UW 8 Flashcards
Chondroma
Benign cartilaginous tumor
MC location - hands and feet
Do reactive nasal polyps cause bony erosions
Not commonly
Crescendo-Decrescendo murmur heart at left sternal border without carotid radiation
HOCM = Interventricular septal hypertrophy
Diff b/t HOCM and AS murmur
AS radiates to carotid
AS is right second IC space
HOCM does NOT radiate to carotid
HOCM Is at left sternal border
Lung Abscess v Empyema
Lung Abscess - discrete abscess cavity typically seen on CXR
Empyema - Loculated, abnormally contoured effusion w adjacent pulmonary consolidation
MCC Empyema
Bacterial seeding of parapneumonic effusion in w bacterial pneumonia
Erythema toxic neonatorum Presentation
TX
Asymptomatic Blotchy Erythematous papules and pustules Spares palm and soles TX: Resolves w/in 2 weeks after birth
Nephrotic syndrome ass’d with lymphoma
Minimal Change
Nephrotic syndrome ass’d with Hep B
Membranous
MembranoProliferative
Nephrotic syndrome ass’d with Adenocarcinoma of lung and breast
Membranous
EKG of Ventricular Aneurysm
Persistent ST elevation after recent MI
Deep Q waves in same leads
EKG of Pericardial Effusion
Low voltage QRS complexes
Electrical alternans = large effusions
CT of Alzheimer’s
Cortical and subcortical Atrophy
Temporal and Parietal Lobes
Enlargement of Lateral Ventricles
Presentation of posterior urethral injury
Blood at urethral meatus
Inability to void
High-riding prostate on DRE
Assn’s with posterior urethral injury
Perineal or scrotal hematoma
Pelvic Fracture
Why are beta blockers used in HOCM
Slow the heart and prolong diastole which leads to more time for heart to fill and lessen outflow obstruction
What maneuver makes HOCM worse
Those that decrease preload since smaller ventricular volumes lead to higher degrees of obstruction
What sound is a harsh shrill
Stridor
MCC of Epiglottis (2)
Hib
Strep pyogenes
TX for MALT
- H.pylori tx - if ineffective ->
2. CHOP
What is CHOP
Cyclophosphamide
Adriamycin
Vincristine
Prednisone
When do we NOT treat HTN
Immediately after ischemic stroke IF Less than 220/120
OR
If pt has CAD
in order to maintain cerebral perfusion
Drugs that cause depression
Methyldopa
a-IFN (tx for viral hep)
Haloperidol - 1st G APs
Sedatives: Alcohol, benzos, barbs
Stimulant Withdrawl
Anti-emetics - metoclopromide, prochlorperazine
Glucocorticoids - can cause mania, insomnia
Diff bt MDD with psychotic features and Schizoaffective
MDD w psychotic features - Mood disorder always present - psychosis develops, may come and go. Never have psychosis w/out mood disorder
Schizoaffective - Psychosis is always present, mood disorder comes and goes. Never have mood disorder w/out psychosis
TX for Serotonin Syndrome
- Withdraw offending agent
- Supportive Care
- Agitation despite benzo’s = Cyproheptadine = Serotonin Antagonist
Do we use phenytoin for TCA OD seizures? Reasoning?
No.
Ineffective for toxin induced seizures
Use benzos, barbs, propofol
Comorbidities with Dysthmia
MDD
Bipolar Disorder
TX for Lithium induced NDI?
Reasoning?
HCTZ + Amiloride
Amiloride closes the Na+ channels at the collecting tubules where Lithium acts
Difference bt MDD and Adjustment Disorder
Adjustment disorder
- Occurs w/in 3 mo’s of stressor
- Disappears w/in 6 mo’s of absence of stressor
- Does not meet criteria for MDD
Difference bt Bereavement and Adjustment Disorder
Bereavement impairs patient’s ability to function normally.
Adjustment - does not impair
Assn’s with Panic Disorder
- MVP
2. Agoraphobia
Difference bt Acute stress disorder and PTSD
Acute stress < 30 days
- Can progress to:
PTSD > 30 days
Which APs have less anticholinergic AE’s: Hi or Low potency
Which are they?
Hi Potency
Haloperiodol, Droperidol, Fluphenazine, thiothxene
Good for + sx’s of schizophrenia
Presentation of Acute Dystonia
TX?
Torticollis, neck spasm
TX: Diphenhydramine, Benztropine
Drugs that have Anticholinergic Activity
Presentation of Tardive Dyskinesia
TX?
Choreoathetosis, writhing of face, tongue, neck, limbs
TX: D/C or reduce offending agent (Neuroletptic).
Switch to Atypical AP, i.e. risperidone, clozapine
Time frame for Parkinsonian SX AEs in pts taking APs
TX?
4 days –> 4 months
TX:
Diphenhydramine
Benztropine
Da Agonist = Amantadine
Presentation of NMS
AMS Muscular rigidity Hyperthermia - High Fever Autonomic instability Rhabdomylosis Within days of starting AP
TX for NMS
Cooling blankets, ice packs in axilla Reduce HTN - clonidine, nitroprusside DVT prevention - heparin, Lovenox Benzos for agitation Dantrolene Bromocriptine, Amandatine to increase Dopamine
DOC for Bipolar in Renal Failure
Valproate
Carbamezapine
CI = Lithium
