Weeks 4-5 Flashcards
describe a keratocanthoma
rapidly growing nodule with ulceration and keratin plug
what is unique about a keratocanthoma
will regress on its own
what can a keratocanthoma turn into?
SCC
what is most effective medication for allergic rhinitis?
intranasal steroids like fluticasone
what are signs of allergic rhinitis on physical exam?
cobblestoning of posterior pharynx
clear drainage
pale turbinates
at what age should baby respond to name?
6 months
at what age should baby say dad or mom?
9 months
common SEs of aromatase inhibitors?
arthralgias and sexual dysfxn
what are features of back pain that are more concerning for malignancy?
worse at night, hx of cancer
what MSK issue can steroids cause?
glucocorticoid induced myopathy
describe issue in glucocorticoid induced myopathy
proximal muscle weakness, normal ESR and CK
who gets vasospastic angina?
ppl that are young
describe the sx in vasospastic angina?
sudden onset chest pain, lasts 15 minutes and goes away
how do you dx vasospastic angina?
ECG with ST elevations during pain
angiogram normal
what is rx for vasospastic angina?
Ca channel blocker
what is oftent the management of a struvite kidney stone?
removal
what is a secondary spontaneous pneumothorax?
spontaneous rupture of pleural bleb that causes a pneumothorax
who gets secondary spontaneous pneumothorax??
patients with known lung disease like COPD or CF
what is rx of secondary spontaneous pneumothorax?
ranges from oxygen to thoracostomy
what are the two types of contact dermatitis?
allergic or irritant
what causes irritant contact dermatitis?
usually stuff you put on hands over and over…chemicals
what type of infection can happen with MMR vaccine?
can get measles mild infxn
what does measles infxn after vaccine look like?
mild maculopapular rash on face and fever…not nearly as contagious
what are the symptoms of acute angle closure glacuoma?
HA, nausea, eye pain, diminished vision
what is physical exam sign of acute angle closure glacuoma?
non reactive and mid dilated pupil
what is initial therapy in acute angle closure glacuoma?
IV acetazolamide
what are some drugs that can cause acute angle closure glacuoma?
decongestants, and anticholinergics
define non allergic rhinitis
basically allergies without a specific allergen triggering it…can have behavioral triggers instead
what is first line therapy of non allergic rhinitis?
intranasal antihistamine or glucocorticoid
what can be triggers for non allergic rhinitis?
walking into cold air, eating
what is currently the only indication for HRT/
vasomotor symptom reduction
two groups with indication for weight loss surgery
40+ BMI
35+ BMI with weight related comorbidity
two first line options for medication for weight loss
orlistat and liraglutide
what is most common inheritied bilirubin disease?
Gilberts
what is issue in gilberts?
decreased UDP action, so decreased conjugation of bilirubin
when does gilbers flare up?
in times of stress..sick..fasting, dehydration, menstruation
what do liver labs do in gilberts?
only indirect bili is up, all else normal
what is alopecia areata?
autoimmune caused hair loss in patches
is alopecia areata ithcy or painful?
Neither
what is rx of alopecia areata?
topical corticosteroids
what is best test to determine if asthma or COPD?
bronchodilator then repeat FEV testing
what is female pattern hair loss?
vertex, center of scalp, spares hair line
what is rx of female pattern hair loss?
minoxidil
what is rx of male pattern hair loss?
minoxidil or finasteride
what other endocrine abnormality can hypothyroid cause/
hyperlipidemia
what should you check in patient with newly found hyperlipidemia before starting on meds?
TSH
what is appearance of discoid lupus erythematous rash?
erythematous plaques with ulceration and central hypopigmentation with surrounding hyperpigmentation
how does olecranon bursitis present?
localized swelling over posterior elbow after microtrauma or overuse
which liver enzyme is highest elevated in NAFLD?
ALT>AST
what comorbidity is most commonly associated with a fib?
chronic HTN
how often should cholesterol screening be done? what age to start it?
3-5 years, starting ta age 40
what does otitis media have that otitis media with effusion doesnt?
fever and TM bulging
what liver labs are mainly elevated in autoimmune hepatitis?
AST/ALT
what is antibody elevated in AI hepatitis?
anti smooth muscle
what is rx for AI hepatitis?
prednisone
what are presenting symptoms of AI hepatitis?
fatigue anorexia nausea jaundice
what is a lifestyle risk factor for colon cancer?
diabetes/obesity
what is the only major risk factor for worsening crohns disease?
smoking
someone with suspected PCOS, what additional tests should be done?
oral glucose tolerance test
patient with skin abrasion, red streaks in skin and lymphadenopathy has what?
acute lymphangitis
what is rx for lymphangitis?
cephalexin
what is blepharitis?
inflammation at the eyelid margin
what are sx of blepharitis?
burning and itching of eyelids, crusting on eyelashes, discharge of eye
what is associated with blepharitis?
seborrheic dermatitis
what is rx of blepharitis?
warm compresses and supportive care
what is the test for lactose intolerance?
lactose breath test
how do the kidneys appear in hypertensive nephrosclerosis?
they appear normal but are small
what are the lab findings in hypertensive nephrosclerosis?
elevated creatinine, bland urinalysis with mild proteinuria
aside from SLE, what other rash can be on face and spare nasolabial folds?
melasma
how does the rash of melasma appear?
irregularly shaped hyperpigmented macules
what is rx of melasma?
sunscreen use
what medication is used to help pass kidney stones?
tamsulosin
how deos tamsulosin help pass kidney stones?
its an alpha 1 antagonist and will relax smooth muscle of the ureter
what two hand joints are commonly involved in OA?
1st carpometacarpal and DIPs
are bony enlargements of joints common in OA?
yes
what are the hematologic findings in JIA?
high white cells, high platelets, anemia, high inflammatory markers
what often precedes pityriasis rosea?
a viral illness
what does rash of pityriasis rosea start as?
herald patch on back
what does rash of pityriasis rosea progress to look like?
oval lesions in christmas tree pattern
is pityriasis rosea itchy?
yes
2 cardiac findings in turner syndrome
coarctation of aorta and bicuspid aortic valve
what is most significant risk factor for pancreatic cancer?
smoking
what is therapy that greatly increases survival for patients with COPD?
long term oxygen therapy
what can thiazide diuretics do to sugar levels?
cause hyperglycemia
what three electrolytes can be low on HCTZ?
K, Na and Mg
what electrolyte can be high on HCTZ?
Ca
patient with measles virus should receive what?
vitamin A
what is most common cause of travelers diarrhea?
enterotoxigenic E coli
what is type of diarrhea with enterotoxigenic E coli?
watery, non bloody
what abx for acute rhinosinusitis?
augmentin
what is the appearance of intertrigo
beefy red plaques within inguinal folds
what is common cause of intertrigo?
candida
is intertrigo itchy?
YES
what is rx for intertrigo?
topical azole
2 common problems aside from muscle issues with Duchennes?
dilated cardiomyopathy and scoliosis
what endocrine issue can cause myopathy?
hypothyroid
strict glycemic control decreases risk of macrovascular, microvascular or both types of complication?
just microvascular, risk of stroke and MI same with good control
what causes a varicocele?
dilation of pampiniform plexus on top of testes
what does varicocele feel like?
bag of worms
does varicocele change with valasalva?
yes…enlarges
what is difference in varicocele and inguinal hernia?
hernia is reducible
four causes of erythema nodosum
abx sarcoidosis malignancy infection crohns
if patient has diffuse scaling of skin, think what?
ichthyosis vulgaris
a patient with itchy red rash around anterior part of wasteline, most likely has what?
contact dermatitis from belt buckle
what is test to confirm tinea pedis?
KOH scrape
what abx class for otitis externa?
fluoroquinolone
MOA of meds to treat ED?
PDE5 inhibitors
name the pde5 inhibitors?
tildanafil
what can you not give PDE5 inhibitors with? why?
alpha blockers…risk of hypotension
what are the symptoms of fibromyalgia?
chronic widespread pain with fatigue and impaired concentration
are any labs abnormal in fibromyalgia?
No will be norml
what is a PE finding in fibromyalgia?
tenderness at trigger points
what is classic symptom of polymyositis?
proximal muscle weakness
what labs are abnormal in polymyositis/
CK and anti Jo `
what is the triad of herpes zoster oticus?
ear pain
facial weakness
vesicular rash in ear canal
1st line treatment for lateral epicondylitis?
counterforce bracing
most common bug that causes bacterial conjunctivitis?
Staph Aureus
what are the two types of neuropathy in Dm?
large and small fiber neuropathy
large fiber neuropathy of DM has what sx?
loss of proprioception and vibration sense, numbness, poor balance, reflex loss
small fiber neuropathy of DM has what sx?
loss of pain and temp sense, burning and stabbing pain
which of large or small fiber neuropathy of DM has loss of reflex?
large
which of large or small fiber neuropathy of DM has loss of proprioception?
large
what anti HTN med is preferred for patients with osteoporosis?
thiazides bc increase calcium reabsorpton
what med for bipolar can cause hypothyroidism?
lithium
how long does cough last in acute bronchitis?
5 days to 3 months
what is proctalgia fugax?
recurring intermittent rectal pain
what causes proctalgia fugax?
pudendal nerve compression
is proctalgia fugax associated with pooping?
no
what is rx for proctalgia fugax?
nothing
what is meralgia paresthetica?
paresthesia and decreased sensation at lateral thigh
what is cause of meralgia paresthetica
compression of lateral cutaneous nerve
what are causes of meralgia paresthetica?
obesity, tight clothing, seat belts
what is rx of meralgia paresthetica?
nothing, change things that may be causing it
what lifestyle change has the largest impact on BP?
weight loss
where does oral leukoplakia occur on tongue?
usually on sides
can oral leukoplakia be scraped off?
no
what are two risk factors for oral leukoplakia ?
smoking and alcohol use
what is risk with oral leukoplakia ?
can be pre cancerous like squamous cell
what is rx of oral leukoplakia /
biopsy and monitor closely
two risk factors for male breast cancer?
klinefelter and obesity
what is common presentation of male breast cancer?
firm subareolar mass
what is used to treat scabies?
permethrin
what is used to treat tinea pedis?
terbinafine or azole cream
what bug causes endocarditis from dental procedure?
strep sanguins
what is rx for polymyalgia rheumatica?
glucocorticoids
how does polymyalgia rheumatica present?
rapid onset pain in shoulders and hips
what labs are elevated in polymyalgia rheumatica?
ESR/CRP
what 3 meds to give for acute asthma exacerbation/.
beta agonist, muscarinic antagonists and oral steroid
what are the main differences between benign renal cyst and malignant?
benign are usually unilocular without septae and uniform
what do you do for benign renal cyst?
nothing
what level AV block indicated placement of permanent pacemaker?
at least Mobitz type II
what two meds should patients with carotid atherosclerotic stenosis be placed on?
statin and aspirin
what percent block of carotids do you revascularize?
80%
curtain falling over eye indicative of what diagnosis?
retinal artery occlusion
what is usual cause of retinal artery occlusion
atheroembolic plaque in ipsilateral carotid
how will eye exam look in retinal artery occlusio?
normal
do basal or squamous cell carcinomas lead to ulcers?
squamous
what type of skin cancer more common to develop in scars?
squamous cell carcinoma
what is the main sx of pill esophagitis?
sudden onset of odynophagia and severe pain in esophagus
what meds commonly cause pill esophagitis?
KCL
doxycycline
aspirin
alendronate
another word for stye
hordeolum
what is a hordeolum (stye)?
erythematous tender nodule at eye lid margin from inflammation in tear duct
what is rx for stye?
warm compress
rx for bells palsy?
steroids
when does CVID onset>
20-20s
what is low in CVID?
IgG and IgA and IgM
what are sx of CVID?
recurrent pulm and GI infxns
what is rx for CVID?
Ig replacement
when should you not use bisphosphonate for osteoporosis?
renal impairment
euvolemic hyponatremia is associated with what?
SiADH
what is first line rx to see if euvolemic hyponatremis truly from SIADH?
fluid restriction
corneal vesicles and dendritic ulcers are characteristic of what?
herpes simplex keratitis
what are sx of herpes simplex keratitis?
redness, photophobia, tearing and pain
wat is rx for herpes simplex keratitis?
valcyclovir
four sx of lead poisoning in adults
GI issues, cognitive deficit/neuropathy, microcytic anemai
what is rx for lead poisoning in adults?
calcium EDTA
what are the three common sx of primary hyperparathyroid?
hypercalcemia, neuropsych issues and kidney stones
what is assoc with prmary hyperparathyroid?
secondary HTN
if patient has HFpEF, what is likely reason?
diastolic dysfxn secondary to HTN
3 reasons to repair aortic valve for stenosis?
EF less than 50,
symptomatic,
undergoing other cardiac surgery
are periarticular erosions more common in OA or RA?
RA
asx mediastinal and axillary lymphadenopathy in elderly is concerning for what?
follicular lymphoma
after 5 years of metformin, what is something to worry about?
b12 deficiency
does a syphilis rash include the palms and soles?
yes
does a syphilis rash include the mouth?
yes
how do nitrates relieve angina?
lessen cardiac LV wall stress, decrease O2 demand
two drugs that commonly induce acne flares
steroids and androgens
four symptoms of zinc deficiency
alopecia
loss of taste
delayed wound healing
pustular skin rash (perioral)
what is hyposthenuria?
kidneys arent able to concentrate urine
who gets hyposthenuria?
sickle cell trait
what tract is affected in ALS?
corticospinal tract
MEN type 1 includes:
hyperparathyroid
pituitary tumor
pancreatic tumor
MEN type 2a includes
medullary thyroid cancer
pheochromocytoma
hyperparathyroid
MEN type 2b includes
medullary thyroid
pheochromocytoma
mucosal neuromas
what is elevated in medullary thyroid cancer?
calcitonin
what are the sx of rhino-orbital-cerebral mucormycosis?
fever, congestion, sinus pain, necrosis of local tissues
who is at risk for rhino-orbital-cerebral mucormycosis?
those with uncontrolled DM
what bug causes rhino-orbital-cerebral mucormycosis?
rhizopus
what is rx of rhino-orbital-cerebral mucormycosis?
surgical debridement and amphotericin B
what joint in hands is often involved in psoriatic arthritis?
DIP
what are some other hand findings in psoriatic arthritis?
nail involvement, sausage digit (dactylitis), hand swelling
gout can cause what three things with joints
acute bursitis
chronic bursitis
bursal tophus
of acute bursitis
chronic bursitis
bursal tophus
which is painful?
acute bursitis
what change can happen that can be seen on imaging in bursal tophus?
bone erosions with overhanging edges of cortical bone
what medication is used to treat aspergillosus?
azoles
three classes of meds used for migraine prevention
beta block
TCA
topiramate
what virus can cause arthritis that looks like RA?
parvo B19
what are some risk factors for osteomalacia?
gastric bypass
celiacs
chronic liver and kidney disease
what are some sx of osteomalacia?
bone/muscle pain, waddling gait
what are levels of PTH, Alk phos, calcium and vit d in osteomalacia?
PTH and alk phos up
CA and vit d down
what is a porcelain gallbladder?
calcium ridden GB
what is porcelain gallbladder at increased risk for?
gallbladder adenocarcinoma
what is imaging used to diagnose pancreatic cancer?
CT scan
what are the sx of chronic prostatitis?
pain in pelvis and genitalia, urgency/hesitancy, and pain with ejaculation
what are the two meds to treat chronic pancreatitis?
alpha blockers and ciprofloxacin
how does prostate feel and what are levels of PSA in chronic prostatits?
prostate feels normal and PSA wnl
patients with recurrent kidney stones can be put on what med?
if calcium stones, HCTZ will help reabsorb calcium
what dietary adjustment should patient with recurrent calcium stone do?
decrease dietary sodium
dietary changes to help with gout
decrease red meat, no beer or liquor, low fat diet
are most parotid gland masses benign or malignant?
benign
what is a feature of parotid gland mass that is concerning for malignancy?
if it involves any cranial nerves..like trigeminal or facial
what is finding on eye exam of open angle glaucoma?
atrophy of optic nerve head (cupping)
what is first sx of open angle glaucoma?
loss of peripheral vision
what is first line rx for open angle glaucoma?
topical prostaglandin like latanoprost
where is nasopharyngeal carcinoma endemic? what is it associated with?
china and EBV
what are some sx of nasopharyngeal carcinoma
headaches, nose bleeds, congestion, facial nerve palsy
pemphigus vulgaris is against what?
desmosomes
which of pemphigus or bullous pemphigoid includes mouth?
pemphigus
which of pemphigus or bullous pemphigoid has tense bullae? and which has erosive bullae?
pemphigus is erosive
what can BPH cause with kidneys?
obstructive uropathy…so rising creatinine
what should you do to assess for obstructive uropathy from BPH?
renal US
when do ACE inhibitors cause creatinine rise?
3-5 days after starting
what antibiotic for a bite wound?
augmentin
name some symptoms of acute interstital nephritis
can have fever rash and arthralgias
what appears in urine with interstitial nephritis?
eosinophils, hematuria and WBCs
what may be elevated in hepatocellular carcinoma/
AFP
if patient has hepatomegaly, high ferritin and high liver enzymes, what is dx?
hereditary hemochromatosis
what do you do for someone with hereditary hemochromatosis?
phlebotomy
how does ankylosing spondylitis present?
<40 years old, morning bakc pain and spinal tenderness
what is first line rx for ankylosing spindylitis?
nsaids
what can happen to lung function tests in sarcoidosis?
restrictive pattern, FEV and FVC about normal and DLCO will decrease `
does amyloid cause nephritic or nephrotic syndrome?
nephrotic syndrome
what is the triad of aspirin exacerbated respiratory disease
asthma, chronic sinusitis, and worsening of sx with NSAIDs
what is toxicity of tacrolimus?
can have kidney injurty
a mechanical aortic valve can cause what heme issue?
macrovascular hemolysis leading to anemia
what labs are elevated in primary sclerosing cholangitis?
Alk phos and bilirubin
what is primary sclerosing cholangitis associated with?
UC
what is imaging finding of primary sclerosing cholangitis?
stricturing and dilation if intrahepatic and extrahepatic bile ducts with onion skinning
what abx used to treat pyelonephritis can cause kidney injury?
any of the aminoglycosides
RTAs cause what kind of metabolic issue?
non anion gap metabolic acidosis
what is vitiligo associated with?
hashimotos thyroiditis
in diabetic nephropahty, what is abnormal on Urinalysis?
protein present
what causes loss of protein in diabetic nephropathy?
damage to basement membrane
what lung cancer is most common in kids?
bronchial carcinoid tumor
what are sx of bronchial carcinoid tumor ?
hemoptysis, recurrent pneumonia, mass
how to calculate attributable risk?
RR-1/RR
patient with incompressible veins has what?
DVT
what should you screen for in patient with DVTs?
cancer screenings
prior to ablation, what therapy should patients with atrial flutter be on?
anticoag…DOAC
patient with diabetic foot ulcer…what should be done for starting abx?
bone biopsy
what type of rash can occur with interstitial nephritis?
maculopapular rash
what is the most common cause of adrenal insufficiency?
autoimmune adrenalitis
what are common symptoms of adrenal insufficiency?
weight loss, abdominal pain, nausea vomiting and hyperpigmentation of skin
what is the most common lab finding in adrenal insufficiency
hyponatremia, hyperkalemia
what can be found on CBC with patient who has adrenal insufficiency?
eosinophilia
what rx should be given to patient who cant have doxy for lyme disease?
amoxicillin
what is a contraindication to using SERMs?
previous DVT
describe dermatitis herpetiformis and what disease it is associated with
pruritic erythematous papules associated with celiac
how is hep a transmitted?
fecal oral mainly
inflammatory back pain has what characteristics?
improves with activity and worsens with rest
what are levels of alk phos, calcium, PTH and phosphorus in osteomalacia?
PTH and alk phos up, calcium and phos down
two symptoms of osteomalacia?
fatigue and bone pain
what type of ulcer gets better with eating?
duodenal
what is rx for duodenal ulcers? what is usual cause?
amox and PPI and H pylori
what test is positive if patient has corneal abrasion?
fuorescein stain
what can happen to patient with corneal abrasion?
slight loss of vision
what nerve is affected in a corneal abrasion that leads to small vision loss?
trigeminal
what is first line drug for fibrmyalgia?
TCAs
what are the first two therapies for COPD?
SABA and SAMA
what can you add to saba/sama as symptoms and COPD get worse?
LAMA and LABA
if LAMA and LABA dont work for COPD what is next step
ICS
what does PPI use put you at increased risk for?
c diff
are breath sounds increased or decreased with lobar pneumonia?
increased
what is egophony associated with?
lobar pneumonia
bloody ascites should make you think of what?
hepatocellular carcinoma
what is triad of cardiac tamponade?
distant heart sounds, increased JVP, and hypotension
what is common finding on cardiac exam of pericardial effuson?
no PMI
what are the symptoms of primary biliary cholangitis?
cholestasis fatigue pruritis and elevated alk phos
what ab is + in primary biliary cholangitis?
anti mitochondrial
what disease has + anti smooth muscle antibody/
AI hepatitis
what is cause of presbyopia?
loss of lens elasticity
what are the rules for transudate versus exudate pleural effusion?
pleural fluid protein/serum protein >0.5
pleural fluid LDH>2/3 serum normal LDH
will glucose be high or low in exudate pleural effusion?
low
does fever have to be present in vertebral osteomyleitis?
NO
if patient is healthy and has positive PPD, what do you do?
only treat if induration >15mm
which of lambert eatong, MG or dermatomyositis causes rash?
dermatomyositis
what does rash of dermatomyositis look like?
erythematous papules on dorsum side of hand
what is most common cause of severe mitral regurgitation?
MVP from myxomatous degeneration
how does isoniazid cause neuropathy?
pyridoxine B6 deficiency
B12 deficiency can cause what with tongue?
glossitis
what is a hepatic hydrothorax?
pleural effusion due to small defects in diaphragm that allow ascites to leek into pleural space
what drug decreases cardiac remodeling in post MI patients?
ACE inhibitors
what systemic disease is associated wit hdialysis?
amyloidosis
what are issues with dialysis related amyloidosis?
bone cysts, carpal tunnel syndrome and arthritis
does baroreceptor sensitivity increase or decreas with age? what can this cause?
decrease…orthostatic hypotension
how do beta blockers decrease angina?
decrease cardiac contractility
where does arthropathy from hereditary hemochromatosis occur?
2nd and 3rc MCP joints
what is rx for arthropathy from hereditary hemachromatosis?
phlebotomy
what are the diagnostic features of acute bronchitis?
cough fo rmore than 5 days without systemic signs and can have wheezing
what is rx for acute bronchitis?
supportive, can give bronchodilator
if you are concerned about cushings/hypercortisolism, what test should you do?
24 hour urine cortisol, or low dose dexamethasone cortisone test
what abx should a person without a spleen take if they get a fever?
augmentin
what can methotrexate cause to the lungs?
hypersesnitivty pneumonitit s
which of lambert eaton and myasthenia gravis has abnormal reflexes?
lambert eaton
prominent V waves are specific for what in JVP?
tricuspid regurgitation
what medication class is notorious for causing secondary hypogonads?
Opioids
what imaging should be done for normal pressure hydrocephalus?
MRI
what can lithium cause in the kidneys?
nephrogenic DI
patients with CF that have involvement of pancreas can develop what endocrine issue?
diabetes
what must you be extra careful about with CF diabetes and why?
low sugars…because pancreas probably not making glucagon either
what is initial rx of hemorrhoids, even if they are internal?
high fiber, goo dhydration, limited BMs and limit straining
what is therapy for idiopathic pulmonary fibrosis/
antifibrotic therapy
what endorcrine issue can celiac cause?
secondary hyperparathyroid, because vitamin D not absorbed and Ca lost in stool
what is most common cause of Aoritc Regrg in USA?
bicuspid valve
what are sx of chronic AR?
pounding heartbeat, shortness of breath, widened pulse pressure
is methotrexxate beneficial for patients with reactive arthitiidies?
NO
if patient with ankylosing spondylitis is not well treated with NSAIDS, what do you try?
TNF- a inhibitors
what are sx of systemic sclerosis
sceradactyly, arthralgias, raynauds, GERD, interstitial lung disease
what is cause of GERD in systemic sclerosis?
atrophy and fibrosis of smooth muscl e
when are PDE5 inhibitors contraindicated?
if patient taking nitrites
what is rx of papulopustular rosacea?
topical metronidazole
what are characteristics of rosacea?
erythematous skin that comes and goes with sun exposure and spicy foods, mainly in women, can be papulopustular
what cancer most commonly moves to liver?
colon
if you see multiple liver tumors, what is likely cause?
metastasis
what is main risk factor for prostate cancer?
AGE
explain a cross sectional study
determine if group has risk factor or not and compare prevalence of disease at present time
what heme issue can patients with OSA have?
polycythemia
what virus commonly causes viral arthritis?
parvovirus
patients on PPIs are at risk of developing what neuro issue?
B12 deficiency neuropathy
what is rx of actinic keratosis?
cryo or 5 fluorouracil
what can contirbute to development/worsening of AAA
smoking
what is given for prophylaxis of variceal bleeding?
beta blockers
what leukemia is associated wiht 9:22 issue? who gets it?
CML and adults
what is rx for CML?
imatinib targeting tyrosine kinase
if patient has thyroid nodule, what should initial imaging test be?
US
when do you do a FNA of thyroid nodule after an US?
if US shows calcifications or vascularity
firm dry and thickened skin is indicative of what issue?
chronic lymphedema
what is a risk for chronic lymphedema?
recurrent cellulitis
what is most common cause of acute urinary holding in older men?
bladder outflow obstruction from BPH
what is a common side effect of niacin therapy? why does it happen?
flushing and itching because of prostaglandin induced vasodilation
what do you give niacin for?
high triglycerides
is diastolic or systolic murmur more worrisome?
diastolic, should get full work up
if patient has new bleeding with poops and is young without risk factors, what should be done to work up the bleeding?
anoscopy
in addition to bactrim, what should be given to patient with severe PJP?
corticosteroids to tame immune response
