Deck 1 Flashcards
(142 cards)
1
Q
what labratory abnormality is seen in antiphospholipid syndrome
A
prolonged PTT
2
Q
signs of antiphospholipid syndrome
A
recurrent fetal loss, recurrent thromboembolism
3
Q
what si the mechanism of acetazolamide
A
this increases urinary excretion of bicarb by inhibiting carbonic anhydrase which combines H and HCO3, meaning more bicarb is excreted
4
Q
effect of altitude on acid base status
A
you develop a respiratory alkalosis because you increase your respiratory drive which blows off CO2
5
Q
HSV encephalitis signs
A
cognitive/personality changes, focal neurologic deficits, and/or seizures due to temporal lobe involvement (often seen on brain imaging).
6
Q
typical manifestations of CMV in HIV patients
A
typically a retinitis
7
Q
manifestations of JC virus in HIV patients
A
PML- focal neuro signs, and cognitive changes
8
Q
manifestations of toxo in hiv patients
A
focal neuro deficits, seen on imaging
9
Q
lab abnormalities in acute tubular necrosis
A
high urine sodium, normal BUN:Cr, often casts
10
Q
what type of AKI is ATN
A
intrarenal
11
Q
what will be seen on UA/BMP of a patient with multiple myeloma
A
bence-jones proteins, elevated urinary calcium, elevated Cr, elevated Ca
12
Q
what the common cause of dilutional hyponatremia
A
primary polydipsia
13
Q
clinical features of chronic mesenteric ischemia
A
postprandial pain, weightloss, nausea/diarrhea, food aversion
14
Q
what is associated with MEN1
A
pituitary (adenomas), Parathyroid (adenomas or hyperplasia), pancreas (VIPoma, glucagonoma, somatostatinoma, insulinoma, gastrinoma)
15
Q
signs of babesiosis
A
flu like sx to severe DIC, ARDS, CHF, splenic rupture
16
Q
what transmits babesia and region
A
ixodes tick, northeast
17
Q
what is associated with better outcomes in SCA outside a hospital
A
faster time to rhythm analysis and defibrillaiton
18
Q
machism of pharmacologic stress test
A
typically its adenosine used and this increases blood flow to all the coronary vessels by causing dilation which then shows varying flow of the contrast because obstructed vessels dont dilate as much
19
Q
manfestations of refeeding syndrome
A
muscle weakness, hyporeflexia, rhabdomyolysis, hemolysis, arrhythmias, and congestive heart failure
20
Q
labratory findings of refeeding syndrome
A
hypophosphatemia
21
Q
whats in the TTP pentad
A
low platelets, neuro changes, signs of hemolytic anemia, renal insufficiency, +/- fever
22
Q
what deficiency can be seen in carcinoid syndrome
A
niacin
23
Q
what are the clinical features of carcinoid syndrome
A
flushing, valvular heart disease, diarrhea, cramping, telangectasias, bronchospasm,
24
Q
which antibiotic can cause phototoxicity
A
doxy
25
signs of CMV infection
fever, fatigue, malaise, lymphocytosis (atyptical lymphocytes), elevated LFTs
26
initial lab testing for non sustained SVT
bmp to check electrolytes
27
effects of a bicuspid aortic valve
these can cause aortic stenosis and aortic regurg
28
where do you hear aortic regurg
you hear it on the left sternal border
29
what type of murmur is aortic regurg
early diastolic decrescendo
30
what is cardiac index
cardiac index is the measure of cardiac output to BSA
31
what is the cardiac index and PCWP in obstructive shock
low cardiac index because heart cannot pump out, and low PCWP because the heart is not getting filled (nothing in LA)
32
what is the cardiac index and PCWP in cardiogenic shock
low cardiac index because heart is not pumping well but high PCWP because it is filling and filling just cant pump
33
what shape are calcium pyrophosphate crystals
rhomboid shaped
34
what causes CPP crystal deposition
this is pseudogout and can be bc of elevated Ca, due to hyperparathyroidism, hypothyroidism, or hemachromatosis
35
what is the hamman sign and what is it associated with
crunching sound on auscultation of chest and this is associated with esophageal perf or pneumothorax
36
where is adenoCA in the lung
peripherally located
37
does gonorrhea cause ulcers
NO
38
what two things cause painful penile lesions
H ducryi and HSV
39
common complication due to nephrotic syndrome
renal vein thrombosis due to loss of anti-clotting proteins (ATIII etc)
40
what drugs to people need to be on post MI
aspirin, clopidegrel (P2Y12 blocker), beta blocker, ACE, statin, mineralicorticoid antagonist
41
treatment of 1st degree AV block
observation
42
treatment of 2nd degree type 1 mobitz AV block
observation
43
treatment of 2nd degree AV block Mobitz Type II
PPM
44
treatment of 3rd degree AV block
PPM
45
what is 1st degree AV block
this is just prolonged PR, so you have about 1 block between the P and QRS
46
differentiate between type one and type two 2nd degree block
type 1 is constant lengthening of the PR and then dropped QRS and type 2 is when you drop the QRS randomly
47
size of LA in acute mitral regurgitation
normal because this is an acute process so no remodeling has occured yet
48
LV end diastolic pressure in acute MR
there is increased EDV because blood flows from the ventricle to the atrium causing increased atrial pressure, then when diastole occurs, the increased LA pressure causes rapid and increased filling of the LV causing increased end diastolic volume
49
signs of decompression sickness
mottling of the extremities, rapid onset confusion, respiratory distress, stroke, dysarthria, etc
50
etiology of decompression sickness
formation of nitrogen gas bubbles that can get trapped and causes weakness, strokes, etc.
51
which endocarditis etiology is associated with colon CA
strep bovis/gallacticus
52
hallmark labs of ischemic liver disease
rapid elevation in liver enzymes can exceed >10,000
53
first line therapy for renal artery stenosis
ace inhibitor because RAS creates excess RAAS activation so you need to turn it down by
54
pathophysiology of raynauds phenomenon
cold- or stress-induced hyperreactivity of the digital arterial smooth muscle, leading to episodic vasospasm
55
what is dx of PAD
ABI <.9
56
what area of the lungs get destroyed in alpha-1-antitrypsin deficiency
the lower lobes
57
vision changes associated with idiopathic intracranial hypertension
vision loss, diplopia due to abducens nerve palsy
58
signs pointing to multiple myeloma
constitutional symptoms, hypercalcemia, constipation, renal insufficiency, bone pain, fractures
59
what is the carotid pulse like in severe aortic stenosis
weak and slow rising
60
signs of theophylline toxicity
tremors, nausea, vomiting, tachyarrythmia, hypotension
61
what does theophylline do
this is a nonspecific phosphodiesterase inhibitor
62
what is lemierre syndrome
oropharnygeal infection that turns to a severe infection and causes internal jugular venous thrombosis, pulmonary nodules, and worsening respiratory distress
63
what is the bug that causes lemierre syndrome
fusibacterium necrophorum
64
what organs is it normal for FDG to pool in in patients underoing a PET scan
brain, kidneys, ureters, bladder etc.
65
what increases risk of MALT gastric cancer
h pylori
66
treatment of DVT
initiate anti Xa (1st choice) or warfarin, dont necessarily need to give heparin, only for hemodynamically unstable patients.
67
what value is high in hereditary spherocytosis
MCHC is increased
68
acute onset onset of palpitations, HTN and fever agitation following CT w/contras
thyroid storm from the excess iodine that causes increased release of the thyroid homrone
69
treatment of hyperkalemia with T waves on ECG
calcium gluconate and insulin/glucose
70
rare side effect of nitrofurantoin (lungs)
acute lung injury- dyspnea fever, bilateral opacities 6-9 days after initiating therpay
71
clinical signs of rhabdomyolysis
muscle weakness, dark urine, decreased urine output, elevated creatinine, and
72
Urinalysis of rhabdo
blood on urinalysis without a significant number of red blood cells (RBCs) on urine microscopy
73
common variable immunodeficiency signs
recurrent respiratory infections, recurrent GI infections, chronic diseases, onset 20-40yo
74
causes of recurrent pneumonia in the same anotomic location
foreign body, malignancy, dysphagia
75
treatment of delierium in an agitated elderly patient
haloperidol
76
what is the phlebitis assiciated with pancreatic cancer
migratory thrombophlebitis
77
dx of polymyositis
EMG
and elevated CK, muscle bx
78
extrarenal manifestations of PCKD in adults
liver cysts, cerebral berry aneurysms, hypertension
79
what is the difference between painless thyroiditis and subacute thyroiditis
both will cause decreased iodine uptake but with painless thyroiditis you have no pain on palpation and in subacute you do have pain
80
what changes do you see on EKG with hyper/hypokalemia
hypo- you see flat T waves, hyper - you see peaked T waves
81
skin manifestations of blasto
wart-like lesions, violaceous nodules, skin ulcers
82
where is blasto vs. histo
blasto extends up in to the midwest more than histo
83
what is the pathophysiology of hepatorenal syndrome
this is where you have splanchnic dilation which causes decreased renal perfusion which then causes activation of RAAS which then causes massive renal vasoconstriction which causes AKI
84
features of pemphigus vulgaris
painful flaccid bullae that erupt on skin and mucosa
85
mucosal involvement in pemphigus vulgaris vs. bullous pemphigoid
PV has mucosa BP no mucosa
86
age of onset for pemphigus vulgaris vs. bullous pemphigoid
PV 40-60yo, BP 60+
87
who has negative CXR but will still likely have pneumonia given the right clinical picture
pts on immunosuppressants (steroids rejection meds etc) because they cant mount an immune response to create an infiltration to be seen on CXR
88
treatment for acute bronchitis
supportive unless they have wheezing then you can do a bronchodilator
89
what systems are involved in granulomatosis with polyangiitis
respiratory, renal, skin
90
dx of vertigo after viral illness
vestibular neuritis- abnormal head thrust test and vertigo
91
treatment of TTP
plasma exchange, steroids, then immunosuppressant
92
initial workup of syncope
ambulatory ECG
93
where do you hear aortic regurg
left sternal border
94
what is a common complication of people with aortic valve endocardiits if it gets bad
perivalvular abcess
95
what is shown on radionucleotide myocardial imaging
these are the coronary arteries that you can see
96
what does it mean if there is less flow after exercise in a radionuleotide myocardial scan
this means there is an obstruction in the coronary arteries which needs to be treated with statin and antiplatelet therapy
97
what age group gets hemangiomas
mostly infants
98
who gets kaposi sarcoma
people on immunosuppresants, HIV, organ transplant,
99
what is the main source of thrombus for PEs
the femoral or popliteal veins
100
where do most foci for atrial fibrillation occur
in the pulmonary vein ostia
101
first step after dx of cirrhosis due to alcohol
upper GI endoscopy
102
prophylaxis of non bleeding esophageal varices
non selective beta blocker like nadolol
103
lab abnormalities in tumor lysis syndrome
hyperphosphatemia, hyperuricemia, hypocalcemia (due to Ca-P preciptation), hyperkalemia
104
when do you administer hypertonic saline for hyponatremia
<120meq
105
treatment of SIADH
fluid restriction and salt tablets
106
what valves are typically effected for rheumatic heart disease
aortic or mitral regurg or stenosis
107
what is hypertrophic osteoarthopathy
this is bilateral enlaragment of wrists and ankles with digital clubbing and is typically associated with pulmonary etiology like adenoCA or CF etc.
108
what drugs need to be held in AKI
metformin, ace/arb etc.
109
clinical course of hyperthyroidism after radioactive iodine treatment
takes about 6 weeks for hyperthyroidism to resolve, and then >90% of patients develop hypothyroidism
110
what test do you need to do dx spontaneous bacterial peritonitis
cell count with diff of the peritonitic fluid
111
what is the sodium level like in diabetes insipidus
it is high because water is not being retained
112
what is sodium level like in primary polydipsia
it is low because the patient is just taking in a bunch of water
113
what would the EKG show of a patient with viral myocarditis
non specifc ST segment changes
114
alternate treatment of syphillis if pt cannot do penicililn
doxy
115
acute management of acute coronary syndrome
nitrates (if chest pain), beta blocker, antiplatelet therapy, anticoagulation, statin therapy, coronary reperfusion
116
extrahepatic manifestations of wilsons
parkinsonism, gait disturbances, depression, psychosis, etc.
117
management of HHS
aggressive rehydration with normal saline and then IV insulin
118
clinical signs of bronchietasis
chronic daily production of thick occosionally blood tinged mucus
119
what area of lymphadenopathy is indicative of secondary syph
epitrochlear (above elbow)
120
what infection can you get from cave exploring
histoplasma
121
what is light's criteria for pleural effusion
pleural: serum protein ratio >0.5 OR pleural:serum lactate ratio >0.6 OR greater than 2/3 upper limit normal of serum lactate pleural lactate
122
what is becks triad for cardiac tampanode
distended neck veins, muffled heart sounds, hypotension
123
hypothyroidism effect on LH and FSH levels
this causes increased prolactin because there is increased TRH which increases both TSH and prolactin and prolactin suppresses LH and FSH
124
hallmarks of amyloidosis due to dialysis
carpal tunnel, bone cysts, shoulder pain and hypertrophy
125
what is broken heart syndrome
this is stress induced cardiomyopathy which is where you get a surge of catecholamines which causes chest pain like an MI
126
EKG changes in broken heart syndrome
can show ischemic changes like t wave inversions or ST changes
127
CT scan of acute aspergillosis
nodules with surrounding ground-glass opacities ("halo sign"
128
leukemoid vs. CML LAP score
LAP is decreased in CML vs. leukemoid reaction
129
metamyelocytes in CML vs. leukemoid
in CML there are more immature cells which are the metamyelocytes and in leukemoid there are more myelocytes which are mature
130
what type of nephritis do patients with RA get
amlyloid nephritis (nephrotic)
131
are deep or superficial infections for diabetic foot ulcers poly or monomicrobial
superficial are mono and deep are poly
132
management of vfib
defibrillation
133
what is the main cause of intrinsic AKI
ATN (85%)
134
muddy brown casts what do they MEANNNN
ATN
135
why do you get secondary mitral regurg in heart failure
as the ventricle dilates, it pulls the chordae tendinae due to papillary muscle displacement which causes continual opening of the valves resulting in regurgication
136
peripheral pulses in HCM vs. AS
in HCM they are brisk and rapid, in AS they are soft and delayed
137
what is the calcium like in hyperparathyroidism due to CKD
it is low or low normal because it is not high bc the kidney is not converting VitD to active form
138
is raynaouds painful
yes
139
what is a poor prognostic indicator for heart failure (labs)
hyponatremia
140
acute kidney injury pathogenesis IV acyclovir
the IV acyclovir precipitates and causes obstructive damage to the tubules
141
enlarged lymph nodes, night sweats, HIV patient
non hodgkins lymphoma due to EBV
142
management of chemotherapy induced diarrhea
loperamide
