UW 15 Flashcards
Complication w bronchiectasis
Hemoptysis
- If massive, bronchial arter embolization
Presentation of duodenal hematoma
Post BAT
Children
Epigastric pain and vomiting
Duodenal hematoma management
NG suction
Parenteral nutrition
Presentation of dactylitis
Hand foot pain and symmetric swelling
6 mos - 2 yrs
Presentation of laryngomalacia
Inspiratory stridor - exacerbated by exertion/distress
Sx’s in first few wks of life
Presentation of MCA Occlusion
Contralateral somatosensory and motor - Face, Arm, Leg Conjugate eye deviation TWD infarct Homonymous hemianopia Aphasia = dominant Hemineglct = non-dominant
Presentation of ACA Occlusion
Contralateral somatosensory and motor deficit - LE
Abulia - lack of will
Dyspraxia, urinary incontience
Emotional changes
Pt presents with Right sided hemiplegia, lower facial paresis and intact sensory - where is stroke?
Pure motor lacunar stroke in posterior limb of internal capsule
Arrhythmia responsible for sudden cardiac arrest most frequently
V Fib
- 50% within 1st hour
Lung Dz with Ankylosing Spondylitis
Fusion of costovertebral joints result in chest wall motion restriction and restrictive patten on PFTs
Normal or Hi FRC
Liver findings in Reye Syndrome
Microvesicular fatty infiltration
Hepatic mitochondrial dysfnc
Lab findings in Reye syndrome
Increased ALT, AST
INcreased PT, INR, PTT
Increased ammonia
Polycythemia Vera findings
Serum EPO Low
JAK2 mutation
Pruritis, HA, dizziness, visual changes
Hyperviscosity
Labs in Polycythemia Vera
High Hg/Hct, platelets, WBC count
Presentation of toxic megacolon
Fever HR > 120 Neutrophilic leukocytosis Anemia Volume depletion Altered sensorium Electrolyte changes HypoTN
Initial test of choice for toxic megacolon
Abd Xray
- confirm dilated colon > 6 cm
TX for Adjustment disorder
Psychotherapy
CBT
MCC of bacterial pneumonia in young children with CF
Staph Aureus - esp with influenza
TX for severe pneumonia in CF child
Vanco
MCC macrocytic anemia in sickle cell
Folate deficiency
What do needle shaped crystal on UA indicate
Uric Acid stones - radiolucent
Imaging modality for Radiolucent stones
CT or IV pyelography
What tests for left sided GI pathology
Barium enema
Sigmoidscopy
Labs in Conn’s syndrome
HTN Hypernatremia (mild) Hypokalemia Metabolic Alkalosis Low Renin High serum Aldosterone High serum Bicarb
Management in pt with high calcium on labs
- Recheck w second serum Ca
2. Serum PTH
TX for actinomycosis
PCN
TX for Nocardia
TMP SMX
How long for Major Depression Dx
2 weeks
Adjustment disorder timeline
Within 3 months of exposure to stressor and lasts up to 6 months after stressor ends
Modifications for controlling HTN - most to least effective
- Weight Loss
- DASH diet
- Exercise
- Dietary Sodium
- Alcohol
Vit D Deficiency Rickets Risk Factors
Increased skin pigmentation
Exclusive breastfeeding
Lack of sun exposure
Maternal Vit D def
Vit D Def Rickets Presentation
Craniotabes
Delayed fontanel closure
Enlarged skull, costochondral joints, long bone joints
Genu Varum = femoral and tibial bowing
Risk Factors for Nasopharyngeal Carcinoma
Mediterranean/Far East descent
Recurrent otitis media
Recurrent epistaxis, nasal obstruction
Smoking, Nitrosamine
What titers are strongly ass’d with nasopharyngeal ca?
EBV
Used to track progress for TX
What does tamoxifen increase risk of? Why
Endometrial cancer
Acts as partial agonist of estrogen on endometrium
Acts as estrogen antagonist on breast tissue
Effect of tamoxifen on osteoclasts
Estrogen receptor agonist on osteoclasts - inhibits bone turnover -> decreases risk of osteoporosis
IDA labs
Only TIBC Hi
Low MCV, Iron, Ferritin, Transferrin
ACD labs
Only Ferritin Hi
Endometriosis
- Dysmenorrhea
- Dyspareunia
- Infertility
Pain is 1-2 wks prior to menses, peaks before menstruation
Presentation of pelvic congestion
Dull, ill-defined pelvic ache
Worsens prior to menstruation or w standing for long periods of time
Relieved by menses
Cause of Howell-Jolly bodies
Nuclear remnants w/in RBCs normally removed by spleen
- Physical abuse of spleen, splenectomy
Heinz bodies cause
Hemoglobin precipitation (G6PD)
How to differentiate Preseptal cellulitis and Orbital Cellulitis
Orbital - Ophthalmoplegia - Pain w EOM - Proptosis - Vision impaired NOT seen in Preseptal Preseptal - oral Abx Orbital - IV Abx
CF GI features
Obstruction - Meconium ileus - Distal intestinal obstruction syndrome Pancreatic dz - Exocrine pancreatic insufficiency - CF diabetes
CF Repro feature
Infertility - congenital BL absence of vas deferens
CF Musculoskeletal features
Osteopenia = Fx
Kyphoscoliosis
Digital Clubbing
Complications of AAA repair
Bowel ischemia
- bloody diarrhea and abd pain
Sickle cell - cause of macrocytic anemia
Folate deficiency
Rubella v Measles
Rubella - Pink maculopapular exanthem face to body < 3 days, low grade fever, tender LA
Measles - Fever > 104, coryza, malaise, rash spreads faster and is darker
Low LH + advanced bone age + coarse axillary/pubic hair + severe cystic acne
Nonclassic CAH by 21-OH deficiency
