USMLE Rx Medicine1 Flashcards
Sx: Addisonian Crisis
Hypoaldosteronism/Adrenal Insufficiency
- Hyperkalemia
- Hypovolemic shock (tachy, HoTN, fever, n/v)
Sausage linked retina, ↑ viscosity of blood
Plasma cell dyscrasia
Sx: Plasma cell dyscrasia
Neuro, HA
Visual
Vertigo
Retinal “sausage link” veins
Sx: Classic Migraine
Unilateral
Scotoma/aura
Rx exacerbating gout
Diuretics (HCTZ, Loops)
4 Kanavel Signs
Flexor Tendon Synovitis
- Finger slight flexed
- Pain with passive extension
- Fusiform swelling
- Tenderness over flexor tendon sheath
Sx: Paronychia
Swelling, inflammation at base of nail bed
Felon
Infxn of the deep pulp (basically a deeper paronychia)
Sx: RA
Arthritis Nodules Splenomegaly Interstitial Fibrosis Vasculitis
Sympathoadrenal activity is seen in
Obstructive Sleep Apnea
HTN Urgency vs. Emergency
Emergency shows end organ damage
Emergency requires IV Nitroprusside
Urgency can start with oral anti HTNs
over Sys-180 or Dias-120
Sickle Cell infxns
S. Pneumo
H. Influ
Flu
Diabetes Inspidus is associated with
Langerhans Histiocytosis
central DI
Tx: Diabetes Insipidus
Central- DDAVP
Nephrogenic- Lithium
Tx: SIADH
Demeclocycline (causes diabetes inspidus)
Silicosis Professions
Construction, drilling, mining, blasting
Sx: Cor Pulmonale
Loud S2 (PA HTN) RVH
Labs: 1° Hyperaldosteronism
↑Na
↓K
↓ACTH
Concave, crescent shaped hyperdensity
Subdural Hematoma
Lens-shaped, convex hyperdensity limited by sutures
Epidural Hematoma
Subdural vs. Epidural Hematoma
Both have lucid intervals
Subdural- usually Pts >60 yoa
Rupture of Middle meningeal artery leads to
Epidural Hematoma
Fixed, dilated, blown pupil
Epidural Hematoma
Irregularly shaped parenchymal hyperdensity
Parenchymal Hemorrhage (no lucid interval)
Labs: von Willebrand
PT- Normal
aPTT- prolonged
BT- prolonged
CT-guided Pericardiocentesis vs Emergent Pericardiocentesis
CT-guided only in hemodynamically stable patients
Path: Myasthenia Gravis
Antibodies against the Postsynaptic Ach receptors
Sx: Myasthenia Gravis
Ptosis, Visual changes, Thymoma, Daily Progressive Fatigue
Tx: Myasthenia Gravis
Thymectomy
Neostigmine/Pyridostigmine (Achesterase Inhibitos)
Path: Lambert Eaton
Autoantibodies attack presynaptic voltage gated Ca Channels at NMJ
Small cell lung CA is associated with
Lambert Eaton
ADH Ectopic release (Bronchogenic SCC)
Path: RA
IgM Antibodies against the IgG
Path: Parkinson’s
Degeneration of the Dopaminergic Neurons within the Substantia Nigra
Tx: Hepatic Encephalopathy
Low protein diet or Lactulose
Serotonin Syndrome
Sinners SELl Drugs That Make ME TRYP
DAMN Fucking Serotonin
Diarrhea, Agitation, Muscle spasms, Nausea, Flushing, Sweating
Also BP changes and Tachycardia
H. Ducreyi vs Syphilis
Syphilis is painless chancres
H. Ducreyi is painFUL chancroids
Etiology: Penile Discharge
Urethritis (N. Gonococcal C. Trachomatis; also Myco Genitalium, U. Urealyticum, T. Vaginalis, rarely HSV)
C. Albicans (white discharge)
FUO in elderly
CT- to find any malignancy (MCC)
Sx: Infective Endocarditis
Duke scale
- multi positive blood Cx
- echo showing involvement or new regurg murmur
Janeway lesions, Osler Nodes, Roth spots, petechiae, splinter hemorrhages
Janeway Lesions vs. Osler Nodes vs. Roth Spots
Both are in IE
Jane- painless, septic emboli
Osler- “ow!” painful, immune complex depositions
Roth- vasculitis in the eyes
HIV infxn of eye
CMV
sfx: Thiazides
Hypokalemia
Hypercalcemia, Hyperlipidemia
Hyperuricemia
Tx: Cocaine overdose
Benzos, help the HTN as well!
Sx: AML
Gingival Hypertrophy
Ecchymoses, petechiae
Fundal hemorrhages
Joint/Bone pain
Sx: ITP
Often women under 50
Bleeding
Bruising. Petehiae
Splenomegaly
Pain with traction of pinna
Otitis Externa
Economic interest in patient care
You are allowed to have care that you profit from (ie an invention), but you must disclose the your economic interest and make sure it has an interest to the patient
Tx: Head injury, almost in comatose state
Insert ET Tube before doing imaging
Part of Prostate for BPH and carcinoma
Peripheral Zone- carcinoma (DRE)
Transitional Zone- BPH
Sx: Goodpasture’s
Renal failure, Pulm Hemorrhage (Hemoptysis)
HTN, Metabolic Alkalosis, Hypokalemia
1° Hyperaldosteronism
Dx: Precocious Puberty
Bone age demonstrates an age of 2 yrs or greater than the chronologic age
↑ ACE, african american
Sarcoidosis
Hypercalcemia, hypercalciuria, respiratory Sx
Sarcoidosis
Noncaseating Granulomas
Sarcoidosis
FEV1/FEV
COPD= <60%
COPD is only partially reversible with albuterol
Sx: Carcinoid tumor
RHF, Tricuspid regurg, Pulm valve involvement
Flushing, nonbloody diarrhea, HoTN
UTI, coagulase negative, gram positive
Acute cystitis due to S. saprophyticus
Painless gross hematuria
possibly Bladder CA!
Polyuria, nocturia, polydipsia
Diabetes Insipidus or Psychogenic Polydipsia
Interstitial Cystitis vs UTI
no bacteria is found in interstitial cystitis
Sx: Renal Cell Carcinoma
Flank pain
Palpable abdominal mass
Hematuria
Sx: Conn’s Syndrome
same as Primary Hyperaldosteronism
HTN, hypokalemia, metabolic alkalosis
Tx: Conn’s Syndrome
Spironolactone
Tx: H. Pylori
Omeprazole, Amoxicillin, Clarithromycin for 2 weeks
Postprandial pain, early sateity, n/v
Gastric Outlet Obstruction
Nonbloody emesis of partially digested food, postprandial pain
Gastric Outlet Obstruction