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Subject Requires Review Flashcards

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1
Q

Abrupt RUQ/epigastric pain. Resolves slowly lasting 30-hours. Nausea precipitated by fatty foods or large meals

Dx? TX?

A

Cholelithiasis

Dx- US Tx- Elective cholecystectomy

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2
Q

Gallstones in the common bile duct assoc. w duct dilation.

Dx: Tx?

A

Choledocholithiasis

Dx- ERCP TX-ERCP stone extraction

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3
Q

Obstruction of the Biliary tract –> to biliary tract infection. MC 2T E. Coli or Klebsiella. Charcot’s/Reynold

Labs: Increased ALP, GGT, and Bilirubin
Dx- Tx-?

A

Acute Cholangitis

Dx- CT (GS-ERCP) Tx- ABX + ERCP

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4
Q

Inflammation/infection 2T gall bladder obstruction @ cystic duct. E.coli/Klebsiella MC.

(+) Murphy’s sign RUQ pain, precipitated by fatty/large meals. DX- Initial and GS Tx-

A

Cholecystitis

Dx- Initial=US “GS=HIDA scan” Tx- NPO, IV, ABX,Sx

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5
Q

SLE specific Diagnosis labs?

A
  • (+) Anti double stranded DNA

- (+) Anti-smith

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6
Q

Scleroderma specific Lab Dx?

A

(+) Anti-centromere AB

+) Anti-SCL 70 (Diffuse disease

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7
Q

Rheumatoid Arthritis specific and initial lab Dx?

A

Anti-Cyclic citrullinated peptide ABs (specific)

RF (Initial test)

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8
Q

Polymyositis / Dermatomyositis specific lab dx?

A

(+) Anti-Jo 1 Ab
(+)Anti-SRP Ab (PM)
(+) Anti-Mi2 Ab (DM)

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9
Q

Sjogren’s Syndrome specific lab Dx?

A

ANA- Anti SS-A (RO)
Anti SS-B (La)

Schirmmer test

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10
Q

< 16 yo: Daily Arthritis, diurnal high fever, salmon color migratory rash?

A

Juvenile Idiopathic Arthritis (Still’s Disease)

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11
Q

< or > 5 joint involvement joint pain with iridocyclitis (Uveitis)

A

Juvenile Idiopathic Arthritis

Pauci-Articular (< 5)
Poly-Articular (>5)

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12
Q

Asymmetric Arthritis: dactylitis (Sausage digits), sacroiliitis, uveitis, pitting of nails (Pencil in cup), +

HLAB27

A

Psoriatric Arthritis

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13
Q

Sacroiliac joint inflammation with progressive stiffness: 15-30 yo: chronic LBP: Increased ESR/HLAB27

A

Ankylosing Spondylitis (Bamboo Spine)

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14
Q

Autoimmune response inflammation caused by “chlamydia”, gonorrhea, salmonella, campy, shigella

Arthritis, conjunctivitis, and urethritis.

A

Reactive Arthritis ( Reiter’s Syndrome)

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15
Q

spinal cord controls Voluntary motor activity: Terminates at anterior horn cell: ascends/descends same side

A

Corticospinal Tract

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16
Q

senses vibration, position and light touch:

Ascends same side, decussates @ medulla

A

Dorsal Columns tract

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17
Q

Senses pain and temperature and ascends at opposite sides crosses immediately

A

Spinothalamic Tract

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18
Q

Motor efferent pathway (Away) of spinal cord

A

Anterior (Ventral Root) (Feeling, fast, front)

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19
Q

Sensory Afferent pathway (Towards) pf spinal cord

A

Posterior (Dorsal Root)

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20
Q

Progressive motor degeneration 2T UMN/LMN necrosis: dysphagia, eventually respiratory: fatal 3-5 years

sensation, urinary sphincter, voluntary eye movement spared Tx:

A

Amyotrophic Lateral Sclerosis (ALS)

Tx: Riluzole

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21
Q

Autosomal dominant nuero-degenerative disease: Chromosome 4 mutation/Abnormal CAG transcription:

behavioral (irritability), chorea, and dementia (<50):   Tx?
Caudate nucleus (Putamen) Atrophy: Fatal 15-20 years
A

Huntington Disease

Tx: Chorea (Tetrabenzine Antidopaminorgics)

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22
Q
  • Resting Tremor (MC lessened with voluntary m.)
  • Bradykinesia (slow voluntary movement)
  • Rigidity
  • Flat Facis (Myerson’s nose tap=blink)
  • Instability w posture
A

Parkinson’s disease clinical manifestations X5

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23
Q

Parkinson’s Disease Tx?

A
  • Levodopa/Carbidopa- converted to dopamine (M.E Tx)
  • Bromocriptine (D. Agonists)
  • Benztropine (Anticholinergic)
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24
Q

Demyelinating polyradiculopathy of the peripheral nerves. Ascending symmetric weakness/paresthesia

Assoc. w Campylobacter. Tx:

A

Guillian Barre Syndrome

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25
Autoimmune Inflammatory demyelinating degeneration of white matter. sensory pain/fatigue, cramping, suspect w young and trigeminal neuralgia, optic neuritis episodic exacerbations; :Tx
Multiple Sclerosis ``` Tx: IVCS, plasmapheresis, Amantadine (Fatigue) Glatiramer acetate (Reduces relapse severity) ```
26
Autoimmune peripheral nerve disorder against Ach Receptors. Thymic hyperplasia/thymoma General muscle weakness (Ocular, Resp., Bulbar): relieved w rest Tx:
Myasthenia Gravis Tx: Pyridostigmine or Neostigmine 1st line Plasmapheresis or IV Ig
27
Restless leg syndrome treatment?
- Pramipexole | - Ropinirole (Both domapine Agonists)
28
CSF: High protein (>400) with a normal WBC (Albumin cytological dissociation) Electrophysiologic decreased motor nerve conduction: Diagnosis studies for?
Guillain Barre Syndrome
29
MRI with Gadollinium (TOC) confirms disorder showing white matter plaque hyper densities (Periventricular).
Multiple Sclerosis
30
Blood test shows Acetylcholine receptor Antibodies (+) Muscle specific Tyrosine Kinase (Musk)
Myasthenia Gravis
31
LP CSF shows increase IgG oligoclonal bands "Pleocytosis"
Multiple Sclerosis
32
Myasthenia gravis Test that includes a rapid response to short acting IV_______?
Edrophonium
33
Constant daily Headache: not worse with activity: BL tight-band/vise-like no phono/photo phobia Tx: Prophylaxis and abortive
Tension Headache Tx: A-NSAI/APAP Amitriptyline P- BBs
34
Headache 4-72 hour in duration: pulsatile, lateralized, throbbing. NV, Phono/Photo phobia, worse w activity Tx: Abortive and Prophylaxis
Migraine Headache Tx: A- Triptans/Ergotamines (5HT-1) vasoconstrictions Metoclopramide, Promethazine, Prochlorperazine. (DBs) P- BBs/CCBs/TCAs
35
UL Headache: Temporal, periorbital, lancinating, < 2hoursseveral times a day/6-8 weeks. worse night/Etoh Horner's syndrome, UL congestion/lacrimation: Tx: A- P-
Cluster Headache Tx: A- 100% O2: Triptan/Ergotamines (Sumatriptan nasal) P- Verapamil
36
Motor and sensory deficits in upper extremities in a "shawl distribution.
Central cord syndrome
37
Ipsilateral motor vibratory and proprioception deficits and contralateral pain and temperature deficits
Brown Sequard syndrome
38
Loss of temperature and pain in lower extremities. TEE-Pee
Anterior Cord Syndrome
39
Damage Associated with voluminous meaningless impaired comprehension (Word Soup)
Wernicke's Aphasia
40
Damage Associated with difficulty remembering words or speaking with relatively preserved
Broca's Aphasia
41
MC type of stroke and what vessel?
Ischemic (Middle cerebral Artery)
42
MC Arterial bleed: Between skull and Dura: involves medial meningeal artery: Lens shape (Convex)
Epidural Hematoma (Hemorrhage)
43
MC Venous bleed: Between dura and arachnoid: involves tearing of bridging veins: Blunt Trauma "elderly" Slow onset and crescent shape: "Midline shift"
Subdural Hematoma (Hemorrhage)
44
Bleed between arachnoid and pia: MC Berry Aneurysm rupture: Sudden thunderclap worse HA of life:
Subarachnoid Hemorrhage
45
Intraparenchymal hemorrhage: HTN, trauma or arteriovenous malformation: LP--> herniation
Intracerebral Hemorrhage
46
- Proteinuria - Hypoalbuminemia - Hyperlipidemia
Nephrotic syndrome manifestations
47
- Hematuria (RBC casts) - HTN - Edema /Azotemia (High nitrogen in blood
Acute Glomerulonephritis (Nephritic Syndrome)
48
Nephrotic syndrome includes what 3 etiologies?
Minimal Change Focal Segmental Glomerulosclerosis membranous nephropathy
49
MC Nephrotic syndrome etiology occurring in children: Effacement of podocytes: Tx is Prednisone
Minimal change Disease
50
Nephrotic syndrome etiology Involves AA, HTN and fibrosis of glomerulus: "Not Steroid responsive"
Focal Segmental Glomerulosclerosis
51
Nephrotic syndrome etiology Involves thickening of the glomerular basement membrane: 2T immune complex depositions
Membranous Nephropathy
52
Nephritic Syndrome (AGN) includes what etiologies?
- IgA Nephropathy (Berger's Disease) - Post infectious - Rapidly Progressive GN - Good Pasture's
53
Nephritic Syndrome (AGN) MC after GABHS or Impetigo: Facial Edema: Post-Strep: coca cola urine
Post Infectious GN
54
Nephritic Syndrome (AGN): Linear IgG depositis, hemoptysis and kidney failure (Hematuria)
Good Pasture's
55
Nephritic Syndrome (AGN) progresses to ESRD in weeks due to fibrin and protein deposition: Crescent formation biopsy Tx:
Rapid Progression GN CS and Cyclophosphamide
56
MC Nephritic Syndrome (AGN) in adults WW: post URI or GI infection; IgA mesangial deposits: Tx: ACE/ CS
IgA Nephropathy (Berger's Disease)
57
Acute Kidney Injury Types
Prerenal (MC). Intrinsic, and post renal.
58
MCC of prerenal AKI is _______: which leads to_______? BUN:Cr is?
Hypovolemia (NSAID/IV contrast): ATN | B:Cr 20:1
59
Intrinsic types of AKI?
Acute Tubular necrosis (ATN MC type) | Acute tubulointerstitial nephritis (AIN)
60
Intrinsic AKI caused by hypo/ tension-volemia or aminoglycosides: UA= Muddy Brown casts/Epithelial cell
ATN
61
AIN is caused by a ________--> to ________ casts?
Hypersensitivity (PCN, NSAID Sulfa: WBC Casts
62
RBC casts are pathognomonic for ?
Acute Glomerulonephritis
63
FeNa >2 you think what AKI?
ATN
64
Low FeNa< 2 you think what type of AKI?
Prerenal
65
Incontinence marked by overactive bladder Detrusor muscle? Tx:Urge incontinence
Urge incontinence Tx: Oxybutynin or Tolterodine (Anticholinergics) TCA-Mirabregon
66
Incontinence marked by increased abd. pressure, ;laxity of pelvic floor muscle: laughing, sneezing, coughing Tx:
Stress Incontinence Tx: Midodrine
67
Incontinence marked by urinary retention (incomplete emptying). underactive detrusor muscle: Dx:
Overflow Incontinence Dx: Post void residual .200 ml Tx: Tamsulosin (A-1 b)
68
Dx: PSA < 4 Tx: 5-A reductase Inh. (Finasteride Dutasteride) "Androgen Inhibitors" (suppresses growth) A-1 blockers Tamsulosin, Terazosin, -zosin (m. relaxation) "Only relieves symptoms"
Benign Prostatic Hyperplasia (BPH)
69
Asthma stages? COPD Stages? CHF Stages? CKD Stages?
Asthma (FEV1 >80 normal decrease in 20s) X4 Stages COPD (FEV1 > 80 normal decrease in 30s) X4 CHF (EF 55-70% normal decrease in 15s) X3 CKD (GFR >90 normal decrease in 30s) X4
70
Methotrexate is the DOC for ?
Rheumatoid Arthritis, Psoriatic Arthritis, Psoriasis, Juvenile Idiopathic Arthritis
71
Carbamazepine (Synthetic Benzo)
- Tic Dolorouxe - Diabetes Insipidus - Anticonvulsant/epileptic
72
MCC cancers are Adeno except for?
Ovarian- Epithelial Vaginal- Squamous Cervical- HPV Bladder- Transitional cell
73
The common bleeding disorder where Desmopressin treatment will not work and will require_____ treatment/
Hemophilia B (Christmas) requires Factor IX

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