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shelf IM > VIII > Flashcards

VIII Flashcards

1
Q

development of palpable mass in epigastrium after acute pancreatitis in recent past

A

pancreatic pseudocyst

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2
Q

clinical signs of hereditary hemochromatosis

A

hyperpigmentation
arthralgia, arthropathy
elevated hepatic enzymes with hepatomegaly, cirrhosis
increased risk hepatocellular CA
DM, secondary hypogonadism and hypothyroidism
restrictive or dilated cardiomyopathy

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3
Q

what infections are those with hereditary hemochromatosis more likely to contract

A

Listeria

Vibrio vulnificus and Yersinia enterocolitica

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4
Q

what mutations occur in hereditary hemochromatosis

A

C282Y, H63D

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5
Q

what can occur if correct hyponatremia too fast

A

osmotic demyleination

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6
Q

what can occur if correct hypernatremia too fast

A

cerebral edema

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7
Q

bradycardia, AV block, hypotension and diffuse wheezing

A

beta blocker OD

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8
Q

what to do with beta blocker OD patient

A

O2 and IV atropine and then glucagon because it increased cAMP

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9
Q

signs of wilsons

A

tremor, rigidity, depression paranoia and catatonia

will have mallory bodies in liver Bx

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10
Q

Dx of wilsons

A

measure ceruloplasmin— low

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11
Q

Tx for empyema

A

surgery

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12
Q

viral myocarditis most likely due to

A

coxsackie B virus

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13
Q

herpes zoster opthalmicus

A

dendriform corneal ulcers and vesicular rash in trigeminal distribution

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14
Q

what will Ca and phosphate levels be in chronic kidney disease

A

high phosphorus from retention
low Ca from dec intestinal absorption from dec active Vit D
increased PTH because of low Ca
all in all causes secondary hyperparathyroidism

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15
Q

sudden onset photopsia and floaters

A

retinal detachment

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16
Q

anemia of chronic disease MCV, iron, TIBC ferritin and transferrin levels

A 
MCV normal/ low
iron low
TIBC low
ferritin normal/ high
transferrin normal/low
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17
Q

anemia from iron deficiecny

MCV, iron, TIBC, ferritin, transferrin levels

A 
MCV low
iron low
tibc high
ferritin low
transferrin low
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18
Q

which drugs can cause esophagitis

A

tetracycline
aspirin and NSAIDs
Alendronate
KCl, quinidine and iron

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19
Q

most important risk factor for squamous cell CA

A

sunlight

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20
Q

production of angiotensin II causes what

A

vasoconstriction of afferent and efferent arterioles increasing renal vascular R and net decrease in blood flow
vasoconstricts efferent more so maintain GFR
stimulates resorption in proximal tubules and increases secretion aldosterone from adrenals– decreased sodium delivery to distal tubule increasing Extracell volume

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21
Q

CHF what happens to RAAS

A

increases Renin to increase angiotensin II to maintain kidney function and increase CO

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22
Q

Hawthorne effect

A

tendency of the study population to affect the outcome since they are aware that they are being studied

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23
Q

sample distortion bias

A

estimate of exposure and outcome association is biased because the study sample is not representattive of the target population

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24
Q

confounding bias

A

one or more variables associated independently with both exposure and outcome

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25
Q

manifestations paroxysmal nocturnal hemoglobinuria

A

hemolysis- fatigue
cytopenias
venous thrombosis

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26
Q

what cutaneous lesions are found with Primary Biliary Cirrhosis

A

xanthelasma

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27
Q

Tx for paroxysmal nocturnal hemoglobinuria

A

iron and folate supplementation

eculizumab

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28
Q

labs for intravascular hemolysis

A

anemia with low haptoglobin and an elevated bilirubin and LDH

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29
Q

when do those not working in high risk environment and no risk factors have to be treated for + ppd

A

> 15mm

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30
Q

what patients need to be treated for tb when ppd >5mm

A

HIV
recent contacts with known tb cases
nodular or fibrotic changes on CX
organ transplants

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31
Q

when to use oseltamivir fo rinfluenza

A 
age >65
pregnant
COPD, CV, renal or hepatic chronic illness
immunosuppression
morbid obesity
native americans
nursing home or chronic care facility
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32
Q

skin lesion in leprosy

A

insensate hypopigmented plaque

progressive peripheral nerve damage causing muscle atrophy

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33
Q

confirm Dx leprosy

A

acid fast bacilli on skin biopsy

34
Q

ethnicity to think leprosy

A

asian

35
Q

Tx for visual Sx of giant cell arteritis

A

high dose corticosteroids and oral therapy with slow taper over the course of months

36
Q

Tx CMV retinitis

A

ganiclovir or foscarnet

37
Q

Dx amebic liver abscess

A

stool examination for trophozoites, serology and liver imaging

38
Q

Tx amebic liver abscess

A

metronidazole

39
Q

what can cause malignant biliary obstruction

A

cholangiocarcinoma
pancreatic or hepatocellular carcinoma
metastatic CA

40
Q

middle ear disease

A

get tinnitus but not vertigo

41
Q

Tx for agitation in elderly

A

low dose haloperidol

atypicals: quetiapine or risperidone

42
Q

what cause bacillary angiomatosis

A

bartonella, gram neg bacillus

43
Q

Tx bacillary angiomatosis

A

erythromycin

44
Q

definition of pulsus paradoxus

A

exaggerated fall in systemic BP >10mmHg

45
Q

pulsus paradoxus is found in what conditions

A

cardiac tamponade but also can happen in severe asthma or COPD

46
Q

Tx toxic megacolon

A

IV fluids, broad spectrum antibiotics and bowel rest

if IBD induced megacolon then use IV corticosteroids

47
Q

cerebellar dysfunction signs in alcoholic

A

gait instability, truncal ataxia, dysdiadachokinesia, hypotonia and intention tremor

48
Q

most common cause of bicuspid aortic valve in developed countries? non developed?

A

developed- bicuspid aortic valve

non developed- rheumatic heart disease

49
Q

Becks triad

A

cardiac tamponade

  • hypotension
  • distended neck vv
  • muffled heart sounds
50
Q

what happens to preload, SV and CO in cardiac tamponade

A

all decrease

51
Q

why does inspiration worsen cardiac tamponade

A

because that increases venous return but the heart cannot accommodate to the increase fluid because restricted

52
Q

fixed upper airway obstruction

A

laryngeal edema

will flatten inspiratory and expiratory flow curves

53
Q

causes of erythema nodosum

A

strep infection most common

sarcoidosis, TB, histo, IBD

54
Q

value for pulmonary hypertension

A

> 25

55
Q

management pulmonary HTN

A

loops and ACEI

56
Q

Type 2 HIT

A

autoimmune from autoAb against heparin platelet factor 4 complexes

57
Q

how to Dx type 2 HIT

A

serotonin release assay

58
Q

Tx for type 2 HIT

A

stop heparin and start alternative anticoagulants like direct thrombin inhibitors

59
Q

what cutaneous lesions are found with Primary Biliary Cirrhosis

A

xanthelasma

60
Q

common extracolonic manifestations of IBD

A

erythema nodosum, pyoderma gangrenosum, eouscleritis, arhtritis, cholangitis

61
Q

which marker is + in Ulc Colitis

A

p ANCA

62
Q

HLA B27

A

ankylosing spondylitis

also assoc with UC

63
Q

low pcwp and high mixed venous O2 saturation

A

septic shock

64
Q

what decreases intensity of mitral prolapse

A

squatting from standing because increases preload

65
Q

behcets

A

recurrent oral ulcers plus 2+:

  • recurrent genital ulcers
  • anterior uceitis
  • erythema nodosum
66
Q

ethnicities of behcets

A

turkish, asian, middle eastern

67
Q

most common occular manifestation of giant cell arteritis

A

anterior ischemic optic neuropathy

68
Q

Tx for visual Sx of giant cell arteritis

A

high dose corticosteroids and oral therapy with slow taper over the course of months

69
Q

Tx for Dx of familial colonic polyposis (auto dom)

A

procto-colectomy

70
Q

what causes conjugated hyperbilirubinemia

A

hepatocellular injury, decreased bilirubin excretion in bile canaliculi, intrahepatic cholestasis or extrahepatic cholestasis from biliary obstruction

71
Q

elevated alkaline phosphatase out of proportion to the transaminases suggests what

A

intrahepatic cholestasis or biliary obstruction

72
Q

what can cause malignant biliary obstruction

A

cholangiocarcinoma
pancreatic or hepatocellular carcinoma
metastatic CA

73
Q

what can cause false positive VDRL

A

Antiphospholipid Ab syndrome

74
Q

Tx antiphospholipid Ab syndrome pregnant lady

A

low molecular weight heparin

75
Q

S4 heart sounf at end of diastole is associated with what

A

L ventricular hypertrophy from prolonged HTN

76
Q

definitive Tx for acute popliteal artery occlusion

A

surgical embolectomy

77
Q

Dx imaging for zenkers diverticulum

A

contrast esophagram

78
Q

signs of zenkers diverticulum

A 
elderly
dysphagia
regurg
foul smelling breath
aspiration
occasionally palpable mass
79
Q

travelers diarrhea with persistent non bloody watery diarrhea >2 weeks

A

cryptosporidium

80
Q

cerebellar dysfunction signs in alcoholic

A

gait instability, truncal ataxia, dysdiadachokinesia, hypotonia and intention tremor

81
Q

young female with history of trigeminal neuralgia

A

MS

shelf IM (12 decks)

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