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STEP2: Tidbits > TEST 9-10 > Flashcards

TEST 9-10 Flashcards

1
Q

Ddx of GRANULOMATOUS ULCERS:

Generally would see SYSTEMIC SIGNS (fever, night sweats)

A

TERTIARY SYPHILIS
TB
DISSEMINATED FUNGAL DISEASE

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2
Q

Crusted ulcer in LOWER LIP

BIOPSY: INVASIVE CORDS OF SQUAMOUS CELLS + KERATIN PERALS

A

SQUAMOUS CELL CARCINOMA = most common carcinoma of lip (particularly in LOWER lip)

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3
Q

Crusted ulcer in UPPER LIP

BIOPSY: Invasive clusters of spindle cels surrounded by PALISADED BASAL CELLS

A

BASAL CELL CARCINOMA

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4
Q

Recurrent, self-limiting ulcerations of oral cavity

BIOPSY: SHALLOW FIBRIN-COATED ulcerations + underlying MONONUCLEAR INFILTRATE

A

ORAL APHTHOUS ULCER

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5
Q

What is first-line Tx of DIFFUSE ESOPHAGEAL SPASM-related chest pain?

ENDOSCOPY: Usually normal
ESOPHAGRAM: Corkscrew
MANOMETRY: Intermittent peristalsis + multiple simultaneous contractions

A

CCB - Diltiazem

Relieves pain and reduces dysphagia

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6
Q

Food impaction + Dysphagia + Heartburn NOT relieved by standard medications
ENDOSCOPY: Esophageal rings/stricture

A

EOSINOPHILIC ESOPHAGITIS

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7
Q

What medications POTENTIATE effect of WARFARIN?

A

1) ACETAMINOPHEN

2) DECONGESTANT (PHENYLEPHRINE - ay elevate BP

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8
Q

What is the main usage of TRANEXAMIC ACID (anti-fibrinolytic agent)

A

1) Heavy menstrual bleeding

2) Prevention of bleeding during certain surgeries

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9
Q

Which state HYPER or HYPOTHYROIDISM causes SYSTEMIC HTN? How is contractility, HR, and SVR affected in each?

A

BOTH HYPER AND HYPO = HTN

1) HYPER - Increase contractility/HR (Increase SNS) + DECREASED SVR
2) HYPO - Decreased contractility/HT + INCREASED SVR

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10
Q

Agent used to treat URINARY RETENTION or ATONIC BLADDER:

A

CHOLINERGIC AGENT (BETHANECHOL)

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11
Q

Agent used to treat URGE URINARY INCONTINENCE (detrusor instability):

A

ANTI-CHOLINERGIC: OXYBUTYNIN

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12
Q

1st line agent for BPH? 2nd Line?

A
  1. TAMSULOSIN - alpha1 blocker

2. FINASTERIDE - 5alpha-reductase inhibitor (blocks conversion of testosterone -> Dihydrotestosterone)

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13
Q

What is an anti-depressant medication used to treat CHILDHOOD ENURESIS (hint: anti-muscarinic effect)

A

IMIPRAMINE - TCA

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14
Q

YOUNG OBESE FEMALE pt with headache (almost suggestive of brain tumor) BUT NORMAL neuroimaging/MRI + elevated CSF pressure (PAPILLEDEMA)

What is the recommended Tx?

Without Tx, what is the most significant complication? What Tx can prevent these complications?

A

BENIGN INTRACRANIAL HTN (PSEUDOTUMOR CEREBRI) - Defective CSF resorption from arachnoid villi

Recommended Tx - weight loss + ACETAZOLAMIDE (if weight loss fails)

BLINDNESS = most significant complication
Tx - SHUNTING, OPTIC NERVE SHEATH FENESTRATION

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15
Q

Erythema of central face + Facial flushing + Telangiectasias of skin + Burning discomfort precipitated by heat, ALCOHOL, emotion, rapid temperature changes

A

ROSACEA

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16
Q

Therapy for ACUTE DECOMPENSATED HEART FAILURE in pts who are NORMOTENSIVE/HYPERTENSIVE:

A
  1. Aggressive diuretics (loop diuretics - furosemide)
  2. Supplemental O2
  3. +/- vasodilators (NITROGLYCERIN, NITROPRUSSIDE)
17
Q

What is the general cutoff value of Glc for HYPERGLYCEMIC NON-KETOTIC STATE for sx - altered mental status + focal neuro deficits?

A

Glc>600

More often >1000

18
Q

Ddx of DIFFERENTIAL BP in UPPER EXTREMITIES:

A

1) AORTA DISSECTION (Right SBP > Left SBP) - dissection impairs flow to the left carotid/left arm
2) AORTA COARCTATION
3) SUPRAVALVULAR AS - Congenital LV outflow tract obstruction due to diffuse narrowing of ascending aorta

19
Q

UNEQUAL CAROTID PULSES + DIFFERENTIAL BLOOD PRESSURES in UE + Palpable thrill in suprasternal notch + Mid-systolic murmur at right ICS

A

SUPRAVALVULAR AORTIC STENOSIS

20
Q

Drugs that cause FACIAL FLUSHING

A 
VANC
Vancomycin - mediated by HISTAMINES
Adenosine 
Niacin - mediated by PGs (controlled by NSAIDs)
CCB
21
Q

What is the MOST effective non-pharmacologic measure of controlling HTN in individuals with BMI >25?

What are other helpful methods?

A

10% WEIGHT LOSS

Also helpful: DASH diet (high in fruits/vegetables, low in saturated fat/total fat) + Exercise + dietary sodium restriction + decreased alcohol intake

22
Q

Which medication should be DISCONTINUED in a diabetic pt who is acutely ill with AKI, liver failure, or sepsis?

A

METFORMIN** - These conditions INCREASE risk of lactic acidosis with HYPOTENSION-related pre-renal azotemia in these acute settings

23
Q

What are the 3 LIGHTS CRITERIA for PLEURAL EFFUSION?

A

1) FLUID LDH>2/3 of upper limit (90)
2) FLUID LDH/SERUM LDH >0.6
3) FLUID TOTAL PROTEIN/SERUM TOTAL PROTEIN >0.5
Any one of these 3 = EXUDATIVE

STEP2: Tidbits (9 decks)

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