U World 6 pick up sticks Flashcards
Anticholinergic toxicity
hyperthermia mydriasis delirium urinary retention dry mouth ↓ bowel sounds
TCA toxicity
Looks like anticholinergic
(dry, hot, red, mad)
+
CNS depression, arrhythmias, and hypotension
Joint pain in a smoker
hypertrophic osteoarthropathy which is associated with lung cancer
digital clubbing, sudden arthropathy, often hands/fingers
Multiple myeloma features
- osteolytic bone lesions
- frequent infection from hypogammaglobulinemia
- Hyper Ca
- Renal insufficiency
What is “normal” hearing (bone vs air)
air> bone
Pattern of hearing loss in sensorineual
air> bone
webber localizes to unaffected
What is the pattern of hearing loss for conductive
bone> air
webber localizes to affected ear
Antibiotics in EHEC
antibiotics ↑ hemolytic uremic syndrome and should be avoided
Diarrhea in C. Perfringens
toxin mediated
food borne
non bloody
What likely contributes to statin induced myopathy
statins ↓ coQ10 –> myopathy
How do statins work
inhibit HMG-CoA reductase
Masses in the mediastinum by location
anterior: thymoma, retrosternal thyroid, lymphoma
middle: bronchogenic cyst
posterior: neurogenic/ esophageal tumors
Serology for lyme disease
very insensitive
if you suspect lyme disease, treat with doxy no need to confirm
When do you not vaccinate in HIV
no live vaccines CD4 under 200
live= MMR, zoster, varicella
When would you use high intensity statin
LDL > 190
ASCVD risk > 7.5
clinical symptoms in under age 75
What are the high intensity statins
40 mg + atrovostaitin and 20 mg + rosuvostatin
Polymyalgia rheumatica
pts > 50
↑ ESR
stiffness of: neck, shoulders, pelvis
Hypersensitivity pneumonitis
inflammation of lung parenchyma from antigen exposure
chronic exposure–> honeycombing of lung
rx: antigen avoidance
What classically alleviates pain from diffuse esophageal spasm
nitrates
Most common cause of megaloblastic anemia in alcoholics
folate
Contraction alkalsis
volume down –> ↑ aldosterone
aldosterone dumps K and acid into the urine
result= met alk and hypo k
Case control study
a case and a control are selected
then determine previous exposures
Acute digoxin toxicity
acute GI symptoms
Amiodarone–> ↑ digoxin
chronic s/s: neurological / visual
How do you treat back pain from prostate mets to the spine
Radiation
bisphosphonates help, but less so
Invasive aspergillosis
fever, chest pain, hemoptysis
CD4 under 50
cxr: focal lesions
Rx for renal transplant rejection
High dose IV steroid
Pellagra
dermatitis
diarrhea
dementia
long term isoniazid can cause this
Acute intermittent porphyria
ab pain
NVD
paresthesias/ confusion
Actinomyces
oral flora bacteria
anaerobic
drains sulfur granules
rx: penicillin
Nocardia
wild west sketchy
bacteria
rx: tpm-smx
Azithromycin drug class
macrolide
good for URIs
CHF blood gas
CHF –> tachypnea –> resp alkalosis
Where do most PEs come from?
The thigh
calf clots are less likely to move
Acute aortic dissection rx?
IV beta blocker
↓ HR, contractility, and BP
Herpes esophagitis
small well defined round ulcers
intranuclear inclusions on biopsy
rx: acyclovir
CMV Esophagitis
large linear ulcers
intranuclear and intracytoplasmic inclusions
rx: ganciclovir
What is an ideal FiO2
under 60%
should try to decrease FiO2 as soon as possible
Can ↑ PEEP if needed
