03 APR 2017 1256 MIX Flashcards

1
Q

Painless hematuria in sickle cell disease is due to what type of renal pathology?

A

Renal papillary ischemia or necrosis

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2
Q

What are the renal complications of sickle cell disease?

A
  • Renal papillary ischemia or necrosis
  • Inability to concentrate the urine (vasa recta damage with inability to maintain concentrated medullary gradient)
  • Distal renal tubular acidosis (tubular damage with impaired proton secretion)
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3
Q

What is the treatment for invasive pulmonary aspergillosis?

A
  • 1-2 weeks IV voriconazole plus an echinocandin (caspofungin)
  • Followed by prolonged therapy with voriconazole alone
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4
Q

What is the gold standard test for diagnosing DM2 in patients with PCOS? Why?

A
  • Oral glucose tolerance test

- More sensitive in detecting glucose intolerance than standard screening tests (fasting glucose, HbA1C)

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5
Q

Why is creatinine clearance not used as a screening tool for diabetic nephropathy?

A

Creatinine clearance is high early in kidney disease due to glomerular hyperfiltration, and low later on

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6
Q

Why is dipstick testing not indicated as screening for protein in diabetic nephropathy?

A

Can only detect macroproteinuria (over 300 mg/24hr)

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7
Q

What is the medication profile for severe asthma exacerbation?

A
  • SABAs
  • Ipratropium nebulizer
  • Systemic corticosteroids
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8
Q

Adding ________________ to SABAs may cause greater bronchodilation than either agent alone and is recommended during emergency care of severe asthma exacerbations

A

Ipratropium

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9
Q

After an hour of severe asthma exacerbation following SABAs, ipratropium, and systemic corticosteroid therapy, what medication can be used?

A

Magnesium sulfate, one time infusion

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10
Q

Urinary retention caused by anticholinergic agents results from impairment of:

A

Detrusor muscle contraction, and to a lesser extent internal sphincter contraction

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11
Q

In adjustment disorder, symptoms must present within ____ months of an identifiable stressor and last no more than ____ months after the stressor ends

A

3, 6

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12
Q

What is the treatment for acute dystonia?

A

Benztropine or diphenhydramine

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13
Q

What is the treatment for akathisia?

A

BB (propanolol) or benzodiazepine (lorazepam)

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14
Q

What is the treatment for parkinsonism (drug-induced)?

A

Benztropine or amantadine

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15
Q

The most common site of metastatic spread of a choriocarcinoma is the:

A

Lungs

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16
Q

Head sparing growth lag suggests fetal growth restriction that occurred during what trimester(s)?

A

2nd or 3rd

17
Q

The most common cause of vaginal bleeding and discharge in the neonatal period is:

A

Maternal withdrawal of estrogen

18
Q

What is the first line imaging study in a woman over 30 with a palpable breast mass? What about women under 30?

A
  • Over 30: mammography

- Under 30: US

19
Q

Definition: lochia

A

Vaginal discharge containing blood and mucous – normal up to 6-8 weeks postpartum

20
Q

Most patients who fall ill with vibrio vulnificus infection have underlying ______________ and show manifestations of:

A
  • Liver disease (hemachromatosis most common)

- Necrotizing fasciitis with hemorrhagic bullous lesions, septic shock

21
Q

What are the unfavorable metabolic side effects of thiazide diuretics? What are the electrolyte abnormalities?

A

Metabolic:

  • Hyperglycemia
  • Increased LDL and plasma trigs
  • Hyperuricemia

Electrolyte:

  • Hyponatremia
  • Hypokalemia
  • Hypomagnesemia
  • Hypercalcemia
22
Q

Osteomalacia can be a consequence of what type of renal tubular acidosis?

A

Type 2 (proximal)

23
Q

Maternal serum AFP is used primarily to screen for:

A
  • Open neural tube defects
  • Fetal abdominal wall defects
  • Multiple gestations
24
Q

How can tay sachs and nieman pick disease be distinguished?

A
  • Tay sachs: hyperreflexia

- Nieman pick: areflexia