UWORLD NOTES Flashcards
Anterior mediastinal mass ddx
thymoma
teratoma
thyroid
terrible lymphoma
Ovarian mass:
- solid with thick septae
- solid
- calicifcations
- ground glass/internal echo
- solid with septae: malignancy
- solid: luteoma/krukenburg
- calcifications: teratoma
- ground glass: endometrioma
What rules out retained placenta
thin endometrial stripe
Damage caused by clavicular fracture
- subclavian artery
- brachial plexus
PSC findings on ERCP
bile duct fibrosis with “onion skinning”
Primary amenorrhea first step in dx
pelvic us
if there is a uterus –> check FSH
no uterus –> check karyotype
Cause of absent uterus with 46XX vs 46CY karyotype
46XX mullerian agenesis
46XY AIS
Breast feeding decreases which cancer risks
breast
ovarian
Causes of hyperandrogrenism in pregnancy
luteoma/theca lutein cyst
Splenectomy med treatment
vax weeks before when possible
penicillin px for 3-5 years
Tumor lysis labs
high uric acid
high K+
high PO4
low Ca
Treatment and risks assc with TLS
IVF, allopurinol
arrhythmia/renal failure
Lights criteria for exudative effusion
+cause
pleural/serum protein ratio more than 0.5; LDH ratio more than 0.6 or LDH greater than 2/3 ULN
cause is increased permeability
Transudative effusion cause
increased hydrostatic pressure or decreased oncotic pressure
Labs assc with hemolytic anemia
high indirect billi, high LDH, low haptoglobin (binds Hgb)
Three causes of low albumin
cirrhosis
nephrosis
protein wasting enteropathy
Pain + fever +hematuria esp when pt has membranous glomerulonephrosis=
renal vein thrombosis
Location of pain in:
IT band syndrome
patellofemoral syndrome
pes anserinus
IT band syndrome: lateral femoral condyle
patellofemoral syndrome: anterior knee
pes anserinus: opposite ITB (medial condyle)
CMV vs HSV retinitis
CMV- fluffy granular painless lesions
HSV- central retinal necrosis, painful
Both assc with AIDS
Normal ABG in pregnancy
respiratory alkalosis
high TV/MV/ PaO2
Cause of hepatorenal syndrome
splanchnic arterial dilation
low GFR with no other clear cause
Porphyria cutanea cause
low uroporphyrinogen decarboxylase = high prophyrins
Treatment PCT
phlebotomy and hydroxychloroquine
RAI needs to be combined with?
steroids or antithyroid meds to treat ophtalmopathy
Thyrotoxicosis effect on circulation
hyperdynamic state; increased contractility and HR
Obstructive lung disease cut off
FEV1/FVC under 0.7
MOS of nitroglycerin
systemic vasodilation –> decreased LV stress –> decreased MVO2
Liver abscess three types/ management
- elederly/chronic med- bacterial must drain and give abx
- asx/ animal contact- echinococcus must drain and give albendazle (calcified, daughter cysts)
- sick/ endemic area- entamoeba = metronidazole no draining!
Strep viridans species
MMMOSS mutans milleri mitis oralis sobrinus sanguinis
PCD vs CF cause of infertility
PCD immobile sperm
CF absent vas
Four causes thyroiditis +
which has +TPO
also: which is the only thyroid disease with increased RAIU?
painless/silent ++TPO (hyperthyroid state)
hashimoto ++TPO
subacute
graves- high RAIU
Soft S2 cause
severe aortic stenosis
Post op/partum fever not responsive to abx:
cause + treatment
septic thrombophlebitis
anticoag and broad spectrum abx
Two bone diseases that have normal Ca/PO4/PTH
pagets
osteoporosis
Management of placenta previa
pelvic rest (no sex or exams) CS at 36-37 weeks
MCC nephrotic syndrome in adults
FSGS
Clue to reactive arthritis vs gonococcal arthritis
reactive- enthesitis (gets nsaids while gonorrhea gets abx)
Polycythemia vera:
labs
treatment risk
all cell lines increased, JAK2 mutation
phlebotomy, hydroxyurea
clots and myelofibrosis
Two MCC prosthetic joint infections
early: aureus, acute pain and fever
late (3+ months): epi, indolent onset
Two smoke toxins
HCN and CO
Treatment for HCN tox (3)
hydroxycobalamin
thiosulfate
nitrates (FE3+ binds HCN)
PE finding that distinguishes hemothorax and PTX
hyperressonance seen with PTX
What distinguishes AIHA from SCA
look at the spleen
spleen large in AIHA, gone in SCA
When to give PEP after rabies
cant quarantine pet
high risk wild animal
Pernicious anemia risk
gastric cx
When is D-dimer an appropriate test?
less than 2 risks per wells criteria
phenytoin tox signs
ataxia
nystagmus
Polymyositis dx
biopsy first patchy necrosis
also have + ANA/Jo
treatment is steroids
PMR vs polymyositis
PMR is STIFFNESS and acute
Poly is weakness and indolent
Paradoxical chest wall motion after MVC =
flail chest
Sporotrix:
-bug type
-exposure
treatment
dimorphic fungus
decaying vegetation
3-6 months intraconazole
Menieres triad and cause
hearing loss
tinnitus
dizziness
increased endolymph pressure (poor absorption)
Joint mass with chalky white appearance
tophaceous hout
Delirium must have
fluctuating consciousness
Thyroid changes in pregnancy
total T4 &TBG which = normal free T4
low TSH
Contraindications to vaginal delivery
previa
prior classical CS
prior myomectomy
Reflex that is diminished with age
Achilles
Weight required for Hep B vaccine
2 kg/ 4.6 lbs
B2 agonists end in ?
erol
Arthrocentesis white count in:
OA
Septic
OA should be under 2k
Septic should be over 50k
Equilibrated cardiac pressures- clue for
tamponade
Vision changes + thickened eyelids=
atopic keratoconjunctivitis
Bacterial ocular discharge clue
comes back after cleaning off
MCC liver mets
GI lung breast
Treatment for Pagets
Bisphos and Ca/D
ESRD patient anticoagulation
just hep –> warf nothing fancy kidneys cant deal.
Supracondylar fracture assc injury
brachial artery/ median nerve
rarely compartment/volkman
Shingles trick
may have skin pain before shingles
Hemophilia A vs B + UA findings
both XR
A is factor 8
B is 9
hematuria with normal renal function
Which is screened for in all preggos: G or C
C, gonorrhea only under 25 or high risk
Constellation for Granulomatosis with Polyangitis
Assc ab
URI + LRTI + renal disease + skin findings
ANCA +
Staph vs TB cavitary lesion
staph is acute TB is indolent
MCC duodenal ulcer
almost always HPylori
What type of bias:
treatment regimen based on disease severity
selection bias (susceptibility)
Lab changes with PRBCs
citrate –> low calcium and mag
Cause of zenkers
dysmotility
Air in chest that is not improved with tube placement is
bronchial rupture
For every 1 decrease in albumin Ca changes by
down 0.8
Advanced ovarian mass next step
straight to lap
- high gluc
- skin pigment
- LFTs high
is….
hemochromatosis (risk KCC)
Meds for enuresis
1st line: desmopressin
2nd line: TCA
Turners risk and treatment
osteoporosis
HRT
Clue to angiodysplasia
- missed on colonoscopy
- painless bleeding and normocytic anemia
- assc with CKD/AS/VWD
Treatment of acalculous chole
abx and perc cholecystostomy
First step in dx’ing cushings
dexa supression
Hemolysis AND thrombosis =
PNH
Clue to bacillary angiomatosis vs kaposcis
bacillary= systemic signs like fever
When to give progesterone for short cervix
if detected earlier than 24 wks GA
Enthesitis is seen in?
reactive arthritis
ank spon
What stress fracture requires treatment
5th metatarsal needs ORIF/casting
SIDs 3 risks
stomach sleeping
smoking
pacifier
Acute hep B is assc with what renal disease
membranous
Gross painless lower GI bleed
diverticulosis
RA treatment
start DMARDs (MTX) as soon as possible regardless of pain level
Ogilvies clue:
treatment:
distended colon on imaging
rectal tube
Presentation vs position in childbirth
presentation: butt vs head
position: part in relation to the pelvis
malposition = mcc second stage labor arrest
Signs of breast feeding failure jaundice
brick red crystals in diaper
dehydration
too many gaps between feeds
Treatment for BCC on face
Mohs
Nontender large salivary glands in alcoholic
sialadenosis
abnormal innervation
Cause of warfarin induced skin necrosis
protein C deficiency
MCC CAP in HIV pt
SP
Adjustment disorder time limit and treatment
3 months
therapy
How to dx ank spon
xray showing sacroilitis
NG tube in pulm cavity =
diaphragmatic rupture
Pseudogout + liver disease +DM =
hemochromatosis
Pt found unconscious and has hemiparalysis think…
Todds paralysis (post epileptic)
High risk pulm nodule size?
intermediate?
low?
2 cm+ high
0.8-2 med
less than 0.8 low risk
Ataxia
Nystagmus
Hammer Toes
Cardiomyopathy
What is THIS?
Freidreichs ataxia
Rash that looks like an oil spill
erythema marginatum of RF
Type of rash assc with serum sickness
urticarial
Intravascular cath MC infection
coag - staph
MC COD in PAD
MI
Fanconis vs Diamond Blackfan labs
Fanconis is aplastic
Diamond is pure red/macro (triphalangeal thumbs)
MCC neonatal sepsis
GBS
Lithium labs to monitor
LFTs
thyroid
Ca
level
Contraindications to vaginal labor are also contraindications to _____
contraction stress test
Cyanosis after topical anesthetic use is
methemoglobinemia
Tet squatting effect
LOUDER murmur but improved CYANOSIS
Components of BPP
NST (2+ accels) AFI (2x1 cm) Movement (3+) Tone (1 flexion/extension) Breathing (1+ breathing episode)
Long QT treatment
BBer
Pacer
MC bug in acute parotitis following surgery
staph
prevent with hydration/hygiene
Peak Pressure = ____ + _____
plateau + airway resistance
Plateau pressure = ____ + ___
PEEP + elastic pressure
Elastic pressure = _____/ ____
TV/ compliance
Increase in peak pressure without a change in plateau pressure means
airway obstruction (mucus plug, biting tube, bronchospasm)
Cause of increasd plateau pressure
PTX/pulm edema/PNA/atelectasis/right sided intubation
Bilious emesis + small colon? big colon?
small colon- meconium ileus
big colon- toxic megacolon
Characterize hypercalemia assc with HCTZ
MILD, like 12 or less
How does viral illness lead to intussusception?
peyers patch hypertrophy
What determines severity of CHF
degree of hyponatremia
All pregnant patients should be screened for which STDs?
Chlamyida
Hep B
HIV
Syphillis
MC kidney stone type
calcium oxalate
Stone type assc with RTA & hyperparathyroidism
CaPO4
MC risk assc with prolonged pregnancy
oligo
Migratory superficial thrombophlebitis next step
CT to look for visceral malignancy
Central precocious puberty –> next step
bone age
normal: reassure
increased: MRI to r/o mass –> GNrH agonist
Two LSD with cherry red macula
Neiman Pick and Tay Sachs
How to distinguish neiman pick and tay sachs
neiman: HSM and arreflexia
tay sachs: normal spleen and reflexes
Krabbes disease typical finding + enzyme
vague… regression of milestones but no HSM, no cherry red macula
a galactosidase
Gauchers disease enzyme + findings
glucocerebrosidase
anemia/low platelets and HSM
Ovarian torsion must have
ovarian mass
Treatment for homocysteine elevation
B6/folate
MCC nonreactive NST
sleeping
Gilberts enzyme def
UDP glucuronosyltransferase
Palpable purpura in adult + renal disease =
cryoglobulinemia –> HCV
Fatigue + proximal muscle WEAKNESS + ^^CK =
thyroid myopathy (can be hypo or hyper)
What three yeasts present with skin and lung findings and how to tell these apart?
blasto- central US
histo- MS/Oh River valleys
coccidio- southwest us
What type of bug is aspergillus
mold
Costochondral joint enlargement=
rickets
myositis
periorbital edema
eosinophilia =
trichinellosis
Vision loss in mac degen (describe)
central vision gone
straight lines look wavy
Bilious emesis first step in evaluation after stabilizing
AXR
double bubble
dilated loops do contrast enema (MI, hirschsprungs)NG tube in duodenum = malrotation
Clubbing + sudden onset arthropathy
hypertrophic osteoarthropathy
Three clues to sickle trait
renal pap necrosis
splenic infarct
exertional rhabdo
Scrotal mass that is worse with standing
varicocele
What type of hernia is felt in the scrotum?
inguinal
Trauma –> delayed heart failure cause?
AVF
At what hgb are patients with GIBs transfused?
7 or less
SCA sudden drop in hgb and retics =
aplastic crisis
Splenic sequestration will not have low retics
Swelling at floor of mouth and submandibular area =
Ludwig angina
dental infection
MTX mc ADR
oral ulcers
Chorio must get what meds in addition to abx
Pitocin to speed up labor even if already in labor.
Appendicits longer than 5 ays is likely
abscess
Treatment of neonatal gonococcal conjunctivitis? chlamydial?
IM ceftriaxone- G
oral macrolide- C
Penile fracture is rupture of what structure?
Whats the first step?
corpus cavernosum
do retrograde urethrogram –> surgery
Histoplasma treatment
mild- itraconazole
widespread- amphotericin
Central cord syndrome is what deficit types
classic: pain and temp
but can also apparently be weakness
fluctuance is basically another word for
abscess
AVF (cranial) sx in the elderly is
amyloid
Carcinoid tumors cause what deficiency
niacin
whistling following rhinoplasty is
septal perforation
Postpartum bleeding + pulmonary infiltrates is?
chorio
Cholecystitis with stone at duct needs ____
cholecystitis without obstruction needs ____
biliary colic needs _____
with stone- ERCP
without- chole within 72 hours
colic- elective chole
Child with unilateral lymphadenitis has
staph aureus
Elderly man with irritative voiding –PSA – infxn:
ddx
chronic prostatitis- back pain
BPH- no back pain
Unstable aortic dissection gets
TEE
Acute agitation in dementia treatment
antipsychotics
Normal T4/TSH but change in T3 is
euthyroid sick syndrome
Lymphatic obstruction should have
thick/rigid skin
Amio ADRs
-ocular blue skin neuropathy pulm fibrosis thyroid hyper or hypo brady or QT long liver disease
(all organ systems)
1st line treatment for HE
lactulose
MCC orbital cellulitis
bacterial sinusitis
Recurrent hemarthrosis leads to
hemosiderin deposition/fibrosis/chronic pain
Microcytic anemia + GI sx + neuropsych sx + uric acid =
lead tox
Recurrent diffuse molluscum test for
HIV
Clotting in lupus is caused by
APL sx
Strongest stroke risk is
HTN
CDH first steps
intubate + gastric tube
Papullary thyroid cancer spread? Follicular?
Papillary is lymph
Follicular is blood
Amenorrhea in athletes stems from
hypothalamus
GnRH low
MC ADR assc with SERMS
hot flashes
How to treat uric acid stones
alkalinize urine with Pot citrate
Liver cyst + calcification + dogs =? treatment?
echinococcus
surg + albendazole
Capillary lead test is positive next step
confirm with venous & treat at 50+
Compensation in met acidosis?
Co2= 1.5(bicarb) + 8 +/-2
Compensation in met alk
1 bicarb = 0.7 Co2
Resp acid compensation
10 CO2 = 1 bicarb
Resp alkalosis compensation
10 CO2 = 2 bicarb
alkalosis compensation stronger
Which anti diabetic causes weight loss? weight gain?
weight loss- GLP1 (glutide)
gain- sulfonylurea, TZDs
Treatment of malignant otitis
IV Cipro
Treament of asx endometriosis
don’t
Attributable risk formula
RR-1/RR
Painless bloody stool, eczema, regurg=
milk protein enterocolitis
Neonatal dx:
respiratory distress
low glucose
high Hct
polycythemia vera
assc with delayed clamping and hypoxia
Inspiratory stridor that is worse when supine:
laryngomalacia
(collapse of supraglottic structure)
*self resolves
Solitary painful bone lesion with high Ca assume
malignancy
Always treat AOM under what age?
2
Cause of sudden death right after intubation
drop in rvp
succinylcholine MC ADR
K+ high –> arrhythmia
Halothane MC ADR
hepatotoxicity
Etomidate MC ADR
inhibits 11B hydroxylase (adrenal insufficiency)
NO MC ADR
inhibits B12 and methionine synthase –> neurotoxic
Growth at 12 months should be?
weight x3 and height up 50%
No fetal heart tones next step
must confirm with transabdominal US
Appropraite workup for IUFD
autopsy
karyotype
placental eval
maternal clotting eval
Treatment of LOCALZIED lyme in pregnancy
amoxicillin
Two year old appropriate speech
50+ words
two word phrases
Valgus stress tests
MCL
How does ZES lead to diarrhea?
acid inactivates lipase
Lynch cancers
colon
endometrial
ovary
FAP cancers
colon
brain
soft tissue
VHL cancers
clear cell renal
hemangioblastoma
pheos
MEN2A cancers
pheo
para
medullary
MEN2B masses
medullary
pheo
marfan habitus
neurofibromas
Lynch px screening
annual endometrial bx or hysterectomy
Papillary cancer cells + treatment
orphan annie, surg –> RAI
Reyes histo
microvesicular fatty infiltration
Toxo methods of acquiring
cat shit
undercooked meat
Only measure that is increased in hypovolemic shock
SVR
Prader willi is loss of ______ 15q11-q13
paternal
Mongolian spots what to do
not shit. they’ll go away. leave that shit alone. let the little babies eat their rice.
Acute rejection treatment
steroids.
Lacunar stroke:
presentation
cause
histo
pure motor
lipohyalinosis
HTN
When to give rhogam
28 wks
exposure to fetal blood
Treatment of postpartum psychosis
hospital
antipsychotics
Hydrocele in neonate management
surg at 1 year but usually resolves
Clue to AD complications
clear lungs: tamponade
crackles: AR
How to distinguish tinea from vitiligo
tinea: chest, back, some color
vitiligo: face/distal, complete loss of color
Inferior MI means patient may also have ____
RVI
95% = within \_\_\_\_SDs 99.7= within \_\_\_\_\_\_SDs 68% = within \_\_\_\_\_ SDs
95-2
99-3
68-1
Dig arrhythmia
atrial tach with AV block
Baldness + skin findings = _____ Deficiency
zinc
Skin depigmentation
sideroblastic anemia
= _____ Deficiency
Cu
If you need to workup any pulm nodule you need to start with ___
CT
Loss to follow up is what bias type?
attrition –> selection
Reporting bias description
patient doesn’t report exposure due to fear of stigma
Normal liver span?
less than 12
McCune Albright constellation + cause
puberty early
pigmentation
polyostotic fibrous dysplasia
cAMP kinase g protein defect
PCOS infertility cause
failed follicular maturation
SCID infection types
viral + fungal + bacterial
RUL lesion? RLL lesion?
UL- TB
LL-Aspiration
LDL needs to be increased to start statin: T or F?
F
just need risk factors
MC complication Ank Spon
anterior uveitis
RA eye complication
episcleritis
Urine pH higher than 8 = what infections
klebsiella
proteus
Which trisomy is associated with midline defects? give some examples?
13
holoprosencephaly
omphalocele
cutis aplasia
GFR, BUN, Cr, urine protein in pregnancy
low BUN/Cr
high GFR
high urine protein
Hgb, plts, fibrinogen, protein C in pregnancy
low hgb, plts, protein C
high fibrinogen
Contrast intellectualization and rationalization
intellectualization: turning something hard into just an intellectual puzzle
rationalization: making excuses for bad behavior
Cause of RUQ pain in HELLP
distention of glissons capsule
MCC SCD post infarction
re-reentrant vtach arrhythmia
MCC hypercoag with NORMAL labs
factor V leidein (protein C resistance)
Lab abnormality in APL
^PTT
Antithrombin deficiency causes
DIC, cirrhosis, nephrosis
MCC nepgrosis in hodgkins
minimal change
Mechanism of vagal maneuvers to stop PSVT/ANRT
increased parasympathetic tone, stops AV node
When and how to work up first UTI in peds
if under age of two, or recurrent
do first RUS –> VCUG
Post MI acute limb ischemia: check for?
LV thrombus (do echo)
How to treat post ictal lactic acidosis
don’t, itll go away on its own soon
Fall with object in mouth -
traumatic carotid injury
SCA hip issue
avascular necrosis
Mom holding baby gets what hand/wrist issue?
de quervains tendonitis
pain at side of wrist
Turners karyotype
45 XO
Klinefelters karyotype
47 XXY
Myelodysplastic syndrome labs
pancytopenia
How to distinguish adenomyosis from endometriosis
adeno should = tender UTERUS and HMB
Botulism clinical presentation + tx
descending paralysis (opposite GBS)
bilateral cranial neuropathies
equine antitoxin
NNT equation
1/ARR
When to workup delayed menarche
14 with no characteristics
16 if has secondary sex characteristics
How to deal with acute pulm hemorrhage
bleeding lung down and bronch
Meningitis management
focal deficits need CT otherwise:
LP –> abx
Targets for gestational DM
keep postprandial under 140
keep fasting under 95
Causes of ascending aortic aneurysm? descending?
dissection?
ascending- CMN/CT disorder
descending- atherosclerosis
dissection- HTN
Eye thing in rubella? toxo?
rubella- cataracts
toxo- chorioretinitis
FOOSH risk for?
rotator cuff tear
Pulsus bisiferens causes
AR PDA HOCM
Expressive aphasia lesion
Brocas, frontal
How to treat pulm HTN
idiopathic- endothelin, PDEi, prostanoids
2/2 LV dysfxn- loop or ace
Assymetric corneal light reflex =
strabismus patch the normal eye
Uterine inversion first step
manual replacement
Systemic sclerosis abs
scl/ topoisomerase
RA ab
anti citrullinated peptide
Retropharyngeal abscess is a risk for
acute necrotizing mediastinitis
Valproate must monitor
LFTs and platelets
Poor kidney function prevents use of what mood stabilizer
Depakote
Prevent worsening diabetic nephropathy by decreasing _____
BP
Sensitivity and Specificity equations
Sensitivity: TP/ TP+ FN
Specificity: TN/ TN+ FP
Crepitus between 3rd and 4th toes is
mortons neuroma (conservative treatment)
Treatment of Dresslers
NSAIDs
Buproprion helps with? Buspirone?
Buproprion- smoking
Buspirone- anxiety
HTN increases risk of?
Preterm labor but not PPROM
Menopausul GU constellation + treatment
stress and urge incontinence
recurrent UTIs
vaginal estrogen
Bacterial meningitis + immunocompromised =
vac, amp, cefepime
Treatment of penetrating trauma to the skull
vanc and meropenem
Swllowed battery when to intervene
in esophagus gotta get out
HTN & bilateral palpable kidneys =
ADPKD
Rapidly fatal neuro disease with brain scarring and atrophy
SSPE
Multiple nonenhancing lesions on brain =
PML
Posterior arm dislocation position
internal rotation
Origin of afib location
pulmonary veins
Origin of aflutter
tricuspid annulus
Goal of O2 in advanced COPD
90-93%
Intracerebral hemorrhage + patient on Coumadin what to do?
Prothrombin complex & K
Persistent productive cough
linear atelectasis
blood tinged sputum
dx
bronchiectasis
Herpangina (coxsackie) vs Herpetic Gingivostomatitis
Herp (cox)= posterior, gray
HSV- anterior, clusters, on gingiva
Dx & tx of lichen sclerosis
bx of vulva
treat with steroids
NF1 is chromosome ___ and called _____.
17; von Recklinghausen
NF2 is chromosome ____ and has bilateral ______ and ______ on skin.
22; bilateral acoustic neuromas; café au lait
Tuberous Sclerosis tumors + skin findings
cardiac/renal tumors; seizures; ash leaf spots
face and arm swelling = _______ caused by ____ or ____.
SVC syndrome caused by NHL or small cell cancers most commonly
GVHD cells implicated
donor T cells
Bullous impetigo =
staph aureus
Nocardia! That _____ ____ _____ needs to get ____!
acid fast aerobe needs to get BACK(trim)
Finger movement and rhomberg test ______.
Pronator drift is a sign of ______.
Finger/rhombeg- proprioception
pronator drift- pyramidal tract disease
Middle mediastinum masses
lymphoma
bronchogenic cyst
Neutropenia
Arthritis
Spenomegaly
Ulcerating skin lesions
===
Felty
How to protect lung when on vent
lower TV to prevent alveolar distention
SpO2 above 88
A1AT biopsy findings
PAS+ globules
Mallory Bodies assc
Wilsons or Alcoholic
Granulosa Cell Tumor = need
endometrial bx
Lithium + NSAID =
decreased renal clearance and high risk for lithium toxicity
Vaccine refusal management
discuss and document
How does ABO disease come about
Mom type O
Baby type A or B
Dysgerminoma= elevated
HCG or LDH
Chronic MR echo finding?
Acute?
Chronic LAE
Acute high LA/LV filling pressures = acute pulm Edema
Gum hypertrophy and hirsutism are seen with what immunosupressant
cyclosporine
When giving EPO you must also give
iron
ACE mechanism is ____cellular and Statins are ___cellular
ACE- extra
Statins- intra
Thalassemias smear finding
microcytic
targets
Dietary recommendations for stones
increased fluids
low salt
Achalasia in pt greater than 60 precaution
do scope, rule out cancer
Management of atypical glandular cells
colposcopy
endometrial bx
endocervical curettage
normal pupil size
2-5mm
Treatment of acute mania
antipsychotics
Hemolytic anemia, jaundice, pigmented gallstones, European =
Hereditary spherocytosis
How to dx acute appendicitis in pregnancy
US not CT
NAFLD pathogenesis
insulin resistance –> increased lipolysis –> FFA build up in liver.
Gluconeogenesis is increased
Rules for sunscreen
50 is max benefit
apply 15-30 mins before exposure
EPO most common ADRs
worsening HTN, HA
Spared eye (noninjured eye) disease
sympathetic ophtalmia = recognition of hidden antigens
MCC death in dialysis patients
CV disease
New preferred agents over warfarin for DVT
Xa inhibitors
When Makenzie filled out jennas food log there was _____
hawthorne effect
Treatment of diverticulitis with abscess
CT guided perc drainage
Nasal discharge + anosmia =
polyp
First trimester noninvasive testing is
cell free fetal DNA
Three meds to hold during stress test
BB, CCB, Nitrates
Negative RPR but clinical picture suggests syph what to do?
empirically treat
Alternatives to heparin in HIT
agatroban, fonduparinux
FTT, jaundice, cataracts in babe is suggestive of
galactosemia
Mumps two most common complications
meningitis
orchitis
MOP (men, orch, parotitis)
Enterotoxin is ingested to cause food poisoning with what two bugs?
staph
b cereus
Toxin is made in gut for what three organisms
clostridium
vibrio
ETEC
Which four bugs cause invasive diarrhea
listeria
salmonella
Yersinia
campy
Periventricular enhancement =
CMV
Subacute meningitis, papilledema, AIDS =
crypto
HSV should have ____ on MRI
temporal lobe involvement
Where is chloroquine an okay malaria px
central America and the caribbean
When to add primaquine to treatment
vivax
MCC symmetric IUFGR
chromosomal abnl
Thyroid storm can be triggered by ____ In ____
stressful situations
undiagnosed patients
Hypomania patient should be able to keep ____
working
Globular mass below umbilicus =
fibroid uterus
Isothenuria/nocturia is common in ____
SCA
Hydroxyurea dose limiting ADR
myelosupression
Oxytocin ADRs
tachysystole
hypoTN
hypoNa
Folate and B12 def both increase
homocysteine
Maternal weight loss = _____ —> __& __
IUGR —> Preterm, polycythemia
Absent philtrum is clue to ____
FAS
Causes of clubbing
R –> L shunts
CF
malignancy
Carpal tunnel best test
nerve conduction
Contact lens keratitis MC bug
pseudomonas
COPD flat diaphragm leads to
increased WOB
How does obesity increase endometrial cancer risk
increased peripheral conversion to estrogen
How to treat hypothermeria
Mild 90-95 passive external cooling (blankets)
Mod 82-90 active external cooling
severe under 82 active internal cooling
Endocarditis murmur should be at _____
apex or in IVDU RLSB
How does PNA cause hypoxia?
R –> L shunting –> VQ mismatch –> low O2
HTN young woman first step in treatment
stop OCP if taking any
MG crisis treatment
IVIG, steroids
Describe factorial design
2+ interventions with 2+ outcomes
Cross over study design
similar to clinical trial but swap intervention mid way through
Basic tests needed when diagnosing HTN
UA
chem panel
lipids
EKG
Trachea/esophagus relationship
Trachea is anterior
Complications of nephrotic syndrome
clotting
infection
loss of D
anemia
Thyroid adenoma two MC complications
tachyarrythmias
bone loss!
(no eye issues with adenoma)
How often to do colonoscopies in UC
q1-2
FAP colonoscopy guidelines
start at 10; do q1
Lynch/HNPCC colonoscopy guidelines
start at 20-25 do q1-2
How does breast feeding lead to amenorrhea?
PRL —-I GnRH
Schizophrenia MRI findings
enlargement of lateral ventricles
decreased hippocampal volume
Baby with accelerated head growth is clue to
autism
Abnormal orbitofrontal cortex/ basal ganglia is found in what psych disorder?
OCD
MCC folate def
alcohol
Thiazide lab changes
all electrolytes lost except ^ Ca
Increased gluc, LDL/TG, uric acid
Meningitis type with ^^^^ opening pressure
cryptococcal
TTP treatment
plasma exchange
Weak, cataracts, tiny testicles, bald = what is the dx/inheritance pattern?
Myotonic Dystrophy; AD
Duchenne & Becker inheritance pattern
XR
Fragile X inheritance pattern
XD
Acute liver failure with acetaminophen tox = need for ____
transplant! stat!
Arm drop test looks for
rotator cuff tear
Giardia treatment
metro
Travelers diarrhea treatment
Cipro
Renal failure + abdominal pain next step
place bladder catheter
Abdominal pain/ NV should clue you to rule out
atypical cardiac
Penetrating trauma + signs of peritonitis next step regardless of FAST
lap
do not do CT, do not do DPL, go straight to surgery
Contrast somatic symptom and panic
panic disorder comes and goes, somatic constant symptoms
Only indication for HRT
women under 60 with menopause within 10 years; vasomotor symptoms not improved with weight loss
Radio-opaque tablets in kid’s stomach –> next step
deferoxamine
Toxic megacolon treatment
start with fluids, abx, steroids –> surgery if no improvement
Aside from PDA, what murmur may be continuous?
Aortic coarctation with collaterals through thorax
*May also have S4
Muscular Dystrophy gold standard in diagnosis
muscle biopsy
Chi squared measures what?
Proportions of categorized outcomes
T tests measure what?
Two means
ANOVA measures what?
Compares 3+ means
When to image UTI of any sort?
After 3 days no improvement on abx
HIT cause
antibodies to platelet components
Trisomy 18 cardiac defect
VSD
MCC zero puberty in female at 16+
Turners (low estrogen, increased FSH/LH)
Hx of rheumatic fever requires _____
continuous abx px
if valve disease they need at least to age 40 and at least 10 years
p value that is statistically significant
less than 0.05
Osteoblastic lesion =
prostate cancer
Cells that are PAS + and without granules
lymphoblasts
Stop mammos at what age?
75
SMH/WH symptoms
proximal muscle weakness lower more than upper
Essential tremor = ____ tremor
intention
MOA 13 valent vs 23 valent PNA Vax
13- T cell + B cell
23- B cell only
1st step after pushing atropine in organophosphate poisoning
remove clothes
Normal post void volume
under 12
Dyschezia rules out _____
vaginismus
ASA exacerbated respiratory disease reaction type
non IgE
Dialted ventricles with diffuse hypokinesia is
dilated cardiomyopathy
Concentric vs Eccentric cardiac hypertrophy causes
concentric- pressure overload
eccentric- volume overload
Salvage therapy is given when?
when standard therapy fails
When is neoadjuvant/adjuvant therapy given?
neo before standard
adjuvant with standard
Treatment of AV Block/ meningitis in lyme disease- peds
IV rocephin
Acute angle closure glaucoma is an ADR of what drug class?
anticholinergics
Inpatient treatment of CAP
FQ or B lac + mac
Outpatient treatment of CAP
mac/doxy or FQ if sick/ recent abx
Treatment of decompensated heart failure
B agonist decreases LVESV (and also) LVEDV
How to distinguish cardiac and liver edema?
hepatojugular reflux + only in cardiac
Pain over tibial tubercle dx + xray findings
Osgood schlatter/ tibial apophysitis
xray shows lifting
Pain at inferior pole of knee =
patellar tendonitis
Horners and decreased gag reflex are seen in what brainstem stroke syndrome
laterally medullary (PICA/Vertebral)
Tongue parlysis is seen in what brainstem stroke syndrome?
Medial Medullary (Vertebral/ ASA)
Ipsilateral ataxia + nystagmus is caused by a stroke where?
cerebellum
JVP should be less than ___
8
Best way to reduce mortality in COPD
O2
Polymyositis abs
ANA JO
Why is HIT dangerous actually?
thrombogenic
arterial and venous clots
Gluconeogenic amino acids are transformed into
pyruvate –> G3P –> glucose
How long after pharyngitis until RF
2-4 weeks
How to distinguish between absence and focal seizures
absence lasts seconds and is provoked by hyperventilation
How to dx ectopic
have to do TVUS not transabdominal
Recurrent nosebleeds hemoptysis and oral lesions dx
hereditary telangiectasia, osler weber rendu (pulmonary AVMs)
Bicuspid aortic valve causes what type of aortic disease
AR or AS
Seborrheic dermatitis can be on scalp or ____
face
Nontender solitary node in neck is _____ until proven otherwise
squamous cell, biopsy and do panendoscopy
How long of poor nutrition until person becomes vitamin K deficienct
1 week
Melanosis coli is seen in what condition
laxative abuse
WPW arrhythmia DOC
procainamide
avoid: CCB, dig, adenosine
Reptile scale skin is called?
How to treat?
ichthyosis vulgaris
use emollients, keratlytics, retinoin
How to treat overflow (constant dribbling) incontinence
cholinergics (bethanechol) & Cath
Acute PCP treatment
steroids + Bactrim or pentamidine
PCP and CMV PNA appearance
patchy/diffuse
Bilateral trigeminal neuralgia is ____
MS
Measles mechanism of spread
airborne
Airway support for COPDE
first try NPPV
PACs lifestyle modification
no cigarettes or beer
Cross sectional study measures ____ and cohort study measures _____
cross sectional - prevalence
cohort - incidence; relative risk
Common injury in peds BAT
duodenal hematoma
Lab changes with Bactrim
increased Cr and K
Insulin effect on K+
Drives into cells
B agonist effect
Drives K+ into cells
BBer effect on cells
Drive K+ out of cells
Prednisone effect on K+
= mineralocorticoid –> increased excretion
Neurocysticercosis bug
taenia solium
Hemihypertrophy, macroglossia, umbilical hernia = ?
Pt needs what screening?
Beckwidth Wiedmin
US/AFP q3 months
Bilateral periorbital cellulitis is ?
cavernous sinus thrombosis
MC location hypertensive hemorrhagic stroke
putamen
Treatment for bone pain in prostate cancer
radiation
Labs in splenic sequestration
low RBC and platelets but high retics
Miscarriage and patient is positive for VDRL –> think of
APL sx
Management of peds vaginal foreign body
remove and irrigate
DM type 1 and vesicular rash =
celiacs
How to dx hyperemesis gravidarum
confirm with ketones
How to distinguish between rotator cuff tear and adhesive capsulitis
adhesive- decreased passive and active ROM
tear- decreased active ROM only
4 markers of lactose intolerance
+hydrogen breath
acidic stool
high stool osmol gap
+ stool reducing substances
Vasovagal syncope management
teach counterpressure maneuvers
How to treat antipsychotic parkinsonism
decrease dose or add amantadine/ benztropine
Hydrozychloroquine requires what monitoring
regular eye exams
Homocystinuria:
cause
stone shape
test
poor renal COLA transport
hexagonal
+cyanide nitroprusside test
How to distinguish IDA from thal
thal has normal RDW/RBC count
B thal has increased hb___
A2
Penetrating wound with absent distal pulses next step
go to OR
Gallstone ileus exam finding
absent bowel sounds
Widened prevertebral space is clue to
retropharyngeal abscess
Treatment of social anxiety disorder
SSRI
RAI and IBD both predispose to
amyloidosis
Hyalinosis is seen in what renal disease
diabetic nephropathy
Randomization controls for
confounders
Trisomy 18 finding on triple screen
normal inhibin rest low
How are TP/FP on ROC curve related to sensitivity and specificity
1-FP= specificity
TP ~sensitivity
Child with PCP And lymphadenopathy has
AIDS not CF or SCID
Drugs that increase warfarin activitiy
NSAIDs/ Tylenol abx amio cimetidine and omeprazole SSRIs
Drugs that decrease warfarin activity
phenobarb/phenytoin/carbamazepine
ginseng and st johns wart
rifampin
BPPV cause
canaliths in semicircular canal
How to distinguish lipoma and epidermal inclusion cyst
lipomas do not regress and reoccur
Treatment for hypercalcemia of malignancy
bisphosphonates
Obesity is the cause of amenorrhea when ____
LH/FSH
When to give Tamiflu
less than 48 hours from onset
above 65 and chronic med patient
Agitation and lower abdominal pain post op next step
do bladder us to check for AUR
Scoliosis + joint laxity =
ehlers danlos
joint laxity, clots, lens dislocation=
homocystinuria
Corneal dystrophy, renal failure, clots, neuropathy=
Fabrys (a glucosidase)
Stable patient with pericardial effusion next stap
do angio to r/o AD before doing pericardiocentesis
Cords on histology is a buzzword for what cancer? palisading
cords- scc
palisading- bcc
Timing of bowel perf 2/2 BAT
several days after
AIS when to do gonadectomy
afer puberty
Atopic dermatitis spares
genitals and groin
Cold dying limb from AE next step
heparin before any testing
Comedonal acne treatment
retinoid and topical acid
inflammatory acne treatment
start with comedonal treatment –> add topical abx –> add oral abx
Nodular/cystic acne treatment
start with topical retinoid, acid, and abx
add oral abx
add oral retinoin
Acne pathogenesis
increased sebum and hyperkeratinzation
inflammation
p acne
What rules out exogenous insulin as cause of hypoglycemia
elevated C peptide
MC stone type
calcium oxalate
Pedunculated red bleeding mass is
pyogenic granuloma
Dermatofibroma clue
central area dimples when pinched
DM neuropathy small vs large fiber
small- pain + symptoms
large- numbness - symptoms
legionella treatment
mac or fq
circulating hormone level=
total
MC location bowel ischemia
splenic flexure
Focal spinal tenderness treat as _____
osteo
Abscesses with ^^^^^^ leukocytes=
LAD
Catalase + bugs and lab findings in CGD
serratia
staph
burkholderia
labs are normal
Papillary rupture presentation
Ventricular aneurysm presentation
rupture- acute MR within the first week
aneurysym- persistent STE several weeks after MI
Lab clue to MAC infection
high alk phos
Wiskott Aldrich inheritance/ cause
XR, cytoskeleton abnormality
Alcoholic cerebellar degeneration presentation
truncal ataxia but normal limb coordination
(weird heel chin but normal finger nose)
*Finger-nose abnormal in B12
Low albumin causes ____ ____.
low calcium
Immobilization raises
Ca
When to bx in abnormal uterine bleeding
above 45 or obese
What lung path has increased breath sounds/ egophony?
consolidation, all others decreased
When is tactile fremitus increased?
consolidation
fremitus ~breath sounds
In lacunar stroke- which is effected more: arm or leg?
equal
Clues to SCC
parasthesias
immunosuppressed
Sheehan path
ischemic necrosis
AML cell type
myeloblasts, acute symptoms
CML LAP score and cell type
low LAP score; myelocytes
Leukemoid reaction cell types
metamyelocytes; high LAP score
Drug induced acne appearance
monomorphic papules on arms/upper back
common with steroids
Clue to conus medullaris
UMN signs, symmetric cauda equine (spinal nerve roots)= LMN
SSRI sodium disorder
SIADH
Clobetasol treats what skin disorder?
bullous pemphigoid
Infection that mimics sarcoidosis
histoplasma
Labs in JIA
increased ESR/CRP/ferritin
increased platelets, Igs
anemic
Aminoglycosides most common tox
hearing and vestibulopathy
NRDS two most common risks
prematurity
maternal DM
Osteonecrosis xray findings
normal often
When to give Td in adults
must confirm at least one TDaP can do Td after than q10
If bilirubin is in urine it is ____
conjugated
Craniophrayngioma presents with what systemic signs
pituitary deficiencies
Confounding means the risk has ____ effect on disease.
Confounder- truly no effect
Effect mod means the risk has effect on disease only when combined with a second risk factor (compounds)
Obstruction, air in small bowel and liver, no air in colon: dx
gallstone ileus
clues: no surgeries, gas in biliary tree
“To and fro” murmur at Left ICS with bounding pulses=
PDA
Cause of bruit in atherosclerosis
lipid accumulation, intimal thickening
Peritoneal dialysis is risk for what infection
SBP
Cause of RLL infiltrate in alzheimers
aspiration; decreased gag reflex
In addition to nystagmus, what are clues to PCP intox
catatonic/coma; violent
Jaundiced patient with dilation of biliary ducts needs:
ERCP
Criteria for intubation
RR above 35
acidic
Clearance for exercise includes
stress test
Tip of thumb innervation
median nerve
Sudden severe back pain=
compression fracture
Rectal fissure treatment
anesthetics and stool softeners –> LIS those fail
First step testicular torsion
dx by H&P then straight to surgery, no need for Doppler if its obvious
Kidney stone- pain stops: assume?
stone is passed
How is staph spread at picnics
poor refrigeration
Anorexia with amenorrhea= risk of
osteoporosis
Low K+ EKG findings
PVCs, flat T waves, ST depression
Encapsulated bacteria assc with what deficiency?
B cell
Post Op Aortic Coarctation BP maintenance
should be below 60 by managing pain
Best way to prevent aspiration
elevate head of bed
Eczema like rash effect only this nipple is
pagets
Green discharge from nipple is
ductal ectasia
draining abscess at nipple is
lactiferous fistula
Achalsia pathogenesis
increased LES done and decreased peristalsis
How do ACEi effect renal flow?
decreased GFR by constricting efferent arterioles
Enzymes take how long to rise in MI?
as many as 6 so don’t assume normal enzymes= no heart attack
Wide complex v tach may look similar to:
diffuse ST elevation
Weakness in legs and bladder issues at time of birth is
spinal dysraphism
TOA is ruled out how
U/S
Lung cancer can cause what symptoms regardless of type
arthralgias
neuropathies
Urine sodium above ____ is high.
40
SIADH sodium is?
high because all fluid is retained
Treatment of patient with both orthostatic hypotension and BPH
finasteride not alpa agonist
Patient with gurgling sounds… what should you do?
get an airway. duh.
Painful post void dribbling is?
urethral diverticulum
ANA in JIA?
negative
Acute lupus flare lab changes
decreased complement increased abs
Sodium disorder common following head trauma
SIADH
cohort vs case control study what is measures
cohort- rr
case control- or
Odds ratio equation/ how to derive
use chart but instead of test result put intervention/risk for vertical column
(a/c)/(b/d)
Relative Risk requation
use chart –> (a/a+b)/ (c/c+d)
relative risk ~PPV/NPV
Attributable risk equation
(a/a+b) - (c/c+d)
relative risk but subtract instead of dividing
RRR equation
1-RR
ARR equation
(c/c+d)- (a/a+b)
NNT equation n
1/ARR
NNH equation
1/AR
Type 1 error
false positive
Type 2 error
false negative
increase power and decrease the risk of this error type by increasing sample size
Vaccine given at birth
Hep B
Vaccines given at 2 months
DR HIP + Hep B
DTaP, Rota, Hib, IPV, PCV13
Vaccines given at 4 months
DR HIP
Vaccines given at 6 months
DIP + flu PRN, 2 doses first season
12-15 month vaccines
MMRV DTaP Hep A (x2) PCV13 Hib
4-5 year vaccines
DIM
DTaP
IPV
MMRV
11-12 year vaccines
meningococcal
TDaP
start HPV series
16 year old vaccines
meningococcal
Age to give zostavax
60, 1 dose
HR change in all forms of shock
increased
Which shock type has increased CO
septic
Cardiac shock parameters
everything but CO increased
Neurogenic shock parameters
everything but HR is decreased
SVR is increased in what forms of shock?
cardiac and hypovolemic
Symptomatic evidence of increased SVR
pale and cool skin
HAP treatment
Must cover for pseudomonas
zosyn, carbapenem, or cefepime/ceftaz
VAP treatment
THREE AGENTS
- antipseudomonal from HAP
- FQ or AG (AP)
- Linezolid or Vanc (AS)
Scaling lips/fissures and corneal vascularization = _____ deficiency
B2/ riboflavin
rash, baldness, and adrenal insufficiency = ____ deficiency
B5/ pantothenic acid
How can you become biotin (B7) deficient?
antibiotics, excess raw eggs
Neuropathy + sideroblastic anemia = _____ deficiency
B6 (pyridoxine)
Hemolytic anemia, weakness, spinocerebellar demyelination= ____ defi
vitamin E
When should baby start saying “mama” “dada” etc?
9 months
it takes nine months to become a mama
When should baby sit/roll/crawl/walk
sit unsupported and roll ~ 6 months
crawl by 9 months
walk by 12-14 months
Stranger anxiety when?
Separation anxiety when?
Stranger- about 6 months
Separation- one year
Words at one year?
about ten
When should kid use complete sentences and understand most basic vocabulary?
age 3
When does intentional smiling start?
2 months
How many blocks should kid stack?
age in years x 3
When do kids start group playing instead of parallel playing?
3
Sideroblastic anemia:
macro or microcytic?
causes?
stain?
can be either
alcohol, lead, INH, B6
Prussian blue
Only form of microcytic anemia with elevated circulating iron?
sideroblastic
HbF is increased in what form of microcytic anemia
B thal minor
What form of thalassemia has high reticulocytes?
three gene deletion a thal
Like hemolytic anemia, B12/folate def high high ____ & ____.
LDH and indirect billi
In addition to dietary/ alcohol causes what can cause B12 def (2)
pancreatic def
pernicious anemia
Sickle Cell mutation
B6 valine –> glutamic acid
Abx to be used in sickle crisis with high fever/ white count
rocephin or FQ
Three prophylactic needs in sickle cell
hydroxyurea
folate
pneumovax
Recurrent hemolysis + splenomegaly + family history=?
dx?
HS; osmotic fragility
put in hypotonic solution
Causes of warm AIHA
CLL; lymphoma; SLE; drugs
Exchange transfusion is used when in SCA?
ACS
priapism
stroke
retinal infarct
Smear in AIHA ?
NO fragmented cells because hemolysis is extravascular
Causes of cold AIHA
Mycoplasma
EBV
Waldenstroms
Warm Agglutinin treatment?
Cold?
warm- steroids –> splenectomy
cold- rituximab –> plasmapheresis (NOT steroids)
Cause of TTP/ HUS
ADAMSTS 13 Def
Labs assc with HUS/TTP
normal PT/PTT/Coombs
low platelets, renal insufficiency, intravascular hemolysis
Episodic dark urine + pancytopenia + clots in weird places = ? dx? tx?
PNH dx with flow cytometry
treatment is steroids
Splenomegaly Bleeding Thrombosis All cell lines up Pruritis after warm shower
dx? tx?
Poly Vera
Phlebotomy and ASA –> hydroxyurea or allopurinol
Pancytopenia + dry tap + tear drop cells = ?
treatment?
myelofibrosis
ruxolinitib (rux)
Why are Auer Rods a big deal?
DIC risk
ALL gets ____ _____
intrathecal MTX
Ringed sideroblasts
pancytopenia
hypercellular marrow=
Myelodysplastic syndrome
leukemic precursor
Abnormality assc with Myelodysplastic syndrome
5q deletion
Bilobed nucleus cell is called? Assc with what d/o?
Pegler Huet
Myelodysplastic
CLL special cell type”?
smudge cell
Treatment CLL
chlorambucil simple –> cyclophospgamide refractory
CML treatment?
TKI–> BMT
Treatment of Hairy Cell
cladribine or pentostatin
CBC in NHL?
Best initial test?
normal
do excisional bx
Treatment of NHL?
CHOP cyclophosphamide hydroxydaunorubicin oncovin (vincristine) prednisone
cyclo
dauno
vinc
prednisone
CHOP OUT LYMPHOMA
Staging of NHL
I- one group
2- two groups
3- two sides diaphragm
4- widespread
Treatment of HL
ABVD
A for Aunt Cindy
Adriamycin
Bleomycin
Vinblastine
Dacarbazine
When should pt be screened for breast cancer after HL radiation?
within 8 years
First test in MM
xray
What distinguishes MGUS from MM?
normal BMBx
What distinguishes Waldenstroms from MM?
Waldenstroms is IgM
MM is IgA/G
Only cause of clotting with high PTT?
APL syndrome
Wright and Hansel stains detect _______ which is seen in _____
eosinophilia
acute interstitial nephritis
*No eos in NSAID induced disease
Dysmorphic red cells in urine =
glomerulonephritis
Hyaline casts are caused by?
dehydration
Tamm Horsfall protein
NSAIDs constrict the _____ while ACEi dilate the ____
NSAIDs constrict afferent arterioles
ACEi dilate efferent
Post renal BUN:Cr
greater than 20:1 same as pre-renal
FeNa/UNa in Pre/Post renal AKI
FeNa less than 1
UNa less than 20
because decreased perfusion increases ADH
FeNa/UNa in ATN?
Isothenuria. Kidneys done broke.
In pre-renal azotemia urine osm should be?
greater than 500 (this is considered concentrated)
How long for a drug to cause renal tox ?
5-10 days.
don’t answer drug induced AKI on same day drug is started
Treatment of rhabdoy
fluids
mannitol
bicarb
Hepatorenal syndrome labs match?
Treatment?
match pre-renal
treatment is octreotide/ midodrine
Labs assc with atheroemboli
eos
low complement
Grossly visible necrotic material is?
Next step in dx?
renal papillary necrosis
CT scan
Alport cause
type IV collagen
PAN spares? It is assc with?
the lung; Hep B
DI sodium level?
SIADH sodium level?
DI high sodium (water loss)
SIADH low sodium (water retention)
Psychogenic polydipsia sodium levels?
high
Best initial test in hypernatremia?
Water deprivation test –> ADH administration
What are the three types of RTAs?
Type 1- distal
Type 2- proximal
Type 4- Hyporenin
Which type of RTA is assc with stones?
Type 2
What is the cause of type 1/distal RTA?
Tubule cant generate bicarb means acid cant be put into tubule means high urine pH above 5.5
What is the cause of type 2/proximal RTA?
prevents bicarb from being reabsorbed
Treatment types 1,2,4 RTA
Type 1-distal- bicarb
Type 2- proximal- thiazide
Type 4- steroids
Urge incontinence treatment
oxybutynin
tolterodine
Little boy with absent tonsil/lymph nodes and frequent sinopulmonary infections think?
Brutons
