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Internal Med > TBL Mashup > Flashcards

TBL Mashup Flashcards

1
Q

Sensitivity

A

proportion of people with disease who test positive (a/a+c)

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2
Q

specificity

A

proportion of people w/o disease who test negative (d/b+d)

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3
Q

PPV

A

proportion of pts who test positive who have the disease (a/a+b)

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4
Q

NPV

A

proportion of pts who test negative who don’t have the disease (d/c+d)

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5
Q

lead-time bias

A

earlier detection w/o change in life expectancy

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6
Q

length-time bias

A

pick up slowly progressive tumors which have a better prognosis no matter what

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7
Q

CHADS2 score

A
  • A-fib anti-coagulation
    • C = CHF (1)
    • H = HTN (1)
    • A = Age > 75 (1)
    • D = Diabetes (1)
    • S = past Stroke or TIA (2)
  • score 0 = nothing or ASA
  • score 1 = ASA or warfarin
  • score 2 = warfarin (INR 2-3)
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8
Q

first line therapy for A-Fib

A
  • -Beta-blockers
  • -Verapamil or diltiazem (nondihydropyradine CCB)
  • -Dronedarone
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9
Q

NYHA Classifications for LV function

A
  • Class 1 (mild)= asymptomatic LV dysfunct –> b-blocker
  • Class 2 (mild)= symptoms with normal physical activity –> b-blocker
  • Class 3 (mod)= symp with minimal activity –> b-blocker + spironolactone
  • Class 4 (sev)= symptoms at rest –> b-blocker + spironolactone
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10
Q

irregular rhythms

A
  1. Sinus tach w/ PACs (premature atrial contractions)
  2. A-Fib
  3. A-Flutter with variable block
  4. Multifocal atrial tachy (MAT)
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11
Q

regular rhythms

A
  1. Sinus Tach
  2. A-Flutter
  3. WPW = wolf-parkinson-white
  4. SVT = super ventricular tachy
  5. AVNRT = AV nodal re-entrant tachy
  6. Ventricular Tach (wide complex)
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12
Q

PR interval

A

0.12- 0.20

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13
Q

QRS complex

A

less than 0.12

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14
Q

Left atrial enlargement on EKG

A
  • P mitrale=
    • P wave > 0.12 sec;
    • P have has 2 humps Lead II
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15
Q

Right atrial enlargement on EKG

A
  • p-pulmonale =
    • P wave > 2.5mm high and looks like it’d hurt to sit on V1
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16
Q

Right ventricular enlargment on EKG

A

larger R wave in V1 or V2

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17
Q

Left ventricular enlargement on EKG

A

Tallest R in V5 or V6

Deepest S in V1 or V2

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18
Q

A-fib features on EKG

A

irregularly irregular rhythm NO P-waves

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19
Q

EKG rate counting on EKG

A

300 - 150 - 100 - 75 - 60 - 50

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20
Q

CURB -65 criteria (predicts mortality in pneumonia)

A
  • C = confusion
  • U = BUN > 7
  • R = RR > 30
  • B = BP less than 90/60
  • 65 = age > 65
  • meets 2 criteria –> admit to hospital
  • meets 3 criteria –> ICU admit
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21
Q

Treatments for Pyelo

A
  • -Oral ciprofloxacin (7days) *preferred*
  • -Levofloxacin (5d)
  • -TMP-SMX (14days)
22
Q

Treatment for complicated UTI

A

extended spectrum cephalosporin +/- aminoglycoside or carbapanem

23
Q

SIRS criteria

A
  • Temp: > 100.4 or < 96.8
  • HR > 90
  • RR > 20 or PaCO2 < 32
  • WBC
    • < 4000
    • > 12,000
    • or >10% bands
  • need 2/4 to diagnose SIRS
24
Q

Sepsis

A

SIRS + source of infection

25
Q

Severe Sepsis

A
  • Sepsis (SIRS + source) + end-organ dysfunction
    • -ileus
    • -acute oliguria
    • -hypoxemia
    • -thrombocytopenia
    • -rise in creatinine > 0.5 mg/dL
    • -coag abn (INR > 1.5 or pTT > 60s)
    • -bilirubin > 4
    • -unexplained metabolic acidosis
    • -AMS
    • -Hyperglycemia
    • -Elevated CRP
    • -elevated plasma procalcitonin
26
Q

Septic Shock

A

arterial hypotension less than 90/60 or reduction of systolic BP >40 from baseline DESPITE adequate volume resuscitation

27
Q

Grave’s disease PE findings

A
  • Exopthalmos
  • Pretibial myxedema
  • thyroid bruit
28
Q

What factors increase Thyroid Binding Globulin?

A
  • Liver Disease
  • Oral Contraceptives
  • Aspirin
  • Pregnancy
29
Q

5 P’s of cretinism

A
  1. Pot-belly
  2. Protruding belly button
  3. Protruding tongue
  4. Puffy face
  5. Pale
30
Q

MEN 1 (Wermer’s Syndrome)

A
  1. Pituitary (prolactin or GH)
  2. Parathyroid
  3. Pancreas (Zollinger-Ellison, insulinoma, VIPoma, glucagonoma)
31
Q

MEN 2A (Sipple’s Syndrome)

A
  1. Medullary thyroid CA–> calcitonin
  2. Pheochromocytoma
  3. Parathyroid tumors
32
Q

MEN 2B

A
  1. Medullary thyroid CA–> calcitonin
  2. Pheochromocytoma
  3. Oral/intestinal ganglioneuromatosis (a/w marfanoid habitus)
33
Q

cancers that spread t/ blood

A
  1. renal cell CA
  2. hepatocellular CA
  3. follicular CA (thyroid)
  4. choriocarcinoma
34
Q

Nephrotic Syndrome diseases

A
  1. FSGS - AA/Hispanic, Obese, HIV, Heroin
  2. Membranous - AdenoCA, Hep B, NSAIDs, SLE
  3. Membranoproliferative - Hep B/C, lipodystrophy
  4. Minimal Change - NSAIDs, lymphoma
35
Q

Features of Nephrotic syndrome

A
  1. proteinuria >3.5g/day
    1. hypoalbuminemia = pitting edema
    2. hypogammaglobulinemia = infection
    3. hypercoaguable = loss of antithrombin III
    4. hyperlipidemia + hypercholesterolemia = fatty casts in urine
36
Q

Inferior MI

A

Q waves + ST elevation in leads:

  • II
  • III
  • aVF

Occlusion of

  • RCA = right coronary artery
  • LCX = left circumflex

A/W hypotension, bradycardia, AV block

37
Q

Anterioseptal MI

A
  • ST elevation MC in V1 - V4 (but may be any in V1-V6)
  • LAD occlusion
    • second degree AV block
38
Q

Posterior MI

A
  • ST depression
    • V1, V2, V3
  • Changes in I and avL
    • depression = RCA
    • eLevation = LCX
39
Q

Lateral MI

A
  • ST elevation
    • I, aVL, V5, V6
  • ST depression
    • II, III, aVF
  • occlusion of
    • LCX
    • Diagonal
40
Q

Right ventricle MI (occurs in 1/2 of inferior MIs)

A
  • RCA occlusion
  • ST elevation in leads V4-V6
41
Q

Which heart murmurs are louder with valsalva?

A
  • HCM
  • MVP with murmur
    • louder and longer (prolapse occurs closer to S1)
  • valsalva decreases other murmurs
42
Q

what murmurs increase with standing and decrease with squatting?

A
  • MVP = louder and longer
  • HCM = louder
43
Q
A
44
Q

What murmurs increase and decrease with handgrip?

A
  • increases regurgtant murmurs
    • aortic regurg
    • mitral regurg (including that a/w MVP)
    • VSD
  • decreases
    • HCM
    • aortic stenosis
45
Q

How can you make HCM murmur louder? softer?

A
  • HCM louder
    • valsalva
    • standing
  • HCM softer
    • squatting
    • sustained handgrip
46
Q

explain how to make a MVP murmur louder? softer?

A
  • MVP louder
    • valsalva
    • standing
    • SUSTAINED HANDGRIP!!!
  • MVP softer
    • squatting
47
Q

6P’s of compartment syndrome

A
  1. pain
  2. paresthesia
  3. pallor
  4. pulselessness
  5. poikilothermia (loss of normal thermoregulation)
  6. paralysis
48
Q

Indications for Aortic Valve Replacement

A
  1. symptomatic AS
  2. Severe AS undergoing CABG or other valvular surgery
  3. asymptomatic patients w/ severe AS and either
    1. Poor LV systolic function
    2. LV hypertrophy > 15 mm
    3. valve area < 0.6 cm2
    4. abnormal response to exercise (i.e. hypotension)
49
Q

Colorectal screening

A
  • Screen all men and women 50-75 years old at average risk
  • No routine screening 76-85y
  • At higher than average risk:
    • 1st degree relative:
      • 10y younger than age at diagnosis
      • OR at age 40 (whichever is first)
50
Q

Osteoporosis Screening and T score meanings

A
  1. Screen all women age 65 or older
    1. Or age 60 with risk factors
  2. Interval: min. of 2 years
  3. Osteoporosis = T-score more than 2.5 SD below normal
  4. Osteopenia = T-score of 1 to 2.5 SD below normal
51
Q

Centor criteria to determine pretest probability of strep pharyngitis.

A
  1. One point is given for each:
    1. Fever
    2. Tonsilar exudates
    3. Tender anterior LAD
    4. Absence of cough
  2. Points
    1. 0-1 point: no further testing needed
    2. 2 points: test w/ rapid strep or culture
    3. 3+ points: empiric tx is option w/o testing
  3. Age sometimes included in modification of Centor criteria with age<14 (+1pt) and age>45 (-1pt)
52
Q

Light’s Criteria (transudative vs. exudative pleural effusion)

A

Exudative pleural effusions meet at least one of the following criteria whereas transudative meet none:

  1. Pleural fluid protein/serum protein >0.5
  2. Pleural fluid LDH/Serum LDH >0.6
  3. Pleural fluid LDH > than 2/3 *normal upper limit for serum

Internal Med (2 decks)

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