UWorld_7.27 Flashcards
Sudden lower limb signs of arterial occlusion w/hx of recent MI ==> dx?
arterial embolism (from L heart s/p MI or atria w/afib)
Arterial thrombosis presentation
- insidious/gradual onset of sx of ischemia
- pulses usually diminished bilaterally
B-thalassemia minor presentation/management
- asx
- mild anemia + high RBC count
- low MCV
- Hb > 10
- no management needed
Delayed complication after blunt trauma/MVC
- diaphragmatic rupture; L>R
- ==> dilated loops of bowel in chest
Physiologic cause of sx of cardiac tamponade
- cardiac tamponade/pericardial effusion ==> shift of interventricular septum towards left ventricle
- ==> reduced left ventricular preload ==> reduced stroke volume/cardiac output
Older pt. w/bone pain, elevated alk phos, normal Ca ==> dx?
paget disease of bone
Paget disease of bone cause/sx
- 2/2 osteoclast dysfxn ==> increased bone turnover
- bone pain/deformity
- @ skull: H/A. hearing loss
- @ spine: spinal stenosis, radiculopathy
- @ long bones: bowing, fx, arthritis
Imaging in paget disease of bone
- XR: osteolytic vs. lytic/sclerotic lesions
- bone scan: focal uptake increased
Tx of paget disease of bone
bisphosphonates
Colon cancer screening in IBD
- 8yrs post-dx
- colonoscopy q1-2 yrs
Colon cancer screening in FAP
- colonoscopy 10 years b4 age dx of relative or @ 40
- repeat q3-5 yrs
Preconception initial screening for thalassemia
- non-african descent: CBC
- african descent: CBC + Hb electrophoresis
Digitalis/Digoxin toxicity arrhythmia
- digoxin ==> increased ectopy and vagal tone
- ==> atrial tachycardia w/AV block
Peripheral smear in sickle cell pt.
Howell Jolly bodies
Howell Jolly bodies ==> ?
asplenia (fxnl or actual)
Tx of ventricular tachycardia
- stable ==> IV amiodarone
- unstable ==> cardioversion
High-yield interventions that improve transitions of care
interventions that target PHARMACY PERSONNEL & HIGH-RISK PATIENTS
Cause of thrombocytopenia in SLE
immune-mediated peripheral destruction
Management of prolactinomas
- asx/micro ( no tx
- sx/macro(>10mm) ==>
1. DA agonists: cabergoline, bromocriptine
2. resection: if >3cm or increase in size while on tx
Primidone: MOA, use
- barbituate
- anticonvulsant, tx of essential tremor
Trihexyphenidyl: MOA, use
- MOA = anticholinergic
- tx of parkinsons; particularly in younger pt. w/tremor as primary sx
Evaluation of rapidly expanding head circumference in infant
- 6mo: CT vs. sedated MRI to spare radiation
Urine collection in children
- clean catch if out of diapers
- infants/toddlers in diapers ==> straight catheterization
anti-topoisomerase I ab association
systemic sclerosis
anti-mitochondrial ab association
primary biliary cirrhosis
ANCA association
polyangiitis (wegener’s) = granulomatous vasculitis
Anti-smooth m. ab association
autoimmune hepatitis
Pulmonary edema impact on lung fxn
- ==> V/Q mismatch, increased A-a gradient, low lung compliance
- moderate supplemental o2 improves status
Presentation of hereditary angioedema
- noninflammatory edema of the face, limbs, and genitalia
- laryngeal edema ==> life threatening
- edema of intestines ==> colicky abdominal pain
- episodes follow infection, dental procedure, or trauma
Cause of hereditary angioedema
- C1 inhibitor deficiency, dysfxn, or destruction
- ==> elevated C2b and bradykinin
Bowel sounds in SBO
high-pitched
SBP vs. SBO
- SBP ==> vague abdominal pain, decreased bowel sounds, AMS (abnormal connect-the-numbers)
- SBO ==> N/V, high-pitched bowel sounds
RAIU in toxic multinodular goiter
patchy distribution
Language development @ 12 mo, 18 mo, 2 yrs
- 12 mo: mama, dada + few other first words
- 18 mo: 10-25 words
- 2 yrs: 50+ words
Imaging in Alzheimer’s disease
atrophy prominent @ temporal and parietal loves
dysphagia + regurgitation + chest pain w/emotional stress ==> dx?
- diffuse esophageal spasm/esophageal motility disorder
- relieved by nitrates
Features of intracerebral hemorrhage stroke
- hx uncontrolled HTN, coag, drug use
- sx progress @ min - hours
- focal neuro sx, then sx of ICP (vomiting, H/A, AMS)
Evaluation of ovarian mass + thickened endometrial stripe
-endometrial biopsy for concomitant malignancy
Tactile fremitus in pleural effusion
decreased
Tactile fremitus in consolidation
increased
Theophylline toxicity presentation
- CNS: H/A, insomnia, seizures
- GI: N/V
- cardiac arrhythmia
S. bovis bacteremia ==> ?
colonoscopy to evaluate for colon cancer
Pellagra
diarrhea, dermatitis, dementia
Ppx for varicella exposure in child
- immunized ==> observation
- unimmunized, immunocompetent ==> varicella vaccine
- unimmunized, immunocompromised ==> VZIG w/in 10 days of exposure
