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Flashcards in 5/5 Deck (84)
1

What is treatment response defined as

When a patient demonstrates significant improvement (with or without a remission) generally 50% better

2

What fluids correct alkalosis

Volume resuscitation with normal saline

3

Who is most likely to get acute bacterial parotitis? most common bug?

Dehydrated post op patients and the elderly
Most common bug is S. aureus

4

Hyperestrogenism in cirrhosis causes

Gynecomastia
Spider angiomas
Palmar erythema
Testicular atrophy

5

What differentiates delirium from other psychotic illnesses

Fluctuating levels of consciousness
Acuity of onset
Association w/ underlying medical illness and/or offending mechanisms

6

Post-partum blues timing

2-3 days (resolves within 10 days)

7

When to give bethmethason to pregnant ladies w/ PPROM

When

8

Fanconi's anemia dx made by? tx?

Made by chromosomal breaks on genetic analysis combined with clinical findings
Tx: hematopoietic stem cell transplant

9

Anemia in Fanconi's

Usually microcytic (w/ congenital marrow failure)

10

Imaging for DDH

11

Big complication with bronchiectasis

Hemoptysis

12

13 vs 23 pneumo vaccine immune response

13- polysaccharides conj to protein --> T cell dependent B cell response
23- capsular polysaccharide--> T cell independent B cell response

13

Who gets PCV13

All infant and young children

14

Who gets PPSV23

Adults

15

PBC ass w/

Ant-Mitochondrial Ab
Sever hyperlipidemia
Metabolic bone disease

16

What causes referring syndrome? clinical manifestations?

Carb intake stimulates insulin activity, promoting cellular uptake of PO4*, K, and Mg
-Arrhythmias and cardiopulmonary failure

17

Drug-induced interstitial nephritis features

Fever, rash, and arthralgia
*sterile pyuria w/ eosinophils*

18

How long for PSGN

10-20 days after strep throat or skin infections

19

What is salvage therapy

Treatment for a disease when standard therapy fails

20

Why follow giant cell arteritis patients with serial chest X-rays

Aortic aneurysms are a well known complication

21

EM usually occurs after?

Herpes simplex lesion

22

SJS by sudden onset of

Mucocutaneous lesions and systemic signs of toxicity

23

Common features of psoriatic arthritis

Morning stiffness
Sausage fingers
Nail involvement

24

Ataxia hemiparesis from stroke where

Pons

25

What is needed differentiate follicular thyroid adenoma from carcinoma

Carcinoma will show invasion of the capsule and blood vessels

26

Lyme tx

Doxy (unless pregnant or under 8 years old)

27

Best initial test for esophageal squamous cell carcinoma

Pandendoscopy (esophagoscope, bronchoscopy, and laryngoscopy)

28

Renal vein thrombosis most commonly seen with what nephropathy? why

Membranous
Loss of antithrombin III

29

Renal vein thrombosis presentation

Acute abdominal pain, fever, and hematuria
Or progressive with gradual renal worsening and proteinuria

30

What causes orthostatic hypotension in elderly

Progressively decreasing baroreceptor sensitivity and defects in myocardial response

31

Greatest risk in completing homicide

Access to firearms

32

Most appropriate test to identify intrauterine fetal demise

Real time US to demonstrate an absence of fetal movements and cardiac activity

33

When should be done in all cases of stillbirth

Autopsy of the fetus and placenta (with permission from the parents)

34

Can pregnant women get Hep A and B vaccines

A resounding yes!

35

Most common cause of decreased fertility in women in their 30s+ who still have periods

Age-related decrease in ovarian reserve

36

Breast milk vs feeding failure jaundice timing

Failure: First week of life
BMJ: starts at 3-5 days, peaks at 2 weeks

37

Cause of breastfeeding failure jaundice

1. Decreased bilirubin elimination
2. Increased enterohepatic circulation
*signs of DEHYDRATION*

38

Cause of breast milk jaundice

High levels of B-glucuronidase in beast milk deconjugate intestinal bill and increase enterohepatic circulation

39

What should be suspected in any patient with pancytopenia following drug, toxin, or viral exposure

Aplastic anemia

40

TTN CXR

Bilateral perihilar linear streaking

41

Persistent pulmonary HTN of newborn CXR

Clear lungs with decreased pulmonary vasulcairty

42

TTN pathophys

Inadequate alveolar fluid clearance at birth resulting in mild pulmonary edema

43

Factitious diarrhea colon biopsy

Dark brown discoloration w/ lymph follicles singing through as pale patches (melanosis coli)

44

1st line therapy for patients w/ HTN and renal artery stenosis

ACEi or ARBs

45

Lab test good for dx of gallstone pancreatitis

ALT > 150

46

Why dec in BUN and Cr in pregnant patients

Inc. in renal plasma flow and GFR

47

In setting of liver disease, what two labs suggests ALF

1. Worsening PT/INR
2. Inc bilirubin

48

What causes acute mitral regurg in inferior MI

Papillae muscle displacement

49

Acute mitral regurg heart changes

Elevated L atrial an ventricular filling pressures
Acute pulmonary edema
*chronic would change atrial/ventricle size and compliance*

50

How dose insulin resistance cause NASh

Inc. lipolysis, TG synthesis, and hepatic uptake of FA
--> Hepatic FA increase oxidative stress and production or pro-inflammatory cytokines

51

What do factorial design studies do

Involve randomization of different interventions with additional study of 2 or more variables

52

What is a cross over study

One group treated and other alternate treatment, then they switch

53

What is a "rare disease assumption"

In case-control studies, if outcome is uncommon in the population, odds ratio is a close approximation to the Relative Risk (which can normally only be calculated from cohort study)

54

RR calculation in cohort study

Compare risk (incidence) of disease among exposed to unexposed
*can't calculate RR in case control study*

55

Relative risk vs OR

RR --> Cohort study
OR --> Case control study

56

Demeocyline used for treating

SIADH --> inhibits ADH-mediated aquaporin insertion in the cortical collecting tubule

57

3 ways to dx lactose intolerance

1. + hydrogen breath test
2. + stool test for reducing substances
3. Low stool pH and increased stool osmotic gap

58

Post-op endothalmitis presentation

Pain and decreased visual acuity
Ex: Swollen eyelids and conjunctiva, hypopyon, corneal edema and infection

59

A-fib EKG features

Irregularly irregular R-R interval
Absent P waves
Narrow QRS complexes

60

Aspergillus serology test

Aspergillus IgG

61

Drug for stable patients with torsades

IV magnesium

62

First step in evaluating post op oliguria

Rule out obstruction

63

2 reasons for low back pain in pregnancy

-Increases in lumbar lordosis
-Relaxation of the ligaments supporting the joints of the pelvic girdle

64

Simple breast cysts management

Needle aspiration (if patient desires)

65

If breast mass in women under 30 is complex cysts/solid looking, next step?

Image-guided core biopsy

66

Mgmt of asymptomatic women with pelvic masses

Transvaginal US and then CA-125 level

67

2 drugs that increase appetite in chronic cancer patients

Progesterone analogues and corticosteroids

68

Splenectomy patients bad w/ encapsulated bugs do to

Impaired antibody mediated opsonization in phagocytosis

69

Congenital rubella triad

1. Sensorineural deafness
2. Cardiac defects (PDA)
3. Cataracts

70

2 Turners heart defects

Bicuspid aortic valve
Coarctation
*Also aortic root dilation*

71

Reactive arthritis tx

NSAIDs

72

Calcium phosphate stones common in

Primary hyper PTh
RTA

73

What is Neurogenic arthropathy

Complication of neuropathy and repeated joint trauma affects weight bearing joints w/ deformity and loose bodies on imaging

74

Big 4 of carbon monoxide poisoning

Polycythemia
Nausea
Dizziness
Headaches

75

Grip myotonia seen in

Myotonic muscular dystrophy

76

Pos PPD tx in HIV pt's

Isoniazid (and pyridoxine) for 9 months

77

Angina like episodes at likely? tx? avoid?

Prinzmentals
CCB and/or nitrates
Avoid non-selective B-blockers and aspirin

78

Most effective way to prevent systemic embolization in patients with non-valvular a-fib

Antithrombotic therapy

79

How does wilsons hurt liver

Hepatolenticular degneration

80

What causes familial hypocalciruic hypercalcemia

Abnormal calcium-sensing receptors on PTH and renal tubules --> Hypercalcemia and borderline high PTH

81

Chronic bronchitis def

Chronic productive cough for 3 month in 2 successive years

82

Phenytoin impairs absorption of what? other drugs do what to this?

Folic acid
MTX and TMP-SMX antagonize its physiologic effects

83

What can you take from drug reps

Only non-monetary gifts that are of minimal value and directly beneficial to patients

84

Pertussis tx

Macrolide antibiotics