STEP 3 Flashcards
LEUKEMIA - adult HIGH WBC bcr/abl traslocation (t[9;22]) splenomegaly very low LAP
CML
- tyrosin kinase inhibitors first
- young, stable, good donor –> can try BMT
High LAP (leukocyte alkaline phosphatase) means ?
leukemoid reaction
What precipitates TdP?
- premature ventricular beats with compensatory pause
- bradyarrythmias (sinus brady or freq pauses)
- low Mg or K
- hypothermia
Cannot extend knee (kick it out), anteromedial thigh/medial calf/arch of foot sensory loss, loss of knee jerk
Femoral nerve injury (saphenous branch for sensation + quads)
Lower leg weakness (including hamstrings), sensation spared (ant + post) above the knee, loss of ankle jerk
Sciatic nerve injury
Intensely pruritic papules/vesicles on extensor surfaces and buttocks/back
Dermatitis herpetiformes
Pruritic erythematous patches (acute) or lichenified plaques (chronic), on extensor surfaces in children/adults (flexor surfaces in infants)
Atopic dermatitis
tx: oral antihistamines, emollients (hydrate skin), avoid extremely hot/cold places
if those don’t work: topical steroids
face/eyelids: topical tacro
Tight glycemic control helps reduce ___ complics
microvascular
no firm link suggesting reduction of macrovascular complications like MI, stroke, PAD
Indications for hospitalization with anorexia
HD instability arrhythmia severe bradycardia acute food refusal lyte abnormalities suicidality
Sx of and tx for refeeding syndrome
Sx: fluid shifts - pulm/peripheral/cardiac edema, cardiac things
Tx: thiamine should be given. PO > IV phos
Medicare Parts A, B, C, D
needs to be 65+
A: inpatient services, hospice
B: outpt physician services/surgery/lab tests, preventative care, hospital OBS
C: “Medicare Advantage” ; private
D: Rx meds
Dyspepsia vs GERD
Dyspepsia: epigastric discomfort/fullness, n/v, heartburn
*causes = PUD, H pylori, NSAID use
GERD: retrosternal burning, reflux
Sjogren causes __ lymphocyte activation. Associated with __ lymphoma.
B
B cell non Hodgkins
Does hypocalcemia cause HYPO or HYPER -reflexia?
HYPERreflexia
Indications for C section with twins
Monoamniotic (one placenta)
Malpresentation
Non reassuring FHR tracing
Treatment for Chlamydia + gonorrhea
Gonorrhea ONLY: single dose CTX
Both: CTX + PO doxy
Why is there an increased risk of DM post transplant?
- GC cause wt gain, decreased insulin sensitivity
- Calcineurin inhibitors: impaired insulin secretion
- Improved renal fxn: increased insulin excretion + more GNG
Post exposure ppx after pertussis?
azithromycin, erythromycin (macrolides)
*if given before 2 wks age, contributes to hypertrophic pyloric stenosis
Aspergillus - classic triad + tx?
Triad: cough, pleuritic cp, hemoptysis
Tx: voriconazole
MC extra-articular manifestations of ankylosing spondylitis?
uveitis
aortic regurg / MVP
IgA nephropathy
restrictive lung disease / apical pulm fibrosis
When can minors provide their own consent?
pregnancy STI life threatening contraception mental health/substance use disorder tx
A/c req’d for mechanical valves?
lifelong a/c (warfarin) + antiplt (ASA)
right heart failure after CABG …
constrictive pericarditis
Sulfonylurea OD (glyburide) … antidote?
- causes hypoglycemia
1. dextrose
2. octreotide
Ppl who get a DVT while on menstrual hormone therap … what do you do?
Discontinue MHT and start SSRI/SNRI (ie escitalopram)
Diarrhea + microcytic anemia + high eos
Hookworm infection
(can have transient cough)
dx: examine stool for eggs
Progression of hyperkalemia cardiac changes
peaked T waves –> PR and QRS prolongation –> loss of P waves –> wide QRS with a sine wave
