Stuff I got wrong on qbank Flashcards
Tx for Cdiff
First line Metronidazole
2nd line and for severe - Vanco
ACL tear MOA
non contact pivoting injury
PCL Tear MOA
“dashboard” injury
MCL Tear MOA
VaLgus stress
LCL Tear MOI
VaRus stress
Sheehan’s syndrome
hypopituitarism after delivery of baby d/t decreased perfusion w/ blood loss.
Tx for Sheehan’s syndrome
Hormone replacement
Schizophreniform disorder
Meets criteria for schizophrenia but <6mo
Schizoaffective disorder
Schizophrenia + mood disorder (MDD, bipolar)
schizophrenia
> 6mo of duration w/ 1 mo of acute sx w/ functional decline.
Positive sx of schizophrenia
Hallucinations
delusions
disorganized speech
movement d/o
What are the positive sx of schizophrenia caused by?
Excess dopamine receptors in the mesolimbic pathway
Negative sx of schizophrenia
Flat affect
social withdrawal
lack of emotional expression and communication
silent patients
What are the negative sx of schizophrenia caused by?
Dopamine dysruction in the mesocrtical pathway
DOC for schizophrenia
2nd gen antipsychotics
Clozapine
Risperidone
Olanzapine
Somatization d/o
Chronic condition in which pt has physical sx including >1part of the body but NO physical cause found
Conversion disorder
Neurologic loss of sensory or motor function
sx are not intentionally produced or feigned
Schizoid personality disorder
voluntary social withdrawal, anhedonic introversion, hermit like behavior
Schizotypal personality disorder
“magical thinking” strange eccentric behavior and peculiar thought patters but without psychosis
Prehn’s sign
Releif of pain w/ elevation of affected scrotum
What testicular disorders have a positive Prehn’s sign
Epididymitis and Orchiitis
MC cause of epidiymitis-orchitis in adult males <35yo
Chlamydia and N Gonorrhoeae
MC cause of epididymitis-orchitis in adult males >35
E coli, klebsiella
MC cause of epididymitis-orchitis in children
Mumps
MC cause of painless scrotal swelling
hydrocele
Difference between spermatocele and hydrocele
Spermatocele contains sperm
Hydorcele is just fluid
NOTHING ELSE
Apbrupt onset of scrotal, inguinal, or lower and pain +/- N/V. Negative Prehn’s sign.
Testicular torsion
Epidemiology of DKA pts
Younger w/ type I
Epidemiology of HHS pt’s
Older w/ type 2
Presenting sx of DKA
Type I DM, thirst, polyuria, nocturia, weakness, fatigue, confusion, fatigue, chest pain, abd pain, Fruity breath and Kussmaul respiration
Explain Kussmaul respiration
Deep continuous resperiation as lung tries to blow off more CO2 to reduce ademia
Plasma glucose of HHS
> 600
Plasma glucose of DKA
> 250
Critical fist step of HHS/DKA management
IV fluid
0.9%NS until hypotension/orthostasis resolved
What do we give all DKA/HHS patients regardless of their levels along with insulin
K,
Pt is always total body potassium deficient and correction of DKA will cause hypokalemia
What does SIADH do in the body?
either the pituitary or an ectopic source inappropriately increases ADH production. –> increased free water retention and impaired excretion –> hypovolemic hyponatremia
Labs for SIADH
Serum osm LOW (<280) NA LOW (<135) Hypouricemia BUN LOW (diluted) Urine osm HIGH (>300) ***KEY IS THE URINE OSM IS HIGH WHILE THE SERUM OSM IS LOW****
What test is the most highly specific for SLE
Anti-smith antibodies
Painless progressive symmetrical proximal muscle weakness, mostly in limbs neck and pharynx
Polymyositis
CREST
calcinosis cutis raynauds phenomenon Esophageal motility d/o Sclerodactyly Telangectasia
What is CREST indicative of?
Scleroderma
w/u scleroderma
Anti-centromere AB
Anti-SCL-70 AB
Acute scleroderma management
DMARDs (methotrexate), Steroids
Philadelphia chromosome
CML - “philadelphia CreaM cheese”
Auer Rods
AML
Howell-Jolly bodies
SCD
Hep A + E
Vowels think Bowels
Both are Fecal Oral for transmission
Hep B+D
Go together
Have to have B in order to be affected by D
Hep C
Blood transfusions < 1992
diarrhea w/ dairy products, mayonnaise, meats, eggs
Staphylococcus
diarrhea w/ fried rice
Bacillus cereus
Diarrhea w/ contaminated food and water abroad
Vibrio cholera
“Travelers Diarrhea” from unpeeled fruit, and unsanitary drinking water
E Coli
T for E coli
FQ’s
Diarrhea w/ abx tx
C. Diff
Tx for C. Diff
Metronidazole, vanco
Name the diarrheas without fecal leuks/blood
Staph Bacillus Cereus Vibrio cholerae E coli C. Diff
Name diarrheas w/ fever, blood, and fecal leuks
shigella yersinia enterocolitica salmonella e. coli (enterohemorrhagic) Camplyobacter enteritis (jejuni)
Fecal oral contaminant causing abd pain, tenesmus, explosive water diarrhea, with blood and mucus that can lead to febrile seizures in children
Shigella
Tx for shigella
Bactrim tx of choice
Diarrhea w/ pork, milk, water and tofu, sx can mimic appendicitis
Yersinia enterocolitica
Management of Yersinia
FQ’s
Diarrhea worse in summer months. Poultry, exotic pets
Salmonella
Tx of Salmonella
FQ’s and ceftriaxone 2 weeks if severe
Diarrhea in pt w/ undercooked ground beef, unpasteurized milk/apple cider, day care center, contaminated water
Enterohemorrhagic E coli
Camplyobacter jejuni
Mc bacterial enteritis in US MC antecedent in post-infectious GBX
DX of C. Jenuni
stool cx gram neg S or Seagull shaped organisms
Tx of C. Jejuni
Emycin, FQ’s or doxy if sever
Tx for mastoiditis
IV ampicillin, cefuroxime
Vertigo’s with no hearing loss
BPPV and Vestibular neuronitis
Vertigo with hearing loss
Labyrinthitis and Menieres
HBsAG
G=Got it
Found throughout clinical illness
Anti-HBs
B=Beat it
Signals the pt was either immunized OR has recovered from HBV
Anti-HBc
C=aCute
Indicates and acute Hep B infection
HBeAg
E=lEvel
Predicts level of Hep B infectivitiy
Normal CSF Opening pressure Protein Glucose WBC
OP: 5-20
Protein: 18-58
Glucose: 50-80
WBC: 0-5
Bacterial CSF Opening pressure Protein Glucose WBC
OP: high
Protein: very high (>200)
Glucose: Very low (<40)
WBC: Extremely high (100-100,000) >80% PMNS
Normal glucose in presence of high or even normal CSF OP think of?
Viral Meningitis
Very high WBC with very low Glucose in presence of high OP on CSF?
Bacterial meningitis
Predominant neutrophils on CSF point to?
Bacterial meningitis
MC Cause of Meningitis in 1mo-18yo
N. Meningitides (remember we vaccinate kids for this)
MC cause of meningitis in 18yo-50yo?
S. Pneumo (then N men.)
TX for bacterial meningitis for pts from 1mo-50yo
Ceftriaxone + Vanco
Rheumatic fever major criteria
Polyarthritis Active carditis Chorea Subcutaneus nodules Erythema Marginatum
Sx of heroin withdrawal
Yawning rhinorrhea lacrimation mydriasis (opposite of while intoxicated) vomiting diarrhea cramps myalgia arthralgia irritability
Cocaine withdrawal
Doesn’t really exist- more of a hangover
EKG findings for Angina
T wav inversions/ST depression or normal
EKG finding for STEMI
ST elevation >2mm in >2 contiguous leads w/ reciprocal cahange in opposite leads or new LBBB
Tx for Hep C:
Pegylated interferon and Ribavirin
Tx for Hep B:
Acute: supportive
Chronic: Alpha interferon 2b, lamivudine, adefovir
W’s of infection post op
Wind Water Walking Wound Wonder about drugs
Wind
24-48h post op - Atelectasis
Water
Day 3-5 h post op - UTI, cathetar
Walking
Day 5-6 post op - DVT , or IV site
Wound
Day 5-7 post op - Check dressings and wound site
Wonder about drugs
Day 7+ post op - think about drug reactions
In a pt w/ SCD who is septic what abx should be administered?
Ceftriaxone IV
MRI of diffuse cortical atrophy and ventricular dilation indicative of what?
Alzheimers dz
change in vision to a yellowish blue tint is a side effect of what med?
Digoxin
Cough w/ hemoptysis, difuse bilateral rales, sodium of 142 mEq/L, a potassium of 4.3 mEq/L, a chloride of 110 mEq/L, a bicarbonate of 24 mEq/L, a BUN of 39 mg/dL, and a creatinine of 2.9 mg/dL. Urinalysis reveals microscopic hematuria and 4+ proteinuria.
Goodpasture’s syndrome
Antiglomerular basement membrane antibodies are test of choice
MC pathogen for IVDA endocarditis
staph aureus
Tx for trigeminal neuralgia
Anticonvulsants (tegretol-Carbemazepine)
congenital hypothyroidism test of choice
T4 and thyrotropin
Side effect of tamoxifen
Endometrial changes
Wegners Dx test
ANCA
Anorgasmia is a side effect of what drug class
SSRI’s
Normal pressure hydrocephalus on MRI
No Atrophy w/ ventricular dilation
SLE Dx test
Anti-smith antibodies
mononucleosis w/u (blood tests)
EBV titer
Heterophile antibody test
Post surgical pt w/ undiagnosed Hypothyroidism who suddenly develops severe sx after surgery. What do we give her?
T4
What lab study is indicative of a oligoarticular juveline rheumatoid arthritis in a child?
ANA
EKG changes of dilated cardiomyopathy
low amplitude of QRS cmplexes
Pathogen most common in eye infection of a contact lens wearer
acanthamoeba
If you are considering a possible diagnosis of kidney, parenchyma, or ureter lesion what study should you do?
CT w/ IV contrast of the kidney ureters and bladder w/ cystoscopy
Status epilepticus tx.
BZD IV fosphenytoin (or phenytoin)
OCD treatment
Fluvoxamine