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Subject Requires Review Flashcards

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
Q

Autoimmune Inflammatory demyelinating degeneration of white matter. sensory pain/fatigue, cramping,

suspect w young and trigeminal neuralgia, optic neuritis episodic exacerbations; :Tx

A

Multiple Sclerosis

Tx: IVCS, plasmapheresis, Amantadine (Fatigue)
Glatiramer acetate (Reduces relapse severity)
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26
Q

Autoimmune peripheral nerve disorder against Ach Receptors. Thymic hyperplasia/thymoma

General muscle weakness (Ocular, Resp., Bulbar): relieved w rest Tx:

A

Myasthenia Gravis

Tx: Pyridostigmine or Neostigmine 1st line
Plasmapheresis or IV Ig

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27
Q

Restless leg syndrome treatment?

A
  • Pramipexole

- Ropinirole (Both domapine Agonists)

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28
Q

CSF: High protein (>400) with a normal WBC (Albumin cytological dissociation)

Electrophysiologic decreased motor nerve conduction: Diagnosis studies for?

A

Guillain Barre Syndrome

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29
Q

MRI with Gadollinium (TOC) confirms disorder showing white matter plaque hyper densities (Periventricular).

A

Multiple Sclerosis

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30
Q

Blood test shows Acetylcholine receptor Antibodies (+) Muscle specific Tyrosine Kinase (Musk)

A

Myasthenia Gravis

31
Q

LP CSF shows increase IgG oligoclonal bands “Pleocytosis”

A

Multiple Sclerosis

32
Q

Myasthenia gravis Test that includes a rapid response to short acting IV_______?

A

Edrophonium

33
Q

Constant daily Headache: not worse with activity: BL tight-band/vise-like no phono/photo phobia

Tx: Prophylaxis and abortive

A

Tension Headache

Tx: A-NSAI/APAP Amitriptyline P- BBs

34
Q

Headache 4-72 hour in duration: pulsatile, lateralized, throbbing. NV, Phono/Photo phobia, worse w activity

Tx: Abortive and Prophylaxis

A

Migraine Headache

Tx: A- Triptans/Ergotamines (5HT-1) vasoconstrictions
Metoclopramide, Promethazine, Prochlorperazine. (DBs)
P- BBs/CCBs/TCAs

35
Q

UL Headache: Temporal, periorbital, lancinating, < 2hoursseveral times a day/6-8 weeks. worse night/Etoh

Horner’s syndrome, UL congestion/lacrimation:
Tx: A- P-

A

Cluster Headache

Tx: A- 100% O2: Triptan/Ergotamines (Sumatriptan nasal)
P- Verapamil

36
Q

Motor and sensory deficits in upper extremities in a “shawl distribution.

A

Central cord syndrome

37
Q

Ipsilateral motor vibratory and proprioception deficits and contralateral pain and temperature deficits

A

Brown Sequard syndrome

38
Q

Loss of temperature and pain in lower extremities. TEE-Pee

A

Anterior Cord Syndrome

39
Q

Damage Associated with voluminous meaningless impaired comprehension (Word Soup)

A

Wernicke’s Aphasia

40
Q

Damage Associated with difficulty remembering words or speaking with relatively preserved

A

Broca’s Aphasia

41
Q

MC type of stroke and what vessel?

A

Ischemic (Middle cerebral Artery)

42
Q

MC Arterial bleed: Between skull and Dura: involves medial meningeal artery: Lens shape (Convex)

A

Epidural Hematoma (Hemorrhage)

43
Q

MC Venous bleed: Between dura and arachnoid: involves tearing of bridging veins: Blunt Trauma “elderly”

Slow onset and crescent shape: “Midline shift”

A

Subdural Hematoma (Hemorrhage)

44
Q

Bleed between arachnoid and pia: MC Berry Aneurysm rupture: Sudden thunderclap worse HA of life:

A

Subarachnoid Hemorrhage

45
Q

Intraparenchymal hemorrhage: HTN, trauma or arteriovenous malformation: LP–> herniation

A

Intracerebral Hemorrhage

46
Q
  • Proteinuria
  • Hypoalbuminemia
  • Hyperlipidemia
A

Nephrotic syndrome manifestations

47
Q
  • Hematuria (RBC casts)
  • HTN
  • Edema /Azotemia (High nitrogen in blood
A

Acute Glomerulonephritis (Nephritic Syndrome)

48
Q

Nephrotic syndrome includes what 3 etiologies?

A

Minimal Change
Focal Segmental Glomerulosclerosis
membranous nephropathy

49
Q

MC Nephrotic syndrome etiology occurring in children: Effacement of podocytes: Tx is Prednisone

A

Minimal change Disease

50
Q

Nephrotic syndrome etiology Involves AA, HTN and fibrosis of glomerulus: “Not Steroid responsive”

A

Focal Segmental Glomerulosclerosis

51
Q

Nephrotic syndrome etiology Involves thickening of the glomerular basement membrane: 2T immune complex depositions

A

Membranous Nephropathy

52
Q

Nephritic Syndrome (AGN) includes what etiologies?

A
  • IgA Nephropathy (Berger’s Disease)
  • Post infectious
  • Rapidly Progressive GN
  • Good Pasture’s
53
Q

Nephritic Syndrome (AGN) MC after GABHS or Impetigo: Facial Edema: Post-Strep: coca cola urine

A

Post Infectious GN

54
Q

Nephritic Syndrome (AGN): Linear IgG depositis, hemoptysis and kidney failure (Hematuria)

A

Good Pasture’s

55
Q

Nephritic Syndrome (AGN) progresses to ESRD in weeks due to fibrin and protein deposition:

Crescent formation biopsy Tx:

A

Rapid Progression GN

CS and Cyclophosphamide

56
Q

MC Nephritic Syndrome (AGN) in adults WW: post URI or GI infection; IgA mesangial deposits: Tx: ACE/ CS

A

IgA Nephropathy (Berger’s Disease)

57
Q

Acute Kidney Injury Types

A

Prerenal (MC). Intrinsic, and post renal.

58
Q

MCC of prerenal AKI is _______: which leads to_______? BUN:Cr is?

A

Hypovolemia (NSAID/IV contrast): ATN

B:Cr 20:1

59
Q

Intrinsic types of AKI?

A

Acute Tubular necrosis (ATN MC type)

Acute tubulointerstitial nephritis (AIN)

60
Q

Intrinsic AKI caused by hypo/ tension-volemia or aminoglycosides: UA= Muddy Brown casts/Epithelial cell

61
Q

AIN is caused by a ________–> to ________ casts?

A

Hypersensitivity (PCN, NSAID Sulfa: WBC Casts

62
Q

RBC casts are pathognomonic for ?

A

Acute Glomerulonephritis

63
Q

FeNa >2 you think what AKI?

64
Q

Low FeNa< 2 you think what type of AKI?

65
Q

Incontinence marked by overactive bladder Detrusor muscle?

Tx:Urge incontinence

A

Urge incontinence

Tx: Oxybutynin or Tolterodine (Anticholinergics)
TCA-Mirabregon

66
Q

Incontinence marked by increased abd. pressure, ;laxity of pelvic floor muscle: laughing, sneezing, coughing

Tx:

A

Stress Incontinence

Tx: Midodrine

67
Q

Incontinence marked by urinary retention (incomplete emptying). underactive detrusor muscle:

Dx:

A

Overflow Incontinence

Dx: Post void residual .200 ml Tx: Tamsulosin (A-1 b)

68
Q

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”

A

Benign Prostatic Hyperplasia (BPH)

69
Q

Asthma stages?
COPD Stages?
CHF Stages?
CKD Stages?

A

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
Q

Methotrexate is the DOC for ?

A

Rheumatoid Arthritis, Psoriatic Arthritis, Psoriasis, Juvenile Idiopathic Arthritis

71
Q

Carbamazepine (Synthetic Benzo)

A
  • Tic Dolorouxe
  • Diabetes Insipidus
  • Anticonvulsant/epileptic
72
Q

MCC cancers are Adeno except for?

A

Ovarian- Epithelial
Vaginal- Squamous
Cervical- HPV
Bladder- Transitional cell

73
Q

The common bleeding disorder where Desmopressin treatment will not work and will require_____ treatment/

A

Hemophilia B (Christmas) requires Factor IX

PANCE (13 decks)

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