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68 Cards in this Set
- Front
- Back
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What is the MCC of chronic cough and how to treat it?
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post nasal drip
give antihistamines or steroids |
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What will you hear on lung exam if PNA?
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bronchial breath sounds
egophony increased tactile fremitus |
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What is the FEV1/FVC ratio is COPD? in restrictive lung dz?
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COPD= low
restrictive=high |
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If pt has a fever 24-48 hours post op what should you think of?
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atelectasis
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What are some causes of atelectasis?
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mucus plug from asthma
RML symdrome from CA extrinsic compression by lymph node in sarcoid will need to get bronchoscopy |
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What changes will be seen on EKG in PE?
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S1Q3T3
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If a women develops a PE during pregnancy what should be done?
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lovenox during preg and then continued 6 weeks postpartum
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What can be done to prevent post-phlebitic syndrome after a DVT?
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pneumatic compression stockings
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Who commonly gets primary pulm HTN, what will be seen on CT and how is it treated?
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1. young women
2. "peripheral pruning seen on Ct 3. tx with epoprostenol, sildenafil and bosentan |
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Who is at highest risk for aspiration PNA?
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alcoholics
post op patients and stroke pts can get ARDS with this |
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What are the classic findings in Kartageners (3)
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1. situs inversus
2. infertility 3. bronchiectasis aka immotile cilia syndrome autosomal recessive d/o affecting cilia of resp tract and fallopian tube |
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What is the Mc immunoglobulin def?
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IgA
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What are risks of giving blood transfusions in secretory IgA deficiency and what can be done to prevent the complications?
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get anaphylaxis with RBC transfusions and so have to use washed RBCS
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What infections are common in IgA def?
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sinopulmonary
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a miner presents with cough, SOb and painful, swollen MCP joints- what is the diagnosis?
What is this also associated with? |
caplan's syndrome
associated with TB |
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What appears as eggshell calcifications on CXr
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silicosis (seen in glass workers)
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who typically gets asbestosis?
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shipyard workers
associated with lung Ca and mesothelioma |
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how to treat pulmonary alveolar proteinosis?
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bronchoalveolar lavage
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how to treat cryptogenic organizing PNA?
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steroids
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Goodpastures
1. what vessels are involved? 2. who commonly presents with this? 3. what are the sx? 4. What lab abnormality? 5. how to treat it? |
1. small vessels
2. males 3. hemoptysis and rapidly progressive glomerulonephritis 4. anti-GMB antibodies 5. plasmapheresis and steroids. may need cyclophosphamide |
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Sarcoidosis
1. who gets it? 2. classic symptoms (4) 3. electrolyte abnormalities? 4. treatment? |
1. blacks
2. uveitis, erythema nodosum, parotid enlargement, 7th nerve palsy 3. hypercalcemia 4. steroids |
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What type of effusion is seen in rheumatoid lung?
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pseudochylous low in glucose
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what to treat pulmonary HTN seen in scleroderma?
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ace-i
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what drugs can cause pulmonary fibrosis? (3 main ones)
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amiodarone
bleomycin nitrofurantoin MTX, cyclophosphamide, sirolimus |
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What is farmers lung?
2. what causes it? 3. what antigen is found? |
1. hypersensitivity pneumonitis
2. moldy hay 3. thermophilic actinomycetes |
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What is the cause of panacinar emphysema? How to tx it?
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Alpha -1 anti trypsin def. tx with replacement
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What does pleural fluid look like in exudative pleural effusion
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Pf Protein/serum protein >0.5. Pf LDH/serum LDH >0.6. Or. Pf LDH >200 Bloody=cancer ;milky=chylous so think lymphoma or leukemia or pseudochylous/low glucose in RA.
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1. what does pleural fluid look like in TB?
2. What does pleural effusion look like in CHF? |
1. low glucose and low lymphocytes
2. usually is on the right side in CHF |
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what does pleural fluid look like in pancreatitis or Boerhaaves?
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hugh amylase
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What two cancers have endobronchial mets?
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colon and renal
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what deficiencies cause atrophic glossitis?
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folate/B12 or iron
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macroglossia is commonly seen in what 4 disorders?
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myxedema
acromegaly downs amyloid |
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What drugs typically casues gingival hyperplasia?
what diseases cause it? |
1. pheytoin, CCBs, cyclosporine
2. pregnancy, scurvy, M5 AML |
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Pt presents with bowel obstruction at age 18 adn is found to have several dark spots on lips. Dx?
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Peutz-Jeghers
(melanin lips adn polyps in jejunum- autosomal dominant disorder and has many associated cancers) |
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what is hairy leukoplakia associated with?
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EBV
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What disorder is characterized by apthous stomatitis, genital ulcers, and conjunctivitis?
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Behcets
(a form of small vessel vasculitis ) |
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What should be considered when a patient presents with dysphagia to solid food? what should be done?
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think peptic stricture or cancer. Need an EDG
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What should you think when someone presents with dysphagia to solids and liquids (on boards)?
how to treat it? |
achalasia -- tight LES
give botox |
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what to think of when pt has dysphagia only to solids?
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oropharyngeal and neurologic problems- get videoflouroscope
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what is the classic triad in plummer- vinson syndrome?
what is the risk of this syndrome? |
dysphagia, esophageal webs, iron deficiency anema (evidenced by PICA)
may have spoon nails and a slick tongue. High risk of gastric cancer |
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what are common organisms seen causing acute esophagitis?
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90% candida
HSV CMV bisphosphonates and radiation can also cause it |
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What is the finding in zollinger ellison?
How to diagnose it? |
will have high gastrin but dx with IV secretin challenge which will show a paradoxical rise in gastrin
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what causes of chronic atrophic gastritis in the fundus and what lab abnormality will be seen?
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caused by antibodies against parietal cells and intrinsic factor
will have pernicious anemia elevated risk of CA |
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What causes chronic atrophic gastritis of antrum and what lab will be associated?
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caused by destruction of G cells
will have H pylori |
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what is the mcc of PUD?
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h pylori
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what is the mcc of gastric ulcer?
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NSAIDS
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male presents with early morning cyclic vomitting that is relieved by showering. Dx?
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cannabis hyperemesis syndrome
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What is the gold standard to screen for malabsorption?
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72 hour quantitative fecal fat
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if pt has an abnormal D-xylose what does that indicated?
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small bowel disease
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What is the mc malabsorption disorder?
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celiac
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celiac
1. what lab abnormalites are seen? 2. what other diseases are strongly associated with this? 3. what is a common finding? |
1. gluten/gliaden ab, anti-endomysial Ab, TISSUE TRANSGLUTAMINASE (tTG)
2. lymphoma, type 1 DM, thyroid dz, IgA deficiency 3. dermatitis herpetiformis |
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1. What causes whipples?
2. What is the common presentation? 3. how to treat it? |
1. tropheryma whippelii a G+ actinomycete
2. polyarthritis with pigmented skin 3. treat with bactrim of PCN |
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What vaccinations should be given before infliximab?
What diseases should be screened for before infliximab? and how long after treatment must live vaccines be held? |
1. pneumococcus, influenza and HPV
2. TB and hep B 3. 3 months after tx |
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what to think of when diarrhea has abundant fecal leukocytes?
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invasive bacterial . not viral. can see in amoeba but no giardia
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what is mcc of diarrhea in kids? in adults?
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rotavirus in kids
norwalk in adults |
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"rice water" stools caused from?
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vibro cholera
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if pt has flushing, wheezing, diarrhea after tuna, mackerel or mahi mahi what is the cause?
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scombroid poisoning
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if pt has diarrhea with clinical presentation similar to appendicitis think of what?
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yersinia enterocolitica
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what disorder is yersinia diarrhea associated with?
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hemochromatosis since it is iron loving and required for replication
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salmonella, shigella, campylobacter, and yersinia are all associated with what two diseases?
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reiters and enteropathic arthritis
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what cause of diarrhea predisposes you to guillan barre?
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campylobacter
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if pt describes stools like clay what should you think?
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liver dz
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what is 1st line tx of c diff? if reccurent? if 2nd relapse?
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metronidazole then met again then po vanc
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best treatment for bacterial diarrheas?
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cipro
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best treatment for giardia (usually from stream water)
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metronidazole
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pt has GIANT rugal folds, low protien and hx of CMV. Dx?
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menetries disease
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mcc of lower gi bleeds in adults?
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diverticulosis
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what is best treatment for diverticulitis?
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flagyl and cipro or sulfa
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