UWorld_6.29 Flashcards
Bloody ascites ==> ?
- Trauma
- malignancy
- rarely TB
Milky ascites ==> ?
- chylous
- pancreatic
Turbid ascites ==> ?
possible infxn
PMNs in ascites indications
no peritonitis
> 250 PMNs @ ascites ==> peritonitis (secondary vs. SBP)
Total protein @ ascites indications
- > ## =2.5 albumin = “high protein ascites”; CHF, peritoneal cancer, TB, Budd-Chiari, fungal
SAAG calculation/indication @ ascites
- SAAG = serum alb. - ascites alb.
- SAAG >=1.1 ==> portal HTN (cirrhosis, Budd-chiari, CHF)
- SAAG no portal HTN
Cyanosis @ rest, relieved by crying and worsened by feeding ==> dx?
choanal atresia
Common bacterial causes of brain abscess
- 50% spread from sinusitis/head&neck infection
- Viridans strep
- anaerobic bacteria (prevotella, peptostrep, bacteroides)
Tx for brain abscess
- drainage if possible
- prolonged abx (4-8 wks)
Methanol intoxication presentation
- H/A, N/V, epigastric pain
- visual problems/optic disc hyperemia
- anion gap metabolic acidsos
- osmolar gap
blood cancer w/strong PAS staining ==>
- ALL
- TdT also positive in almost all pt.s
Cyclosporine: MOA, SE
- MOA: calcineurin-inhibitor
- SE:
- nephrotoxicity
- hyperkalemia
- HTN
- gum hypertrophy
- hirsutism
- tremor
Tacrolimus: MOA, SE
- MOA: calcineurin-inhibitor
- SE:
- nephrotoxicity
- hyperkalemia
- HTN
- tremor
Azathioprine: use, SE
- use: immunosuppressant
- SE:
- diarrhea
- leukopenia
- hepatotoxicity
Mycophenolate: use, SE
- use: immunosuppressant
- SE: marrow suppression
Salmeterol: MOA
long-acting B2 adrenergic agonist
Management of ventilator-associated PNA
- CXR
- lower respiratory tract sampling for gram stain/culture
- empiric abx
Complication of acute pancreatitis
- hypotension 2/2 intravascular volume loss b/c of local and systemic vascular endothelial injury
- ==> vasodilation, increased vascular permeability, plasma leak into retroperitoneum ==> systemic hypotension
- hypotension ==> multi-organ failure
Tests for CGD
- dihydrorhodamine 123 test
- nitroblue tetrazolium
CH50 assay use
determine total complement concentration
XR in stress fx
- may show nothing on XR
- stress fx = clinical dx w/TTP @ site of pain + local swelling
- can be seen on MRI/bone scan
Wells Criteria
- +3 points: Signs of DVT; alt. dx less likely
- +1.5 points: previous PE or DVT; HR>100; recent surgery/immobilization
- +1 points: hemoptysis; cancer
- PE Unlikely ==> d-dimer
- > 4 points total ==> PE likely ==> CT pulmonary angiography
Metatarsus adductus management
- Type I = corrects passively/actively into abduction ==> spontaneous correction
- Type II = corrects passively/actively into neutral ==> orthosis vs. casting if needed
- Type III = no correction ==> serial casting
Entamoeba histolytica illness
- develops after prolonged exposure to native areas: SE Asia, Africa, Central/South America
- abdominal pain + bloody diarrhea
