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51-112 Flashcards

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1
Q

What kind of disease cause linear glomerular deposits versus granular deposits

A

Linear deposits are seen in Goodpasture’s disease, whereas granular deposits are seen in complex diseases (SLE, PSGN)

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2
Q

What kind of disease cause linear glomerular deposits versus granular deposits

A

Linear deposits are seen in Goodpasture’s disease, whereas granular deposits are seen in complex diseases (SLE, PSGN)

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3
Q

How do you treat hypercalcemia?

A

*If mild (Ca 14, or Ca between 12-14 with symptoms, give normal saline as well as possibly calcitonin and bisphosphanate for long-term management

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4
Q

Describe the phases of psychiatric illness

A

Response: Significant improvement (>50%) in symptoms after intervention
Remission: Minimal symptoms after intervention
Relapse: Return of symptoms
Recovery: Minimal symptoms, only maintenance therapy

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5
Q

Are vaccines given by gestational or chronologic age?

A

Chronological age

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6
Q

What are criteria for a positive PPD?

A

> 5 mm if HIV positive, immunosuppressed, have signs of TB on CXR, or have known recent contact with TB-infected individual
10 mm if from endemic region, IVDU, high risk setting, diabetes/hematologic malignancy/CKD/fibrotic lung disease, child 15 mm in everyone else

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7
Q

Describe factorial study design

A

Many different independent variables are studied simultaneously

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8
Q

What is the first step in pulseless electrical activity?

A

Do CPR - no defibrillation!!

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9
Q

Contrast radiation pneumonitis from secondary malignancy by clinical presentation as well as CXR findings

A

Pneumonitis: Dyspnea manifesting 4-24 months s/p XRT, diffuse process on CXR
Secondary malignancy: Presents within years (up to 20), nodule on CXR

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10
Q

What is the first step in managing PPROM?

A

Determine GBS status, if unknown, give prophylactic penicillin.

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11
Q

What is the dreaded complication of compartment syndrome

A

Volkmann’s ischemic contracture (dead muscle is replaced by fibrotic tissue)

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12
Q

What is a likely cause of a positive anti-D antibody screen in a patient who has received RhoGam during prior pregnancy?

A

Failure to correct postpartum dose for intrapartum hemorrhagic event

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13
Q

Contrast the lens subluxation in Marfan’s and Homocystinuria

A

Upward in Marfan’s, downward in Homocystinuria

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14
Q

What laboratory values are associated with hypercalcemia of malignancy?

A

Very high calcium (>14), low PTH, normal vitamin D

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15
Q

How do you treat hypercalcemia?

A

*If mild (Ca 14, or Ca between 12-14 with symptoms, give normal saline as well as possibly calcitonin and bisphosphanate for long-term management

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1
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16
Q

Describe the phases of psychiatric illness

A

Response: Significant improvement (>50%) in symptoms after intervention
Remission: Minimal symptoms after intervention
Relapse: Return of symptoms
Recovery: Minimal symptoms, only maintenance therapy

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17
Q

How do you treat inactive TB vs Active TB?

A

Inactive: INH and B6 for 9 months
Active: 3+ drugs for 6 months

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18
Q

What are criteria for a positive PPD?

A

> 5 mm if HIV positive, immunosuppressed, have signs of TB on CXR, or have known recent contact with TB-infected individual
10 mm if from endemic region, IVDU, high risk setting, diabetes/hematologic malignancy/CKD/fibrotic lung disease, child 15 mm in everyone else

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19
Q

Describe factorial study design

A

Many different independent variables are studied simultaneously

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20
Q

What is the first step in pulseless electrical activity?

A

Do CPR - no defibrillation!!

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21
Q

Contrast radiation pneumonitis from secondary malignancy by clinical presentation as well as CXR findings

A

Pneumonitis: Dyspnea manifesting 4-24 months s/p XRT, diffuse process on CXR
Secondary malignancy: Presents within years (up to 20), nodule on CXR

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1
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22
Q

What is the first step in managing PPROM?

A

Determine GBS status, if unknown, give prophylactic penicillin.

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23
Q

What is the dreaded complication of compartment syndrome

A

Volkmann’s ischemic contracture (dead muscle is replaced by fibrotic tissue)

How well did you know this?
1
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2
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4
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24
Q

What is a likely cause of a positive anti-D antibody screen in a patient who has received RhoGam during prior pregnancy?

A

Failure to correct postpartum dose for intrapartum hemorrhagic event

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25
Contrast the lens subluxation in Marfan's and Homocystinuria
Upward in Marfan's, downward in Homocystinuria
26
How does trichinellosis present? How is it distinguished from endocarditis?
Trichinellosis presents with GI complaints followed by eosinophilia, periorbital edema, and myositis. While trichinella and IE both have subungual splinter hemorrhages as well as retinal hemorrhages, IE lacks the prior presentation.
27
How do you compute PAO2 from an ABG?
FIO2(Patm-PH2O) - PCO2 / 0.8
28
Parkinson's med most associated with anticholinergic toxicity?
Trihexyphenidyl
29
How do you treat inactive TB vs Active TB?
Inactive: INH and B6 for 9 months Active: 3+ drugs for 6 months
30
What is the presentation and management of an RV infarct?
Presentation: Hypotension, clear lung fields, and JVD after an inferior MI Treatment: Fluids, avoid nitrates
31
What lab values are suggestive of factitious thyroid ingestion?
Elevated T3/T4, low TSH, low RAIU (pattern also seen with iodide, extraglandular production, and thyroiditis), as well as low thyroglobulin (not seen with the above)
32
How is SIADH treated?
First line is fluid restriction. If symptomatic or severe, can give hypertonic saline.
33
Do you discontinue an OCP in a patient who is hypertensive, or do you treat the hypertension?
Discontinue the OCP first and that usually corrects the HTN
34
If a fetus has decreased fetal movement, how do you manage?
NST. If NST reactive, repeat in 1 week. If nonreactive, do BPP. If BPP 4 or less, deliver. If BPP 6 or less with oligohydramnios, deliver if >32 weeks. If 6 or less without oligo, deliver if >37 weeks.
35
Distinguish anserine bursitis from patellofemoral syndrome in terms of presentation
Anserine bursitis: sharply localized pain over anteromedial part of knee, worse at night Patellofemoral syndrome: Peripatellar pain worsened by prolonged sitting or activity
36
What distinguishes carcinoid syndrome from generic other causes of diarrhea? What vitamin deficiency are these people at risk for?
Flushing and valvular heart disease are present in carcinoid syndrome... At risk for niacin deficiency.
37
How does prednisone-induced avascular necrosis of the hip present?
Progressive hip pain without change in range of motion as well as normal radiographs.
38
What drugs are contraindicated in A-tach secondary to WPW?
Digoxin, verapamil, beta blockers and adenosine, as all of these slow down the AV node. Treat with procainamide.
39
What antiplatelet must be given in patients with TIAs as well as acute strokes?
Aspirin. Aggrenox if recurrent stroke.
40
How to distinguish PSGN from IE in patient with hematuria?
While both can cause proteinuira and hematuria, PSGN is preceded by an illness has no arthritis or fingertip involvement
41
How do you distinguish carcinoid syndrome from glucagonoma?
While both can have diarrhea and weight loss, carcinoid syndrome patients have prominent flushing, whereas glucagonoma patients have necrolytic migratory erythema
42
Most common thyroid nodule?
Benign colloid nodule
43
What TLS treatment is effective at preventing gout?
Allopurinol; IVF are useful to prevent kidney damage
44
How is SIADH treated?
First line is fluid restriction. If symptomatic or severe, can give hypertonic saline.
45
How is pertussis diagnosed?
If 4 weeks: Serology
46
What does the direct Coombs' test look like in hereditary spherocytosis?
Negative
47
How does Ehrlichiosis present and how is it treated?
Ehrlichiosis can present with leukopenia, thrombocytopenia, and a worsening transaminitis. It is treated empirically with doxycycline before confirming the diagnosis
48
What kind of syncope is most likely when an older male passes out while using the bathroom?
Situational syncope
49
Most common cause of death in acromegaly?
CHF
50
What do you need to use for empiric antibiotics in treating immunocompromised patients with meningitis?
In addition to ceftriaxone and vancomycin, you need to cover Listeria with ampicillin
51
Which is useful for comparing 2 different means: two-sample t test or two-sample z test?
Two sample t test
52
What do you do for a patient with chronic HCV and normal liver enzymes?
Do not treat or biopsy
53
How does leukocyte adhesion deficiency present?
Recurrent bacterial infections, leukocytosis (similar to steroid use, due to demarginalization) and a failure for the umbilical cord to separate at birth.
54
What causes wedge-shaped opacities on CT?
PE (pulmonary infarctions secondary to them)
55
What is the difference between projection and displacement?
``` Projection = attributing your own unacceptable thoughts on others Displacement = acting out against a third party when you're actually angry against someone else ```
56
What valvular abnormality is associated with an opening snap?
Mitral stenosis
57
Contrast the presentations of echinococcosis and trichinellosis
Echinococcosis increases your risk of hydatid cysts which are typically in the liver. Trich manifests as neurocysticercosis
58
How do diabetic foot ulcers cause osteomyelitis
By direct inoculation: poorly perfused tissue causes ulcer soft tissue to more easily invade into the neighboring bone
59
Does HCV or HBV more commonly produce waxing and waning transaminase levels?
HCV
60
What kind of syncope is most likely when an older male passes out while using the bathroom?
Situational syncope
61
What kind of CXR pattern does disseminated histoplasmosis cause?
Miliary
62
What is the diagnosis for a woman who has tenseness with penetration?
Genitopelvic pain/penetration disorder

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