world questions Flashcards
polyarteritis nodosa
(PAN)
- panmural inflammation of the arterial wall
sx: months of fever, weight loss, muscle joint pain due to cytokines
associated with hep B
-commonly see occlusion of renal arteries and oi abdominal artery aneurysms
fibromuscular dysplasia
cause, presentation, diagnosis
- non-inflammatory, nonatherosclerotic condition that affects small medium arteries and results in ischemia
*Renal artery stenosis (normally bilateral)
- secondary htn, abdominal bruit, flank abdominal pain, CKD
*cerebrovascular
-HA, neck pain, cervical bruit, tinnitus
-TIA, stroke, horners, amaurosis fugax
Diagnosis: string of Beads
-duplex ultrasonography, CT angio
-digital subtraction angiography
- see renal infarction, but don’t see months of constitutional symptoms ie fever, weight loss, muscle joint pai,n
ADR of erythrocyte stimulating agent
onset: 2-8wks of starting
worsening hypertension due to systemic vasoconstriction
hypercalcemia can be caused by what electrolyte deficiency?
hypomagnesemia
reflex change you would see with brain death
-deep tendon reflexes
cause?
herpes keratitis
meningitis vs encephalitis signs
meningitis- nuchal rigidity
neck stiffness
encephalitis: AMS, seizures
HSV encephalitis findings
increased lymphocytes
-behavioral changes, seizures
-temporal lobe damage on MRI
most common cause of b12 deficiency and increases risk for
pernicious anemia
- destruction of intrinsic factor receptors form gastric acid
gastric cancer
caused by?
with erythema nodosum, lymphadenopathy
-effects on electrolytes
sarcoidosis
GRUELING
Granuloma
aRthritis
Uveitis
Erythema nodosum
Lymphadenopathy
Interstitial fibrosis
Negative TB test
Gammaglobulinemia
-increases calcitriol, serum Ca, urinary Ca
-decreases PTH
Cause?
HIV patient
toxoplasmosis encephalitis
given to slow heart down for tacycardia
- adenosine
- vagal maenuver: carotid massage
amiodarone ADR
hypothyroidism hepatoceluar injury
pancreatic cyst management
endoscopic ultrasound guided biopsy
if it has high risk features
- large size>3cm
- solid components or calcifications
- main pancreatic duct involvement
- thickened or irregular cyst wall
conn syndrome
aka primary aldosteronism
-hypokalemia + low plasma renin + elevated serum sodium bicarb (metabolic alkalosis)
save sodium, kick out potassium
Treatment for MAC and CD4 risk cutoff
- CD4 <50/mm^3
- macrolide + ethambutol
increased erythrocyte destruction results in inc/dec haptoglobin?
decreased
looks like MI ,but no signs of obstructive coronary artery disease on coronary angiography
stress-induced cardiomyopathy
- changes in precordial leads
-apical left ventricular ballooning
transverse myelitis
tx
inflammation of parts of spinal cord:
- motor weakness
-authonomic dysfunction
-sensory dysfunction (numbness with distinct sensory level)
steroids , plasmapheresis
murmur associated with infective endocarditis
mitral regurgitation
common causes of massive transaminitis in thousands
ischemic hepatic injury
urine osmolality
value when it is too dilute
<40
meds that cause SIADH
SSRI NSAIDS
carbamazepine
vasospastic angina, what is it and treatment?
heart pain that mimics MI, can wake person up from sleep or at rest,
will see ST elevations, but no sings of occlusion on CT angio
Tx: diltiazem
CXR with ring of calcification around heart + constrictive pericarditis
TB
cardiac surgery
viral pericarditis
cause?
bacillary angiomatosis
first line treatment for arterial claudication
low dose ASA + statin + exercise therapy
if it fails revascularization or
symptoms of hyperaldosteronism
hypOkalemia
metabolic acidosis
hypertension
High leukocute alkaline phosphatase (lap) score means
high number of mature
wbc,
cardiovascular effects of marfans
aortic aneurysm ,
autosomal dominant polycystic kidney disease increases risk for ?
cause?
cerebral aneurysm / intracranial bleed
cause:
gene mutation causes impaired vascular integrity + htn from kidney changes
bronchiectasis
lots of mucis, chronic coughs, recurrent infections, blood tinged sputum
hereditary hemorrhagic telangiectasia
- autosomal dominant disorder where structural defects in vessel wall cause post-capillary venous pooling, arteriovenous shunting
- recurrent epistaxis, telangiectasia, cyanosis,
paroxysmal nocturnal hemoglobinuria
genetic defect that causes RBS to lose GPI anchor protection, results in hemolysis
Features: excessive fatigue, jaundice , hemoglobinuria, vein thrombosis (hepatic), pancytopenia
smoking related lung disease changes on XR presents as
ground glass infiltrates
myasthenia crisis vs cholinergic syndrome
myasthenia crisis: tachycardia , normal pupils
otherwise both will have muscle weakness, sweating, dyspnea, that leads to respiratory failure
Tx: intubation, prednisone, plasma exchange
peripheral vs central vertigo
central: postural instability, other ins symptoms ie weakness diplopia
- not fatiguable and no latency period
klinefelter
syndrome
xxy syndrome
-testicular dysgenesis results in testosterone deficiency
-testicular atrophy
-gynecomastia
-reduced facial hair
-tall stature with long extremities
HIV Associated Neurocognitive Disorder: HAND
- how does it look on MRI?
- RF
MRI: diffuse ventricular enlargement, brain atrophy, increased white matter intensity
KAPOSIS SARCOMA
-common in someone who is immunosuppressed, organ transplant aids
Steven johnson vs toxic epidermal necrolysis
SJS < 10% of body
ten > 30% of body
myeloproliferative disorder
groups of diseases in which bone marrow makes too many ribs, abc, or platelets
when do you treat hypercalcemia?
treatment?
when >14 or symptomatic
-NS + Calcitonin
-long term biphosphonate
epidermolysis bullosa
genetic conditions that causes skin to become fragile & blister easily
incidence vs prevalence
-incidence # of new changes, remains unchanged
-prevalence: number of total cases at a certain point in time,
cancer treatments that prolong survival will prolong prevalence but incidence will remain unchanged
chronic epigastric pain that is relieved by sitting up and leaning forward is most likely due to
- eval method
pancreatitis- abdominal ct
esophageal varice
px med
tx med
px: nonselective beta blocker
tx ocreotide
HCM murmur vs aortic stenosis
both crescendo decrescendo murmur but HCM -brisk carotid/ peripheral pulse vs AS soft delayed peripheral pulse
why are patients with pancreatic diabetes more susceuptible to hypoglycemia (9 DM from destruction of beta cells)
alpha cells of pancreas are destroyed too so they cannot make gglucagon when glycogen stores are depleted
-condition that affects 2nd 3rd MCP joint, chondrocalcinosis on XR
onset <40yo
tx?
arthropathy of hereditary hemochromatosis
tx: NSAIDS, phlebotomy
numbness and pain in 3rd and 4th toe, with clicking sensation when squeezinf the 3rd and 4th metatarsal joints together
morton neuroma
organisms that cause urinary alkalinization and kidney stones
proteus and klebsiella
asteristix can occur with
hypercapnia, uremia, and drug intoxication
mixed cryoglobulinemia
associated with hepatitis C, glomerulonephritis
when is transplant indicated for APAP overdose?
- PT> 100 seconds, grade 3/4 hepatic encephalopathy, SCr > 3.4
pericarditis
abnormal T waves, pleauritic chest pains
can be caused by uremia
hydroxychloroquine ADR
retinopathy
h”eye”droxychloroquine
eye exam q5y
criteria for extubation
-pH> 7.25
-PaO2 >/=60 on FiO2 </=40 and peep </=5
-intact inspiratory effort and sufficient
mental alertness to protect airway
what treatment for graves worsens eye disease
radioactive iodine
signs of lead poisoning
-microcytic anemia( basophilic stripping),
peripheral neuropathy, confusion
-htn, constipation
-nephrotoxicity, hyperuricemia
adenocarcinoma vs squamous cell carcinoma
adenocarcinoma- occurs in periphery and more common in non-smokers ( a for abstinence)
- SCC: central and smokers
cause of joint effusion
gout: monosodium urate crystals
osteoblastic lesions
associated with (cancer)?
sclerotic, focal lesion
normal-low Ca
high alkaline phosphatase
prostate cancer
CKD induces bone changes
radiographic evidence of widespread osteopenia and subperiosteal bone turn over
management of pancreatitis
- hydration , pain control
- get lipid panel (based on TG level )
0insuline infucsion or therapeutic plasma exchange
what type of murmur is benigh
midsystolic murmur
signs of epiglottitis
sore throat, laryngotracheal tenderness to palpation, fever
pooled oral secretions, respiratory compromise
