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42 Cards in this Set
- Front
- Back
Treatment of irregular periods with cytology showing "complex hyperplasia without atypia"
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cyclic progestins, repeat biopsy after 3-6 months of treatment
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Treatment of irregular periods with cytology showing "complex hyperplasia with atypia"
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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.
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si/sx of analgesic nephropathy
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sterile pyuria (meaning WBCs and WBC casts without infection), polyuria, renal colic and hematuria can occur if papillary necrosis occurs, mild proteinuria, fatigue
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associations with chronic analgesic abuse
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premature aging, atherosclerotic disease, urinary tract cancer
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What's the defect that causes Bruton's agammaglobulinemia
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x-linked recessive defect in tyrosine kinase in B cells
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si/sx of Bruton's agammaglobulinemia
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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
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what is dacryocystitis?
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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
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what is a hordeolum?
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abscess over upper or lower eyelid, it appears as a local red swelling
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what is a chalazion?
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chronic granulomatous inflammation of the meibomian gland, appears as a hard painless lid nodule
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PFT findings in pulmonary fibrosis?
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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
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treatment of abruptio placenta
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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
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Risk factors for abruptio placenta
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cocaine use, maternal htn, previos abruption, trauma, rapid decompression of polyhydramnios, short umbilical cord, tobacco use, folate deficiency
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best test of Addison's disease? Why?
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cosyntropin stimulation test, cosyntropin is an analogue of ACTH, and if it produces any increase in cortisol levels, Addison's can be ruled out
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what causes Addison's disease?
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destruction of adrenal cortex, usually by autoimmune causes, but can be because of infections (TB, viral, fungal)
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si/sx of addison's disease?
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weakness, fatigue, weight loss, hyperpigmentation, hypotension,
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si/sx of RMSF?
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fever, myalgia, HA, petechial rash, hypotension and shock later
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treatment of RMSF?
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doxycycline, start based on clinical suspicion, any delay can allow progression to shock,
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tx of beta blocker OD
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atropine, isoproterenol, then glucagon
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so your pt has syphilis, what test do you order?
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HIV elisa
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what is the dx for cape-like distribution of sensory loss and reflexes
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syringomyelia (it's called syringobulbia if it extends into the medulla oblongata)
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si/sx of subclavian vein thromosis
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presents after a couple of weeks of having a central line there, swelling in pallor of arm, pain,
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tx of subclavian vein central line thrombosis
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first remove the central line, apply heat and elevate arm, get ultrasound to document the thrombus, start anticoagulation
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which congenital heart disease is the most common to present with cyanosis in the first 24 hours of life?
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transposition of the great vessels
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immediate treatment of transposition of the great vessels?
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prostaglandins to keep that ductus open!
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best test for acute cholecystitis?
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HIDA scan
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what do you know about aneurysms of the descending thoracic aorta?
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second most common site of an aortic aneurysm, most pts also have an aneurysm in the abdominal aorta, due to atherosclerosis
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what do koplik's spots look like
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red spots with blue center, on buccal mucosa
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describe the course of a measles infection
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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
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what metabolic abnormality does acetazolamide cause?
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metabolic acidosis (non anion gap), because it causes kidneys to waste bicarb
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what do you do if you suspect aortic rupture on chest x-ray?
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get a chest CT or echo
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treatment of acute hepatitis C
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interferon and ribavirin,
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si/sx of heroin withdrawal in an infant
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tremors, wakefulness, loose stools, high-pitched cry, poor feeding, tachypnea, vomiting, fever, sx within first 48 hours of life
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associations of acanthosis nigricans
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diabetes, abdominal malignancy (in older pts)
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what is the difference between incomplete abortion and inevitable abortion
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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
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define dysthymia
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depressed mood for most of the day for two years
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define unstable angina
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angina of sudden onset, onset at rest, post-infarct angina, a change in the character of stable angina
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treatment of unstable angina
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hospitalization with aspirin, heparin, nitroglycerin with non-emergent angiography once chest pain has resolved
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si/sx meniere's disease
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recurrent episodes of positional vertigo, sensorineural hearing loss, tinnitus
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si/sx of acoustic neuroma
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progressive, constant tinnitus and vertigo
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si/sx of paget's ds of nipple
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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
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strongest indicator for future suicide
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previous suicide attempts
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vitamin deficiency assoc with dilantin
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folic acid
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