Week 7 Uworld Flashcards
what do you calculate in ascites to determine if from portal HTN or not?
SAAG
what is equation for SAAG?
serum albumin minus ascites albumin
what numbers signify what for SAAG?
> 1.1 means portal HTN
<1.1 means other causes
what is cause of primary MR?
myxomatous degeneration or valvular issue
what is cause of secondary MR?
often caused by heart failure and volume overload leading to displacement of papillary muscles
cryptococcal meningitis has how many phases of treatment?
3 phases
what is first phase of rx for cryptococcal meningitis?
amphotericin b and flucytosine
what is second phase of rx for cryptococcal meningitis?
high dose fluconazol e
what is third phase of rx for cryptococcal meningitis?
low dose fluconazole
if patient has new red skin lesion that dimples when it is pinched, what is it?
dermatofibroma
what bugs are associated with ventilator pneumonia?
pseudomonas, e coli, klebsiella mrsa and strep
patient with ARDS on ventilator has low oxygen, what should you adjust?
increase PEEP
what is a very common side effect of hodkin lymphoma when treated with radiation?
often leads to secondary malignancy (30%) of cases
what are chronic symptoms of arsenic poisoning?
stocking and glove neuropathy, hypo ad hyperpigmentation and hyperkeratosis
what are acute sx of arsenic poisoning?
nausea, garlic breath, vomiting and diarrhea
what is rx of arsenic poisoning?
dimercaprol
repetitive arm motions put baseball players at risk for what finding in their arms?
DVTs
what do you monitor to assess treeatment of DKA?
anion gap
what does hairy cell leukemia cause in bone marrow?
fibrosis leading to cytopenias
what is given for MS flares that are refractory to steroids?
plasmapheresis
what are the classic features of klinefelter syndrome?
tall, small testes, infertile, gynecomastia, minimal hair growth
which of lambert eaton or MG is associated with lung cancer?
lambert eaton
which of lambert eaton or MG is associated with diminished reflexes?
lambert eaton
von hippel lindau syndrome is associated with what three things?
hemangioblastoma
renal cell carcinoma
pheochromocytoma
does low or high thyroglobulin mean exogenous thyroid intake?
low is exogenous, high is thyroiditis
what drugs can cause crystal induced AKI?
acyclovir, uric acid, methotrexate
what imaging is used to dignose bronchiectasis?
chest CT
brain abscesses are caused by what three bugs?
staph a, strep viridans, and anaerobes
what is effect of hyperthyroidism on heart?
high cardiac output due to low SVR, tachycardia, can go into a fib too
what endocrine issue can amiodarone cause
hypothyroid
what can amiodarone do to the liver?
hepatocellular injury
a cherry red spot on macula on eye exam is consistent with what?
retinal artery occlusion
what are sx of retinal artery occlusion?
sudden loss of vision in one eye, with curtain dropping vertically down
what is first and second line therapy of urge incontinence?
kegel exercises then antimuscarinics (oxybutynin)
what happens to levels of FSH/LH in hypothyroid?
they decrease
what happens to menstrual cycles in hypothyroidism?
can become irregular becasue decreased FSH and LH
what are some lab abnormalities in histoplasmosis?
elevated liver enzymes, pancytopenia
what are skin findings in histoplasmosis?
papules, nodules and ulcers
what is rx of severe histoplasmosis?
amphotericin b, itrconazole if mild
what opiates should be avoided in patients with kidney disease?
morphine, tramadol, codeine
when does a pericardial knock occur?
with constrictive pericarditis, it is mid diastolic
what is found on imaging in constrictive pericarditis?
calcifications of pheart
what is severe SE of trastuzamab?
cardiac toxicity,get echo before starting
if patient has bilateral nystagmus, where is issue in eye?
medial longitudinal fasciculus
bilateral internuclear opthalmoplegia is associted with what?
MS
/what is internuclear opthmoplegia
nystagmus of both eyes when looking laterally
when do you start therapy for hyperkalemia?
6.5m g
if patient with ongoing stemi has flash pulmonary edema, what should be given?
lasix…even if before reperfusion completed
what is rx of sporotrichosis?
itraconazole
aside from arterioocclusive symptoms, what other symptoms can be seen in takaysu arteritis?
blood pressure discrepancies, fever, fatigue, arthralgias
what is rx of takayasu arteritis?
systemic roids
what is imaging to diagnose takayasu?
CT angio
what are two heme complications of EBV that are pretty rare??
autoimmune hemolytic anemia and thrombocytopenia
aside from cardiac tamponade, what else can cause pulsus paradoxus?
asthma and COPD
two types of meningitis that cause low glucose?
fungal and bacterial
two types of meningitis that cause high lymphocytes?
viral and fungal
can bicuspid aortic valve cause aortic stenosis?
you bet
what lung cancer causes hypercalcemia? how?
squamous cell via PTHrp
what is imaging finding in acute cholangitis?
dilated bile ducts
what is rx of acute cholangitis?
abx and drainage of biliary tree
what is MoA of statin?
HMG coa reductase inhibitor
what are characteristics of tularemia?
single rapidly progressive ulcer with supporative lymphadenitis
what are sx of anterior uveitis?
painful red eye with photophobia and loss of visual acuity
what is first line therapy of chemotherapy induced nausea dn vomiting?
ondansetron
what is rash of leprosy?
macular hypopigmented skin lesions with raised borders
what can happen to nerves in leprosy?
painful nerves with loss of sensation
how do you diagnose leprosy?
full thickness biopsy
what is rx of leprosy?
dapsone and rifampin
what lab can be elevated in non hodgkin lymphoma?
LDH
what is the most common cause of pancytopenia
idiopathic
what are some known causes of pancytopenia?
infection, autoimmune, drugs and toxins
what is necrolytic migratory erythema?
erythematous papules that coalesce to form large plaques with central clearing
what is necrolytic migratory erythema associated with?
glucagonoma
what are sx of glucagonoma?
diarrhea, diabetes, weight loss, necrolytic migratory erythema
do blockers cause hyper or hypokalemia?
hyperkalemia
what abx causes hyperkalemia?
bactrim
what kidney stone is radiolucent?
uric acid stones
what is rx of uric acid kidney stone?
potassium citrate
name three common side effects of tacrolimus
nephrotoxicity, tremor and glucose intolerance
what are common SEs of azathioprine?
hepatotoxicity and bone marrow suppression
what is prodrome of vasovagal syncope?
warmth and nausea
how do vagal maneuvers stop AVNRTs?
slow AV nodal firing
what is cor pulmonale?
right heart failure due to pulm Htn
what are signs of cor pulmonale?
elevated JVP, ascites, liver enlargement, edema
what heart murmur may be found in cor pulmonale?
tricuspid regurgitation
how do you diagnose CLL?
flow cytometry
how does CLL present?
can be asymptomatic, but will have lymphocytosis with anemia and thrombocytopenia
what is post exposure prophylaxis for rabies?
vaccines and IVIG
if patient is bitten by a pet, but not sure about rabies, what do you do?
observe animal for 10 days and treat patient if animal shows signs. If you cannot observe animal then treat patient
if patient bitten by wild animal and unknown if animal has rabies, what do you do?
give post exposure prophylaxis
what two meds should be started for patient with peripheral arterial disease?
aspirin and statin
superior vena cava syndrome causes what to happen?
impeded venous return to heart from head neck and arms…so swelling there
what is mc cause of superior ven cava syndrome?
malignancy
what is imaging for superior vena cava syndrome?
cxr
what medication is used to treat hypertriglyceridemia from 100-999?
statins only
what medications for hypertriglyceridemia above 1000?
statin and fenofibrate
what else should patient with hypertriglyceridemia do to help lower aside from medication therapy?
weught loss, limit saturated fat and sugar, limit alcohol
what are two mainstay medications for acute exacerbation of COPD?
inhaled bronchodilators and oral steroids
what are two test options for PJP?
sputum culture or bronchial lavage
increased stroke volume and cardiac output in sepsis can lead to what physical exam finding?
bounding pulses
inferior MI is what vessel?
RCA
what is treatment of spinsal cord compression from cancer?
steroids
erysipelas is commonly caused by what bug?
strep a pyogenes
what does erysipelas look like?
erythematous rash with well demarcated raised borders
what are other symptoms of erysipelas?
early onset of fevers and regional lymphadenitis
what is common abx for eryisipelas?
ceftriaxone or ampicillin
what is therapy for urethreal chlamydia infection of man?
single dose of azithromycin
what are the two main lights criteria?
fluid/serum protein >0.5
fluid/serum LDH >0.6
what are sx of RMSF?
headache, fatigue, arthralgias fever
what labs can be abnormal in RMSF?
hyponatremia, elevated liver enzymes and thrombocytopeni a
what is 1st line rx of renal artery stenosis due to non occlusive atherosclerosis?
ACE inhibitor
what blood cancer commonly causes white counts above 100000?
CML
what does luekocyte alk phos help differentiate?
leukocyte reaction versus CML
what is leukocyte alk phos in reaction vs CML?
low in CML high in reaction
patient with hiv has single ring enhancing lesion and EBV noted in CSF, what is cause?
CNS lymphoma
EBV causes increased risk for what two cancers in HIV patients?
non hodgkin lymphoma and CNS lymphoma
what is a very common MSK side effect of hemodialysis? does it improve or worsen with dialysis?
carpal tunnel syndrome…worsens
when can odds ratio be considered the same thing as relative risk?
if disease is very rare
what are calcium, phosphate and PTH levels in osteomlacia?
low ca and phos, high PTH
what is initial therapy for BPH?
tamsulosin or prazosin
what is moa of tamsulosin?
alpha adrenergic antagonist
amyloidosis is associated with what class of diseases?
autoimmun e
medullary echogenicity is consistent with what on renal US?
papillary necrosis
what happens to PCWP and central venous pressure in obstrictive shock?
PCWP normal and CVP high
