The other 105 topics Flashcards
1
Q
What is the skin sloughing sign associated with blisters?
A
Nikolsky’s sign.
2
Q
What two conditions are associated with Nikolsky’s sign?
A
Toxic Epidermal Necrolysis
Steven’s Johnson’s Syndrome
3
Q
What are five management steps for SJS/TEN?
A
Stop offending agent Pain control Wound care Monitor for infection Fluid balance Electrolyte balance
4
Q
What are three risk factors for pityriasis versicolor?
A
Activity in hot climates
Corticosteroids
Changes in activity
5
Q
List three ways to confirm the diagnosis of pityriasis versicolour.
A
Clinically
Wood’s lamp
Presence of hyphae on KOH prep
Scraping
6
Q
What are three treatments for pityriasis versicolour?
A
Ketoconazole shampoo
Topical terbinafine
Systemic fluconazole (severe)
7
Q
What three things would you tell somebody about the natural course of pityriasis versicolour?
A
Fungus goes away after two weeks
Not contagious
Pigment comes back slowly
Triggered by warm/humid environments.
8
Q
List 5 risk factors for CHF.
A
Smoking Previous myocardial infarction Hypertension Alcohol consumption Hyperlipidemia
9
Q
What are 5 signs and symptoms of CHF?
A
PND Orthopnea Edema Ascites Cough Dyspnea Hypotension S3
10
Q
What are 5 tests you would order to categorize/evaluate CHF?
A
Chest X-ray ECG BNP Sodium eGFR Potassium Echo
11
Q
What are 5 investigations you would order if you suspect a flare-up of diverticulitis?
A
Abdominal CT with oral contrast Lactate Blood glucose White cell count Hgb
12
Q
What one test must you order prior to getting a contrast CT?
A
Creatinine
13
Q
What three diagnoses would you suspect with shortness of breath on a background of wet cough?
A
Pleural effusion
Pneumonia
Heart failure exacerbation
PE
14
Q
What one cardiac abnormality would you suspect with a high pitched pan-systolic murmur in heart failure?
A
Aortic stenosis
15
Q
What is your first pharmacologic management step for pleural effusion?
A
Lasix
16
Q
What are 5 risk factors for DVT?
A
Smoking Immobility Trauma Surgery Family history of clotting disorder Malignancy
17
Q
What are three tools for assessing risk of PE?
Which is validated during pregnancy?
A
PERC
Wells
YEARS - pregnancy validated
18
Q
What organism should you suspect in a child with sore throat, fever and rash?
A
Group A beta-hemolytic strep
19
Q
What are two complications associated with group A strep
A
Post-streptococcal glomerular nephritis
Rheumatic disease
20
Q
How do you treat Group A strep?
A
Penicillin
21
Q
What diagnose would you suspect in an individual with ++ NSAID use , fatigue and decreased urine output?
A
Pre-renal AKI
22
Q
What are 5 physical exam findings associated with pre-renal AKI?
A
Decreased skin turgor, Dry mucous membranes Tachycardia Orthostasis Edema Elevated JVP S3
Note: kidney failure will have symptoms of both volume deletion and fluid overload
23
Q
What would cause somebody to scratch in kidney failure?
A
Uremia
24
Q
What are five lab findings in a pre-renal AKI?
A
Elevated urea Elevated creatinine Elevated urea/cr ratio Increased urine osmolality Decreased urine sodium
25
What are two risk factors for pulmonary hypertension?
Scleroderma
| Smoking
26
What three investigations should you order for suspected pulmonary hypertension
Cardiac MRI
Echocardiogram
Right heart catheterization
27
What are three supportive management steps for pulmonary hypertension?
Patient education
Cardiology referral
Oxygen
Physical rehabilitation
28
What are three pathways by which the drugs for pulmonary hypertension work?
```
Nitric oxide pathway (PDE5i)
Endothelin pathway (endothelia receptor antagonist)
Prostacyclin pathway (soluble guanalate cyclase inhibitors)
```
29
What is the lab test to confirm celiac?
Anti-tissue transglutaminase
30
What are five non-pharm treatment options for chronic mechanical back pain?
```
Stretching
Heat
Ice
Massage
Yoga
```
31
What three things should you document prior to starting opiates?
```
Pain history
Medical history
Substance use history
Previous analgesia use
Opioid treatment agreement
```
32
What is the one best tool for assessing risk with opiates?
Opioid Risk Tool
Think OAT/ORT
33
What three things must you discuss with patients prior to starting opiates?
Benefits
Harms
Risks
34
What are two other diagnoses you should consider if you are thinking aortic dissection?
Intramural hematoma
Penetrating atherosclerotic ulcer
Think Acute aortic syndrome
35
What imaging do you order for acute aortic syndrome
ECG gated CT aorta with contrast
36
By what two metrics do you determine that chronic non-cancer opiates are working?
Improved function
| Reduction in pain by 30%
37
List 5 side effects of opiates.
```
Nausea
Somnolence
Pruritus
Vomiting
Vertigo
```
38
What are two medical complications associated with opioid therapy
Sleep apnea
| Opioid-induced hyperalgesia
39
What are three risk factors specific to upper arm DVT?
IV catheters
Pacemaker/ICD
Overhead arm activity
40
What is the syndrome associated called for upper arm DVT?
Paget-Schroetter
41
What test should you order if you suspect upper extremity DVT
Arm venous duplex doppler U/S
42
What is the difference between primary and secondary erythrocytosis?
Primary is when RBCs are produced from an RBC secreting tumour like polycythemia vera
Secondary is when RBCs are elevated due to something else that stimulates RBC production such as EPO secreting tumours
43
What are 5 tests you would order to distinguish between primary and secondary causes of erythrocytosis?
```
Hgb
Peripheral blood smear
Creatinine
K
Na
GGT
ALT
AST
Ferritin
```
44
What is the name of the gene mutation associated with the primary form of erythrocytosis (Polycythemia vera)
JAK2
45
What are 2 conditions that would predispose somebody to erythrocytosis?
COPD
| OSA
46
What are three treatments for erythrocytosis?
Phlebotomy
ASA
Treat underlying cause
47
What are two definitions of chronic kidney failure?
eGFR < 60
ACR > 3
Either must be present3 months
48
What is the target BP for CKD?
120/90
49
How often should somebody with CKD have physical exam and labwork?
q6months
50
What labwork should be done at CKD checkups?
```
U/A
K
Na
eGFR
Creatinine
ACR
```
51
What are 5 lifestyle modifications for CKD?
```
Exercise
Weight loss
Decrease salt intake
Protein restriction
Smoking cessation
Decrease alcohol intake
```
52
What are 5 signs/symptoms that suggest testicular torsion?
| What is the screening tool?
TWIST
```
Absent cremasteric reflex
Hard testicle
Swollen testicle
High riding testicle
Nausea/Emesis
```
53
What are 5 things to consider on diffential with testicular pain?
```
Torsion
Orchitis
Tumour
Epidimytis
Nephrolithiasis
```
TOTEN = german for kill
54
What is a three treatments for fibromyalgia?
TCA's
SNRI
Gabapentin/Pregabalin
55
What tool could you utilize to mitigate aberrant drug behaviours when starting opioids?
Opioid contract
56
What are three ways you can titrate the dosage of opioids for patients who are at increase risk of opioid misuse?
Frequent dispensing
Frequent follow-up
Lower dose/increase frequency
57
List one long-term complication of endocarditis.
Congestive Heart Failure
58
What organism is most responsible for endocarditis in IVDU?
S. aureus.
59
What are four signs of physical exam associated with heart failure.
Elevated JVP
Ascites
Pitting edema
Hepatomegaly
60
What is the numerical echocardiogram cutoff for heartfailure with reduced EF?
<40%
61
List 5 conditions associated with high output heart failure.
```
Hyperthyroidism
Obesity
Liver disease
Lung disease
Pregnancy
```
Think that blood flow forward is HOLLuP
62
What is one necessary treatment step in all of beriberi, Wernicke's encephalopathy and Korsikoff syndrome?
Thiamine for two weeks
63
What are two risk factors and one genetic predisposition for ankylosing spondylitis?
Adolescent
Male
HLA-B27
64
What diagnosis would you suspect in an adolescent male with A.M. back pain relieved with exercise?
Ankylosing spondylitis
65
What are three medications to treat ankylosing spondylitis?
NSAIDs
TNF blockers
Methotrexate
66
Pretibial myxedema (edema with overlying hyperkeratosis) is associated with what disease?
Grave's disease
67
What is the pathophysiology of Grave's disease?
TSH receptor antibodies cause ++ over production of TSH.
68
What are two treatments for pretibial myxoedema?
Topical steroids
| Compression stockings
69
What is one scoring tool to be able to determine somebody's chance of organ failure outside of ICU?
qSOFA
70
What are the three elements of qSOFA?
Altered mental status (GCS <15)
Resp rate > 22
SBP < 100
71
What are 5 investigations you should order for the sick patient?
```
Hgb
WBC
Glucose
Blood cultures
Chest x-ray
ECG
U/A
```
72
What is the one most likely bug in community acquired pneumonia?
S. pneumonia
73
What are 5 symptoms associated with anaphylaxis?
```
Angioedema
Wheeze
Drooling
Emesis
Drowsiness
Hypotension
```
74
What is the dose of epinephrine for ananphylaxis?
0.01 mg/kg
75
What are 5 other adjuncts to epinephrine?
```
Antihistamines
Steroids
Dopamine
IV fluids
Oxygen
```
76
What most you look out for after an anaphylactic reaction?
| How do you manage this?
Bi-phasic reaction
Monitor for up to 8 hours.
77
What are the cutoffs for the stages of kidney disease?
```
> 90 with kidney damage = stage 1
60-89 = stage 2
30-59 = stage 3
15-29 = stage 4
< 15 = stage 5
```
78
What is the target hgb level for somebody with CKD?
110
79
What are 6 complications of CKD?
```
Anemia
Osteoporosis
HTN
Hyperkalemia
Depression
Restless legs
```
80
How do you treat anemia associated from CKD?
EPO
| Iron supplementation
81
What might you suspect in a patient with kidney disease and restless legs?
Uremia
82
What are three indications for referral to nephrologist?
GFR < 30
Rapidly decreasing GFR
ACR > 60
83
List 5 organs to look at when suspecting sarcoidosis.
```
Lung
Liver
Spleen
Eyes
Skin
Lymph nodes
Joints
Heart
Kidneys
```
84
What is your second line treatment for otitis media in a child?
Ceftriaxone IM
85
What three investigations do you order if you suspect sarcoidosis?
```
Chest X-ray
PFTs
ECG
Creatinine
Calcium
AST/ALT/GGT
Hgb
```
86
What key finding would you expect in stage 1 of sarcoidosis?
Bilateral hilar lymphadenopathy
87
What pulmonary condition are patients with sarcoidosis at risk of developing?
Pulmonary fibrosis
88
What form of dysfunction does HOCM cause?
Diastolic
89
What maneuvers will increase a HOCM murmur?
| Decrease?
Increase: Valsalva/standing
Decrease: Hand grip, leg raise, squatting
90
What are 3 complications with HOCM?
```
Ventricular arrythmias
CHF
Infective endocarditis
Atrial fibrillation
Embolic phenomenon
```
91
What are 5 diagnoses to consider in LLQ with rebound tenderness and fever
```
Diverticulitis
Bowel obstruction
Colorectal cancer
Gastroenteritis
IBD
```
92
What are 4 associated features with diverticulitis?
Anorexia
Nausea
Vomiting
Constipation
93
What would categorize diverticulitis as complicated?
```
Abscess
Phlegmon
Fistula
Obstruction
Perforation
```
94
What are three symptoms associated with endometriosis?
Pain with defecation
Pain with urination
Pain with intercourse
95
What are 5 classes of medications for endometriosis?
```
NSAIDs
Combined OCPs
Progestins
IUS
Aromatase inhibitors
```
96
What are 3 tests to confirm endometriosis?
Physical exam
MRI pelvis
Laparosocpy
