UWorld_7.15 Flashcards
Precipitating factors of hepatorenal syndrome
- reduced renal perfusion (GI bleed, vomiting, sepsis, diuretics, SBP)
- reduced glomerular pressure/GFR, e.g. NSAID use
Dx of hepatorenal syndrome
- FeNa hypoperfusion
- absence of tubular injury (no RBC, protien, or granular casts)
- no improvement in renal fxn with fluids
Tx of hepatorenal syndrome
- address precipitating factors
- splachnic vasodilators = midodrine, ocreotide, norepi
- liver transplant
McCune-Albright presentation
- 3 Ps:
- prec. puberty
- pigmentation
- polyostotic fibrous dysplasia
- cushing’s assoc. w/M-A
Peutz-Jeghers sydnrome presentation
- GI tract polyposis
- mucocutaneous pigmentation
- +/- estrogen secreting tumor
Bacterial causes of dacrocystitis
- s. aureus
- beta-hemolytic strep
Complications of pancreatitis
- pleural effusion
- ileus
- pancreatic pseudocyst/abscess/necrosis
- ARDS
Leydig cell tumor presentation
- peripheral prec. puberty w/low LH that remains low after GnRH stimulation
- unilateral testicular enlargement/testicular mass
Most common galactosemia
galactaose-1-phosphate uridyl transferase deficiency
Length of mania @ bipolar I vs. bipolar II
- bipolar I ==> mania = >1wk w/severe impairment
- bipolar II ==> hypomania = >=4 days, no psychotic ft.
Fat necrosis presentation
-firm, irregular mass w/out nipple d/c
Damage to lateral ST tract ==>
contralateral loss of pain and temperature beginning @ two levels below level of lesion
Urgent indications for dialysis
- AEIOU
- Acidosis = metabolic acidosis of pH6.5 or sx
- Ingestion = toxic alcohols, salicylate, lithium, sodium valproate, carbamazepine
- Overload
- Uremia = sx encephalopathy, pericarditis, bleeding
HUS + penetrating wound ==> ?
laparotomy
Chronic hep C presentation
- asx vs. nonspecific fatigue and arthralgias/myalgias
- waxing/waning LFTs
- extrahepatic: mixed cryoglubulinemia, porphyria cutanea tarda, MPGN