TEST6/EYE Flashcards
BRONCHIECTASIS Tx with goals of aiding sputum clearance
Chest physiotherapy with percussion and vibration
Primary long-term therapy of asthma?
IHC
Primary long-term therapy of COPD?
LAMA inhaler - tiotropium, aclidinium
Tx for SEVERE, LIFE-THREATENING asthma exacerbations
IV Mg sulfate
ISOLATED SYSTOLIC HTN criteria =?
Pathophys =?
SBP >140
DBP
What abnormal values are seen with OSTEOPOROSIS?
NONE
Normal Ca, PO4, PTH, ALP
Which vitamin toxicity (2) presents with hypercalcemia?
VitA toxicity
VitD toxicity
Which murmur is most common with INFECTIVE ENDOCARDITIS?
Aortic Regurg
What are the 2 major criteria of DUKE for INFECTIVE ENDOCARDITIS?
- BLOOD CULTURE for micro-organism (S. viridans, S. aureus, Enterococcus)
- ECHO showing valvular vegetation
What are the 6 minor criteria of DUKE for INFECTIVE ENDOCARIDITS?
- BLOOD CULTURE not typical (s. aureus, viridans, enterococcus)
- Temp >38C (100.4)
- Embolic phenomena (Janeway lesions, neuro phenomena)
- Immunologic phenomena (Glomerulonephritis, Osler nodes)
- IVDA
- Pre-disposing cardiac lesion
Management/Diagnostic testing of ACUTE IE
3 serial blood cultures from separate venipuncture sites over 1hr period -> antibiotics
Management/Diagnostic testing of SUBACUTE IE
3 Blood cultures over SEVERAL hours -> antibiotics
NECROLYTIC MIGRATORY ERYTHEMA (lesions that enlarge/central clearing/blistering/crusting and scaling at borders- generally in FACE/ PERINEUM/ EXTREMITIES) over 7-14d + MILD HYPERGLYCEMIA (not requiring insulin) + NORMOCYTIC, NORMOCHROMIC ANEMIA + Weight loss + secretory diarrhea
GLUCAGONOMA
Radiographic imaging to confirm GLUCAGONOMA
What level of glucagon confirms GLUCAGONOMA diagnosis?
Abdomen CT or MRI - Localize pancreatic neuroendocrine tumor
GLUCAGONOMA (glucagon >500)
LOW INSULIN + anti-glutamic acid decarboxylase Abs = ?
INDOLENT LATE-ONSET AUTOIMMUNE TYPE 1 DIABETES
CARCINOID SYNDROME (most commonly small bowel) WITH METASTASIS TO LIVER presents with _?
BRONCHOSPASM + SECRETORY DIARRHEA + SKIN FLUSHING (5-HIAA goes from hepatic veins to lungs and skin)
RIGHT SIDED Ds - PULMONIC STENOSIS + TR
Steatorrhea and mal-absorption disrupts absorption of which vitamins?
Prevents usual fat emulsification -> Disrupts chylomicron-mediated VitD absorption
VITD DEFICIENCY -> LOW Ca, LOW PO4
HACEK - EIKENELLA CORRODENS INFECTIVE ENDOCARDITIS is most commonly seen in what setting?
POOR DENTITION and/or periodontal infection + dental procedures involving gingival or oral mucosa
What is the first management step of elderly pts with ACUTE URINARY INCONTINENCE?
URINARLYSIS + CULTURE = UTI = leading cause of urinary incontinence in elderly
What are the reversible causes of ACUTE URINARY INCONTINENCE in the elderly?
"DIAPPERS" D- delirium, I - Infection (UTI), A- atrophic urethritis/vaginitis P- pharmaceuticals P- psychological (depression) E- excess urine output (e.g. DM, CHF) R- restricted mobility (post-surgery) S- stool impaction
What medications can cause ACUTE URINARY INCONTINENCE in elderly?
1) ALPHA BLOCKERS - Urethral relaxation
2) anti-cholinergics, Opiates, CCB - Urinary retention/overflow
3) DIURETICS - Excess urine production
What are the 3 stages of DIABETIC RETINOPATHY
1) SIMPLE/BACKGROUND = Microaneurysms + hemorrhages + exudates + macular edema
2) PRE-PROLIFERATIVE = Cotton wool spots
3) PROLIFERATIVE/MALIGNANT = Neovscularization + often Vitreous hemorrhage
What is the main driving factor of visual impairment of DIABETIC RETINOPATHY?
MACULAR EDEMA from SIMPLE or BACKGROUND RETINOPATHY (by IDDM or NIDDM)
What is the Tx of preventing visual impairment complications of DIABETIC RETINOPATHY?
ARGON LASER PHOTOCAGULATION (since this is a microaneurysm)
GRADUAL loss of PERIPHERAL vision “tunnel vision” followed by loss of CENTRAL VISION = ?
Fundoscopy = OPTIC DISC CUPPING
OPEN ANGLE GLAUCOMA
Distorted vision + CENTRAL SCOTOMA (either atrophic Dry or exudative Wet) + DRUSEN deposits
EARLIEST FINDING: Straight lines appear wavy
MACULAR DEGENERATION
SUDDEN, UNILATERAL visual impairment noted at WAKING UP in morning + DISC SWELLING + VENOUS DILATION + TORTUOS RETINAL HEMORRHAGES (tomato squashed) + COTTON WOOL SPOTS
CENTRAL RETINAL VEIN OCCLUSION
CARDINAL Sx of HEAT STROKE:
TEMP>105 (40C)
ALTERED MENTAL STATUS
HYPOTENSION, TACHYCARDIA, JVD, TACHYPNEA
Pathophysiology of HEAT STROKE
Failure of thermoregulatory center to dissipate heat at a rapid enough rate to maintain EUTHERMIA
COMPLICATION OF HEAT STROKE if body temp >41C (105.8) = ?
RHABDOMYOLYSIS
UA sign of rhabdo =
+ Large gross blood
0 RBC
Which two anesthetic drugs can cause MALIGNANT HYPERTHERMIA (uncontrolled Ca efflux from SR) + Temp>45C (113)?
HALOTHANE
SUCCINYLCHOLINE
What is difference between HEAT EXHAUSTION and HEAT STROKE?
HEAT EXHAUSTION:
1) Pathophys - Due to inadequate Na and H2O retention -> Failed CO
2) Temp40 (105)
3) YES Altered mental status