibrillation?
disopyramide
CREST syndrome
CREST for limited cutaneous subset systemic sclerosis corresponds to: Calcinosis, Raynaud’s, alterations of esophageal motility, sclerodactyly and telangiectasia.
T/F Both symptoms of inattention and hyperactivity/impulsivity must necessarily be present for a diagnosis of ADHD
F
What is Jacques sign
Jacques’ sign is in fact the most common sign of mastoiditis, in which the mastoid inflammation and subsequent tissue edema move the auricle forward
What is the first-line medical therapy for asymptomatic, noncritical carotid stenosis?
An antiplatelet drug (ASA or Clopidogrel)
Bovine spongiform encephalitis
Scombroid syndrome
Hepatitis A
S.Aureus enteritis
Are all foodborne diseases
T
The diagnostic technique of choice in malignant gastric tumors is
“EGDS with biopsies”
What drugs are used to treat ADHD
psychostimulants and non-stimulant drugs such as Atomoxetine are effective. The first line is represented by Methylphenidate, an amphetamine derivative; in other countries, similarly, dexamfetamine, and its prodrug lisdexamfetamine, is increasingly used.
The Tenzel flap is used for the reconstruction of
the lower eyelid
In coma due to mesencephalic lesion, the pupil:
It is mydriatic ipsilateral to the lesion. Direct parasympathetic innervation to the pupil comes from the Edinger-Westphal nucleus in the dorsal midbrain, through the nucleus of the third cranial nerve (oculomotor) to the pupillary constrictor muscle. Thus, a lesion at this level (midbrain) causes ipsilateral pupillary mydriasis!
Saturnine colic is typical of intoxication from:
lead
Burns
B) In the adult patient, in burns below 15% extension, systemic involvement is minimal
C) In the patient pediatric, in burns below 10% extension, systemic involvement is minimal.
How many calories does 1 gram of protein provide?
4 kcal.gr
SIADH is characterised by
Normovolemic hyposmolar hyponatremia.
Pontine myelinolysis as a rapid correction of hyponatremia usually occurs
n a nuanced manner after a few days after the rapid correction of the sodium level.
for suspected aortic aneuryms in ER, what exam do you order to confirm?
chest-abdomen CT with contrast medium
(choilonychia)
Spoon nails in iron deficiency
An 85-year-old man presents with locally advanced prostate cancer. What is the role of radiotherapy in prostate cancer?
Exclusive
Palliative
Neoadjuvant
Adjuvant
Which is the most frequent clinical manifestation of recurrent polychondritis?
chondritis of the auricles.
is an uncommon inflammatory disease that affects the cartilaginous structures of the entire body, as well as the organs of hearing and vision, the kidney and the cardiovascular system.
First line treatment is high dose corticosteroids
what are the 3 categories of personality disorders
Cluster A (“the bizarre”/paranoid), Cluster B (“the hyperemotional/narcissist”) and Cluster C (“the anxious”).
tuberous sclerosis presents as
childhood seizures, early cognitive decline, sebaceous adenomas, fibroids, and intracranial calcifications visible on neuroimaging.
genetically determined by the mutation of the tumor suppression gene 1 on chromosome 9 and 2 on chromosome 16.
What is pellagra
niacin (vb3) deficiency
How is the severity of calcaneal-talar fractures measured?
Bohler angle
Cobb and Metha angles are used to classify
scoliosis
The Gustillo classification is used for
open fractures
the Neer classification is used for
fractures of the proximal humerus
Which diuretic drugs can lead to a condition of metabolic acidosis?
acetazolamide, spironolactone
Podocytes at the glomerular level are also called:
visceral epithelial cells
The Friedewald formula is used to calculate LDL cholesterol. It is
LDL cholesterol = total cholesterol - [HDL cholesterol + (triglyceridemia/5)].
mnemonic to remember causes of acute pancreatitis
GET SMASHED
Gallstones
Ethanol (alcohol), Trauma, Steroids (steroid), Mumps (mumps), Autoimmune, Scorpion Sting (scorpion sting), Hypercalcemia or Hypertriglycerides (Hypercalcemia or hypertriglyceridemia), ERCP, Drugs (drugs such as azathioprine or bactrim).
in the decorticated posture:
the arms are in a triple flexion attitude while the lower limbs are extended. The lesion is located cranial to the red nucleus of the midbrain (it can be cortical or brainstem up to the red nucleus).
Decerebrate posture
arms and legs are extented
Wallenberg syndrome is caused by a lesion
Lateral bulbar ischemic lesion by occulsion of the vertebral or PICA artery
Le PeP is:
HIV post exposure prophylaxis
You take them once or twice a day for 28 days: For adults, the CDC recommends tenofovir, emtricitabine (these two drugs come in one pill), and a third drug, either raltegravir or dolutegravir
mirizzi syndrome
is due to compression from the infundibulum of the gallbladder (therefore ab extrinseco) of a gallbladder stone on the main bile duct (Mirizzi I). In its evolution, it can cause a cholecysto-choledochal fistula (Mirizzi II).
Zieve syndrome
is characterized by the triad of jaundice, hemolytic anemia, and hyperlipidemia secondary to alcoholic liver injury.
Menetrier syndrome
is precancerous hyperplasia of the gastric mucosa.
Q fever is caused by
Coxiella bunettii
Otosclerosis facts
A) It can be stapedial or cochlear
B) It is bilateral in 80% of cases
D) It can be responsible for a conductive hearing loss
Is more common in females
Newborn has congenital clubfoot. What will it most likely be characterized by?
Equinus-varus-supinated foot.
Winterbottoms sign
refers to the swelling of the lymph nodes at the level of the posterior cervical triangle characteristic of African trypanosomiasis, particularly the western form caused by the protozoan Trypanosoma brucei subspecies gambiense.
Sleeping sickness
T/F in the case of liver lesions suspected of metastasis, the first tumor to suspect is colon cancer:
T
The PreP is:
HIV pre-exposure prophylaxis.
Hunner’s ulcers are typical of which pathology?
interstitial cystitis
idarucizumab
antidote for dabigatran.
Antidote for morphine
naloxone
Antidote for unfractionated heparin
protamine
antidote for fondaparinzux/apixaban
andexanet alfa
High frequency vibrations are more absorbed:
the hand-wrist joint level.
hypertrophic cardiomyopathy murmur fun fact
Hypertrophic cardiomyopathy presents with a crescendo-decrescendo systolic murmur at the cardiac and/or parasternal apex; what peculiarly distinguishes this pathology from others is, however, the modification of the murmur with dynamic maneuvers: it is reduced with the increase in preload and afterload and increases in intensity with the reduction in preload.q
carpel tunnel syndrome involves which fingers
I, II, III and medial part of the fourth finger of the hand.
T/F strong opiods have a max dose above which the alagesic effect does not increase
F
weak opiates have a max dose
Which etiological agent is most frequently responsible for infectious complications in heart transplant patients?
CMV
Which is are a contraindication to bariatric surgery?
major depressive disorder, terminal illness, decompensated hypothyroidism, BPD
The oral loading dose of Clopidogrel is:
600 mg
