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Mixed > UW 13 > Flashcards

UW 13 Flashcards

1
Q

How does acute massive PE present?

A

Syncope

Shock

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2
Q

Cath values in acute massive PE

A

High RA and PA pressure

Normal PCWP

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3
Q

Hypovolemic shock Cath values

A

Low intravascular volume
Low RA, RV, PA, PCWP
High SVR

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4
Q

Cardiogenic shock cath values

A

High PCWP, SVR

Low CO

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5
Q

Septic shock cath values

A

Peripheral VD
High CO
Low SVR
Low RA, PA, PCWP

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6
Q

HIV testing

A
  1. ELISA

2. Western Blot = confirm

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7
Q

Pulmonary Cavitation in HIV

A 
M.TB
Atypical Mycobacteria
Nocardia
Gram - Rods
Anaerobes
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8
Q

Nocardia

A

Gram +
Weakly acid fast
Filamentous branching Rod
Immunocompromised hosts

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9
Q

Tx for Nocardia

A

TMP-SMX

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10
Q

Lack of response to progestin withdrawl =

A

Low estrogen

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11
Q

Staph Scalded Skin Syndrome
Pathophys
Presentation

A

Toxin targets desmoglein 1 = keratinocyte adhesion in superficial epidermis
Prodrome of fever, irritability and skin tenderness
Erythema starts on face -> genearlizes 24-48 hours
Superficial flaccid blisters develop
Nikolsky sign +

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12
Q

Impetigo pressentation

A

Flaccid blisters
Honey colored crusted lesion
Nikolsky -

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13
Q

TX for Hairy cell leukemia

A

Cladribine - Purine analog

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14
Q

AE’s of Cladribine

A

Neuro

Renal

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15
Q

Opioid Presentation

A

Miosis
Depressed mental status
Depressed RR, bowel sounds
HypoTN, Bradycardia

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16
Q

Best predictor of intoxication in opioid toxicity

A

Respiratory Rate

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17
Q

Conditions that cause V/Q Mismatch

A

Pulmonary embolism
Atelectasis
Pleural Effusion
Pulmonary Edema

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18
Q

A-a gradient and acid base in

V/Q mismatch

A

A-a increas

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19
Q

Acid base seen in Alveolar hypoventilation

A

Respiratory Acidosis
High PaCO2
Low PaO2 - may just be this alone, 50-80

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20
Q

Causes of Alveolar Hypoventilation and Respiratory Acidosis

A

Pulmonary/thoracic dz: COPD, OSA, Obesity hypoventilation, scoliosis
NM Dz: MG, Lambert-Eaton, GBS
Drugs: Anesthetics, narcotics, sedaties
Primary CNS dysfnc: Brainstem lesion, infxn, stroke

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21
Q

What does A-a gradient measure

A

PAO2 - PzO2

Measures oxygen transfer from alveoli to blood

22
Q

What is a normal A-a gradient

A

< 15

23
Q

Causes of hypoxemia

A 
Reduced inspired oxygen tension
Hypoventilation
Diffusion limitation 
Shunt
V/Q mismatch
24
Q

What is the most common presentation of Primary Hyperparathyroidism (PH)

A

Asymptomatic 80%

25
Q

How to differentiate PH from familial hypocalciuric hypercalcemia

A

24-hour urinary calcium
> 250 = PH
< 100 = Familial

26
Q

TX for Asymptomatic PH

A

Surgery (parathyroidectomy) if 1+

  1. Serum Calcium >1mg/dL above upper limit
  2. Young < 50yoa
  3. BMD < -2.5 any site
  4. Reduced Renal Fnc (GFR < 50mL/min)
27
Q

When is bisphosphonates the TX in PH

A
  1. Refuse surgery

2. Hx of oxteopenia/osteoporosis

28
Q

Presentation of hypercalcemia in malignancy (labs)

A

Low PTH

mod-severe Hypercalcemia = > 13

29
Q

Presentation and pathophys of hypercalcemia due to immobilization

A

Immobilized pt
Pre-existing high bone turnover
Median onset - 4 wks
High bone turnover = increased osteoclastic activation

30
Q

TX for hypercalcemia due to immobilization

A
  1. Hydration

2. Bisphosphonates

31
Q

Presentation of Ehrlichiosis

A 
Tick bite - white tail deer
SE and SC US (Arkansas)
Flu-like illness
- febrile, malaise
Neuro sx's
No rash
32
Q

Labs in Ehrlichiosis

A

Leukopenia
Thrombocytopenia
High LFTs
High LDH

33
Q

DX for Ehrlichiosis

A

Intracytoplasmic morulae in WBCs

PCR

34
Q

TX for Ehrlichiosis

A

Doxycycline

2nd line = Chloramphenicol

35
Q

Presentation for RMSF

A

Maculopapular rash involving palms and soles after fever

36
Q

Do we vaccinate pts w influenza that are symptomatic (moderate to severe)

A

No. CDC recommends agasint it

37
Q

TX for influenza

A 
Oseltamivir, Zanamivir (NA inhibitor)
- If pt presents w/in 48 hrs of onset
OR
- sx's not improving or high risk
IC'd, pregnant, > 65, Native American
38
Q

TX for Bartonella henselae

A

Azithromycin

39
Q

Eschar presentation

A

moderate full thickness burn w pain and swelling = eschar constriction

40
Q

Management for Eschar

A
  1. IVF
  2. Analgesics
  3. Topical Abx and wound dressing
  4. Monitor for signs of healing
  5. Doppler US for peripheral pulses and compartment pressure
    - 25-40 = threshold for escharotomy
41
Q

ABO incompatibility seen in?

A

Group O Mother
Group A or B Baby
A and B Ags are antigenic - mother forms IgG abs to A or B = cross placenta

42
Q

EEG w sharp, triphasic and synchronous discharges

A

Creutzfeldt-Jakob Disease

43
Q

Creutzfeldt Jakob Presentation

A

Rapidly progressive dementia
Myoclonus
Sharp, triphasic synchronous discharges on EEG

44
Q

Acne TX

A
  1. Topical retinoids, salicylic
    • benzoyl peroxide
    • Topical Abx = erythromycin, clindamycin
    • Oral Abx
  5. Oral isotretinoin = only for unresponsive severe
45
Q

TX for acne that is severe or nodular OR moderate acne unresponsive to topical Abx

A

Oral Abx

46
Q

MOA of spirnolactone

A

Blocks effects of testosterone at receptor

47
Q

MC symptoms of MR

A

Exertional dyspnea
Fatigue
- Decreased CO and increased LA Pressure

48
Q

Pt with MR + dry cough

A

Pulmonary congestion/edema
Severe dz
LV dysfnc

49
Q

What does PCWP measure

A

LA Pressure

LVEDV

50
Q

Hypovolemic shock findings

A 
HypoTN
Tachycardia
Low CO
High SVR
Low CVP, PCWP
51
Q

Bacteria in IE w nosocomial UTI, cytoscopy

A

Enterococcus

52
Q

Differentiate b/t IM and Primary HIV infxn

A

Rash and diarrhea = less common in IM

Tonsillar exudates = uncommon in primary HIV

Mixed (19 decks)

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