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142 Cards in this Set
- Front
- Back
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incubation period of HEV |
15-60 days |
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transmission of HEV typically occurs through ... |
fecally contaminated water |
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Dx of HEV infection is comfirmed with detection of .... by ... in the serum or feces or by the detection of ... |
HEV RNA by PCR; IgM AB to HEV |
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.... occurs in 15-25% of pregnant women infected with hepatitis E virus, especially those in the third trimester |
fulminant hepatitis |
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presentation of a patient with secondary syphilis (3) |
rash;generalized lymphadenopathy; constitutional symptoms |
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initial testing for syphilis(2); confirmation (1) |
non-treponemal test: RPR or VRDL; confirmed with a specific treponemal test - FTA-ABS |
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Jarisch-Herxheimer reaction -? |
acute febrile reaction with headaches and myalgias durin antibiotic treatment |
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do cutaneous drug reactions involve the palms and soles? |
no |
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pityriasis rosea is a cutaneous reaction that usually follows a ... |
viral illnes |
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does pityriasis rosea involve the palms and soles |
no |
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what areas of the body are involved in psoriasis process? |
elbows and knees |
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the rash in .... begins as a maculopapular eruption on the wrists and ankles that spreads to the trunk, etremeties, palms and soles around day 5 of the illnes |
rickettsial diseases: RMSF or ehrlichiosis |
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most common cause of rash in children |
viral exanthem |
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Str. viridans group (6) |
sanguinis; mitis; oralis; mutans; sobrinus; milleri |
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infective endocarditis with .... is commonly encountered after dental procedures involving manipulation of the gingival tissue or oral mucosa and procedures involving incision and biopsy of the respiratory tract |
str. viridans group |
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common coause of healthcare-associated endocarditis associated with nosocomial urinary tract infections |
enterococci species (enterocccus faecalis) |
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soagulase-negative staphylococci: (2) |
aureus; epidermidis |
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.... and are usually seen in infective dnocarditis in patients with indwelling IV catheters or implicated prostetic valves or devies and in IV drug users |
Staph. aureus and staph. epidermidis |
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... usually causes urinary tract infections in young women |
Staph. saprophyticus |
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infective endocarditis due to ... is seen in patients with ulcerative lesions of the colon due to colon cancer or inflammatory bowel disease |
staph. bovis(gallolyticus) |
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patients with .... esophagitis have oral thrush |
Candida |
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symptomatic patients with candida esophagitis can be treated with ... |
fluconazole |
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most commonly implicated viruses in viral esophagitis (2) |
HSV and CMV |
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... virus esophagitis usually causes circular or ovoid vesicular and ulcerated lesions |
herpes simplex |
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... virus esophagitis usually causes large, linear distal esophageal ulcers |
cytomegalovirus |
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HIV patient with severe odynophagia without dysphagia or thrush |
viral esophagitis |
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specific type of cullulitis, characterized by inflammation of the superficial dermis, thereby producing prominnet swelling |
erysipelas |
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most likely causative organism of erysipelas is group ... |
A beta-hemolytic str. (str. pyogenes) |
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causative organism of gas gangrene |
clostridium perfringens |
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next step in management of patient with acute ST-elevation MI with persistent pain, hypertension or heart failure after O2, Aspirin, Clopidogrel, Sublingual nitrates, Beta blockers, Statins, Anticoag thx |
IV nitroglycerin |
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contraindications of nitroglycerin use in patients with acute ST-elevation MI (3) |
hypotension; right ventr. infarct; severe aortic stenosis |
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next step in management of patient with acute ST-elevation MI with persistent severe pain after O2, Aspirin, Clopidogrel, Sublingual nitrates, Beta blockers, Statins, Anticoag thx |
IV morphine |
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next step in management of patient with acute ST-elevation MI with unstable sinus bradycardia after O2, Aspirin, Clopidogrel, Sublingual nitrates, Beta blockers, Statins, Anticoag thx |
IV atropine |
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next step in management of patient with acute ST-elevation MI with pulmonary edema after O2, Aspirin, Clopidogrel, Sublingual nitrates, Beta blockers, Statins, Anticoag thx |
IV furosemide |
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contraindications of furosemide use in patients with acute ST-elevation MI (2) |
hypotension; hypovolemia |
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used for rate control in patients with rapid atrial fib. and to improve symptoms in patients with CHF |
digoxin |
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why oes amlodipine is contraindicated in the acute management of MI or congestive heart faialure |
vasodilation can result in refle tachycardia and increased myocardial O2 demand |
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contraindications of beta-blockers in pateitns with acute MI |
pulmonary edema |
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second line drug for management of angina pain |
verapamil |
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Ca channel blocker used in te management if hypertension and supraventricular tachycardia |
verapamil |
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sudden onset of sever chest pain radiating to the back and widened mediastinum on chest x-ray are suggestive of ... |
aortic dissection |
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hypotension, tachycardia, distended jugular veins, pulsus paradoxus are consistent with the presence of ... |
cardiac tamponade |
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pulsus in aortic stenosis |
parvus et tardus |
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basic workup of initial evaluation of scondary causes of hypertension include (4) |
urinalysis; chemestry panel; lipid profile; baseline ECG |
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characteristic findings of Cushing's syndrome (3) |
central obesity; abdominal striae; facial plethora |
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... is used to evaluate for Cushing's syndrome |
24-hour urine cortisol ecretion |
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low plasma renin + hupokalemia + hypertension |
primary hyperaldosteronism |
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additional studies in patients with hypertension if there is an elevated serum creatinine or abnormal urinalysis (2) |
(imaging studies)renal ultrasound; doppler ultrasound |
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24-hours metanephrines and cathecholamines are levated in patients with ... |
pheochromocytoma |
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screen for occult hypothyroidism |
thyroid-stimulating hormone |
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extracellular deposit of insoluble polemeric protein fibrils in tissues and organs |
amyloidosis |
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type of primary amyloidosis |
AL |
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chronic inglammatory conditions leadinf to seondary amyloidosis(AA) (5) |
inflammatory arthritis(rheumatoid arthritis); chronic infections; inflammatory bowel disease; malignancy; vasculitis |
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initial thx for chronic venous disease |
leg elevation; exercise; compression stockings |
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ECG findings in acute pericarditis |
diffuse ST elevations, with PR depressions |
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change in cardiac preload in patients with arteriovenous fistula |
increased cardiac preload |
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causes of high-output heart failure |
arteriovenous malformations; thyrotoxicosis; Paget disease; anemia; thiamine deficiency |
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SLE and chronic steroid use are .... for accelerated coronary atherosclerosis |
risk factors |
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first step in Dx of coronary disease if baseline resting EKG is normal |
exercise stress test |
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EKG in constrictive pericarditis |
afib; low-voltage QRS complex |
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EchoKG in constrictive pericarditis |
pericardial thickening; abnormal septal motion; biatrial enlargement |
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complication of mediastinal irradiation |
constrictive pericarditis |
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why aortic stenosis causes anginal pain in physical activity |
hyperthrophy and increased oxygen demand |
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vasovagal syncope is precipitated by ... and is preceded by ... |
emotinal reaction; dizzines, weakness, nausea |
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cause of orthostatic syncope |
autonomic dysfunction; drug-induced postural hypotension |
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most common cause of resistant hypertension |
renovascular |
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aldosterone/renin ration > 20:1 |
primary aldosteronism |
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resistant hypertension with uneplained hypokalemia |
primary aldosteronism |
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urinary ecretion of vanillylmandelic acid is increased in ... |
pheochromocytoma |
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patients with ... generally presents with episodic pounding headaches, palpitations, and diaphoresis associated with paroxysmal elevation in blood pressure |
pheochromocytoma |
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HFE gene mutation |
hemochromatosis |
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HFE gene encoding ... |
beta-2 macroglobulin |
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liver complications of hemochromatosis |
cirrhosis; hepatocellular carcinoma |
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medication to treat hempchromatosis |
deferoxamine |
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deferoxaimne-? |
iron chelator |
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location of gene mutation in hereditary hemochromatosis |
HFE gene on chromosome 6 |
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renovascular hypertension should be suspected in all patients with resistant hypertension and ..(3) or (1) |
diffuse atherosclerosis; asymmetric kidney size; recurrent flash pulmonary edema; or creatinine >30% |
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... caused by temporary spasm of the coronary arteries |
variant angina(Prinzmetal's angina) |
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... occur in the setting of hypertension, and affect small, penetrating arteries which supply the basal ganglia, subcortical white matter, and pons |
lacunar stroke |
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occlusion of small penetrating arteries by microatheroma and lipohyalinosis is the mechanism of ... |
lacunar stroke |
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reversible risk factors for atrial premature beats (2) |
tobacco and alcohol |
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most specific arrythmia for digitalis toxicity |
atrial tachycardia with AV block |
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heart sound "ken-tuc-KY" |
third heart sound |
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... is believed to result when inflow from the left atrium strikes blood that is already in theleft ventricle, causing reverberation of blood between the left ventricular walls |
S3 |
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S3 appearence later in life is often a sign of ... |
left ventricular failure |
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diltiazem is not beneficial in the treatment of patients with decompensated heart failure due to ... |
its negative inotropic effects |
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cardivascular features of Marfan syndrome(3) |
aortic insuficiency; mtral valve prolapse; aortic dissection |
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pulmonary features of Marfan syndrome |
spontaneous pneumothorax from apical blebs |
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skin manifestations of Marfan syndrome (2) |
recurrent or incisional hernia; skin striae |
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ocular complications of Marfan syndrome (1) |
ectopia lentis |
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a wide and fixed splitting of the second heart sound is present in patients with ... |
atrial septal defect |
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Holt-Oram syndrome -? |
upper limb defects + atrial septal defect |
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opening sanp is asociated with .. |
mitral stenosis |
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pulse with decreased amplitude and elayed peak |
pulsus parvus et tardus |
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pulsus parvus et tardus is commonly seen in |
severe aortic stenosis |
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common side effect of the treatment with dihydropyridine Ca-channel antagonists |
peripheral edema |
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... causes temporary AV block, which is useful in underlying - and in some cases, terminating supraventricular tachycardia |
adenosine |
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thx of symptomatic sinus bradycardia |
IV atropine |
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viral myocarditis is most commonly seen following .... infection |
Coxackievirus B |
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initial management for atrial fibrillation (2) |
rate contorl with beta-blockers or Ca blockers(diltiazem) |
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patients with afib >48 hours can develop ... |
left atrial appendage thrombus |
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patients with long standing afib(<48 hours) should receive initial .... with 3-4 weeks of ... before cardioversion is attempted |
initial rate control with 3-4 weeks of anticoagulation |
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persistent ST-segment elevation after a recent MI and deep Q waves in the same leads |
ventricular aneurism |
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mechanical complication of acute MI that typically occus 2-7 days after the infarct; causes an acute severe mitral regurgitation |
papillary muscle rupture |
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most common ECG signs of pericardial effusion (2) |
low-voltage QRS complexes; electrical alternans |
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occlusion of the proximal right coronary artery leads to (2) |
right ventricular infarction; inferior wall MI |
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capture of electrical signal through both the atrium and ventricle briefly |
fusion beat |
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preffered thx for sustained monomorphic ventricular tachycardia |
IV amiodarone |
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ultra-short acting beta bloker used for rapid rate control in atrial flutter or fibrillation |
esmolol |
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common causes of exertional syncope (2) |
ventricular tachycardia; left ventr. outflow obstruction |
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pulsus paradoxus calssically is seen in ... |
cardiac tamponade |
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capillary pulsations in the fingers and lips may be observed in ... |
aortic regurgiation |
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late diastolic murmurs are heard most commonly in ... |
mitral stenosis |
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opening snap is seen in .. |
mitral stenosis |
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patients with mitral stenosis present with (2) |
pulmonary edema; atrial fibrillation |
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etiology of constrictive pericarditis (3) |
idiopathic/viral; cardiac surgery/radiation; TB |
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clinical presentation of constrictive pericarditis (6) F and D; PE and A; JP; PK; PP; KS |
fatigue and dyspnea on exertion; peripheral edema and ascites; elevated jugular venous pressure; pericardial knock; pulsus paradoxus; Kussmaul's sign |
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ECG in constrictive pericarditis |
afib; low QRS voltage |
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2 most common causes of cor pulmonale |
COPD; pulmonary emboli |
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signs of pulmonary hypertension (2) |
widley split S2; increased intensity of the pulmonic component of S2 |
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cause of CHagas disease |
trypanosoma cruzi |
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Chagas disease can cause (3) |
megacolon; megaesophagus; cardiac failure |
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common side effect of Ca blocker thx |
peripheral edema |
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mechanism of Ca blocker thx edema |
preferential dilation of precapillary vessels(arteriolar), which leads to increased capillary hydrostatic pressure and fluid etravasation |
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what medications decreas risk of Ca blocker thx associated edema |
ACE inhibitor/ARBs |
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side effects of hydrochlorthiazide (5) |
electrolyte imbalances; renal failure; hyperuricemia; high glucose; high cholesterol |
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losartan -? |
angiotesin receptor blocker |
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side effects of beta blockers (5) |
worse of CHF; bradyarrythmias; increased airway resistance(in asthma); generalized fatigue; sexual dysfunction |
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severe hypertension with retinal hemorrhages, exudates, or papilledema |
malignant hypertension |
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features of malignant hypertension (3) |
retinal hemorrhages, exudates, or papilledema |
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features of hypertensive encephalopathy (2) |
cerebral edema; non-localizing neuro symptoms and signs |
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severe hypertension with cerebral edema and non-localizing neuro symptoms and signs |
hypertensive encephalopathy |
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acute thx for dissection of aorta |
IV labetalol |
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use of Ca++ blockers in aortic dissection leads to |
can cause reflex tachycardia and increases stress on aortic wall |
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main reasons for the increased incidence of orthostatic hypotension in the eldery (2) |
decreasing baroreceptor sensitivity and defects in the myocardial response to baroreflex |
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noniflammatory and nonatherosclerotic condition caused by abnormal cell development in the arterial wall that can lead to vessel stenosis, anurrysm, or dissection |
fibromuscular dysplasia |
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dx confirmation of fibromuscular dysplasia |
CT angiography of the abdomen or duplex ultrasound |
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the reason why renin is low in primary hyperaldosteronism |
aldosterone supresses the renin through a feedback inhibition |
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cardiac manifestations of hereditary hemochromatosis (3) |
restrictive cardiomyopathy; dilated cardiomyopathy; conduction adnormalities |
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infectious manifestations of hereditary hemochromatosis (3) |
icreased susceptibility to listeria, vibrio vulnificus and yersinia enterocloitica |
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endocrine manifestations of hereditary hemochromatosis (3) |
diabetes mellitus; secondary hypogonadism; secondary hypothyroidism |
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triad of hemochromatosis |
cirrhosis; diabetes mellitus; skin pigmentation |
