Smart book Flashcards
Transudative vs Exudative effusions
Exudative
Plueral-serum protein >.5
Pleural-serum LDH >.6
Exudative-when the membranes have increased permeability or disruption of lymph drainage
Transudative- difference in oncotic pressure
Presentation of Dermatomyositis
And what illness is associated with it
Shawl sign-Rash on the face, neck, shoulders, chest
Heliotrope Rash - Rash involving the eyelids
Associated with Cancer in 25% of cases
Which Drug is used to stimulate contractions in the uterus
Oxytocin
Manifestations of Tumor Lysis syndrome (kidney failure after acute chemo)
increased Phosphorus, potassium, uric acid
Decreased Calcium
Difference between Dipyridamole/adensoine stress test vs Dobutamine
Dipyridamole/adenosine vasodilator vessels which increases blood flow. but the unstenosed get wayyy more blood than the stenotic -shows the difference
Dobutamine- increased myocardial oxygen consumption to provoke ischemic changes
Pain along the tendon sheaths
Gonnococemia
What drug is used to promote passing of kidney stones
Tamsulosin
a-1-antagonist that relaxes the muscle and decrease intraurethral pressure
Breastfeeding contraindications
Active TB HIV Herpetic breast lesion Varicella Chemo or substance use
Treatment given for Hypertrophic Cardiomyopathy
BetaBlockers / CCBs
What should you check in ANY clavicle fracture
Angiogram to rule out any damage to the subclavian artery
AntiPsychotic meds and the effects on Dopamine brain pathway
Mesolimbic-antipsychotic efficacy
Nigrostriatal- EPS symptoms: Dystonia,akasthesia, parkinsonism
Tuberoinfundibular-Hyperprolactinemia
Management for Ecclampsia
Magnesium sulfate
Antihypertensive drugs
Deliver the baby
What weeks do you consider amniocentesis / chorionic villus sampling?
Chorionic villus sampling: 10-13 weeks
Amniocentesis: 15-20 weeks
Teenage athlete with knee pain, tenderness on the tibial tubercle
pain elicited by extension of the knee against resistance
OSgood-Schlater
aka traction apophysitis
What is serum sickness-like reaction? which drugs can cause it
fever, joint pain, rash after starting antibiotics
Beta lactams/ sulfa drugs
Cough lasting greater than 5 days, yellowish sputum, maybe some blood in there. tx?
Acute bronchitis
supportive
CML translocation - which type of drugs affect it
9;22 philedelphia BCR-ABL Tyrosine Kinase (duh)
Which vaccine should you consider in a person getting ready to travel overseas
Hep A
What is a Marjolin ulcer
An Squamous cell carcinoma (SCC) lesion arising at the site of the burn
Whats the screening test for ovarian cancer
There is none
What type of murmurs do you work up?
Grade 3/+ systolic
or ANY diastolic
what does EKG look like for pericarditis
Electric alternans
DIFFUSE ST elevation
PR DEPRESSION
Whats becks triad
what is it a sign of
JVD, muffled Heart sounds, HYPOtension
Cardiac tamponade - pulsus paradoxes
Tx for vasovagal syncope
Beta blocker
What do you give to treat akisthesia (restlessness)
Beta blocker
First thing to think of if you see “guarding” on physical exam. and what test should you get?
Bowel perf
Abdominal/chest xray
whats the mnemonic for baby ekgs
VEAL CHOP varied-cord compression early- head compression (normal) A? Late-placenal insufficiency
presentation/workup/ treatment of Sarcoidosis
Bilateral Hilar lymphadenopathy, Non caseating granulomas, Bells palsy, Heart block, restrictive cardiomyopathy, uveitis
High Res CT
Steroids
what makes the S4 sound?
“Stiff left ventricle”
i.e.- some type of ventricular hypertrophy
lytic bone lesion, onion skinning, moth eaten appearance?
Ewings sarcoma (teenagers)
MI locations based on EKG leads
V1-V6 = LAD (anterior)
II, III, aVF = RCA (inferior)
V1-V3 depression = LCX (posterior)
how do you treat hypercalcemia?
saline fusion and calcitonin
bones moans psychic overtones
Obese Adolescent with hip problems?
and whats the other one it gets confused with?
SCFE
Slipped capital femoral epiphysis
Legge-calve-perthes which is avascular necrosis of the ip in 5 year olds
How do you tell its follicular thyroid cancer?
Invasion of the tumor capsule/blood vessel
tx for PE
warfarin + heparin
Tx for COPD exacerbation
what about stable COPD
O2, B-agonist, Oral steroids, Abs (FQ or Macrolides)
SABA, anticholinergic (tropium)
Tx for CHF
B-blocker/CCB, diuretic
presentation/workup/ treatment of Sarcoidosis
Bilateral Hilar lymphadenopathy, Non caseating granulomas, Bells palsy, Heart block, restrictive cardiomyopathy, uveitis
High Res CT
Steroids
Wtf is Choanal atresia
its an atresia of the sinuses to where the baby can’t breath thru his nose. so he turns cyanotic while feeding but gets better once he starts crying
Sidee effect of antithyroid drugs
agranulocytosis
How do you tell on phsyical exam its Frozen shoulder (Adhesive capsulitis)
Decreased ACTIVE & PASSIVE ROM
What is biomarker CA-125 used for?
Ovarian cancer (specifically post menopausal)
What does Protein C resistance cause?
Factor V Leiden
Treatment for Fibromyalgia
Amitriptyline (TCAs)
Schistocyes, Thrombocytopenia, renal damage, altered mental status
TTP
Adamst 13
Tx-Plasmapharesis or FFP
Immune Thrombocytopenia tx?
Observation if its just cutaneous bruising
IVIG if its worst
what infections are associated w/ Chronic Granulomatous Disease?
how do you diagnose it?
Catalase (+)
Nitroblue Tetrazolium – (both test neutrophil function)
Dihydrohodamine
oxidative burst
Resistant HTN - abdominal bruit systolic/diastolic
Renal Artery stenosis
Cause of Acute Epididymitis
E. Coli
Sidee effect of antithyroid drugs
agranulocytosis
types of lung cancer and treatment
Small cell - chemo radiation
non small cell
Squamous -
Adeno - non smoking
signs of HypOcalcemia
Perio Oral tingling
Tetony
Trousuea/chevoskty sign
lab values for pagets dz
Tx?
Calcium/Phos normal
Alk Phos - increased
Urine Hydroxyproline - increased
Bisphosphonates
What can Preeclampsia lead to in the baby?
Utero-placental insufficiency aka SMALL FOR GESTATIONAL AGE
whats the inheritance of Hypertrophic obstructive cardiomyopathy HOCM
Autosomal dominant
Antihypertensives used in pregnancy
Methyldopa
Labetalol
Hydralazine
What are the outcomes in infants with diabetic mothers?
Respiratory distress
Macrosomnia
Preterm delivery
jaundice, weight loss, vague abdominal pain (no vomiting)
pancreas problem
which knee injury results from twisting?
Meniscal tear
pain is immediate but swelling is slowww
when do you prophylax for dental procedures
prosthetic heart valve, or previous endocarditis
most common ovarian tumor in post menopausal
epithelial ovarian carcinoma
Renal failure, hypercalcemia, anemia
should make you think of what?
Multiple myeloma
how often should peeps get mammograms
colonoscopy
when do pap smears get discontinued?
mamamogram- every 2 years
colonoscopy - every 10 years
at age 65
tx for cholecystitis
NPO, IV fluids, antibiotics
+ cholecystectomy
tx for cholecystitis
NPO, IV fluids, antibiotics
+ cholecystectomy
Antibodies for Celiac dz
Anti TTG
anti endomesyial
“blunting of the villi”
what is HELLP syndrome
and what are the treatments
Hemolysis
Elevated liver enzymes
Low platelets
DELIVERY
magnesium (for siezures)
antihypertensives
RUQ pain from dissension of the liver capsule
pRBC
FFP
Cryoprecipitate
packed RBCs-fixes anemia
FFP-replaces clotting factors (bleeding)
Cryo-replace fibrinogen (DIC)
How do you test for cushings syndrome/dz
Low-dose dexamethasone suppression test
late night cortisol
24 hr cortisol excretion
what is the side effect of hydroxychloroquine?
Retinal toxicity
Lateral ventricuhttps://www.brainscape.com/packslar enlargement
Schizophrenia
which deficiency does carcinoid syndrome cause?
Niacin - due to the increased production of serotonin/tryptophan
Neurofibromatosis Type 1 vs type 2
1- cafe au lait, axillary freckles
2- Cataracts / bilateral acoustic neuromas
How to fix hyperK quickly
Insulin/glucose
B agonists
sodium bicarb
digeorge syndrome
CATCH 22 Cotruncal abnormalities Abnormal facies Thymic aplasia Cleft palate HypOcalcemia
Thyroid resection can lead to which deficiency?
HypoCalcemia
Tx for minimal change dz?
Steroids
Whats the tx for endometritis
Clinda & Gentamicin
which abdominal symptom can HSP lead to?
Intussusception
reversal for warfarin
FFP
pap smear dates?
begin at 21 - 30 (every 3 years)
30 -65 (every 5 years)
Colonoscopy dates?
begin @ 50 (every 10 years)
Lung cancer screening?
low dose ct @ 55 (if smoker)
Tetanus vaccine?
every 10 years
When to screen for osteoporosis
DEXA scan @ 65
what acid base status does ASPIRIN cause?
Tinnitus/hyperventalation
Respiratory alkalosis —>metabolic acidosis
increased anion gap
Treatment for carbon monoxide poisoning
100% oxygen
if severe —>Hyperbaric oxygen
Tx for methemoglobin
methylene blue!
Tx for methemoglobin
methylene blue!
tx for organophosphates?
pralidoxime/atropine
Tx for lead poisoning
Chelating agents like Succimer/dimercaprol
initial treatment for PULSELESSNESS
CPR you dummy
Txs for Asystole VFib Vtach? Afib SVT
Asystole-epinephrine Vfib-Defib! -(unsynchronized) Vtach (pulseless) - Defib Vtach (hemo unstable) - cardiovert Vtach (hemo stable) - amiodarone, lidocaine, procainamide AFib- rate control/anticoag (CHADS) SVT- vagal maneuver --> adenosine
Prepattelar bursitis?
tenderness infant of patellar w/ hx of repeated pressure (concrete worker)
Passive movement is painless
tx for asymptomatic bacteruria
Cephalexin, amox-clav, nitrofuration
most dangerous complication of Kawasaki?
coronary anuerysm
most dangerous complication of Marfans?
aortic dissection
SPIROMTERY for obstructive vs restrictive
Obstructive
FEV1 - decreased
FEV1/FVC - decreased (<70)
Restrictive
FEV1-
FEV1/FVS - increased (>70)
FVC - decreased
Risk factors for Breast Cancer
HRT
Alcohol
Nullparity
Main cause and tx of infective endocarditis
Straph aureus
Vanc
Lambert eaton, MG, polymyositis
which has loss of deep tendon reflex?
Lambert eaton
Most common brain tumor in kids
pilocytic astrocytoma
most common cause of lymphadenitis?
Staph A
diff between marfans and homocysteinuria
Homo has downward lens sublux and I.D
What is a key finding in psuedogout? in regards to the joint
Chondrocalcinosis
complications of placental abruption
Hypovolemic shock, DIC
Side effect of hydroxyurea
Myelosuppresion
Side effect of hydroxyurea
Myelosuppresion
Tamoxifen is an estrogen ag/antagonist? and where
estrogen Antagonist on breast (breast cancer)
Agonist on uterus
what problems does increased AFP levels indicate?
neural tube defects/abdominal wall defects
egg on a string
Transposition of vessles
require some type of PDA or shunt
how do infants with Diabetic mothers present?
Macrosomnia of all organs (polycythemia)
jittery due to low blood glucose after birth
VSD
diagnosis for PCOS besides clinical?
LH:FSH greater than 3
what does aromatase deficiency look like?
normal internal genetalia but ambiguous external
you can’t convert androgens into estrogen
hemi-hyperplasia
Beckwith wedelman
macrosomia/ macroglossia /abdominal wall defects
How do you tell ACL tear
rapid change of directions
rapid deterioration
popping sensation
how do you treat aspiration pneumonia?
clindamycin
VIRAL meningitis CSF analysis
normal glucose
increased protein
INCREAD LYMPHOCYTES
Treatment for anal fissures
sitz baths
stool softeners
Lidocaine/nifedipine
what is felty syndrome
arthritis
Neutropenia
splenomegaly
