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161 Cards in this Set
- Front
- Back
GI troubles associated with henoch schonlein
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intussusception and GI bleed
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metabolic acidosis post seizure.
next step? |
nada. it resolves
|
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heart irregularity cuased by massive PE
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RV dilatation
|
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immunosuppressive rx that leads to
tremor gum hypertrophy hirsuitism |
cyclosporine
|
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immunosuppressive rx that leads to
diarrhea leukopenia hepatotoxicity |
azathioprine
|
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immunosuppressive rx that leads to
bone marrow suppresion |
mycophenolate
|
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accumulation of ammonia
production of flase neurotransmitters increased sensitivity to GABA zinc deficiency |
hepatic encephalopathy
|
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most important factor in AAA
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smoking (>HTN), even though it results from athero
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is the pain when appendicities points visceral or somatic
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somatic (with peritoneum)
(visceral is referred) |
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increased Ca++ associated with which lung ca
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Squamous sCa++mous
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superimposed on healing lesions of atopic dermatitis in presence of HSV
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eczema herpeticum
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rx toxicity with
tremor hyperreflexia ataxia seizures |
lithium
|
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rx toxicity with
horizontal nystagmus cerebellar ataxia confusion |
phenytoin
|
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rx toxicity with
slurred speech unsteady gait drowsy mild respiratory depression |
benzo
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hereditary blood disorder that can present with cholecystitis
tx? |
hereditary spherocytosis
splenectomy and folic acid supplementation |
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HTN
55 y/o male no MD for 15 years vaccines? |
Td
Pneumo Flu |
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bug that people with hemachromatosis are susceptible to
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listeria
(a long list of iron cells) |
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effect of Reye's on liver
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extensive fatty vacuolization
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balloon degeneration with PMN cellular infiltrate
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acute alcoholic hepatitis
|
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panlobular mononumclear infiltration wtih hepatic cell necrosis
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acute viral hepatitis
|
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piecemeal necrosis, leading to
septal fibrosis, leading to bridging fibrosis |
chronic active hepatitis
|
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heavy lymphocytic infiltrate in portal tracts
associated with inflammatory, granulomatou destruction of small and medium intrahepatic biliary ducts |
PBC
|
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test for pheylketonuria
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Guthrie test
|
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main cause of anemia in ESRD pts
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decreased EPO
|
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side efects of EPO
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increased HTN
headache flu-like red cell aplasia |
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rx for PSVT
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vagal manoeuvres, leading to
adenosine |
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young child
flulike illness tissue necrosis worsening myocardial function holosystolic murmur |
myocarditis
|
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suspect esophageal rupture
next step? |
gastrografin contrast esophagram
|
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contraindication for succinylcholine
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increased K or states conducive to it, et.
- crush or burn injuries - demyelinating - tumor lysis syndrome |
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gram + branching rods
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nocardia
no to no meas positive heart (cardia) branches out |
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tx for nocardia
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bactrim
|
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stones, bones, groans and psychiatric overtones
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increased Ca++
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post MI rupture leading to tamponade
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ventricular free wall rupture
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post MI reupture leading to VSD
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interventricular wall rupture
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rapid onset pulseless electrical activity post MI
tx |
pericardial tamponade as a result of free wall rupture
rapid diagnosis and pericardiocentesis |
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5 days after MI
new holosystolic murmur at apex |
papillary muscle rupture
|
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systemic embolization days to months after MI
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ventricular aneurysm
)also akinesis and ventricular arrhythmias) |
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bleeding time is about
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platelet formation
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when you do a bleeding time test
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platelet type bleeds and normal platelet count
|
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what does ristocetin cheon on?
when is it used? |
checks if VWF is sticky enough
used if platetelt bleeding and normal platelet count |
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rx causing allergic interstitial nephritis
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penicillin
sulfa rifampin allopurinol quinidine |
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first step if low plt count suspected
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prednisone
|
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isolated decreased platelet count in healthy person with normal size spellen
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ITP
|
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decreased platelet count with bowel or brain leed in ITP.
tx? can you give platelets? |
IVIG = fastest way to lift plt count
= rhogam don't give platelets because they'll just get eaten up |
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plt type of bleeding with normal platelet count
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von Willibrand disease
|
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rxx that can reveal VW disease
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aspirin
|
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test for VW disease
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bleeding time
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HIT test tests for
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C14 serotonin release assay
|
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factor level test for
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clotting factor deficiency
|
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tx for increased bleeding time and decreased VWF is
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DDAVP
mechanism is increased release of subendo stores of VIII and VWF |
|
e amnio caproic acid used for?
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fibrinolysis
|
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first test fo hemophilia
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PTT
|
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elevated PTT.
What's the problem? What test do you do? How does it work? |
mixing study
mix with normal if corrects to normal then its a deficiency |
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tx for hemophilia
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factor VIII (severe) or DDAVP (mild)
|
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what goes up with hemolysis
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LDH
bilirubin retics |
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what goes down with hemolysis
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platelets
|
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which change is the main problem in hemolysis
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pleatelet decrease
|
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most accurate test for DIC
|
ddimer
fibrin split products` |
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tx in DIC
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replace what' being consumed NOT heparin
so give plts + FFP |
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plts wnl
coags wnl plt kind of bleeding |
acquired storage pool disorder
|
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Ib or 2b/3a receptors missing
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galnzman
bernard woulier |
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effect of uremia on plts
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can't work
can't release granules |
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tx for uremia leadign to an acquired storage pool disorder
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desmopression
it increases vWF and factor VII (?) |
|
PE
pt on heparin HIT develops next step |
stop heparin
switch to argatroban (or hirudin, lipirudin), a direct acting thrombin inhibitor |
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test for HIT
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Plt facto IV assay
|
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anemia
uremia thronbocytopenia |
hemolytic uriemic syndrom
|
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hemolysis,
uremia thrombocytopenia fever AMS |
TTP
|
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what splits the vWF from platelets
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ADAMTS 13
|
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PT PTT in
HUS TTP DIC |
wnl
wnl increased |
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in hemolysis
bilirubin? LDH? Haptoglobin? |
up
up down |
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tx for HUS TTP
|
ffp (to replace ADAMTS)
or plasmapharesis |
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rx that can cause TTP HUS
|
clopidogrel
ticlopidine |
|
clot creator
preserver destroyer |
thrombin
factor 13 plasmin |
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what comes along with flushing in carcinoid
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hypotension
|
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palpitations
sweating tachy no hypertension |
insulinoma
|
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episodic HTN
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pheochromycytoma
|
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what makes eyes stick out in proptosis with graves
|
mucopholysaccharide
|
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most common side effect of proptosis
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corneal ulcers
|
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tx for proptosis
|
1) steroids
2) external beam radiation |
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thickened skin, some edema
tx? |
pretibial myxedema
topical steroids and graves control |
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1 leg red
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cellulitis
|
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thyroid levels in goiter
|
either up or down
not graves |
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thyroid tenderness
|
subacute thyroiditis (de Quervain)
(silent thyroiditis is silent) |
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TSH down
T4 up RAIU up |
Graves
|
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TSH up
T4 down RAIU up |
tumor making TSH
|
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TSH down
T4 up RAIU down |
silent and subacute thyroiditis
|
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thyroid in silent/subacute
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injured, not hyperfunctioning
just leaking out |
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wide complex tachycardia with no p waves
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thyroid something
|
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P waves at 100/min no always w QRS at 30-40
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complete heart block
|
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narrow complex tachycardia with no set p waves
R-R irregularly irregular intial tx? |
a fib in thyroid
tx is propranolol |
|
multifocal atrial tachycardia
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COPD
|
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best test for graves
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radioactive uptake
|
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hyperthyroidism - best tx?
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propylthiouracil or
methmiazole |
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mechanism of propulthiouracil or methimazole
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block thyroperoxidase that ? iodide
|
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T2 or T4:
which has longer half life which is more active |
T4 has longer half life so more of it in blood
T3 is more active (not protein bound) |
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rx for thyroid storm
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1) steroids (blocks T4-T3) +
2) radioactive iodine.... ... to block 3) PTU to block thyroidperoxidase 4) propranolol to inhibit target organ effect |
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when is surgery used for hyperthyroid
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airway compression
pregnancy |
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bad side effect of PTU/methimazole
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neutropenia
|
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mechanism of cretinism
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not enough T4 in developing brain
|
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only organs after uterine development/birth that don't need thyroxine for metabolic rate
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gonads
uterus brain |
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only hormone in body not made in pulsatile
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T4
|
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Tx fo cretinism
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T4 to 6 mos.
after that nothing can be done |
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thyroid nodule
first test? if TFTs normal? hyper? |
TFT
biopsy block with PTU |
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what thyroid nodule is neither benign nor malignant?
tx? |
follcular
excisional biopsy take the whole thing cause you have to see active area |
|
medullary.
what next? Why? how to find it? how to deal with it while doing thyroid surgery |
check for pheo by plasma and urine catecholamines because excision in presence of pheo would lead to hypertensive crisis
MIBG scanning for extra-adrenal ones phenoxybenzamine (peripheral alpha blocker) to prevent hypotensive crisis |
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levothyroxine and cardiac disease unrecognized leads to
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MI
|
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tx for skin findings in Graves
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steroids
|
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effect of TSH exogenous on pituitary? thyroid?
|
shuts off pituitary
involutes the thyroid |
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role of renin
|
antiotensinogen to ang I
|
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role of ACE
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in the lung it converts angiotensin I to II
|
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role of ARBS
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inhibit angiotensin II to aldosterone
blocks aldosterone |
|
precursor to vasopression
|
ang II
vasopressin from pituitary |
|
role of aldosterone
|
Na and water reabsorbed in DCT and CD
|
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hypotension
JVD muffled heart sounds pulsus paradoxus |
tamponade
|
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flumenazil is for
|
benzos
|
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murmur that increases with valsalva
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hypertrophic cardiomyopathy
|
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malnourished
confused ataxia first step |
Wernickes
thiamine |
|
weakness
fatigue cold intolerance constipation decreased HR skin dry and rough nails brittle hair thing + hyperpigmentation - hyperpigmentation |
+ is primary adrenocortical insufficiency (glococorticoid deficiency and hypothyroid)
- is secondary adrenal insufficiency (hypothyroid or pituitary failure) |
|
weakness
fatigue depression irritability lymphocytosis eosinophilia |
glucocorticoid deficiency
|
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hypersegmented neutrophils
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folate/B12
|
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crescendo-decrescendo murmur at LLSB
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hypertrophic cardiomyopathy
|
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effect of valsalva
|
decreases preload
|
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abnormality of valve in hypertrophic cardiomyopathy
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abnormal leaflet motion of MV
|
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motor diarrhea
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hyperthyroid
|
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osmotic diarrhea
|
lactose intolerance
|
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watery diarrhea post seafood
|
vibrio parahemolyticus
|
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diarrhea from daycare
|
shigella
|
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diarrhea from pork ingestion
|
yersinia
|
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diarrhea from undercooked infected poultry
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campylobacter
|
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screening tool for osteoporosis
|
DEXA scan
|
|
hempotysis and a murmur
associated with which arrhythmia |
MS
A fib (2/2 left atrial dilation) |
|
bug for mucormycosis
|
rhizopus
|
|
bug for sinusitis
|
1) h flu
2) moraxella |
|
haptoglobin in hemolysis
|
down
|
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MVA leading to patchy alvoelar infiltrates
|
pulmonary contusion
|
|
cyanosis at birth
|
TGV
|
|
how does CHF lead to effusion
|
decreased output
increased hydrostatic pressure in pulm vasculature transudate from pulm capillaries alveolar spaces |
|
most common predisposing factor leading to bacterial sinusitis
|
URI
|
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heart med to avoid in lung disease
|
amiodarone
|
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1st step for SIADH
|
remove causative agent
fluid restriction |
|
step is SIADS if
-severely symptomatic |
hypertonic saline
|
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lung cancer associated with SIADH
|
small cell
|
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mode of killing of encapsulated organisms
|
phagocytosis
|
|
3 main encapsulateds
|
s pneumo
n meningitidis h flu |
|
kind of killing decreased in
and inheritance pattern in CGD LAd DiGeorge |
intracellular (x linked)
chemotaxis (AR) you LeAD in LAD cell mediated immunity |
|
NADPH oxidase deficient in
|
CGD
|
|
dental surgery leads to endocarditis. Likely bug?
|
strep mutans (a strep viridans)
|
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strep associated with colon cancer
|
bovis
|
|
bug in prosthetic valve endocarditis
|
s epidermidis
|
|
fever
chills LUQ pain splenic fluid collection |
endocarditis with infarcts to the spleen
|
|
new onset diabetes II with decreased renal fun
1st med? with increased weight? |
not metformin
sulfonylurea, TZD, insulin |
|
+TPO antibodies with enlarged rubbery thyroid
|
hashimotos
|
|
associated risk in hashimotos
|
thyroid lumphoma
|
|
doughnut sign of thyroid
|
thyroid lymphoma
|
|
what to track to monitor progress of DKA tx
|
anion gap
|
|
high pitched
blowing early eiastolic decrescendo murmur in left 3rd intercolstal space -intensified by hand grip |
AR (Diastolic Decrescendo)
|
|
what does hand grip cause?
|
increased afterload
|
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widened pulse pressure
|
AR
|
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screening for ovarian cancer?
|
none
|
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tingling toes after folic acid tx that does increase Hgb
|
B12 deficiency, which should have been checked for
|
|
recommended rx for cirrhotic pt with varices
|
beta blocker
|