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Mixed 2 > UW 2 > Flashcards

UW 2 Flashcards

1
Q

What heme effect is seen with pulmonary HTN

A

Polycythemia - from hypoxemia, stimulates EPO

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2
Q

Pt with massive hemoptysis - management

A
  1. Endotracheal tube
  2. If bleeding persists - Bronchoscopy to localize bleeding site, provide suction to improve visualization, other interventions
    If can’t localize source - pulmonary arteriography
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3
Q

When can external cephalic version be done

A

Bt 37 weeks and onset of labor if no CI

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4
Q

CI to External cephalic version

A 
Ruptured membranes
Hyperextended fetal head
Fetal/uterine abnormalities 
Non-reassuring fetal monitoring
Oligohydramnios
Multiple Gestatino
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5
Q

TX for GoodPasture’s

A

Emergency Plasmapheresis

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6
Q

Management for pts with renal insufficiency and need CT w contrast

A

Non-ionic contrast agents
IV hydration
Acetylcysteine

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7
Q

Presentation of Meniere’s DZ

A 
Vertigo
Ear fullness
Tinnitus
Low-frequency, sensorineural hearing loss
Vomiting, Postural instability
Nystagmus
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8
Q

TX for Meniere’s

A
  1. Strict, salt restricted diet 2-3 g/day
    Avoid alcohol, caffeine, nicotine
  2. Meds - diuretics, antihistamines, anticholinergics
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9
Q

CYP 450 Inhibitors

Effect on Warfarin

A 
Increase Warfarin Effect = Increase bleeding
Acetaminophen, NSAIDs
Abx, antifungals (metronidazole)
Amiodarone
Cimetidine
Cranberry juice, Ginkgo, VIt E 
Omeprazole
Thyroid hormone
SSRIs
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10
Q

CYP 450 Inducers

Effect on Warfarin

A 
Decrease Warfarin effect = decrease efficacy, increase thrombosis
Carbamezapine
Ginseng
Green veggies = spinach
OCPs
Phenobarb
Rifampin
St.John's wort
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11
Q

Presentation of VIPoma

A

Watery diarrhea
Hypo or achlorhydria b/c decreased gastric acid secretion
Flushing, lethargy, N/V
Muscle Weakness/Cramps

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12
Q

Labs in VIPoma

A

Hypokalemia
Hypercalcemia
Hyperglycemia

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13
Q

Dx for VIPoma

A

VIP level >75 pg/mL

Abdominal CT or MRI - localizes tumor in pancreas

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14
Q

TX for VIPoma

A

IV hydration

Octreotide

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15
Q

Where does carcinoid tumor occur

A

Small Intestine

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16
Q

3 MCC of chronic cough

A
  1. Upper-airway cough syndrome/postnasal drip
  2. Asthma
  3. GERD
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17
Q

Pt w high risk pregnancy (HTN/preeclampsia) @ 32 weeks - Next step

A

NST weekly in 3rd trimester

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18
Q

Difference bt breastfeeding failure jaundice and breast milk jaundice

A

Breastfeeding failure

  • First week of life
  • Decreased BR elimination
  • Suboptimal feeding
  • Dehydration

Breast Milk

  • Age 3-5 days, peaks @2wks
  • High B-glucuronidase in breast milk
  • Normal exam
19
Q

TX for breastfeeding failure jaundice

A
  1. Optimize lactation - increase feeding frequency

2. Supplement w cow’s milk based formula if insufficient amt

20
Q

Vaccinations for HIV pts at time of DX

A

Influenza
Hepatitis viruses
S.pneumonia
MMR in pts with CD4 > 200 + no AIDS defining lesion

21
Q

Live vaccines CI in HIV

A 
BCG
Anthrax
Oral Typhoid
Intranasal Influenza
Oral Polio
Yellow fever
22
Q

Presentation of Bell’s Palsy

A 
Sudden onset
Unilateral facial paralysis 
Affected side
- Inability to raise eyebrow/close eye
- drooping of mouth corner
-Disappearance of nasolabial fold
- Decreased tearing
- Hyperacusis
-Loss of taste sensatin anterior 2/3 tongue
23
Q

Where do Bell’s lesions occur

A

Lesion Below the Pons

24
Q

What does forehead muscle sparing in Bell’s pt indicate

A

Intracranial lesions

Brain imaging req’d

25
Q

Presentation of steroid-induced folliculitis/Steroid Acne

A

Monomorphous pink papules

Absence of comedones

26
Q

Granulosa cell tumors

A

Bimodal age distribution
Excessive estrogen production
Young - precocious puberty, 2 sexual traits, breast and external genitali hypertrophy, pubic hair growth, hyperplasia of uterus

27
Q

Dysgerminoma

A

Younger women/children
Age 20 = avg
Unilateral, cause torsion
Does not secrete sex hormones

28
Q

Sertoli-Leydig cell tumor

A

Produce androgens

Defeminization -> masculinization

29
Q

Disseminated Histo presentation

CXR

A 
Low grade fever, malaise, anorexia, wt loss
LA
Pancytopenia
HSM
Palatal ulcers
CXR - hilar LA
30
Q

AE of prolonged seizures or Status Epilepticus

A

Cortical Laminar necrosis

31
Q

Otosclerosis Presentation

A

Conductive hearing loss
Low frequency loss
Middle aged individuals

32
Q

Presbycusis

A

Sensorineural hearing loss
AGING
Symmetric
High frequency hearing impairment

33
Q

Presentation of giant cell tumor of bone

A

Young adults
Pain, swelling, decreased ROM
Wt bearing joints - Distal femur and proximal tibia = knee joint

34
Q

X ray findings Giant Cell Tumor of Bone

A

Expansile and eccentric lytic area = soap bubble appearnce

35
Q

Pathology of giant cell tumor of bone

A

Sheets of interspersed large osteoclast giant cells

Round-to-oval polygonal or elongated mononuclear cells

36
Q

First line TX for giant cell tumor of bone

A

Surgery

37
Q

Presentation of Baker’s cyst

A

Swelling on medial side of popliteal fossa

38
Q

Cause of osteitis fibrosa cystica

Imaging findings

A

von Recklinghausen dz of bone
Hyperparathyroidism from parathyroid carcinoma
Subperiosteal bone resorption on radial middle phalanges, distal clavicular tapering

39
Q

Presentation of osteoid osteoma

A

Sclerotic, cortical lesion w central nidus of lucency

Pain worse at night, not related to activity

40
Q

Which murmurs should be worked up and how

A

Diastolic
Continuous
Echo - TTE

41
Q

Abdominal pain + hematemesis + Metabolic acidosis + tablets seen on xray

A

Iron poisoning

Iron pills radiopaque

42
Q

Pathognomonic for Crohn’s

A

Non-caseating granulomas

43
Q

Presentation of cholesterol embolization

A

Majority of cases = post angiography
Skin: feet, blue toe syndrome, Livedo reticularis, reddish/cyanotic skin discoloration
Acute Renal Failure
Labs: Increased eosinophils, low complement levels

Mixed 2 (9 decks)

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