UW 12 Flashcards
AE’s of Lithium
GI distress Nephrotoxic Hypothyroidism Leukocytosis Tremors Acne Psoriasis flares Hair loss Edema
MCC death Dialysis
Cardiovascular
Nerve that does knee extension and hip flexion
Femoral Nerve
Provides sensation to anterior thigh and medial leg
Femoral Nerve
Adduction of leg and sensation of medial thigh
Obturator Nerve
Tx of infertility for premature ovarian failure
IVF w donor oocyte only option
No viable oocytes
Cardiac amyloidosis
Unexplained CHF
Echo = increased LV thickness, normal LV cavity
Low voltage EKG
Amyloidosis Pathophys
Extracellular deposit of insoluable polymeric protein fibrils in tissues and organs
Amyloidosis secondary due to?
Inflammatory arthritis Chronic Infxn IBD Malignancy Vasculitis
Amyloidosis Presentation
Asymptom proteinuria Nephrotic syndrome Hepatomegaly Peripheral Neuropathy Visible organ enlargement Bleeding diathesis Waxy thickening, skin bruising
Dx for Amyloidosis
Tissue Bx
What is a torus palatinus
Growth on hard palate Fleshy, immobile mass Benign Midline suture Genetic and environmental Ulcerates w trauma Heals slowly
Tx for torus palatinus
Surgery
What does aromatase do
Converts androgens into estrogens
Presentation of aromatase deficiency
Masculinization of mother resolves w delivery Virilization Normal internal genitalia Ambigious external genitalia Clitoromegaly
Presentation of aromatase deficiency later in life
Delayed puberty
osteopororosis
Undetectable estrogen
Polycystic ovaries
Labs with aromatase deficiency
High FSH/LH
Low estrogen
McCune Albright triad
Cafe au lait spots
Polyostotic fibrous dysplasia
Autonomous endocrine hyperfnc
- Precocious puberty
Kallman syndrome Presentation and Labs
46 XX Hypogonadotropic hypogonadism Anosmia Delayed puberty Normal internal reproductive organs Low or absent LH and FSH
Tx for premature ovarian failure infertility
IVF with donor oocytes
Premature ovarian failure
< 40 yoa Amenorrhea Hypoestrogenism Increased FSH and LH Low Estrogen
Management for threatened abortion
Reassurance and outpatient f/u after assess fetus w US
Tx for asymptomatic PVCs
Observation
Tx for symptomatic PVCs
Beta blockers
Amiodarone
Langerhans cell histiocytosis Presentation
Solitary, lytic long bone lesion
Painful, tender swelling
Hypercalcemia
Tx for HCV
Peg IFN
Ribavarin
Anticholinergic excess si/sx’s
Red as a beet - flushing
Dry as a bone - anhidrosis/dry mouth
Hot as a hare - hyperthermia
Blind as a bat - vision changes/mydriasis
Mad as a hatter - delirium/confusion
Full as a flask - urinary retention/constipation
Parkinson drug with anticholinergic excess sx’s
Trihexyphenidyl
Benztropine
Presentation of amebic liver abscess
Hx of travel Dystentery RUQ pain Single cyst - right lob of liver Bloody diarrhea Pleuritic like pain - if on surface
Dx for E.Histolytica infxn
Stool for trophozoities
Serology
Liver imaging
Hydatid cyst
Echinococcus granulosos
Dog contact
Hepatic adenoma
Solid lesion
What is another name for pseudotumor cerebri
Idiopathic intracranial HTN
IIH
Meds that cause IIH
Vit A and derivatives
GH
Tetracyclines
MEN Type I
Primary PTH
Enteropancreatic tumors
Pituitary tumors
MEN 2A
Medullary thyroid cancer
Phaeo
Parathyroid hyperplasia
MEN 2B
1.MTC
2. Pheo
3.Mucosal/intestinal neuromas
Marfanoid
Extra renal complications of ADPKD
- Hepatic cysts
- Valvular heart dz - MVP, AR
- Colonic diverticula
- Abd wall and inguinal hernia
Isolated Systolic HTN (ISH) Pathophysiology
Decreased elasticity of arterial wall -> increased SBP (no change in DBP)
Rigid arteries with aging = reduces compliance, and ability to dampen SBP
Tx for ISH
Low dose thiazide
ACE
CCB - long acting
What is PANDAS
Pediatric AI Neuropsychiatric disorder
How does PANDAS present
Recent GAS infxn
Acute onset OCD
Tic disorder
What heart change seen in cor pulmonale
TR
Loud P2
RV S3
Dx with cath for cor pulmonale
Elevated PA SBP
> 25 mmHg
What does PCWP estimate
LV EDV
What is presentation of Necrolytic Migratory Erythema (NME)
Erythematous papules/plaques
Coalesce
Form large, painful, inflammatory blisters
+/- crusting and central clearing
Presentation of glucagonoma
DM NME Wt loss Diarrhea Anemia
Glucagonoma v Gastrinoma
Both: diarrhea, wt loss, anemia, abd pain
Only glucagonoma ass’d with DM and NME
How to confirm dx of glucagonoma?
Glucagon > 500 pg/mL
NPV relationship with pretest probability
Pt with high probability of having dz = LOW NPV
Pt with low probability of having dz = HIGH NPV
Do sensitivity and specificity vary with pretest probability
NO
What measures probability of being free of dz if test result is negative
NPV
Management of DM pt w acute pyelonephritis
Parenteral Abx 48-72 hrs
Clear response - change to oral abx for 10-14 days
What is the Ghon complex
Tubercle
Ass’d LA
Reactivation TB = upper lobe infiltrate
Comorbidities of panic disorder
Major Depression Bipolar Agoraphobia Substance Abuse Increased SI/attempts
Disorders ass’d with Vitiligo
Pernicious Anemia Grave's Type 1 DM Primary adrenal insufficiency Hypopituitarism Alopecia areata
Where do we see pleural plaques
Bronchogenic carcinoma
What is the MC malignancy ass’d with asbestos
Bronchogenic Carcinoma
then, mesothelioma
What vitamin reduces morbidity and mortality in measles
Vit A
