1 Flashcards
1
Q
Angioedema
A
Ace inhibitors
2
Q
Brucellosis incubation period
A
Varies widely : weeks-months
3
Q
Brucellosis - first antibody to appear
A
IgM
4
Q
Brucellosis treatment
A
1 IM streptomycin + PO tetracycline (e.g doxy)
Alternative : Aminoglycoside ( IV gentamicin)
5
Q
Brucellosis treatment duration
A
Adults- acute non-focal disease -> a 6 week course
Complex or focal disease-> 3 or more months
6
Q
Most common cause of asymptomatic hypercalcemia in otherwise healthy individuals
A
PRIMARY hypERparathyroidism
7
Q
Cerebral Toxoplasmosis Tx
A
6 wks sulfadiazine and pyrimethamine
8
Q
Antibodies to HIV appear
A
3-12 weeks after infection
9
Q
COPD exacerbation- PaCO2 > 45 mmhg
A
Non-invasive positive pressure ventilation NIPPV
10
Q
NIPPV contraindications
A
Cardiovascular instability
Impaired mental status / inability to cooperate
Copious secretions/ inability to clear secretions
Respiratory arrest
-> INTUBATE
11
Q
CKD + Hx of recurrent UTIs in childhood
A
Reflux nephropathy
12
Q
Early signs of aortic regurgitation
A
Palpitations while lying down
13
Q
Most sensitive test for cardiac involvement in amyloidosis
A
Cardiac MRI
14
Q
Amyloidosis Dx
A
Fat pad or rectal biopsy or biopsy from an involved organ
Congo red -> apple green
15
Q
Alabaster-coloured pale skin
A
SECONDARY adrenal insufficiency only
16
Q
Erythropoietin treatment -> iron deficiency anemia
A
Increased iron demand and usage
17
Q
Bronchiectasis Dx imaging of choice
A
CT
18
Q
Multiple myeloma most common infections & pathogens
A
Pneumonia ( streptococcus pneumonia & staphylococcus aureus) and pyelonephritis (E. coli)
19
Q
Renal failure in multiple myeloma
A
25% of pts
20
Q
Mitral leaflet perforation->
A
Heart failure
21
Q
Tricuspid valve endocarditis ->
A
Pulmonary abscess
22
Q
Most common cause of a paravalvular abscess
A
Aortic valve endocarditis
23
Q
Major modified duke criteria
A
1) positive blood cultures of typical bacteria >12h apart / Coxiella burnetti titer IgG>1:800
2) characteristic echocardiography findings
24
Q
Cardio - prophylactic antibiotics indications
A
- prosthetic heart valves
- Hx of previous endocarditis
- unrepaired cyanotic CHD, including palliative shunts
- within 6 months of CHD repair
- incomplete repair of CHD, leading to residual defect near the prosthetic material
- post-cardiac transplantation valvopathy
- LV assist device or implantable heart
- surgical or transcatheter pulmonary artery valve or conduit placement
25
Streptococcus endocarditis Tx
Penicillin G / Ceftriaxone
26
Enterococcus endocarditis Tx
Ampicillin (+/- Gentamicin)
27
Endocarditis - Staph - MSSA on NATIVE valve Tx
Cefazolin/ Naficillin/ Oxacillin/ Flucloxacillin/ Vancomycin
28
Endocarditis - Staph - MSSA on PROSTHETIC valve Tx
Naficillin / Oxacillin / flucloxacillin + Gentamicin + Rifampin
29
Endocarditis MRSA on a NATIVE valve Tx
Vancomycin
30
Endocarditis MRSA on a PROSTHETIC valve Tx
Vancomycin + Gentamicin + Rifampin
31
Endocarditis Coxiella burnetti Tx
Doxycycline + Hydroxychloroquine
32
Paravalvular abscess can present with
Arrhythmia
33
Every pt with diabetic nephropathy should be screened for concomitant _________
Retinopathy
34
Kidneys in diabetic nephropathy are ________ in size
Relatively large
35
Most common bacterial pathogens in Bronchiectasis
Pseudomonas and H.influenza
36
______ is necessary for the Dx of IBS
Abdominal pain
37
Asthma Dx - reversibility with SABA - FEV1/FVC & FEV1 increase by
>12% + 200ml
38
Asthma Dx - Methacholine test
REDUCES FEV1 by 20%
39
PCO2 in Acute asthma attack
Usually LOW due to hyperventilation
40
Steroids in acute asthma attack
ORAL (systemic)
41
Aspirin-sensitivity Asthma
Asthma, aspirin sensitivity, nasal polyps
42
Churg-Strauss
Asthma + eosinophilia + granulomatous vasculitis
43
First-line Tx for Crohns fistula
Anti-TNF (infliximab)
44
Hemoglobinuria , pancytopenia, venous thrombosis (e.g hepatic vein; budd-chiari)
Paroxysmal nocturnal hemoglobinuria
45
PNH definite Dx
Flow cytometry CD55 CD59 (absent)
46
Giant cell arteritis is closely associated with
Polymyalgia rheumatica
47
Negative-birefringent NEEDLE-shaped crystals
GOUT
48
Gout in pts with Renal failure - Tx
Steroids
49
Calcifications affecting the hilar lymph node “eggshell” appearance
X-ray: opacities affecting the UPPER lung lobes
Silicosis
50
UC salvage therapy
Cyclosporine
51
Gingival hyperplasia is a SE of
Cyclosporine
52
Atypical pneumonia -Tx
Macrolides/ Fluoroquinolones/ Tetracyclines
53
Tx of pneumonia outpatient- no comorbidities
Doxycycline or
Macrolide or
Doxycycline/Macrolide + Amoxicillin
54
Tx of pneumonia outpatient- with co-morbidities
Respiratory fluoroquinolone ( levofloxacin/moxifloxacin/gemfloxacin) OR
Macrolide/Doxycycline + Amoxi-clav/ Cephalosporin
55
Tx of pneumonia - Inpatient- Non-severe
Beta-lactam (penic/cephalo) + Macrolide OR
Respiratory Fluoroquinolone
56
Tx of pneumonia Inpatient- severe
Beta-lactam + Macrolide OR
Beta-lactam + Respiratory Fluroquinolone
57
Pneumonia with suspicion for MRSA Tx
Vancomycin or Linezolid
58
Pneumonia with suspicion for Pseudomonas Tx
Carbapenems / Tazocin/ Cefepime/ Ceftazidime/ Aztreonam
59
Polycythemia with decreased erythropoietin
Polycythemia Vera (1ry)
60
Test of choice to diagnose Paget’s dz of the bone
Alkaline phosphatese (also for follow-up)
61
SBP most common pathogen
E.coli
62
SBP Tx
IV Ceftriaxone 5 days
63
TTP Pentad
Fever
Anemia
Thrombocytopenia
Renal involvement
Neurological involvement (confusion)
64
TTP Tx
Plasma exchange
65
TTP ADAMTS13<10% - Tx to reduce mortality
Caplacizumab and Anti-vWF antibody
66
_______________ is an antipseudomonal beta-lactam
Piperacillin-tazobactam
67
Small or large painful reddish maculopapular lesions unique to P.auroginosa
Ecthyma gangrenosum
68
First-line for mild-mod UC
5-ASA (Sulfasalazine and Mesalamine)
69
5-ASA side effects
Pancreatitis
Agranulocytosis
Hypersensitivity pneumonitis
70
COVID19 ; _____ of pts are asymptomatic
One third
71
Chronic mitral regurgitation
HOLOsystolic murmur
Wide split of S2
S3
72
Chronic MR murmur _________ with handgrip
Increases
73
Benign ventricular arrhythmia after reperfusion (esp with fibrinolytics), No Tx needed
Accelerated Idioventricular rhythm (AIVR)
74
The typical pneumonia of CMV is ________ with ___________ predominance
Bilateral, Interstitial
75
Mononeutitis multiplex (drop foot) could be a feature of
Eosinophilic granulomatosis with polyangiitis (Churg-Strauss)
76
Churg-Strauss
P-ANCA
77
Octreotide/somatostatin MOA in variceal bleeding
Splanchnic artery vasoconstriction
78
Antibiotic prophylaxis in Variceal bleeding is with
Ceftriaxone
79
Variceal bleeding - unstable pt/Massive - failure of endoscopy ->
Blakemore tube
80
Salmonella typhi is a Gram
Negative bacilli
81
________ are the sole reservoir for Salmonella typhi
Humans
(It’s unique to humans)
82
S.typhi penetrates into the walls of the __________ intestine
SMALL
83
Rose spots (maculopapular rash)
Salmonella
84
S.typhi Tx
Ceftriaxone
Azithromycin
Ciprofloxacin
85
LBBB and a wide QRS ->
CRT (cardiac resynchronisation therapy)
86
RVMI suspected (MI + hypotension) ->
Right precordial leads ECG + IV fluids
87
E-lyte disturbance with PPIs
HypoMg
88
HIT Dx
ELISA - antibodies against platelet factor 4 (PF4)
89
HIT Tx
D/c LMWH
With thrombosis risk-> Fondaparinux or Argatroban
90
Congenital hypothyroidism- Dx imaging
Scintigraphy (Technetium scan)
91
Fever, hives and joint pains in children after certain drugs (beta-lactams e.g penicillin or Sulfa-drugs)
Serum Sickness-Like Reactions (SSLR)
92
Severe Serum sickness like reactions Tx
Prednisone
93
Bacterial Osteomyelitis-like picture with STERILE cultures and recurrent attacks in CHILDREN
CHRONIC RECURRENT MULTIFOCAL OSTEOMYELITIS (CRMO)
94
ADULT form of CRMO
SAPHO Syndrome
(Synovitis, Acne, Pustulosis, Hyperostosis, Osteitis)
95
CRMO Tx
Initial: NSAIDs
2nd-line: Corticosteroids, TNF-inhibitors, Bisphosphonates.
96
Persistent hydrocele >12-18months of age ->
Surgery
97
Cough, coryza, conjunctivitis
Cephalocaudal rash
Koplik spots
MEASLES
98
Most common complication of measles
Otitis media
99
_________ reduces measles complications
Vitamin A
100
In young children Eosinophilic esophagitis initial management
Elemental diet
101
Peds- formula for selecting ET tube size
(Age in years/4)+4
102
Systolic murmur, pectus excavatum, biphasic T waves on ECG
Marfans syndrome - Mitral valve prolapse
103
In infancy - cardiomegaly, hypotonia, macroglossia, hepatomegaly, normal glucose
Pompe disease - Acid alpha-glucosidase deficiency
(Glycogen storage dz)
104
Pompe diseases Tx
Enzyme replacement therapy
105
Glasgow coma scale
Eye opening (4) spontaneous, to voice, to pain, none
Verbal response (5) oriented, confused, inappropriate, incomprehensible, none
Motor response (6) obeys, localizes pain, withdraws, flexion, extension, none
106
Prolonged severe limb pain after injury, pain is disproportionate, possible edema
Normal labs and imaging
Complex regional pain syndrome
(More in female children)
107
Complex regional pain syndrome Tx
Physical therapy and cognitive-behavioural therapy
108
Crepitus during knee flexion
Patellofemoral pain syndrome
109
Localized tenderness at the tibial tubercle
Osgood-Schlatter disease
110
Ataxia-telangiectasia therapy
SUPPORTIVE
111
Hypertrophic gastropathy management
Hydration
112
Known adrenal insufficiency + stressor event (illness/surgery) , steroid dose _____
Regular dose should be INCREASED to stimulate an adrenal stress response
113
Opsoclonus-myoclonus
Peri-orbital ecchymoses
Rosette cells
Urine VMA HVA
Neuroblastoma
114
Males📍
Adrenal insufficiency
Neurological abnormalities (e.g Academically, behavioural, seizures)
Testicular dysfunction
X-linked ADRENO-LEUKOdystrophy
(Adrenal) (brain)
115
In AdrenoLeukodystrophy, there’s accumulation of
Very Long Chain Fatty Acids (VLCFAs)
116
To prevent refeeding syndrome
Add vitamin B1 IV beforehand
117
Nisseria meningitis Tx
Penicillin IV+ Ceftriaxone 5-7days
118
PHACE syndrome
Posterior fossa
Hemangioma
Arterial anomalies
Cardiac anomalies
Eye anomalies
119
Apgar score
HR: absent=0, <100=1, >100=2
Resp: absent=0, irregular=1, good=2
Tone: limp=0, mild flexion=1, active=2
Nostril cath response: absent=0, grimace=1, cough/sneeze=2
Color: pale/blue=0, pink body&blue extremities=1, pink=2
120
Constricted pupils (miosis), hypotension, *respiratory depression*
OPIOID poisoning
Give NALOXONE
121
Mydriasis (dilation), TACHYcardia, dry skin, HYPERthermia, flushed skin
(As in a desert; hot, dry, confused, flushed, dilated eyes)
Anticholinergics poisoning
Antidote: Physostigmine
122
Tuberous sclerosis is associated with cardiac
Rhabdomyomas
123
Fetal alcohol syndrome triad
Narrow eye slits
Smooth philtrum
Thin upper lip
124
Indications for antibiotic Tx in Gastroenteritis
Age < 3 months
HIV (even if treated)
Cancer / Immunodeficiency / Immunosuppression
Sickle cell disease
-> empirical antibiotics until culture results are available
125
Antibiotics for salmonella (certain cases)
Cefotaxime 5-14 days
Ceftriaxone 7 days
Ampicillin 7 days
Cefixime 7-10 days
