Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
67 Cards in this Set
- Front
- Back
|
Psych techniques
- psychoanalysis - behavior therapy - cognitive therapy - supportive |
- neutral role, clarifying, confronting, interpret, dreams
- teach relaxation techniques and recondition - identify negative thoughts to alter connection to mood - warm, empathetic, reliable support s.a. acute crisis, chronic psych |
|
|
Hypercortisol causes and responses to doses of dexamethasone
|
ACTH dependent (high)
- pituitary or ectopic Next: dexamethasone - HD suppresses pituit but not ectopic ACTH independent (low) - adrenal Cushings (ACTH pituitary) |
|
|
Hypercortisol treatments
|
Cushings - 1st) transsphenoidal microadenectomy, 2nd) pituitary radiation
Adrenal options: metyrapone (block secret) or adrenalectomy ... later line: mitotane |
|
|
Multifocal atrial tachycardia def'n and associated disorders
|
HR>100 w/3+ p-wave morphologies
COPD, IHD, glucose intolerance, hypokal, hypomag |
|
|
Acute right heart/ventric failure in inferior wall MI tx
|
Preload dependent >> IVF
Avoid: nitro and diuretics (which decr preload) |
|
|
Valproate and phenytoin interaction
|
relative contraindication to drug combination: shared plasma binding >> phenytoin levels rise (monitor or choose other agent)
|
|
|
ARDS diagnosis criteria
|
1) acute
2) bilateral patchy 3) wedge pressure <18 or no clinical LV dysfcn 4) P(aO2):FiO2<200 |
|
|
Completely dilated (second stage) + multiple late fetal decels
|
fetal distress (UP insuff)
Next: reposition LLD (open IVC), stop oxytocin (incr ut perfusion), O2 C-sect if loses variability, no change for 2-3 hours in cervical exam Forceps or vacuum if full dilated, fetus greater than 2+, anesthetized, no CPD |
|
|
Criteria for referal to burn center
|
2nd degree >20% adult or >10% if <10yo or >50yo
3rd degree >5% any age inhalation injury, suspected abuse, significant face or genitals or joints, associated injuries (s.a. fx) |
|
|
Catatonic schizophrenia characteristics:
|
2+ excessive motor activity, immobility, extreme negativism, mute, waxy flexibility, echolalia, echopraxia
|
|
|
hypercalcemia sx, tx
|
bones
-pain/fx w malig/lytic stones -calcium kidney stones groans -PUD, pancreatitis psych overtones -fatigue, depression, irritable, sleep disturbance ECG - short QTc Acute tx: IVF, loop diuretic (furosemide) |
|
|
child - painless GIB
|
#1 meckel's diverticulum <2yo (and in 2%)
|
|
|
Childhood bone findings:
-Osteoid osteoma -Bone cyst -Enchondroma -Ewing's sarcoma -Osteosarcoma |
-night pain, aspirin helps, lucency + surrounding sclerosis, ~leg, haphazard trabeculae
-leg, eccentric lysis, thinning cortex -hands, diaph lysis, thinning cortex, typ asx -prox long bones, lysis, onion skinning, periost rxn, F, WBC, ESR -10-20yo M, metaph, "Codman triangle" periost rxn |
|
|
Nonreassuring fetal tracings
|
tachy >160 bpm
prolonged brady <100 bpm lost beat-beat variability variable decels >1min |
|
|
Developmental hip dysplasia tx
|
<6mo: Pavlik harness (flex, abduct)
6-15mo: closed reduction + spica cast 15-24mo: open reduction if closed failed |
|
|
Thyroid cancers (detail)
|
#1 Papillary ~70%
Hyperthyroid, F>M #2 Follicular ~20% Hyperthyroid #3 Medullary ~7% Calcitonin, MEN IIA/B |
|
|
Risks associated with acromegaly
|
Colon polyps/cancer, CAD, HTN, DM, sleep apnea
|
|
|
Biopsy findings dermatomyositis vs polymyositis
|
DM - perivasc and perimysial inflammation
PM - endomysial inflammation |
|
|
Hereditary GI polyp disorders
|
Peutz-Jeghers
-hamartomatous polyps -abnl ser-threo kinase Lynch = HNPCC -if get polyp, rapid transformation Bloom -UV and rad sensitive Turcot's (APC or HNPCC gene) APC: cafe au lait, childhood medulloblastoma Gardner's APC, polyps, osteomas, skin/soft tissue tumors |
|
|
Facial skin tumors: keratoacanthoma vs squamous cell carcinoma vs
basal cell carcinoma |
-rapid grow (d-w), central depression, ~disappear spontaneously; mimic SCC but grow faster
-#2 skin cancer, verrucous, nodular, ulcerated, esp s/p burn or actinic keratosis #1 skin tumor, nodular most common (waxy nodule, vessels around it), central crater -> ulcer (ex: on ear) |
|
|
FDA approved alzheimer's medications
|
Cholinesterase inhibitors for mild-moderate disease
Donepezil (least fx) Rivastigmine Galantamine Tacrine |
|
|
Nephrogenic DI, Central DI, and SIADH treatments
|
Water Restriction
Desmopressin (DDAVP) - fx: incr vWF w/indirect incr in FVIII Thiazides Demeclocycline - fx: nephro DI |
|
|
Child motor development
|
3mo sit w/support
7mo sit alone (rounded back) and pull to stand 10mo cruising, sit w/back straight 12mo walk holding hand |
|
|
Child vocal development
|
3mo "ahh" single sylable
7mo babble 10mo "mama" |
|
|
Child hand skills
|
10mo - wave bye bye
|
|
|
Mycoses risk factors
|
Cryptococcus
- soil, pigeon droppings Blastomycosis - Central US - violaceous skin lesions Histoplasmosis - Mississippi river valey - skin, GI, CNS, adrenals - spelunking, bird/bat guano Coccidiomycosis - SW US - erythema multiforme or nodosum, bones, CNS |
|
|
Aldosterone functions and syndromes
|
Mineralocorticoid resorb Na, excrete K
Excess (hypokal) - Conn's Deficient - Addison Congenital: 21 hydroxylase def |
|
|
Triple screen and birth findings
- Trisomy 13 - Trisomy 18 - Trisomy 21 |
aFP, estradiol, bhcg
Patau (die wks-mos) - sm head, polydactyly, small head, vision, cleft, celes (spine, stomach), rocker feet Edwards (#2) - all decr - hypotonia later hypertonia, horseshoe kidney, flexed overlap fingers, GI malrotation Down's (#1) - decr aFP, estradiol - incr bhcg High afp w/NTDs, GI cele, multis |
|
|
Tx breast-feeding mastitis
|
Diclox 10-14d
Alt if allergic: Azithro |
|
|
IgA nephropathy
|
young adult male, s/p URI, nephritic
IgA deposits + normal C3 Tx: glucocorticoids ACEi if Uprot too |
|
|
Treatment of childhood neuro disorders:
Spastic CP West Syndrome Tics |
Baclophen, diazepam, dantrolene (relaxants)
ACTH and clonazepam Pimozide |
|
|
Childhood rash: trunk outwards
|
HHV-6 (roseola, 6th dz)
s/p URI, typ high fever |
|
|
Childhood rash: head/face then down
|
Measles
- fades head down, desquamates, brown discoloration Rubella - tender, fades rapidly as redness spreads Parvovirus B12 (erythema infectiosum, 5th disease) -slapped cheeks, LGF, trunk and prox extrem |
|
|
Tuberous sclerosis
von Hippel-Lindau Sturge-Weber |
MR, sz (cortical tubers), leathery patches, ash leaf sponts, growths (ungal, retinal hamart, cardiac, astrocyte, renal angio)
CNS hemangioblastomas, retinal angioma, misc tumors angiomas: facial (port-wine), leptomening, choroidal |
|
|
Acute adrenal crisis (and name in meningococcemia)
|
Hydrocortisone and IVF before labs return
Waterhouse-Friderichsen typ 2/2 adrenal hemorrhage |
|
|
Triple screen and birth findings
- Trisomy 13 - Trisomy 18 - Trisomy 21 |
aFP, estradiol, bhcg
Patau (die wks-mos) - sm head, polydactyly, small head, vision, cleft, celes (spine, stomach), rocker feet Edwards (#2) - all decr - hypotonia later hypertonia, horseshoe kidney, flexed overlap fingers, GI malrotation Down's (#1) - decr aFP, estradiol - incr bhcg High afp w/NTDs, GI cele, multis |
|
|
Tx breast-feeding mastitis
|
Diclox 10-14d
Alt if allergic: Azithro |
|
|
IgA nephropathy
|
young adult male, s/p URI, nephritic
IgA deposits + normal C3 Tx: glucocorticoids ACEi if Uprot too |
|
|
Treatment of childhood neuro disorders:
Spastic CP West Syndrome Tics |
Baclophen, diazepam, dantrolene (relaxants)
ACTH and clonazepam Pimozide |
|
|
Childhood rash: trunk outwards
|
HHV-6 (roseola, 6th dz)
s/p URI, typ high fever |
|
|
Childhood rash: head/face then down
|
Measles
- fades head down, desquamates, brown discoloration Rubella - tender, fades rapidly as redness spreads Parvovirus B12 (erythema infectiosum, 5th disease) -slapped cheeks, LGF, trunk and prox extrem |
|
|
Tuberous sclerosis
von Hippel-Lindau Sturge-Weber |
MR, sz (cortical tubers), leathery patches, ash leaf sponts, growths (ungal, retinal hamart, cardiac, astrocyte, renal angio)
CNS hemangioblastomas, retinal angioma, misc tumors angiomas: facial (port-wine), leptomening, choroidal |
|
|
Acute adrenal crisis (and name in meningococcemia)
|
Hydrocortisone and IVF before labs return
Waterhouse-Friderichsen typ 2/2 adrenal hemorrhage |
|
|
Adenocarcinoma of the lung manifestations
|
clubbing, thrombophleb, nonbacterial verrucous endocarditis
Subtype: bronchoalveolar w/multiple nodules, interstitial infiltrate, lots sputum |
|
|
Kawasaki's dz criteria
|
F 5+ days
Four of the five: - b/l conjunctivitis - lip/oral lesions - extremity red/edema - rash - cervical LN |
|
|
Ranson's criteria (severity of acute pancreatitis)
|
On admission:
- >55yo - WBC>16K - LDH >350 - AST >250 - Gluc >200 48hrs - HCT decr 10% - BUN incr 5 w/adeq IVF - Ca <8 - PO2 <60 - BD >4 - fluid seq >6L Note: good HR and BP indicate fluid status |
|
|
Multiple myeloma serum marker for tumor mass and response to treatment
|
B2-microglobulin
|
|
|
Trace metal deficiencies:
- diarrhea, dermatitis, alopecia (w/o alopecia) - glucose intolerance, lipid changes -anemia, neutropenia - cardiomyopathy, sk muscle dysfcn |
- Zinc, esp w/TPN (niacin, no assn w/TPN)
-Chromium -Copper, esp w/TPN free AAs - Selenium |
|
|
Tick borne diseases
|
Ehrlichia
- Ixodes tick - neuro sx (esp confusion) - intraneutrophil - doxycycline Lyme (borrelia) - Ixodes tick - rash, migratory arthritis - doxycycline (alt: azithro) Babesiosis - protozoa carried by several ticks (Ixodes, deer, etc) - intraerythrocytic - quinine + clinda |
|
|
Primary biliary cirrhosis
|
F>>>M
Esp assn w/RA and Sjogrens Antimitochondrial ab |
|
|
Primary sclerosing cholangitis
|
M>F
Esp assn w/UC pANCA |
|
|
low phos, Ugluc, acidosis
|
RTA II - Fanconi syndrome
|
|
|
11B-hydroxylase def
17a-hydroxylase def 21-hydroxylase def |
#2 cause congen adrenal Hplasia- disting bc HTN + decr K (no cortisol)
w/def 17,20-lyase, delayed puberty HTN, hkal, hgonad (no cortisol or androgens or estroen) #1 cause congenital CAH typ w/hTN, hNa, HK, MAcid (low cortisol and aldosterone) |
|
|
Ejection murmur bt apex and LLSB, cresc-decr, non-radiating
|
Hypertrophic cardiomyopathy
tx: b-blockers, CCB |
|
|
Schizophrenia subtypes
|
Paranoid
- #1, prominent bizarre delusions, auditory hall Catatonic - immobility w/periods of extreme excitement Disorganized - poor px, prevents functioning in society Residual - if had a different type and loses positive sx vs. Schizotypal PD - odd, eccentric, not severely psychotic perceptions, withdrawn, typ still a few friends |
|
|
EEG 3Hz spike and wave
|
Absence sz - often regress during puberty
tx w/ethosuxi mide (a CCB) |
|
|
First childhood seizure
|
Febrile (>100.4) 6mo-6yo - decr temperature
Absence with char EEG (3Hz spike and wave) - ethosuximide Nonfebrile w/EEG changes - option to treat (phenobarb for complex partial) |
|
|
Aphasias:
- Broca - Conduction - Wernicke - Transcortical sensory - Global |
- production problem; comprehension preserved (sup div MCA, inferior post frontal)
- problems repeating only (arcuate fasciculus) - problems w/comprehension, output paraphasic, circumloc (post 1/3 sup temp gyrus) - (near Wernicke's) - (large L hemi) |
|
|
Adult PCKD diagnostic criteria
|
2+ cysts if <30yo
2+ each side <60yo 4+ each side 60+ |
|
|
Diabetes screening criteria
|
>45yo BMI 25+
<45yo BMI 25+ w/RF Fasting Glucose, if 100-126, rpt, if still impaired do 2hr GTT and fasting insulin |
|
|
Thrombolytic contraindications
|
- Stroke or head trauma w/in 3mo
- Recent MI - prior ICH - major surgery w/in 2wks - GI/GU bleed w/in 3wks - seizures at stroke onsest |
|
|
Lichen planus vs lichen sclerosis
|
atrophic, flat purple papules on inner labia
postmen, atrophic thin white labia, shrink/agglut of minoras |
|
|
NF 1
NF 2 TS |
cafe au lait, fold Hpigment, iris hamart (lisch nodule), optic glioma
acoustic neuromas (deaf ~20yo) hamartomas (facial, ungal, retinal, cortical, subependymal), ash leaf, leathery neck, MR, autism, giant cell astrocytoma, kidney angiomyolipoma, renal cysts, lungs, heart rhabdomyoma (also cafe au lait) |
|
|
Esophageal varices management
|
prevent bleed: Bblock
acute bleed: somatostatin tx or analog + endoscopic ligation or sclerotherapy refractory or recurrent: balloon tamponade or PS shunt |
|
|
tx pyelonephritis
|
10d cipro (but not moxi which does not concentrate in urine as well)
|
|
|
Pneumonia treatments
- CAP - Atypical - HAP |
- empiric CAP (macrolides: erythro, clarithro)
- CAP Pneumococcus (rapid devel, consol, quellung: ampicillin or ceftriaxone if PCN-res) - erythro, azithro, (alt: doxy) - Aztreonam (monobactam, GN) |
|
|
OCD vs OCD PD
|
more severe w/ritualized behavior impairing their life, distresed by behavior, ~anxiety disorder (>> CBT + SSRI)
preoccupation with details, rules, org, no sense of conflict |
