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;
34 Cards in this Set
- Front
- Back
5 things metastasize to vertebral column
|
Brain
Liver Thyroid Kidney Pancreas (BLT with kosher pickle) |
|
Relationship between Digoxin and potassium
|
Dig competes with K for binding site on NA/K pump. So, hypokalemia gives Dig a competitive edge, creating a relative toxicity. When dig levels are too high, K can't bind and hyperkalemia is the result.
|
|
3 signs of critical Aortic Stenosis
|
1. chest pain
2. syncope 3. heart failure |
|
Hypertensive emergency
|
Signs of end-organ damage:
headache, change in vision, chest pain, EKG changes (ST changes - concave ok, but straight or tombstoning bad) |
|
5 Mechanisms of hypoxemia
|
1. Low FiO2 (altitude)
2. Hypoventilation (drugs, CNS, resp fatigue) 3. V/Q mismatch (emphysema, PNA, asthma) 4. Shunt (ARDS, CHF, PE) 5. Diffusion abnl (uncommon and controversial - early PCP maybe) |
|
Describe paradoxical respiratory motion
|
Nl: diaphragm contracts down w/ inspiration, pushing abd out
Paradox: diaphragm is tired/ paralyzed, so with inspiration, intrathoracic pressure decreases and diaphragm is sucked up into chest, pulling abd inward |
|
Haldane effect
|
deoxygenated hemoglobin has decreased affinity for O2 increased CO2 (if you've let go of your O2 already, you want it to be able to pick up whatever CO2 is around), oxygenated hemoglobin has decreased affinity for CO2
|
|
Non-gap metabolic acidosis is associated with what?
|
Hyperchloremia
|
|
How to get rid of excess K? (5 ways)
|
1. Diuretics (pee it out)
2. Kayexalate (bind it up) 3. B-agonist 4. Insulin (+glucose) 5. Bicarb (these 3 push it into cells) **give Ca gluconate for cardiac protection (increases firing threshold) |
|
Plummer-Vinson Syndrome
|
esophageal webs
burning sensation on tongue big red tongue women > men premalignant |
|
Signs of cor pulmonale
|
rvh w/ parasternal lift
loud pulmonic sound split s2 (neck vein distention, peripheral edema, liver enlargement) |
|
bronchiectasis
|
Permanent thick, abnl dilated bronchial walls with destruction of cilia
Marked by excessive sputum and purulent exacerbations with mild hemoptysis. ppt'd by infection with obstruction or impaired drainage - usu in childhood |
|
pneumonia ass'd with bronchiectasis (agents and tx)
|
usu pseudomonas or staph aureus
Tx= resp fluoroquinolone + aminoglycoside |
|
bronchiolitis
|
onset after viral URI, may be ass'd with RA
usu self-limited, but may leave perm damage |
|
BOOP
|
Bronchiolitis Obliterans Organizing PNA
-inflammatory dz that looks like PNA -flu-like sx tx w/ steroids |
|
drugs responsible for interstitial lung dz
|
bleomycin
amiodarone phenytoin nitrofurantoin |
|
CXR has ground glass appearance with bilateral alveolar infiltrates that resemble a BAT
|
Pulmonary Alveolar Proteinosis
|
|
Histiocytosis X
|
ILD
ass'd with Langerhans cells Smokers get it and smoking cessation may stabilize or reverse dz CXR - honeycomb CT - cystic lesions |
|
Lupus in the lung
|
"shrinking lung" due to diaphragmatic dysfn and atelectasis
presents with fever, dyspnea, hemoptysis |
|
Flumazenil
|
given for benzo OD
|
|
3 sx of critical aortic stenosis
|
1. Chest Pain
2. Syncope 3. Heart failure (also dyspnea, murmur) |
|
Sx of pericarditis
|
sudden sharp stabbing substernal pain, radiation to trapezius
-relieved by sitting forward, worse on inspiration/lying flat *may be preceded by URI |
|
EKG signs of pericarditis
|
ST elevation
PR depression |
|
Wide mediastinum
|
think about Aortic dissection
|
|
What do you have to worry about after an MI?
|
Mechanical dysfn (2-7 d out)
1. papillary rupture-->mitral regurg (can--> pulm edema and hypotension) 2. VSD 3. Left Ventricular free wall rupture-->cardiac tamponade |
|
Causes of hemolytic anemia
|
1. sickle
2. hereditary spherocytosis 3. g6pd 4. Autoimmune Hemolytic Anemia 5. Paroxysmal Noct Hematuria |
|
Spherocytes and Coombs test
|
hereditary sphero = Coombs neg
AHA = coombs pos |
|
Which hemolytic anemia can
--> myelodysplasia, aplastic anemia, myelofibrosis, and acute leukemia? |
Paroxysmal Nocturnal Hematuria
sx include back, abd, msk pain tx: usu BMT def of anchor proteins --> chronic intravasc hemolysis and complement mediated lysis of RBCs, WBCs, plts (pancytopenia) |
|
Agents & treatment of Spontaneous Bacterial Peritonitis
|
E.coli (also Klebsiella and Strep pneumo)
Empirically treat with 3rd gen ceph or fluoroquinolone while awaiting C&S |
|
Volvulus
|
abdominal pain, obstipation
Plain films: omega loop sign (bent inner tube) - sigmoidal (most common) --> non-operative reduction via sigmoidoscopy coffee bean sign (cecal) - younger pts as congenital lack of fixation --> emergency surgery |
|
Crohn's disease associated with
|
strictures, fistulae, noncaseating granulomas, sm bowel fat creeping, pseudomembranes
|
|
Electrolyte imbalances in bulimia
|
hypochloremia, hypokalemia
|
|
HACEK bacteria
|
Haemophilus
Actinobacillus Cardiobacterium Eikenella Kingella |
|
You suspect aortic dissection, confirm it with TEE, now do what?
|
Give IV B-blocker immediately to dec BP and HR
(can later give IV vasodilator, if needed, to control BP) If it is in the ascending aorta, prep for surgery. |