5/20/13 Flashcards Preview

STEP II > 5/20/13 > Flashcards

Flashcards in 5/20/13 Deck (23):
1

Unexplained hemolytic anemia, thrombocytopenia, and acute renal failure in a normally healthy pt should raise suspicion for what?

TTP-HUS

2

What is the pathogenetic cause of TTP-HUS?

deficiency of or Ab against ADAMTS-13, an enzyme that cleaves vWF

3

What happens when there is a deficiency of ADAMTS-13?

vWF and plt clumps exhaust plt stores and cause microangiopathic hemolysis

4

What is the tx for TTP-HUS?

plasmapheresis

5

What is the most common cause of orbital cellulitis?

bacterial sinusitis

6

Bursts of atrial tachycardia followed by bradycardia on EKG is probably indicatve of what?

sick sinus syndrome (impaired AV node automaticity)

7

In a pt w/ CHF, at what Hb is a blood transfusion required?

<10 g/L

8

In a previously healthy pt, at what hemoglobin is a blood transfusion required?

<7 or 8 g/L

9

Why is plt transfusion contraindicated in TTP-HUS?

it can worsen nephro and neuro Sx

10

Why does TTP-HUS cause confusion?

microthrombi

11

How does plasmapheresis treat TTP-HUS?

removes Abs and replenishes ADAMTS-13

12

What is the most specific test for acromegaly?

oral glucose tolerance test

13

What is the result of an oral glucose tolerance test if the pt has acromegaly?

failurew to suppress growth hormone

14

What is the first-line of treatment for a GH secreting macroadenoma?

transsphenoidal surgery

15

What are the medical treatments for acromegaly?

somatostatin analogs (octreotide) or dopamine agonists ( cabergoline, bromocriptine)

16

What is the size limit for a pituitary microadenoma?

1 cm

17

Microcytic anemia w/ normal RBC count and distribution width (RDW) strongly suggests what Dx?

Thalassemia!

18

How is thalassemia confirmed?

Hb electrophoresis

19

What are the results of iron studies in thalassemia?

normal

20

Which type of bilirubin, conjugated or unconjugated, can be found in the urine?

conjugated

21

Which 2 syndromes resulting from hepatic enzyme deficiencies cause conjugated hyperbilirubinemia?

Rotor's and Dubin-Johnson

22

How can Rotor's syndrome be differentiated from Dubin-Johnson?

Rotor's causes elevated coproporphyrin

23

What 2 syndromes resulting from hepatic enzyme deficiencies cause UNconjugated hyperbilirubinemia?

Gilbert's and Crigler-Najjar