Flashcards in 13 Deck (32)
Difference between prospective cohort vs cross sectional studies
Prospective cohort compares disease incidence
Cross sectional compares disease prevalence
Patients with celiac sprue who presents with GI sx (watery diarrhea) despite adherence to gluten free diet most likely has what disease?
Intestinal T cell lymphoma
oliguria, hypotension, elevated BUN and creatinine in hospitalized patient. Ddx?
Acute tubular necrosis (muddy brown cast, high FeNA)
Steps in evaluating impaired gastric emptying
1. first rule out mechanical obstruction; upper endoscopy
2. if nondiagnostic, and malignancy is a concern, obtain CT or MRI
3. then perform tests for gastric dysmotility, like scintigraphic gastric emptying tests
Treatment for pregnant TB infected patients
9 months of isoniazid, ethambutol, rifampin
unless drug resistant, avoid pyrazinamide due to teratogenicity
Causes of acute painless vision loss
- central retinal artery occlusion: sudden, cherry red spot, hx of amaurosis fugax, pale fundus
- central retinal vein occlusion: subacute, retinal hemorrhage, optic disc edema ("blood and thunder")
- retinal detachment: floaters, fundus with vitreous hemorrhage, marked elevation of retina
- vitreous hemorrhage: decreased red reflex, hemorrhage on funduscopy, bed rest with elevation
Characteristic lesions of cutaneous cryptococcus, confirmatory test?
small, reddish brown papules with central umbilication (like molluscum contagiosum)
Common fractures when you fall on an outstretched hand
colles fracture (distal radius)- at risk for acute CTS
ulnar styloid fracture
Treatment of bacterial vaginosis (fishy odor, homongenous vaginal discharge)
oral metronidazole or clindamycin
Which diseases are related to multiple skin tags? dermatitis herpertiformis?
- skin tags: insulin resistance, pregnancy, crohn's dz (perinanal)
- derm. herp: celiac disease
Management of pts with acute ischemic stroke who received TPA
- keep bp <185/105
- do not give antiplatelets, anticoagulation, invasive therapy in the first 24 hours
Initial diagnostic test of dermatomyositis (proximal muscle weakness, helitrope rash, gottron's papules, elevated muscle enzymes)? must needed screening test?
- ANA testing
- serum antibodies; anti Ro, La, anti Jo
- cancer screening test needed as it is associated with malignancy
Management of breast mass in women under 30 and above 30?
- <30: ultrasound +/- mammogram--> complicated cyst? then core biopsy, if not, elective needle aspiration1
->30: mammogram +/- ultrasound--> malignancy? then core biopsy
Autoimmune hepatitis (young to middle aged women, elevated AST/ALT and normal everything else) diagnosis test?
ANA, anti smooth muscle ab
opioid withdrawal management
- opioid antagonist: methadone, buprenorphine (preferred under supervised setting)
- nonopioid: clonidine, antiemetics, antidiarrheals, benzos
clinical presentation of nondominant parietal lesion vs dominant parietal lesion
- nondominant (right): construction apraxia---confusion, difficulty drawing lines, dressing issues
- dominant (left): Gerstmann syndrome---acalculia, finger agnosia, agraphia, left right confusion
strongest known risk factor for breast cancer in male
first line treatment of severe bipolar mania in pregnant patients
Pernicious anemia shows what in gastric endoscopy?
- glandular atrophy
- intestinal metaplasia
best diagnostic test for sickle cell anemia
Most common complication of cat scratch disease
suppuration of lymph nodes
Most common cause of pediatric pneumonia and treatment
- preschool or focal lung findings: strep pneumo, high dose amoxicillin
- older or b/l lung findings: mycoplasma, azithro
Primary prevention of esophageal varices? Management of acute esophageal bleeding?
- nonselective beta blockers- propanolol, nadolol
- banding with endoscopy at first attempt, at recurrence, try again. Then if that fails, try TIPS
Clinical presentation of acute mesenteric ischemia
- acute abdominal pain where physical exam does not match severity of pain.
- metabolic acidosis
presentation of esophageal perforation/boerhaave's syndrome
- acute chest pain with repeated vomiting
- tear in distal third of esophagus, leads to pleural effusion
- pneumomediastinum, pneumothorax can be seen
trimethoprim, methotrexate, and phenytoin can cause what kind of anemia through which mechanism? Tx?
- macrocytic anemia by inhibiting DHFR
- need folinic acid, not folic acid, as folinic acid is more potent
What can prevent febrile nonhemolytic transfusion reaction (occurs 1-6 hours after transfusion)
** washing cells is for IgA deficiency
Most common complication of patients admitted with acute variceal bleeding, what ppx treatment is needed?
need fluoroquinolone agent for 7-10 days