UW 20 Flashcards
Alcoholic neuropathy
Toxic neuropathy
Stocking and glove sensory deficits + ataxia
Burning pain, loss of pin prick and vibratory sensation
Loss of ankle reflexes
(If thiamine deficiency… demyelination occurs)
Fructose intolerance
Aldolase B deficiency
Symptoms appear once fruits and vegetables are including in the diet (or formula)
Vomiting ==> poor feeding ==> lethargy ==> seizures
Galactose intolerance
Galactosemia: (galactose-1 phosphate uridyl transfarase)
Jaundice, hepatomegaly, failure to thrive in the few first days of life
Lacunar strokes manifestations
Affect small penetrating arteries
Sings and symptoms are very specific: eg. pure sensory, pure motor.
Nightmare disorder vs. Sleep terror
Nightmare disorder: remembers dream, can be consoled. Occurs during REM. Full awakening
Sleep terror: does nor remember, patient is not fully awake, cant be consoled. Non-REM disorder
Treatment of psycosis (in order)
2nd generation antypsychotic (execpt clozapine)
1st gen
+/- benzo for agitation
Clozapine: for resistant (failure of >2 trials)
Long acting injectable medication: for non adherance
Add on therapy for DM that reduces cardiovascular risk
SGLT2 inhibitors: canagliflozin, empagliflozin. Increased urinary excretion of Na and glucose
SE: euglycemic ketoacidosis. increase UTI
GLP1 receptor agonist: semaglutide, liraglutide. Slow gastric emptying, decrease glucagon, increases insuline like growth factor.
FACT:
Patient with liver disease and prerenal AKI
HEPATORENAL SD
Splanic vasodilation ==> low vascular resistance ==> RAS system activation ==> renal vasocontriction ==> decreased perfusion and glomerular filtration
Treat with: volume repletion first, octreotide, mirodine, norepinephrine
Alarm symptoms to consider in a patient with Irritable bowel sd.
Onset >50 yoa Nocturnal diarrhea Worsening pain Unintended weight loss Abnormal labs (iron def anemia, elevated inflammatory markers) GI bleeding
Causes of secretory diarrhea
Infection
Neoplastic (VIPoma, gastrinoma)
Microscopic colitis
Bile salt diarrhea
Preferred fluid for resuscitation in burn victims
Ringer lactate
Preferred fluid for resuscitation in patients with bacterial peritonitis or hepatorenal sd
Albumin
In utero exposure to diethylstibestrol
Clear cell carcinoma
Risk factors for vaginal cancer (4)
> 60 yoa
VPH
Smocking hx
In utero diethylstibestrol (clear cell)
Management of DVT
Modified wells criteria
> 2 pts… Pressure ultrasound
Positive: anticoagulation
Discoid rash description
Scaly erythematous plaques
Ulcerate and scar
Hypopigmentation in the middle, surrounding hyperpigmentation
Phantom limb pain management
Multidrug treatment:
TCAs, gabapentina, NMDA receptor antagonist (ketamine), opiods, acetaminophen
Adjuvant: biofeedback, CBT, mirror therapy
Pronator drift significance
UMN symptom (piramydal/corticospinal tract disease)
Lab findings in hyperemesis gravidarum
Hypocloremic metabolic acidosis
Ketonuria
Hypokalemia
Hemoconcentration
Angiodisplasia (GI)
Common cause of painless bleeding. AV malformation
Incidence increases with age and is associated with Aortic stenosis, renal disease and vWF deficiency
More common in right colon but can be found anywhere
Maturity onset diabetes of the young
Glucokinase mutation
Decrease secretion of insulin at any glucose level
Hyperglycemia is not as high as in DM
Management of Gastroenteritis
If mild: supportive care only
Antibiotics reserved for severely ill patients
Factorial desing
2 or more different interventions
Studying 2 or more different variables
Cross-over study
Two groups.. two different treatments
Then.. switch
When is macrocephaly normal?
Normal development
Normal neurological exam
Family hx
Eczema herpeticum
Superimposed Herpes 1 infection
Regular herpes presentation + hemorrhagic crusting
Present with fever, irritability and lymphadenopathy
LFTs in alcoholic hepatitis
Liver transaminase elevated but no more than 500
Pyogenic liver abscess causes
Biliary infection Intestinal infection (through the portal system) eg. diverticulitis Hematologic spread (systemic infection)
Drainage and culture
CP450 substrates, inducers and inhibitors pg 254 FA Step 1
Warfarin, OCPs, Theophyline, Antiepileptic
Medications that influence Warfarin effect but not CP450
Acetaminophen: interruption of Vit K recycling. Risk of bleeding
Antibotics: decrease vitamin K producing bacteria. Risk of bleeding
Medications that cause SIADH
Carbamazepine , SSRI, NSAIDs
