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A2 > Uworld review 5 > Flashcards

Uworld review 5 Flashcards

1
Q

What are the most common sites of cerebral hemorrhage 2/2 cerebral amyloid angiopathy?

A

occipital and parietal lobes

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2
Q

Who usually gets cerebral amyloid angiopathy?

A

Elderly pts with alzheimers

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3
Q

What are the presenting s/sx of cerebral hemorrhage 2/2 amyloid angiopathy?

A

Progressive confusion and lethargy over several hours

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4
Q

How does a cerebral hemorrhage appear on a head CT?

A

White hyperdensity

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5
Q

True or false: cerebral amyloid angiopathy is associated with systemic amyloidosis

A

False–just with alzheimers

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6
Q

How does a cardioembolic stroke appear on head CT?

A

Multiple infarcts, particularly at the gray=white matter junction

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7
Q

How does an ischemic stroke appear on non-contrast head CT?

A

Area of hypodensity

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8
Q

How does a subarachnoid hemorrhage appear on non-contrast head CT?

A

Areas of hyperintensity throughout the brain, particularly around the ventricles

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9
Q

What might an x-ray of the lumbosacral spine show with ankylosing spondylitis? (2)

A

Arthritic changes at the sacrolumbar junction

Bamboo spine

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10
Q

What eye symptoms are pts with ankylosing spondylitis at risk of developing?

A

Anterior uveitis

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11
Q

What are the components of the uveal eye tract?

A

Iris
Ciliary body
Choroid

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12
Q

What are the s/sx of anterior uveitis?

A

Conjunctival injection
Photophobia
Pain

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13
Q

What is episcleritis?

A

INflammation of the white part of the eye, away from the iris

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14
Q

Episcleritis is associated with which systemic disease?

A

RA and IBDs

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15
Q

What are the s/sx of cutaneous larval migrans?

A
  • Hookworm shape in the skin of affected area (usually feet)

- Intensely pruritic

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16
Q

Where is cutaneous larval migrans most commonly acquired?

A

Sandy beach where dogs play

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17
Q

What is the treatment for cutaneous larval migrans?

A

Will self resolve, but ivermectin will help

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18
Q

What are the lesions like with a brown recluse spider bite?

A

Red plaque or papule with a central clearing, sometime developing into a necrotic eschar

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19
Q

What is the name of the irritant contained within poison ivy?

A

Urushiol

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20
Q

What are the s/sx of sporotrichosis?

A

Rose scrape leads to nodule that usually ulcerates and drains an odorless, non-purulent fluid

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21
Q

What is the timeframe goal for cathing an STEMI?

A
  • Within 12 hours of symptom onset
  • Within 90 minutes of arriving at the door
  • Within 120 minutes if needed to transfer
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22
Q

Type A aortic dissections can lead to what sort of MI?

A

Dissection can lead to a flap covering the RCA, leading to an inferior MI

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23
Q

What are the EKG findings of acute pericarditis?

A

ST-elevation in ALL leads

PR segment depression

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24
Q

How can you differentiate between polymyositis vs polymyalgia rheumatica clinically and via labs?

A

Polymyositis is proximal muscle weakness with mild to absent pain. CK,AST are elevated from muscle breakdown

PR is stiffness in shoulder/hip girdle (not weak), and has systemic s/sx. ESR and CRP elevated.

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25
Q

What are the autoantibodies associated with polymyalgia rheumatica?

A

ANA

Anti-Jo-1

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26
Q

What will a bx of polymyositis show?

A

Endomysial infiltrate, patch necrosis

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27
Q

What is the gold standard for diagnosing polymyositis?

A

Muscle bx

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28
Q

What are the medications that have been shown to improve survival in pts with CHF? (4)

A

ACEIs/ARBs
Beta blockers
ASA
Spironolactone

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29
Q

What are the s/sx of mitral stenosis?

A

DOE
HF
Elevated left main stem bronchus

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30
Q

Elevated main stem bronchus on CXR suggests what disease process?

A

Mitral stenosis

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31
Q

What are some of the major causes of rhabdo?

A

Prolonged immobilization

Amphetamine/cocaine abuse (from vasoconstriction)

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32
Q

What is the underlying pathophysiologic process of Multiple sclerosis?

A

Demyelination of the nucleus

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33
Q

Bilateral trigeminal neuralgia is strongly suggestive of what disease?

A

MS

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34
Q

Cerebral vasospasms involving the brainstem characterizes what disease process?

A

Migraines

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35
Q

How does cavernous sinus thrombosis usually present?

A

HA, fever, proptosis

Ipsilateral deficits in CN III, IV, VI and V

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36
Q

What are the presenting s/sx of a baker cyst rupture?

A

Posterior calf and knee pain, with TTP and swelling of the calf resembling a DVT. An arc of ecchymosis (crescent sign)

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37
Q

What is a popliteal (baker’s) cyst?

A

Extrusion of synovial fluid from the knee joint into the gastrocnemius or semimembranosus bursa through a communication between the joint and the bursa

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38
Q

What is the usualy presentation of an intact baker’s cyst?

A

Asymptomatic bulge behind the knee

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39
Q

What is a dermatofibroma? (s/sx, appearance, histological pathogenesis)

A

Fibroblast proliferation causing an isolated or multiple lesion, most commonly on the lower extremities.

Etiology is unknown, but appear as non tender, and discrete, firm, hyperpigmented nodules that are usually less than 1 cm in diameter, with a dimpling in the center.

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40
Q

What is the treatment for a dermatofibroma?

A

Cryosurgery or shave excision, but not required unless symptomatic, or changes in color/size

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41
Q

What is the appearance of the lesions with Kaposi’s sarcoma?

A

Multicentric red, purple, or brown macules that can appear on the trunk, extremities, or face

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42
Q

What are the two most common pathogens that cause osteomyelitis from deep puncture wounds?

A

Pseudomonas and staph aureus

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43
Q

Which bacteria causes osteomyelitis after receiving a puncture from a nail through a shoe?

A

Pseudomonas

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44
Q

How long does it take for changes of osteomyelitis to form?

A

2+ weeks

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45
Q

On an abdominal CT, what is the double duct sign, and what is it suggestive of?

A

Dilation of both the Common bile duct and the Pancreatic duct

Pancreatic cancer

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46
Q

What is Courvoisier’s sign?

A

Nontender distended gallbladder just below the right costal margin

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47
Q

How do beta agonists cause hypokalemia?

A

stimulate the Na/K ATPase pump and the Na-K-2-Cl cotransporter

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48
Q

Which vitamin is deficient in Wernicke-Korsakoff syndrome?

A

Thiamin (B1)

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49
Q

How does osteonecrosis of the femoral head present?

A

Decreased ROM, and most will have an underling disorder that disrupts flow in the microcirculation

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50
Q

Where is the pain felt with trochanteric bursitis?

A

Caused by friction of the tendons of the gluteus medius and TFL, so over the greater trochanter

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51
Q

What is meralgia paresthetica?

A

Compression of the lateral femoral cutaneous nerve at the waist. It causes burning sensation and paresthesias at the lateral tight. Symptoms are unaffected by motion

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52
Q

What is the appearance of giant cell tumors of bone?

A

eccentric lytic area of “soap bubble” appearance at the metaphysis

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53
Q

What are giant cell tumors of bone? s/sx?

A

Benign and locally aggressive skeletal neoplasm, that causes bone pain and pathologic fractures

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54
Q

What are osteoid osteomas, and how do they appear on x-ray?

A

Sclerotic, cortical lesions on imaging with a central nidus of lucency. Typically causes pain unrelated to activity and worse at night

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55
Q

What is the difference between thyroid induce myopathy vs polymyositis?

A

Thyroid induced has myalgias, proximal muscle weakness, and elevated CK. Decreased DTRs

Polymyositis has sed rate elevation and no myalgias or changes in DTRs

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56
Q

What are the s/sx of legionnaires disease? Treatment?

A

Pneumonia with GI s/sx

Levofloxacin

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57
Q

What is the morphology of Legionella?

A

Hard to stain, so usually just get PMNs.

Gram negative

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58
Q

What electrolyte abnormality can be seen with legionnaires disease?

A

Hyponatremia

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59
Q

If NSAIDs do not relieve back pain that is 2/2 mets, what is the next pharmacotherapy of choice?

A

Short acting opioids

If that doesn’t work, then long acting

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60
Q

Viral conjunctivitis is usually caused by which pathogen?

A

Adenovirus

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61
Q

What is the MOA and use of olopatadine?

A

Mast stabilizer used in the treatment of allergic conjunctivitis

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62
Q

What is the MOA and use of azelastine?

A

Mast stabilizer used in the treatment of allergic conjunctivitis

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63
Q

Which organ in particular take a hit and cause a rise in their markers with amiodarone?

A

Liver

Thyroid

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64
Q

What is tophaceous gout?

A

Gout that causes large deposits of uric acid crystals in joints, causing a largely deformed joints

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65
Q

What is calcinosis cutis?

A

Deposition of Ca and phosphorus in the skin, presenting with whitish papules, plaques, or nodules.

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66
Q

How do rheumatoid nodules present?

A

Firm, Flesh colored papules that are non-tender. Typically occur over elbow and extensor surfaces of the proximal ulna

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67
Q

What is the definition of resistant HTN?

A

HTN that is not controlled with 3+ anti-HTN meds

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68
Q

What are the three major findings that suggest renovascular HTN?

A
  • Recurrent flash pulmonary edema
  • Diffuse atherosclerosis
  • Asymmetric kidney size
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69
Q

What is the presentation of CMV retinitis? (symptoms, fundoscopic findings, pathophys)

A
  • Full thickness retinal inflammation that moves centripetally along the vasculature, causing edema and scarring
  • Blurred vision, floaters and photopsia
  • Fundoscopy shows yellow-white, fluffy hemorrhagic lesions along the vasculature.
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70
Q

What is the treatment for CMV retinitis?

A

Valganciclovir and HAART if HIV+

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71
Q

What is the most likely cause of cervical spondylosis?

A

Bony spurring, causing osteophyte-induced radiculopathy and isolated sensory abnormalities

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72
Q

What is poikilocytosis?

A

Presence of poikilocytes in the blood. These are abnormally shaped RBCs with a spiked appearance. These can be seen in folate/b12 deficiency

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73
Q

Which hormones does prolactin suppress?

A

LH and FSH

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74
Q

What level of prolactin is virtually diagnostic of a prolactinoma?

A

Over 200 ng/mL

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75
Q

What is the classic pattern of allergic contact dermatitis?

A

Streaks of where the plant or other item rubbed against them

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76
Q

How can you differentiate between HSV retinitis vs CMV?

A

HSV is usually painful, and causes necrosis

CMV is not painful, and does not cause necrosis

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77
Q

What is the difference on fundoscopic exam between CMV and HSV retinitis?

A 
CMV = Fluffy or granular retinal lesions near the retinal vessels and associated hemorrhages
HSV = Keratitis with widespread, pale, peripheral retinal lesions and central *necrosis*
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78
Q

Fluffy or granular retinal lesions near the retinal vessels and associated hemorrhages on fundoscopic exam suggests what infectious process?

A

CMV retinitis

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79
Q

True or false: there is decreased diffusion capacity in the lungs associated with asbestosis

A

True

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80
Q

Which CN provides sensory innervation to the cornea?

A

CN V1

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81
Q

What is the underlying pathophysiology of the development of a Zenker’s diverticulum?

A

Sphincter dysfunction and esophageal dysmotility

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82
Q

What is unique in the EKG findings associated with uremic pericarditis?

A

Does not usually cause diffuse ST segment elevation or PR depression

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83
Q

What are the drugs used in the symptomatic treatment of ALS?

A

Riluzole

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84
Q

What is the MOA and use of Riluzole? Side effects?

A

Glutamate inhibitor used to treat symptoms of ALS

Side effects are dizziness, nausea, weight loss, increased LFTs, and skeletal weakness

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85
Q

True or false: Phenytoin needs to be tapered if discontinued

A

True–may risk recurrence of seizures if not.

86
Q

What is the treatment for MS flares that are resistant to high dose corticosteroids?

A

Plasmapheresis

87
Q

What is the role of baclofen in the treatment of MS?

A

Treat muscle spasticity

88
Q

What is the role of head/neck CT in the evaluation of a thyroid mass?

A

Not used–US is much better

89
Q

What is the first step in the workup of a painless thyroid mass?

A

TSH levels and US

90
Q

If an US report for a thyroid nodule comes back and is concerning for CA, what should be obtained?

A

FNA

91
Q

If a TSH level is normal or elevated for a painless thyroid mass, what test should be obtained?

A

FNA

92
Q

If a TSH level is low in the evaluation of a painless thyroid mass, what test should be obtained?

A

Iodine scintigraphy

93
Q

What is the treatment for sporotrichosis?

A

Oral itraconazole

94
Q

How can you distinguish between sporotrichosis from Bartonella?

A

LAD will be present with bartonella

95
Q

What are the common side effects of methotrexate use? (4)

A

Alopecia (balding)
Aphthous ulcers (bleeding)
Pulmonary toxicity (breathing)
Bone marrow suppression

96
Q

What is Felty syndrome?

A

Long standing RA that causes neutropenia and splenomegaly

97
Q

What is the treatment for the side effects from methotrexate use?

A

Folic acid

98
Q

Where is Broca’s area located? Which artery is usually affected to cause a dysfunction here?

A

Dominant frontal lobe

MCA

99
Q

What are the associated features of Broca’s aphasia?

A

Right hemiparesis of the face and upper limb

100
Q

What are the associated features of Wernicke’s aphasia? Why?

A

Right superior visual field defect

Involvement of Meyer’s loop

101
Q

Which type(s) of aphasia have relatively preserved comprehension?

A

Broca’s

Conduction

102
Q

What are the characteristics of the speech with Broca’s aphasia?

A

Sparse and non-fluent

103
Q

What are the characteristics of the speech with Wernicke’s aphasia?

A

Fluent and voluminous, but lacks meaning

104
Q

What are the characteristics of the speech with conduction aphasia?

A

Fluent with phonemic errors

105
Q

Where in the brain is Wernicke’s area located?

A

Dominant temporal lobe

106
Q

Where in the brain is the conduction pathway between broca’s area and Wernicke’s area located?

A

Dominant parietal lobe

107
Q

What is hyposthenuria? What disease is this commonly seen in and why? What is seen on UA?

A
  • Impairment in the kidney’s ability to concentrate urine
  • Commonly seen in sickle cell trait d/t RBCs sickling in the vasa rectae of the inner medulla, which impairs countercurrent exchange and free water reabsorption. UA is unremarkable
108
Q

What are Light’s criteria for exudative pleural effusions?

A
  • Pleural protein/serum over 0.5
  • Pleural LDH/Serum over 0.6
  • Pleural LDH more than 2/3 UNL of serum
109
Q

What defines a low risk pt for CAD?

A

Atypical chest pain in
-Men less than 40
-Women less than 50
with no significant risk factors for CAD

110
Q

True or false: HIT produces a prothrombotic state

A

True

111
Q

What signs should raises suspicion for HIT?

A

Drop in platelets by 50%+

New thrombus within 5-10 days starting heparin

112
Q

What is the pathophysiology behind HIT?

A

Heparin induces a conformational change to platelet factor 4 PF4, which creates a neoantigen. This causes IgG rxn against it. This causes the platelets to become activated (prothrombotic) and the spleen to remove them from circulation (thrombocytopenia).

113
Q

How can you confirm the diagnosis of HIT?

A

Functional assay

114
Q

Which arthritis causes significant dactylitis?

A

Psoriatic arthritis

115
Q

What is the usual presentation of psoriatic arthritis?

A
  • DIP arthralgia with dactylitis
  • Pain is worse in the morning, improves throughout the day
  • Nail involvement (onycholysis)
  • Silver scale skin
116
Q

What are the skin lesions like with psoriasis?

A

Silver-scales

117
Q

What is the treatment for psoriatic arthritis?

A

NSAIDs
MTX
Anti-TNFalpha

118
Q

What are Gottron’s papules, and what disease process are they seen in?

A

Violaceous plaques, slightly scaly overlying the MCPs.

Dermatomyositis

119
Q

What is the most common skin manifestation of Sarcoidosis?

A

Erythema nodosum

120
Q

In pts with what history are beta agonists contraindicated for the use of beta agonists in the treatment of hyperkalemia?

A

h/o CAD.

121
Q

What are the cutaneous manifestations of Bartonella infections in HIV or immunocompromised pts? What is this condition called?

A

Large, friable papules/nodules

Bacillary angiomatosis

122
Q

What is the morphology of Bartonella?

A

Gram negative, intracellular bacteria

123
Q

What are the two main vectors for Bartonella infections?

A

Cats

body/head lice

124
Q

What is bacillary angiomatosis?

A

Large, modular, friable vascular cutaneous lesions that are purple, and present throughout the body. Associated with HIV or immunocompromised states

125
Q

What two main organ system does nocardia affect?

A

Pulmonary and CNS

126
Q

What is the presentation of disseminated blastomycosis? (4)

A
  • Constitutional symptoms
  • Lytic lesions in ribs
  • Upper lobe consolidation
  • Ulcerated/Verrucous skin lesions
127
Q

What sort of occupation predisposes one to blastomycosis?

A

Wood working or lumberjack

Construction

128
Q

What disease is associated with antimitochondrial antibody?

A

Primary biliary cirrhosis

129
Q

What is the pathogenesis of primary biliary cirrhosis?

A

Autoimmune granulomatous destruction of intrahepatic bile ducts

130
Q

What is the pathogenesis of primary sclerosing cholangitis?

A

Inflammation and /fibrosis of intrahepatic and extrahepatic bile ducts

131
Q

What is the classic appearance of primary sclerosing cholangitis on histology?

A

Onion skin appearance

132
Q

What are the imaging findings of primary sclerosing cholangitis?

A

Uninvolved regions are dilated, resulting in a beaded appearance on imaging

133
Q

What biliary issue is associated with ulcerative colitis?

A

Primary sclerosing cholangitis

134
Q

What is the antibody that is found with primary sclerosing cholangitis?

A

pANCA

135
Q

What are some of the extrahepatic manifestations, besides jaundice, of primary biliary cholangitis?

A

Hyperlipidemia, causing xanthelasmas

136
Q

What is a major associated sequale of primary biliary cirrhosis? Why?

A

Lack of bile salts means lower fat soluble vitamins including vit D. Thus, osteomalacia can develop

137
Q

Which labs are more abnormal in intravascular hemolysis as compared to extravascular?

A
  • LDH level is higher
  • Haptoglobin is lower
  • Indirect bili slightly higher (although both have elevations)
138
Q

What is the causative agent of molluscum contagiosum?

A

Poxvirus

139
Q

How can one differentiate between skin lesions of molluscum vs Cryptococcus?

A

Cryptococcus are usually disseminated, and also have involvement of other organ systems (lungs, CNS)

140
Q

In terms of study design, what is selective survival?

A

Occurs in case-control studies when cases are selected from the entire disease population instead of those that are just newly diagnosed. For example, a study on Ca survival that is not limited to newly diagnosed pts will contain a higher proportion of relatively benign malignancies, at these pts generally live longer

141
Q

What is the best test to perform after discovery of a head/neck lymph node with SCC?

A

Panendoscopy (esophagoscopy + bronchoscopy + laryngoscopy)

142
Q

What are the two major tests for c.diff?

A

PCR and/or enzyme immunoassay (both are very sensitive and specific)

143
Q

Is tactile fremitus increased or decreased with pleural effusions?

A

Decreased (water around lung absorbs energy more than air).

144
Q

Is tactile fremitus increased or decreased with lung consolidation?

A

Increased

145
Q

What happens to breath sounds (increased or decreased) with pleural space fluid vs intraparenchymal lung process?

A

Increased with consolidation

Decreased with pleural effusion

146
Q

How can O2 administration worsen hypercapnia in COPD pts? (3)

A
  • Loss of compensatory vasoconstriction in areas of ineffective gas exchange
  • Increase oxyhemoglobin reduces uptake of CO2 from tissues by the Haldane effect
  • Decreased respiratory drive
147
Q

What is the haldane effect?

A

Increased pO2 leads to increased CO2 and H+ unloading of RBCs

148
Q

What is the effect of hypercapnia on cerebral vasculature?

A

Causes cerebral vasodilation–may induce seizures

149
Q

What are the s/sx of spontaneous bacterial peritonitis?

A

Fever, abdominal pain, and AMS

150
Q

How do you confirm the diagnosis if spontaneous bacterial peritonitis?

A

Paracentesis

151
Q

Pure motor or pure sensory strokes are caused by a lesion where?

A

Lacunar area (internal capsule)

152
Q

What is the most common cause of a lacunar stroke?

A

HTN

153
Q

What is the treatment for exercise induced bronchospasm? Second line?

A

Albuterol before exercise or Antileukotriene if unable to tolerate albuterol

154
Q

When are steroids indicated for the treatment of exercise induced bronchospasm?

A

If exercise daily and need pretreatment

155
Q

PAS positive bowel bx = ?

A

Whipple’s disease

156
Q

What extraintestinal symptoms may arise from whipple’s disease?

A

Migratory non-deforming arthritis
LAD
Low grade fever

157
Q

What is the usualy presentation of intestinal lymphoma?

A

Abdominal pain
Weight loss
n/v
FOBT+ stools

158
Q

What is the pharmacotherapy of choice for vasospastic angina?

A

CCBs

159
Q

What is the most common complication of ADPKD?

A

Intracranial bleed

160
Q

What is the most common extrarenal manifestation of ADPKD?

A

Hepatic cysts

161
Q

True or false: autonomic dysfunction is uncommon with eaton-lambert syndrome

A

False–relatively common occurrence

162
Q

What is the usual presentation of toxoplasma encephalitis?

A
  • HA
  • Focal neurologic deficits
  • MRI with ring enhancing lesions
163
Q

What is the treatment for toxoplasma encephalitis? (2)

A

Sulfadiazine and pyrimethamine

164
Q

How do you diagnose toxoplasmosis reactivation?

A

IgG serology, clinically

165
Q

What is the treatment for neurocysticercosis?

A

Albendazole

166
Q

What are the FSH and LH levels in klinefelter syndrome and why?

A

Increased since the XXY genotype causes seminiferous tubule degeneration

167
Q

What will a cholangiopancreatography show with primary sclerosing cholangitis?

A

Beads on a duct

168
Q

Which cell types proliferate in hair cell leukemia?

A

B cells

169
Q

Describe the evolution of shingles?

A

Starts as several papules that can become confluent and evolve into vesicles or bullae with subsequent crusting 7-10 days later

170
Q

What is Guttate psoriasis?

A

A type of psoriasis that presents as small lesions over the upper trunk and proximal extremities. Classically erupts after a strep throat infx.

Pruritic
Erythematous
Dry

171
Q

What is the treatment for tinea versicolor?

A

Selenium sulfide or ketoconazole

172
Q

Which generally has CNS s/sx: wilson’s disease, or hemochromatosis?

A

Wilson’s disease

173
Q

What are frontal release signs? What are the following

  • Glabellar reflex
  • Snout reflex
A
  • Primitive reflexes that appear when frontal lobe is damaged (Pick’s disease for example)
  • Glabellar is tapping of the forehead to cause blinking with each tap, for more than just the first few
  • Snout reflex is pursing of the lips when touching them gently
174
Q

What are the 5 types of lacunar strokes?

A
  • Pure motor/hemiparesis
  • Ataxic hemiparesis
  • Dysarthria/clumsy hand
  • Pure sensory
  • MIxed sensorimotor
175
Q

What causes the pure motor/hemiparesis form of lacunar strokes?

A

Infarct in the posterior limb of the internal capsule, basilar pons, coronas radiata

176
Q

What causes the ataxic hemiparesis forms of lacunar strokes?

A

Infarct in the posterior limb of the internal capsule and others

177
Q

What causes the dysarthria/clumsy hand form of lacunar strokes?

A

Infarct toe the basilar part of the pons and anterior part of the internal capsule

178
Q

What causes the pure sensory form of lacunar stroke?

A

Infarct in the VPL nucleus and internal capsule

179
Q

What causes the mixed sensorimotor form of lacunar strokes?

A

Infarct to the thalamus and adjacent posterior internal capsule

180
Q

What is the pathogenesis of lacunar strokes?

A

Chronic HTN leads to lipohyalinosis/atheroma formation of the deep penetrating arteries in the brain

181
Q

What PNS symptoms occur with a carotid artery dissection?

A

Horner’s syndrome 2/2 compression

182
Q

What happens to the following with systemic atheroemboli:

  • WBCs
  • Complement levels
  • Creatinine
A
  • Eosinophilia
  • Decreased complement levels
  • Increased Cr if kidneys affected
183
Q

What are the UA findings of contrast nephropathy?

A

Muddy brown casts.

184
Q

What is the usual urine pH with uric acid stones?

A

Acidic

185
Q

What is the treatment for uric acid stones?

A
  • Alkalization of the urine, and a low purine diet

- Oral K-citrate will alkalinize the urine

186
Q

How does heparin work?

A

ACtivates antithrombin III

187
Q

What is the definition of resistant HTN?

A

Use of more than 3 anti-HTN agents

188
Q

What is the appropriate f/u for pts with adenomatous polyposis coli?

A

Annual Colonoscopies

189
Q

True or false: ASA has been shown to decreased colon CA risk in pts with FAP

A

False

190
Q

What is the defect in Lynch syndrome (HNPCC)?

A

DNA mismatch repair, causing microsatellite instability

191
Q

What is the normal role of G6PD?

A

NADP to NADPH to use for reducing glutathione and thus free oxygen radicals

192
Q

What two drugs classically cause autoimmune hemolysis?

A

Alpha-methyldopa and PCN

193
Q

What is the most common cause of dysphagia in pts with chronic GERD?

A

Esophageal strictures

194
Q

How does esophageal narrowing 2/2 adenocarcinoma vs strictures differ on Ba swallow?

A

Strictures are uniform, circular stricture, whereas CA is no uniform

195
Q

What are the drugs that can cause crystal induced nephropathy?

A 
Methotrexate
Ethylene glycol
Sulfa
-Navirs (protease inhibitors)
Acyclovir

(“MESNA”)

196
Q

What is the metabolite in the urine that is found in carcinoid syndrome?

A

5-HIAA

197
Q

Are LFTs elevated with chronic cirrhosis?

A

No

198
Q

What are the s/sx of a VIPoma?

A
  • Watery diarrhea
  • Tea colored stools
  • hypokalemia
  • increased stool osmolal gap.
199
Q

Where are most VIPomas located?

A

Pancreas

200
Q

What type of study: pts with and without disease of interest are asked about exposure to some variable. What measure is obtained from this?

A

Case-control study.

Odds ratio

201
Q

What are the s/sx of isopropyl alcohol ingestion?

A
  • CNS depression
  • Disconjugate gaze
  • Absent ciliary reflex
202
Q

What are the lab findings of isopropyl alcohol poisoning?

A

High osmolar gap, but NO increased anion gap, and NO metabolic acidosis

203
Q

Ca oxalate crystal formation are specific to which ingestion poisoning?

A

Ethylene glycol

204
Q

What are the medications that are associated with an increased survival rate in patients with CHF? (3)

A

ACEIs/ARBs
Beta blockers
mineralocorticoid antagonists

205
Q

What is the MOA and use of Eplerenone?

A

aldosterone receptor antagonist

206
Q

What are the appropriate tests to order in a pt with the first time of an unprovoked DVT?

A

Age appropriate CA screens

207
Q

When are procoagulation tests indicated in the work up of a DVT?

A

2+ unprovoked clots, or in age less than 45/unusual sites of thrombosis

208
Q

What are Ca levels in Paget’s disease of bone? Alk phos?

A

Normal Ca, elevated alk phos

209
Q

Elevated urine hydroxyproline is seen in what disease?

A

Paget’s disease of bone

210
Q

What are Ca levels with Multiple Myeloma?

A

Elevated

A2 (26 decks)

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