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185 Cards in this Set
- Front
- Back
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- fever, cough, coryza, conjunctivitis, maculopapular rash from head to trunk to ext.
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intravascular hemolysis - schistocytes, increased indirect bili and urinary UBG, hemoglobinemia / uria. haptoglobin binds free
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160/90, pulse 50/min. pt is herniating w/ blown out pupil, down n out,
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IPF - results in restrictive lung disease. decreased diffusing capacity of CO, increased fev1/fvc, decrease residual volume, and
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90+% of duodenal ulcers include h.pylori which u treat w/ ppi and abx
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is mc carcinoma of the lid margin and may appear similar to chalazion
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abdominal circumference is most effective parameter for estimatoin of fetal weight in cases of suspected fgr
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is only when CD4<200. Diffuse infiltrates w/ high A-a gradient.
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abdominal ct is better for detecting stones than axr
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IVDA are likely ot have staph bacteremia / right sided endocarditis / septic emboli that lead to cavitary pneumonia. Pneumocystis
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abuse
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joints and results in functional limitation, deformity and DJD due to DM, periph n. damage, spinal cord injury , b12 deficiency, and
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acalculous cholecystitis may occur after extensive burns, severe trauma, prolonged TPN, prolonged fasting, and mechanical
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kids with congenital heart disease + new neurological deficits may have brain abscess. especially if febrile.
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acei, arbs and spironolactone cause hyperK and hypoNa
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lactose intolerance- positive hydrogen breath test, positive stool test for reducing substances, low stool pH and increased stool
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acromegaly pts die of cardiovascular causes.
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lidocaine - not used prophylactically in pts w/ ACS. decreases risk of v-fib but increases risk of asystole
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acute adrenal insufficiency
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ligament vs meniscus tear - ligaments have more rapid swelling due to actual blood supply. menisci sweall over 24 hours
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acute afib w/ RVR. pt is HD unstable. DC cardioversion indicated and preferable to pharmacological. recent onset a-fib has 90%
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like fibro but patients complain of extreme fatigue and not pain. no trigger points. polymyalgia rheumatica presents w/ pain and
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adductors. peroneal goes to anerior and lateral leg and foot dorsum
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listless babies w/ jaundice should get bcx and LP to r/o sepsis and meningitis
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adenomyosis - like lyomyomas but regularly shaped and lyomyomas are irregularly shaped. both have dysmennorhea,
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lithium - single episode, go on lithium for 1 year at least, then wean. 3+ relapses - go on permanent lithium for life
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adjacent to eyes or ethmoid and sphenoid sinusitis
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lithium tox - tremor, hyperreflexia, ataxia, sz. opioid - resp dep + miosis. phenytoin tox - horizontal nystagmus, cerebellar atax,
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adolescents presenting w/ behavioral changes - suspect drugs, violence, rape, pregnancy
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local invasion. followed by whole brain radiation
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adrenals and ovaries secrete DHEA.
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long term oxygen supplementation has been proven to prolong survival and improve quality of life for hypoxemic COPD patients.
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affect on aldosterone.
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loss of temp + pain below as well. bilateral.
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after biopsy confirmed CIN 2/3, pt should be screened q6m until 3 negative screens are obtained. then back to normal annual
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low tsh, high t3/t4 with signs of thyrotoxicosis in a girl trying to lose weight should suggest factitious thyrotoxicosis. may be due to
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after draining fibrocystic mass and seeing it disappear, f/u in 4 weeks rather than getting cytology
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lower extremity sensor / motor loss
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albinos should stay out of the sun / minimize exposure. sunscreeen is less reliable.
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lumbar spinal stenosis is mcc by degenerative disk disease and presents w/ lbp and leg pain. spinal cord compression has focal
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alcoholic steatosis, hepatitis and early fibrosis of the liver can all be reversible with cessation of alcohol intake. true cirrhosis (w/
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lumbar spinal stenosis is MCC by DJD. aka neuropathic claudication. symptoms worse when standing and going down hill due to
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alternate complement pathway. Antibodies reacting with C3 convertase lead to persistent complement activation and kidney
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lymphadenopathy are common.
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alveolar infiltrates.
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maintenance and low-salt diet
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always check placement of central catheter before infusing with abx or heparing to make sure u are in the right space. CXR
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malignant otitis externa is seen in elderly pts w/ poorly controlled dm, mcc is pseudomonas. sx include ear pain, drainage, and
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and extenso surfaces of extremities. diaper region is usually spared
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mallory-weiss tears - bleeding from ruptured submucosal arteries in distal esophagus / proximal stomach. varices are veins.
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and less fatigue or respiratory muscles.
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mammography, and core biopsy if suspicious.
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and prostate
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manic episode in someone who started lithium - UDS to r/o drugs, lithium level for whether they are compliant, then consider
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and s/b avoided. quit smoking
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mc site of lacunar infarct is posterior internal capsule, producing pure motor stroke.
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anerobic, w/ sulfur granules, more commonly causes cervicofacial dz
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MCC of AR - aortic root dilatoin / bicuspid valve. in 3rd world its rhematic hd
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anterior cord syndrome - assoc w/ burst fracture of vertebra, characterized by total loss of motor function below the lesion and
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mcc osteomyelitis - staph. if stepping on nail through shoe can be pseudomonas.
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antigen.
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mcc travelers diarrhea is e coli
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arthritis + renal failure - think tubulointerstitial nephritis 2/2 nsaids
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mediastinitis
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asymptomatic pts w/ paget's dz do not require treatment. symptomatic ones are best treated w/ oral or iv bisphosphonates
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mediastinum
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ataxia.
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medullary syndrome - medial - contralateral spastic hemiplegia, vibratory, proprioception loss and tonge deviation to side of
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atopic dermatitis presents in infancy w/ pruritis and skin lesions typiccally distributed symmetrically over the face, scalp, chest
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membranproliferative glomerulonephritis type 2 aka dense deposit disease is caused by IgG against C3 convertase of the
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b blockers lower risk of hemorrhage from varices
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menieres disease - vertigo, ear fullness, tinnitis, hearing loss. first line is environmental and dietary modification, including
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b6, folate and b12 are involved in the metabolism of homocysteine. b6 lowers homocysteine levels by acting as cofactor for
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menorrhagia and large uterus.
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bacteria, acidifying the colon and reducing ammonia absorption. abx work too.
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microcytic anemia is different from thalassemia in that RDW > 20% in iron deficiency. Retic ct is low in pt w/ fe deficiency due to
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baker's cyst develop as result of excessive fluid production by inflamed synovium, in RA, OR or cartilage tears. mass is tender in
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mid diastolic rumble - mitral stenosis or obstruction of mitral valve due to tumor. atrial myxoma is mc primary intracardiac tumor,
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bc unconj bili is very tightly bound to albumin, bilirubinuria is indicative of conjugated hyperbilirubinemia. hemolytic disease are
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most common causes of thyrotoxicosis w/ low radioactive iodine uptake : subacute painless thyroiditis, subacute granulomatous
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because of diffusion for nourishment / no hemarthroses
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moving HOB from supine to sitting can increase FRC by 20-35%. In normal adults this is several hundred CC of lung volume.
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before using it..
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mucormycosis in DM- tx w/ surgical debridement and IV amphotericin
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bence jones proteins collect in renal collecting tubules in multiple myeloma, so its known as a paraproteinemia. also look for
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multiple thin walled caviites on cxr but shows interstitial infiltrates.
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biophysical profile - NST, fetal tone, movements, breathing movements and amniotic fluid volume. out of 10, 8/10 is normal. 2 is
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muscle necrosis. mortality is 10-20%
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bird fanciers lung is hypersensitivity pneumonitis. HP may lead to pulmonary fibrosis and restrictive lung pattern. tx is avoid
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MVA - pt hypotensive, tachycardic, given ivf, sent to hospital becomes drowsy and develops right sided weakness. bp now
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blastomycosis is broad based budding yeast endemic to south-central and north-central US. affects lungs, skin, bones, joints,
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nephropathy has less than 5 day latency, PSGN from pharyngitis is 10 days, and PSGN from impetigo is 21 days.
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blood into the ventricle in early diastole, and is associated w/ elevated LV filling pressures.
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neuro + renal + anemia + low MCV = lead poisoning.
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bloody diarrhea, abdominal pain and lack of fever in pt w/o travel hx suggests EHEC.
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neuro deficits. herniated disk pain worsens w/ sitting, has sciatica.
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blowing systolic murmur at cardiac apex s/p MI may be mitral regurg due to papillary muscle rupture. requires emergent surgery,
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neurogenic arthropathy, aka charcot's joints, is a complication of neuropathy and repeated joint trauma. it effects weight bearing
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bone conduction greater than air conduction in rinne and weber tests prove conductive hearing loss, i.e. some obstruction in
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neuropathy.
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BPH - smooth, firm prostate enlargement. UA and serum cr are recommended to r/o bladder ca, infection and obstruction.
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never undertreat pain even if there is risk of abuse. fastest mediicne is the best for acute pain
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break bad news, give prognosis, keep it simple.
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nevirapine. indinavir = crystal induced nephropathy.
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breaking bad news: make sure comfortable, ask how much they know, ask how much they would like to know, give warning shot,
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NIPPV is recommended in pts w/ respiratory distress with pH < 7.35, or PaCO2 > 45 or RR > 25, due to better alveolar ventilation
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breast and lung ca.
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nitroglycerin is the most rapidly acting med for treating symptoms of cardiogenic pulmonary edema. mainstay is look diuretics.
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bronchogenic cysts - mass in middle mediastinum. thymoma - mass in anterior mediastinum. neurogenic tumors - posterior
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NMS is a drug induced idiosyncratic reaction from antidopaminergics. its parkinsonism + hyperthermia, w/ elevated ck and
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bullous pemphigoid - igg targets hemidesmosomes / basement membrade causing tense bullae. subepidermal bullae have
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NMS should be treated w/ dantrolene, bromocriptine and amantidine.
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BUN / Cr ratio is useful indicator of dehydration
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non-small cell lung cancer single met to brain - preferred tx is surgical resection to get histo diagosis, reduce mass effect and
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calculated by examining peak airway pressures. peep is calculated w/ end-expiratory hold maneuver.
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normal pc02 during asthma attack is bad sign of severe airway obstruction or respiratory muscle fatigue.
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cannot be presented to t-cells. polysaccharide vaccines yield a b-cell only, t-cell independent response.
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Notes
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cauda equina syndrome - LBP, bowel / bladder dysfxn, saddle anesthesia, perineal anesthesia, poor rectal tone, sciatica and
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NS + K will help correct this
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causes stricture.
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OA primarily effects DIP joints. XR shows joint space narrowing, subchondral stenosis, osteophytes, and subchondral cysts.
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caustic poisoning - does not alter consciousness. pt presents w/ dysphagia, severe pain, heaving salivation and mouth burns.
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occuring in 2nd or 3rd decade is 5%
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cavernous sinus thrombosis - HA, low-grade fever, periorbital edema and cranial nerve palsies. typically occurs w/ skin infections
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Oral contraceptives may raise blood pressure
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chest pounding / waterhammer pulse - AR. usually worse when Left lateral decubitus or supine due to heart close to chest wall.
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osmotic gap
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chlordiazepoxide (librium) is a drug of choice of alcohol withdrawal. its a bzd
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osteophytes are mc finding on cervical radiographs of pts w/ cervical spondylosis but are nonspecific.
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choramnionitis after 35 weeks - give broad spectrum and expedite delivery.
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painful 3rd trimester vaginal bleeding w/ normal u/s is likely placental abruption. placenta previa is painless uterine bleeding w/
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circulation loss.
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partially acid-fast, aerobic, gram-positive branching rods in pt w/ TB like symptoms - nocardia, tx w/ bactrim. actinomyces is
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circumstantiality - drift away from topic but eventually return. tangentiality - abrupt, permanent deviation from current subject.
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parvovirus b19 arthritis of the mcp, pip wrist and ankle joint can be diagnosed with anti-b19 serum antibodies
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CJD - rapidly progressive dementia, myoclonus and sharp, triphasic synchronous discharges on EEG.
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path of sound.
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concentration of urine. (hyposthenuria)
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patients w/ postprandial pain, vomiting of partially digested food and early satiety may have a pyloric obstruction, which presents
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concurrently.
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PE pleural effusions are almost always exudative and small.
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condylomata acuminata - anogenital warts. may be treated w/ trichloroacetic acid, 5fu epi gel, or podophyllin, or imiquimod,
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peritoneal signs = some kind of peritoneal process
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confusion. bzd tox - slurred speech, unsteady gait, drowsiness w/ minor resp depression
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peritonsillar abscesses must be trained immediated and given IV abx. risk of spread to carotid sheath thru paratonsillar space
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congenital aromatase deficiency - prevents converstionof androgens to estrogens. causes gestational maternal virilization and
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persistent pneumothorax and significant airleak after CT placement suggests tracheobronchial rupture. other findings include
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consistent with fetal asphyxia. BPP < 4 delivery is indicated of > 26 weeks gestation.
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person / object
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contagiosum, which is due to pox virus and common in cellular immunodeficiency.
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perthe aka idiopathic avascualr osteonecrosis of femoral capital head affects kids 4 to 10 with hip, groin and knee pain w/ fu**ed
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contractions.
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pharmacologic maangement of variant angina is w/ CCB or nitrates. nonselective B blockers and aspirin worsen vasoconstriction
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COPD - progressive expiratory flow limitation causing air trapping, decreased VC and increased TLC. FEV1 is disporportionaly
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pickwickian syndrome aka obesity hypoventilation syndrome pt breathes slower all the time and chronicly retains CO2, so ABG
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ct after ischemic bowel will show thickening of bowel wall. often occurs s/p vascular surgery w/ aortic cross clamp or collateral
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pneumatic otoscopy
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cystathionine beta synthase.
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pneumococcal vaccine is polysaccharide. while peptides get presented to t-cells by b-cells and macrophages, polysaccharides
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cytological paps.
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pneuomediastinum and subq emphysema.
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damage
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polycythemia + L sided varicocele = RCC. diagnose w/ CT abdomen
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damage results from necrosis of the tissue of gi tract. stomach or esophageal perforation may occur causing peritonitis or
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popliteal fossa.
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dapsone - doc for dermatitis herpetiform
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populations
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decreased compared to VC
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pospartum hemorrhage - fundal massage, iv access, ivf infusion for sbp > 90, notify blood bank need prbc. give oxytocin
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decreased erythropoeisis
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posterior dislocation of the shoulder is common in tonic clonic seizures, w/ the patient holding the arm adducted and internally
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deficiency or soemthing
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Prevents postop atelectasis.
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demand)
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primary hyperparath - high Ca, low or normal . secondary hyperparath - low to normal Ca, high pth. (crf)
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depressoin is best treated w/ cognitive therapy.
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printed instructions w/ signs / sx that warrant return to hospital.
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DES during pregnancy increases risk of baby having clear cell adenocarcinoma of vagina
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prospective cohorts are the best for determining the incidence of disease because it allows calculation of relative risk in two
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desmogleins, DIF shows igg everywhere scattered.
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pt a/ SAH may get cerebral salt wasting syndrome, due to inappropraite vaspressin secretion and increased ANP/BNP.
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develop autoimmune hemolytic anemia and thrombocytopenia 2-3 weeks post onset.
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pt w/ mild-to-moderate TBI can be discharged under care of adult if they have normal CT scan. caretaker should be given
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diabetic mononeuropathy often involved CN3. damage is ischemic, and only somatic fibers are affected while parasympathetic
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pt w/ severe BPH may show urinary obstruction. AUS will r/o hydronephrosis
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diaphragmatic rupture happens on left side due to stomach moving up during trauma i.e. mvc / seatbelt
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pt w/ shock after immobility, likely PW. other findings: normal PCWP ( 6-12) , high PA pressure (>40) and high RA pressure (>10)
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diarrhea from seafood - vibrio parahemolyticus
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pt w/ sore throat and drooling may have epiglottitis, caused by hemophilus or strep pyogenes.
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digitalis toxicity causes increased ectopy and increase vagal tone. a-tach w/ av block occurs from combination of these dig
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pt w/ UC. after 8 years, annual colonoscopy is recommended.
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dipstick urine testing only finds macroalbuminuria. for micro, get microalbumin / Cr ratio for screening.
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pts w/ chronic lung dz end up w/ pulm htn 2/2 hypoxemia resulting in pulm vasc constriction and RHF. cor pulmonale.
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displacement - psych defense mechanism in which unacceptable feelings about one person/ object are displaced onto another
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pulmonary edema - differentiate b/w ards and chf pe based on PCWP. >18 = cardiogenic, <18 = ARDS. cxr shows bilateral
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dizziness, headache, and agitation. after several years u get involunary movements.
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Question Id
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DM, arthropathy and hepatomegaly = hemochromatosis. diagnose w/ serum iron studies. liver bx to confirm.
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radiation therapy works for vaginal SCCA
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do Mohs on basal cell CA in tough places like perioral, nose, lips, ears...
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randomization helps to control known risk factors as well as unknown difficult to measure confounders.
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does exist.
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recently changed mole is the strongest risk factor for melanoma w/ RR of up to 200
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dont violate HIPAA w/o SIGNED consent form.
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recurent chalazion requires histopathological examination due to risk of sebaceous meimbomian gland carcinoma. basal cell CA
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dosing or med change
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regenerative nodules) is irreversible, regardless of alcohol abstinence.
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drug induced pancreatitis - diuretics, IBD, immunosuppresants, sz d/o, AIDS and pt on abx are all at high risk for pancreatitis
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remove tick as quickly as possible to prevent lyme dz
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dude in underground parking garage w/ dizziness, polycythemia and headaches = CO poisoning.
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renal failure, hypercalcemia and back pain / fatigue.
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dullness to percussion on exam = pleural effusion. must be drained to find source. except in CHF where u try diuresis first.
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resolution of weakness w/ rest is hallmark of myasthenia gravis, unlike MS.
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during ovulation, cervical mucus is clear, thin, pH=6.5 and profuse (friendly to sperm, ferning). during menstrual period, its thick,
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results in oval shaped erythematous scaling patches in christmas tree shape
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dysfunctional uterine bleeding - mild - fe supplements. moderate - progestin + fe. severe - estrogen therapy.
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retrograde urethrogram is 1st step in evaluation of urethral injury. dont cath due to worsening damage / risk of abscesss.
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dysthymia is a chronic lowe grade depression that last years. "ive felt this way my whole life"
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rocky mountain spotted fever - rash starts on wrists and ankles and spreads to body. syphilis rash is secondary and starts on
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echinococcus granulosis forms hydatid cysts in liver and lung. spread from sheep farmers
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rotated. neurovascular impairment is unusual
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eczema herpeticum - primary HSV associated w/ atopic dermatitis. numerous vesicles over area of atopic dermatitis, can be life
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rubella - pt w/ fever, macpap rash (head to trunk to ext), occipital and posterior auricular lymphadenopathy and arthritis. measles
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effects, relatively specific for dig toxicity because its a rare combination.
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s/b abnormal
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emergent surgical drainage will prevent avascular necrosis of femoral head
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s/p bowel removal, osteomalacia has low ca, low phos, high pth
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EMG only works for LMN issues, may dont detect UMN problems. use MRI if pt has umn and lmn problems.
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S3 heart sound is a soft diastolic sound produced by tensing of the pappillary chordal apparatus when ther is rapid influx of
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eosinophilic intranuclear and basophilic intracytoplasmic inclusion bodys (owl eyes)
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salvage therapy - tx for disease when standard therapy fails.
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eosinophils. DIF shows IgG and C3 linearly along BMZ / dermal epidermal junction. vulgaris is intraepidermal w/ igg binding
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scant and acidic.
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erythema multiforme is characteristic extrapulmonary manifestation of mycoplasma pneumonia, MCC of atypical pneumonia
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scleroderma - sticking sensation in throat / dysphagia and manometric findings in LES
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essential tremor- better at rest, worsens w/ goal directed movement.
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screen for syphilis in all preggers regardless of hx or risk factors
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external hordeolum is a common staph abscess of the eyelid, which responds to warm compresses. shorter onset. chalazion is a
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seborrheic dermatitis - waxy scaling with udnerlying erythema on scalp, central face, presternal region, interscapular areas,
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fat necrosis mimics brca on radio and image presentation due to fixed mass w/ nipple retraction, coarse calcification (unlike micro
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senile purpura is due to perivascular connective tissue atrophy
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femoral nerve - anterior compartment of thigh, knee extension / hip flexion. obturator innervates medial compartment of
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serous otitis media - middle ear effusion w/o signs of active infection. exam shows dull tympanic membrane thats hypomobile on
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fetal virilization fo xx fetuses. affected girls have normal internal but ambiguous external genitalia.
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serum sickness-like reaction may occure 1-2wks post certain drugs, pcnor cefaclor. fever, rash, polyarthralgia and
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fibers retain function. ptosis and down n out gaze in conjunction w/ normal light and accomodation reflexes indicate diabtic CN3
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severe pain in a pt w/ mild urinary obstruction such as bph may cause urinary retention due to inability to valsalva.
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fibroids are painless, endometriosis is painful. both are masses
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shoulder pain and weakness on lifting the arm suggests rotator cuff pathology. MRI is excellent for soft tissue.
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fibromyalgia - chronic widespread pain, fatigue and poor sleep with trigger points. tricyclics and exercise help. chronic fatique is
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slipped capital femoral epiphysis is usually structurally intact within the acetabulum. usually in a fat teenager w/ pain. legg calves
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fibrous tissue.
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smoker + horner syndrome = lung cancer. simple cxr should be first test
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fingerstick lead levels are inaccurate w/ many FP, confirm positive w/ serum lead level.
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so far no case reports of congenital rubella syndrome in women inadvertently vaccinated during early pregnancy.
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first renal abnormality in DM is glomerular hyperfiltration, which causes intraglomerular htn causing glom damage. acei treat
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someone w/ autoimmune dz w/ acute postop abdominal pain, hypoglycemia and hypotension after a stressful event may have
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fixing nursemaids elbow - aka subluxation of radial head in preschool kid - gentle passive elbow flexion and forearm supination.
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source, whereas elevated DHEAS w/ normal testosterone indicates adrenal source. Only adrenals secrete DHEAS, but both
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fluroscein examination for eye examination
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spinal cord compression - UMN signs distal to compression site. prompt MRI is necessary
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fmhx of sickle cell and nocturia - sickle cells in vasa rectae cause nocturia even w/ carriers. impairs countercurrent exchange /
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spinal extension / canal smaller. pain is improved w/ flexion going uphill and sitting
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for cancer cachexia, progestins and corticosteroids are beneficial but progestins are first line due to better side effect profile.
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staph and strep cause septic joints like OM by spreading hematogenously. Signs are fever, WBC ct, extreme pain, elevated ESR.
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for central retinal artery occlusion, ocular massage + high flow oxygen is tx of choice.
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stiffness in shoulder and pelvic girdle, with ESR eleveated. complaint is stiffness rather than weakness or pain.
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for idiopathic VTE, INR goal = 2-3 for prosthetic valves, INR goal = 2.5-3.5
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strawberry hemangiomas are infantile, cherry hemangiomas are senile.
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for neoplastic virilization, measure serum testosterone and DHEAS levels. elevated tes and normal DHEAS indicates ovarian
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subacute to chronic abdominal pain, bloody diarrhea and tenesmus is most likely IBD (over weeks not days). worsening
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for restless leg syndrome, dopamine agonists like pramipexole and ropinerole or levodopa reduce sx and improve sleep quality
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subcortical and frontal features characterize NPH, cortical features characterize alzheimers (early memory and visuospatial signs)
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found on EKG. Pap muscle rupture is similar but hapens 3-7 days post MI and has no STE
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success w/ cardioversion
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gastric contents are hydrogen,chloride and K. vomiting causes hypochloremic metabolic alkalosis and hypokalemia. use of IVF
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sudden behavioral changes, unstable economic background and parents w/ h/o drug alcohol abuse are high risk for sexual
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gestation dm - macrosomia, hypoCa, hypoglycemia, hyperviscosity (2/2 polycythemia due to hypoxia from increased metabolic
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suspect this and get quantitative bHCG and ultrasound if markedly elevated
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gestational trophoblastic dz - enlarged uterus, hyperemesis and markedly elevated b-HCG. with hyperemesis gravidarum
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symptoms of CHF after radiation therapy - can be due to constrictive pericarditis resulting in increased JVP. venous valve
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gestations and confirm viable preg.
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symptoms w/ signs of sepsis should consider toxic megacolon
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get acetaminphen levels 4 hours after ingestion for poisoning. give N-acetylcysteine w/in 8 hours for maximal effect
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syncope + confusion = seizure.
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granulation tissue in ear canal. may progress to OM of skull base and destruction of facial nerve.
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systemic and topical corticosteroids may cause acneiform reaction on face, trunk and extremities
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granulomatous inflammation of meimobian gland and incision / curettage are recommended.
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tabes dorsalis.
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HCTZ toxicity is best treated with IVF.
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tachycardia (fetal and maternal). leukocytosis, fever, fetal tach are not components of normal labor
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HCV + palpable purpura, proteinuria, arthralgias, HSM, hypocomplementemia = mixed essential cryoglobulinemia
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tension pneumo vs hemothorax - pneumo shows hyperresonance and hemo shows dullness to percussion
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hemisensory loss w/ severe dysesthesia in affected area is typical of thalamic stroke.
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test for histo w/ urine antigen
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hemoglobin, so hemolysis will result in decreased serum haptoglobin.
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the most effective symptomatic therapy for parkinsonsism is levo-carbidopa. mc early side effects include hallucinations,
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hemorrhoids can be r/o w/ rectal exam. diverticulosis is mcc of lower GI bleed in elderly.
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threatening in infants and requires acyclovir
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hepatic ductopenia is found in PBC, failing liver transplant, hodgkin lymphoma, GVH disease, sarcoid, cmv infection and med
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thyroiditis, iodine induced thyroid toxicosis, levothyroxine o/d, struma ovarii
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hiv drugs - didanosine - pancreatitis, abavacir - hypersensitivity syndrome, lactic acidosis - any NRTI, SJS NNRTI, liver failure -
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toxicity.
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hiv pt w/ bloody diarrhea and normal stool needs colonscopy and biopsy to r/o CMV colitis. biopsy shows cytomegalic cells with
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trachoma presents w/ follicular conjunctivitis and pannus (neovascularization) formation in the cornea
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HSV and VZV in Immunocompromised pts may cause rapidly progressing bilateral necrotizing retinitis (acte retinal necrosis)
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trali or febrile nonhemolytic reactions are due to cytokines. a reaction immediate after transfusion is likely anaphylaxis due to iga
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hypercalcemia of malignancy can be caused by cytokines (invasion) pthrp, calcitriol or ectopic pth. mcc is cytokines \ invasion in
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treat heatstroke with evaporative cooling rather than ice bath
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hyperemesis gravidarum - severe persistent vomiting, weight loss and ketonuria
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treat hepatic encephalopathy with lactulose, a nonabsorbable disaccharide syrup that is converted to fatty acids by colonic
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hypertension has the highest risk for stroke, even more than smoking
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treat pertussis w/ macrolides regardless of age / immunization status.
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hypothyroidism causes generalized myxedema, resulting in mucopolysaccharide deposition everywhere, including the carpal
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treat strep throat w/ penicillin v
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hypoxemia in trauma patient is indication of pulm contusion. esp w/ chest wall bruises. fat embolism is long bone fx.
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treat tourettes w/ traditional antipsychotics like haldol or pimozide
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if fetus is dead dont give methotrexate, just d+c
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treatment of choice for fibromuscular dysplasia is percutaneous angioplasty w/ stent placement.
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if maternal serum AFP is abnormal, next step is u/s to confirm gestational age, detect structural abnormalities and detect multiple
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trunk and spreads to periphery. both have palm and sole involvement.
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if woman with small firm cyst is < 30, u/s, if simple cyst needle aspirate, if complex or mass core biopsy. if > 50, u/s and
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tunnel casuing CTS. In pregnancy its not due to MPS but accumulation of fluid in the carpal tunnel
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iga nephropathy and PSGN are major causes of glomelular hematuria s/p URI. IGA nephropathy is MCC of GN in adultes. IgA
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turner syndrome pts have elevated FSH because ovaries dont give negative feeedback
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immediately.
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umbilicated, firm, flesh-colored dome shaped papules on the trunk, limbs or anogenital area are characteristic of molluscum
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in androgen insensitivity syndrome complete gonadectomy should be completeed after puberty as risk of testicular carcinoma
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umbilicus and folds. more common w/ HIV / parkinson dz... Pityriasis rosea is common cutaneous eruption associalted with HHV7,
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in BRBPR, if cause is unk, then anoscopy or proctoscopy in office s/b done. if cause is not found, then sigmoid/colonoscopy
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unconj, and gilbert is mixed. only rotor syndrome is mainly conjugated due to poor storage of cbili.
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in brca) and solid on U/s. s/p surgery suggests fat necrosis
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unrecognized bowel ischemia is a common cause of lactic acidosis in pts w/ severe atherosclerotic dz.
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in iatrogenic (central or tertiary) adrenal insufficiency, glucocorticoids suppress CRH release, lowering acth and cortisol. no
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up gait
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in mechanically ventilated pts, lung compliance is calculated by performing end-inspiratory hold maneuver. airway resistance is
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up to 1/3 of pts w/ porcelain gallbladder will develop gallbladder adenocarcinoma. look for calcified gallbladder on ct
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in pt w/ hypovolemic shock 2/2 hemorrhage, volume resuscitate prior to intubation / mechanical ventilation because increasing
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ursodeoxycholic acid is DOC for PBC. methotrexate and colchicine also help.
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in pt w/ shoulder / hip pain + ESR + CK, get muscle biopsy to confirm dermato/polymyositis. give corticosteroids
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use non-ionic contrast for contrast CTs in pt's with CRF / DM
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in sickle cell pts, acute severe anemia w/ low to absent retics is consistent w/ aplastic crisis.
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use u/s for developmental dysplasia of the hip because xrays cannot see acetabular problems til 4 months
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in unstable trauma pt, FAST first, then DPL, then CT once stable.
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USPSTF recommends screening for strabismus, amblyopia and refractive errors in children age 0-5
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incompetence causes dependent edema not increased jvp
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usually in left atrium. causes systemic fever and weightloss, neuro symptoms due to emoblization and presents w/ mass on echo.
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increase warfarin activity - vit E, garlic, ginkgo biloba, st john's wort, and abx
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varicocele of pampniform veins will increase in size on valsalva. worse pain when standing, dull or dragging discomfort.
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increased a-a gradient.
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ventilation.
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increases LA pressure.
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ventricular aneurysm occurs days to months s/p MI, sx include chf arrhythmia, MR and thrombus formation. Persistent STE are
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infectious mono presents in young pt w/ st, fever, malaise, splenomegaly and generalized lymphadenopathy. pts with im may
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vitD toxicity looks like hyperCa. constipation, abdominal pains, polydipsia and polyuria
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INH causes pyridoxine b6 def, not folate b9 def. b9 and b12 def can cause macrocytic anemia.
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volkmann's ischemic contracture is the final sequel of compartment syndrome in which dead muscle becomes replaced with
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injury. lateral - ipsilateral horner syndrome, loss of pain / temp in face, weakness of palate, pharynx, vocal cords, cerebellar
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w/ abdominal succession splash (full stomach) by placing stethascope over abdomen and rocking patients' hips. acid ingestion
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interferon alpha, or surgery
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weight loss + IVDA - suspect HIV
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intraglom htn.
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weight loss or attention seeking
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intramniotic infection s/b suspected in prolonged or premature ROM w/ maternal fever, leukocytosis, uterine tenderness and
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when recovering from URI if pt gets worse pneumonia its either staph a., strep pneum, or hemo infl. legionnaires does not cause
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intrathoracic pressure may cause CV collapse
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women over 65 need a one time dexa scan
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.
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zoster develops w/ reactivation of VZV often in immunocomprimised patients. pain may precede rash by several days or appear
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