Week 1 UWorld/MedEd Flashcards
if patient has terminal diagnosis and has uncontrolled pain, what can you do?
keep adding on more morphine
what is febrile neutropenia?
ANC less than 1500 and a fever
what is common cause of febrile neutropenia?
patient on chemo with new infection
if patient has febrile neutropenia without known source of infection, what is most likely source?
bloodstream infection
what bugs are likely in febrile neutropenia?
pseudomonas and gram +s
what abx should be given empirically for a patient with febrile neutropenia of unknown origin?
carbapenem/zosyn/cefepime
what is a huge risk factor for stress induced ulcers?
ICU admission
what is imaging of choice for primary sclerosing cholangitis?
MRCP
what are two EKG findings of pericarditis?
ST elevation, PR depressions
what is rx of viral pericariditis?
ibuprofen and colchicine
if a stool osmotic gap is low, what type of diarrhea?
secretory
if a stool osmotic gap is high, what kind of diarrhea?
osmotic
what are the symptoms of ehrlichiosis?
high fever, HA, myalgia, chills and confusion, no RASH
what are lab abnormalities in ehrilichiosis?
anemia, thrombocytopenia, and elevated liver enzymes
what is rx for ehrlichiosis?
doxy
how is ehrlichiosis transmitted?
lone star tick
what electrolyte can be elevated with statin myopathy?
potassium
what can happen with kidneys with statin myopathy?
can look like an AKI with the release of creatine
what is cause of menieres disease?
increased endolymph pressure
what is rx for menieres disease?
decreased sodium intake
what are GI/urinary symptoms of polyarteritis nodosa?
mesenteric ischemia, kidney infarcts
what are two treatment options for salicylate toxicity?
activated charcoal and IV sodium bicarb
if patient has 1-2 weeks of fever, night sweats, cough and foul smelling sputum, what should you think might be the cause?
anaerobic lung abscess
what is rx of cholinergic toxicity?
atropine then pralidoxime
what are manifestations of cholinergic toxicity?
Diarrhea Urination Miosis Bronchospasm/Bradycardia Emesis Lacrimation Salivation
patient with parkinsons keeps getting community acquired pneumonia, what should be done?
swallow study
patient with microcytic anemia that doesnt respond to iron should be thought to have what?
thalassemia
how long after iron initiation should you see improvement in Hgb?
4 weeks
what are three signs of theophyline toxicity?
headaches/insomnia
arrythmias
nausea/vomiting
does spinal cord compression lead to upper or lower motor neuron signs?
BOTH
what is a cause of spinal cord compression in IV drug users?
epidural abscess
what veins cause the majority of DVTs that lead to PEs?
proximal leg veins
what is the clinical triad of fat embolism?
petechiae
neurologic dysfxn
respiratory distress
what is rx for fat embolism?
supportive care only
what drug should be given for hypertensive emergency?
nitroprusside
what is risk with nitroprusside?
cyanide toxicity
what happens with cyanide toxicity?
AMS, seizures, coma
what type of metabolic abnormality does laxative use lead to?
metabolic alkalosis
if patient has diarrhea and is from laxative use, what acid base issue is there?
metabolic alkalosis
what are symptoms of splenic abscess?
LUQ pain, fever, and splenomegaly
what should you try to do for patient that is on ventilator as far as feeding goes? ie what route?
g tube as quickly as possible as this prevents malnutrition
what parasite causes long course of travelers diarrhea?
cryptosporidium parvum
what is a marine dwelling bug that can cause severe sepsis quickly?
vibrio vulnificus
who is at risk of getting bad infection from vibrio vulnificus?
those with liver disease
what is rx of vibrio vulnificus?
doxy and ceftriaxone
what lab is elevated in upper GI bleed?
BUN:creatinine ratio
what is the main difference betwene primary and secondary raynauds?
primary is symmetric and secondary is asymmetric
what should work up consist of in secondary raynauds?
CBC, CMP, ANA, complements, ESR
what is a neuro finding of AIP?
peripheral neuropathy most commonly in upper extremities
what is rx for AIP?
glucose and hemin
what are signs/symptoms of constrictive pericarditis?
fatigue, dyspnea, edema, ascites, increased JVP
what is a common cause of constrictive pericarditis?
radiation therapy from hodgkins lymphome
what is rx for CMV esophagitis?
ganciclovir
what are opioid withdrawal treatment options?
methadone, buprenorphine, clonidine
Do you have to have hemoptysis to have DAH?
NO
what does CSF look like in TB meningitis?
high cell count, low glucose, high protein and lymphocyte predominance
what is most common cause of Cn III palsy?
diabetic poor control leading to ischemia to nerve
what are signs of CNIII palsy?
eye down and out, ptosis
what are some common causes of renal vein thrombosis?
malignancy, nephrotic syndrome and OCPs
what are symptoms of renal vein thrombosis?
hematuria, flank pain and enlarged kidney on CT
what is in urinalysis with renal vein thrombosis?
blood, thats it
what is rx for renal vein thrombosis?
anticoags or thrombectomy
what is imaging to diagnose lumbar spinal stenosis?
MRI
what is calcific uremic arteriopathy?
when arteriolar and soft tissue calcification occurs
what are clinical symptoms of calcific uremic arteriopathy
painful nodules and ulcers, soft tissue calcification on imaging
what are risk factors for calcific uremic arteriopathy?
kidney disease, hypercalcemia and hyperphosphatemia, hyperparathyroid
no P waves and sine wave pattern on EKG are indicative of what?
hyperkalemia
what should be given in hyperkalemic emergency?
calcium gluconate and insulin
what is treatment of TTP?
plasma exchange, steroids, and rituximab
5 findings in TTP
renal insufficiency, MAHA, thrombocytopenia, neuro changes and fever
what are symptoms of cryptococcus neoformans in those with HIV?
headache, nausea, confusion, CN VI palsy and skin papules
what is finding on head imaging with cryptococcus neoformans?
elevated ICP leading to enlarged ventricle
what is test to diagnose cryptococus?
LP with india stain
what imaging to diagnose epiglottitis?
lateral neck radiograph
what symptoms can occur in fibromuscular dysplasia?
hypertension, CVAs, vision loss
what imaging to diagnose fibromuscular dysplasia?
CT abdomen or duplex US
what are symptoms of bacillary angiomatosis?
vascular cutaneous lesion, systemic symptoms, liver involvement
what causes bacillary angiomatosis?
bartonella
who gets bacillary angiomatosis?
HIV, from cats and lice
what is rx of bacillary angiomatosis?
doxycycline or erythromycin
what is shape of crystals in fake gout?
rhomboid
what are symptoms of abdominal stage of trichenellosis?
abdominal pain, nausea, vomiting and diarrhea
what are symptoms of abdominal stage of trichenellosis?
myositis, fever, periorbital edema, subungual splinter hemorrhages
what is heme finding with trichinelllosis?
eosinophilia
if patient has bright red blood per rectum and no hemorrhoids what is likely cause?
diverticular hemorrhage
postprandial epigastric pain in chronic alcohol user should make you think what?
chronic pancreatitis
what is rx of mild UC?
mesalamine (5-aminosalacyclic)
what are sx of mild UC?
watery diarrhea less than 4 times a day, no anemia, no imflammatory markers
what electrolyte change can trigger hepatic encephalopathy?
hypokalemia
MALT lymphoma of stomach should make you think about what?
H pylori infection
