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IM MedEd > UW1 > Flashcards

UW1 Flashcards

1
Q

+DIPs +morning stiffness +nail erosions/involvement +SAUSAGE Digits

Dx? Tx? Other shit?

A

+pencil in cup deformity on hand xray, psoriasis plaques

==>Psoriatic Arthritis!
Tx: NSAIDs +/- methotrexate

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2
Q

Female patient with increasing weakness, clear lungs but SOB + using accessory muscles to breath, +difficulty eating/swallowing food

Dx? Tx?

A

MYASTHENIC CRISIS = usually follows Physio stress and can be an early manifestation of MG
Tx: intubation + IVIG + steroids

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3
Q

Patient post-cardiac cath w/red-blue blotchy feet + sx of pancreatitis +AKI

Dx? Tx?

A

Cholesterol Embolism
Tx: supportive care

Red-blue blotchy skin = livedo reticularis

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4
Q

Parkinsons v Alzheimers v LB Dementia

Early parkinson tremors?

A

Parkinsons!

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5
Q

Parkinsons v Alzheimers v LB Dementia

Hallucinations?

A

LBD!

Park and Alz dont have this

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6
Q

Parkinsons v Alzheimers v LB Dementia

Fluctuating Cog. Impairment?

A

LBD!

Others are slow and insidious and do not wax and wane

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7
Q

Parkinsons v Alzheimers v LB Dementia

Late dementia?

A

Parkinsons!

Alz + LBD both have early onset dementia

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8
Q

Diabetic w/sudden loss of vision +floating debri in eye +difficult to see fundus +dark red glow on exam

Dx? Tx?

A

Vitreous Hemorrhage!

Tx: conservative

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9
Q

Contact wearer with painful red eye + yellow discharge +ulceration of cornea +hazy color over lens

Dx? Tx? MCC?

A

Contact Lens Keratitis! MCC: Pseudomonas & Serratia

Tx: remove lens & give Abx

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10
Q

> 250 CSF opening pressure, NV HA in the morning. all other CSF values are normal. dx? causes?

A

Idiopathic Intracranial HTN!

  • may be worse when laying flat.
    causes: tetracyclines(mino, doxy), Vitamin A + derivitives(isoretinoin=acne tx)
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11
Q

What is LAP? when will you see this elevated? when will you not?

A

Leukamoid Alkaline Phosphate

*elevated with infections but will not be elevated with CML

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12
Q

What is a QTc? What does this tell u?

A

Corrected QT interval! this tells you if shit is torsades or not

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13
Q

What will you see with Choroidal Rupture?

A

hx of blunt ocular trauma, central scotoma(LOV), retinal edema, hemidetachment, cresent shaped streak + blurred vision

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14
Q

painless loss of vision, optic disc pallor, cherry red fova. dx?

A

Central Retinal Artery Occlusion

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15
Q

40-70 yoa, flashes of light, floaters, Curtin being pulled over eyes, gray retina. dx?

A

Retinal Detachment

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16
Q

Elderly person who is immuno comp. F, Malaise. Burning, itching, periobitall + cutaneous rash on 1st division of CN5, decreased vision + conjuntivitis + “Dendriform Corneal Ulcers”. dx? tx?

A

herpes zoster ophthalmicus

tx: acyclovir

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17
Q

Whats the big difference between HSV keratitis and Herpes Opthalimicus?

A

HSV will have pain + photophobia + decreased vsion + Dedritic Ulcers + vesicles but NO SYTEMIC SIGNS.

HZO:Elderly person who is immuno comp. F, Malaise. Burning, itching, periobitall + cutaneous rash on 1st division of CN5, decreased vision + conjuntivitis + “Dendriform Corneal Ulcers”.

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18
Q

Stool Osmotic Gap. What will this look like with Secretory vs Osmotic diarrhea?

A

secretory = decreased gap bc anions in serum are being secreted into GI

Osmotic = increased bc GI isnt absorbing shit and instead is pulling water out.

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19
Q

NS = ?

A

0.9%

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20
Q

45 yo male w/arm weakness, now has trouble swalling + chewing. Some M stiffness, sensory ok. Fasciculations, Hyperreflexia, decrased bulbar reflexes. dx?

A

Fasciculations = LMN defect
Hyperrefelxia = UMN defect
sensory ok! M impaired = ALS!

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21
Q

Pt in house fire + seizure otw to hosp. Pulse ox reading 96% tx?

A

GIVE 100% O2! pulse ox cannot differentiate between CarboxyHg & reg Hg!

22
Q

Older lady w/recent onset of Hirsutism. What test shoudl you look at?

A

older lady w/hirsutism +- virilization = think an androgen tumor!
==>check testosterone & DHEA
*Test>DHEA = ovarian tumor
*Test

23
Q

Young lady w/oligoovulation, virulization, hirsutism. dx? tests?

A

PCOS! Look for LH>FSH = excess testosterone from theca cells

24
Q

Pt gets blood transfusion then goes into anaphylaxis + hypotension, angioedema, difficulty breathing. dx? tx?

A

IgA deficiency, give Epi + support

25
Q

pt gets blood transfusion then develops fever, chills within 6hr dx?

A

Acute non-hemolytic ABO mismatch

26
Q

pt gets blood transfusions then develops F, Flank Pain, DIC, RF w/in an hr. tx?

A

Acute Hemolytic ABO mismatch.
+/- hemoglobinemia +coombs +pink plasma
tx w/IVF + Support

27
Q

pt playing soccer & hears pop in knee. Presents to ER w/swollen knee w/blood aspirate dx?

A

ACL tear = they will bleed!

28
Q

Osteomalacia cause?

A

def in vita D resulting in impaired osteoid matrix mineralization

29
Q

SVT criteria? tx?

A

> 150bpm + P &Twaves blend into one another on ECG, Narrow QRS

tx: carotid massage, ice on head, Adenosine >Verampil

30
Q

TCA OD sx? tx?

A

3 C’s of overdose: Convulsions, Coma, Cardiotoxicity (arrhythmias)

*respiratory depression, hyperpyrexia, urinary retension, dilated pupils, hyperthermia, intestinal ileus, increased QRS`

Rx for overdose = NaHCO3

31
Q

why can you use mesalamine for UC but not crohns?

A

bc its a 5ASA compount that is release in the rectum. but crohns can be anywhere so its not good for that but UC always involves the rectum.

32
Q

elevated Ca, Elevated PTH and dec P(all mild) w/no sx. how would you dx?

A

Familial hypocalciuric hypercalcemia. dx w/urine Ca levels.

*should see high Ca in serum and low Ca in urine

33
Q

Pt with sudden onset of bilateral eye redness, eyelid swelling, watery discharge but no change in vision, normal pupils, bilateral conjunctival injection + granular appearance of conjunctiva. + history of asthma or other atopy. Dx?

A

Allergic conjunctivitis

34
Q

Viral Conjunctivits vs Bacterial Conjunctivitis

A

Viral: bilateral > unilat, watery, itchy, preauricular andopathy, no tx, bumpy eyelid

bacterial: unilat >bilat, purulent, no adenopathy, tx w/abx

35
Q

Old lady w/slow decrease in vision + distortion of straight lines. dx?

A

macular deveneration! usually central loss of vision + “Drusen Spots”
tx w/ VEGF inhibitor

36
Q

adult w/3 episodes of pneumonia over the last 3 years, blood diarrhea 6m ago. severe sinusitis a year ago. presents now w/cough + sob + fine crackles over right lower lung. HIV -. dx? tx?

A

Common Variable Immunodeficiency! = recurrent sinopulmonary infections in adults(bronchitis, pneumonia, sinusitis, otitis media)+/- Giardiasis, Sprue, Anemia due to decrease B cells production of IgGAM.

tx: tx infection + give regular Ig infusions

37
Q

Person keeps getting skin infections…whats the most likely dx

A

Hyper IgE syndrome

38
Q

kid w/immunodeficiency = gets sick alot + thrombocytopenia & Eczema. dx? tx?

A

Wiskott-Aldrich Syndrome = Tcell deficiency!
(WATER = Wis-Aldrich Thrombo, Eczema, Recurrnet infec)
tx: bone marrow transplant

39
Q

child w/sinopulmonary infections alot w/ absence or decreased of the tonsils, adenoids, lymph noes and or spleen. dx? tx?

A

Xlinked agammaglobulinemia(burton)

tx: long term IVIG

40
Q

Dude got stabbed on R side of body @T8. What sx would you see? what is this?

A

Brown-Sequard Sx = No motor on Right extremity(crosses in pyramid/medulla), no Pro,Vib, Light Touch on R @ level of lesion, loss of PIT on Lside just below that so like T10ish.

41
Q

Dude in high speed motor cycle accident who now has bilateral lower extremity weakness + loss of PIT but Pro,vib & light touch are fine. what caused this?

A

Anterior cord syndrome! = spares dorsal columns

42
Q

Nerve involved in carpal tunnel syndrome? tunnel name? fingers?

A

Median Nerve over radius bone = thumb +pointer finger, transverse carpal ligament

43
Q

Describe Tophaceous Gout

A

pt with multiple white/fleshy(looks liek white chaulk under skin) nodules in hands w/painful arthritis.

44
Q

What type of hemorrage will give you left sided hemineglect?

A

right parietal lobar hemorrhage

45
Q

MC sights for HTN intraparenchymal hemorrhage?

A

BG(putamen) > cerebellar nuclei > thalamus > pons >cerebral cortex

46
Q

Pt w/high hematocrit + recurrent epistaxis + ruby colored papules on his lips that blanch w/pressure. dx?

A

Hereditary Telangiectasias(Osler-Weber-Rendu Syndrome) = widespread AV malformations that causes blood shunting from R–>L = hypoxia & chronic reactive Polycythemia.

47
Q

62 yo Pt with sudden onset photophobia, NV, severe HA + pain, redness & conjunctival flushing in one eye w/nonreactive mid-dilated pupil. dx? tx?

A

Acute Angle closure glaucoma = dx w/Tonometry(measure IOP)

tx: iridotomy, IV acetazolamide, mannitol or Pilocarpine drops ASAP

48
Q

female patient with chronic musculoskeletal pain and tenderness with TRIGGER POINTS, occuring at many sites(neck, shoulders, back and hips). dx? tx?

A

Fibromyalgia

tx: regular aerobic exercise > SSRI > TCA

49
Q

CYP Activators(7)

A
  • Rifampicin
  • Alcohol
  • Phenytoin
  • Griseofulvin
  • Pheobarbitone
  • Sulphonylureas
  • carbemazepines
50
Q

CYP Inhibitors(11)

A
  • Isoniazid
  • Cimetidine
  • Ketoconazole
  • Erythromycin
  • Sulfonamide
  • Ciprofloxacin
  • Omeprazole
  • Metronidazole
  • Grapefruit juice
  • Sodium valproate
  • Fluconazole

IM MedEd (24 decks)

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