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Medicine > step 3 28 > Flashcards

step 3 28 Flashcards

1
Q

complications of varicoceles

A
  • infertility and testicular atrophy (due to elevated scrotal temperatures)
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2
Q

hydrocele vs varicocele

A 
varicocele = bag of worms (it's dilation of pampiniform plexus veins) that changes with valsalva and position
hydrocele = fluid between layers of tunica vaginalas, cystic
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3
Q

varicocele management

A
  • If testicular trophy and young – gonadal vein ligation

- If older and no interest in kids – scrotal support and NSAIDs

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4
Q

cyanosis in kid occurring during feeding and improving with crying?

A

bilateral choanal atresia

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5
Q

malignant efffusion management

A
  • thoracentesis
  • if recurrent slowly, repeat thoracentesis
  • if recurs quickly (less than 1 month), chemical pleurodesis
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6
Q

management of effusion from rheumatologic disease

A

steroids

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7
Q

2 most common cause of acquired long QT

A
  • fluoroquinolones

- antipsychotics

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8
Q

QTc cutoff for prolonged QT

A
  • Greater than 450 in men

- Greater than 470 in women

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9
Q

electrolyte abnormalities associated with long QT

A

hypomag

hypokalemia

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10
Q

monitoring after prostatectomy

A

serial PSA measurements (should be close to zero)

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11
Q

how to induce sputum for PCP diagnosis

A

hypertonic saline

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12
Q

management of candida in urine culture

A
  • often happens in ICU patients with foleys or recent abx
  • usually just colonization so you can just change the catheter but treat with antifungals if symptomatic-neutropenic-fever-leukocytosis
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13
Q

indications for plain film with ankle injury

A
  • pain near malleoli
  • inability to bear weight
  • bony tenderness at malleoli
    (can have distal tib-fib fractures)
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14
Q

when you need antibiotic ppx before dental procedures OR surgery on skin or muscle

A
  • prosthetic valve
  • previous IE
  • congenital heart disease
  • NOT INDICATED for MVP
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15
Q

activated charcoal timeframe for tylenol poisoning

A

under 4 hours

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16
Q

single greatest RF for pancreatic cancer

A

cigarette smoking

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17
Q

ICD indications

A
  • MI + LVEF less than 30%
  • NYHA class II or III symptoms = LVEF less than 35%
  • prior VF or unstable VT
  • sustained VT with cardiomyopathy
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18
Q

other term for Factor V Leiden

A

activated protein C resistance

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19
Q

initial labs for obesity

A

A1c
TSH
Lipids
Hepatic enzymes

20
Q

obesity management

A

Initial dietary modification (low calory and fat or mediterranean)
- if failed, orlistat

21
Q

EHEC presentation

A

kid with animal exposure or undercooked meat exposure with bloody diarrhea + abdominal pain + ABSENT fever

22
Q

presentation of BK induced nephritis

A

worsening renal function, UA with interstitial nephritis, basophilic intranuclear inclusions

23
Q

half of medicaid enrollees are

A

children, who generally consume a low amount of healthcare and expenditures

24
Q

management of fat babies in diabetic women

A

C-section for babies greater than 4.5 kg (9.9 lbs)

25
Q

management of patients with medication controlled diabetes

A

deliver at 39 weeks gestation

26
Q

heme and metabolic complications of hypothyroidism

A

normocytic anemia
mild hyponatremia
hyperlipidemia

27
Q

first line for migraine prophylaxis

A

beta blockers (metoprolol)
tca’s (amitriptyline)
anticonvulsants (valproate)

28
Q

drop in pressure after intubation is due to

A

hypovolemia (positive pressure ventilation increases intrathoracic pressure, which in a hypovolemic patient with CVP can collapse IVC and cut off venous return. Loss in RV preload causes a large drop in output and leads to marked hypotension.

29
Q

pregnancy complications of parvovirus infection + management

A
  • fetal anemia
  • hydrops fetalis
  • fetal demise
    management = period ultrasound (MCA doppler)
    diagnosis of hydrops = abnormal fluid accumulation in at least 2 body compartments (ascites, effusions)
30
Q

presentation of medication induced esophagitis

A
  • feels like severe heartburn (burning chest pain) + possible odynophagia

(meds like doxy can cause localized chemical injury to the esophagus with prolonged mucosal contact)

31
Q

other meds that can cause esophagitis

A

NSAIDS
KCL
Fe

32
Q

other contraindications to NPPV

A

inability to cooperate

inability to clear secretions or mucus (not just sputum production though)

33
Q

bulimia therapy

A

SSRI’’s + CBT

34
Q

treatment of candida vulvovaginitis in pregnancy

A

vaginal clotrimazole, miconazole, and nystatin (oral associated with risk of spontaneous abortion and congenital defects).

35
Q

workup of metabolic akalosis + hypokalemia

A

urine chloride (low in vomiting (you lose HCL with vomiting so kidneys respond by reabsorbing chloride. High with diuretics (blocked chloride reabsorption), or abnormal sodium handling as seen in Gitelman and Bartter)

36
Q

best med for treating depression in dementia and stroke patients

A

citalopram

37
Q

other possible manifestation of depression in dementia and stroke patients

A

restlessness, anxiety, behavioral agitation

38
Q

management of furuncles and carbuncles

A
  • any antibiotic with MRSA activity (clinda, bactrim, doxy)

- I&D

39
Q

biceps tendon rupture presentatoin

A

anterior shoulder pain, hearing a “pop”, bruising

40
Q

clinical significance of focal seizurse

A

usually secondary to a structural abnormality of the brain

41
Q

Management of vertebral osteomyelitis

A
  • ## if cultures are positive with a likely pathogen, you don’t need bone biopsy
42
Q

staph aureus features as bacteria

A

gram-positive cocci

43
Q

management of all staph aureus bacteremia

A

tEe to rule out infective endocarditis

44
Q

most common complication of GPA

A

DAH

45
Q

presentation of dAH

A

SOB + hemoptysis + diffuse alveolar opacities on CXR

46
Q

presentation of PSC

A
  • usually people are mostly asymptomatic and it’s picked up by lab abnormalities. If symptoms occur, fatigue and pruritus are common
47
Q

management of intrauterine fetal demise

A
  • offer parents the opportunity to view and hold the baby after delivery
  • refer to baby by name
  • allow parents as much time as they wish with the baby

Medicine (71 decks)

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