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EOR - Internal Med > Rosh Material #1 > Flashcards

Rosh Material #1 Flashcards

1
Q

pleural effusions cause _ tactile fremitus

A

decreased

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2
Q

what sx is typically only present in pt’s w. an exudative pleural effusion

A

chest pain

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3
Q

mcc of transudative vs exudative pleural effusion

A

transudative: CHF
exudative: 1. infxn, 2. malignancy, 3. PE

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4
Q

_ criteria is used to differentiate btw transudative and exudative pleural effusion

A

light

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5
Q

transmission cycle for lyme dz

A

white-footed mouse -> ixodes scapularis -> human

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6
Q

what tick borne illness causes RBC hemolysis and is diagnosed w. thick and thin smear

A

babesiosis

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7
Q

what tick borne illness causes a biphasic fever

A

colorado tick fever

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8
Q

what tick born illness causes a centripetal rash (greatest concentration on trunk, fewest on distal extremities)

A

RMSF

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9
Q

describe tick paralysis

A

ascending flaccid paralysis

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10
Q

what tickborne illness causes ulcers, LAD, conjunctivitis, and PNA

A

tularemia

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11
Q

list the cause of the following tick borne illnesses:

babesiosis:
colorado tick fever:
ehrlichiosis:
lyme dz:
RMSF:
tick paralysis:
tularemia:

A

babesiosis: babesia
colorado tick fever: orbvirus
ehrlichiosis: rickettsia like coccobacilli
lyme dz: spirochete borellia burgdorfi
RMSF: rickettsia rickettsii
tick paralysis: demacentor spp.
tularemia: francisella tularensis

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12
Q

what 3 tick borne illnesses are treated w. doxy

A

ehrlichiosis
lyme dz
RMSF

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13
Q

tx for tularemia

A

streptomycin

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14
Q

tx for babesiosis

A

atovaquone
+
azithromycin

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15
Q

what tick borne illness is deadly in asplenic pt’s

A

babesiosis

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16
Q

_ is pathognomonic for lyme dz

A

bilat facial palsy

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17
Q

tx for temporal arteritis: no vision loss vs vision loss

A

no vision loss: high dose prednisone
vision loss: IV methylprednisolone + high dose ASA

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18
Q

temporal arteritis is associated w. what condition

A

polymyalgia rheumatica

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19
Q

management of SIADH: asymptomatic vs symptomatic

A

asymptomatic: fluid restriction + 2 g Na tablets
symptomatic: 3% hypertonic saline 100 mL over 10 min

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20
Q

what is this showing

A

rat bite erosions -> gout

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21
Q

what is this showing

A

white lines of chondrocalcinosis -> pseudogout

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22
Q

joint mc affected by pseudogout

A

knee

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23
Q

what causes pseudogout

A

calcification of cartilage from buildup of calcium pyrophosphate crystals

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24
Q

mc rf for aortic dissection

A

htn

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25
Q

what are the steps in TB infxn

A
  1. tubercle (macrophage accumulation)
  2. regional LAD
  3. ghon complex formation
  4. ranke complex
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26
Q

3 phases of TB

A

primary: asymptomatic
latent: asymptomatic
reactivation: fever, night sweats

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27
Q

light criteria for exudative pleural effusion

A

presence of one:
-pleural fluid pro > 0.5
-pleural fluid LDH:serum LDH > 0.6
-pleural fluid LDH > 2/3 UNL of normal LDH

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28
Q

2 bx findings of parkinsons

A

lewy bodies in substantia nigra
decrease in dopaminergic neurons in substantia nigra

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29
Q

sjorgen’s increases risk for what 2 diseases

A

lymphoma
ILD

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30
Q

test indicated for RA pt’s who require intubation/sedation

A

cervical spine XR

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31
Q

management of SVT: stable vs unstable

A

stable: cold stimulus to face, valsalva, stimulate gag reflex

unstable: 1. adenosine, 2nd line: procainamide, amiodarone, bb, 3. cardioversion

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32
Q

office based management of hemorrhoids

A

-rubber band ligation: healthy pt, grade I, II, III, or internal
-sclerotherapy: anticoagulants/antiplatelets, immunocompromised, portal htn
-excision: actively thrombosed external

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33
Q

contraindication for office based procedures for hemorrhoids

A

grade IV internal

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34
Q

pericardial knock on cardiac auscultation
kussmaul sign
pulsus paradoxus

A

constrictive pericarditis

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35
Q

4 causes of restrictive cardiomyopathy

A

amyloidosis
sarcoidosis
hemochromatosis
tropical endomyocardial fibrosis

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36
Q

paradoxical increase in JVP that occurs during inspiration

A

kussmaul sign -> constrictive pericarditis

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37
Q

tx for constrictive pericarditis

A

pericardiectomy

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38
Q

bloody diarrhea, crampy abd pain, tenesmus

A

UC

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39
Q

which IBD is associated w. increased colon ca risk

A

UC

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40
Q

advanced prostate ca is associated w. PSA levels >

A

40

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41
Q

tx for coccidioidomycosis

A

-at risk (HIV/organ transplant): fluconazole vs itraconazole
-meningitis, first trimester pregnancy, failed azole: amphotericin B

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42
Q

2 derm manifestations of coccidioidomycosis

A

erythema nodosum
erythema multiforme

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43
Q

stages of de quervain thyroiditis

A
  1. hyperthyroid
  2. euthyroid
  3. hypothyroid
  4. euthyroid (recovery)
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44
Q

etiology of de quervain’s thyroiditis

A

viral URI

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45
Q

dx/tx for de quervain thyroiditis

A

dx: clinical
tx: naproxen vx steroids, propranolol (anxiety)

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46
Q

presentation of blastomycosis

A
  1. pna - mc
    skin: verrucous lesions - mimic scc
    osteomyelitis
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47
Q

blastomycosis is endemic in the (2)

A

midwest
southern states

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48
Q

gs dx for cor pulmonale

A

right heart cath

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49
Q

dx for acromegaly

A

1. serum IGF1 - gs
2. unequivocal: r.o acromegaly
3. equivocal: oral glucose suppression test

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50
Q

PE findings of acromegaly

A

increased head/glove/shoe size
coarse facial features
oily skin
visual field defects
DM

51
Q

symptomatic management of sjorgens

A
  1. artificial tears/saliva
  2. cyclosporine drops
  3. oral cholinergics: pilocarpine
52
Q

CSF findings of MS

A

oligoclonal IgG bands

53
Q

what is lhermitte sign

A

spinal electric shock sensation w. neck flesion

54
Q

3 PE findings of MS

A

-marcus gunn pupil (afferent pupillary defect)
-lhermitte sign
-impaired bilat eye adduction (bilat internuclear ophthalmoplegia)

55
Q

main med to know for MS tx

A

glatiramer acetate - interferon beta-1a

56
Q

what gene is associated w. CML

A

BCR-ABL1 (philadelphia)

57
Q

conditions associated w. HLAB27

A

pair:
psoriatic arthritis
ankylosing spondylitis
IBD
reiter’s syndrome

58
Q

pharm for acute angle closure glaucoma

A

topical timolol
topical apraclonidine - alpha agonist
pilocarpine - miotic
acetazolamide - cah inhibitor

59
Q

the HOCM murmur is increased w.:
and relieved w.:

A

increased: valsalva, standing
relieved: squatting, trendelenburg

60
Q

2 genetic conditions associated w. MVP

A

marfan
ehlers danlos

61
Q

2 PE findings associated w. MVP

A

scoliosis
pectus excavatum

62
Q

t/f: MVP requires f/u w. cardiology before a pt can participate in sports

A

f!

can be a normal finding in healthy, think, young women

63
Q

2 sx of prolactinoma

A

amenorrhea
impotence

64
Q

hallmark sx of dressler syndrome (post MI syndrome)

A

pleuritic cp radiating to the back -
worse w. lying down
improved w. leaning forward

65
Q

3 PE finding of post MI syndrome

A

pericardial friction rub
persistent low grade fever
leukocytosis

66
Q

3 rf for dermatomyositis

A

female
40-60 yo
occul malignancy

67
Q

sx of dermatomyositis

A

insidiou, painless proximal m weakness
rash
dysphagia

68
Q

PE findings of dermatomyosistis

A

heliotrope rash
gottron papules
mechanic’s hand
shawl sign/v-sign
photodistributed poikiloderma

i honestly have no idea what most of these are #sacrificiallamb

69
Q

what abs are associated w. dermatomyositis

A

anti Jo-1 abs

70
Q

what is this showing

A

short PR interval
delta wave
wide QRS

WPW

71
Q

mcc of WPW

A

accessory conduction pathway (bundle of kent)

72
Q

definitive tx for WPW

A

radiofrequency ablation

73
Q

progression of colon polyps to malignant

A
  1. hyperproliferation
  2. adenomatous polyps
  3. dysplasia (pre cancer)
  4. adenocarcinoma
  5. invasive cancer
74
Q

indication for repeat scan 5 years after first colonoscopy

A

tubular adenomas < 10 mm

75
Q

4 indication for colonoscopy 3 years after first scan

A

> /= 3 polyps
tubular adenomas > 10 mm
villous adenomas
high grade dysplasia

76
Q

progressive tender weakness of 3 mos duration

A

polymyositis

77
Q

2 abs associated w. polymyositis

A

anti-Jo
anti-SRP

78
Q

bb are contraindicated in what type of angina

A

prinzmetal

79
Q

mainstay of tx for prinzmetal angina (2)

A

ccb
nitrates

80
Q

mc route of infxn for prostatitis

A

ascending urethral spread

81
Q

lab characteristics of anemia of chronic dz

A

low: serum iron, TIBC
high vs normal: ferritin

82
Q

order of tx for BPH

A
  1. alpha blockers
  2. 5 ART inhibitors
  3. TURP
83
Q

tx for venous insufficiency

A
  1. leg elevation
  2. compression therapy
  3. ulcer care
  4. ablation
84
Q

2 rf for plyarteritis nodosa

A

male age 40-60
hep B infxn

85
Q

starburst livedo - painful violaceous plaques surrounded by livedo reticularis

A

pathognomonic for polyarteritis nodosa

86
Q

small vessel vasculitides to know

A

hypersensitivity vasculitis
henoch schonlein purpura
goodpasture
granulomatosis w. polyangitis

87
Q

3 medium vessel vasculitides to know

A

polyarteritis nodosa
behcet dz
microscopic polyangitis

88
Q

2 large vessel vasculitides to know

A

giant cell arteritis
takayasu arteritis

89
Q

what 2 conditions are associated w. palpable purpura

A

-hypersensitivity vasculitis -> isolated palpable purpura
-henoch schoenlein purpura -> palpable purpura w. abd pain, hematuria, n/v/d

90
Q

cough
hemoptysis
glomerulonephritis

A

goodpasture

91
Q

sinusitis
pulmonary infiltrates
nephritis

A

granulomatosis w. polyangitis

92
Q

skin ulcers
nephritis
mesenteric ischemia

A

polyarteritis nodosa

93
Q

recurrent painful oral and genital ulcers
uveitis, iritis, or optic neuritis

A

behcet dz

94
Q

pulmonary infiltrates
nephritis

A

microscopic polyangitis

95
Q

large vessel vasculitis
finger ischemia
arm claudication

A

takayasu arteritis

96
Q

cardiomegaly w.o pulmonary congestion

A

pericardial effusion

97
Q

order of tx for hemochromatosis

A
  1. phlebotomy
  2. erythrocytapheresis
  3. iron chelation - deferoxamine
  4. dietary changes
98
Q

4 complications of hemochromatosis

A

liver dysfxn
hypogonadism
arthralgias/arthritis
cardiomyopathy

99
Q

3 causes of superior vena cava syndrome

A

mediastinal tumors
thrombosis
aortic aneurysm

100
Q

4 PE findings of superior vena cava syndrome

A

facial swelling
plethora (purple skin)
upper extremity swelling
JVD

101
Q

mcc of secondary htn in adults

A

renal artery stenosis

102
Q

3 causes of renal artery stenosis

A

fibromuscular dysplasia
atherosclerosis
kidney transplant

103
Q

what are the 3 normocytic anemias

A

anemia of chronic dz (early)
hemolytic
aplastic

104
Q

fx mc associated w. multiple myeloma

A

vertebral

105
Q

crest syndrome is associated w.

A

scleroderma

calcinosis of skin
raynaud
esophageal dysmotility
sclerodactylyl
telangiectasia

106
Q

what is this showing

A

multifocal atrial tachy

at least 3 different p wave morphologies
rate 100-180
irregular

107
Q

3 causes of MAT

A

COPD
hypoxia
pulmonary htn

108
Q

tx for MAT

A

O2
rate control

109
Q

meds that cause drug-induced SLE

A

hipps:
hydralazine
INH
procainamide
phenytoin
sulfonamides

110
Q

recommended contraception for pt’s w. SLE

A

progestin only due to higher thromboembolic risk

111
Q

labs associated. w SLE

A

flares: low complement

antidsDNA abs
anti smith
antiphospholipid

112
Q

abs associated w. drug induced SLE

A

anti histone abs

113
Q

tx for SLE

A

-steroids
-hydroxychloroquine
-cyclophosphamide, mycophenolate, mofetil, azathriprine, rituximab

114
Q

which heart sound is always pathologic

A

S4

115
Q

which heart sound is associated w. right sided heart failure

A

S3

116
Q

empiric tx for HAP

A

cefepime
levofloxacin
vanco

117
Q

what rash is associated w. RMSF

A

maculopapular eruption on palms and soles

118
Q

what dementia is associated w. early age onset, changes in behavior/personality, and social conduct - ex. impulsivity, criminal behavior, inappropriate sexual advances, child like sense of humor, lashing out at pets, primal reflexes, binge eating, and eating inedible objects

A

frontotemporal

119
Q

first line tx for erosive esophagitis

A

ppi

120
Q

5 causes of atrial flutter

A

COPD
PE
thyrotoxicosis
mitral valve dz
etoh

121
Q

pathophys of a flutter

A

single excitable electrical focus in the left or right atrium

122
Q

metabolic syndrome criteria

A

any 3 of the following:
-abdominal obesity
-TG >/= 150
-HDL < 40 (w), <50 (m)
-BP >/= 130/85
-FBG >/= 100 OR on meds for hyperglycemia

123
Q

harsh midsystolic crescendo-decrescendo murmur radiating to the left shoulder

A

pulmonic stenosis

124
Q

what is carvallo sign

A

pansystolic murmur that becomes louder during inspiration -> tricuspid regurgitation

EOR - Internal Med (13 decks)

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