X Flashcards
Dx chronic pancreatitis
CT pancreas calcification
delayed sleep phase syndrome
sleep onset insomnia and excessive morning sleepiness
type of respiratory involvement in wegeners
lower respiratory
respiratory involvement in good pastures
upper respiratory
chronic liver disease Physical signs
new onset ascites, pedal edema, spider angiomata, plamar erythema, caput medusa, nail changes, gynecomastia, splenomegaly, testicular atrophy
most important step in management of non ketotic hyperglycemic coma
fluid replacement- normal saline
what acid base disorder is caused by aspirin toxicity
mixed respiratory alkalosis and metabolic acidosis
which diuretic decreases tolerance to glucose
thiazides
lectrolyte abnormalities from thiazides
hyponatremia, hypokalemia, hyperCa
febrile neutropenia
EM
start early empiric antibiotic therapy
anti pseudomonals are good
anti pseudomonals
cefepime, meropenem, piperacillin-tazobactam
what cause respiratory alkalsosis
hyperventilation from pneumonia, high altitude or salicylate intoxication
findings of coccidiomycosis
fever, fatigue, cough, weight loss, pleuritic chest pain, erythema multiforme and erythema nodosum
where is histoplasmosis found
Southeastern, mid atlantic and central US
where is blastomycosis found
south central and north central
where does blastomycosis affect in the body
lungs, skin, bones, joints, prostate
usually immunosupressed
what drugs can lead to invasive aspergillosis
cyclosporine
high dose glucocorticoids
CT shows pulmonary nodules with halo sign or air crescent
invasive aspergillosis
quickest way to correct hyperkalemia
insulin and glucose
which drug can cause macrocytic anemia
MTX
what to supplement with MTX
folic acid
side effects of MTX
macrocytic anemia, nausea, stomatitis, rash, hepatotoxicity, interstitial lung disease, alopecia and fever
what causea anaphylactic reaction in blood transfusions
recipient anti IgA Ab
risk factors for adenocarcionm of esophagus
barretts, obesity, high dietary calorie, fat intake, smoking, medications that promote GERD
major risk factors for squamous cell CA of esophagus
smoking, alcohol, dietary deficiency of beta carotene, vit B1, zinc, selenium, viral infections, toxin producing fungi, hot food and beverages, pickled vegetables and food rich in N nitroso compounds
increased risk for what with hiatal hernia
barretts
iron and ferritin levels in sideroblastic anemia
normal to high serum Fe
normal to high ferritin
adverse effects of antithyoid drugs
agranulocytosis
methimazole- 1st trimester teratogen and cholestasis
propothiouracil- hepatic failure, ANCA-associated vasculitis
tolvaptan
V2 vasopressin R antagonist that causes selective water loss in kidney w/o changing Na or K
only used for significant hypervolemia in heart failure or euvolemic hyponatremia in SIADH
differentiate mild/mod and severe C dif
mild/mod: WBC15,000
Cr >1.5x baseline
serum albumin
what are the Tx options for C dif
metronidazole for mild/mod
oral vanco for severe
super severe go for colectomy… that is if toxic megacolon like
what can prevent febrile nonhemolytic reaction and reduce risk of HLA alloimmunization and CMV transmission
leukoreduction
blood transfusion reactions timline
anaphylaxis- secs to minutes
acute hemolytic- minutes to hours
febrile nonhemolytic- 1-6 hours
delayed hemolytic- 2 days to 10 days
skin manifestations of cholesterol emboli from cardiac cath
blue toes, livedo reticularis, gangrene and ulcers
whipples disease
trophyerma whippelii
weight loss, diarrhea and abdominal pain, malabsorption, flatulence and steatorrhea
migratory polyarthropathy, chornic cough and myocardial or valvular involvement
PAS + material in lamina propria in small intestine
whipples disease
bloody diarrhea primarily caused by what pathogens
E coli, Shigella, CAmpylobacter
what to avoid in enterohemorrhagic e coli
empiric antibiotic therapy because can increase risk of HUS
signs of acute angle closure galucoma
severe eye pain with n/v
red eye with steamy cornea and moderately dilated pupil that is non reactive to light
if BP is greater in R arm than L
coarctation aorta
BP hard to control despite many medications
secondary HTN
most likely renal artery stenosis
appearance of pseudogout
rhomboid shaped crystals with + birefringence
findings of lead poisoning
microcytic anemia
PBlood smear shows basophilic stippling
in clinical trials what makes randomization successfull
when similar baseline characteristics of patients in treatment and placebo group are seen
development of new conduction delay in someone with infective endocarditis
perivalvular abscess
Tx for severe hypovolemic hypernatremia
0.9% saline
Tx for mild hypovolemic hypernatremia
0.5% dextrose in .45% saline
what type of lung cancer releases PTHrP
squamous cell
what labs are elevated in Pagets disease
alk phos hydroxyproline deoxypyridinoline N telopeptide C telopeptide
Xray of skull shows bone resoprtion and sclerosis
R leg pain for past year
pagets
