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184 Cards in this Set
- Front
- Back
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tx for bleeding varices of esophagus
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scleropathy
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rx for hepato renal
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octreotide and milrinone
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tx for primary syphillis in pcn allergic
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2 weeks doxy or tetracycline
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tx for neuro syphillis
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IV aqueous crystaline pcn
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best way to confirm CLL diagnosis
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flow cytometry
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JAK2 mutation
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polycythemia
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negatively birefringent crystals??
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gout
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pruritis with a hot bath
gout splenomegaly |
polycythemia
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HFE gene
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hemochromatosis
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wrinkled paper appearance of bone marrow
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Gauchers
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elenmeyer flask deformity of distal femer
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Gauchers
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sphigomyelinase decrease
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Niemann Pick
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beta galactosidease decrease
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GM1 gangliosidoses
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beta-glocosidase decrease
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Gaucher
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GM2 gangliosidoses
decreased hexosaminidase |
Tay Sacks, Sandhoff
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decreased ceramidase
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Farber
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infant
hepatosplenomegaly failur to thrive nero trouble death by 2-3 |
Nieman Pick
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at birth/early infancy
hepatosplenomegaly keletal abnormalities |
GM1 gangliososes
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cherry red spot
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Tay Sachks, Sandhoff, Niemann Pick
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chronic fatigue
easy bruising bone pain pathological fractures Ashkenazi adolescent |
Gauchers
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heart rx contraindicated in ACS
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nifedipine (peripheral vasodilation)
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sawtooth pattern
cause? |
a fluttervariable AV node conduction
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exercise induced symptoms
3/6 systolic ejection murmur crescendo-decrescendo patient has LVF next step? |
echo
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heart rx contraindicated in ACS
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nifedipine (peripheral vasodilation)
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blu finger tips post surgery
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norepi led to vasospasm
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sawtooth pattern
cause? |
a fluttervariable AV node conduction
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tx for vfib
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defib
D fib 4 V fib |
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exercise induced symptoms
3/6 systolic ejection murmur crescendo-decrescendo patient has LVF next step? |
echo
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arrhythmia cured by immersion in cold water and other vagal manoevers
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PSVT (Please Submerge Votre Tete)
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blu finger tips post surgery
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norepi led to vasospasm
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cause of PSVT
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AV node reentry
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tx for vfib
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defib
D fib 4 V fib |
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test for definitive diagnosis of AS
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echo
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arrhythmia cured by immersion in cold water and other vagal manoevers
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PSVT (Please Submerge Votre Tete)
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most common cause of MR
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MVP
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cause of PSVT
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AV node reentry
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causes of pulsus paradoxus
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tamponade
pericardial effusion tension pneumo severe asthma |
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test for definitive diagnosis of AS
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echo
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most common cause of MR
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MVP
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causes of pulsus paradoxus
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tamponade
pericardial effusion tension pneumo severe asthma |
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cause of high output heart failure
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AV fistula
thyrotoxicosis paget's anemia thiamine deficiency |
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increased QRS
cause? why? |
flecainide
use dependence |
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rupter leads to VSD and new holosystolic murmur
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interventricular
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rupture leads to tamponade
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ventricular
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exertional syncompe is associated with?
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1) vtach
2) outflow obstruction (AS, hypertrophic cardiomyopathy |
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how do nitrates work on the heart
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increased blood pooling
decreased cardiac work |
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wide QRS,
bizarre EKG morphology tx if pt asymptomatic tx if pt symptomatic |
observation
beta blockers |
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cause of wide QRS
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i'm not sure but I've seen
r or l BBB |
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young person
increased DOE waking up at night with choking sensation recent travel b/l pitting edema 3rd heart sound enlarged cardiac silhouette small pleural effusions unremarkable EKG diagnosis likely cause |
myocarditis (because of age)
leading to CHF coxsackie |
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painful fingertips
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osler's nodes (endocarditis)
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most common vascular injury following blunt trauma in MVA, sometimes without symtpoms because a hematoma forms
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aortic rupture
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best study to diagnose aortic dissection
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TEE (CT, mri)
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prologed QRS vs. QT
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QRS leads to brady
leads to tachy |
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rx with side effects of cutaneous flushing and pruritis
how to prevent? |
niacin
prescribe with aspirin |
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rx causing decreased tolerance to glucose
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thiazides
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electrolyte side effects of thiazides
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decreased Na
decreased K increased Ca++ thiazids are Ca++nadian not ameriKNA |
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decreased PCWP
normal MVO2 |
septic shock
(vasodilation and hyperdynamic) |
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cause of septic shock
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vasodilation
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a fib during cardiac arrest
next step? |
compressions!!!
no shock for a fib "a fib is not shocking!!" |
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bilateral facial palsy: 2 causes
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lyme
sarcoid |
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skin finding with sarcoid
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lupus pernio
erythema nodosum |
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vesicular breath sounds
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normal
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bronchial breath sounds
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bronchi open
alveoli closed |
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egopahny
bronchophany whispered pectorioquy |
consollidation
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rales
crepitations crackles |
alveoli popin ope
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type of breath sounds in sarcoid
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rales, crepitations, crackles
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wheeze
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asthma
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heart finding in sarcoid
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III AV block
infiltrative disease zaps your condduction system |
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QT prolongation
causes? |
beta blockers or congenital
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enzyme finding in sarcoid
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ACE
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why is Ca++ high?
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overproduction of vitamin D from granulomas
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most accurate test
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biopsy of lymph node
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finding on biopsy
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non caseating granuloma
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what rx do sarcoid pts need to avoid
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interferon (makes granulomas)
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what does erythema nodosum indicate?
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better prognosis
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visual trouble in sarcoid
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uveitis
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descending paralysis
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botulism
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weakness better with exercise
associated with lung ca |
Eaton Lambert
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ascending weakness
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Guillan Barre
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lid lag
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grave's disease
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ptosis
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MG
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best initial test
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acetylcholine receptor Ab
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most accurate test
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EMG
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muscle biopsy is best for
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polymyositis
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nerve conduction study is best for
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guillan barree
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rx to avoid in MG
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aminoglycosides (gentamicin)
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plasmapharesis requiring disease
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Guillan barre
MG Goodpastures |
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best acute tx
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IVIG
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MIBG scan
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pheochromocytoma (functional test)
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gallium scan
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to find cancers/infections
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functional scans
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Gallium
HIDA MIBG PET |
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thymectomy:MG::Splenectomy:
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ITP
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age limit on thymectomy
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<60
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mediastinal masses
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thymus
thyroid teratoma terrible lymphoma |
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most accurate test for effusion
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thoracentesis
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tx when pt too old for thymectomy or pyrodistigmine not working
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prednisone
after that, any other immune med |
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red eye with photophobia
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iritis/uveitis
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association of pyoderma gangrenosus
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IBD and erythema nodosum
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association of dermatities herpetiformis
tx? |
eliac
dapsone |
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malar rash that goes up to forehead
rx? layer of skin involved? |
erysipelas
strep involves dermis |
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what does erythema nodosum indicate?
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severity of disease in IBD
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dot on cornea
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uveitis/iritis
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eye association with IBD
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iritis/uveitis
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tx for uveitis/iritis
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topic steroid
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tx of IBD
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mesalamine
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dark urine
jaundice no liver tenderness alk phos, GGT |
sclerosing cholangitis
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fever
shaking chill jaundice tenderness |
charcot's triad for ascending cholangitis
(pyelo of the liver) |
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Ca associated with IBD
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colangiocarcinoma
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biliary disease associated with IBD
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sclerosing cholangitis
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r/o if liver not tender
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ascending cholangitis, cholecystitis
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alk phos and GGT indicate
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obstruction
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cancer that sclerosing cholangitis can cause
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cholangiocarcinoma
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what kind of IBD is most associated with cholangiocarcinoma
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UC
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test for sclerosing cholangitis
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ERCP
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test for all other liver diseases
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biopsy
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only liver disease for which biopsy is not the diagnosis
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sclerosing cholangitis
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ANCA +,
anti saccaromyces cerviciai - |
UC
check what I meant by "opposite" in relation to this |
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anti smooth muscle
anti microsomal |
autoimmune hepatitis
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tx for sclerosing
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ursodeoxy
cholestyramine (to bind ...) |
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dilated fundoscopic exam is for
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optic neuritis
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gram stain and culture for eyes?
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never
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ANCA and Anti saccharomycis cerevisiae in UC and Crohns
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aNCA + and ASC - is Crohns
other way around is UC Cerevisae with Crohns |
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cobblestoning on colonoscopy
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crohnss
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transumarl granulomas
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crohns
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crypt abscess with
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UC
Under the Crust is the Crypt |
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when to screen for colon ca
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8 years after IBD diagnosed
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cause of bleeding nad perf with Crohns
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granulomas
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granulomas in which IBD
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crohns
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biggest differentiation between crohns and UC
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rectal in UC (Ucky reCtum)
UC can be cured by colectomy UCan Cure UC with Colectomy |
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drugs that can help keep IBD pts off steroids
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6 mercapto
azathioprine cyclosporine |
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formulations of mesalamine
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all are 5-asa derivates
asacol pentasa rowasa |
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Crohns pt with dark, smelling urine
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fistula
old crohn gave me the fist up my butt |
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tx for fistula
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plant PPD (granulomas an issue)
treat TB if needed give infliximab or TNF alpha |
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crohns not controlled with mesalamine and budesonide?
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give asathiprine
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adv of budesonide
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affects the gut only (1st pass to liver) no systemic effects
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if mesalamine, budesonide, azathioprine not working and there's perianal involvement
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cipro and metronidazole!!
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chlorambucil is for
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CLL
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young female
evanescent rash and join pain decreased hematorcrit hemoglobinopathy |
parvo B19
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upper limit of PR
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200=1 big box
5 little boxes |
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Q wave tall if
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>1 box wide
AND 1 box deep AND at least 1/4 of total height |
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ischemic pain maybe.
EKG nl next step |
stress test
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indications for echo
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valve disease
vegetations wall motion the three Vs of Vecho |
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palpitations
EKG nl. next step |
holter
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acute chest pain NOW.
next step after EKG |
CKMB and troponin
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to assess EF most accurately
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MUGA
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T wave inversion in V4,5,6.
Stress test? what? |
stress echo
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+ stress test shows
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ST depression
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good max heart rate formula in stress test
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220-age
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what does stress thalium look for
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decreased perfusion
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chest pain
+ stress test. next step? |
aspirin
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test for prinzmetal
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ergonovine and angiogram
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viagra and nitrations =
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hypotension
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elevated V2,3,4,5
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old infarct
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Q wave V2,3, AVF
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old inferior wall MI
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wide QRS
no R waves in V1V2 |
LBBB
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ST segment depression in V2,3,4,5
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ischemia
anterior wall |
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V5, V6
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lateral wall
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2,3,AVF
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inferior wall
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use of dipyridamole
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add to aspirin for stroke
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1st enzyme to go up? when?
next? when? |
myoglobin up in 1-4 hours
troponon and CKMB up in 4-6 hrs |
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rx that lowers mortality in STEMI
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Angioplasty
aspirin Clopidogrel Statin Thrombolytics (within 12 hours) |
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when do ACEis lower inhibit????
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low EF
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indication for thrombolytics
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stemi within 12 hours and new LBBB
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how long can troponin stay up
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2 weeks
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next rx after aspirin with ST depression in V3,4,5
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enoxaparin b/c clot forming
maybe be nothing |
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vent adj for decreased O2 in ARDS
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PEEP
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risk factors for RDS or Hyaline membrane disease
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prematurity
diabetes |
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engorged veins on chest wall
next step |
SVC
CXR |
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fatigue
skin darkening no joint pain |
adrenal insufficiency
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fatigue
skin darkening joint pain |
hemochromatosis
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site of iron absorption (and of all divalent cations)
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duodenum
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site of iron exretion
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nowhere, only skin and menstrual flow
can only get rid of 1-3 |
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most common cause of hemochromatosis
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over absorption
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joint pain in hemochromatosis is caused by
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pesudogout (calcium pyro)
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shape of deposits/refringence
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rhomboids positive
pseudo positive pyro |
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where are copper deposits in Wilsons
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liver, not joints
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hemosiderin laden macrophages indicate
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chronic hemoptysis
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- birefringent needle shaped crystals
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gout
negative needle |
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why DM in hemochromatosis
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deposits in pancreas
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cause of ED in hemochromatosis
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hypopituitarism leading to decreased FSH LH
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most likely abnormal test
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echo
restrictive cardio myopathy |
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cause of death most common
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cirrhosis
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hemochromatosis avoids what body part
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Avoids the Adrenas
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most common cause of hep????
(in fish lecture) |
hemochromatosis
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