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BUZZ3 Flashcards

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1
Q

Pneumonia: CBC

A
  • Increased WBC (NV: 4500 -
    11000)
  • Increased Neutrophils (NV:
    2500 - 8000)
  • Decreased Lymphocytes (NV:
    1000 - 4800)
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2
Q

Gram +, lancet-shaped

A

Streptococcus pneumoniae

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3
Q

Antibiotic of choice for
pneumonia caused by
Streptococcus
pneumoniae

A

No co-morbid illness:
Amoxicillin (DOC)
Extended macrolides
(azithromycin, clarithromycin)

Stable co-morbid:
B- lactam/BLIC combination
2nd generation Cephalosporins
+/- extended macrolides

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4
Q

40/M with CC: DOB
(+) fever, dry cough for 5
days; PE: crackles at
both bases & right mid
lung fields
Expected PE findings

A
  • RR of 32/min
  • HR of 120/min
  • Apical S3 or 3rd heart sound
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5
Q

40/M with CC: DOB
(+) fever, dry cough for 5
days; PE: crackles at
both bases & right mid
lung field
Expected ABG findings

A
  • Oxygen saturation of 80%
  • pH of 7.45
  • Partial pressure of oxygen of
    55 mmHg
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6
Q

40/M with CC: DOB
(+) fever, dry cough for 5
days; PE: crackles at
both bases & right mid
lung field
PaO2/FiO2 ratio

A

150

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7
Q

Differential diagnoses
for 52/M, smoker,
hypertensive, diabetic
(+) severe, crushing
chest pains, cold sweats,
shortness of breath 1-hr
duration

A
  • Acute pulmonary embolism
  • Acute massive myocardial
    infarction
  • Acute aortic dissecting
    aneurysm
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8
Q

Possible ECG findings
for 52/M, smoker,
hypertensive, diabetic
(+) severe, crushing
chest pains, cold sweats,
shortness of breath 1-hr
duration

A
  • 3-4mm ST elevation in V1-V6
  • 3-4mm ST depression in V1-V6
  • Diffusely low QRS voltages
    with pathologic Q waves
  • T wave inversion in V1-V5, I,
    AVL, II,III, AVF
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9
Q

52/M, smoker,
hypertensive, diabetic
(+) severe, crushing
chest pains, cold sweats,
shortness of breath 1-hr
duration
Trop I = 0.40 ng/ml; BP:
80/60; HR: 120 bpm
Most appropriate
intervention

A

Percutaneous coronary
intervention

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10
Q

Case: HF in CKD?
Values expected in the
case

A
  • Hyperkalemia
  • Hypernatremia
  • Hypertriglyceridemia
  • Elevated HbA1c
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11
Q

Anti-diabetic drug to be
avoided if the estimated
GFR is
29/ml/min/1.73/m2

A

Metformin

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12
Q

Recommend renal
replacement therapy

A

GFR less than
15ml/min/1.73/m2

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13
Q

Diarrhea due to cholera

A

Secretory diarrhea

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14
Q

Ion lost most
significantly in cholera

A

Sodium

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15
Q

Intestinal fluid secreted
in cholera

A

Isotonic

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16
Q

Diarrhea associated
with bowel movement
of 6 or more per day

A

Secretory diarrhea

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17
Q

Diarrhea associated
with inhibition of
absorption in the gut

A

Osmotic diarrhea

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18
Q

Diarrhea caused by
ingestion of excessive
sugar or salt

A

Osmotic diarrhea

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19
Q

Elderly patient rushed to
ER presenting with sudden
on dyspnea and orthopnea
preceded by chest
discomfort
PE: apical S3, high-pitched
blowing systolic murmur,
bilateral crackles

A

Acute mitral regurgitation

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20
Q

Most likely cause of acute
mitral regurgitation in the
case above

A

Ischemic papillary muscle

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21
Q

Acute mitral
regurgitation
management

A
  • Diuretics
  • Beta-blockers
  • ACE inhibitors
  • Digitalis
  • Intravenous vasodilator
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22
Q

Serum amylase and
lipase in acute
pancreatitis

A
  • Lipase is more sensitive to
    pancreas and remains
    elevated longer
  • Serum lipase rises within 3-6
    hours from onset of
    pancreatitis
  • Have no role in assessing
    disease severity
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23
Q

Normal serum amylase
in acute or chronic
pancreatitis

A

Suppression of pancreatic
zymogens or proenzymes

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24
Q

Falsely elevated serum
amylase

A

Salivary gland disease
Bowel obstruction, infarction
Perforated ulcer

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25
Confirm the presence of a nodule and assess the status of thyroid gland
Thyroid ultrasound
26
Evaluate the physiologic function of thyroid nodules
* TSH assays: assessment of thyroid function * Antithyroid antibodies: determine etiology of thyroid dysfunction * Thyroid UTZ: diagnosis and evaluation of nodular thyroid disease * Calcitonin test: marker for medullary thyroid carcinoma * Fine needle aspiration: most accurate test for determining malignancy
27
Detection of metastases of thyroid cancer
Scintigraphy
28
51/F, lost to follow up with her endocrinologist Erratically taking Methimazole Presents with acute onset of restlessness and agitation, confusion, vomiting and diarrhea
Thyroid storm
29
Expected findings in thyroid storm
* Pyrexia * CNS alterations (agitation, delirium, psychosis, seizure, coma) * GI dysfunction (diarrhea, jaundice) * Tachycardia * CHF
30
Management for thyroid storm
* Stop production of thyroid hormone: PTU, methimazole, hydrocortisone * Block peripheral effect of thyroid hormone: propranolol * Inhibit hormone release: SSKI, sodium iodide
31
Most common extra articular manifestation of ankylosing spondylitis
Anterior uveitis (20-30%) Others: * Inflammatory bowel disease * Heart conduction disturbances * Aortic insufficiency * Psoriasis * Renal abnormalities * Osteoporosis * Vertebral fractures
32
Minimum size of kidney stone that can block ureter
8mm (Ureteral diameter is 5-8mm)
33
Anemia of inflammation usually associated with
Cancer-related anemia a.k.a. Anemia of chronic disease
34
Most common type of hallucination in psychotic patients
Auditory hallucinations
35
Specific treatment for dysuria caused by UTI
Phenazopyridine
36
Lymphocyte cells commonly associated in lymphocytic leukemia
B-cells
37
Most common cause of uncontrolled BP elevation in secondary hypertension
Renovascular stenosis
38
OSAHS is likely contributory to the following comorbidities
* Pericardial effusion, pulmonary hypertension, or right-sided heart failure * NAFLD * Refractory hypertension, systemic hypertension, coronary artery disease, cardiac arrhythmias, heart failure and stroke * Metabolic syndrome and Type 2 diabetes * Neuropsychiatric dysfunction
39
Minimum duration of productive cough in acute bronchitis
At least 3 months in each of 2 consecutive years
40
Rapid correction of hyponatremia may lead to
Osmotic demyelination syndrome (ODS), previously known as Central Pontine Myelinolysis (CPM)
41
Acute gouty arthritis
* Higher vitamin C intake is independently associated with a lower risk of gout. Supplemental vitamin C intake may be beneficial in the prevention of gout. * negatively birefringent needleshaped monosodium urate crystals in aspirated joint fluid * occurs commonly in beerdrinkers and meat eaters * blood uric acid levels may be normal during an attack
42
Viral or idiopathic pericarditis treatment
* Aspirin or Ibuprofen * Colchicine * Corticosteroids
43
Most predominant underlying cause of acne vulgaris
Genetic predisposition
44
95% of cells in the epidermis
Keratinocytes
45
Effective treatment in acute severe allergic reactions
* Epinephrine (adrenaline) – reduction of body’s allergic response * Oxygen – to aid in breathing * IV antihistamine and corticosteroids – reduction of inflammation of air passages and improvement of breathing * Beta-agonists – relief of breathing symptoms
46
Tried to retard progression of rheumatoid arthritis
Hydroxychloroquine
47
HIV / AIDS
Prolonged asymptomatic stage after initial infection Median time: ~ 10 years
48
Fast phase nystagmus Peripheral vestibular lesion
Cold water in the ear, which causes ipsilateral vestibular dysfunction, produces nystagmus to the opposite side (Mnemonic: “cows”)
49
Supportive treatment of acute dengue
* Maintaining hydration with oral or parenteral fluids * Paracetamol as antipyretic or analgesic * Platelet transfusion in more severe cases of thrombocytopenia * NSAIDs are contraindicated for management of pain and fever because of potential increase in bleeding risk
50
HbA1c goal for patients with Type 2 DM
<7.0%
51
Antibody in allergic reactions
IgE
52
Dengue vaccine indications
9 to 16 years old with laboratoryconfirmed previous dengue infection and living in endemic areas
53
Allergic reactions
Immunoglobulin binds to allergen and mast cells
54
Metabolic syndrome
Criteria: * Central obesity – Waist circumference >102cm (M) or >88cm (F) * TG ≥ 150 mg/dL or use of specific medication * HDL <40mg/dL (M) or <50mg/dL or use of specific medication * BP ≥130 systolic or ≥85 diastolic or use of specific medication * ≥100 mg/dL or use of specific medication or previously diagnosed T2DM
55
Most common primary cancer that cause brain metastasis
Lung cancer
56
Prevention of oral thrush in patients on inhaled steroids
Rinse mouth with water immediately after using inhaler
57
Most common offending organisms in infective endocarditis
Streptococci and Staphylococci
58
Sjögren syndrome
Dry skin, mouth, eyes, nose Confirmed by tissue biopsy Avoid antihistamines like diphenhydramine
59
Long term inhaled steroids increase risk for
Pneumonia
60
Most common cause of UTI
E. coli
61
Primary antibiotics for UTI
Nitrofurantoin and Fosfomycin
62
Nerve associated with sinus arrhythmia
Vagus nerve
63
Drug associated with development of renal cell carcinoma
Aspirin, Ibuprofen, Paracetamol
64
Smoking increases risk for kidney cancer by how much
2 times the risk
65
Bruising in flanks of hemorrhagic pancreatitis
Grey-Turner sign
66
Scleroderma
* woman with thickened skin, tight fingers “sclerodactyly * Raynaud’s phenomenon or digital pitting scars – dark shiny skin on distal phalanges of both arms * Associated with sclerodactyly * Associated with Vitamin D deficiency

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