XI Flashcards
diastolic murmur in 20 y.o
investigate with echo
main cause of orthostatic hypotension
hypovolemia
how to confirm hypovolemia with CMP
elevated BUN/Cr ration because it is prerenal azotemia
acute epididymis in elderly population
non STD related
E coli
autoimmune conditions associated with vitiligo
pernicious anemia, autoimmune thyroid disease, type 1 DM, primary adrenal insufficiency, hypopituitarism, alopecia areata
actinic keratosis on light microscopy
areas of acanthosis, parakeratosis, dyskeratosis and hyperkeratosis
lung CA that realses ADH
small cell
What are small cell lung cancer assoc paraneoplastic synromes
ectopic ACTH leading to Cushing
Lamber Eaton syndrome
SIADH
mass in middle of mediastinum
bronchogenic cysts
main step when suspect acromegaly
measure IGF-I
glucose does what to GH
suppress it
characteristics of nephrosclerosis
hypertrophy and intimal medial fibrosis of renal arterioles
DM nephropathy characteristics
increased extracellular matrix, basement membrane thickening, mesangial expansion and fibrosis
upper lobe cavitations
suspect TB
increased LDHa nd bilirubin
decreased haptoglobin
hemolytic anemia
antibiotics for human bite or dog bite
augmentin
amox-clavulanate
management of DKA
1 restore volume with normal saline
correct hyperglycemia with regular insulin
correct electrolytes- potassium
treat precipitating factors like infecitons
most useful intervention for peripheral arterial claudication
supervised graded exercise program
Good Pastures
nephritic proteinuria, acute renal failure, urinary sediment with dysmorphic RBC and casts
pulmonary– SOB, cough, hemoptysis
fever, weight loss, arthralgias
udnerlying cause of goodpastures
Ab to alpha 3 chain type IV collagen
microscopy of goodpastures
linear IgG deposition along the glomerular BM
common causes of nephrotic syndrome
focal segemental glomerulosclerosis, minimal change disease, membranous nephropathy, DM, primary amyloidosis, IgA nephropathy
causes of nephritic syndrome
IgA nephropathy, lupus nephritis, thin BM disease
Dx mixed cryoglobulniemia
serum cryos, low Complement levels
most common cause of cyroglobulinemia
chronic Hep C
empyema
intrapleural colleciton pus usually from bacterial pneumonia
bacteria that cause empyema
strep pneumo
staph aureus
klebsiella pneumo
signs of empyema
fever cough, SOB and pleuritic chest pain
radiograph findings in empyema
free flowing or loculated pleural effusion with lung consolidations with air bronchograms
when to suspect gastrinoma
when endoscopy shows multiple stomach ulcers and thickened gastric folds
which syndrome is zolinger ellison syndrome apart of
MEN1
secretin test
secretin stimulates gastrin in gastrinoma
usually gastic G cells are inhibited by secretin so usually should not cause an increase in gastrin
most common extrapulmonary sites for nocardia
brain and skin
Tx nocardia
TMP SMX
Tx uncomplicated cystitis
nitrofurantoin
tMP SMX
fosfomycin
Tx complicated cystitis
fluoroquinolones for 5-14 days
outpatient Tx pyelonephritis
fluoroquinolone
inpatient Tx pyelnephritis
IV fluoroquinoones, aminoglycoside +/- ampicillin
Tx hemophilia A or B
factor VIII or Ix
desmopressin for mild hemophilia A
what is elevated in hemophilia: PT or PTT
PTT
Dx C dificile
stool sample
murmur in mild AR vs severe
mild has a early diastolic murmu
severe has holosystolic
bounding pulses
seen with aortic regurg from increased SV
pneumonia in right lower lobes is usuallyd ue to what
local obstruction or recurrent aspiration
mitral stenosis is most commonly due to what
rheumatic fever
what heart pressures are elevated in mitral stenosis
left atrial and pulmonary vasculature
also get an elevation of the L main bronchus
most cmmon cause of nephrotic syndrome in the US
FSGS
non inflammatory chronic prostatitis
afebrile with irritative voiding Sx
PE unremarkable and UA normal
most cmmon cause of adhesive capusltiis
rotator cuff tendinopathy
signs of cocaine intoxication
psychomotor agitation dilated pupils atrophic nasal mucosa HTN acute myocardiacl sichemia
CV effects of cocaine
coronoary vasoconstriciton, inc HR, inc BP inc myocardial oxygen demand
increase thrombus formation by promotoing platelet activation and aggregation
