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Flashcards in 5/17 Deck (98)
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1

What is dumping syndrome? Who gets it?

Posgastrectomy patients get poops and farts as well as palpitations and sweating after eating

2

What causes dumping syndrome

Rapid emptying of hypertonic gastric contents into duodenum and small intestine, causing fluid shifts stimulating vasoactive peptides and autonomics

3

retropertineal hematoma presentation after cardiac cath

Sudden hemodynamic instability and ipsilateral flank or back pain

4

3 big drugs for interstitial nephritis

Penicillins, cephalosporins, and sulfonamides

5

1st line therapy for PMDD

SSRIs

6

Pregnancy excercise

>30 min daily at low or moderate activity

7

Type I vs II RTA issue

Type 1: poor hydrogen secretion into urine
Type 2: Poor bicarb reabsorption

8

RTA tx

Oral bicarb replacement

9

3 big complications of orbital cellulitis

1. Orbital abscess
2. Intracranial infection
3. Cavernous sinus venous thrombosis

10

What is Trypanosome cruzi

Protozoan

11

Laryngomalacia vs Vascular ring

LM: Worsens in supine and improves in prone (4-8 months)
VR: Improves w/ neck extension, ass w/ cardiac abnormalities

12

What part of adrenal gland is pheo in

Adrenal medulla

13

3 big in Cushin's

Hypertension
Hyperglycemia
Weight gain

14

Two first line tx for tine corporis

Topical clotrimazole or terbinafine

15

Topical nystatin for

Candidal skin infections

16

2 big things pt's with nephrotic syndrome at increased risk for

Atherosclerosis (hyperlipidemia)
AV thrombosis (loss of antithrombin III)

17

When to get vaccines for splenectomy

Either 2 weeks before or 2 weeks after

18

What is most commonly associated w/ splenic abscesses

Infective endocarditis

19

Guardia tx

Metronidazole

20

PE of methanol ingestion

Optic disc hyperemia

21

Most 1st degré AV blocks w/ normal QRS occur due to

Conduction delay in the AV node and need no further eval

22

Who gets FSGS

AA and Hispanics
Fat people
HIV and heroin

23

Who gets membranous nephropathy

Adenocarcinoma
NSAIDS
Hep B
SLE

24

Who gets membranoproliferazive glomerulonephritis

Hep B and C
Lipodystrophy

25

MCD associated w/ what cance

Lymphoma

26

Def of chronic bronchitis

3 consecutive months of productive cough in 2 successive years

27

What is essential in distinguishing dementia from normal changes of aging

Impairment of daily functioning

28

Why can folic acid make B12 def worse

B12 used in processes other than RBC making, so the folate uses whats left in making RBCs to correct anemia first

29

B-blocker OD presentation

Bradycardia and hypotension --> cardiogenic shock
Hypoglycemia
Wheezing (bronchospasm)

30

B-blocker OD tx

Glucagon (also good for CCB OD)

31

Big drugs that precipitates myasthenic crisis

Fluorquinolones
Amingoclycosides
B-blockers

32

What is spared in polymyositis

respiratory muscles

33

Most significant complication of IIH

Blindness

34

Why put the women in left lateral decubitus position for abrubtion

To displace the uterus off the aortocaval vessels and maximize cardiac output

35

Heat stroke vs Heat exhaustion

Stoke: thermoregulation failure w/ CNS dysfunction
Exhaustion: Due to inadequate fluid and salt replacement (T

36

Think what w/ sudden onset pleural effusion w/ exudate and blood

PE

37

Primary murmur of TOF

Harsh, systolic ejection murmur over left upper sternal border from pulmonary stenosis

38

What age for S aureus in CF

Under 20 (highest around 10 years0
Older than that think pseudomonas

39

Xray of jejunal atresia?
Risk factors?

xray: Tripple bubble and gasless colon
Risks: prenatal exposure to cocaine and other vasoconstrictive drugs

40

First step if COPD exacerbation not getting better

Noninvasive positive pressure ventilation

41

Persistent pneumothorax and air leak in pt w/ BAT following chest tube likely

Tracheobronchial rupture

42

What does alveolar hypoventilation refer to

Uniform fall in inspired O2 in all regions of the lung (narcotic overdose, neuromuscular weakness)

43

4 big causes of V/Q mismatch

1. Obstructive lung dz
2. Atelectasis
3. Pulmonary edema
4. Pneumonia

44

Shunt that doesn't correct w/ O2 besides cardiac

Extensive ARDs

45

What should be done if fetal movement decreases

NST (also done in high risk pregnancies starting at 32-34 weeks)

46

Reactive NST

At least 2 accelerations of 15 above baseline lasting 15 seconds each in 20 minutes

47

Pt's w/ positive RET mutation detected should get what

Total thyroidectomy

48

Xray of rotator cuff tear may show what

Underlying calcific tendinitis

49

2 big risks for untreated hyperthyroidism

Rapid bone loss from increased osteoclastic activity in bone cells and cardiac tachyarrhythmias

50

"Blood and thunder" appearance on ophthalmoscope in what

Central retinal vein occlusion

51

Pt's w/ non-inflammatory chronic pancreatitis are what

Afebrile and have irritative voiding symptoms

52

What alleviates pain in chronic pancreatitis

Sitting up or leaning forward

53

COPD exacerbation ABG

Respiratory acidosis and hypoxia

54

CHF exacerbation ABG

Hypocapnia and respiratory alkalosis

55

Suspect what in patients w/ hemolytic anemia and thrombocytopenia

TTP

56

Hypovolemic hypernatrema fluid flowchart

IV NS until euvolemic, then 5% dextrose in water, then free water

57

Kleptomania tx

CBT

58

Tx for UGIB

Supplemental O2
Bowel rest
IV fluids
IV PPI for acid suppression

59

Vaccine exception for premies

weight should be > 2 kg (4.6) before first hepatitis B vaccine

60

POV dx

-Increased serum FSH and LH levels
-Decreased estrogen levels

61

How can hypomagnesemia cause hypocalcemia

By inducing PTH resistance as well as decreasing PTH secretion
*see in alcoholics*

62

Why does it take awhile for Ca to raise after treating low Mg

PTH levels increase rapidly but resistance persists despite improvement in mag levels

63

What provides relief in epiglottidis

Keeping neck hyperextended

64

Why are G6PD levels normal in acute episode

G6PD def RBCs are hemolyzed early and reticulocytes (normal G6PD levels) are abnormally high

65

Two path features of C diff

Enterotoxin A: Watery diarrhea
Cytotoxin B: Colonic epithelial cell necrosis and fibrin deposition

66

Attributable risk percent formula

(RR-1) / RR

67

When surgery in pt's w/ native valve infective endocarditis

1. Significant valvular dysfunction
2. Persistent/difficult to treat infection
3. Recurrent embolism

68

Why hyponatremia in Addisons

Volume contraction (mineralocoritocoid def) and increased vasopressin secretion (lack of cortisol suppression)

69

Why pain relief in NO after MI

Dilation of veins and decrease in ventricular preload

70

Worsening postprandial pain that leads to avoidance of food characteristic of

Chronic occlusion of visceral arteries

71

Stepwise approach for treatment of ascites

1. Na and H2O restriction
2. Spironolactone
3. Loop diuretic
4. Frequent abdominal paracentesis (if renal function okay)

72

What do peptic structures cause

Symmetric and circumferential narrowing of the involved esophagus w/ dysphagia for solids but no weight loss

73

How can TMP-SMX cause hyperkalemia

Due to blockade of the epithelial Na channel in collecting tubule, also inhibits Cr secretion leading to falsely elevated level

74

What Ab can cause QT prlongation

Macrolides (also cholestasis)

75

How can long term analgesics cause CKD

Tubulointerstitial nephritis and hematuria due to papillary necrosis

76

Mammogram ages

50-75

77

What is elevated in intrahepatic cholestasis of pregnancy

Bile acids and LFTs
*will have intense pruritus - esp on palms and soles*

78

What should you not do in congenital diaphragmatic hernia

bag and mask (intubate instead and place ng tube)

79

How can CDH cause polyhydramnios

Result of esophageal compression

80

Who gets worse Babesiosis dz

Those over 40
Those without a spleen
Immunocompromised

81

Babesiosis tx

Quinine-linda
or Atovaquone-azithro

82

What is phyllodes tumor

Rare breast mass that presents as a unilateral, smooth painless and mobile firm breast mass (large fibroadenoma)

83

What can help distinguish peritonsillar abscess from epiglottitis

Deviation of the uvula and unilateral lymphadenopathy

84

Fetal hydantoin syndrome

Small body size
Microcephaly
Digital and nail hypoplasia
Cleft palate and rib abnormalities

85

5 big features of billiard atresia

1. Jaundice
2. Echoic stools or dark urine
3. Hepatomegaly
4. Inc direct bili
5. Mild LFT elevation

86

MC congenital heart defect in down's PTs

Complete AV septal defect

87

In B12 and folate def, what does replacing only folic acid do

Corrects megaloblasosis but leads to rapid progression of neurologic symptoms

88

Gallbladder imaging of pancreatic Ca

Intra and extra hepatic biliary tract dilation

89

CNs in the cavernous sinus

III, IV, V and VI

90

Eye manifestation of SS

Keratoconjunctivis sick (dry eyes, irritation, and photosensitivity)

91

Chronic epigastric pain that suddenly worsens and becomes diffuse w/ pneuomperitoneum concerning for

Likely perforated PUD

92

Cholestasis and biliar dilation

Dilated: extra hepatic
Not dilated: intrahepatic

93

Stains for ALL

PAS (in lymphoblasts)
TdT

94

Polymyositis dx

Muscle biopsy

95

What causes MVP

Myxomatous degeneration the mitral valve leaflets

96

Change after hyper filtration in DM II nephropathy

Thickening of the glomerular basement membrane

97

Osteomalacia vs Osteoporosis

Osteomalacia will have bone pain and muscle weakness
Xray will show decreased bone density with thinning of cortex and pseudo fractures

98

"Steppage gait" MCC

L5 radiculopathy or neuropathy of the common peroneal nerve