Vol. 4 Flashcards
B2 deficiency sxs
Angular cheilosis, stomatitis, glossitis, normocytic anemia, seborrheic dermatitis
Hairy cell leukemia pathology
Dry tap, TRAP stain +,
Hairy cell tx
Cladribine
BUN/Cr ratio increased by what
Dehydration, GI bleed, steroid use
Rubella classic triad
Cataracts, PDA, Hearing loss
valproate contraindication
liver disease
FTA-ABS
syphilis confirmatory test
Acute Liver failure definition
Severe liver injury with encephalopathy and impaired synthetic function (INR>1.5) in a pt without cirrhosis
Amebic liver abscess cause
Entamoeba histolytica, in Mexico
Cerebellar dysfunction in alcoholism
Gait instability, truncal ataxia, dysdiadochokinesia, hypotonia, intention tremor
Most common nephropathy associated with HIV
focal segmental glomerulosclerosis
tick-borne paralysis
they release a neurotoxin that causes an ascending flaccid paralysis with no autonomic or CSF changes
Treating carcinoid
Octreotide, surgery for liver mets
TTP and HUS symptoms
????
Ulnar nerve entrapment
Leaning on elbows
Membranoproliferative glomerulonephritis histology
dense intramembranous deposits that stain for C3 (dense deposit disease). Persistent activation of complement leading to renal disease.
saline responsive met. alkalosis examples
Vomiting, diuretics, laxatives
tx saline responsive met. alk.
NS infusion to increase volume and stop maintenance phase.
Waterhouse-Friderichsen syndrome
Meningococcemia + sudden petechiae and vasomotor collapse from Adrenal hemorrhage
Friedreich ataxia progression
neurological (dysarthria, ataxia) in young individual with scoliosis, feet deformities who dies from cardiomyopathy
Squamous cell lung cancer paraneoplastic
PTH-rP
1st and 2nd most common sites of arterial aneurysms
- Popliteal 2. Femoral
can alzheimer’s have gait impairment?
Yes, NPH will have gait impairment as a prominent symptom early on
Phenytoin and vitamin relationship
Leads to low Folate
When to screen for Hep C in people
IVDU and Blood transfusion before 1992
Cause of malignant otitis externa
Pseudomonas
Which side adnexal torsion more common
Right side
Describe Patau’s appearance
Cleft lip, polydactyly, hypotelorism, visceral and genital anomalies
Describe Edward’s appearance
Low birth weight, closed fists with fingers overlapping, microcephaly, prominent occiput, micrognathia, Rocker-Bottom feet
Hereditary Spherocytosis triad
Hemolytic anemia, jaundice, splenomegaly
tx for RSV bronchiolitis
palivizumab
When to treat FLu with oseltamavir
Within 48 hrs of symptoms
McCune-Albright appearance
Precocious puberty, cafe-au-lait spots, bone defects (polyostotic fibrous dysplasia)
McCune-Albright mnemonic
3 Ps: Precocious puberty, Pigmentation, Polyostotic fibrous dysplasia
Migratory thrombophlebitis
Trousseau sign, sign of pancreatic cancer
Pancreatic CA presentation
Constant and gnawing epigastric pain worse at night, anorexia with weight loss, jaundice
Deliberate burn injury signs
sharp demarcation, uniform burn depth, spared flexor surfaces
Wegener’s is also called
Polyangiitis with granulomatosis
Wegener’s Ab
C-ANCA
Wegener’s triad
Systemic vasculitis, upper/lower airway disease, glomerulonephritis
wegener’s treatment
cyclophosphamide
Carcinoid presentation
Flushing, telangiectasias, bronchospasm, and TR
Can see diarrhea
Carcinoid dx
Elevated 24 hr urinary 5-hydroxyindoleacetic acid
Isolated hyperCa followup
PTH level
Kallman syndrome presentation
Anosmia and no puberty, defect of migration of GnRH cells
Endometriosis 3 Ps
dyspareunia, dysmenorrhea, dyschezia
What to do with cat, dog, ferret bite for rabies concern
Quarantine animal and don’t do PEP if animal is fine
FSGS assocations
african americans, hispanics, obesity, HIV, heroin use
Minimal change disease risk factors
NSAIDs, lymphoma
Membranoproliferative GN risk factors
Hepatitis B&C, lipodystrophy
Membranous GN
Adenocarcinoma (e.g. breast, lung); NSAIDs; hep B; SLE
Does placenta previa have pain?
No
difference between alzherimers and pseudodementia
Alzheimers arent bothered by the deficits, they confabulate
CF appearance
recurrent sinopulmonary infections, nasal polyps, digital clubbing
Precocious puberty ages
Girls
Chorioamnionitis diagnosis
Maternal fever and >1 of uterine tenderness, fetal or maternal tachy, malodorous amniotic fluid, purulent vaginal discharge
C section for chorioamnionitis?
NO, just expedite delibery and use broad spectrum abx
Ovarian torsion and bleeding?
NO
Ovarian torsion vs. cyst rupture
Cyst rupture during rigorous coitus or exercise, NO N/V like in torsion
Osteitis fibrosa cystica
Caused by extremely high PTH (like from Cancer), affects upper extremities and skull, brown tumors
Unilateral cervical lymphadenitis tx
Clindamycin
Extrarenal manifestations of ADPKD
Berry aneurysms, hepatic cysts (Most common), valvular heart dz (MVP and AR), diverticulosis, abd. wall and inguinal hernia.
tumors of Beckwith-Wiedemann syndrome
Hepatoblastoma, Wilms tumor. Screen with AFP and u/s
What’s inside amebic liver abscess
sterile, just treat with flagyl
post-flu PNA
staph aureus
ACA stroke sxs
motor weakness, LE > UE, sensory deficits, incontinence (this is a cortical sign)
Cat-scratch disease tx
azithromycin
cat-scratch dz hallmark
tender, regional LAD
Felty syndrome
long term, severe RA with neutropenia and splenomegaly
methotrexate adjunct to minimize side effects
folic acid
endocardial fibroelastosis
idiopathic, diffuse fibroelastic thickening of the LV endocardium, occurs in first 2 yrs of life, restrictive cardiomyopathy
hemochromatosis heart disease
dilated cardiomyopathy, HF, and conduction abnormalities (sick sinus syndrome)
COPD and oxygen patients
PaO2
When to suspect babesiosis
tick bite, with evidence of hemolysis in pt who is splenectomized
Complication of bronchiolitis
if
Order of dx for low back pain
observation/conservative for 4-6 wks, back Xrays and ESR, then MRI
Gonococcal vs. chlamydial conjunctivitis
Gonococccal is 2-5 days, Chlamydia is 5-14 days
erythromycin ointment for kids eyes
only prevents gonococcal conj.
Causes of normal to high PTH in hyperCA
primary & tertiary hyperPTH, familial hypercalcemic hypocalciuria, lithium-induced, teriparitide
MCC of hyperCa in ambulatory patients
primary hyperPTH
pathognomonic of Crohn’s dz
non-caseating granulomas
Crohn’s dz signs
transmural, skip lesions, cobblestone appearance to colon, creeping fatty appearance of mesentery, fistulas, fissures, and perianal disease
Characteristics of UC
Crypt abscesses
UC rectal involvement
ALWAYS
CRC and CD
NO, the association is with UC
How often to screen for CRC in CD
8 yrs after diagnosis and every year afterwards