Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
99 Cards in this Set
- Front
- Back
|
major risk factors for CAD(6)
|
diabetes
symptomatic carotid artery dz BP >140/90 HDL<40 FH of early CAD (male<55, female <65) Age (male>45, female>55) |
|
|
people with a broad differential for dysphagia for both solids and liquids should have what test first
|
barium esophagram
they will probably eventually need endoscopy but esophagram first is better for seeing achalasia and safer in the case of upper esophageal lesions and strictures |
|
|
pt with epistaxis, HTN, headaches, high voltage QRS, downsloping ST-segment depression, T wave inversion
|
aortic coarctation
check BP in all ext brachial-femoral delay well-developed upper body compared to lower cont cardiac murmur "3 sign" on CXR |
|
|
pt with cholelithiasis who doesnt want surgery, what med?
|
ursodeoxycholic acid
but costly and has high relapse rate avoid fatty foods |
|
|
icteric pt, conjugated hyperbilirubinemia, dark granular pigment in hepatocytes, otherwise fine
|
dubin-johnson syndrome
more common in jews triggered by illness, pregnancy, OCP use normal urinary coproporphyrin level but high subtype of coproporphyrin I as opposed to NL ppl with high subtype III liver is strikingly black |
|
|
characteristics of crigler-najjar syndrome
|
type 2 more severe - results in permananet neurologic impairment and death
autosomal recessive unconjugated hyperbilirubinemia phototherapy/plasmapheresis helpful but need transplant |
|
|
most common cause of decreased fertility for women in fourth decade who still experience menstrual cycles
|
decreased ovarian reserve
|
|
|
postvoid residual bladder volume considered diagnostic for urinary retention
|
50 ml
|
|
|
external cephalic version indicated between what weeks of pregancy
|
37-onset of labor
|
|
|
polyuria polydipsia in a pt with increased serum osm and decreased urine osm, preference for cold beverages
|
diabetes insipidus
in contrast, primary polydipsia would have decreased urine and serum osm |
|
|
betamethasone should be admin to females with PPROM before how many weeks
|
32 weeks
some center still give btwn 32-34 typically not given after 34 weeks |
|
|
burr cells commonly seen in what
|
uremia or artifact
|
|
|
abdominal pain, RUQ tenderness, low Hgb, low plts, high bili, high LDH, low haptoglobin, hepatic vein thrombosis
|
paroxysmal nocturnal hemoglobinuria
abnormal cell membrance anchor GP1 prohibits binding of CD55 and CD59 RBCs attacked by complement, hemolysis occurs tendency towards venous thromboses |
|
|
post influenza pneumonia with consolidation, tow organism
|
staph aureus
|
|
|
how can you differentiate B12 and folate deficiency
|
B12 is also involved in conversion of methylmalonic acid conversion to succinyl CoA so MMA will be high in B12 deficiency
both B12 and folate involved in homocysteine conversion to methionine, so high homocysteine is present in both deficiencies |
|
|
port wine stain in V1 distribution, angiomatous malformations of the brain, seizures, hemiparesis
|
sturge-weber syndrome
|
|
|
ash leaf hypopigmentation, cardiac rhabdomyomas, kidney angiomleiomuomas, mental retardation, seizures
|
tuberous sclerosis
|
|
|
carcinoid tumors can cause what vitamin deficiency
|
niacin
precursor tryptophan used to make serotonin instead |
|
|
polyuria, polydipsia, growth/mental retardation, usually early in life, high urine Cl, hypokalemia, high serum bicarb, normal serum sodium, metabolic alkalosis, high plasma renin and high plasma aldosterone, normotensive
|
barrter or gitelman syndrome
defect in sodium and chloride reabsorption in Loop of henle and DCT, respectively |
|
|
newborn with closed fists, overlapping fingers, microcephaly, prominent occiput, micrognathia, and rocker bottom feet, narrom hips with limited abduction, short sternum, cardiac and renal malformations, mental retardation
|
edward's syndrome trisomy 18
|
|
|
newborn with cleft lip, flexed fingers, polydactyly, ocular hypotelorism, bulbous nose, low-set malformed ears, small abnormal skull, cerebral malformation, microphthalmia, cardiac malformation, scalp defects, hypoplastic ribs
|
patau's syndrome trisomy 13
|
|
|
seizure with no LOC
pt remembers event well |
simple partial
|
|
|
seizure with LOC, aura present, automatisms
|
complex partial
|
|
|
seizure with LOC and tonic clonic activity
|
partial seizure with secondary generalization
|
|
|
most common risk factor for abruptio placentae
|
maternal HTN
|
|
|
when to begin meningococcal vaccination series
|
age 11-12
|
|
|
when to administer rotavirus vaccine
|
btwn 2-8 months
first dose should be between 6-14 weeks should not be initiated after 15 weeks final dose should not be beyond 8 months |
|
|
infant with failure to thrive, non anion gap metabolic acidosis, low serum bicarb, increased Cl, tow
|
renal tubular acidosis
|
|
|
pts with RA are at risk for what additional bone dz
|
osteopenia and osteoporosis
|
|
|
cause of osteitis fibrosis cystica
|
hyperparathyroidism
- condition of osteoclastic resorption of bone and replacement with fibrous tissue(brown tumors) |
|
|
replacement of lamallar bone with abnormal woven bone in Paget's dz
|
osteitis deformans
|
|
|
hyposthenuria is common in what blood dz
|
sickle cell
presents as nocturia |
|
|
child with macrocytic anemia, low retics, and congenital anomalies (webbed neck, cleft lip, shielded chest)
|
Diamond-Blackfan Syndrome or congenital hypoplastic anemia
- it is megaloblastic but differentiated from B12 deficiency bc no hypersegmented neutrophils -tx with corticosteroids |
|
|
tx for pasteurella multocida
|
amoxicllin/clavulanate for 5 days
|
|
|
histology of reye's syndrome
|
extensive fatty vacuolization without inflammation
|
|
|
classic triad of normal pressure hydrocephalus
|
incontinence, dementia, and ataxia
|
|
|
tx of stroke in sickle cell patient
|
exchange transfusion
- fibrinolytic therapy unlikely to be helpful |
|
|
two bacterial species that most commonly cause brain abscesses
|
streptococci and bacteroides (anaerobes)
|
|
|
tx of pertussis
|
erythromycin for 14 days
|
|
|
TTP tx
|
plasma exchange
|
|
|
criteria for diagnosing metabolic syndrome
|
3 of the 5
1. waist >40in for men, >35in for women 2. fasting glucose >100-110 3. BP >130/80 4. Trigs >150 5. HDL <40 in men, <50 in women |
|
|
in dysfunctional uterine bleeding, women should have endometrial biopsy if they have any of these 4 risk factors in the presence of nl exam and a negative pregnancy test
|
1. age >35
2. obese 3. chronic HTN 4. diabetic |
|
|
in hyperkalemia with ECG changes, give what first to stabilize cardiac membrane
|
calcium gluconate
|
|
|
agents used to shift K into cells(3)
|
insulin and glucose
sodium bicarbonate beta-2 agonists |
|
|
pneumonia accompanied by high fever, malaise, nonproductive cough, abdominal pain, loose stools, and HYPONATREMIA
|
Legionella
|
|
|
tx of severe DUB, or moderate DUB with active bleeding, in hemodynamically stable patient
|
high dose estrogen therapy
|
|
|
tx of severe hyponatremia(<120)
|
3% saline
|
|
|
riley-day syndrome
|
familial dysautonomia, AR in jews, gross dysfunction of autonomic nervous system with severe orthostatic hypotension, usually in children
|
|
|
Shy-Drager syndrome(multiple system atrophy), 3 characteristics
|
1. Parkinsonism
2. autonomic dysfunction 3. widespread neurologic signs |
|
|
some factors to differentiate orbital cellulitis and cavernous sinus thrombosis
|
orbital
-fever, proptosis, ophthalmoplegia, and visual deficits CST - headache, b/l periorbital edema, b/l CN findings |
|
|
the most characteristic feature of Crohn's, considered pathognomonic
|
non-caseating granulomas
|
|
|
recurrent oral ulcers plus 2 of the following: recurrent genital ulcers, uveitis, retinal vascularization, erythema nodosum, acneiform nodules, and papulopustular nodules, typically in turkish, asian, middle eastern population
|
behcet's dz
|
|
|
alk phos, calcium, and phosporous level in paget's
|
elevated alk phos
NL calcium and phosphorous |
|
|
as many as 37% of paget's pts have enlargment of temporal bone resulting in what
|
hearing loss
|
|
|
autosomal dominant muscular dystrophy, second most common overall
|
myotonic muscular dystrophy
*delayed muscle relaxation, temporal wasting, thin cheeks, inverted V upper lip, distal muscle wasting, testicular atrophy |
|
|
hyperthyroid tx known to cause acute worsening of symptoms
|
radioactive iodine
|
|
|
SGA infants are at risk for the following complications (7)
|
hypoxia
perinatal asphyxia meconium aspiration hypothermia hypoglycemia hypocalcemia polycythemia |
|
|
first step in managing acquired torticollis
|
X-ray cervical spine
|
|
|
diabetes screening typically performed between what weeks of pregnancy
|
24-28
unless they are high risk, then it's done at first visit |
|
|
what is the initial screening glucose test for gestational diabetes
|
one hr 50g oral glucose tolerance test
(should be <140) if >140, 3 hr 100g oral glucose tolerance test is performed |
|
|
during the 3 hr 100g OGTT, levels are checked periodically; gest diabetes is diagnosed if 2 or more values are obtained at the following intervals
|
fasting >95
one hour >180 two hour >155 three hour >140 |
|
|
two types of cast seen in chronic renal failure
|
broad casts
waxy casts |
|
|
five phases of iron intoxication
|
GI phase: 30min-6hrs, n/v, hematemesis, melena, pain
Latent phase: 6-24hrs, asymptomatic Shock and metabolic acidosis: 6-72hrs hepatotoxicity: 12-96hrs bowel obstruction/scarring: weeks later |
|
|
FSH and LH levels in Kallman syndrome
|
decreased
|
|
|
patients with sickle cell trait may have renal issue such as
|
hematuria
isosthenuria (nocturia, polyuria) |
|
|
patients with hemochromatosis and cirrhosis are at increased risk from infection with
|
listeria monocytogenes
yersinia enterocolitica vibrio vulnificus |
|
|
what is the rule when giving sildenafil to patient on an alpha blocker
|
must be taken 4 hours apart
|
|
|
Protein, WBC, RBC, Glucose findings in guillan barre pt's CSF
|
protein elevated
WBC, RBC, Glucose normal |
|
|
ppx for splenectomy pts should include
|
vaccination for haemophilus, pneumococcal, and meningococcal several weeks before operation
daily penicillin for 3-5 years s/p splenectomy *risk of sepsis is present for up to 30 s/p splenectomy |
|
|
treatment of hypercalcemia
|
IV fluids and loop diuretics
|
|
|
palpable purpura, proteinuria, hematuria, low serum complement, HCV positive
|
mixed cryoglobulinemia
|
|
|
emergent tx of CRAO
|
ocular massage and high flow oxygen
AC paracentesis to lower IOP can also be used later intraarterial thombolytics helpful if given in 4-6 hrs |
|
|
preferred long-term tx in hyperthyroidism
|
radioactive iodine therapy
|
|
|
SAAG calculation
|
subtract ascites albumin from serum albumin
difference of >1.1 equals transudate |
|
|
combo of trastuzumab and chemo know to lead to what toxicity
|
cardiac
perform echo prior to tx |
|
|
auscultative findings in lung consolidation
|
bronchial breath sounds over consolidated portion; louder and more prominent expiratory component
|
|
|
homocystinuria and stroke in fair skinned, blue eyed child with marfanoid habitus, downward lens dislocation
|
think cystathionine synthase deficiency
tx is high dose Vit B6 |
|
|
beta-glactosidase deficiency presentation (Krabbe's)
|
total absence of myelin
MR, blind, deaf, paralysis, peripheral neuropathy, seizures |
|
|
tay sach's presentation
|
beta-hexoaminidase A deficiency
MR, blindness, cherry red macula, weakness, seizures |
|
|
Fabry's presentation
|
alpha-galactosidase deficiency
angiokeratomas, peripheral neuropathy, corneal dystrophy, kidney and heart failure, thromboembolic events |
|
|
tx for overflow incontinence secondary to epidural anesthesia
|
intermittent catheterization
|
|
|
thrombocytopenia, hemolytic anemia, renal failure in HIV pos pt
|
TTP
get a peripheral smear - look for schistocytes |
|
|
newborn with failure to thrive, bilateral cataracts, jaundice, hypoglycemia, hepatomegaly, convulsions
|
galactosemia
galactose-1-phosphate uridyl transferase deficiency |
|
|
presentation of galactokinase deficiency
|
cataracts only
|
|
|
hard, unilateral, non-tender lymph nodes in submandibular or cervical region in older smoker, tow
|
squamous cell carcinoma
|
|
|
most specific test for acromegaly
|
GH levels after oral glucose load
they are unable to suppress GH IGF1 is a good screening test but not gold standard |
|
|
Beck's Triad
|
cardiac tamponade:
1. hypotension 2. distended neck veins 3. muffled heart sounds *pulsus paradoxus also seen |
|
|
most common cause of congenital hypothyroidism in USA
|
thyroid dysgenesis
|
|
|
an expected finding in idiopathic pulmonary fibrosis
|
increased A-a gradient
|
|
|
postprandial cramps, weakness, lightheadedness, and diaphoresis in gastrectomy pt
|
early dumping syndrome
tx with dietary modifications in resistant case, use octreotide, then reconstructive surgery as last resort |
|
|
threshold compartment pressure to perform escharotomy in burn patient
|
25-40 mmHg
|
|
|
pt with XY genotype and female external genitalia who show virilization at puberty
|
5 alpha reductase deficiency
cant convert testosterone to DHT |
|
|
anaphylaxis following blood transfusion, tow
|
IgA deficiency
|
|
|
TRALI pathogenesis
|
transfusion-related acute lung injury
reaction to cytokines stored in transfused blood product |
|
|
non productive cough worse at night in an otherwise healthy young non-smoker
|
be thinking post nasal drip
give antihistamine |
|
|
bullous/pustulous skin rash, alopecia, change in taste, what deficiency?
|
zinc
|
|
|
most important feature of selenium deficiency
|
cardiomyopathy
|
|
|
most common cause of hypercalcemia in admitted patients
|
malignancy
|
|
|
clinical features of hypercalcemia
|
polyuria
polydipsia nausea vomiting constipation |
