Week 4 Uworld Flashcards
what abx for meningitis in immunocompromised?
ampicillin, vancomycin and cefepime
what abx for meningitis in someone 50+?
ampicillin vancomycin and 3rd gen cephalosporin
what murmur is common in aortic dissection?
aortic regurgitation
what can happen to kidneys in aortic dissection, why?
if it involves the renal arteries can have kidney injury…creatinine bump
multiple long nodules with cavitation at periphery of lungs should make you think what?
septic emboli from infective endocarditis
what are the sx of GVHD?
diarrhea, liver inflammation and maculopapular rash
when does someone develop GVHD?
within 100 days of transplant
what is rx of GVHD?
steroids
what is pathogenecity of GVHD?
Cd8 cells from transplant against host
is radioiodine uptake increased or decreased in graves disease?
increased
is radioiodine uptake increased or decreased in painless thyroiditis?
decreased
what are two reversal agents of warfarin
vit K and prothrombin complex concentrate
what electrolyte conributes to hypocalcemia?
hypomagnesemia
what is murmur of hypertrophic cardiomyopathy
crescendo decrescendo at LUSB
what is murmur of bicuspid aortic valve?
aortic regurg, diastolic decrescendo at LUSB
what are the symptoms of digoxin toxicity?
nausea anorexia weakness fatigue and confusion
what medication often interacts with digoxin and causes toxicity?
amiodarone
what common medication can cause interstitial nephritis?
analgesic nephropathy (pain pills)
what should be given for anaerobic pneumonia as outpatient?
amox-clav
if you have steroid induced adrenal insufficiency, what are levels of ACTH, cortisol and aldosterone?
low acth and cortisol, normal aldosterone
if you have primary adrenal insufficiency, what are levels of ACTH, aldo and cortisol?
all low
3 findings in wernicke encephalopathy
ataxia, encephalopathy and nystagmus
two ppl that get wernickes encephalopathy?
alcoholics and severely malnourished
rx of wernickes?
thiamine then glucose
what rhythm agents are used in a fib initially?
diltiazem and verapamil
aside from lifestyle changes, what else can help patients with chronic pancreatitis?
pancreatic enzyme supplementation (included lipase)
what are signs of kidney transplant rejection?
proteinuria and worsening creatinine
when does kidney transplant rejection occur?
within 6 months of transplant
what is rx for kidney transplant rejection?
high dose IV steroids
what are ecg findings of hypokalemia?
flat T waves and U waves
what are symptoms of hypokalemia?
weakness, cramps, hyporeflexia, rhabdomyolysis
what are some causes of hypokalemia
diuretics, vomiting, diarrhea, hypomagnesemia, and loads of beta agonists
what is the main difference between a case control and cohort study?
in a cohort study, you take people with and without a risk factor and compare incidence of disease while in a case control you take cases of disease and controls without disease and compare if they had certain risk factors
isoniazid can cause what kind of anemia? how?
microcytic anemia…through pyrodoxine deficiency
is hemodynamic instability common in acute transplant rejection?
no, should make you think of bacterial infection
what abx for syphilis if you cannot give penicillin?
doxy
what will central venous pressure and capillary wedge pressure be in a PE?
CVP will be elevated and capillary wedge pressure will be normal or low
what blood cancer is associated with DIC?
APML
what is the A wave of JVP?
right atrial contraction
what is the C wave of JVP?
RV contraction against closed tricuspid
what is the V wave in JVP?
peak of right atrial filling
what can cause prominent A waves or cannon A waves?
atrioventricular disassociation leading to atrium contracting against closed ventricle
what is best malaria prophylaxis?
mefloquine for 2 weeks before and 4 weeks after
are bone infections from diabetic ulcers mono or polymicrobial?
usually polymicrobial
what is a pulmonary side effect of amiodarone?
chronic interstitial pneumonitis
renal vein thrombosis is most common with which nephrotic syndrome?
membranous nephropathy
if there is a concern for ACS but no diagnosis yet, what should patient be given right away/
aspirin
what can you give to diurese cirrhotic patient?
furosemide and spironolactone together
what is triad of gonnococemia?
dermatitis, tenosynovitis and polyarthralgia
straight lines looking wavy to someone is an early sign of what?
macular degeneration
what TB drug is associated with hepatitis?
Isoniazid
what should you do if patient wiht Tb has mild liver enzyme elevation while on isoniazid?
continue treatment
how does dobutamine help decompensated heart failure?
beta agonist and leads to decrease in end systolic LV volum e
does heart failure cause respiratory alkalosis or acidosis?
alkalosis
does COPD cause respiratory alkalosis or acidosis?
acidosis
what coag test can be abnormal in VWD?
PTT
what is rx of cryptococcal meningitis?
amphotericin B
what are CSF signs of cryptococcal meningitis?
high opening pressure, low glucose, high protein and low WBCs
what is cause of AKI in cardiorenal syndrome?
increase in central venous pressure
what is post exposure prophylaxis for HIV?
immediate test and start triple therapy
does IgA nephropathy have to have significant amount of protein in urine?
NO will be blood and protein mixed
what is test for ITP?
there isnt one…test for causes of ITP like autoimmune diseases
what are three requirements for acute liver failure diagnosis?
high liver enzymes, poor fxn and hepatic encephalopathy
can lupus cause seizures?
YEs
what is first line therapy of BPH?
alpha antagonists
what is first line therapy of patient with torsades?
magnesium
ring enhancing lesions on brain MRI are suggestive of what in HIV patient?
toxoplasmosis
what CD4 count makes you worried about toxo? what is ppx?
bactrim at <100 cells
what are three meds to use for dementia?
rivastigmine, donepezil and galantamine
what med is used for a fib in patient with wolf parkinson white?
procainamide
why should you not give beta blockers or caclcium channel blockers to patients in afib who have WPW?
can promote conduction across accessory pathways
what are two lung volume changes in pregnancy
decreased residual volume and FRC and increased minute ventilation
why will patient with OSA have low chloride?
because of metabolic alkalosis compensation leading to high bicarb and low Cl
heroin use and HIV put you at risk for what kidney disease?
FSGS
if worried about acromegaly, what is first lab to check?
insulin like growth factor
what are signs and symptoms of acromegaly?
skin tags, enlarged facial features, enlarged hands, arthralgia, carpal tunnel,
patients with nephrotic syndrome have increased risk of what two things with blood vessels?
hypercoagulation and hyperlipidemia
what do ppl usually pick up histoplasma from?
bat/bird droppings
what imaging to diagnose budd chiari?
US of abdomen
how soon after MI does papillary muscle rupture occur?
3-5 days
how soon after MI does free wall rupture happen?
5 days to weeks
how soon after MI does ventricular aneurysm develop?
weeks to months
what is imaging for chronic mesenteric ischemia?
Ct angio
what is mononeuritis multiplex?
neuropathy of more than 3 non contiguous nerves
what is mononeuritis multiplex a feature of?
polyarteritis nodosa
what are systemic sx of polyarteritis nodosa?
fever, weight loss and fatigue
what are renal sx of polyarteritis nodosa?
HTN and renal insufficiency
what are skin findings in polyarteritis nodosa?
nodules and livedo reticularis
what is GI sx in polyarteritis nodosa?
mesenteric ischemia
what are neuro sx ofpolyarteritis nodosa?
headache, seizure and mononeuritis multiplex
pt with suicide attempt has oral ulcers and drooling and is in severe pain, what did they do?
caustic ingestion
what LVEF supports mitral valve repair in MR? why?
30-60% and because it actually isnt this high bc part of cardiac output going into right atrium
what are two types of mitral regurg? which one gets surgery?
primary and secondary (primary gets operated on)
what is a common cause of secondary MR?
MI
what is most common cause of primary MR?
myxomatous degeneration of valve
what is difference between SJS and TEN?
TEN is more of body involved like greater than 30%
what happens to cardiac output, SVR and BP in hypovolemic shock?
CO down due to loss, BP down and SVR up due to those being down
what are some signs of RCC?
hematuria, flank pain, varicoceles
what can happen to RBCs and platelets in RCC?
can have anemia or erythrocytosis and thrombocytosis
what are levels of alk phos, calcium and phosphate in paget disease?
alk phos up, other normal
what is rx of paget disease?
bisphosphonate s
hammer and claw toes are classic findings of what?
T2DM neuropathy
what causes BPPV?
often due to debris in canals
