UWORLD Flashcards
OSA does what to blood?
decreased O2 = kidney increases EPO = polycythemia (increase in Hct/Hgb)
JAK2 mutation
polycythemia vera
itching after bathing + facial plethora/ruddy cyanosis + splenomegaly + low EPO
polycythemia vera
recurrent nose bleeds + oral lesions + increase Hct
hereditary telangiectasia (Osler Weber Rendt syndrome) occurs with artereiovenous shunting due to AVMs = hypoxia with reactive polycythemia
new onset TCP + arterial venous thrombosis + increased in PTT, nml PT
HIT
increased MCHC + hemolytic anemia , jaundice, splenomegaly, cholecystitis
hereditary spherocytosis
hypercalcemia, normocytic anemia, protein gap > 4 (t pro - alb) + rouleaux/stacking on peripheral smear
multiple myeoloma
MCC megaloblastic anemia in alcoholics
folate deficiency
chronic abdominal pain + increase ESR + anemia, +watery diarrhea, mouth ulcers
crohns
GU compliance of sickle cell
hyposthenuria (impairs ocuntercurrent exchange and free H20 reabsorption = nocuturia
effect of lupus anticoagulant of coag numbers
increased PTT in vitro
painful joint swelling, decreased ROM, usually in epiphyseal area of long bones…xray shows expansile/eccentric/”soap bubble” lyric area
giant cell tumor of bone (benign and locally aggressive) usually in young adults, treat with surgery
MCC of abnormal hemostasis in aptients with chronic renal failure (BT prolonged, but PT/PTT/ and plt count normal)
platelet dysfunction (usually due to uremia) treat with ddavp
hemolytic anemia + thrombocytopenia + venous thromboembolism (intrabdominal/cerebral venous thrombosis) dx, test, treatment
paroxysmal nocturnal hemoglobinuria
dx with cytometery (lack of CD55 and CD59)
treat with immune modulators like eculizimab
How to differentiate between CML and leukomoid reaction?
CML will have decreased leukocyte alkaline phosphatase score
nonhealing, painless, bleeding/oozing skin ulcer associated with chronic scar
suggests squamous cell carcinoma!!
biopsy that shit then refer for mohs micrographic surgery if high risk/cosmetic
how do glucocorticoids cause leukocytosis
mobilization of marginated neutrophils
numbness/pain between 3rd/4th toes….clicking sensation
Morton neuroma, treat conservatively
compression of tibial nerve at ankle…burning, numbness, and aching of distal plantar surface
tarsal tunnel syndrome
pain plantar surface of heel, worse when initiating running or first steps of day
plantar fascitis
young female athelete, anterior knee pain, pain reproducible when patella is compressed into trochlear groove)
patellofemoral pain syndrome
rx with activity modification and strengthing/stretching exercises
elderly patient, back pain radiating to bilateral thighs, worse with standing and standing still, better with leaning forward (sitting/biking)
lumbar spinal stenosis
rx with physical therapy
not to be confused with disc herniation which will get WORSE with leaning over/biking
pregnant g3po lady comes in with positive VRDL negative FTA ABS…what treatment to start
low molecular weight heparin!!! 2 miscarriages concern for APS…can give false negative VRDL
side effect of mycophenolate
mmmmmmycophenolate gives bone mmmmmmmarrow suppression
signs of cyclosporine toxicity
usually in patient transplant
nephrotoxicity, hyperkalemia, hirsuitism, gum enlargement, tremor
similar to tacro but tacro doesn’t give hirsuitism
azothioprine toxicity
dose related diarrhea, luekopenia, hepatotoxicity
nasal congestion, rhinorrhea, sneezing, post nasal drip no identifiable triggers/etiology, boggy/erythematous nares…dx and rx
nonallergic rhinitis (allergic will usually have trigger/pattern and will have pale/blue nasal mucosa).... treat with intranasal antihistamine or glucocorticoids
b symptoms, large anterior mediastinal mass, elevated bHcg and AFP
nonseminomatous germ cell tumor
tumor, pregnancy, elevated bHCG
choriocarcinoma
dry cough, weight loss, pain in right arm, 30 year pack history, lesion in top lobe of lung
superior pulmonary sulcus (pancoast tumor) can involve brachial plexus
initial treatment of PE in patient with GFR<30
UNFRACTIONATED HEPARIN then warfarin once INR therapeutic
patient treated with radiation for hodgkins lymphoma develops left sided chest pain circle on xray
watch out for new malignancy (common in patients treated with chemo and radiation for hodgkins)….can eb seen in lung, breast, thyroid, bone, and GI
patient treated with antibiotic (bactrim) for UTI has resolving of symptoms but now has dark urine that stains Prussian blue
prussian blue = hemosiderin = hemolysis
due to oxidatve stress from bactrim (g6pd)
enlarging chronic non healing skin lesion with keratinization and ulceration/crusting/bleeding…patient on immunosuppressive therapy
squamous cell carcinoma!!!
depigmented macules on acral areasa/extensorsurfaces…gradual onset
vitiliggo
associated with autoimmune disorders like pernicious anemia, hashimotos
