Test 21 - Created July 17 Flashcards
clinical presentation of constrictive pericarditis
fatigue, dyspnea on exertion, peripheral edema, ascites, incr. JVP, pericardial knock, pulsus paradoxus, Kussmaul’s sign; pericardial calcifications on CXR
why constrictive pericarditis may occur
viral, CABG, radiation, TB
attributable risk percent
(risk in exposed - risk in unexposed)/risk in exposed
population attributable risk percent
(risk in total pop - risk in unexposed)/risk in total pop
how you get Vibrio vulnificus
eating oysters or wound contamination during raw fish handling
presentation of Vibrio vulnificus
- progresses < 12h
- sepsis - shock, bullous lesions
- cellulitis - hemorrhagic bullae, nec fasc
dx and tx of Vibrio vulnificus
dx: Cx, leukocytosis with left shift, renal insuff.
tx: IV ceftriaxone and doxycycline; TREAT NOW
presentation of Mycobacterium marinum
papular and ulcerative lesions that develop over days after contact with salt/fresh water and wound infection
what to do if under-anticoagulated and thrombotic disease worsens
give IV heparin or subQ LMWH; do CT if pt has PE-like sxs
difference btwn TH resistance syndrome and TSH-secreting pituitary adenoma
both: elev TSH, T4, T3, goiter
res: normal levels of alpha subunit and sex HBG; suppressible by levothyroxine
what to do if patient invites you to significant life event
use professional judgment and cultural sensitivity
reversible causes of asystole/PEA: 5Hs
Hypovolemia, Hypoxia, Hydrogen iosn, Hypo/hyperkalemia, Hypothermia
reversible causes of asystole/PEA: 5Ts
Tension Ptx, Tamponade, Toxins, Thrombosis, Trauma
when to test for Lyme disease
when patients present with early disseminated and late Lyme disease; no need to test of early localized (rash, flu-like sxs)
testing for Lyme disease
ELISA followed by Western blot
tx for Lyme disease
oral doxy; IV ceftriaxone if severe
things that increase risk of C.diff diarrhea
- PPIs
- recent ABx (FQN, clinda, PCNs, cephalosporins)
- hospitalization
- advanced age (more likely to have 1 of 3 above)
why anemia occurs in patients with end-stage renal disease
decreased renal EPO but also can be from iron def., severe hyperPTH, folate def., systemic infl., and aluminum toxicity
when to give end-stage renal disease patient an EPO-stimulating agent
Hgb < 10; give IV iron if transferrin sat < 30% and ferritin < 500
2 labs to monitor active renal dx in patients with SLE
anti-dsDNA and complement
mgt of Bell’s palsy
NO imaging; prescribe corticosteroids and artificial tears; workup for Lyme or sarcoidosis if bilateral
tx of CAH
hydrocortisone, fludrocortisone, salt, surgery for girls, psychosocial support
high-intensity statin
atorva 40-80
rosuva 20-40
medicine to treat severe hypertriglyceridemia
fibrates (gemfibrozil)
presentation of polymyositis
progressive, painless proximal muscle weakness (problems with stairs, exiting chair/car, lifting arms above head); labs show elevated CK, LFTs, CRP
elevated antibodies in polymyositis
ANA and anti-Jo-1
important thing to check in patient with polymyositis
PFT’s (or a CT) for interstitial lung disease development
clinical features of mitral stenosis
SOB, orthopnea, PND, hemoptysis, Afib. thromboembolus, hoarse voice
PE features of mitral stenosis
loud S1, opening snap, mid-diastolic rumble at cardiac apex
MCC of mitral stenosis
rheumatic heart disease
Noonan syndrome
short, facial dysmorphisms, heart issues (PS, ASD, HCMP)
