UW 11 Flashcards
Metabolic acidosis in sepsis
High metabolic demand causes a shift to anaerobic metabolism, increasing lactid acid
CHF with hx of viral infection
Myocarditis
Can also present with chest pain or arrythmias
Some people recover cardiac function. Others develope dilated cardiomayopathy Dilated myocarditis Alcoholism Beri beri Chagas Coxackie Cocaine Doxirubicin hEmochromatosis
Patient with irregular rithym tachy and weight loss
Afib due to hyperthyroidsm
Acute iron poisoning
Abdominal pain, hematemesis, diarrhea, melena
Shock,
liver necrosis (1-2 days after ingestion)
Stools may be green/black due to iron
pill visualization on xray
Elevated iron levels
Management
Deferoxamine
Whole bowel irrigation
Indication of prophylaxis in Infective endorcarditis and management
Indications:
Prosthetic valve
Hx of previous IE
Valve defect in transplanted heart
Uncorrected cyanotic congenital heart disease
Corrected cyanotic congenital heart disease with residual dysfuntion
Prophylaxis:
Dental: S. viridians. Amoxicillin
GU/GI: enterococcus: ampicilin (if active infection)
Infected skin or muscle: S. aureus. Vanco
Placement of prosthetic cardiac material: S. aureus. Vanco
Rituximab (MOA and use) (NOT SURE WHAT IS THE CORRECT ANSWER)
CD20 inhibitor (expressed on lymphocytes)
First line treatment in CLL??
Usually fludarabine and chlorambucil
CLL sings and symptoms
Lymphadenopathy + hepatosplenomegaly
Constitutional symptoms
Cytopenias (anemia and trhombocytopenia)
Leukocytosis with lymphocytosis
Treatment for CML
Imatinib
BCR-ABL tyrosine kinase inhibitor (the product of t(9,22) translocation. Philadelphia chromosome
Smudge cells
Clasic finding of CLL
Fragile malignant lymphocytes are disrupted during blood smear preparation)
Etiology of infections in sickle cell Pneumonia Osteomyelitys/septic arthritis Meningitis Bacteriemia/Sepsis
Pneumonia: S. pnumonia
Osteomyelitys/septic arthritis: S. aureus, Salmonella
Meningitis: S. pneumonia
Bacteriemia/Sepsis: S. pneumonia. H. influenzae
Empiric antibiotics:
3rd gen cephalosporin +/- vanco if osteomyelitis or meningitis
Digoxin toxicity
Anorexia, nausea, vomiting, diarrhea
Confusion, lethargy, blurry vision
Atrial tachy + avblock
Prolactinemia due to pituitary adenoma treatment
Bromocriptine
Mid shaft humerus fracture
Structure compromised?
Radial nerve
Wrist drop and decreased sensation of dorsum of the hand
Atrial septal defect ausculatotry findings
Wide fixed split of S2: Due to delay clossure of pulmonic valve
Mid sistolic ejection murmur: Due to increased flow through the pulmonic valve. (The low flow through the defect does not produce a murmur)
Mid diastolic rumble: due to increased flow through the tricuspid valve
Pathologic finding in lewi body dementia
Eosinophilic incluision in the susbsantia nigra
Renal disease in Multiple Myeloma
Direct tubular damage do to light chain deposition that clog renal tubules
Hematuria and no proteinuria (light chain is not detected on urianalysis)
Glomerular demage: Amyloidosis and Monoclonal Inmunoglobolin deposition disease.
Nephrotic sd.
Psoriasis:
Extensor or Flexor?
Extensor
Atopic dermatitis
Extensor o flexor?
Flexor (in adults)
Extensor in infants
Labs in Hemolysis
LDH
WBC
Elevated
May also present with elevated WBC
Delirium managment
If patient is agressive and hallucinating, administer haloperidol
Benzos are contraidicated because they can worsen delirum. Indicated only in delirum due to alcochol/benxo withdrawal
Acutely psychotic patient managment
Haloperidol
Benzo
or Combination of both
