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Flashcards in 5/2 Deck (112)
1

Adjustment disorder timing

Within 3 months of stressor

2

Rubin-Johnson high level of what

High levels of coproporphyrin I

3

Atelectasis blood gas

Hypoxemia
Hypocapnia
Respiratory alkalosis

4

Adenomyosis def

Presence of endometrial glands in uterine muscle
*boggy and symmetrically enlarged*

5

Earliest vaso-occlusive manifestation in SS

Dactylitis

6

B-HCG level to see intrauterine pregnancy

1,500-2000

7

Uremic pericarditis features? tx?

-When BUN >60
-EKG won't look like other causes due to lack of inflammation
-Tx is dialysis

8

What causes anemia of pre-maturity? labs?

Diminished Epo levels, shortened RBC life span, and blood loss
-Labs will show decreased hgb and hct w/ relatively low retic count

9

Small HPV lesions tx

Trichloroacetic act or podophyllin

10

Best frostbite tx

Rapid re-warming with warm water
*don't debride tissue initially*

11

MCC of gross lower GI bleeding in adults

Diverticulosis

12

Diverticulosis vs Angiodysplasia

Diverticulosis: high volume arterial bleeding, more common
Angiodysplasia: low volume venous bleeding

13

DMD gen location

Deletion of dystrophin gene on Xp21

14

Craniopharyngioma path

Nests of squamous cells in a loose stroma (looks like embryonic tooth bud enamel)

15

Think what with proximal muscle weakness + inc ESR and CK

Polymyositis or dermatomyositis

16

Fibromyalgia physical exam

Point muscle tenderness in mid trapezius, lateral epicondyle, chostochondral junction in chest, and greater trochanter

17

HSV encephalitis dx

Viral DNA PCR in the CSF

18

Colonoscopy schedule in UC

-Begin 8 years post diagnosis (12-25 if dz only in left colon)
-Colonoscopy with biopsy every 1-2 years

19

FAP colonoscopy schedule

Begin at age 10-12
Colonoscopy every year

20

LAD features

Delayed umbilical chord separation, recurrent skin and mucosal bacterial infections (w/ purulence) and server PERIODONTAL dz

21

GD features

-Infections from catalase pos organisms (S. aureus, serratia, burkholderia)
-Neg nitroblue tetrazolium test
-NO neutrophillia

22

Dermatitis herpetiformis treatment

Dapsone and gluten-free diet
*will see on extensor surfaces*

23

CMV vs Cryptosporidium diarrhea in AIDS pts

Crypto: Severe watery diarrhea
CMV: Frequent, small volume w/ hematocheiza and abdominal pain

24

Key feature of MAC diarrhea in AIDS pt

High Fever (> 39 C or 102.2 F)

25

Diffuse axonal injury CT scan

Numerous minute punctate hemorrhages with blurring of grey-white interface

26

PD tremor frequency

4-6 Hz (look for asymmetry and associated rigidity)

27

Drug for young PD with mainly tremor

Trihexyphenidyl (anticholinergic)

28

What is Lamivudine

Reverse transcriptase inhibitor used to treat HIV and Chronic Hep B

29

what is a pericardial knock

Mid-diastolic sound

30

Patients > 35 with gross hematuria workup

CT urogram and cystoscopy

31

PNA risk assessment for out vs inpt

Confusion
Uremia (BUN > 20)
RR-Tachypnea (> 30)
BP - Hypotension
65 (age >)
*CURB 65* (>2 do inpatient)

32

MCC of CAP

S. pneumo, Heamophilus, and atypicals

33

CAP input current guidlines

Inpt: Fluoroquinolone or Beta-lactam + macrolide

34

3 reasons for kidney stone with neg scan

1. radiolucent stone (uric acid, xanthine)
2. Calcium stones

35

Tx of uric acid stones

Hydration
Alkalization of the urine (potassium citrate-also reduces crystallization)
Low purine diet

36

Drug for recurrent hypercalciruic renal stones

HCTZ - decreases urinary calcium excretion

37

What is Trastuzumab? What should be done before starting therapy

mAb for HER2
Do echo before starting

38

Electrical alternans EKG

Varying amplitude of the QRS complexes
(this w/ sinus tach --> probs pericardial effusion)

39

Thyroglobulin level in dx'ing hyperthyroid

Will be high in endogenous hyperthyroidism and low w/ exogenous use

40

How long to do cholecystectomy during acute cholecystitis

Within 72 hours

41

Pagets lab's

Increase in alk phos and normal serum Ca and PO4 levels

42

Long term panic disorder tx

SSRI/SNRI and/or CBT

43

Displacement vs Projection

Displacement: transferring feelings to amore acceptible object
Projection: Attributing one's own feelings to others

44

What is sublimation

Channeling impulses into socially acceptable behaviors

45

Common causes of neonatal polycythemia

Delayed clamping of umbilical chord, in-utero hypoxia (maternal HTN), poor placental gas exchange (maternal DM)

46

Neonatal polycythemia tx

Hydration for asymptomatic
Symptomatic need partial transaction of blood for NS

47

Symptomatic neonatal polycythemia features

respiratory distress, hypoglycemia, and neurologic manifestations

48

When to give Rhogam

28 weeks gestation and w/in 72 hours of delivery

49

What is the Kleihauer-Betke test

For Rho-gam dose needed - adult hgb spread on slide and exposed to acidic solution, and adult hemoglobin lyses

50

Lung consolidation PE findings

Bronchial breath sounds, dullness to percussion, increased fremitus
*bronchial breath sounds have full expiratory phase*

51

Pleural effusion PE findings

Fluid blocks sound transmission from the air-filled lungs --> decreasing errythang

52

Best test to dx intusseception

US

53

Multiple myeloma

Hypercalcemia
Renal
Anemia
Bone pain (also lytic lesions and fractures)

54

Protein levels in multiple myeloma

Paraprotein gap --> greater than 4 g/dL separating total serum protein and albumin

55

How long can the liver store Vit K

30 days (but acutely ill liver failure patients can run out in 7 days)

56

Vit K def labs

Prolonged prothrombin time flooded by prolonged PTT

57

Most common renal vascular lesions in HTN

Arteriosclerotic lesions of afferent and efferent renal arterioles and glomerular capillary tufts

58

DM nephropathy features

Increased ECM, BM thickening, mesangial expansion, and fibrosis

59

First stage of DM nephropathy

Glomerular hyper profusion and renal hypertrophy with increase in GFR

60

What is eplerenone

Very selective mineralocorticoid antagonist (like spironolactone but no hormonal stuff)

61

Drugs for bilateral adrenal hyperplasia or poor unilateral surgical candidates

Spironolactone or eplerenone (aldosterone antagonists)

62

Lead tox in adults

Nonspecific symptoms (fatigue, insomnia, irritability), myalgia, HTN, neurcog defects, perps

63

Bacillary angiomatosis in AIDs pt's? tx?

Bright red, firm, friable, exophytic nodules
Tx is oral erythromycin

64

Features of lupus arthritis

Migratory, symmetric, polyarticular, and accompanied by brief morning stiffness (much shorter than RA)
*NO evidence of joint destruction*

65

Clindamycin often used for

Anaerobic infections (in particular lung abscesses and bacterial infections of mouth and neck)

66

All patients with new onset ascites need what

Paracentesis to determine the cause

67

Risk of sepsis lasts how long after splenectomy

Up to 30 years

68

Hereditary spherocytosis mutation

Lack of spectrin in red cell membranes

69

Superior vena cava syndrome features

Dyspnea
Venous congestion
Swelling of head neck and arms

70

Actinomyces micro

Anaerobic, gram pos and filamentous branching bacteria
*colonizes oral cavity*

71

Nocardia affects what

Brain, soft-tissue/skin, and lungs of immunocompromised folks

72

What does generalizability, or external validity, pertain to?

Applicability of study results to other populations

73

What is commonly employed to compare the means of two groups of subjects

Two-sample T test

74

What is the NOVA used for

To compare 3 or more means (vs two sample T test for 2)

75

Test to confirm abnormal capillary blood lead level

Venous blood level

76

Drug if lactulose doesn't lower serum ammonia in hepatic encephalopathy

Rifaximin

77

First line for sever mania w/ acute agitation

Antipsychotic (works faster than lithium or valproate)

78

Cause of post-ischemic compartment syndrome

Interstitial edema and intracellular swelling following ischemia and subsequent repercussion

79

Preferred initial DVT test

Compression US

80

Infertility + ovarian mass + normal studies in young woman

Endometriosis

81

How does endometriosis cause infertility ? US of?

Distortion of pelvic anatomy with inflammation and adhesions
US will show cystic ovarian mass

82

MCC of stress incontinence

Pelvic floor muscle weakness

83

CXR of primary pulmonary hypertension

Enlargement of the pulmonary arteries with rapid tapering of the distal vessels and enlargement of the right ventricle

84

Partial 21-hydroxylase def

Presents in adolescence as hyperandrogegism (hirsituism), irregular menses, and elevated 17-hydroxyprogesterone

85

Breast engorgement tx

Cool compress acetaminophen, and NSAIDs

86

Meconium ileum associated with what dz

Cystic fibrosis

87

Hirschsprung dz with what other disease

down syndrome

88

What does squatting do in Tet spells

Increases SVR to less than pulmonary vascular resistance

89

4 tet featurs

1. RV outflow tract obstruction
2. RVH
3. Over-riding aorta
4. VSD

90

Think what in elderly men with dysphagia, regurg, and stinky breath? test to dx?

Zener's diverticulum
Test to dx is contrast esophagram

91

Beck's triad of pericardial tamponade

Distant heart sounds, distended jugular veins, and hypotension

92

Uterine rupture presentation and exam

Bleeding, pain, and fetal distress
Exam will show palpable fetal body parts abdominally at rupture site and no presenting fetal parts vaginally

93

Gait impairment in NPH vs AD

Early finding in NPH and late finding n AD

94

How does pernicious anemia lead to increased risk of gastric cancer

Chronic atrophic gastritis with decreased production of intrinsic factor by gastric parietal cells

95

What is the succession splash for

Gastric outlet obstruction --> splash sound will indicate hollow viscus filled with fluid and gas

96

tx of post herpetic neuralgia

TCAs (amitriptyline or notryptyline)

97

Pain with neck extension seen in what kind of abscess

Retropharyngeal
*worry about spread into mediastinum*

98

What decreases mitral valve prolapse murmur

Squatting from a standing position --> by increasing pre-load and thus left ventricular volume (but may increase in severe MVP)

99

Why is LCP disease less common in kids

Kids has 2 blood supplies (ascending arteries and foveal artery) and foveal artery may become obliterated in older patients

100

Indications for O2 in COPD

PaO2 55% or
Evidence or cor pulmonale

101

HIV ppx meds for pt's with CD4

TMP-SMX for TCP and toxo
Azithromycin for MAC
*Itraconazole for histo endemic areas*

102

Massive PE is defined as

PE complicated by hypotension and/or acute right heart strain

103

Suspect what in post op patient with hypotension, JVD and new onset RBBB

Massive PE

104

Neonatal conjunctivitis timeline and tx

2-5 days - Gonococcal (eye erythromycin to prevent)
5-14 days - Chlamydial (oral erythromycin to treat)

105

Mucomycosis drug

Amphotericin

106

Consider what in a post bone marrow transplant pt who presents with pneumonitis and diarrhea

CMV

107

What is rosacea characterized by

Erythema, edema, and telangiectasias on central face
*worse with spicy foods and inc temp*

108

ABO mismatch features

Fever, flank pain, hemolysis, oliguric renal failure and DIC w/in an hour of tranfusion

109

MC adverse reaction to transfusion w/ features

Febrile non hemolytic transfusion reactions -Fever and chills w/in 1-6 hours of transfusion

110

Triad of multi-system atrophy

1. Parkinsonism
2. Autonomic dysfunction
3. Widespread neurological signs

111

Hyper IgM features

X linked defect in CD40 ligand w/ H IgM, low IgG and IgA and normal lymphocyte populations

112

Symptomatic HCM drug

B-blockers