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42 Cards in this Set

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Treatment of irregular periods with cytology showing "complex hyperplasia without atypia"
cyclic progestins, repeat biopsy after 3-6 months of treatment
Treatment of irregular periods with cytology showing "complex hyperplasia with atypia"
If she wants to preserve fertility, give her cyclic progestins (there's a lower response rate), if she doesn't want to preserve fertility, give her a hysterectomy.
si/sx of analgesic nephropathy
sterile pyuria (meaning WBCs and WBC casts without infection), polyuria, renal colic and hematuria can occur if papillary necrosis occurs, mild proteinuria, fatigue
associations with chronic analgesic abuse
premature aging, atherosclerotic disease, urinary tract cancer
What's the defect that causes Bruton's agammaglobulinemia
x-linked recessive defect in tyrosine kinase in B cells
si/sx of Bruton's agammaglobulinemia
male infant, asymptomatic till 6-9 months, when he gets recurrent pyogenic infections (strep pneumo, h flu). labs show low gammaglobulins, absent B cells on peripheral smear
what is dacryocystitis?
infection of tear duct, it occurs in infants and adults over 40, redness and pain in medial canthus region, usual bugs are staph or strep
what is a hordeolum?
abscess over upper or lower eyelid, it appears as a local red swelling
what is a chalazion?
chronic granulomatous inflammation of the meibomian gland, appears as a hard painless lid nodule
PFT findings in pulmonary fibrosis?
decreased diffusing capacity of CO, reduced total lung volume, reduced residual volume, reduced functional residual capacity, flow volumes are reduced but FEV1/FVC is normal-increased, increased A-a gradient
treatment of abruptio placenta
careful monitoring, large bore IV, foley catheter, available blood products, rapid vaginal delivery, only do C-section if there rapid deterioration of mother or fetus. If abruption is mild and stable, you could use Mag to tocolyze and
Risk factors for abruptio placenta
cocaine use, maternal htn, previos abruption, trauma, rapid decompression of polyhydramnios, short umbilical cord, tobacco use, folate deficiency
best test of Addison's disease? Why?
cosyntropin stimulation test, cosyntropin is an analogue of ACTH, and if it produces any increase in cortisol levels, Addison's can be ruled out
what causes Addison's disease?
destruction of adrenal cortex, usually by autoimmune causes, but can be because of infections (TB, viral, fungal)
si/sx of addison's disease?
weakness, fatigue, weight loss, hyperpigmentation, hypotension,
si/sx of RMSF?
fever, myalgia, HA, petechial rash, hypotension and shock later
treatment of RMSF?
doxycycline, start based on clinical suspicion, any delay can allow progression to shock,
tx of beta blocker OD
atropine, isoproterenol, then glucagon
so your pt has syphilis, what test do you order?
HIV elisa
what is the dx for cape-like distribution of sensory loss and reflexes
syringomyelia (it's called syringobulbia if it extends into the medulla oblongata)
si/sx of subclavian vein thromosis
presents after a couple of weeks of having a central line there, swelling in pallor of arm, pain,
tx of subclavian vein central line thrombosis
first remove the central line, apply heat and elevate arm, get ultrasound to document the thrombus, start anticoagulation
which congenital heart disease is the most common to present with cyanosis in the first 24 hours of life?
transposition of the great vessels
immediate treatment of transposition of the great vessels?
prostaglandins to keep that ductus open!
best test for acute cholecystitis?
HIDA scan
what do you know about aneurysms of the descending thoracic aorta?
second most common site of an aortic aneurysm, most pts also have an aneurysm in the abdominal aorta, due to atherosclerosis
what do koplik's spots look like
red spots with blue center, on buccal mucosa
describe the course of a measles infection
10 days after exposure, a prodrome starts (cough, coryza, conjunctivitis), then Koplik's spots appear, then the maculopapular rash appears on face then migrates down the body
what metabolic abnormality does acetazolamide cause?
metabolic acidosis (non anion gap), because it causes kidneys to waste bicarb
what do you do if you suspect aortic rupture on chest x-ray?
get a chest CT or echo
treatment of acute hepatitis C
interferon and ribavirin,
si/sx of heroin withdrawal in an infant
tremors, wakefulness, loose stools, high-pitched cry, poor feeding, tachypnea, vomiting, fever, sx within first 48 hours of life
associations of acanthosis nigricans
diabetes, abdominal malignancy (in older pts)
what is the difference between incomplete abortion and inevitable abortion
Both have dilated cervix and vaginal bleeidng. Incomplete abortion has only parts of the conceptus in the uterus, while the inevitable abortion contains the entire conceptus but without fetal heart activity
define dysthymia
depressed mood for most of the day for two years
define unstable angina
angina of sudden onset, onset at rest, post-infarct angina, a change in the character of stable angina
treatment of unstable angina
hospitalization with aspirin, heparin, nitroglycerin with non-emergent angiography once chest pain has resolved
si/sx meniere's disease
recurrent episodes of positional vertigo, sensorineural hearing loss, tinnitus
si/sx of acoustic neuroma
progressive, constant tinnitus and vertigo
si/sx of paget's ds of nipple
red, oozing, crusting lesion of the areola that doesn't respond to abx or steroids, on path--large malignant cells with halo areas invading the epidermis
strongest indicator for future suicide
previous suicide attempts
vitamin deficiency assoc with dilantin
folic acid