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100 Cards in this Set
- Front
- Back
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CO2 balance...Pco2 =?
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Pco2= 0.863(Vco2/Va)
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Alveolar air equation
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PAo2 = PI02 - Pco2/R
PIo2 = FI02 ( Patm - Ph2o) R = Vco2/Vo2 |
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Normal A-a gradient
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5-10 mm
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5 Causes of Hypoxemia
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Hypoventilation
V/Q Mismation (most common) Shunt Diffusion Impairment Altitude |
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Diffusion capacity in bronchitis? emphysema?
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bronchitis = normal DLco
emphysema = dec |
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Obstructive v. Restrictive?
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Obstructive blocks airways and has DECREASED FEV-1.
Restrictive fibroses alveoli and has DECREASED TLC |
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Virchow's triad?
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venous stasis, endothelial injury, alterations in coagulation
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Reversible airway obstruction? Irreversible?
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Asthma = reversible
COPD = irreversible |
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Obstructive v. central apnea?
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cessation of breathing for >10 s with effort (obstructive) or without (central)
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Sleep apnea syndrome?
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>5 apneas/hr or 30/night
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Lung function tests for interstitial lung disease?
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Restrictive so decreased FEV-1, TLC, and FRC. Normal or inc FEV-1 %
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Types of interstitial lung disease?
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Sarcoidosis, aspestosis, Interstitial Pulmonary Fibrosis, Bronchiolitis Obliterans Organizing Pneumonia (BOOP).
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Typical v. atypical community acquired pneumonia?
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Typical: high-grade fever, productive cough, lobar consolidation. S. pneumo, H. infl
Atypical: low-grade fever, non-productive cough, patchy infiltrates. Legionella, mycoplasma, Chlamydia |
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Hospital acquired pneumonia?
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Gram - bacilli: pseudomonas, enterobactericacea
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Nephritic syndromes?
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Acute post-streptococcal glomerulonephritis
Membranoproliferative glomerulonephritis Rapidly progressive glomerulonephritis Goodpasture's IgA Nephropathy Alport Syndrome |
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Nephrotic syndrome?
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MEMBRANOUS GLOMERULONEPHRITIS
Minimal Change Disease Focal Segmental Glomerular Sclerosis Diabetic Nephropathy SLE Amyloidosis |
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Cause of prerenal azotemia?
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hypovolemia...restore volume
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Renal azotemia?
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Tubulointerstitial: Acute Tubular Necrosis, Acute Interstitial Nephritis
Glomerular: acute post-infections g-nephritis, lupus Vascular: Wegener's, Henoch-Schlein, Hemolytic-Uremic Syndrome, Malignant Hypertension |
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Post-renal azotemia?
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Obstruction
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How can you slow the progression of chronic renal failure?
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Once GFR gets below 40 you start to see anemia (normochromic, normocytic) and osteodystrophy. At 30 you see acidosis and Na retention. At 10-15 uremia.
To prevent this control blood pressure, give ACE i's (dec vasoconstriction), and limit protein intake. |
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Most common cause of hypokalemia?
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Diuretic use
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U waves on EKG?
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hypokalemia
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Diagnosis of hyperkalemia? Manifestations? Treatment?
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EKG (wide QRS, peak T wave),
CARDIOtoxicity, NEUROmuscular toxicity CaCl2 |
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What is the problem in hyponatremia? Hypernatremia?
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NOT TOO little Na, but too much water.
HYPER, NOT too much Na, but too little water. |
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What's the problem in hyponatremia?
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ADH
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Anion Gap?
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Na-Cl-HCl = 8-12 mEq/L
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How does the body respond to metabolic acidosis?
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Hyperventilation
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How does the body respond to metabloic alkalosis?
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Hypoventilation
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Common cause of metabolic alkalosis?
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vomitting and diarrhea...lose bicarb
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Body's response to respiratory acidosis?
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reabsorb bicarb
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Body's response to respiratory alkalosis?
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secrete bicarb
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Why do women get UTI's?
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proximity of rectum to urethra
short urethra (ascending infxn most common) sex OCP's |
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Most common cause of UTI's?
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E. coli
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HTN?
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140/90, headache, blurred vision, epistaxis, fatigue, dizziness, chest pain.
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Major causes of secondary HTN?
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renal artery stenosis
hyperaldosteronism pheochromocytoma |
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Migratory arthritis?
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Gonorrhea
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Pseudogout?
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calcium pyrophosphate crystals, in kid = hemochromatosis
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Bouteneir deformity? Swan neck?
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Rheumatoid Arthritis
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Diagnose rheumatoid arthritis?
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1. Morning Stiffness
2. Arthritis at 3+ joint areas 3. Rheumatoid nodules 4. Arthritis @ PIP, MCP, MTP 5. serum Rheumatoid Factor 6. symmetric arthritis 7. radiographic changes 4 of 7 for more than 6 weeks |
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Acute monoarthritis?
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Septic
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Symmetric arthritis?
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Rheumatoid
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HLA for seronegative spondyloarthropathies?
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B27
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symmetrical, bilateral inflammation of sacro-iliac and unusual gait?
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ankylosing spondylitis
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Heberden's nodes? Bouchard's?
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DIP, PIP (BP)
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Most common person with SLE?
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african-american woman 15-35
also hispanic and asian |
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Malar rash?
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SLE
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Definitive diagnosis of vasculitis? Polyarteritis nodosa?
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Biopsy, arteriogram
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Most common vasculitis?
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Giant cell (65 yr old caucasians)
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c-ANCA?
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Wegener's granulomatosis
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granuloma's in lung, sinuses, upper respiratory tract, and kidney
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Wegener's
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CREST?
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calcinosis, raynaud's phenomenon, esophageal dysmotility, sclerodactaly, telangiectasia
Associated with scleroderma |
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Entrapment of median n.?
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Carpal tunnel syndrome
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Tennis Elbow
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lateral epicondylitis
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Causes Scarlet Fever
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Staph aureus erythrogenic toxin, see strawberry tongue
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Causes toxic shock syndrome
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Staph aureus, Group A Strep
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Child comes in with thick, golden crusts in August. His mom says he scratches it.
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Impetigo-staph aureus
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Effect of ischemia to brain after 30 sec? 1 min? 5 min?
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30 sec--> metabolism affected
1 min --> no neuronal function 5 min--->irreversible brain damage |
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Cause of intracerebral hemorrhage?
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HTN
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Most common presentation of MS? Others?
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Relapsing remitting.
primary progressive, secondary progressive, progressive relapsing. |
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Optic neuritis + parasthesia + Rhomberg sign?
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MS
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Benign essential tremor versus Parkinson's tremor?
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Benign essential: genetic, better w/alcohol, L-dopa doesn't help, worse with anxiety, not age related.
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Most common type of peripheral neuropathy?
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Distal symmetric polyneuropathy.
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Where is the problem in radiculopathies?
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Nerve root
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Myotonic dystrophy exhibits proximal or distal weakness?
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Distal.
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Trinucleotide muscular dystrophy?
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Myotonic dystrophy, AD, anticipation
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stroke in pons causing occlusion of basilar artery?
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Locked in syndrome
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Weber's syndrome?
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ipsi Oculomotor nerve + contralateral hemiparesis
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5 levels of consiousness?
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1. Alert
2. Lethargy: sleepy, but there 3. Obtunded: opens eyes only 4. Stupor: no eyes, withdraws to pain 5. Coma: no response to verbal or physical stimuli |
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Knife edge atrophy?
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Pick's Disease, problems planning and with law
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6 categories of Mini-Mental status exam?
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Orientation
Memory Attention/calculation Language Visiospacial Multistep command |
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Seizure that starts from one side of the brain?
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Partial seizure
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Precursor to achalasia?
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Diffuse Esophageal Spasm (of LES)
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Precursor to adenocarcinoma in esophagus?
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Barret's Esophagus
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How does GERD occur?
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relaxation of LES i.e. it's a motility problem.
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Are peptic ulcers a motility problem?
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No, secretory problem.
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5 things that protect stomach from peptic ulcers (autodigestion)
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1. Bicarb
2. Prostaglandins 3. Mucous 4. Cell turnover (~4d) 5. Blood flow (supplies bicarb) |
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2 types of Inflammatory Bowel Disease?
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Chrohns and UC
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5 causes of non-infectious diarrhea?
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Celiac Sprue
Lactase deficiency Zollinger-Ellison Carcinoid Intestinal resection = bile acid diarrhea |
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Non-inflammatory versus inflammatory diarrhea (infectious)?
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Non-inflammatory: In small bowel, large volume, watery stools, NO fever, NO wbc's, NO rbc's, with cramping and gas.
Inflammatory: Large bowel, small volume and frequent, FEVER, WBC, RBC, pain |
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Causes on non-inflammatory infectious diarrhea?
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Food poisoning (ETEC, EPEC, Vibrio)
Viral (Roto, Norwalk) Protazoa Giardia, Cryptosporidium |
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Causes on inflammatory infectious diarrhea?
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Salmonella, Shigella, Campylobacter, EIEC, EHEC, C. dificile
CMV Entomeba histolytica |
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Cause of traveler's diarrhea?
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ETEC, non-inflammatory.
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What are functional bowel disorders?
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Abnormality in digestive tract that has no histological or anatomical detected.
See Irritable Bowel Syndrome. |
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Hirschprung's Disease?
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Congenital megacolon, lack of myenteric ganglia causes constriction, megacolon occurs proximal to this.
No nerves = contriction = proximal dilation = megacolon |
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Most common tumor of GI tract?
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Adenocarcinoma
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Unconjugated hyperbilirubinemias?
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Gilbert's syndrome, Crigler-Najjal Syndrome
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Conjugated Hyperbilirubinemias?
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INTRAHEPATIC = Dubin-Johnson, hepatocellular disease (PBC)
EXTRAHEPATIC = obstruction |
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Most common cause of chronic hepatitis in US?
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Hep C
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Most common cause of chronic hepatitis in the world?
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Hep B
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Primary biliary cirrhosis?
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Disease of small bile ductules, autoimmune, in middle aged women.
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Primary sclerosing cholangitis?
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Disease of large bile ducts, associated with UC
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Budd-Chiari syndrome?
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Occlusion of hepatic vein or IVC causing hepatomegaly, abdominal pain, and ascites.
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Labs important for liver function?
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Alk phos, AST/ALT, albumin, PT
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High HbS Ag?
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acute hep b infection
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High HbE Ag?
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acute infection and active replication
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High HbsAb or HbeAb IgM?
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Recent infection
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High HbsAb or HbeAb IgG, no IgM?
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past infection
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Titers in chronic carrier hep b?
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HbsAg, HbcAb +
NO HbsAb |
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Physiologic jaundice of newborn caused by?
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Deficiency of glucoronyl transferase and deficiency of uptake of bilirubin.
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2 most common causes of acute pancreatitis?
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alcohol and gallstones
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