19 JAN 2017 0836 IM Flashcards Preview

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Flashcards in 19 JAN 2017 0836 IM Deck (24)
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1
Q

HIV patients with CD4 counts under ______ should not receive live vaccines

A

200

2
Q

in diabetic neuropathy small fibers cause what types of symptoms? large fibers?

A
  • small fibers: POSITIVE symptoms (pain, paresthesias)

- large fibers: NEGATIVE symptoms (sensory loss)

3
Q

what types of medications can cause acute angle closure glaucoma?

A
  • decongestants
  • antiemetics
  • anticholinergics
4
Q

hordoleums (styes) are usually caused by what bacterium? what is the treatment?

A
  • staph aureus

- warm compress

5
Q

patients with HIV who develop progressive disseminated histoplasmosis require what treatment medication?

A
  • IV amphotericin B (liposomal): 1-2 weeks

- oral intraconazole: for 1 year maintenance

6
Q

what do lab studies show in a VIPoma? what are the reasons for each?

A
  • hypokalemia: increased intestinal potassium secretion
  • hypercalcemia: increased bone resorption
  • hyperglycemia: increased glycogenolysis
  • Low stool osmotic gap < 50 mosm/kg (OG = 290 - 2*Na - K)
7
Q

what is confirmatory for diagnosing a VIPoma?

A

VIP level over 75

8
Q

what are the treatment options for a VIPoma?

A
  • volume repletion

- octreotide to decrease diarrhea

9
Q

an anaphylactic reaction can potentially be delayed up to how long?

A

several hours

10
Q

patients with syphilis who have PCN allergy receive alternate treatment with _____________

A

oral doxycycline

11
Q

when is PCN desensitization indicated for syphilis treatment?

A
  • CNS involvement (ocular, neuro)
  • multiple treatment failures with other agents
  • pregnancy
12
Q

what is the treatment of choice for early syphilis?

A

IM benzathine PCN G

13
Q

definition: observer bias

A

when investigator’s decision is adversely affeected by knowledge of the exposure status

14
Q

what is the first step when encountered with a painless hard testicular mass and suggestive US?

A

orchiectomy (remove testicle and cord) - remove first and investigate later!

15
Q

how can polymyositis be differentiated from lambert eaton?

A

in polymyositis:

  • reflexes are preserved
  • elevated creatine kinase
16
Q

patients with ankylosing spondylitis can develop what type of pulmonary disease? why?

A
  • restrictive lung disease

- diminished chest wall and spinal mobility

17
Q

optic glioma is a well known complication of ___________________

A

neurofibromatosis type I

18
Q

definition: enthesitis

A

inflammation at sites of ligamentous insertion

19
Q

what is the mainstay of therapy for Dressler’s syndrome?

A

NSAIDs (corticosteroids if NSAIDs are contraindicated)

20
Q

what are the symptoms of wallenberg syndrome?

  • vestibulocerebellar
  • sensory
  • bulbar
  • autonomic
A
  • vestibulocerebellar: vertigo, falling to side of lesion, diplopia and nystagmus (horizontal and rotational), ipsilateral limb ataxia
  • sensory: loss of pain and temperature on ipsilateral face and contralateral trunk / limbs
  • bulbar: dysphagia, aspiration, dysarthria, dysphonia, hoarseness (ipsilateral vocal cord paralysis)
  • autonomic: ipsilateral horners, hiccups
21
Q

wallenberg syndrome (lateral medullary infarct) occurs due to occlusion of what artery(ies)?

A

PICA or vertebral

22
Q

after ____ hours, gluconeogenesis represents the sole source of glucose production

A

24

23
Q

what is the main cause of hypercapnia in COPD?

A

increased dead space ventilation

24
Q

minute ventilation is the product of:

A

tidal volume and respiratory rate