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42 Cards in this Set

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U/A results in UTI?

How can you tell if sample contaminated?
Leuk est +ve, Nitrite +ve
WBC & Bacteria in sample

If epithelials then contaminated
Retroperitoneal structures
Kidney/AG
Aorta/IVC
Pancreas
Most of duodenum
What are ways to decrease post op fever from atelectasis?
Stop smoking before surgery
Post op ambulation,incentive spirometry, minimal narcotics.
Pseudogout
Usually presents as a tender and swollen knee. Arthrocentesis will show +ve birefringent calcium pyrophosphate crystals that are rhomboid shaped. Makes articular cartilage speckle on x-ray and widens the koint space
Fibromyalgia
S/S
Tx
Neck and trap/shoulder/low back pain in someone who is under alot of stress.

NSAID, Rest, Anti-depressants
Pro thrombotic conditions(4)
1) Factor 5 leiden def(multiple DVT & PE)

2) Protein C&S deficiency

3) Anti-thrombin 3 def

4) Lupus procagulant(high PTT and alot of miscarriages)
Carcinoid tumor
S/S
Excess serotonin so have:
-Flushing
-Diarrhea
-High urine 5-OH indolenic acid
-Fibrosis of R heart valve
Basal Cell Cx
RF
What it looks like
Tx
UV

Pearly, umbilicated w/ tealangiectasias

Excisional biopsy
Mouth & throat cancer
RF
Type of cancer
ETOH & All tobacco. Pre cancer is erythroplakia which is seen as velvety red lesions. Cancer type is squanous cell cx.
Hairy cell leukoplakia
Culprit
SS
white plaque seen on lateral side of tongue in HIV patient from EBV. Not malignant.
Tumor Markers
Liver/Testicle: AFP

Pancreas: CA 19-9

Prostate: PSA or Acid phosphatase if extends out of capsule

Ovary: CA-125

Breast: CA 15-3 & 27-29

Mole/chorio: B-Hcg

GI(colon/bowel): CEA
Prick on rose w/ rash and axillary lymphadenopathy./
-Culprit
-Tx
Sporothrix scheneckki fungi
KI
Myasthenia gravis
SS
Dx
Tx
Anti Ach receptor Ab cause vision problems(diplopia & ptosis) with progressive weakness.

Dx: Tensilon/erdophonium

Tx: pyridostigmine

***All get thymectomy to prevent future thymoma***
Goodpasture
SS
Pathophys
Dx
Tx
Young man with dyspnea,hemoptysis & renal failure. Anti-glomerular BM Ab mediated (type II HS).

Dx: Biopsy kidney/lung and find linear pattern IgM/IgG/C3 on immunoflourescence.

Tx: Cyclosporine & steroids.
Pemphigus
SS
Dx
Tx
Bullae in the mouth and then moves to body(Type II HS rxn). Biopsy shows lacelike or fishnet pattern.

Tx: corticosteroids
COPD Pneumonia
Gram -ve cocobacilli(H.influenzae & M.Cattharalis)
PDA Drugs
Protaglandin to keep it open
Indomethacin(NSAID) to close
Diastolic Dysfunction Tx
Ventricle needs time to fill so slow it down with B-blockers and Ca blockers
VSD at birth Tx
Just observe b/c many will close by themselves. Otherwise do surgery if they get symptomatic
When to do ORIF
If skin breaks and give Abx also. if skin closed do CR.
Mitral Stenosis
Causes
Sound
Secondary to
-Rheumatic heart disease
-Atrial myxoma(echo to dx)

-Opening snap w/ diastolic rumble at apex.

-Increases pressure to all structures behind it
Mitral Regrgitation
Causes
Sound
Rheumatic heart disease or ruptured papillary/chordae tendinae

Systolic murmur that radiates to axilla
Aortic stenosis
Causes
Sound
Tx
Systolic murmur w/ decreased carotid upstroke & soft S2.

Will lead to LVH(S4) causing angina and syncope
Aortic regurgitation
Diastolic blow murmur
Causes of pancreatitis
Tx
ETOH
Stones
Trauma
Hypercalcemia
Steroids

NPO-Fluids-NG tube-Meperidine
**No Abx**
Lead time Bias
Maybe outcome is not due to Tx but due to screening b/c it catches the disease sooner
Confounding Variables
Other factors not considered that may have affected the outcome
Non-Response Bias
People who do not respond in a telephone survey
Recall Bias
In a retrospective study people do not recall events well
Unacceptability Bias
People do not admit to their ways b/c embarassed("yes i exercised and ate low fat all month!")
Interviewer Bias
Knows who is placebo and who is drug group
MMR CI
A live vaccine that is not ok for:

Pregnant(Rubella is TORCH)
Immunocompromised(AIDS ok)
Egg Allergy
Neomyacin allergy
Influenza A vaccine
Give annually
-adults >50
- <50 w/ chronic disease
- Kids w/ on ASA tx to prevent Reye
Pneumococcal vaccine
All newborns and those w/ increased risk of encapsulated infections
-Nephrotic syn/Renal failure
-Asplenia
-Sickle cell
-IC
-Adults>65
When to give Tetanus Booster
Give booster every 10 years or after wound/burn injury
HIV
-how long till you see symptoms
-Initial symptoms look like?
Symptoms seen in 1-3mo after body make anti-HIV Ab

Initial symptoms like EBV mono
Tinea Versicolor
SS
Tx
White patches and tx is Selenium sulfide
ACNE Tx
First peroxide & salicyclic acid

Then clinda & tetracycline

Finally isotretinoin(teratogen & liver disease)
RDS
Premie w/o enough surfactant and see ground glass infiltrates x-ray.

-Prevent w/ steroids in utero and give surfactant after birth.

-May get BPD
Dysphagia DDX
Achalasia

-Liquid & solid w/ chest pain
-High LES pressure on mannometry w/ abnormal peristalsis in entire esophogus
-bird beak appearance on barium w/ dilated esophogus proximal.

SYSTEMIC SCLEROSIS
-Liquid & Solid w/ reflux
-Lowered esophogeal sphincter pressure and poor peristalsis at lower 2/3 of distal esophogus.
AIDS esophogitis or mouth conditions.
Candida: Oral & esophogeal thrush(tx: fluconazole)

EBV: Hairy leukoplakia white plaque on lateral tongue.

CMV-Herpes esophagitis: Pain on swallowing.
Normal values of BUN/CR?

Primary causes of CRF?

Electolytes changes in CRF?

Supplements to give in CRF?
BUN= 5-25
CR= .6-1.2

ARF progression, DM, HTN, PCKD

-High K+,Mg+,PO4+,BUN/CR
-Low EPO(anemic), Ca+
-Metabolic acidosis

-Give Ca carbonate to bind PO4 and elevate calcium.
-Lower K+ in the diet
-Water soluble viamins