UWorld Medicine Flashcards
Complications of acute pancreatitis
Effusion, ileus, pseudocyst, abscess, necrosis, renal failure, ARDS
Immediate treatment for CRAO/amarousis fugax
Ocular massage, high flow oxygen
Treatment for Prinzmetal’s angina
Cardizem
Kaposi’s sarcoma is caused by
HHV-8
Ventricular arrhythmias 2/2 AMI Type IA vs IB
1A: re-entrant
1B: abnormal automaticity
HBV treatment indicated when… Treat with…
Cirrhosis, CTX/IS, acute liver failure. Tenofovir
Tinnitus, hearing loss, acoustic neuroma, cafe-au-lait spots
NF
Which fungal infection mimics sarcoid?
Histoplasmosis
NC granulomas are characteristic of which fungal infection?
Histoplasmosis
The 2 fungal infections that mimic TB
Histo-cough/nodosum/NC gran; and Blasto
Blasto: skin lesions, osteolytic, prostate
This fungal infection is endemic to SW USA.
Coccidocymycosis
What types of screening should be performed in patients with compensated cirrhosis?
U/S, EGD, AFP q 6 months
Medical therapy for variceal hemorrhage
Beta blockers
Treatment for ascites
Paracentesis, Na restriction
Oligoclonal bands in CSF
MS
Albuminocytologic dissociation in CSF
GBS
Decreased FEV1:FVC
Obstructive lung disease; decreased DLCO: COPD vs . non-decreased=asthma
Normal FEV1:FVC
Restrictive lung disease; Decreased DLCO: ILD vs. non-decreased: OHS, MG, ALS, chest wall
Winter’s formula
Determines appropriate respiratory compensation
PaCO2 = (1.5 x HCO3) + 8 +/-2
Polyarthralgias, tenosynovitis, vesiculopustular lesions
Disseminated gonococcal infection
Erythema migrans
Lyme
What type of rash in disseminated meningococcal infection/
Petechial
The major blood transfusion reactions
Immediate: IgA, anaphylactic
1-hour: Acute hemolytic 2/2 ABOi, fever/flank/DIC
Urticarial: 2-3 hours, IgE
Febrile: 1-6 houts 2/2 WBC releasing cytokines (leukocyte reduced)
2-10 days: Delayed hemolytic; anamestic Ab/sensitized
ALI: donor anti-leukocyte Ab; respiratory distress
Which nephrotic syndrome a/w AA’s, HIV, heroin?
FSGS
Which nephrotic syndrome a/w HBV?
MN
Differentiate between 2 types of esophageal ca.
Adenoca: GE junction 2/2 Barrett’s
Squamous: Anywhere, smoking/EtOH
Low risk vs high risk for esophageal cancer studies
Low risk: Barium esophagram
High risk: Endoscopy
Initial treatment of a prolactinoma with no visual symptoms.
Cabergoline, bromocriptine
Beck’s triad
Hypotension, JVD, muffled heart sounds
Pulsus paradoxus
Decrease in SBP by 10 with inspiration
Leukemoid reaction vs. CML
L: 50,000, high LAP
CM: 100,000 bcr-abl; basophilia
Most ideal treatment for HTN
Weight loss
Live attenuated vaccines
MMR, VZV, Yellow fever, IN influenza, Oral polio, Rota
Klinefelter has high or low FSH/LH
High
What combination of drugs can be used to correct K abnormalities in treatment of CHF?
Lasix, ACEi
Anti-topoisomerase Ab
Scleroderma
Anti-mitochondrial Ab
PBC
Anti-smooth muscle Ab
AI hepatitis
What is ichthytosis
Dry and rough skin with horny plates on the limbs
CYP Inducers
Phenobarbital, Carbamzepine, Rifampin, OCP, Ginsing, St. Johns
CYP Inhibitors
Tyl, Flagyl, NSAIDS, Amiodarione, Cranbery, SSSI, Omeprazole
What drug relieves symptoms of diffuse esophageal spasm?
NG
Where is angiotensinogen made?
Liver
Why should you avoid NSAID’s in acute kidney injury?
PG’s help dilate the afferent arteriole
Pulmonary hypertension in obesity hypoventilation syndrome is 2/2
Hypoxic vasoconstriction
Major potential adverse effect of PTU/Methimazole
Agranulocytosis
Broca’s aphasia vs. Wenicke’s aphasia
Broca’s: Expressive
Wernicke’s: Comprehension
Greatest risk factor for CVA
Hypertension
What converts angiotensinogen into A1?
Renin
Where is ACE enzyme located?
Lung
What infection is common to gardeners?
Sporothrix
Hepatic hydrothorax can lead to R or L effusion?
R
Do you need a contrast CT for nephrolithiasis?
No
Does lupus anti-coagulant leads to increased or decreased PTT?
Increased
What is d-dimer
It is cross-linking fibrin, when the clot dissolves, d-dimer goes up
A potential complication of mono, besides splenic rupture.
AIHA (Cold, IgM)
How do you treat severe uremic pericarditis?
Dialysis
Long-term use of NSAIDS can lead to…
Peptic ulcers
What is the FDA approved drug to use in cancer cachexia?
Progesterone analogues: megestrol
For what is Marinol approved?
AIDS wasting
Does hyper or hypothyroid predispose to carpal tunnel syndrome?
Hypothyroid
Differentiate Mobitz 1 vs 2
1: Increasingly long PR interval –> dropped
2: Dropped QRS every x-time
What skin findings is a/w glucagonoma?
Necrolytic migratory erythema
Differentiate Boerheave from MW.
Boerheave: painful, perforation
Reactive arthritis
Can’t pee, see, climb a tree
What substance is indicated in hepato-renal syndrome?
NO; try to induce splanchnic vasoconstriction
HIT is 2/2
Conformational change of PF4 –> IgG platelet activation, thrombosis and thrombocytopenia
CMV ppx
Valgancyclovir
PCP ppx
Bactrim
Smudge cells are pathognomic for…
CLL
3 major AE’s of Amiodarone
TFT, LFT, PFT
Where is angiodysplasia most likely to be located in colon?
Right colon
Anti-glutamate decarboxylase Ab
DM1
Spontaneous bacterial peritonitis
Fever, AMS, abdominal pain
PMN’s > 250; +CX; Protein 1.1
T/F Angiodysplasia is a/w aortic stenosis
True; AS –> VW disease/renal disease
FAP is AD/AR. What is the colon cancer risk? When is total proctocolectomy indicated?
AD; risk is 100%; at the time of diagnosis
T/F Any patient with an acute, severe illness may have abnormal thyroid function tests
True
The pathogenesis of ACEi induced cough…
Increase in circulating inflammatory mediators: bradykinin, substance P, PG’s
Rapidly progrssive dementia, myoclonus, sharp, triphasic synchronus discharges on EEG
Creutzfeld-Jakob disease
Dementia caused by a defect in AD gene on ch 4
Huntington’s: striatal neuro-degeneration
Histopathological findings of neurfibrilary tangles and amyloid plaques
Alzheimer’s
Neurodegeneration of frontal and temporal lobes
Pick’s disease
Bitter almond breath indicates inhaled…
CN
This toxin, when inhaled, results in a pinkish-red skin hue
CO
This inhalation results in cyanosis and bluish discoloration of skin and mucus membranes
MethHgb
This syndrome is caused by excessive intake of Ca and absorable alkali
Milk Alkali Syndrome
Major effect of Angiotensin 2 in the renal artery…
Preferential vasoconstriction of the efferent arterioles, resulting in increased intra-glomerular pressure
A young obese female with headaches and shrunken ventricles…
Pseudotumor cerebri
Examples of first generation anti-histamines
Diphenhydramine, doxepin, hydroxyzine
T/F Acyclovir can result in crystal-induced kidney injury
True, along with sulfonamides, MTX, protease inhibitiors
The most common cause of isolated aortic regurg in young adults in developed countries… And in developing countries
Bicuspid aortic valve
- Rheumatic heart disease
Wide, fixed and split S2
ASD
Harsh creschendo-decrescendo systolic murmur at apex
HOCOM (Valsalva and standing decrease PL and increase intensity of murmur)
Treatment of stable VT (wide complex, fusion beats)
IV Amiodarone (procainamide, sotalol, lidocaine)
Treatment of paroxsysmal SVT
Carotid massage
Upper vs. lower lip; BCC vs. SCC
Basal cell: upper lip; SCC: lower lip
Most common cause of esophageal rupture
Endoscopy
What is the best study to demonstrate esophageal perforation?
Contrast esophagram with water soluble contrast (barium has higher sensitivity, but is second line)
Acute chest pain, subcutaenous emphysema, left-pleural effusion classically represents
Esophageal perforation
Major complication of pseudotumor cerebri
Blindness
The pathophysiology of pseudotumor cerebri
Impaired absorption of CSF by arachnoid villi
Medical treatment of pseudotumor cerebri
Weight reduction and acetazolamide
Surgical treatment of pseudotumor cerebri
Shunting or optic nerve sheath fenestration
Complications of pneumonia
Complicated parapneumonic effusions, empyema
Do complicated parapneumonic effusions have positive or negative pleural fluid gram stain?
Negative
This tick-borne illness is a/w leukopenia and thrombocytopenia, elevated LDH and transaminitis
Ehrlichia; treat with doxy (SE US)
CT scan after TBI that shows numerous minute punctate hemorrhages with blurring of grey-white interface
DAI
T/F Heterophile Ab can be negative early in the course of infectious mononucleosis
True
Common cause of false positive VDRL in pregnant women
Antiphospholipid antibody syndrome
Is Warfarin contraindicated in pregnancy?
Yes
Anti-thyroid peroxidase Ab
Hashimoto’s thyroiditis
This type of skin cancer arises from an enlargening nodule, and can display early perineural invasion
SCC
Which skin cancer is especially common in patients on chronic IS therapy?
SCC
The most popular treatment for hyperthyroidism in the USA
Radioactive I.
The greatest risk of developing hypothyroidism following radioactive I treatment is seen in patients with…
Graves disease
Contact-lens keratitis is usually secondary to…
Gram negative organisms, i.e Pseudomonas
In keratitis, is the cornea spared?
No. Whereas in conjunctivitis, it is spared
Pityriasis rosea vs. Pityriasis versicolor
Rosea: Xmas tree herald patch
Versicolor: Malassexia, hypopigmented, don’t tan
Spaghetti and meatball pattern on KOH
Pityriseas versicolor
Hashimoto’s thyroiditis can lead to…
Lymphoma of the thyroid
Thyroid cancer of C cell origin
MTC
Initial treatment of severe hypovolemic hypernatremia? What about less severe?
IV NS; less severe are treated with D51/2NS
Treatment for euvolemic/hypervolemic hypernatremia
D5W
Treatment of hypernatremia based on volume status
Hypovolemic-Severe: IV NS
Hypovolemic-Mild: D5 1/2 NS
Euvolemic/Hypervolemic: D5W
Anti-histone Ab
Drug-induced lupus
Anti-CCP
RA
Triad of inflammatory arthritis, splenomegaly and neutropenia
Felty syndrome (patients with long-standing RA)
What is the anion gap?
Na - (Cl+HCO3)
MGUS vs. Waldenstrom’s macroglobulimemia
MGUS: no end organ anemi, HSM, LAD, systemic symptoms
Overdose: hyperthermia, dilated pupils, intestinal ileus, QRS prolongation
TCA
QT prolongation 2/2 TDP is treated with
Mg
Overdose: Bradycardia, miosis, salivation
Cholingergic toxicity - treat with atropine
Crohn’s vs. UC: bloody diarrhea, pseudopolyps, non-rectal sparing, no skip lesions, mucosal/SM involvement, crypt absecess
UC
T/F Tick borne paralysis usually progresses over hours
True
Descending paralysis and CN involvment
Botulism
Rapidly progressive ascending paralysis (asymmetrical), absence of fever/sensory abnormalities, normal CSF
Tick-borne paralysis
* Remove the tick!
Trihexyphenidyl
Anti-cholinergic used in younger Parkinson’s patients for whom tremor is the predominant symptom
First-line treatment for essential tremor
Propranolol
Treatment of Warm AIHA
CS
Treatment of Cold AIHA
Rituxan
Butterfly appearance of a brain tumor
GBM
Treatment of Nocardia vs. Actinomyces
Nocardia: Bactrim
Actinomyces: PCN
Anaerobic, filamentous branching bcteria that colonizes the oral cavity
Actinomyces
Aerobic cs. Anaerobic: Nocardia/Actinomyces
Nocardia: Aerobic
Actinomyces: Anaerobic
Cervicofacial involvement in a diabetic patient undergoing dental procedure
Actinomyces
Describe how a patient with a PE can experience signs/symptoms of hypocalcemia.
Respiratory alkalosis results in albumin letting go of H+, and then it picks up Ca.
Three forms of Ca in the blood
Ionized (active), albumin, inorganic anions
TRAP+, CD11a+ leukemia
Hairy cell leukemia
Reed-Sterberg cells are characteristic of…
Hodgkin’s lymphoma
Vagal maneuvers can abolish PSVT by…
Decreasing AV nodal conductivity (also adenosine)
Activated charcoal within X hours of Tylenol ingestion
4
What is the toxic dose of Tylenol ingestion?
7.5 g
When do you I&D a stye?
After 48 hours of non-improvement with warm compresses
Bird-beak narrowing on barium swallow
Achalasia
Foul smelling sputum along with an indolent course of fever, malaise, cough
Aspiration pneumonia caused by anaerobes
Drug of choice for PCP pneumonia
Bactrim
3 options for anaerobic coverage from oral pathogens
Amoxicillin, Augmentin, Clinda
Diastolic decrescendo murmur with widened pulse pressure
Aortic regurgitation
Pulsus parvus and tardus
Aortic stenosis
Valve surgery is indicated in native valve bacterial endocarditis when…
Valvular dysfunction resulting in CHF, infection persistent or difficult to treat medically, recurrent septic embolization
Causes of microscopic hematuria
Renal (cancer, nephropathy), Ureteral (stricture, stone), bladder (cancer, cystitis), prostate/uretheral (BPH, prostate cancer, uretheritis)
Most important risk factor for bladder cancer
Cigarette smoking
Rectal sparing: UC or Crohn’s
Crohn’s
Intestinal complications of Crohn’s vs. UC
Crohn’s: Fistulas, strictures, abscesses
UC: Toxic megacolon
Crohn’s vs. UC: Absence of perianal abnormalities
UC
Crohn’s vs. UC: Continuous inflammation
UC
Crohn’s vs. UC: Bloody diarrhea
UC
Crohn’s vs. UC: Rectal inflammation
UC
Crohn’s vs. UC: Pseudopolyps
UC
Crohn’s vs. UC: NC granulomas
Crohn’s
Crohn’s vs. UC: Cobblestoning
Crohn’s
Reduced spermatogenesis, gynecomastia, mood disturbances, aggressive behavior
Androgen abuse
Immediate synchronized direct current cardioversion is indicated when patients p/w
Tachyarrhythmia causing hemodynamic instability (hypotension, shock, AMS, pulmonary edema)
A patient with RA with a soft, tender mass in the popliteal fossa
Baker’s cyst (2/2 excessive fluid production by inflamed synovium)
The hallmark of frostbite treatment
Rapid rewarming in a warm water bath
Overdose: dry as a bone, blind as a bat, hot as a hare, full as a flask
Anti-cholinergic
Hypotension, pigmentation, hyponatremia, hyperkalemia, eosinophilia, high ACTH, and low corisol
Primary adrenal insufficiency
Most common cause of primary adrenal insufficiency in developed countries
Autoimmune adrenalitis
Lambert-Eaton Syndrome is 2/2
Auto-antibodies to presynaptic membrane voltage-gated Ca channels: diminished or absent deep-tendon reflexes
Dematomyositis is a paraneoplastic syndrome resulting from
Muscle fiber injury
Gottron papules, heliotrope rash
Dermatomyositis
All patients with CRF and HCT
Fe deficiency
Most common AE’s of EPO therapy
Worsening of hypertension, headache, flu-like, red cell aplasia
Leading cause of ESRD in US
DM: glomerular hyperperfusion/hypertrophy; GBM thickening; microalbuminuria–> nephropathy
Bence-Jones proteinuria
MM
________________ common in travelers in tropical regions, characterized by pruritic, serpiginous lesions on the skin; contact with sand
Cutaneous larva migrans
Lateral chest leads
I, avL
Anterior chest leads
V1-V4
Inferior chest leads
2, 3, avF
Strongest predictor of cardiac stent thrombosis within 12 months
Premature discontinuation of (dual) anti-platelet therpay
T/F Tylenol potentiates the anticoagulant effect of Warfarin
True
What is prothrombin complex concentrate?
Kcentra’ contains vitamin K dependent clotting factors (2, 7, 9, 10)
To reverse Coumadin immediately
Kcentra, FFP, (Vitamin K)
Urgent reversal of heparin
Protamine sulfate
Pulmonary infection PLUS impaired bacterial clearance (obstruction of airway, impairment of drainage, defect in immune response)
Bronchiectasis
Lower lobe emphysema is c/w
Alpha-1-antitrypsin deficiency
Periodic febrile paroxysms coupled with nonspecific malaise, headache, n/v, abdominal pain, HSM
Malaria (Plasmodium falciparum)
First line treatment for Alzheimer’s
Cholinesterase inhibitors (donepezil, galantamine, rivastigmine)
Side effect of high-dose niacin for severe hypertriglyceridemia; how do you prevent it?
Cutaneous flushing and intensive generalized pruritis 2/2 peripheral vasodilation. Can be prevented with ASA
What is doxazosin? Caution should be used in prescribing this with what other drug?
Alpha-blocker; caution in Rx with Viagra
First line treatment for Giardia
Flagyl
Valsalva, abrupt standing, and NG effect on HOCM murmur
Increase intensity 2/2 decreased preload
Two most common mutations in HOCM
Cardiac myosin binding protein C gene; cardiac beta-myosin heavy chain gene
AE Methotrexate
Purine antimetabolite; hepatotoxicity, stomatitis, cytopenias
AE Leflunomide
Pyridine synthesis inhibitor; hepatotoxicity, cytopenias
AE Hydroxychloroquine
TNF/IL-1; Retinopathy
AE TNF inhibitiors: Adalimumab, Etanercept, Infliximab
Anti-cytokine agents; Infection, demylination, CHF, malignancy
The conversion of homocysteine to methionine requires
B12/Folate
To differentiate between folate or B12 deficiency, order the blood level of this substance
MMA
Most common primary immune deficiency
IgA deficiency
Patients with IgA deficiency p/w these 2 types of infection
Sinopulmonary, GI (Giardia)
Syndrome: recurrent sinopulmonary infections, eczema, thrombocytopenia
Wiskott-Aldrich
Symptoms of theophylline toxicity
CNS stimulation (ha, insomnia, seizures), GI disturbances, arrhythmia
Beta vs. Alpha thal geography
Beta: Mediterranean
Alpha: SE Asia
HIV: White plaques in esophagus
Candida
HIV: Large linear ulcers in esophagus (intranuclear and intracytoplasmic)
CMV/Gancyclovir
HIV: Vesicles; round; ovoid ulcers
HSV/Acyclovir
Mild oral thrush in HIV can be empirically treated with
Fluconazole
Scrombroid p/w
Flushing, urticria
Listeria p/w
meningitis
Ciguateriap/w
Paresthesia
On flow cytometry, absence of CD55 and CD59
PNH; these proteins normally inhibit the activation of complement
Treatment of PNH
Fe, Folate; Eculizumab (Mab that inhibits complement activation)
Hemolysis, Cytopenia, Portal Vein Thrombosis
PNH
Third most common cause of acute pancreatitis
Hypertriglyceridemia
Three most common causes of AS
- Bicuspid
- Senile plaques
- Rheumatic
Most common valvular manifestation of rheumatic fever
MS
What type of diuretic can decrease the amount of Ca excreted in the urine?
Thiazide
In areas with chloroquine resistant malaria, which drugs are preferred for chemoppx?
Mefloquine, atovaquone-prograunil, doxy
Name the bug: Periorbital edema, myositis, eosinophilia (with GI complaints)
Trichinellosis
In PCP pneumonia, what is characteristically elevated in the blood?
LDH
Progressive and bilateral loss of central vision; peripheral fields maintained
Macular degeneraation
Gradual loss of peripheral vision over a period of years and consequent tunnel vision
Open angle glaucoma
Do cataracts recur?
No
Visual hallucinations and spontaneous Parkinsonism
Lewy body dementia
Most frequent location of ectopic foci that cause atrial fibrillation? Atrial flutter
Pulmonary veins
- Flutter: tricuspid annulus
How is a myasthenic crisis treated?
Intubation; plasmapheresis/IVIG and corticosteroids
Inherited disease causing recurrent renal stone formation; hard/radioopaque stones showing hexagonal crystals with + cyanide nitroprusside test
Cystinuria
Most common etiologies of cirrhosis
HBV/HCV, EtOH, NAFLD, Hemochromatosis
AI, PBC, PSC, A1AT, cardiac cirrhosis, MTX/INH, Wilson disease
How often should women 50-75 years old get mammograms?
q 2 years
Post-stroke sensory pain syndrome can be seen with strokes in this area of the brain
Thalamus (PCA)
Two possible agents for diabetic gastroparesis.
- Reglan
2. Erythromycin
Reglan AE
EPS // tardive dyskinesia
Acute unilateral painless loss of vision
Central retinal vein occlusion 2/2 thrombosis
Underlying pathophysiology behind G6PD leading to hemolysis
Oxidative stress
Most common valve effected in endocarditis
Mitral (MVP/MR)
IVDU’s have endocarditis of this valve
TCV
Preferred therapy for central DI
Desmopressin (Intranasal)
SIADH treatment
Demeclocycline
Preferred therapy for nephrogenic DI
HCTZ
Treatment of Toxoplasmosis
Sulfadiazine, pyrimethamine (plus leucovorin)
PPX Toxo
Bactrim
Multiple ring-enhancing lesions on MRI w/ CD4 count
Toxo
Treatment of neurocysticercosis
Albendazole
Treatment of cryptococal meningitis
Amphoteracin B, flucytosine
Treatment of MAC
Clarithromycin, ethambutol
Severe retinitis in AIDS patients (keratitis and conjunctivitis followed by rapidly progressive visual loss)
Herpes (HSV/VZV)
T/F CMV retinitis in AIDS patients is painless
True
What is coronary steal?
Dipyridamole is used during myocardial perfusion scanning to reveal areas of restricted myocardial perfusion. The redistribution is called steal b/c vessels distal to the obstruction are already maximally dilated
T/F Patients with cirrhosis are itnravascularly depleted and impressive salt retainers
True
AD disorder characterized by diffuse teleangiectasias, recurrent epistaxis and widespread AVM’s
Hereditary teleangiectasis (Osler-Weber-Rendu) - AVM's in the lungs can shunt blood from the right to left heart causing hypoxemia and reactive polycythemia
> 20 mm Hg variation in SBP arms
Acute aortic dissection
Hemi-neglect syndrome is caused by a stroke to which brain cortex?
Parietal
Succs is a depol/non-depol NM blocker
Depolarizing
Succs shouldn’t be used in which patients for RSI…
Hyperkalemia
Alpha-1 antagonist that relaxes ureteral muscle and decreases intra-ureteral pressure
Tamsulosin
Does PSGN have low C3?
Yes
Malignant necrotizing otitis externa in DM patients caused by… What is the treatment of choice?
Pseudomonas (Cipro = treatment of choice)
2 anti-cholinergics used for PD
Benztropine/Trihexyphenidyl
MAC PPX
Azirthromycin
Most common middle ear pathology in patients with AIDS
Serous otitis media
Demyelinating disease seen in AIDS patients
PML 2/2 JC virus
Sensory ataxia, lancinating pains, neurogenic incontinence, Argyll Robertson pupil
Tabes dorsalis
These types of testicular tumors secrete testosterone and are capable of estrogen production 2/2 markedly increased aromatase expression
Leydig
Patients with HOCM have this abnormality to the Mitral Valve
Abnormal mitral leaflet motion
Ascites
- Bloody
- Milky
- Turbid
- Straw
Bloody: trauma, malignancy
Milky: chylous, pancreatic
Turbid: infection
Straw: benign
What is SAAG?
Serum-to-ascites albumin gradient
Serum albumin minus peritoneal fluid albumin
(>1.1 = portal HTN)
Pneumonia w/ high fever, relative bradycardia, hyponatremia, hepatitis. Treatment?
- Legionella pneumonia
- ML/FQ
Management of cocaine-induced chest pain. Are beta-blockers indicated?
Benzo’s
- Beta-blockers contraindicated
Complications of acute diverticulitis
Abscess, obstruction, fistula, perforation
Risk factors for diverticular disease
Chronic constipation, high-fat diet
Watery diarrhea, c-scope shows dark brown discoloration of the colon with lymph follicles shining through as pale patches [melanosis coli]
Factitious diarrhea/laxitive abuse
History of gastrectomy and presence of glossitis is c/w
B12 deficiency
In _____, there is an accessory pathway (bundle of Kent) that directly connects the atria to the ventriclces bypassing the AV node.
WPW Syndrome
* Short PR, delta wave (slurred upstroke QRS), QRS widening
Empiric antibiotics for HAP/VAP
Gram positive, negative/pseudomonal, MRSA
Solid liver mass: a/w anomolous arteries; arterial flow and central scar on imaging
FNH
Solid liver mass: women on LTM OCP’s; possible hemorrhage or malignant transformation
Hepatic adenoma
Tumor marker for HCC
AFP
Most common malignancy of the liver
Mets from another primary
Where is Zn digested? What are the symptoms of its deficiency?
Jejunum; lopecia, abnormal taste, bullous lesions, impaired wound healing
Vitamin deficiency: blindness, dry skin, impaired immunity
Vitamin A
AE of PTU
Agranulocytosis, hepatic failure, ANCA-associated vasculitis
Ramsay Hunt syndrome
A form of herpes zoster that causes Bell’s palsy
MEN 1
Pituitary, parathyroid, pancreas
MEN 2A
MTC, pheo, parathyroid
MEN 2B
MTC, pheo, marfanoid
First two treatments for SIADH
Fluid restriction; Demeclocycline
Triad of fever, leukocytosis, LUQ pain
Splenic abscess (Staph, strep, Salmonella)
Methanol vs. Ethylene glycol ingestion
Methanol: Visual blurring
Ethylene glycol: Flank pain; Ca oxalate crystal
Treatment of choice Ethylene glycol poisoning
Fomepazole
Treatment for methemoglobinemia
Methylene blue
Antidote for CN poisoning
Sodium thiosulfate
Treatment for PMR
Low dose glucocorticoids
Toxic ingestion: optic disk hyperemia and high anion gap metabolic acidosis
Methanol
Tropical infection: high fever, severe polyarthralgia, headahe, rash, lymphopenia, thrombocytopenia
Chikungunya
High urobilinogen is indicative of C or UC bilirubin
UC
Positive urine bilirubin assay is indicative of C or UC bilirubin
C
Can TB cause pericarditis?
Yes
Most common cause of constrictive pericarditis in developing countries
TB
Common etiologies of contrictive pericarditis in the US
Viral, cardiac surgery, chest radiation
Osteoclast dysfunction is characteristic of what disease?
Paget disease
80% of all carcinoids are in what location…
Small intestine
Zollinger Ellison Syndrome
Gastrinoma, multiple gastric ulcers
Pancreatic cholera, watery diarhea, hypokalemia
VIPoma
Which class of antibiotics is a/w tendinopathy/tendon rupture?
FQ
Sudden loss of vision and onset of floaters in a patient with diabetic retinopathy
Vitreous hemorrhage
Upper, lower respiratory symptoms, renal GN, skin non-healing ulcers
Wegener’s granulomatosis with polyangiitis
* ANCA+
In HD stable patients with WPW and rapid Afib, the ideal treatment is…
Procainamide
What is the mutation in polycythemia vera?
JAK2
Mainstay treatment for polycythemia vera?
Phlebotomy
What IV medication is used for suspected variceal hemorrhage?
IV octreotide (Somatostatin analogues inhibit release of vasodilator hormes, which leads indirectly to splanchnic vasoconstriction and decreased portal flow)
What do these medications have in common? Beta-blockers, ACEi, ARB’s, K-sparing diuretics, digoxin, NSAIDS
Can cause hyperkalemia
Amebic liver abscess p/w RUQ pain and colitis. Treatment?
Enantomeba histolytica; Flagyl
Areflexic upper extremity weakness and dissociated sensory loss following a cape-like distribution
Syringomyelia
Rapidly progressive bilateral cellulitis of the submandibular and sublingual spaces
Ludwig angina
AE nitroprusside gtt. Treatment?
CN toxicity; sodium thiosulfate
What shortens the QRS interval in TCA overose?
Biacarb
Most significant environmental risk factor for pancreatic cancer
Cigarette smoking
T/F Serotonin syndrome has myoclonus and hyperreflexia
True
T/F Thyroid storm can be precipitated by iodinated contrast
True
Drug approved for ALS
Riluzole/Glutamate inhibitor
Post-cataract eye pain/decreased visual acuity, swollen eyelids, conjunctivaa
Post-operative endopthalmitis; vitreous infection
Chronic low back pain and limited chest expansion w/ elevated ESR
Ankylosing spondylitis
Normal or decreased DLCO: Chronic bronchitis, asthma
Normal
Normal or decreased DLCO: Sarcoid, Asbestosis, ILD
Decreased
Subacute onset of AMS and multifocal neurological deficits in a transplant recipient
PML
Examples of saline resistant metabolic alkalosis
Primary hyperaldosteronism, Cushing’s syndrome
Name the gait: Ataxic, staggering, wide-based gait
Cerebellar
Name the gait: Foot drop, excessive hip and knee flexion while walking, slapping quality, falls
Steppage (Motor neuropathy)
Name the gait: Unsteady/falling to one side
Acute labyrinthitis, Menieres disease
Can S4 be heard during AMI?
Yes
MOA Zofran
Serotonin receptor antagonist
Definition of neutropenia
ANC
Second line agents for nausea/vomiting after Zofran
Dopamine antagonists, i.e. Reglan; prochlorperazine
Type of neuropathy found in diabetics
Symmetrical distal polyneuropathy
Low Hgb, elevated retics, increased LDH, decreased haptoglobin
Intravascular hemolytic anemia
MEN2A+B are caused by a gain of function mutation involving which proto-oncogene on which chromosome?
RET/Ch 10
In suspecting acromegaly, the best first test to order is…
IGF-1 (GH can fluctuate throughout the day)
What is the confirmatory test in patients with elevated IGF-1?
75g oral glucose suppression test; will normally suppress GH to
Definition of acute liver failure
Severe liver injury without underlying liver disease; transaminitis, encephalopathy, synthetic dysfunction (INR > 1.5)
Most common cause of death in acute liver failure
Brain stem herniation 2/2 cerebral edema
In a cirrhotic patient, decreased glomerlar filtration in the absence of shock, proteinuria, or other cause of renal dysfunction and failure to respond to 1.5L NS bolus
Hepatorenal syndrome (Type 1 rapidly progressive, Type 2 3-6 months)
Most common causes of death from hepatorenal syndrome
Infeciton, hemorrhage
Aminoglycoside toxicity
Ototoxicity/Vestibulopathy
Most common cause of peptic ulcer in the developed world?
H. pylori
T/F Sialadenosis is commonly found in patients with advanced liver disease
T
Straight lines appear wavy in what ocular disorder?
Macular degeneration
Most common cause of back pain
Lumbrosacral strain
T/F Straight leg raise is usually positive in a herniated disk
True
Following an MI, sharp, pleuritic pain that is worse in the supine position and improved by siting up and leaning forward
Acute pericarditis
PEA and pericardial tamponade 3-7 days after an MI
Ventricular free wall rupture
New systolic murmur following an MI
Papillary muscle rupture
RV infarction following what type of MI
Inferior wall MI; p/w hypotension
Is phenytoin a teratogen?
Yes; causing fetal hydantoin syndrome (orofacial clefts, microcephaly, nail/digit hypoplasia, cardiac defects)
What AE for the fetus are a/w valproate?
NTD’s
A tea and toast diet is a/w deficiency…
Folate deficiency
Primary vs secondary adrenal insufficiency
Primary: glucocorticoid, mineralocorticoid, adrenal
Secondary: glucocorticoid and adrenal androgen (mineralocorticoid – RAA – not the pituitary)
SCC lung is a/w what paraneoplastic syndrome?
Hypercalcemia (2/2 PTHrP)
Small cell lung cancer is a/w which paraneoplastic syndromes?
ACTH/SIADH
P-ANCA is positive in which IBD?
UC
Anti-endomysial Ab
Celiac
Anti-TTG Ab
Celiac
Soap-bubble tumor of bone
Giant cell tumor (benign)
RLS treatment
Dopamind Ag (pramipexole)
INO in MS p/w
Dysconjugate horizontal gaze
Giving folate to a B12 deficient patient will correct the anemia, but…
Rapidly deteriorate neurological symptoms
T/F Hypercalcemia can occur in prolonged immobilization
True
Tenderness to gentle percussion over spinous processes
Vertebral osteo
Severe odynophagia without dysphagia or thrush
Viral esophagitis
Postural hypotension
> 20/10 decrease in SBP/DBP
Murmur that gets louder with squatting (PL) & handgrip (AL)
AR, MR, VSD
A dehydrated patient with hyponatremia and elevated urine sodium
Salt wasting, i.e diuretics, CSW, adrenal insufficiency
What lab value is increased in PCP pneumonia?
LDH
When are CS indicated in the treatment of PCP pneumonia?
PaO2 35
Definition of SPN
Rounded opacity
Large anterior mediastinal mass with elevated beta-HCG and AFP
Nonseminomatous germ cell tumor
Mode of inheritance: Wilson’s disease. Why neuro s/s?
AR; 2/2 copper deposition in the basal ganglia
Confirmation of Wilson’s disease
Low serum cerruloplasmin + increased urine copper + KF rings
PAS+, diastase-resistant liver biopsy
A1AT
Parkinsonism, Autonomic dysfunction (postural hypotension, abnormal sweating, bowel/bladder, abnormal salivation, impotence), Widespread neurological signs (cerebellar, pyramidal, LMN)
Shy-Drager Syndrome/MSA
Treatment for MSA
Fludrocortisone, salt supplementation, alpha-Ag, constrictive garments
3 medication classes that reduce mortality in CHF
Beta blockers, ACE inhibitors, Mineralocorticoid receptor antag
Low Ca and elevated PTH causes
Endo (Vitamin D deficiency, CKD), Inflammatory (Pancreatitis, sepsis), Oncology (tumor lysis)
Which kidney is easier to palpate, L or R
R: it lies lower than the L kidney
Multiple renal cysts, intermittent flank pain, hematuria, UTI, nephrolithiasis
ADPKD
Most common cause of macrocytic anemia in a patient with SCD
Folate deficiency
Severe anemia with reticulocytosis in SCD
Hyperhemolytic crisis
What type of glomerular nodules are pathognomonic for diabetic GN?
Kimmelstein-Wilson nodules
Bright red, firm, friable, exophytic nodules in an HIV+ patient
Bacillary angiomatosis
Most common cancer diagnosed in patients with asbestos exposure?
Bronchogenic carcinoma
US findings in acute cholecystitis
GBWT, pericholecystic fluid, sludge
In alcoholic hepatitis, how high are AST/ALT?
Anti-Jo Ab
Polymyositis
Triad: headache, focal neurological signs and fever. Bugs?
Brain abscess; S virians > Staph in ethmoid sinutitis
Cerebral infection in patients with poorly controlled DM
Rhizopus (Mucormycosis)
Can pulsus paradoxus be seen in severe asthma?
Yes
In HIV+ patient: pancytopenia, transaminitis, reticulonodule infliltrate, constitutional symptoms, HSM/LAD in Midwest USA
Disseminated histo
Treatment of disseminated histoplasmosis
Amphotericin B
Colon cancer screening recommendations
q annual FOBT; flex sig q 5 years with FOBT q3; C-scope 1 10 years
Colon cancer screening recommendations with cancer in a first-degree relative
Age 40 or 10 years before the age of the relative’s diagnosis
UMN or LMN: Fasiculations
LMN
Most common cause of spontaneous brain lobar hemorrhage in adults > 60 years old
Amyloid angiopathy
Most common cause of SVC syndrome?
Malignancy, i.e. lung ca (SCLC), NHL
H’s and T’s
Hypoxia, Hypovolemia, Hypoglycemia, Hyper/Hypokalemia, H acidosis
Tension PTX, Tamponade, Toxins (Narc/Benzo), Trauma, Tbx (PE, MI)
Initial management of gastric outlet obstruction
NGT, IVF, endoscopy
Succussion splash
diagnoses…
Gastric outlet obstruction
Primary LTM treatment for asthma vs. COPD
Asthma: ICS; COPD: Anti-cholinergics
Most common renal stones
Ca
Treatment of choice for trigeminal neuralgia? AE?
Carbamazepine; AE aplastic anemia
Electrical alternans with sinus tachy is pathognomic finding in…
Varying amplitudes of QRS complexes; seen in pericarditis
Reactive precancerous lesion that represents hyperplasia of oral squamous epithelium; risk of progression to SCC?
Leukoplakia (1-20% progress to cancer)
Is Clinda effective against gram negatives?
No
Drug of choice for dog bites.
Augmentin
When do you begin screening colonscopy in IBD? FAP? HNPCC?
8 years post-diagnosis (12-15 years if disease only in left colon); q 1-2 years; FAP-10-12 y.o.; HNPCC-20-25 y.o..
Most common presentation of a Pancoast tumor.
Shoulder pain
Definition for ARDS
Non-cardiogenic pulmonary edema, PaO2 to FiO2 ratio
Severe agitation, combativeness, psychosis, delerium, myoclonus for a prolonged duration of time
Bath salts
Multi-directional nystagmus toxic ingestion
PCP
Trousseau’s syndrome
Hypercoagulable disorder p/w unexplained superficial venous thrombosis. Mucin is released from the tumor cells, which react with platelets to form platelet-rich microthrombi
The hallmark of shock liver, or ischemic hepatic injury
Rapid and massive increase in the transaminases with modest accompanying elevations in TBili and ALP.
Chronic malabsorptive diarrhea, protein-losing enteropathy, weight loss, migratory non-deforming arthritis, LAD, low-grade fever. Classic histology?
Whipple’s disease; PAS+
Where are 80% of cardiac myxomas located?
Left atrium
2 major AE of INH
Peripheral neuropathy, hepatotoxicity
Timing to recognize B12 vs. Folate deficiency w/ dietary deficiency
B12: 4-5 years; Folate: 4-5 months
Syndrome with keratoconjunctivitis, xerostomia. What Ab?
Sjogren’s syndrome; Anti-SSA (Ro)/ SSB (La)
Most common cause of death in acromegaly
congestive heart failure
Bleeding stops spontaneously in what % of patients with MW tear?
90%
Pathogenesis of contrast-induced nephropathy
Renal vasoconstriction and tubular injury
Disseminated MAC is prophylaxed with…
Azithromycin
T/F There is an 18-fold increased risk of secondary cancers in patients initially treated for Hodgkin’s Lymphoma
True
Accumulation of alpha-synuclein within the neurons of the substantia nigra
Parkinson disease
Indications for CEA
Men: Asx 60+; Sx: 70+
Women: 70+
Causes of hemopytiss
Pulmonary, Cardiac, Infectious, Coagulopathy, PE/AVM, Coagulopathy, trauma, cocaine
What kind of scan detects carcinoid mets?
Octreotide
Order of incerased mets-to-the-brain cancers
Lung, breast, unknown, melanoma, colon (Solitary- breast, colon, RCC); multiple (lung, melanoma); rare (prostate, esophageal, oral, HCC, skin ca)
Warfarin induced skin necrosis
Decrease in Protein C to 50% within first day, while factors 2, 7, 9, 10 decline more slowly; increased risk for Warfarin-induced skin necrosis with underlying protein C deficiency
Majority of superficial erysipelas are caused by…
GAS
Triad of encephalopathy, ocular dysfunction, and gait ataxia
WE; treat with thiamine before gluocse
Most common extra-renal manifestation of ADPKD
Hepatic cysts; MVP/AR; diverticula; hernia
First serologic marker in acute hep B infection
HBsAg
Panendoscopy
Esophagoscopy, bronchoscopy, larngoscopy
T/F Optic glioma occurs with NF-1
T
T
T/F Panacinar = Lower Lobes in A1AT
T
Action tremor in the absence of additional neurological signs
Essential tremor
First line treatment of essential tremor
Propranolol
> 5, >10, >15 mm induration of PPD
> 5: HIV, contacts, IS
10: immigrants, IVDU, high-risk employees
15: healthy individuals
Treatment for latent TB
INH+Rifapentine q weekly for 3 months
INH monotherapy for 6-9 months
Rifampin for 4 months
INH+Rifampin for 4 months
Active TB requires treatment for 4 drugs for how many months?
2 months; combo therapy for 4 months
Infection of the lacrimal sac
Dacryocystitis
Abscess lovated over the upper or lower eyelid
Hordeolum
Abrupt onset fever, proptosis, restriction of EOMI and swollen, red eyelids
Orbital cellulitis
What color does Rifampin turn urine?
Red/Orange
HPV vaccine age recommendations for men vs. women
Men: 11-21
Women: 9-26
Leuk esterase vs. Nitrates
LE: pyuria
Nitrates: Enterobacteria (convertes urinary nitrates to nitrites)
T/F A negative dipstick in a patient with symptoms of UTI should have urine cultures
T
Microcytic hypochromic anemia simulating iron-deficiency anemia
Acquired sideroblastic anemia (2/2 pyrodixine-B6/INH)
Weight gain, fatigue, constipation, hoarseness, memory changes
Hypothyroidism
When can you push TPA?
Within 3.5-4 hours of onset of stroke
Chronic phenytoin therapy can cause
Megaloblastic anemia
Which 3 drugs can cause megaloblastic anemia?
Bactrim, MTX, Phenytoin
INH can deplete…
Vitamin B6
Caudia equina syndrome is 2/2 compression of…
Spinal nerve roots
Cauda equina vs. Conus medularis syndromes
CE: LMN; asymmetric
CM: Upper and lower motor neuron; symmetric
Pseduoappendictis bug
Campylobacter
Stroke: Unilateral motor impairment, no sensory/cortical deficits, no visual field abnormalities
Posterior limb of IC (lacunar)
Contralateral somatosensory; motor deficit (face, arm, leg), conjugate eye deviation toward side of infarct, aphasia/hemineglect
MCA stroke
Contralateral somatosensory and motor; predominantly in lower extremity
ACA stroke
Alternate syndromes with contralateral hemiplegia and ipsilateral CN involvement, ataxia
Vertebrobasilar system
GI, neuro symptoms (neuropathy/psych) + anemia with basophilic stippling on peripheral smear
Lead poisoning
Most common cause of PTH-independent hypercalcemia
Humoral hypercalcemia of malignancy
Tumor lysis syndrome electrolyte abnormalities
Hpocalcemia, Hyperphosphatemia, Hyperuricema, Hyperkalemia (Phosphate binds Ca)
Treatment of CO poisoning
100% oxygen
Alternative to IM penicillin for syphillis
Doxy x 14 days (unless pgx, CNS)
In a patient with a DVT 2/2 homocystinuria, what vitamin should be administered in addition to AC?
Vitamin B6
T/F Atropine should be avoided in acute glaucoma
True (Use mannitol, Diamox, Pilocarpine, Timolol)
T/F MS can p/w bilateral trigeminal neuralgia
T
Erythema nodosum is a/w
Sarcoid, TB, IBD
Anti-dote to Beta-blocker overdose? Refractory cases?
Atropine followed by Glucagon
Negatively birefringent
Yellow when parallel to polarizing axis, and blue when lying perpendicular
T/F Patients with large anterior STEMI are at highest risk of LV thrombus and anteroapical aneurysm formation
T
T/F Folate deficiency is the most common cause of megaloblastic anemia is alcoholics
T
Bouchard and Heberden nodes are a/w
a/w OA
Systolic hypertension in thyrotoxicosis is 2/2
Hyperdynamic circulation resulting from increased myocardial contractility and HR
Acute renal failure and malignant hypertension in a patient with systemic sclerosis…
Cutaneous systemic sclerosis
Two primary manifestations of Chagas disease
Megacolon/megaesophagus; cardiac disease
Antidote to organophosphate poisonoing
Atropine; Achesterase is non-functional
Straight leg raise tests positive for
Sciatica
MOA: Cyclosporine. AE?
IL-2 inhibitor; nephrotoxicity, HTN, neurotoxicity, glucose intolerance, infection, malignancy, gingival hypertrophy
Major AE MMF
Bone marrow suppression
Major AE Azathioprine
Diarrhea, leukopenia, hepatotoxicity
Decreased ADAMSTS13 activity
TTP; large vWF multimers and resulting in diffiuce thrombi
TTP pentad
TBOpenia, Microangiopathic hemolytic anemia, renal insufficiency, fever, neuro s/s
Approved for the treatment and PPX of amyloidosis
Colchicine
T/F Fluphenazine is a typical anti-psychotic that can cause hypothermia by inhibiting the body’s shivering mechanism
True
EtoH withdrawal peaks during what day?
Second day following cessation
T/F Radioactive I ablation can worsen opthalmopathy
True
T/F Spinal stenosis is better with spine flexion
True
T/F Thiazide diuretics can lead to glucose intolerance
True
The d-xylose test is for…
Celiac disease/proximal small intestinal mucosal disease and cannot absorb D-xylose.
T/F PBC is a/w cholestasis, hepatomegaly, severe hyperlipidemia
True
Feared complication of temporal arteritis
Aortic aneurysm
Arrhythmia most specific for digitalis toxicity
Atrial tachycardia w/ AV block
Common causes of restrictive cardiomyopathy
Sarcoid, amyloid, hemochromatotis, fibrosis, idiopathic
Etiology of diabetic oculomotor neuropathy
Ischemic
Treatment of Legionella pneumonia
Levaquin
MMSE score lower than this number is indicative of dementia
24
Neuroimaging demonstrating atrophy which is more prominent in the temporal and parietal lobes
Alzhemiers
Ulcers in this area are indicative of ZES
Jejunum
What is triple therapy treatment for H. pylori?
Amoxicillin, clarithromycin, PPI
Dense intramembranous deposits that stain for C3 is a characteristic microscopic finding for…
MPGN (Persisent activation of alternative complement)
Atrophy of the caudate is a/w
Huntington’s disease
Antibiotic class of Amikacin
Aminoglycoside
3 major mechanical complications of MI
Papillary muscle rupture: Soft systolic
LV free wall rupture: Tamponade
IV septum rupture: pansystolic
Life threatening complication of metformin
Lactic acidosis
AE TZD’s
CHF
Best diabetic drug for weight loss
Exenatide, GLP-1 receptor agonist
AE Amantadine
Livedo reticularis
To treat the psychomotor agitation a/w PCP ingestion
Benzos
To differentiate CML from leukemoid reaction
LAP; basophilia
Auer rods
AML
Most common extraskeletal manifestation of AS
Episcleritis
Extrahepatic manifestations of HCV
Essential mixed cryoglobulinemia, MPGN, PCT, DM
A disorder of the inner ear characterized by increased volume and pressure of endolymph
Meniere disease
Does MG improve with ice pack?
Yes
Order of use of anti-HTN agents in acute dissection
Beta-blocker followed by nitroprusside
Anterior Mediastinum mass
Middle Mediastinum mass
Posterior Mediastinum mass
A: Thymoma, retrosternal thyroid, teratoma, lymphoma
M: Bronchogenic cyst, tracheal tumor, pericaridal cyst, LN, aneurysm
P: Neurogenic tumors, hernias
Drug of choice in PBC
Ursodeoxycholic acid
Hypok/Hyperkalemia potentiates the AE of digoxin
Hypokalemia
Most common type of radioopaque stone
Ca oxalate
PBC patients at risk of developing
Osteomalacia
Vertigo, nystagmus, loss pain/temp ipsilateral face/contralateral limb, hoarseness, Horner’s syndrome
Lateral medullary syndrome
Tongue deviation toward side of lesion and contralateral paralysis
Medial medullary
Severe sore throat with odynophagia, drooling and airway obstruction
Epilogttis (H. flu/GAS)
Actinomyces vs. Nocardia
A: G+, Anerobic – PCN
N: G+, AF – Bactrim
Cyclophosphamide is a/w … Prevent with
Hemorrhagic cystitis (Take MESNA)
Anti-RNP, anti-Jo-1, anti-Mi2
Dermatomyositis
In otherwise healthy patients who develop CHF, what should be considered high on the differential?
Viral myocarditis
Activated protein C resistance
Factor 5 Leiden
HIV PPX therapy with low CD4
Bactrim (PCP, Toxo), Azithro (MAC
Polyp a/w most pre-malignant condition
Villous adenoma
Multiple demyelinating, non-enhancing lesions with no mass effect in HIV+
PML/JC
Condition affecting new mothers who hold their infants with thumb outstretched
De Quervain tenosynovitis
3 major liver functions
Synthetic, metabolic, excreatory
Most common pathogen causing PNA in nursing home patients
S. pna
High pH on UA is concerning for infection with what bug?
Proteus
Can pseudotumor cerebri be caused by isotretinoin?
Yes
Palpable purpura, proteinuria, hematuria in HCV+
Mixed cryoglobulinemia
Treatment of Paget disease
Bisphosphonates
Very low MCV is seen in which microcytic anemia?
Thalassemia
Measles vs. Mumps
Measles: higher fever, no arthritis
Mumps: w/in 24 hours cranial-caudal spread
6 P’s
Pain, pallor, pulselessness, paresthesia, paralysis, pokilothermia
Pathogenesis Zenker diverticulum
Sphincter dysfunction and esophageal dysmotility
Which bug causes bacillary angiomatosis?
Bartonella henselae/quintana
T/F Positive H+ ion breath test in lactose intolerance
T
Untreated hyperthyroid patients at high risk for…
Bone disease
