UWSA1 Flashcards
what to think of if someone drinks antifreeze
ethylene glycol poisoning
- causing a metabolic acidosis with increased anion gap
- compensatory drop in paCO2
pt taking medication for BPH and nocturnal urinary symptoms, what should you be concerned about
they could be taking an alpha-blocker in which case lookout for orthostatic symptoms which occur du e to peripheral vasodilation
what heart problem can occur after a viral illness
acute pericarditis which can cause cardiac tamponade
why is there RBC elevation in CSF of someone with herpes encephalitis
result of hemorrhagic destruction of frontotemporal lobes
how does interstitial lung disease present
- progressive dyspnea and nonproductive cough
- fine bibasilar velcro-like crackles
pulmonary fibrosis that leads to stiffening of lungs and decreased lung compliance
-FEV1 and FVC decrease proportionally so the ratio is roughly the same or may even be increased
what is the most common cause of spinal stenosis and what is the classic symptom
dx definitively with MRI of spine even tho x-ray can suggest it
cause: degernative osteoarthritis (spondylosis)
symptom: neurogenic claudication, lower extremity pain with extension of spine and flexion relieves the pain
if pt has increased pigmentation in palmar creases what do you immediately think of
increased levels of ACTH (polypeptide) b/c when POMC gets cleaved into ACTH it also stimulates melanogenesis
when to use vaginal misoprostol
used for cervical ripening (softening and thinning of the cervix) in pts undergoing labor induction
-not used for pts in spontaneous active labor
most common etiology of active phase protraction of labor when cervical dilation is slower than expected (< 1cm ever 2 hours)
contraction inadequacy is most common
-give oxytocin
how to help prevent thrombotic events in pts with a.fib
give warfarin or NOAC (rivaroxaban, dabigatran, apixaban, edoxaban)
explain pleural fluid in pt with tb
very elevated protein (always >4), lymphocytic leukocytosis, low glucose < 60
what color is the fluid in a chylothorax
turbid or milky white
-due to leakage of chyle into thoracic space from obstruction of thoracic duct
when to give what vaccinations for HIV pts with CD4 count above 200
- all pts with HIV require pneumococcal and INACTIVATED influenza
- Zoster vaccination indicated for those with no hx of disease and no evidence of immunity
- once CD4count is below 200 then treat prophylactically for opportunistic infections
most common cause of superior vena cava syndrome
malignancy
-do radiation therapy
how does spontaneous bacterial peritonitis occur
peritoneal fluid becomes infected by enteric organism that translocates across intestinal wall
- >250 PMNs on paracentesis is diagnostic
how to treat bullous pemphigoid
high-potency topical glucocorticoids
which cancers most commonly go to the brain
melanoma, lung, breast, renal
why does tension pneumothorax lead to hypotension
essentially causes superior vena cava syndrome
- high intrathoracic pressure impedes venous return by compressing the vena cava
- needle decompression causes an increase in venous return
what is the most common manifestation of temporal lobe epilepsy
focal seizures with impaired awareness
-you know its from the temporal lobe because of the associated automatisms like hand or mouth movements
all forms of poorly controlled diabetes (pre and gestational) in pregnancy have increased risk of what
fetal lung immaturity
preterm delivery
macrosomia
when you see a pt with v.tach what is the next thing to do
determine if the pt is stable or unstable
-if stable then give IV amiodarone
how to treat supraventricular tachycardia/tachyarrhythmia
-adenosine
-digoxin
(verapamil or metoprolol if adenosine doesnt work)
what to think of if a pt has weakness and leg cramps after initiation of thiazide diuretic
significant hypokalemia
what to think of if pt has persistent hypertension OR hypertension and hypokalemia (muscle weakness)
hyperaldosteronism
- primary = tumor
- secondary = mimickers