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469 Cards in this Set
- Front
- Back
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Classic ECG finding in atrial flutter |
“Sawtooth” P waves
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Definition of unstable angina
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Angina is new, is worsening, or occurs at rest
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Antihypertensive for a diabetic patient with proteinuria
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ACEI
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Beck’s triad for cardiac tamponade
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Hypotension, distant heart sounds, and JVD
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Drugs that slow AV node transmission
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β-blockers, digoxin, calcium channel blockers
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Hypercholesterolemia treatment that → flushing and pruritis
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Niacin
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Treatment for atrial fibrillation
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Anticoagulation, rate control, cardioversion
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Treatment for ventricular fibrillation
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Immediate cardioversion
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Autoimmune complication occurring 2–4 weeks post-MI
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Dressler’s syndrome: fever, pericarditis, ↑ ESR
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IV drug use with JVD and holosystolic murmur at the left sternal border. Treatment?
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Treat existing heart failure and replace the tricuspid valve
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Diagnostic test for hypertrophic cardiomyopathy
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Echocardiogram (showing thickened left ventricular wall and outflow obstruction)
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A fall in systolic BP of > 10 mmHg with inspiration
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Pulsus paradoxus (seen in cardiac tamponade)
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Classic ECG findings in pericarditis
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Low-voltage, diffuse ST-segment elevation
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Definition of hypertension
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BP > 140/90 on three separate occasions two weeks apart
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Eight surgically correctable causes of hypertension
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Renal artery stenosis, coarctation of the aorta, pheochromocytoma, Conn’s syndrome, Cushing’s syndrome, unilateral renal parenchymal disease, hyperthyroidism, hyperparathyroidism
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Evaluation of a pulsatile abdominal mass and bruit
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Abdominal ultrasound and CT
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Indications for surgical repair of abdominal aortic aneurysm
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> 5
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Treatment for acute coronary syndrome
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Morphine, O2, sublingual nitroglycerin, ASA, IV β-blockers, heparin
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What is the metabolic syndrome?
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Abdominal obesity, high triglycerides, low HDL, hypertension, insulin resistance, prothrombotic or proinflammatory states
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50-year-old male with angina can exercise to 85% of maximum predicted heart rate. What test?
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Exercise stress treadmill with ECG
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65-year-old woman with left bundle branch block and sever osteoarthritis has unstable angina. What test?
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Pharmacologic stress test (e.g. , dobutamine echo)
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Target LDL in a patient with diabetes
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< 70
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Signs of active ischemia during stress testing
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Angina, ST-segment changes on ECG, or ↓ BP
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ECG findings suggesting MI
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ST-segment elevation (depression means ischemia), flattened T waves, and Q waves
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A young patient has angina at rest with ST-segment elevation. Cardiac enzymes are normal
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Prinzmetal’s angina
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Common symptoms associated with silent MIs
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CHF, shock, and altered mental status
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The diagnostic test for pulmonary embolism
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V/Q scan
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An agent that reverses the effects of heparin
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Protamine
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The coagulation parameter affected by warfarin
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PT
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A young patient with a family history of sudden death collapses and dies while exercising
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Hypertrophic cardiomyopathy
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Endocarditis prophylaxis regimens
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Oral surgery—amoxicillin; GI or GU procedures—ampicillin and gentamicin before and amoxicillin after
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The 6 P’s of ischemia due to peripheral vascular disease
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Pain, pallor, pulselessness, paralysis, paresthesia, poikilothermia
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Virchow’s triad
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Stasis, hypercoagulability, endothelial damage
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The most common cause of hypertension in young women
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OCPs
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The most common cause of hypertension in young men
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Excessive EtOH
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“Stuck-on” appearance
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Seborrheic keratosis
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Red plaques with silvery-white scales and sharp margins
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Psoriasis
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The most common type of skin cancer; the lesion is a pearly-colored papule with a translucent surface and telangiectasias
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Basal cell carcinoma
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Honey-crusted lesions
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Impetigo
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A febrile patient with a history of diabetes presents with a red, swollen, painful lower extremity
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Cellulitis
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(+) Nikolsky’s sign
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Pemphigus vulgaris
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(-) Nikolsky’s sign
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Bullous pemphigoid
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A 55-year-old obese patient presents with dirty, velvety patches on the back of the neck
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Acanthosis nigricans. Check fasting blood sugar to rule out diabetes
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Dermatomal distribution
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Varicella zoster
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Flat-topped papules
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Lichen planus
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Iris-like target lesions
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Erythema multiforme
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A lesion characteristically occurring in a linear pattern in areas where skin comes into contact with clothing or jewelry
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Contact dermatitis
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Presents with a herald patch, Christmas-tree pattern
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Pityriasis rosea
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A 16-year-old presents with an annular patch of alopecia with broken-off, stubby hairs
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Alopecia areata (autoimmune process)
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Pinkish, scaling, flat lesions on the chest and back. KOH prep has a “spaghetti-and-meatballs” appearance
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Pityriasis versicolor
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Four characteristics of a nevus suggestive of melanoma
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Asymmetry, border irregularity, color variation, large diameter
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Premalignant lesion from sun exposure that can → squamous cell carcinoma
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Actinic keratosis
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“Dewdrop on a rose petal"
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Lesions of 1° varicella
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“Cradle cap"
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Seborrheic dermatitis. Treat with antifungals
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Associated with Propionibacterium acnes and changes in androgen levels
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Acne vulgaris
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A painful, recurrent vesicular eruption of mucocutaneous surfaces
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Herpes simplex
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Inflammation and epithelial thinning of the anogenital area, predominantly in postmenopausal women
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Lichen sclerosus
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Exophytic nodules on the skin with varying degrees of scaling or ulceration; the second most common type of skin cancer
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Squamous cell carcinoma
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The most common cause of hypothyroidism
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Hashimoto’s thyroiditis
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Lab findings in Hashimoto’s thyroiditis
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High TSH, low T4, antimicrosomal antibodies
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Exophthalmos, pretibial myxedema, and ↓ TSH
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Graves’ disease
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The most common cause of Cushing’s syndrome
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Iatrogenic steroid administration. The second most common cause is Cushing’s disease
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A patient presents with signs of hypocalcemia, high phosphorus, and low PTH
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Hypoparathyroidism
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“Stones, bones, groans, psychiatric overtones"
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Signs and symptoms of hypercalcemia
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A patient complains of headache, weakness, and polyuria; exam reveals hypertension and tetany. Labs reveals hypernatremia, hypokalemia, and metabolic alkalosis
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1° hyperaldosteronism (due to Conn’s syndrome or bilateral adrenal hyperplasia)
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A patient presents with tachycardia, wild swings in BP, headache, diaphoresis, altered mental status, and a sense of panic
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Pheochromocytoma
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Should α- or β-antagonists be used first in treating pheochromocytoma?
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α-antagonists (phentolamine and phenoxybenzamine)
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A patient with a history of lithium use presents with copious amounts of dilute urine
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Nephrogenic diabetes insipidus (DI)
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Treatment of central DI
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Administration of DDAVP ↓ serum osmolality and free water restriction
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A postoperative patient with significant pain presents with hyponatremia and normal volume status
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SIADH due to stress
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An antidiabetic agent associated with lactic acidosis
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Metformin
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A patient presents with weakness, nausea, vomiting, weight loss, and new skin pigmentation hyponatremia and hyperkalemia. Treatment?
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1° adrenal insufficiency (Addison’s disease). Treat with replacement glucocorticoids, mineralocorticoids, and IV fluids
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Goal hemoglobin A1c for a patient with DM
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< 7.0
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Treatment of DKA
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Fluids, insulin, and aggressive replacement of electrolytes (e.g. K+)
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Why are β-blockers contraindicated in diabetics?
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They can mask symptoms of hypoglycemia
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Bias introduced into a study when a clinician is aware of the patient's treatment type
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Observational bias
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Bias introduced when screening detects a disease earlier and thus lengthens the time from diagnosis to death
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Lead-time bias
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If you want to know if race affects infant mortality rate but most of the variation in infant mortality is predicted by socioeconomic status, then socioeconomic status is a _____.
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Confounding variable
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The number of true positives divided by the number of patients with the disease is _____.
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Sensitivity
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Sensitive tests have few false negatives and are used to rule _____ a disease.
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Out
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PPD reactivity is used as a screening test because most people with TB (except those who are anergic) will have a + PPD. Highly sensitive or specific?
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Highly sensitive for TB
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Chronic diseases such as SLE—higher prevalence or incidence?
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Higher prevalence
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Epidemics such as influenza—higher prevalence or incidence?
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Higher incidence
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Cross-sectional survey—incidence or prevalence?
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Prevalence
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Cohort study—incidence or prevalence?
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Incidence and prevalence
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Case-control study—incidence or prevalence?
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Neither
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Describe a test that consistently gives identical results, but the results are wrong
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High reliability, low validity
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Difference between a cohort and a case-control study
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Cohort studies can be used to calculate relative risk (RR), incidence, and/or odds ratio (OR). Case-control studies can be used to calculate an OR
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Attributable risk?
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The incidence rate (IR) of a disease in exposed − the IR of a disease in unexposed
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Relative risk?
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The IR of a disease in a population exposed to a particular factor ÷ the IR of those not exposed
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Odds ratio?
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The likelihood of a disease among individuals exposed to a risk factor compared to those who have not been exposed
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Number needed to treat?
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1 ÷ (rate in untreated group − rate in treated group)
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In which patients do you initiate colorectal cancer screening early?
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Patients with IBD; those with familial adenomatous polyposis (FAP)/hereditary nonpolyposis colorectal cancer (HNPCC); and those who have first-degree relatives with adenomatous polyps (< 60 years of age) or colorectal cancer
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The most common cancer in men and the most common cause of death from cancer in men
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Prostate cancer is the most common cancer in men, but lung cancer causes more deaths
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The percentage of cases within one SD of the mean? Two SDs? Three SDs?
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68%, 95.5%, 99.7%
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Birth rate?
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Number of live births per 1000 population
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Fertility rate?
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Number of live births per 1000 women 15–44 years of age
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Mortality rate?
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Number of deaths per 1000 population
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Neonatal mortality?
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Number of deaths from birth to 28 days per 1000 live births
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Postnatal mortality?
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Number of deaths from 28 days to one year per 1000 live births
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Infant mortality?
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Number of deaths from birth to one year of age per 1000 live births (neonatal + postnatal mortality)
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Fetal mortality?
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Number of deaths from 20 weeks’ gestation to birth per 1000 total births
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Perinatal mortality?
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Number of deaths from 20 weeks’ gestation to one month of life per 1000 total births
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Maternal mortality?
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Number of deaths during pregnancy to 90 days postpartum per 100,000 live births
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True or false: Once patients sign a statement giving consent, they must continue treatment
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False. Patients may change their minds at any time. Exceptions to the requirement of informed consent include emergency situations and patients without decision-making capacity
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A 15-year-old pregnant girl requires hospitalization for preeclampsia. Should her parents be informed?
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No. Parental consent is not necessary for the medical treatment of pregnant minors
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A doctor refers a patient for an MRI at a facility he/she owns
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Conflict of interest
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Involuntary psychiatric hospitalization can be undertaken for which three reasons?
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The patient is a danger to self, a danger to others, or gravely disabled (unable to provide for basic needs)
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True or false: Withdrawing life-sustaining care is ethically distinct from withholding sustaining care
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False. Withdrawing and withholding life are the same from an ethical standpoint
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When can a physician refuse to continue treating a patient on the grounds of futility?
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When there is no rationale for treatment, maximal intervention is failing, a given intervention has already failed, and treatment will not achieve the goals of care
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An eight-year-old child is in a serious accident. She requires emergent transfusion, but her parents are not present.
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Treat immediately. Consent is implied in emergency situations.
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Conditions in which confidentiality must be overridden
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Real threat of harm to third parties; suicidal intentions; certain contagious diseases; elder and child abuse
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Involuntary commitment or isolation for medical treatment may be undertaken for what reason?
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When treatment noncompliance represents a serious danger to public health (e.g., active TB)
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A 10-year-old child presents in status epilepticus, but her parents refuse treatment on religious grounds
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Treat because the disease represents an immediate threat to the child’s life. Then seek a court order.
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A son asks that his mother not be told about her recently discovered cancer
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A patient’s family cannot require that a doctor withhold information from the patient
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Patient presents with sudden onset of severe, diffuse abdominal pain. Exam reveals peritoneal signs and AXR reveals free air under the diaphragm. Management?
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Emergent laparotomy to repair perforated viscus, likely stomach
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The most likely cause of acute lower GI bleed in patients > 40 years old
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Diverticulosis
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Diagnostic modality used when ultrasound is equivocal for cholecystitis
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HIDA scan
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Sentinel loop on AXR
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Acute pancreatitis
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Risk factors for cholelithiasis
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Fat, female, fertile, forty, flatulent
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Inspiratory arrest during palpation of the RUQ
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Murphy’s sign, seen in acute cholecystitis
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Most common organism
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Campylobacter
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Recent antibiotic use
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Clostridium difficile
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Camping
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Giardia
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Traveler’s diarrhea
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ETEC
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Church picnics/mayonnaise
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S. aureus
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Uncooked hamburgers
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E. coli O157:H7
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Fried rice
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Bacillus cereus
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Poultry/eggs
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Salmonella
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Raw seafood
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Vibrio, HAV
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AIDS
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Isospora, Cryptosporidium, Mycobacterium avium complex (MAC)
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Pseudoappendicitis
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Yersinia
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A 25-year-old Jewish male presents with pain and watery diarrhea after meals. Exam shows fistulas between the bowel and skin and nodular lesions on his tibias.
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Crohn’s disease
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Inflammatory disease of the colon with ↑ risk of colon cancer
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Ulcerative colitis
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Extraintestinal manifestations of IBD
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Uveitis, ankylosing spondylitis, pyoderma gangrenosum, erythema nodosum, 1° sclerosing cholangitis
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Medical treatment for IBD
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5-aminosalicylic acid agents and steroids during acute exacerbations
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Difference between Mallory-Weiss and Boerhaave tears
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Mallory-Weiss—superficial tear in the esophageal mucosa; Boerhaave—full-thickness esophageal rupture
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Charcot’s triad
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RUQ pain, jaundice, and fever/chills in the setting of ascending cholangitis
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Reynolds’ pentad
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Charcot’s triad plus shock and mental status changes, with suppurative ascending cholangitis
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Medical treatment for hepatic encephalopathy
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↓ protein intake, lactulose, neomycin
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First step in the management of a patient with acute GI bleed
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Establish the ABCs
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A four-year-old child presents with oliguria, petechiae, and jaundice following an illness with bloody diarrhea. Most likely diagnosis and cause?
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Hemolytic-uremic syndrome (HUS) due to E. coli O157:H7
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Post-HBV exposure treatment
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HBV immunoglobulin
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Classic causes of drug-induced hepatitis
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TB medications (INH, rifampin, pyrazinamide), acetaminophen, and tetracycline
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A 40-year-old obese female with elevated alkaline phosphatase, elevated bilirubin, pruritus, dark urine, and clay-colored stools
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Biliary tract obstruction
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Hernia with highest risk of incarceration—indirect, direct, or femoral?
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Femoral hernia
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A 50-year-old man with a history of alcohol abuse presents with boring epigastric pain that radiates to the back and is relieved by sitting forward. Management?
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Confirm the diagnosis of acute pancreatitis with elevated amylase and lipase. Make the patient NPO and give IV fluids, O2, analgesia, and “tincture of time”
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Four causes of microcytic anemia
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TICS—Thalassemia, Iron deficiency, anemia of Chronic disease, and Sideroblastic anemia
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An elderly male with hypochromic, microcytic anemia is asymptomatic. Diagnostic tests?
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Fecal occult blood test and sigmoidoscopy; suspect colorectal cancer
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Precipitants of hemolytic crisis in patients with G6PD deficiency
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Sulfonamides, antimalarial drugs, fava beans
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The most common inherited cause of hypercoagulability
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Factor V Leiden mutation
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The most common inherited hemolytic anemia
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Hereditary spherocytosis
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Diagnostic test for hereditary spherocytosis
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Osmotic fragility test
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Pure RBC aplasia
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Diamond-Blackfan anemia
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Anemia associated with absent radii and thumbs, diffuse hyperpigmentation, café-au-lait spots, microcephaly, and pancytopenia
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Fanconi’s anemia
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Medications and viruses that → aplastic anemia
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Chloramphenicol, sulfonamides, radiation, HIV, chemotherapeutic agents, hepatitis, parvovirus B19, EBV
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How to distinguish polycythemia vera from 2° polycythemia
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Both have ↑ hematocrit and RBC mass, but polycythemia vera should have normal O2 saturation and low erythropoietin levels
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Thrombotic thrombocytopenic purpura (TTP) pentad?
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Pentad of TTP—“FAT RN”: Fever, Anemia, Thrombocytopenia, Renal dysfunction, Neurologic abnormalities
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HUS triad?
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Anemia, thrombocytopenia, and acute renal failure
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Treatment for TTP
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Emergent large-volume plasmapheresis, corticosteroids, antiplatelet drugs
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Treatment for idiopathic thrombocytopenic purpura (ITP) in children
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Usually resolves spontaneously; may require IVIG and/or corticosteroids
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Which of the following are ↑ in DIC: fibrin split products, D-dimer, fibrinogen, platelets, and hematocrit
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Fibrin split products and D-dimer are elevated; platelets, fibrinogen, and hematocrit are ↓
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An eight-year-old boy presents with hemarthrosis and ↑ PTT with normal PT and bleeding time. Diagnosis? Treatment?
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Hemophilia A or B; consider desmopressin (for hemophilia A) or factor VIII or IX supplements
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A 14-year-old girl presents with prolonged bleeding after
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von Willebrand’s disease; treat with desmopressin, FFP, or cryoprecipitate
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A 60-year-old African-American male presents with bone pain. Workup for multiple myeloma might reveal?
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Monoclonal gammopathy, Bence Jones proteinuria, “punched-out” lesions on x-ray of the skull and long bones
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Reed-Sternberg cells
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Hodgkin’s lymphoma
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A 10-year-old boy presents with fever, weight loss, and night sweats. Examination shows anterior mediastinal mass. Suspected diagnosis?
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Non-Hodgkin’s lymphoma
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Microcytic anemia with ↓ serum iron, ↓ total iron-binding capacity (TIBC), and normal or ↑ ferritin
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Anemia of chronic disease
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Microcytic anemia with ↓ serum iron, ↓ ferritin, and ↑ TIBC
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Iron deficiency anemia
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An 80-year-old man presents with fatigue, lymphadenopathy, splenomegaly, and isolated lymphocytosis. Suspected diagnosis?
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Chronic lymphocytic leukemia (CLL)
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A late, life-threatening complication of chronic myelogenous leukemia (CML)
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Blast crisis (fever, bone pain, splenomegaly, pancytopenia)
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Auer rods on blood smear
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Acute myelogenous leukemia (AML)
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AML subtype associated with DIC
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M3
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Electrolyte changes in tumor lysis syndrome
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↓ Ca2+, ↑ K+, ↑ phosphate, ↑ uric acid
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Treatment for AML M3
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Retinoic acid
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A 50-year-old male presents with early satiety, splenomegaly, and bleeding. Cytogenetics show t(9,22). Diagnosis?
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CML
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Heinz bodies?
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Intracellular inclusions seen in thalassemia, G6PD deficiency, and postsplenectomy
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An autosomal-recessive disorder with a defect in the GPIIbIIIa platelet receptor and ↓ platelet aggregation
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Glanzmann’s thrombasthenia
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Virus associated with aplastic anemia in patients with sickle cell anemia
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Parvovirus B19
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A 25-year-old African-American male with sickle cell anemia has sudden onset of bone pain. Management of pain crisis?
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O2, analgesia, hydration, and, if severe, transfusion
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A significant cause of morbidity in thalassemia patients. Treatment?
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Iron overload; use deferoxamine
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The three most common causes of fever of unknown origin (FUO)
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Infection, cancer, and autoimmune disease
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Four signs and symptoms of streptococcal pharyngitis
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Fever, pharyngeal erythema, tonsillar exudate, lack of cough
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A nonsuppurative complication of streptococcal infection that is not altered by treatment of 1° infection
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Postinfectious glomerulonephritis
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Asplenic patients are particularly susceptible to these organisms
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Encapsulated organisms––pneumococcus, meningococcus, Haemophilus influenzae, Klebsiella
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The number of bacteria on a clean-catch specimen to diagnose a UTI
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10^5 bacteria/mL
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Which healthy population is susceptible to UTIs?
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Pregnant women. Treat this group aggressively because of potential complications
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A patient from California or Arizona presents with fever, malaise, cough, and night sweats. Diagnosis? Treatment?
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Coccidioidomycosis. Amphotericin B
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Nonpainful chancre
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1° syphilis
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A “blueberry muffin” rash is characteristic of what congenital infection?
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Rubella
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Meningitis in neonates. Causes? Treatment?
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Group B strep, E. coli, Listeria. Treat with gentamicin and ampicillin
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Meningitis in infants. Causes? Treatment?
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Pneumococcus, meningococcus, H. Influenzae. Treat with cefotaxime and vancomycin
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What should always be done prior to LP?
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Check for ↑ ICP; look for papilledema
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CSF findings: Low glucose, PMN predominance
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Bacterial meningitis
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CSF findings: Normal glucose, lymphocytic predominance
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Aseptic (viral) meningitis
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CSF findings: Numerous RBCs in serial CSF samples
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Subarachnoid hemorrhage (SAH)
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CSF findings: gamma globulins
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MS
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Initially presents with a pruritic papule with regional lymphadenopathy and evolves into a black eschar after 7-10 days. Treatment?
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Cutaneous anthrax. Treat with penicillin G or ciprofloxacin
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Findings in 3° syphilis
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Tabes dorsalis, general paresis, gummas, Argyll Robertson pupil, aortitis, aortic root aneurysms
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Characteristics of 2° Lyme disease
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Arthralgias, migratory polyarthropathies, Bell’s palsy, myocarditis
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Cold agglutinins
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Mycoplasma
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A 24-year-old male presents with soft white plaques on his tongue and the back of his throat. Diagnosis? Workup? Treatment?
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Candidal thrush. Workup should include an HIV test. Treat with nystatin oral suspension
|
|
|
Begin Pneumocystis carinii pneumonia (PCP) prophylaxis in an HIV-positive patient at what CD4 count? Mycobacterium avium-intracellulare (MAI) prophylaxis?
|
≤ 200 for PCP (with TMP-SMX); ≤ 50–100 for MAI (with clarithromycin/azithromycin)
|
|
|
Risk factors for pyelonephritis
|
Pregnancy, vesicoureteral reflux, anatomic anomalies, indwelling catheters, kidney stones
|
|
|
Neutropenic nadir postchemotherapy
|
7–10 days
|
|
|
Erythema migrans
|
Lesion of 1° Lyme disease
|
|
|
Classic physical findings for endocarditis
|
Fever, heart murmur, Osler’s nodes, splinter hemorrhages, Janeway lesions, Roth’s spots
|
|
|
Aplastic crisis in sickle cell disease
|
Parvovirus B19
|
|
|
Ring-enhancing brain lesion on CT with seizures
|
Taenia solium (cysticercosis)
|
|
|
Name the organism: Branching rods in oral infection
|
Actinomyces israelii
|
|
|
Name the organism: Painful chancroid
|
Haemophilus ducreyi
|
|
|
Name the organism: Dog or cat bite
|
Pasteurella multocida
|
|
|
Name the organism: Gardener
|
Sporothrix schenckii
|
|
|
Name the organism: Pregnant women with pets
|
Toxoplasma gondii
|
|
|
Name the organism: Meningitis in adults
|
Neisseria meningitidis
|
|
|
Name the organism: Meningitis in elderly
|
Streptococcus pneumoniae
|
|
|
Name the organism: Alcoholic with pneumonia
|
Klebsiella
|
|
|
Name the organism: “Currant jelly” sputum
|
Klebsiella
|
|
|
Name the organism: Infection in burn victims
|
Pseudomonas
|
|
|
Name the organism: Osteomyelitis from foot wound puncture
|
Pseudomonas
|
|
|
Name the organism: Osteomyelitis in a sickle cell patient
|
Salmonella
|
|
|
A 55-year-old man who is a smoker and a heavy drinker presents with a new cough and flulike symptoms. Gram stain shows no organisms; silver stain of sputum shows gram-negative rods. What is the diagnosis?
|
Legionella pneumonia
|
|
|
A middle-aged man presents with acute-onset monoarticular joint pain and bilateral Bell’s palsy. What is the likely diagnosis, and how did he get it? Treatment?
|
Lyme disease, Ixodes tick, doxycycline
|
|
|
A patient develops endocarditis three weeks after receiving a prosthetic heart valve a prosthetic heart valve. What organism is suspected?
|
S. aureus or S. Epidermidis
|
|
|
A patient presents with pain on passive movement, pallor, poikilothermia, paresthesias, paralysis, and pulselessness. Treatment?
|
All-compartment fasciotomy for suspected compartment syndrome
|
|
|
Back pain that is exacerbated by standing and walking and relieved with sitting and hyperflexion of the hips
|
Spinal stenosis
|
|
|
Joints in the hand affected in rheumatoid arthritis
|
MCP and PIP joints; DIP joints are spared
|
|
|
Joint pain and stiffness that worsen over the course of the day and are relieved by rest
|
Osteoarthritis
|
|
|
Genetic disorder associated with multiple fractures and commonly mistaken for child abuse
|
Osteogenesis imperfecta
|
|
|
Hip and back pain along with stiffness that improves with activity over the course of the day and worsens at rest. Diagnostic test?
|
Suspect ankylosing spondylitis. Check HLA-B27
|
|
|
Arthritis, conjunctivitis, and urethritis in young men. Associated organisms?
|
Reactive (Reiter’s) arthritis. Associated with Campylobacter, Shigella, Salmonella, Chlamydia, and Ureaplasma
|
|
|
A 55-year-old man has sudden, excruciating first MTP joint pain after a night of drinking red wine. Diagnosis, workup, and chronic treatment?
|
Gout. Needle-shaped, negatively birefringent crystals are seen on joint fluid aspirate. Chronic treatment with allopurinol or probenecid.
|
|
|
Rhomboid-shaped, positively birefringent crystals on joint fluid aspirate
|
Pseudogout
|
|
|
An elderly female presents with pain and stiffness of the shoulders and hips; she cannot lift her arms above her head. Labs show anemia and ↑ ESR
|
Polymyalgia rheumatica
|
|
|
An active 13-year-old boy has anterior knee pain. Diagnosis?
|
Osgood-Schlatter disease
|
|
|
Bone is fractured in fall on outstretched hand
|
Distal radius (Colles’ fracture)
|
|
|
Complication of scaphoid fracture
|
Avascular necrosis
|
|
|
Signs suggesting radial nerve damage with humeral fracture
|
Wrist drop, loss of thumb abduction
|
|
|
A young child presents with proximal muscle weakness, waddling gait, and pronounced calf muscles
|
Duchenne muscular dystrophy
|
|
|
A first-born female who was born in breech position is found to have asymmetric skin folds on her newborn exam. Diagnosis? Treatment?
|
Developmental dysplasia of the hip. If severe, consider a Pavlik harness to maintain abduction
|
|
|
An 11-year-old obese, African-American boy presents with sudden onset of limp. Diagnosis? Workup?
|
Slipped capital femoral epiphyses. AP and frog-leg lateral view
|
|
|
The most common 1° malignant tumor of bone
|
Multiple myeloma
|
|
|
Unilateral, severe periorbital headache with tearing and conjunctival erythema
|
Cluster headache
|
|
|
Prophylactic treatment for migraine
|
β-blockers, Ca2+ channel blockers, TCAs
|
|
|
The most common pituitary tumor. Treatment?
|
Prolactinoma. Dopamine agonists (e.g., bromocriptine)
|
|
|
A 55-year-old patient presents with acute “broken speech." What type of aphasia? What lobe and vascular distribution?
|
Broca’s aphasia. Frontal lobe, left MCA distribution
|
|
|
The most common cause of SAH
|
Trauma; the second most common is berry aneurysm
|
|
|
A crescent-shaped hyperdensity on CT that does not cross the midline
|
Subdural hematoma—bridging veins torn
|
|
|
A history significant for initial altered mental status with an intervening lucid interval. Diagnosis? Most likely etiology? Treatment?
|
Epidural hematoma. Middle meningeal artery. Neurosurgical evacuation
|
|
|
CSF findings with SAH
|
Elevated ICP, RBCs, xanthochromia
|
|
|
Albuminocytologic dissociation
|
Guillain-Barré (↑ protein in CSF with only a modest ↑ in cell count)
|
|
|
Cold water is flushed into a patient’s ear, and the fast phase of the nystagmus is toward the opposite side. Normal or pathological?
|
Normal
|
|
|
The most common 1° sources of metastases to the brain
|
Lung, breast, skin (melanoma), kidney, GI tract
|
|
|
May be seen in children who are accused of inattention in class and confused with ADHD
|
Absence seizures
|
|
|
The most frequent presentation of intracranial neoplasm
|
Headache
|
|
|
The most common cause of seizures in children (2–10 years)
|
Infection, febrile seizures, trauma, idiopathic
|
|
|
The most common cause of seizures in young adults (18–35 years)
|
Trauma, alcohol withdrawal, brain tumor
|
|
|
First-line medication for status epilepticus
|
IV benzodiazepine
|
|
|
Confusion, confabulation, ophthalmoplegia, ataxia
|
Wernicke’s encephalopathy due to a deficiency of thiamine
|
|
|
What % lesion is an indication for carotid endarterectomy?
|
Seventy percent if the stenosis is symptomatic
|
|
|
The most common causes of dementia
|
Alzheimer’s and multi-infarct
|
|
|
Combined UMN and LMN disorder
|
ALS
|
|
|
Rigidity and stiffness with resting tremor and masked facies
|
Parkinson’s disease
|
|
|
The mainstay of Parkinson’s therapy
|
Levodopa/carbidopa
|
|
|
Treatment for Guillain-Barré syndrome
|
IVIG or plasmapheresis
|
|
|
Rigidity and stiffness that progress to choreiform movements, accompanied by moodiness and altered behavior
|
Huntington’s disease
|
|
|
A six-year-old girl presents with a port-wine stain in the V2 distribution as well as with mental retardation, seizures, and leptomeningeal angioma
|
Sturge-Weber syndrome. Treat symptomatically. Possible focal cerebral resection of affected lobe
|
|
|
Café-au-lait spots on skin
|
Neurofibromatosis 1
|
|
|
Hyperphagia, hypersexuality, hyperorality, and hyperdocility
|
Klüver-Bucy syndrome (amygdala)
|
|
|
Administer to a symptomatic patient to diagnose myasthenia gravis
|
Edrophonium
|
|
|
1° causes of third-trimester bleeding
|
Placental abruption and placenta previa
|
|
|
Classic ultrasound and gross appearance of complete hydatidiform mole
|
Snowstorm on ultrasound. “Cluster-of-grapes” appearance on gross examination
|
|
|
Chromosomal pattern of a complete mole
|
46,XX
|
|
|
Molar pregnancy containing fetal tissue
|
Partial mole
|
|
|
Symptoms of placental abruption
|
Continuous, painful vaginal bleeding
|
|
|
Symptoms of placenta previa
|
Self-limited, painless vaginal bleeding
|
|
|
When should a vaginal exam be performed with suspected placenta previa?
|
Never
|
|
|
Antibiotics with teratogenic effects
|
Tetracycline, fluoroquinolones, aminoglycosides, sulfonamides
|
|
|
Shortest AP diameter of the pelvis
|
Obstetric conjugate: between the sacral promontory and the midpoint of the symphysis pubis
|
|
|
Medication given to accelerate fetal lung maturity
|
Betamethasone or dexamethasone × 48 hours
|
|
|
The most common cause of postpartum hemorrhage
|
Uterine atony
|
|
|
Treatment for postpartum hemorrhage
|
Uterine massage; if that fails, give oxytocin
|
|
|
Typical antibiotics for group B streptococcus (GBS) prophylaxis
|
IV penicillin or ampicillin
|
|
|
A patient fails to lactate after an emergency C-section with marked blood loss
|
Sheehan’s syndrome (postpartum pituitary necrosis)
|
|
|
Uterine bleeding at 18 weeks’ gestation; no products expelled; membranes ruptured; cervical os open
|
Inevitable abortion
|
|
|
Uterine bleeding at 18 weeks’ gestation; no products expelled; cervical os closed
|
Threatened abortion
|
|
|
Indications for medical treatment of ectopic pregnancy
|
Stable, unruptured ectopic pregnancy of < 3.5 cm at < 6 weeks’ gestation
|
|
|
Medical options for endometriosis
|
OCPs, danazol, GnRH agonists
|
|
|
Laparoscopic findings in endometriosis
|
“Chocolate cysts,” powder burns
|
|
|
The most common location for an ectopic pregnancy
|
Ampulla of the oviduct
|
|
|
How to diagnose and follow a leiomyoma
|
Ultrasound
|
|
|
Natural history of a leiomyoma
|
Regresses after menopause
|
|
|
A patient has ↑ vaginal discharge and petechial patches in the upper vagina and cervix
|
Trichomonas vaginitis
|
|
|
Treatment for bacterial vaginosis
|
Oral or topical metronidazole
|
|
|
The most common cause of bloody nipple discharge
|
Intraductal papilloma
|
|
|
Contraceptive methods that protect against PID
|
OCP and barrier contraception
|
|
|
Unopposed estrogen is contraindicated in which cancers?
|
Endometrial or estrogen receptor (+) breast cancer
|
|
|
A patient presents with recent PID with RUQ pain
|
Consider Fitz-Hugh–Curtis syndrome
|
|
|
Breast malignancy presenting as itching, burning, and erosion of the nipple
|
Paget’s disease
|
|
|
Annual screening for women with a strong family history of ovarian cancer
|
CA-125 and transvaginal ultrasound
|
|
|
A 50-year-old woman leaks urine when laughing or coughing. Nonsurgical options?
|
Kegel exercises, estrogen, pessaries for stress incontinence
|
|
|
A 30-year-old woman has unpredictable urine loss. Examination is normal. Medical options?
|
Anticholinergics (oxybutynin) or β-adrenergics (metaproterenol) for urge incontinence
|
|
|
Lab values suggestive of menopause
|
↑ serum FSH
|
|
|
The most common cause of female infertility
|
Endometriosis
|
|
|
Two consecutive findings of atypical squamous cells of undetermined significance (ASCUS) on Pap smear. Follow-up evaluation?
|
Colposcopy and endocervical curettage
|
|
|
Breast cancer type that ↑ the future risk of invasive carcinoma in both breasts
|
Lobular carcinoma in situ
|
|
|
Nontender abdominal mass associated with elevated VMA and HVA
|
Neuroblastoma
|
|
|
The most common type of tracheoesophageal fistula (TEF). Diagnosis?
|
Esophageal atresia with distal TEF (85%). Unable to pass NG tube
|
|
|
Not contraindications to vaccination
|
Mild illness and/or low-grade fever, current antibiotic therapy, and prematurity
|
|
|
Tests to rule out shaken baby syndrome
|
Ophthalmologic exam, CT, and MRI
|
|
|
A neonate has meconium ileus
|
CF or Hirschsprung’s disease
|
|
|
Bilious emesis within hours after the first feeding
|
Duodenal atresia
|
|
|
A two-month-old presents with nonbilious projectile emesis. What are the appropriate steps in management?
|
Correct metabolic abnormalities. Then correct pyloric stenosis with pyloromyotomy
|
|
|
The most common 1° immunodeficiency
|
Selective IgA deficiency
|
|
|
An infant has a high fever and onset of rash as fever breaks. What is he at risk for?
|
Febrile seizures (roseola infantum)
|
|
|
What is the immunodeficiency? A boy has chronic respiratory infections. Nitroblue tetrazolium test is (-)
|
Chronic granulomatous disease
|
|
|
What is the immunodeficiency? A child has eczema, thrombocytopenia, and high levels of IgA
|
Wiskott-Aldrich syndrome
|
|
|
What is the immunodeficiency? A four-month-old boy has life-threatening Pseudomonas infection
|
Bruton’s X-linked agammaglobulinemia
|
|
|
Acute-phase treatment for Kawasaki disease
|
High-dose aspirin for inflammation and fever; IVIG to prevent coronary artery aneurysms
|
|
|
Treatment for mild and severe unconjugated hyperbilirubinemia
|
Phototherapy (mild) or exchange transfusion (severe)
|
|
|
Sudden onset of mental status changes, emesis, and liver dysfunction after taking aspirin
|
Reye’s syndrome
|
|
|
A child has loss of red light reflex. Diagnosis?
|
Suspect retinoblastoma
|
|
|
Vaccinations at a six-month well-child visit
|
HBV, DTaP, Hib, IPV, PCV
|
|
|
Tanner stage 3 in a six-year-old female
|
Precocious puberty
|
|
|
Infection of small airways with epidemics in winter and spring
|
RSV bronchiolitis
|
|
|
Cause of neonatal RDS
|
Surfactant deficiency
|
|
|
A condition associated with red “currant-jelly” stools
|
Intussusception
|
|
|
A congenital heart disease that cause 2° hypertension
|
Coarctation of the aorta
|
|
|
First-line treatment for otitis media
|
Amoxicillin × 10 days
|
|
|
The most common pathogen causing croup
|
Parainfluenza virus type 1
|
|
|
A homeless child is small for his age and has peeling skin and a swollen belly
|
Kwashiorkor (protein malnutrition)
|
|
|
Defect in an X-linked syndrome with mental retardation, gout, self-mutilation, and choreoathetosis
|
Lesch-Nyhan syndrome (purine salvage problem with HGPRTase deficiency)
|
|
|
A newborn female has continuous “machinery murmur"
|
Patent ductus arteriosus (PDA)
|
|
|
First-line pharmacotherapy for depression
|
SSRIs
|
|
|
Antidepressants associated with hypertensive crisis
|
MAOIs
|
|
|
Galactorrhea, impotence, menstrual dysfunction, and ↓ libido
|
Patient on dopamine antagonist
|
|
|
A 17-year-old female has left arm paralysis after her boyfriend dies in a car crash. No medical cause is found
|
Conversion disorder
|
|
|
Name the defense mechanism: A mother who is angry at her husband yells at her child
|
Displacement
|
|
|
Name the defense mechanism: A pedophile enters a monastery
|
Reaction formation
|
|
|
Name the defense mechanism: A woman calmly describes a grisly murder
|
Isolation
|
|
|
Name the defense mechanism: A hospitalized 10-year-old begins to wet his bed
|
Regression
|
|
|
Life-threatening muscle rigidity, fever, and rhabdomyolysis
|
Neuroleptic malignant syndrome
|
|
|
Amenorrhea, bradycardia, and abnormal body image in a young female
|
Anorexia
|
|
|
A 35-year-old male has recurrent episodes of palpitations, diaphoresis, and fear of going crazy
|
Panic disorder
|
|
|
The most serious side effect of clozapine
|
Agranulocytosis
|
|
|
A 21-year-old male has three months of social withdrawal, worsening grades, flattened affect, and concrete thinking
|
Schizophreniform disorder (diagnosis of schizophrenia requires ≥ 6 months of symptoms)
|
|
|
Key side effects of atypical antipsychotics
|
Weight gain, type 2 DM, QT prolongation
|
|
|
A young weight lifter receives IV haloperidol and complains that his eyes are deviated sideways. Diagnosis? Treatment?
|
Acute dystonia (oculogyric crisis). Treat with benztropine or diphenhydramine
|
|
|
Psychiatric medication to avoid in patients with a history of alcohol withdrawal seizures
|
Neuroleptics
|
|
|
A 13-year-old male has a history of theft, vandalism, and violence toward family pets
|
Conduct disorder
|
|
|
A five-month-old girl has ↓ head growth, truncal dyscoordination, and ↓ social interaction
|
Rett’s disorder
|
|
|
A patient hasn’t slept for days, lost $20,000 gambling, is agitated, and has pressured speech. Diagnosis? Treatment?
|
Acute mania. Start a mood stabilizer (e.g., lithium)
|
|
|
After a minor fender bender, a man wears a neck brace and requests permanent disability
|
Malingering
|
|
|
A nurse presents with severe hypoglycemia; blood analysis reveals no elevation in C peptide
|
Factitious disorder (Munchausen syndrome)
|
|
|
A patient continues to use cocaine after being in jail, losing his job, and not paying child support
|
Substance abuse
|
|
|
A violent patient has vertical and horizontal nystagmus
|
Phencyclidine hydrochloride (PCP) intoxication
|
|
|
A woman who was abused as a child frequently feels outside of or detached from her body
|
Depersonalization disorder
|
|
|
A man has repeated, intense urges to rub his body against unsuspecting passengers on a bus
|
Frotteurism (a paraphilia)
|
|
|
A schizophrenic patient takes haloperidol for one year and develops uncontrollable tongue movements. Diagnosis? Treatment?
|
Tardive dyskinesia. ↓ or discontinue haloperidol and consider another antipsychotic (e.g., risperidone, clozapine)
|
|
|
A man unexpectedly flies across the country, takes a new name, and has no memory of his prior life
|
Dissociative fugue
|
|
|
Risk factors for DVT
|
Stasis, endothelial injury, and hypercoagulability (Virchow’s triad)
|
|
|
Criteria for exudative effusion
|
Pleural/serum protein > 0.5; pleural/serum LDH > 0.6
|
|
|
Causes of exudative effusion
|
Think of leaky capillaries. Malignancy, TB, bacterial or viral infection, pulmonary embolism with infarct, and pancreatitis
|
|
|
Causes of transudative effusion
|
Think of intact capillaries. CHF, liver or kidney disease, and protein-losing enteropathy
|
|
|
Normalizing PCO2 in a patient having an asthma exacerbation may indicate?
|
Fatigue and impending respiratory failure
|
|
|
Dyspnea, lateral hilar lymphodenopathy on CXR, noncaseating granulomas, increased ACE, and hypercalcemia
|
Sarcoidosis
|
|
|
PFT showing ↓ FEV1/FVC
|
Obstructive pulmonary disease (e.g., asthma)
|
|
|
PFT showing ↑ FEV1/FVC
|
Restrictive pulmonary disease
|
|
|
Honeycomb pattern on CXR. Diagnosis? Treatment?
|
Diffuse interstitial pulmonary fibrosis. Supportive care. Steroids may help
|
|
|
Treatment for SVC syndrome
|
Radiation
|
|
|
Treatment for mild, persistent asthma
|
Inhaled β-agonists and inhaled corticosteroids
|
|
|
Acid-base disorder in pulmonary embolism
|
Hypoxia and hypocarbia (respiratory alkalosis)
|
|
|
Non–small cell lung cancer (NSCLC) associated with hypercalcemia
|
Squamous cell carcinoma
|
|
|
Lung cancer associated with SIADH
|
Small cell lung cancer (SCLC)
|
|
|
Lung cancer highly related to cigarette exposure
|
SCLC
|
|
|
A tall white male presents with acute shortness of breath. Diagnosis? Treatment?
|
Spontaneous pneumothorax. Spontaneous regression. Supplemental O2 may be helpful
|
|
|
Treatment of tension pneumothorax
|
Immediate needle thoracostomy
|
|
|
Characteristics favoring carcinoma in an isolated pulmonary nodule
|
Age > 45–50 years; lesions new or larger in comparison to old films; absence of calcification or irregular calcification; size > 2 cm; irregular margins
|
|
|
Hypoxemia and pulmonary edema with normal pulmonary capillary wedge pressure
|
ARDS
|
|
|
↑ risk of what infection with silicosis?
|
Mycobacterium tuberculosis
|
|
|
Causes of hypoxemia
|
Right-to-left shunt, hypoventilation, low inspired O2 tension, diffusion defect, V/Q mismatch
|
|
|
Classic CXR findings for pulmonary edema
|
Cardiomegaly, prominent pulmonary vessels, Kerley B lines, “bat’s-wing” appearance of hilar shadows, and perivascular and peribronchial cuffing
|
|
|
Renal tubular acidosis (RTA) associated with abnormal H+ secretion and nephrolithiasis
|
Type I (distal) RTA
|
|
|
RTA associated with abnormal HCO3− and rickets
|
Type II (proximal) RTA
|
|
|
RTA associated with aldosterone defect
|
Type IV (distal) RTA
|
|
|
“Doughy skin"
|
Hypernatremia
|
|
|
Differential of hypervolemic hyponatremia
|
Cirrhosis, CHF, nephritic syndrome
|
|
|
Chvostek’s and Trousseau’s signs
|
Hypocalcemia
|
|
|
The most common causes of hypercalcemia
|
Malignancy and hyperparathyroidism
|
|
|
T-wave flattening and U waves
|
Hypokalemia
|
|
|
Peaked T waves and widened QRS
|
Hyperkalemia
|
|
|
First-line treatment for moderate hypercalcemia
|
IV hydration and loop diuretics (furosemide)
|
|
|
Type of ARF in a patient with FeNa < 1%
|
Prerenal
|
|
|
A 49-year-old male presents with acute-onset flank pain and hematuria
|
Nephrolithiasis
|
|
|
The most common type of nephrolithiasis
|
Calcium oxalate
|
|
|
A 20-year-old man presents with a palpable flank mass and hematuria. Ultrasound shows bilateral enlarged kidneys with cysts. Associated brain anomaly?
|
Cerebral berry aneurysms (autosomal-dominant PCKD)
|
|
|
Hematuria, hypertension, and oliguria
|
Nephritic syndrome
|
|
|
Proteinuria, hypoalbuminemia, hyperlipidemia, hyperlipiduria, edema
|
Nephrotic syndrome
|
|
|
The most common form of nephritic syndrome
|
Membranous glomerulonephritis
|
|
|
The most common form of glomerulonephritis
|
IgA nephropathy (Berger’s disease)
|
|
|
Glomerulonephritis with deafness
|
Alport’s syndrome
|
|
|
Glomerulonephritis with hemoptysis
|
Wegener’s granulomatosis and Goodpasture’s syndrome
|
|
|
Presence of red cell casts in urine sediment
|
Glomerulonephritis/nephritic syndrome
|
|
|
Eosinophils in urine sediment
|
Allergic interstitial nephritis
|
|
|
Waxy casts in urine sediment and Maltese crosses (seen with lipiduria)
|
Nephrotic syndrome
|
|
|
Drowsiness, asterixis, nausea, and a pericardial friction rub
|
Uremic syndrome seen in patients with renal failure
|
|
|
A 55-year-old man is diagnosed with prostate cancerTreatment options?
|
Wait, surgical resection, radiation and/or androgen suppression
|
|
|
Low urine specific gravity in the presence of high serum osmolality
|
DI
|
|
|
Treatment of SIADH?
|
Fluid restriction, demeclocycline
|
|
|
Hematuria, flank pain, and palpable flank mass
|
Renal cell carcinoma (RCC)
|
|
|
Testicular cancer associated with β-hCG, AFP
|
Choriocarcinoma
|
|
|
The most common type of testicular cancer
|
Seminoma—a type of germ cell tumor
|
|
|
The most common histology of bladder cancer
|
Transitional cell carcinoma
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Complication of overly rapid correction of hyponatremia
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Central pontine myelinolysis
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Salicylate ingestion → in what type of acid-base disorder?
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Anion gap acidosis and 1° respiratory alkalosis due to central respiratory stimulation
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Acid-base disturbance commonly seen in pregnant women
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Respiratory alkalosis
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Three systemic diseases → nephrotic syndrome
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DM, SLE, and amyloidosis
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Elevated erythropoietin level, elevated hematocrit, and normal O2 saturation suggest?
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RCC or other erythropoietin-producing tumor; evaluate with CT scan
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A 55-year-old man presents with irritative and obstructive urinary symptoms. Treatment options?
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Likely BPH. Options include no treatment, terazosin, finasteride, or surgical intervention (TURP)
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Class of drugs that may cause syndrome of muscle rigidity, hyperthermia, autonomic instability, and extrapyramidal symptoms
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Antipsychotics (neuroleptic malignant syndrome)
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Side effects of corticosteroids
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Acute mania, immunosuppression, thin skin, osteoporosis, easy bruising, myopathies
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Treatment for DTs
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Benzodiazepines
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Treatment for acetaminophen overdose
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N-acetylcysteine
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Treatment for opioid overdose
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Naloxone
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Treatment for benzodiazepine overdose
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Flumazenil
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Treatment for neuroleptic malignant syndrome
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Dantrolene or bromocriptine
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Treatment for malignant hypertension
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Nitroprusside
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Treatment of AF
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Rate control, rhythm conversion, and anticoagulation
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Treatment of supraventricular tachycardia (SVT)
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If stable, rate control with carotid massage or other vagal stimulation; if unsuccessful, consider adenosine
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Causes of drug-induced SLE
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INH, penicillamine, hydralazine, procainamide, chlorpromazine, methyldopa, quinidine
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Macrocytic, megaloblastic anemia with neurologic symptoms
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B12 deficiency
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Macrocytic, megaloblastic anemia without neurologic symptoms
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Folate deficiency
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A burn patient presents with cherry-red flushed skin and coma. SaO2 is normal, but carboxyhemoglobin is elevated. Treatment?
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Treat CO poisoning with 100% O2 or with hyperbaric O2 if severe poisoning or pregnant
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Blood in the urethral meatus or high-riding prostate
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Bladder rupture or urethral injury
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Test to rule out urethral injury
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Retrograde cystourethrogram
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Radiographic evidence of aortic disruption or dissection
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Widened mediastinum (> 8 cm), loss of aortic knob, pleural cap, tracheal deviation to the right, depression of left main stem bronchus
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Radiographic indications for surgery in patients with acute abdomen
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Free air under the diaphragm, extravasation of contrast, severe bowel distention, space-occupying lesion (CT), mesenteric occlusion (angiography)
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The most common organism in burn-related infections
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Pseudomonas
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Method of calculating fluid repletion in burn patients
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Parkland formula
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Acceptable urine output in a trauma patient
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50 cc/hour
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Acceptable urine output in a stable patient
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30 cc/hour
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Cannon “a” waves
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Third-degree heart block
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Signs of neurogenic shock
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Hypotension and bradycardia
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Signs of ↑ ICP (Cushing’s triad)
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Hypertension, bradycardia, and abnormal respirations
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|
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↓ CO, ↓ pulmonary capillary wedge pressure (PCWP), ↑ peripheral vascular resistance (PVR)
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Hypovolemic shock
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|
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↓ CO, ↑ PCWP, ↑ PVR
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Cardiogenic shock
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|
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↑ CO, ↓ PCWP, ↓ PVR
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Septic or anaphylactic shock
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Treatment of septic shock
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Fluids and antibiotics
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Treatment of cardiogenic shock
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Identify cause; pressors (e.g., dopamine)
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|
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Treatment of hypovolemic shock
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Identify cause; fluid and blood repletion
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Treatment of anaphylactic shock
|
Diphenhydramine or epinephrine 1:1000
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|
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Supportive treatment for ARDS
|
Continuous positive airway pressure
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|
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Signs of air embolism
|
A patient with chest trauma who was previously stable suddenly dies
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|
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Trauma series
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AP chest, AP/lateral C-spine, AP pelvis
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What vitamin deficiency? Night blindness, dry skin
|
Vitamin A
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What vitamin deficiency? Beriberi (polyneuritis, dilated cardiomyopathy, high-output CHF, edema), Wernicke-Korsakoff syndrome
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Vitamin B1 (thiamine)
|
|
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What vitamin deficiency? Angular stomatitis, cheilosis, corneal vascularization
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Vitamin B2 (riboflavin)
|
|
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What vitamin deficiency? Pellagra (diarrhea, dermatitis, dementia)
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Vitamin B3 (niacin)
|
|
|
What vitamin deficiency? Dermatitis, enteritis, alopecia, adrenal insufficiency
|
Vitamin B5 (pantothenate)
|
|
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What vitamin deficiency? Convulsions, hyperirritability; required during administration of INH
|
Vitamin B6 (pyridoxine)
|
|
|
What vitamin deficiency? Macrocytic, megaloblastic anemia; neurologic symptoms (e.g., optic neuropathy, subacute combined degeneration, paresthesias); glossitis
|
Vitamin B12 (cobalamin)
|
|
|
What vitamin deficiency? Scurvy (e.g., swollen gums, bruising, anemia, poor wound healing)
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Vitamin C
|
|
|
What vitamin deficiency? Rickets in children (bending bones), osteomalacia in adults (soft bones), hypocalcemic tetany
|
Vitamin D
|
|
|
What vitamin deficiency? ↑ fragility of RBCs
|
Vitamin E
|
|
|
What vitamin deficiency? Neonatal hemorrhage; ↑ PT and aPTT, normal BT
|
Vitamin K
|
|
|
What vitamin deficiency? Dermatitis, enteritis. Can be caused by ingestion of raw eggs or antibiotic use
|
Biotin
|
|
|
What vitamin deficiency? The most common vitamin deficiency in the United States. Sprue; macrocytic, megaloblastic anemia without neurologic symptoms
|
Folic acid
|
|
|
What vitamin deficiency? Weakness, muscle cramps, exacerbation of hypocalcemic tetany, CNS hyperirritability → tremors, choreoathetoid movement
|
Magnesium
|
|
|
What vitamin deficiency? Keshan disease (cardiomyopathy)
|
Selenium
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