General Im

Front 1

Define HTN

Back 1

reading of 140/90 on 3 separate occasions

Front 2

Define prehypertension

Back 2

120-139/80-89

Front 3

Define Stage 1 HTN

Back 3

140-159/90-99

Front 4

Treatment of choice for Stage 1 HTN?

Back 4

thiazides

Front 5

Define Stage 2 HTN

Back 5

>160/>100

Front 6

Treatment for stage 2 HTN?

Back 6

thiazide plus at least one other agent

Front 7

Treatment for pregnant patients with HTN?

Back 7

hydralazine, labetalol, or alpha-methyldopa

Front 8

Treatment for hypertensive emergencies or urgencies?

Back 8

nitroprusside, nitroglycerin, or beta-blocker (e.g. labetalol)

Front 9

What does nitroprusside dilate?

Back 9

arteries and veins

Front 10

What does nitroglycerin dilate?

Back 10

veins only

Front 11

hydralazine, alpha antagonists, Ca2+ blockers all act on what?

Back 11

dilate arteries

Front 12

what is the most common cause of secondary HTN in a young women?

Back 12

OCPs

Front 13

How do you diagnose renovascular HTN?

Back 13

renal bruit; CT or MR angiogram
(can also use US or nuclear medicine)

Front 14

How do you treat renovascular HTN?

Back 14

angioplasty

Front 15

Young man with HTN?

Back 15

excessive alcohol intake or "exotics" - pheo, Cushing's, Conn's, PKD

Front 16

Test to order for suspected pheochromocytoma?

Back 16

urinary catecholamines (vanillylmandelic acid, metanephrine)

Front 17

Sx of pheo?

Back 17

intermittent severe HTN, dizziness, diaphoresis

Front 18

Flank mass, family hx, elevated BUN/Cr

Back 18

PKD

Front 19

Test to order for suspected Cushing's?

Back 19

Dexamethasone suppression or 24 hour urine cortisol

Front 20

Lab findings in Conn's syndrome?

Back 20

high aldosterone, low renin

Front 21

Diagnosis of diabetes made by what lab values?

Back 21

fasting plasma glucose >126 or
random glucose of 200
(if asymptomatic, test should be repeated)

Front 22

Threshold for diagnosing diabetes with OGTT?

Back 22

if 200 mg/dL reached within 2 hours of 75g glucose

Front 23

Goal of diabetes treatment is to keep postprandial glucose ____

Back 23

<180-200

Front 24

Goal of diabetes treatment is to keep fasting glucose _____

Back 24

<130

Front 25

Islet cell pathology in Type I DM?

Back 25

insulitis (loss of most beta cells)

Front 26

Islet cell pathology in Type II DM?

Back 26

normal number, but with amyloid deposits

Front 27

HLA association with what type of diabetes?

Back 27

Type I

Front 28

Level of C peptide in people with accidental OD or factitious disorder?

Back 28

low

Front 29

Level of C peptide in someone with an insulinoma?

Back 29

high

Front 30

Treatment of DKA?

Back 30

fluids, IV regular insulin, K & Phos replacement

Front 31

Diagnosis of DKA requires what 3 things?

Back 31

hyperglycemia, hyperketonemia, and metabolic acidosis

Front 32

Diagnosis of nonketotic hyperglcemic hyperosmolar state requires what?

Back 32

hyperglycemia and hyperosmolarity without ketonemia

Front 33

Treatment of nonketotic hyperglcemic hyperosmolar state?

Back 33

IV fluids, IV insulin, electrolyte replacement

Front 34

what class of drugs helps to prevent nephropathy?

Back 34

ACE-Is

Front 35

How do you treat gastroparesis?

Back 35

metoclopromide

Front 36

If a patient has a high 7 am glucose, what do you do to dinner NPH?

Back 36

increase

Front 37

Patient has a high noon glucose - what do you do?

Back 37

Increase morning regluar insulin or increase before-breakfast lispro or aspart

Front 38

What is the Somogyi effect?

Back 38

body's reaction to hypoglycemia - if too much insulin is given at night, 3 am glucose will be low ->body releases stress hormones -> 7 am glucose is high

Front 39

what is the dawn phenomenon?

Back 39

hyperglycemia caused by normal early morning growth hormone secretion - 7am glucose is high wthout 4am hypoglycemia

Front 40

How much insulin should diabetic patients undergoing surgery get?

Back 40

1/3- 1/2 of normal insulin dose; monitor closely intra- & post-op with D5W and IV regular insulin

Front 41

Why should beta-blockers be used cautiously in diabetic patients?

Back 41

can mask the sx of hypoglycemia (tachycardia, diaphoresis)

Front 42

Goal for total cholesterol?

Back 42

<200

Front 43

Goal for triglycerides?

Back 43

<150

Front 44

pancreatitis without alcohol use or gallstones may be a marker for what?

Back 44

familial hypercholesterolemia

Front 45

medications that can cause hypercholesterolemia?

Back 45

OCPs, glucocorticoids, thiazides, beta-blockers

Front 46

Risk factors for coronary heart disease?

Back 46

age (men-45, women-55 or with premature menopause and no estrogen tx)
family hx of premature CHD
current smoking (>10/day)
HTN
low HDL (<40)

Front 47

List four things that decrease HDL

Back 47

smoking, androgens, progesterone, hypertriglyceridemia

Front 48

3 things that increase HDL

Back 48

exercise, estrogens, moderate alcohol intake

Front 49

Raynaud's in a young male smoker?

Back 49

Beurger's disease

Front 50

ophthalmoplegia, nystagmus, ataxia, & confusion

Back 50

Wernicke's syndrome (acute)

Front 51

anterograde amnesia and confabulation

Back 51

Korsakoff's syndrome (chronic)

Front 52

pathophysiology of Wernicke's & Korsakoff's?

Back 52

damage to mamillary bodies and thalamic nuclei due to thiamine deficiency

Front 53

characteristics of fetal alcohol syndrome

Back 53

MR, microcephaly, microphthalmia, short palpebral fissures, midfacial hypoplasia, & cardiac defects

Front 54

always give what first to an alcoholic with hypoglycemia?

Back 54

thiamine!

Front 55

if you give glucose to an alcoholic before thiamine, what can you precipitate?

Back 55

Wernicke's encephalopathy