Thomas Day 7 Dit

Front 1

acute heart failure treatment

Back 1

LMNOP

loop diuretics
morphine
nitroglycerin
02
positioning and pressors (left lateral, digoxin)

Front 2

what heart sounds increase in left lateral decubritis position?

Back 2

mitral regurg, mitral stenosis, left sided s3 and s4

Front 3

crescendo-decrescendo systolic murmur at right sternal border

Back 3

aortic stenosis

Front 4

early diastolic decrescendo murmur best heard at left sternal border

Back 4

pulmonic regurgitation

Front 5

late diastolic decrescendo murmur heard best along left sternal border

Back 5

tricuspid stenosis

Front 6

pansystolic murmur at apex

Back 6

mitral regurgitation

Front 7

late systolic murmur with mid-systolic click

Back 7

mitral valve prolapse

Front 8

pansystolic murmur heard best at lower left sternal border

Back 8

tricuspid regurgitation
or
VSD

Front 9

diastolic opening snap with murmur

Back 9

mitral stenosis

Front 10

diastolic murmur with widened pulse pressure

Back 10

aortic regurgitation

Front 11

what abnormal heart sounds increase with squatting

Back 11

increased afterload

aortic regurg
mitral prolapse
mitral regurg

Front 12

5 causes of aortic stenosis

Back 12

senile calcification (presents after 60)
bicuspid valve (presents after 40)
chronic rheumatic heart disease
unicuspid valve
syphilis (can also cause aortic regurgitation)

Front 13

3 causes of aortic regurgitation

Back 13

syphilis
marfan's
rheumatic heart disease

Front 14

pt with fever and round white spots on retina surrounded by hemorrhage indicate

Back 14

bacterial endocarditis

Front 15

diagnose bacterial endocarditis, do it before what?

Back 15

get blood cultures, do it before administering antibiotics

Front 16

HACEK organisms cause what type of endocarditis?

Back 16

culture-negative endocarditis

HAEMOPHILUS
actinobacillus
cardiobacterium
eikenella
kingella

Front 17

treatment for neurogenic shock (brain injury, spinal cord injury)

Back 17

IV fluids, corticosteroids

Front 18

J(heart)NES criteria

Back 18

for rheumatic fever

J- joints (migratory polyarthritis)
Heart- pancarditis
N- subcutaneous nodules (aschoff bodies)
E- erythema migratorum (rings on skin)
S- syndenham's chorea

Front 19

pulsus paradoxus?
seen when

Back 19

exaggerated decrease in systolic pulse during inspiration

anytime excessive inspiration occurs
(cardiac tampanode, asthma, obstructive sleep apnea, croup)

Front 20

difference between kaussmal's sign and pulsus paradoxus?

which seen in pericarditis?

Back 20

kaussmal's is decrease in RV filling causing increased JVD, seen in pericarditis

pulsus paradoxus is any time pt has increased inspiration volume, resulting in drop in systolic pressure more that 10mmHg on inspiration (cardiac tamponade, asthma, obstructive sleep apnea, croup)

Front 21

how can renal failure cause pericarditis?
what is hemorrhagic pericarditis tied to?

Back 21

uremia

malignancy (melanoma)

Front 22

EKG change showing electrical alternans indicates

Back 22

cardiac tamponade

Front 23

vasculitis in young asthmatic, think about

Back 23

churg-strauss (pANCA positive)

Front 24

strawberry tongue, lymphadenitis, desquamative skin rash?
what is complication?

Back 24

kawasaki disease

coronary aneurysm

Front 25

hepatitis B with vasculitis, think

what type of hypersensitivity

Back 25

polyarteritis nodosum

type 3

Front 26

half of people with temporal arteritis will also get

Back 26

polymyalgia rheumatica (pain in shoulder and pelvic girdle)

Front 27

red lesion associated with trauma or pregnancy

Back 27

pyogenic granuloma

Front 28

immunity of killed vs. live attenuated viral vaccines

Back 28

killed- only humoral immunity

live attenuated- humoral AND cellular immunity

Front 29

pneumonic for live attenuated vaccines

Back 29

Live! see SMALL YELLOW CHICKENS get vaccinated with SABIN's and MMR
smallpox
yellow fever
chickenpox
sabins
MMR
intranasal influenza

Front 30

pneumonic for killed vaccines

Back 30

RIP Always
rabies
influenza (IM)
salk polio
HAV

Front 31

2 vaccines to avoid if egg allergy

Back 31

influenza
yellow fever

Front 32

what live vaccine can be given to HIV patients

Back 32

MMR

Front 33

2 recombinant vaccines

Back 33

HBV
HPV

Front 34

VZV stays where

Back 34

in trigeminal and dorsal root ganglia

Front 35

6 cancers caused by EBV

Back 35

burkitt's
Hodgkins
nasopharyngeal
thymic carcinoma
primary CNS lymphomas in HIV
oral hairy leukoplakia

Front 36

fever, exudative pharyngitis, hepatoslpenomegaly, post. cervical lymphadenopathy

Back 36

mononucleosis

has "atypical lymphocytes" -t cells with fluffy cytoplasm, but really normal, just responding to B cells

Front 37

few days of high fever, then skin rash is what?

Back 37

HHV-6 (Roseola, 6th disease)

Front 38

what is pathogenesis of kaposi's sarcoma

Back 38

is not a malignancy. is neovascularization due to HHV-8 causing lympangiogenic growth factor release (TNF-alpha, IL-6, PDGF)

Front 39

which antivirals are nephrotoxic?

Back 39

gancyclovir
foscarnet

Front 40

what are toxicities of gancylovir (3)

Back 40

neutropenia, leukopenia, nephrotoxcity

Front 41

for herpresviruses, which drug does not need phosphorylation

Back 41

foscarnet

(acylovir and gancyclovir do, but foscarnet 2nd line behind these because of nephrotoxicity)

Front 42

what is HBV virion enzyme for nucleotides?

Back 42

is DNA-dependent DNA polymerase

(but has RNA intermediate transcribed by cellular RNA polymerase and reverse transcriptase)

Front 43

which virus causes painful gingival ulcers

Back 43

HSV-1

Front 44

congenital infection with hearing loss, seizures, petechial rash

Back 44

CMV infection

Front 45

HBV and HCV pneumonic for main characteristics

Back 45

chronic (10% in HBV, 90% in HCV)

cirrhosis

carcinoma

carriers

Front 46

HCV drugs (2)

Back 46

IFN-alpha

ribavirin

Front 47

which hepatitis virus causes high mortality in pregnant women

Back 47

HEV (fecal oral, like HAV)

Front 48

which hep virus is picornovirus?

Back 48

HAV (ss RNA, no envelope unlike HCV which is a flavivirus)

Front 49

what hep marker is positive in window?

Back 49

anti HBc-Ab

Front 50

what is state of Anti-HBcAb in acute infection? chronic?

Back 50

acute- IgM

chronic- IgG

Front 51

kid with
conjunctivitis plus diarrhea
or
pharyngitis with diarrhea
probably what

Back 51

adenovirus

Front 52

what is most common viral UTI cause

Back 52

adenovirus (acute hemorrhagic cystitis)

Front 53

ssRNA is

Back 53

parvo B19

(5th disease, erythema infectiosum, aplastic anemia in sickle cell, hydrops fetalis))

Front 54

milk-maid's blisters

Back 54

cowpox= vaccinia (a poxvirus, ds circular)

Front 55

if see multiple small flesh colored dome lesions with central dimple, is what

Back 55

molluscum contagiosum (a poxvirus)

Front 56

what are the 3 double stranded circular dna viruses?

Back 56

HBV (partially circular)

papilloma virus

polyoma virus (JC virus)

Front 57

what are the classes of DNA viruses? (7)

Back 57

HHAPPPPy to be DNA virus

Herpes
Hepadna (HBV)
Adenovirus
Parvovirus
Papillomavirus
Polyomavirus (JC virus)
Pox virus

Front 58

what HPV strains cause warts (4)

Back 58

1,2,6,11

Front 59

in HIV patient, encephalopathy with demyelination

Back 59

PML (by JC virus, a polyomavirus)

Front 60

outbreak of diarrhea in a daycare during winter months

Back 60

Rotavirus

(number 1 cause of fatal diarrhea in kids in world)

Front 61

what is only double stranded RNA virus?

Back 61

Reoviruses

are ROTAVIRUS (diarrhea outbreaks in winter)

and Colorado Tick Fever

Front 62

diarrheal illness, later weakness in legs is what?
flu-like illness, same presentation is what?

affecting what neurological structure?

Back 62

Polio (enterovirus)
West Nile Virus (Flavivirus)

affects Anterior Horns

Front 63

2 viruses that can cause aseptic meningitis and myocarditis?

Back 63

Echoviruses

Coxsachievirus

(both enteroviruses, a subset of picornovirus)

Front 64

name the enteroviruses (5)

Back 64

all picornoviruses, with HAV

polio
echovirus
coxsachievirus
rhinovirus (which can't get through stomach)

Picornoviruses Enter the Colon Roughly

Front 65

Hepevirus has

Back 65

Hep E virus

Front 66

fever, truncal rash, postauricular lymphadenopathy?

Back 66

rubella (german 3 day measles)

Front 67

H1N1 presentation

Back 67

flu + GI symptoms

Front 68

headache, malaise, back pain, myalgia, anorexia symptoms of what

Back 68

flu symptoms

Front 69

virus with URI, GI, pancytopenia, elevated LFTs

Back 69

Avian Flu

Front 70

respiratory distress with low pitched "seal barking" cough?

high pitched, brassy cough?

Back 70

seal-barking cough - Croup (parainfluenza)

high pitched brassy cough- RSV

Front 71

Palivizumab use

Back 71

monoclonal ab against RSV (use in winter months for premies)

Front 72

can you use ribavirin against RSV?

Back 72

NOT FOR KIDS, only adults

Front 73

what disease can cause subacute sclerosing panencephalitis?

Back 73

Measles

Front 74

what is a complication of mumps

Back 74

aseptic meningitis (like echovirus, coxsachievirus)

Front 75

virus:
fever, hemorragic disease (black vomit), renal disease, jaundice

Back 75

yellow fever

Front 76

common cause of aseptic meningitis in summer months

Back 76

echovirus (from pools)

think of kids echoing as they yell in the pool, then oh shit they get aseptic meningitis

Front 77

Ribavirin mech
use (2)
toxicities (2)

Back 77

inhibits guanine synthesis by competitive inhibition of IMP dehydrogenase

Front 78

Amantadine mech
alternate use?
side effects?
derivative

Back 78

inhibits binding and uncoating of influenza (M2 protein) but most resistant

has ataxia, dizziness, anticholinergic effects (dry mouth, urinary retention, etc)

increases dopamine, can be used in parkinsons

Rimantidine doesn't cross BBB, has less CNS side effects

Front 79

what do oseltamavir and zanamivir block?

Back 79

neuroaminidiase

(all influenzas)

Front 80

an X4 HIV trophic virus binds what receptor?

an R5 HIV trophic virus binds what receptor?

Back 80

X4- binds CXCR4 (T cells)and CD4

R5- binds CCR5 (macrophages) and CD4
(homozygous mutants for CCR5 are immune to this one)

Front 81

env
gag
pol
products?

Back 81

env- gp 120 (adherence)
gp-41 (fusion and entry)

pol- reverse transciptase)

Front 82

Ritinovir drug class, common side effects (3) and specific side effect

Back 82

protease inhibitor

GI distress
inhibits cytochrome p450
hyperglycemia and lipodystrophy

pancreatitis

Front 83

Indinavir drug class, common side effects (3), and specific side effect

Back 83

Protease inhibitor

GI distress
inhibit cytochrome p450
hyperglycemia and lipodystrophy

kidney stones

Front 84

Zalcitabine class

Back 84

NRTI

Front 85

abacavir class

Back 85

NRTI

Front 86

lamivudine class

Back 86

NRTI

Front 87

Efavirenz class

Back 87

NNRTI

Front 88

Nevirapine

Back 88

NNRTI

Front 89

Declaviridine

Back 89

NNRTI

Front 90

if see rash with HAART therapy, think what class

Back 90

NNRTIs (Nevirapine, Efavirenz, Declaviridine)

Front 91

Enfuvirtide class

Back 91

Fusion inhibitor (the only one, enFUvirtide, inhibits gp41)

Front 92

zidovudine can cause (2)

Back 92

GI distress, bone marrow suppression

Front 93

Raltegravir class

Back 93

Integrase inhibitor

Raltegravir aggrivates integrase

Front 94

Maraviroc class

Back 94

CCR5 inhibitor

MaraviroCCR5

Front 95

2 populations pseudomonas osteomyelitis seen in?

Back 95

diabetics and drug addicts

Front 96

4 main UTI bugs

Back 96

E coli
staph saprophyticus
klebsiella
proteus (makes struvite stones)

Front 97

what 2 torch infections can cause hydrops fetalis

Back 97

syphilis, parvo B19

Front 98

what torch infection causes chorioretinitis, hydrocephalus, intracranial calcifications

Back 98

toxoplasma

Front 99

torch infection that causes pulmonary artery hypoplasia, cataracts, deafness, blueberry muffin rash, PDA

Back 99

rubella

Front 100

torch infection with hearing loss, seizures, petechial rash

Back 100

CMV

Front 101

torch infection:
hepatosplenomegaly, hemolytic anemia, rash followed by desquamation of hands and feet
blood-tinged nasal secretions

Back 101

early syphilis (before 3 months)