Things I need to know better...day 4 Flashcards
What has to be done with a hydrocele?
Nothing…reassurance
How does thyroid toxicosis cause hypertension?
Increased cardiac contractility…increased sensitivity to catecholamines
A kid feels like he smelled something funny, then lost consciousness…he woke up and was really sore. What happened?
This is a partial seizure with secondary generalization
Aura –> partial
Tonic-clonic activity –> generalization
What should you do if you have clinically diagnosed myasthenia gravis?
Chest CT –> thymus issues
Patient has had some headaches and confusion…labs show anemia, thrombocytopenia, and renal failure…smear shows many fragmented red cells. What is going on? what should be done?
Consider TTP-HUS
Plasmapheresis
Patient has s/s of Raynaud’s plus has tissue damage (ulcers) …what is going on? What should be done?
Secondary Raynaud’s…primary does NOT cause tissue damage
Evaluate and treat underlying cause
A patient is started on warfarin, and within days has necrotic skin lesions on breast, trunk, extremities and/or penis. What is causing this? How is ti treated?
Warfarin-Induced Necrosis…often secondary to protein C deficiency
Stop warfarin and give protein C
A person from Mississippi has a likely fungal infection, what should be considered? Where is this fungus common?
Histoplasmosis…rarely symptomatic
Mississippi and Ohio River valleys and Central America
A kid has headache and vomiting + on exam he has limited upward gaze, ptosis, and upper eyelid retraction. What could be going on? What else could be seen? What should be done?
Pinealoma
Precocious puberty
Get an MRI
What murmurs get louder with the valsalva maneuver? What is going on physiologically? What other maneuver does the same thing?
HOCM and MVP
Decreased venous return while straining
Standing
Cardio physiologically, what happens with squatting?
Increased venous return
Increased afterload
Increased regurgitant fraction
What murmurs get louder with squatting?
AR
MR
VSD
What murmurs get quieter with squatting?
HOCM
MVP
Cardio physiologically, what happens with hand gripping?
Increased afterload
Increased blood pressure
Increased regurgitant fraction
What murmurs get louder with hand gripping?
AR
MR
VSD
What murmurs get quieter with hand gripping?
HOCM
AS
What are some prophylactic meds that can be used for cluster headaches?
Verapamil
Lithium
Ergotamine
What kind of factors cause asymmetric growth restrictions?
Maternal factors: vascular disease, autoimmune, substance abuse (tobacco, alcohol, cocaine)
What kind of factors cause symmetric growth restrictions?
Fetal factors: chromosome abnormalities, congenital heart disease, intrauterine infection
Are immunizations given according to chronological age or gestational age for premies?
Chronological age
A 2-5yo child has s/s of a lymphoma/leukemia. What is most likely? How is it diagnosed?
Acute lymphoblastic leukemia (ALL)
Bone marrow biopsy
How is Duchenne’s muscular dystrophy diagnosed?
Genetic testing (X-linked recessive)
Patient has a DVT and is found to have elevated homocysteine. Besides heparin and warfarin, what else should be given to this patient?
Pyridoxine (B6)
What can cause an older patient to look at a grid of straight horizontal and vertical lines, and see the vertical lines as being bent and wavy?
Macular degeneration
A patient has a burn wound that has mostly healed, but one spot that just won’t. What is a concern? What other conditions are worrisome for this?
Squamous cell carcinoma
Osteomyelitis, radiation scars, venous ulcers
What is the big difference between anorexia nervosa and bulimia nervosa?
Anorexia BMI is LESS THAN 18.5
Bulimia BMI is GREATER THAN 18.5
Besides loss of vision, what is another possible complication of Giant Cell Arteritis?
Arteritis of aortic branches
Aortic aneurysm
Which medications can trigger acute angle-closure glaucoma?
Decongestants
Antiemetics
Anticholinergics
What medication can help with delayed gastric emptying?
Metoclopramide
