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51 Cards in this Set

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  • Back
Most common cause of rhabdomyolysis
alcoholism
What lab tipoff tells you rhabdomyolysis is going on?
Urine dipstick is positive for blood, but there's hardly any RBCs on microscopic review. Also, creatinine levels rise disproportionately higher than BUN.
Treatment of rhabdomyolysis?
Hydration, alkalinization of urine. Diuresis with mannitol is sometimes needed.
triad of renal cell cancer?
dull flank pain, hematuria, fever.
Predisposing factors for aortic dissection?
Marfan's, HTN, Ehlers-Danlos, Turner's, coarctation of the aorta, bicuspid aortic valve
which bisphosphonate should you give to bedridden pts?
pamidronate IV, it doesn't cause esophageal irritation like the others.
Define Reiter's syndrome
Arthritis, conjunctivitis, and urethritis.
Skin lesions associated with Reiter's syndrome
keratoderma blenorrhagicum found on palms and soles. These are clear vesicles on red bases that evolve into macules and papules. Also, circinate balanitis, which are painless shallow ulcers on the glans penis or urethral meatus
Causes of Dupuytren's contracture.
cigarette smoking, diabetes, alcoholism
three reasons why pts get post-op cholestasis
1. increased pigment load from transfusion
2. decreased liver function from hypotension
3. decreased renal bilirubin excretion (from tubular necrosis)
when does post-op cholestasis show up?
post-op day 2-3
what kinds of labs do you see in post-op cholestasis?
AST and ALT are normal or slightly elevated, while Alk phos is markedly elevated.
What tells you that pts have acute liver failure?
prolonged PT and neuro si/sx of encephalopathy, decreased albumin levels.
what happens to LES tone in scleroderma?
the tone is decreased-->reflux
what does esophageal spasm look like on barium swallow?
cork-screw pattern
What can cause chronic thrombocytopenia?
lupus, CMV, toxoplasma, hepatitis, HIV, hematological diseases that cause decrease in bone marrow activity.
What's the best measurement of lung involvement in Guillain-Barre?
serial measurements of vital capacity.
What is membranoproliferative glomerulonephritis type 2 called?
dense deposit disease
What causes dense deposit disease?
IgG antibodies against C3 convertase of the alternate complement pathway (C3 nephritic factor) cause activation of the alternate complement pathway at the glomerular basement membrane.
What does membranoproliferative glomerulonephritis type 2 (dense deposit disease) look like under the microscope?
dense intramembranous deposits that stain for C3.
cavitary lung lesions in HIV pts.
Tuberculosis, atypical mycobacterium, nocardia, gram-negative rods, anaerobes, coccidioides
how do you treat nocardia?
TMP-SMX
Causes of acute GI hemorrhage in the elderly
angiodysplasia, diverticulosis, PUD
si/sx of erhlichiosis
headache, nausea, vomiting, malaise, myalgia
lab finding in erhlichiosis
thrombocytopenia, leukopenia, elevated LFTs.
treatment of erhlichiosis
doxycycline
si/sx of acute angle closure glaucoma
blurred vision, eye pain, nausea, vomiting, red eye, fixed dilated pupil, hazy cornea
how do you reverse an overdose of calcium channel blockers?
calcium chloride, fix hypotension with normal saline, insulin and glucose may be needed for severe poisoning
why isn't ABO incompatibilty such a big deal during pregnancy?
because ABO antibodies don't cross the placenta
what does sodium cromolyn do?
it stabilizes mast cells, good for asthma and atopy.
how do you quickly reverse warfarin?
fresh frozen plasma
what is myerson's sign
in Parkinson's, repetitive tapping of the chin produces prolonged blinking.
what antibodies are assoc with celiac sprue?
anti-endomysial antibodies
describe the arthritis assoc with lyme disease?
intermittent, tends to involve the knee, warmth, swelling, effusion, restriction of movement, the episodes gradually disappear in about ten years if untreated.
define arrest of dilation
no cervical change in 4 hours (and cervix is greater than 2cm dilated)
define arrest of descent
no change in descent in over an hour
when would you give a pt a yellow fever vaccine?
if they're going to sub-saharan africa or equatorial south america
si/sx of intrahepatic cholestasis of pregnancy
intense pruritus, worse on palms and soles, worse at night,
si/sx of posterior urethral injury
blood at urethral meatus, scrotal hematoma, high riding prostate,
first step in management of posterior urethral injury?
retrograde urethrogram (then you do a delayed repair)
how do you diagnose bladder injury?
retrograde urethrogram with post void films
first step in management of anterior urethral injury
immediate surgical repair
why do liver failure pts get respiratory alkalosis?
progesterone stimulates respiratory center
what kind of corneal ulcers do pts with herpes zoster ophthalmicus get?
dendriform ulcers
what kind of corneal ulcers do pts with herpes simplex ophthalmicus get?
dendritic ulcers
what embryologic cells do wilm's tumors arise from?
metanephros
what does the metanephros give rise to?
renal parenchyma
what's the first step in management of preterm labor?
bed rest and hydration
define preterm labor
between 20 and 37 weeks--the presence of 4 contractions in 20 minutes, effacement of 80%, or cervical dilation of 2cm or more.
what are the syndromes assoc with lacunar infarcts?
1. pure motor hemiparesis
2. pure sensory stroke
3. dysarthria-clumsy hand syndrome
4. ataxic hemiparesis
si/sx of anterior cerebral artery stroke?
contralateral motor and/or sensory deficits, worse in lower limb, urinary incontinence, gait apraxia, primitive reflexes, abulia, paratonic rigidity.