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128 Cards in this Set
- Front
- Back
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Primary Heart block
etiology: diseased infranodal conduction system signs/symptoms EKG Findings treatment |
etiology: occurs in normal individuals, increased vagal tone
sings/symptoms asymptomatic treatment: not necessary |
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Secondary heart block (Mobitz type I)
etiology signs/symptoms EKG Findings treatment |
etiology: drug effect, increased vagal tone
sings/symptoms: usually asymptomatic EKG findings: increasing PR interval until a dropped beat occurs (wenckebach); PR then resets Treatment: stop offending drug |
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Secondary Heart block (Mobitz type II)
etiology signs/symptoms EKG Findings treatment |
Etiology: diseased infranodal conduction system
Signs/symptoms symptoms are rare EKG findings: Unexpected dropped beat without change in PR interval Treatment: ventricular Pacemaker |
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Tertiary Hear block
etiology signs/symptoms EKG Findings treatment |
etiology: no electrical communication between the atri and ventricles
signs/symptoms: syncope, dizziness, acute heart failure, hypotension, cannon A waves EKG Findings: no relationship between P waves and QRS complexes Treatment: ventricular pacemaker |
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Atrial fibrillation
Sings/Symptoms EKG findngs Treatment |
Sings/ Symptoms: asymtomatic, shortness of breath, chest pain, palpitations, irregularly irregular pulse
EKG findings: wavy baseline without discernible p waves ; variable and irregular QRS respons Treatment: anticoagulation, rate control drugs, cardioversion |
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Atrila flutter
EKg findings |
regular rhythm "sawtooth appearnce"
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ventricular fibrillation
etiology signs/symptoms ekg treatment |
etiology - associated with CAD/MI
signs/symptoms - syncompe, hypotension, pulselessnes EKG findings: totally erratic tracing treatmetn: immediate electricla cardioversion, cpr, lidocaine and/or epinephrine |
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premature ventricular contraction
EKG findings |
early wid QRS compexes not preced by a P wave
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What is a sign of perforated ulcer on a abdominal x-ray
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free air under the diaphragm
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What is the most likely cause fo acute lower GI bleed in pateints > 40 years old
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diverticulosis
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What are complications of diverticulitis
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abscess, perforation, fistulas to bladder, skin or vagina, sepsis
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Does diverticulits bleed?
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no
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What are risk factors for cholelithiasis
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fat, female, fertile, forty, flatuelnt
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What is a sign of perforated ulcer on a abdominal x-ray
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free air under the diaphragm
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What is the most likely cause fo acute lower GI bleed in pateints > 40 years old
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diverticulosis
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What are risk factors for cholelithiasis
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fat, female, fertile, forty, flatuelnt
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Does diverticulits bleed?
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no
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Does diverticulits bleed?
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no
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What is a sign of perforated ulcer on a abdominal x-ray
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free air under the diaphragm
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Does diverticulits bleed?
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no
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What is the most likely cause fo acute lower GI bleed in pateints > 40 years old
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diverticulosis
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Does diverticulits bleed?
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no
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What are risk factors for cholelithiasis
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fat, female, fertile, forty, flatuelnt
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What are risk factors for cholelithiasis
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fat, female, fertile, forty, flatuelnt
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What are complications of diverticulitis
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abscess, perforation, fistulas to bladder, skin or vagina, sepsis
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What are risk factors for cholelithiasis
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fat, female, fertile, forty, flatuelnt
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What are risk factors for cholelithiasis
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fat, female, fertile, forty, flatuelnt
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What are risk factors for cholelithiasis
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fat, female, fertile, forty, flatuelnt
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Does diverticulits bleed?
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no
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What are risk factors for cholelithiasis
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fat, female, fertile, forty, flatuelnt
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Intestinal inflammation presenting wth watery diarrhea and weight loss; fistulas between bowel and skin, urinary tract, or other parts o fbowel may ocur
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crohn's disease
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inflammatory disease of the colon with increased risk of clon cancer
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ulcerative colits
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immunosuppressive agent used for both ulcerative colits and crohn's
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sulfasalzine
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dull, waxing/waning perumbilical pain that then shifts to the RLQ and becomes sharp and continuous
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appendicitis
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Ulcerative Colitis/Crohn's Disease:
Sit of involvement |
ulcerative colitis: the rectum, may extend in a continuous fashion to involves ome or all of he colon
Crohn's diease: may involve any portion of the GI tract, particularly the ieocecal region, in discontinuous patter. |
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ulcerative colitis/ crohn's disease
symptoms and signs |
ulcerative colits: bloody diarrhea, lower abdomina cramps and urgensy, abdomina tenderness, frank blood on rectal exam, extraintestinal mafestations
Crohn's Disease: abdomina pain, abdomina mass, low grade fever, watery diarrhea, , abdominal tnederness or mass, preanal fissues, fistulas, extraintestinal manifestations |
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ulcerative colitis/ crohn's disease
extraintestinal manfestations |
ulcerative colitis: apthtous stomatitis, episceritis/uveiits, arthritis, sclerosing cholangitis, erythema nodosum, and pyoderma gangrenosum
Chron's disease: nephrolithiasis and fistulas to the skin, biliary tract, urinary tract, or between bowell loops |
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Ulcerative colits/crohn's disease
what would you see on a colonoscopy |
ulcerative coliits: diffuse and continuous colorectal involvement, friability, edema, pseudopolyps
crohn's disease: ulcers, strictures, "cobblestoning" and "skip lesions." |
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Crohn's disease/ ulcerative colitis
treatment |
ulcerative colitis: sulasalzine, total colectomy is curative
Crohn's disease: sulfasalzien, resection may be necessary, but crohn's disease may recur lesewhere in the GI tract |
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Which is more likely to cause cancer ulcerative colitis or crohn's disease
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ulcerative colitis has a higher risk for colon cancer, although they both have some risk
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What is normal range of pH?
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7.36 to 7.44
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ph and pCO2 for metabolic acidosis
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pH < 7.36
pCO2 < 40 mmHg |
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ph and pCO2 for respiratory acidosis
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pH < 7.36
pCO2 > 40 |
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pH and pCO2 for metabolic alkalosis?
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pH > 7.44
pCO2 > 40 |
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pH and pCO2 for metabolic acidosis
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pH > 7.36
pCO2 < 40mmHg |
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Treatment for metabolic acidosis
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IV fluids
possibley HCO3, for very low pH trat underlying disease |
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treatemnt for rspiratory aciosis
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Iv flids, O2
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Peaked T waves on an EKG means
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hyperkalemia
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capral spasm upon inflation of lood pressure cufff
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hypocalcemia
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first line treatrment for moderat yhpercalcemia
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IV hydration adn loop diuretics (furosemide)
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49 year old male presents with acute onset flank pain and microscoic hematiure, what the most likely diagnosis
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IV hydration and loop diureticsnephrolithiasis
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the presence of red cell casts in uirn sediment indicates
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glomerluonephirits
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eosinophis isn urine sediment indicates
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allergic interstiial nephirits
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low uirine specific gravity in the presence of high serum osomolaitiy indicates
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diaebetes insipidus
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salicylate ingestion results in wht type of acid base diorder
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anion gap acidosis
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acid base distubance commonly seen in pregnant women
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respiratory alkalosis
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risk factors for DVT
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stasis, endothelial injry and hypercoagulability
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What acid base disorder do you get in pulmonary embolism
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respiratory alkaosis
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Acute onset tachypnea, pleuritic chest pian in tall, thin young men
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spontaneous pneumothorax
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what test do you use for cystic fibrosis
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sweat chloride test
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How is TLC affected in obstructive vs restrictive lung disease
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TLC increased in obstructive, decreased in restrictive
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what is the most common caue of headaches in chldren age 2-10
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infection
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What is the most common cause of headaches in children age 18-35
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trauma
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tension headache
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chonic headaches, vise-like or tigh pain, genrally in occipitalnad neck region,
diagnosis of exclusion |
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migraine headache
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throbbing headache that lasts > 24 hours. typically associated with nausea and vomiting, photophobia
classic migrains ar commonly unilateral, associated withn aura and preced by visual symtoms. Migrains more commonly present without these associated symptoms and may be bilateral and periorbital |
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who gets migrains more men or women
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women
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cluster headache
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a brief, sever, unilateral periorbital headache. attacks ten d to occur in clusters affecting the the same part of the head and taking palce the same time of day. may be precipitated by alocohol or vasodialting drugs
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what is the most important diganostic ttest for sizures
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EEG
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rocky mountain spotted fever
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tic born, presents with headache, fever, maise, and a rash on the palms and soles. treat with doxycycline
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woman has puruelnt cervical discharge, what could it be? treatment?
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chlamyidia - doxycycline or azithromycin
gonrorrhea - ceftriaxone |
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causes of microcyitc anemia
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thalassemia, iron deficiency, anemia of chornic disease
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dietary suppplement ot geive to paitents with tthalasseimia
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folate, but not iron
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How doyou distinguish polycthemia vera from secondary polycythemai
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normal oxygen saturation, EPO leve, high RBC mass and heamtocrit
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Patient presents with excessive bleeding after dental work. Labs show normal Pt/PTT with pronolged bleeding time. Most liekly diganois
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von willebrand's disease
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Trsymotms of sicle cell crisis
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cute onset boen/chest pain, fever
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monoclonal gammopathy, bence jones proeinureia, "punched out lesions in ckull and long bones.
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multiple myeloma
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most common cancer of childhool
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acute lympocyitic leukemia
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auer rods are pathogomic for..?
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acute myelogenous leukemia
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A patient presents with early satiety, LUQ fullnes/pain, splenomegally, bleeding, and diathesis. cytogenics sow t9,22
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chronic myelogenous leukemia withthe philadelphia chromosome
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reed sternber cells are a sign of ?
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hodgkin's lymphoma
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risk factors for non hodgkin's lymphoma
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EBV, HIV infection
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Which has regional adenopathy, hodgkins or non-hodgkin's lymphoma
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non-hodgkins lymphoma
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treatment of von willebrand's disease
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desmopressin
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Disseminated Intraascular Coagulation
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systemic disease with pahtologic coagulation and lack of physiologic coagulatin,
may occur secondary to sepsis, transfusion, neoplasia, trauma, obstttric compications diffuse bleeding, digital cyanosis, tachycardia, tacypnea, respiratory failure, low fibrinogen, elvated pt/PTT, low hemocrit |
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classic EKG findings in pericarditis
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low-voltage, diffuse ST segment elevation
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symptoms of pallor, high pressure, palpitations, headache pain, and perspiration
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pheochromocytoma
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first line treatment of rgrowth hormone secreint pituitary adnemoa
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teansphenoidal surgical resection
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patient complains of headache, weakness, and polyuria; exam reaveals hypertension andtentany. labs include hypernatremia, hypokalemai, and metabolic alkalosis
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primary hyperaldosteronism due ot Conn's ynrome or bilateral adrenal hyperplasia
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morning hyperglycemia that is a reboud response to nightime hypoclycemia, not a need for more insulin
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somoyogi affect
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signs and symptoms of hyperparathyroidsim
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"stones, bones, groans, psychic overtones"
stoens: nephrolitiasis or nephrocalcinosis bones - bone pain, muslce aches, arthralgias, fractues groans, PUD, pancreatitis psychic overtones - fatigue depression, anxiety, irrativility, sleep disturbances |
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patient preseins with wekness, nausea and vomiting, weigh loss, and new skin pgmentation. labs how yponatremai and hyperkalemai
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addison's disease
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peptic ulcer disease
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damage ot the gastic or duodienal mucosa,
dul/burning/aching epigasric paintha t improves ieth meals, hematemesis ("coffe-ground" emsis) and blood inthe stool (melena or hemtochezia epigastric tenderness |
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hepatitis A
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causes acute hedpatis
fecal-oral transmission (contaminated food/water/shellfish) does NOT cause chronic hepatitis |
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temporal arteritis
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most feared complicatin is blindess seconcary to occlusion f othe central retinal artery
you get temporal tenderness, jaw claudicatioon, monocula rblindess, ESR > 50 trat with prendisone |
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positively bifringent rhonboid crystals
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pseudogout
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negatively bfvely bifringent needle like crystals
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gout
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gout treatment
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acutely: colchicinene, NSAIDS, sterois
long term - allpurinol and prbencid avoid thizide / loop diuretics |
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Labs for SLE
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positive ANA - sensitive but not specific
Anti-NDA and anti-SM andtibodies - specific but not sensitive |
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who gets SLE themost
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women, especally black women
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treatment of SLE
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steroids,
hydroxychorquinie cyclophosphamide avoid sun exposure |
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symtoms of SLE
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MALAR RASH, joint nenderns, joint pian, photosensitvty, oral ulcer, pericaditis,
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fibromyalgia
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diagnosis of exclusion
multiple diffuse tender areas and standard "trigger areas" that produce pain on palpation and sleep disorders |
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what are the primary and dompensatory responses for metaboloic acidosis?
cause? |
primary: decreased HCO3-
secondary: decreased pH, decresed PCO2 hyperventilation cause: diabetic ketoacidosis; diarrhealactic acidosis; salicylate OD, acetazolamid OD |
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what are the primary and dompensatory responses forrespiratory acidosis?
cause? |
Primary: Increased pCO2
secondary decreased pH, increased HCO3- Renal [HCO3-] reabsorption cause: COPD; airway obstruction |
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what are the primary and dompensatory responses for respiratory alkalosis?
cause? |
primary: decreased pCO2
secondary: increased pH, decreased HCO3- Renal [HCO3-] secretion cause: high altitude; hyperventilation |
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what are the primary and dompensatory responses for metaboloic alkalosis?
cause? |
primary: increased [HCO3-]
secondary: increased ph; increased [HCO3-] hypoventilation causes: vomiting |
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chronic bronchitis
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a productive cough lasting at least three months per year for two consecutive yeras
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emphysema
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pahtolgoic dignosis of termina airway destruction to smoking (cintrilobular) inherited alpha 1-antitrypsin deficiency (panlobular)
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symptoms of emphysema
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"pink puffer"
decreaed breath souns, minimal cough, dypnea, pursed lips, hypercarbia/hpoxia late, barrel chest |
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symptoms of chronic bronchitis
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"blue bloater"
rhonic, productive cough, cyanotic but with mild dyspnea, hypercarbia/hypoxia early, frequently overweight with peripheral edema. |
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Sings and symptoms of ASthma
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History: Cough, episodic wheezing , nad o chest tighntes, dyspnea, worse at night or early in the morning
PE: prolonged expriatory duration, accessory muxle use tachypnea, tachycardia, decrased O2 struation, hyper resonance |
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noncaseating granulomas indicate
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sarcoidosis
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treatment ofr tension pneumothorax
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immediate decompression using a needle in the second intercostal space; chet tube placement
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lung disease of coal miners
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pneumoconiosis
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increased risk of what infection with silicosis
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M. tuberculosis
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hepatitis A
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causes acute hedpatis
fecal-oral transmission (contaminated food/water/shellfish) does NOT cause chronic hepatitis |
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Hepatitis B
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causes acute hepatitis or chronic hepatitis
major cuase of hepatocellular carnioma spred by lood and other body fluids including saliva there is a vacccine |
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Heaptitis C
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causes acute or chronic hepatitis, major cause of cirrhosis and psot transfusion hepatitis
associated with Iv dug abuse, spread by blood |
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Hepatitis D
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Only causes disease in asscoiatin wiht hepatitis B, acute or chronic, blood borne
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Hepatitis E
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normaly self - limted, dangerous in pregnant women, spread by fecal-oral tranmission
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treatments for Tuberculosis
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multiagnet therapy (INH, rifampin, pyrazinamide, ethambutol, streptomycin)
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treatment for toxoplasmosis
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pyremethamine, sulfadizine, clindamycin
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What is somoygi effect
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nocturnal hypoglycemia casuing elevated morning glucose due to release of coutnerregulatory hormones (reduce insulin to treat)
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What is Dawn phenonomen
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in diabetis, early moning hyperglycemia cased by reduced effectiveness of insulin at this time
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Derm related difffering symptom for addison's disease and secondary adrenal insfficiency
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addison's disease: increased skin pigmentation
secondary adrenal insfficency: no hyperpgmentation |
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presentign symptoms of adrenal inufficiency
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inlude weakness, weight loss, nausea, and vomiting
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Lab results ofr addison's disease and secondary adrenal insuffiency
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addison's disease: ELEVATED plasmaACTH and low cortisol levels in respons to ACTH challenge
secondary adrenal insuffiency: DECREASED palsma ACTH and increased cortisol levels in response to ACTH both can also get hypnatremia, hyperkalemia, and eosinophilia |
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common cause of secondary adrenal insufficiency
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abrupt cesssation of chronic glucocorticoid treatment.
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