Test 26 - IM

Question 1

Px Human Monocyte Ehrlichiosis

Answer 1

acute febrile illness, malaise and altered mental status with NO RASH
carries by Lone Star Tick in SE and S united states.
Labs: elevated liver Alk Phos, AST, ALT

Question 2

What is Pellegra? What are the symptoms?

Answer 2

Dietary deficiency of niacin. Often found in people who eat mainly corn based diets in india, africa and china. It has the 3 Ds: Dimentia, Diarrhea, Dermatitis.

Question 3

Picmonic: Niacin

Answer 3

a

Question 4

What is isolated systolic hypertension?

Answer 4

ISH: hypertension in systole with normal diastole. Important source of HTN in elderly thought to be due to increased rigidity of the arterial wall.

Question 5

Isolated Systolic Hypertension (ISH) is an important risk factor for what? What do you do for it?

Answer 5

Cardiovascular risk factor in the elderly. Treat with low dose HCTZ, ACE-inhibitor, or long acting Ca channel blocker.

Question 6

Common side effect of lithium for bipolar? Trt?

Answer 6

Nephrogenic diabetes insipidus. Trt: Na restriction and dc lithium.

Question 7

What do you check on any patient on a statin who presents with myalgias?

Answer 7

Creatine Phosphokinase (CPK) - liver toxicity. If elevated, stop.

Question 8

Why do multiple myeloma patients develop renal insufficiency?

Answer 8

50% of MM patients develop renal insufficiency most likely due to obstruction of the distal and collecting tubules with globs of bence-jones proteins stuck together. This is referred to as paraproteinemia.