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STEP2: Tidbits > TEST8 > Flashcards

TEST8 Flashcards

1
Q

Which part of spinal cord results in PARAPLEGIA, BLADDER/FECAL INCONTINENCE, ABSENT SENSATION from nipple downwards?

A

UPPER THORACIC SPINAL CORD (T4 = NIPPLE)

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2
Q

Which part of spinal cord results in ABSENT SENSATION FROM UMBILICUS downwards?

A

LOWER THORACIC SPINAL CORD (T10 = UMBILICUS)

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3
Q

Lesion of POSTERIOR FOSSA causes what sx?

A

N/V + ataxia

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4
Q

Typical presentation of MYELODYSPLASTIC SYNDROME?

Pt age, CBC panel, blood smear

A

Elderly

PANCYTOPENIA + macro-ovalocytic anemia (Elevated MCV, but not hypersegmented)

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5
Q

What is the mainstay Tx for VARICEAL BLEEDING?

A

OCTREOTIDE = SST analog

Inhibits vasodilator hormones -> Indirectly leads to splanchnic vasoconstriction + Decreased portal flow

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6
Q

What is the cutoff value of INR for transfusing FRESH FROZEN PLASMA (FFP)?

A

INR>1.6

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7
Q

What is the cutoff value of PLT transfusions?

A

PLT

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8
Q

What diagnostic tests should ALL cirrhosis pts undergo? Why?

What surveillance test should all cirrhosis pts undergo?

A

1) ESOPHAGEAL ENDOSCOPY - Because esophageal varices = major cause of morbidity/mortality that occurs in 50% of pts
2) Ultrasound surveillance for HEPATOCELLULAR CARCINOMA +/- aFP every 6mo

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9
Q

What is the PRIMARY prevention of VARICEAL HEMORRHAGE?

A

NON-SELECTIVE BETA BLOCKERS

Repeat EGD every year

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10
Q

What is the best anti-malaria chemoprophylaxis for short-term travelers to Sub-saharan Africa, southeast Asia?

A

Africa, Southeast Asia = high rates of chloroquine-resistant P falciparum
CHEMOPROPHYLAXIS with “MAD” - MEFLOQUINE, ATOVAQUONE-PROGUANIL, DOXYCYCLINE

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11
Q

What is the most commonly used anti-malaria chemoprophylaxis for travelers to Korea peninsula, Mexico?

A

Highest rates of P. ovale and vivax

Chemoprophylaxis with PRIMAQUINE

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12
Q

MRI: Multiple, hypodense, NON-ENHANCING lesions with no mass effect
Immunocompromised pt with HIV CD4Ct

A

PROGRESSIVE MULTIFOCAL LEUKOENCEPHALOPATHY

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13
Q

What is seen on imaging studies of AIDS Dementia?

A

CORTICAL/SUB-CORTICAL ATROPHY + secondary ventricular enlargement

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14
Q

When a SLE pt starts HYDROXYCHLOROQUINE therapy (TNF and IL-1 suppressor), what evaluation should be done periodically?

A

EYE EXAM

AE = retinopathy

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15
Q

LAB signs of ALCOHOLIC HEPATITIS:

A
  1. AST:ALT>=2
  2. Macro-ovalocytic anemia - MCV>100
  3. LOW PLT
  4. Slight ELEVATED INR
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16
Q

What distinguishes METABOLIC ALKALOSIS of SURREPTITIOUS VOMITING vs DIURETIC/GITELMAN/BARTTER?

A

Distinguish by URINE CL-
Vomiting = Saline-responsive MA = hypovolemia = HYPOCHLOREMIC = LOW URINE Cl-

Diuretic/Bartter/Gittelman = NORMOTENSIVE and HIGH URINE Cl-

Saline-resistant MA = EXCESS MINERALOCORTICOID = Increased H+/K+ loss and Increased Na+ retention = INCREASED EXTRACELLULAR VOLUME = INCREASED Na+/Cl- diuresis = HIGH URINE Cl-

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17
Q

What is the pharmacotherapy for RESTLESS LEG SYNDROME?

A
  1. FIRST LINE = DOPAMINE agonists (PRAMIPEXOLE)**

2. ALPHA-2-DELTA CALCIUM channel ligands (GABAPENTIN, enacarbil)

18
Q

What is the non-pharmacotherapy therapy of PSVT (HR between 160-220 generally due to re-entry in AV node)?

What is the pharmacotherpy?

A

DECREASE AV NODE CONDUCTIVITY by INCREASING VAGAL TONE (Vagal maneuvers - valsalva, carotid sinus massage, immersion in cold water)

PHARM: ADENOSINE

19
Q

Diseases that generally cause Mitral valve prolapse (4)

A

MARFAN
EHLER DANLOS SYNDROME
MUSCULAR DYSTROPHY
GRAVES DISEASE

20
Q

Criteria for Long term O2 therapy

A
  1. PaO2 55%, or POLYCYTHEMIA VERA
21
Q

Female pt with acute HIRSUTISM:

Which hormone can STIMULATE ERYTHROPOIESIS by suppressing hepcidin -> Increases HGB? Which pathology is thus associated?

A

Female pt: TESTOSTERONE

Associated with hyper-androgenism (either OVARIAN or ADRENAL GLAND)

22
Q

How do you distinguish between HYPERANDROGENISM (ovarian source) and HYPERANDROGENISM (Adrenal source)

A

OVARY: Elevated testosterone + NORMAL DHEAS

ADRENAL: Elevated testosterone + ELEVATED DHEAS

23
Q

PROLONGED PTT + FALSE POSITIVE VDRL + THROMBOCYTOPENIA + recurrent miscarriages = ?

Tx = ?

A

ANTI-PHOSPHOLIPID SYNDROME

Tx = Low dose ASA + LMWH

24
Q

HYPERCALCEMIA + NORMOCYTIC ANEMIA + renal insufficiency (bence jones proteins) + PROTEIN GAP (total protein - albumin >4) = ?
Screening test?
How is diagnosis confirmed?

A

MULTIPLE MYELOMA
M-spike SPEP

Confirmation: Bone marrow biopsy (>10% clonal cells)

25
Q

What is the PRIMARY INTERVENTION to slow decline of DIABETIC NEPHROPATHY?

A

INTENSIVE BP CONTROL to target BP of 140/90

**Use ACE inhibitors/ARBs

26
Q

What are the radiologic hallmark abnormalities of ASBESTOSIS - progressive dyspnea + clubbing + end-inspiratory crackles
What is the associated occupational exposure?

A

INTERSTITIAL FIBROSIS + PLEURAL PLAQUES**

Asbestos exposure - plumbers, shipyard workers, construction workers

27
Q

What is the cutoff value for normal JVP?

A

5

28
Q

What is the management for a pt with amitryptiline-induced urinary retention (SUPRAPUBIC FULLNESS + ABDOMINAL PAIN)?

A

URINARY CATHETERIZATION + D/c amitriptyline

29
Q

What is an UPRIGHT ABDOMINAL X-RAY generally used for?

A

ILEUS
SMALL BOWEL OBSTRUCTION
TOXIC MEGACOLON

30
Q

SIGNS of acute abdomen (e.g. BOWEL PERFORATION or MECHANICAL OBSTRUCTION)

A

GUARDING
Absent bowel sounds (PERFORATION)
GI Sx: Mod-severe abdominal pain, N/V
DILATED BOWEL LOOPS WITH AIR FLUID - imaging

31
Q

BRIGHT RED FRIABLE EXOPHYTIC NODULES in HIV infected pt = ?

A

BACILLARY ANGIOMATOSIS

32
Q

NORMAL CSF GLC + ELEVATED CSF PROTEIN + ELEVATED CSF WBC (LYMPHOCYTES) Ct

+ FEVER/ AMS/ AGITATION/SEIZURES

What is the most common etiological microbe? Empiric Tx while waiting for PCR?

A

ASCEPTIC (VIRAL) ENCEPHALITIS

HSV
IV ACYCLOVIR - empiric tx after LP results

Confirm diagnosis - CSF viral DNA PCR

33
Q

What is the main distinguish factor between CRYPTOCOCCAL MENINGOENCEPHALITIS and HSV ENCPHALITIS?

A

CRYPTOCOCCAL MENINGOENCPHALITIS = MARKEDLY ELEVATED opening pressure

HSV encephalitis = nl opening pressure

34
Q

CSF LOW Glc + CSF ELEVATED PROTEIN (>250mg) + CSF ELEVATED WBC Ct (neutrophil predominance) = ?

What is the empiric Tx?

A

BACTERIAL SEPTIC MENINGITIS

Empiric Tx = IV Ceftriaxone + Vancomycin
Ampicillin if age>50yo

35
Q

What is used to treat ALCOHOL WITHDRAWAL in hospitalized pts?

A

CHLORDIAZEPOXIDE (LLIBRIUM)

36
Q

HIGH-VELOCITY EYE INJURY (drilling, hammering, grinding) - Greater probability of globe penetration + FOREIGN BODY** formation than low-velocity eye injury

What is the next step of management?

A

FLUORESCEIN application -> Wood’s lamp/slit lamp exam

37
Q

How does an UPPER AIRWAY OBSTRUCTION (larygnospasm during extubation) cause NEGATIVE PRESSURE PULM EDEMA?

A

UPPER AIRWAY OBSTRUCTION - Inspiration against obstruction -> large negative intrathoracic pressure -> Non-cardiogenic pulm edema

38
Q

2 Days after intubation, pt presents with high-grade fever. What does pt have?

A

VENTILATOR-associated PNEUMONIA

39
Q

EXQUISITE TENDERNESS to gentle percussion over involved vertebra in IVDU/SICKLE CELL/ IMMUNOSUPPRESSED pt/ RECENT DISTANT SITE INFN (e.g. UTI) has highest suspicion for __?

A

OSTEOMYELITIS

40
Q

What is the confirmatory diagnostic test for OSTEOMYELITIS?

A

MRI

41
Q

What are the drugs that cause ACUTE INTERSTITIAL NEPRHITIS (fever, rash, arthralgia, eosinophilia in urine and blood, hematuria)? Tx?

A 
6P's: 
P - pee diuretics (thiazide)
P - PPI
P - pain analgesics (NSAIDS)
P - rifampin, phenytoin
P - Penicillins, cephalosporins, sulfa
P - alloPurinol
42
Q

How does ACUTE INTERSTITIAL NEPHRITIS present? What does UA show?

A

FEVER + MACULOPAPULAR RASH + RENAL FAILURE

UA: WBC Casts + EOSINOPHILS

STEP2: Tidbits (9 decks)

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