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67 Cards in this Set
- Front
- Back
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Most effective agent in the treatment of Allergic Rhinitis
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Intranasal corticosteroids
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Define orthostatic hypotension
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Drop in both systolic (>20mmHg) and diastolic (>10mmHg) in association with symptoms of decreased cerebral blood flow (lightheaedness, blurry / dark vision or syncope)
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What are common causes of orthostatic hypotension?
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Hypovolemia (Blood loss, adrenal insufficiency)
Autonomic insufficinecy (sympathetc nervous system dysfunction) Medications (Hydralazine, ACE-I, Nitrates, CCB's, TCA's, phenothiazines, diuretics) |
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Compensatory increase in heart rate with a subsequent drop in blood pressure is caused by what?
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hypovolemia (blood loss, diuresis, adreal insufficiency)
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NO compensatory increase in heart rate with a drop in blood pressure is caused by what?
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Autonomic insufficiency (Diabetes mellitus)
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Sudden onset of fever, chills, myalgia, headache- 2 days later, diffuse macular and petechial rash is noted including the soles and palms
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Rocky Mountain spotted fever
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Rhinorrhea, sneezing, nasal congestion, post nasal drip, no specific allergic, infectious metabolic or pharmacologic etiology- all year symptoms
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Vasomotor rhinitis
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What organism is responsible for the majority of deaths in CF patients?
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Pseudomonas Aeruginosa
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Patients with nasal polyps and a history of asthma should avoid what medication and why?
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ASA, can cause severe bronchospasms
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Patients who have coarctation of the aorta typically have what type of aortic valce?
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Bicuspid
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Paroxysmal hypertension, with associate sweating and tachycardia
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Pheochromocytoma
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Glucose intolerance, hypokalemia, rounded face, buffalo hump, truncal obesity, purple striae
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Cushings syndrome
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A patient with COPD and clubbing should be worked up for what?
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Lung Cancer
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What are some causes of clubbing?
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Lung CA (primary & mets)
Cyanotic congenital heart disease Endocarditis Long standing CF Mesothelioma Bronchiectasis Lung abscesses Pulmonary fibrosis Hepatic cirrhosis Crohn's Disease |
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Subperiosteal formation of new bone- pain in shoulders, knees, ankles, wrists, elbows
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Hypertrophic osteoarthropathy
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When is hypertrophic osteoarthropathy found?
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In patients who have clubbing due to lung CA, mesothelioma, bronchiectasis or cirrhosis
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Elderly patient with Isolated systolic hypertension, apathetic, anorexia, weight loss, atrial fibrillation
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Check for hyperthyroidism
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What are some causes of isolated systolic hypertension?
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1- Age
2- Hyperthyroidism 3- Chronic aortic regurg |
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What is the preferred treatment for isolated systolic hypertension and the alternative?
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Preferred- thiazide diauretic
Alternative- dihydropine CCB (ie, amlodapine) |
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What are the earliest neurologic abnormalities associated with Vitamin B12 deficiency?
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Loss of vibratory sensation and proprioception (ABNORMAL ROMBERG)
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Lyme disease most commonly affects which cranial nerve?
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CN VII - bilateral
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An unruptured cerebral aneurysm wil most commonly cause palsy of what cranial nerve?
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CN III
Patients present with facial pain, headache or visual acuity loss |
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Sarcoidosis patients will develop what type of palsy?
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CN VII
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Patients with diabetes mellitus will develop palsy's with what nerves?
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CN III- atypical presentation pupil size will remain normal
CN IV CN VI AFFECTING extraocular movement!!!! |
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Thyroid function tests should be checked every 3-4 months in patients taking what medications?
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1. Lithium
2. Amiodarone |
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Congenital long QT syndrome - the child is most likely to faint when?
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Druing periods of exercise or stress
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Apical lift, systolic ejection murmur near the apex bisferirns carotid pulse
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Hypertrophic obstructive cardiomyopathy
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Low plasma cortisol, elevated plasma ACTH, hyponatremia, hyperkalemia
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Addisons disease (primary adrenal insufficiency)
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Low plasma cortisol, LOW plasma ACTH, hyponatremia
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Secondary adrenal insufficiency
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Elevated serum alkaline phosphatase and increased urinary hydroxyproline, expanded bone on radiology, normal calcium, normal phosphorus
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Pagets disease
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What is used to treat Pagets disease?
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Biphosphonates
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Dexamethasone supression test
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Cushings syndrome
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Schillings test
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Pernicious anemia
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Coombs test
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Hemolytic anemia
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Urea breath test
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H. Pylori
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Vasopressin challenge test
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Diabetes Insipidus
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Adrenal cortico tropin stimulation test
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Addisons
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24hour urine for vanillylmandelic acid
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Pheochromocytoma
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facotry worker, involved with treatment of cotton chest tightness, and symptoms occur after returning to work from the weekend
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Byssinosis
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rockmining stone cuting, pottery
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silicosis
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mining, installing insulation, construction, ship building
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abestosis
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manufacturing alloys, ceramics and electronics
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berlliosis
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Inhalation of magnesium sulfate- mining, installing insulation, construction, ship building
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talcosis
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1st line agent for hypertension in a heart failure patient, LVD, history of STEMI, DM or renal failure
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ACEI
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1st line agent for hypertension in a male who has BPH
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Alphy 1-adrenergic blocker
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Preferred antihypertensive in a patient with angina pectoris or atril fibrillation
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Beta-adrenergic blocker or nondihydropine calcium channel blocker
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What class of drugs is sildenafil
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phosphodiesterase 5 inhibitor
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Centrally located on face and neck, pustules with erythema and telangictasia. Aggrevated by alcohol and stress.
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Rosacea
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papular rash with fine white streaks on the skin and mucus membranes, painful buccal involvement.
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Lichen planus
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Patient with abnormal movements and postures, a desire to be in constant motion is exhibiting signs of
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EPS
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Patient taking SSRI and begins to take St. Johns Wort, begins to have agitation, delirium, vomiting, diarrhea and sweating. Pupils are dilated , skin is flushed, tachycardia and fluctuating hypertension.
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Serotonin syndrome
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What advice would be given to patients taking methotrexate?
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Milk reduces absorption
Patients need LFT's every 4-8 weeks Take Folic Acid to reduce the risk of hepatotoxicity Avoid alcohol |
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Endocaditis prophylaxis for dental, respiratory or esophagel procedures
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Amoxicillin 1 hour prior
PCN allergic patients: Clindamycin, azithromycin or cephalexin |
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Endocarditis prophylaxis for gastrointestinal or genitourinary procedures
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ampicillin plus gentamycin or vancomycin plus gentamycin
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What is the most common organism causing ticlotrimazone, econazole, sulconazole, terbinafine or butenafineea corpis
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Trichophyton rubrum
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What is the treatment of tinea corpis
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miconazone, clotrimazole, econazole, sulconazole, terbinafine or butenafine
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what drug is not recommended to treat tinea corpis
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betasone dipropionate with clotrimazole (Lotrisone)
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Diffuse annular lesions affecting the palms, soles and mucus membranes
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secondary syphilis
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what bacteria causes syphilis
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treponema pallidum
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What drugs may cause a psoriasis-like rash
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lithium
chloroquine beta blockers |
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arthritis associated with psoriasis usually presents where
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distal and affecting few joints
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What are the early radiological findings in RA
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occur initally on the wrists or feet
soft tissue swelling and demineralization |
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What drugs may worsen the rash of psoriasis
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beta blockers
lithium anti-malarials HMG-CoA reductase inhibitors (statins) |
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What are some nail changes seen in psoriasis
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pitting of the nails
tan-brown discoloration may occur |
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Acute pancreatitis with a normal serum amylase is caused by
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alcohol ingestion
elevated plasma triglycerides |
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What medications may elevate serum amylase levels
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ASA
Codeine Estrogens Metronidazole Thiazides Iodine containing contrast media |
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What medical conditions are associated with elevated serum amylase levels
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Mesenteric infarction
Ruptured ectopic pregnancy Myltiple myeloma Cystic fibrosis Obstructed bowel Perforated bowel PID |
