Deck 1 Flashcards
(104 cards)
1
Q
Behcet Disease
A
typically presents with multiple oral and genital ulcers that are painful and recurrent. Uveitis commonly occurs
2
Q
Felty syndrome
A
this is advanced RA that is associated with neutropenia and splenomegaly
3
Q
What may present with arthritis that is symmetric, migratory and non-erosive, with a very brief period of morning stiffness (shorter than morning stiffness of RA)?
A
SLE
4
Q
FATRN
A
thrombotic thrombocytopenic purpura – decreased ADAMTS13 activity. F-fever, A -hemolytic anemia, T-thrombocytopenia (non-palpable purpura), R-renal injury, N-neurologic findings (confusion, stroke)
5
Q
Mixed cryoglobulinemia syndrome – what is it associated with? how does it present (5)? labs show?
A
caused by immune complex deposition in small- to medium-size blood vessels.
Associated with chronic Hepatitis C.
Presents w/ fatigue, PALPABLE purpura, arthralgias, renal disease (hematuria, proteinuria, glomerulonephritis), and peripheral neuropathies.
Lab studies show serum cryoglobulins, hypocomplementemia, +RF, elevated transaminases, and kidney injury
6
Q
acute massive PE, what will pulmonary artery catheterization show?
A
elevated RA pressure, elevated Pulmonary artery pressure, NORMAL pulmonary capillary wedge pressure
7
Q
hypovolemic vs cardiogenic shock, pulm artery catheterization will show?
A
hypovolemic: decreased RA pressure, PA pressure, and PCWP. cardiogenic: INCREASED RA pressure, PA pressure, and PCWP.
8
Q
what conditions can you see pulsus paradoxus in?
A
exaggerated fall in systemic BP > 10 mm Hg during inspiration. frequently seen in cardiac tamponade, may also be seen in severe asthma or COPD
9
Q
Benzo overdose
A
slurred speech, unsteady gait, and drowsiness. pupil size is normal (2-4mm bright light, 4-8mm dark light) and there is only mild respiratory depression
10
Q
Lithium toxicity
A
tremor and hyperreflexia, ataxia and seizures
11
Q
Presbycusis
A
age-related hearing loss! progressive b/l symmetric hearing loss - it’s predominantly high-frequency sensorineural hearing loss that occurs over years. Pts hear well in one-on-one convos, but competing noise causes a decline. overtime subjective bilateral tinnitus can develop too
12
Q
ototoxic meds?
A
aminoglycosides (streptomycin) and loop diuretics (furosemide, bumetanide)
13
Q
Seborrheic dermatitis
A
causes pruritic, erythematous plaques with fine, loose, yellow, and GREASY-looking plaques, that predominantly affect the scalp (dandruff) and face (primarily affects areas w/ many sebaceous glands). common at age 1 and 30-60 yo. associated w/ Parkinson dz and HIV. Tx = Topical antifungals (selinium blue shampoo 1st).
14
Q
Reversible causes of asystole/pulseless electrical activity (5 Hs & 5 Ts)
A
5 Hs: Hypovolemia, Hypoxia, Hydrogen ions (acidosis), Hypokalemia or hyperkalemia, Hypothermia. 5 Ts: Tension pneumothorax, Tamponade or cardiac, Toxins (narcotics, benzos), Thrombosis (pulmonary or coronary), Trauma.
15
Q
Electrical alternans (varying amplitude of the QRS complexes) is a pathognomonic ECG finding for??
A
Pericardial effusion!! -it is due to the swinging motion of the heart in the pericardial cavity that causes a beat-to-beat variation in QRS axis and amplitude
16
Q
PDE-5 inhibitors (sildenafil) used to tx erectile dysfunction can cause hypotension, especially in patients taking what?
A
alpha blockers (doxazosin) or nitrates
17
Q
Rectangular, envelope-shaped calcium oxalate crystals in the urine are classically seen in pts who have ingested what?
A
Ethylene glycol! (antifreeze ingestion) – acute renal failure is the major complication
18
Q
Hemodynamically stable pts with new onset A Fib can receive rate control with what meds?
A
beta blockers, Diltiazem (CCB), or digoxin
19
Q
Tx for polycythemia vera?
A
serial Phlebotomy
20
Q
What is the most common cause of symptomatic hyperoxaluria and oxalate stone formation?
A
Increased absorption of oxalate – Ca normally binds oxalate in the gut and prevents its absorption. in pts w/ Crohn’s or other conditions resulting in fat malabsorption, Ca is preferentially bound by fat and oxalate is left unbound and is free to be absorbed into the bloodstream
21
Q
What meds are recommended to reduce the risk of stent thrombosis after intracoronary drug-eluting stent placement?
A
long-term dual antiplatelet therapy with ASPIRIN and Platelet P2Y12 receptor blocker (CLOPIDOGREL, prasugrel, ticagrelor)
22
Q
For a normal distribution, 95% of all values are within __ standard deviations from the mean.
A
2 standard deviations
23
Q
What tx for hyperthyroidism (Grave’s disease) can worsen the ophthalmopathy?
A
Radioactive iodine tx! Grave’s ophthalmopathy is due to the effects of activated T cells and thyrotropin receptor Abs (TRAB) on TSH receptors that are located on retro-orbital fibroblasts and adipocytes. Radioactive iodine tx can raise titers of TRAB and worsen the ophthalmopathy.
24
Q
How do superior pulmonary sulcus tumors (Pancoast tumors) present?
A
Referred Shoulder pain! other common findings include Horner syndrome (ipsilateral ptosis and miosis) and radicular pain, paresthesias, or weakness of the ipsilateral arm due to invasion of the brachial plexus.
25
An asymptomatic pt has an elevated Alk Phos, normal hepatic transaminases, normal RUQ US, and Positive antimitochondrial Ab assay. What is the Dx and Tx?
Primary Biliary Cholangitis. Tx = Ursodeoxycholic Acid. (early stages of dz)
26
Prolonged infusion (at high rates) of what anti-HTN drug can lead to cyanide toxicity? how does it present?
Sodium Nitroprusside. (esp. be careful in pts w/ CKD). Typically presents w/ headache, confusion, arrhythmias, flushing, and respiratory depression.
27
HIV pt w/ CD4 count <100 complains of painful swallowing and substernal burning?
Esophagitis -- frequent complication of advanced HIV. Commonly caused by Candida (pts may have oral thrush), HSV, CMV, or noninfectious (aphthous) ulcers
28
What is the Leukocyte Alkaline Phosphatase score?
It is a marker of neutrophil activity, that is typically LOW in CML. CML is marked by dramatic leukocytosis, absolute basophilia, and a shift towards very early neutrophil precursor cells (myelocytes > metamyelocytes).
29
What medication frequently prescribed for acne commonly causes phototoxic drug reactions?
Tetracyclines (Doxycycline)
30
___ in pts w/ CHF parallels the severity of heart failure and is an independent predictor of adverse clinical outcomes.
Hyponatremia.
It is caused by increased levels of renin, NE, and ADH (in response to low cardiac output and decreased perfusion pressure at the baroreceptors and renal afferent arterioles)
31
Autoimmune hemolytic anemia is characterized by?
normocytic anemia, splenomegaly, reticulocytosis, jaundice w/ elevated indirect bilirubin, increased serum lactate dehydrogenase, and decreased serum haptoglobin levels. Dx of warm AIHA is confirmed by Direct Antiglobulin (Coombs) test.
32
What are the unfavorable metabolic side effects of Thiazide diuretics (chlorthalidone, HCTZ)?
and electrolyte abnormalities?
Hyperglycemia, increased LDL, increased triglycerides.
| hyponatremia, hypokalemia, hypomagnesemia, Hypercalcemia.
33
Pt presents w/ back pain, normocytic anemia, and arm pain w/ an x-ray showing many osteolytic (lucent) lesions. What do you suspect? What screening tests do you want?
Multiple myeloma. Screen for using Serum protein electrophoresis (detects elevated serum monoclonal protein/M-spike), urine protein electrophoresis, or free light chain analysis. (Dx can be confirmed w/ bone marrow biopsy)
34
What study do you use to dx aortic dissection in pts w/ hemodynamic instability or renal insufficiency?
Transesophageal Echo. (CT angiography is preferred in hemodynamically stable pts who can tolerate contrast)
35
early decrescendo diastolic murmur best head at the left sternal border of the 4th intercostal space
Aortic regurgitation! (in ascending aortic dissection, may hear due to extension of the dissection into the aortic valvular annulus)
36
Pt presents w/ chronic weakness, wt loss, hyponatremia, and hyperkalemia. What disease do you suspect? What two tests do you order first?
Primary Adrenal Insufficiency (Addison disease). Initial evaluation should include an 8AM serum cortisol level and ACTH stimulation test (cosyntropin test).
37
HIV pt (CD4 < 100) presents w/ fevers, HA, and signs of elevated ICP (papilledema). What do you suspect?
Cryptococcal meningitis (Cryptococcus neoformans). Dx via cryptococcal antigen testing of CSF.
38
How do you tx pts w/ moderate or moderate-to-severe inflammatory acne?
Topical antibiotics, such as Erythromycin or Clindamycin. (oral Abx (tetracyclines) are reserved for pts w/ severe or nodular acne and for moderate acne unresponsive to topical Abx)
39
List the 3 types of acne vulgaris in order of increasing severity.
1. Comedonal acne - closed or open comedones
2. Inflammatory acne - inflamed papules (<5 mm) and pustules; erythema
3. Nodular (cystic) acne - large (>5 mm) nodules that can appear cystic
40
untreated hyperthyroid pts are at risk for what?
rapid bone loss -- due to increased osteoclastic bone resorption (direct effects of thyroid hormones); can lead to osteoporosis and increased fracture risk
41
Pt w/ exertional dyspnea, orthopnea, bibasilar rales, lower extremity edema, and normal ejection fraction on echo has what kind of HF?
heart failure w/ preserved ejection fraction (HFpEF), or diastolic dysfunction (likely due to hypertensive heart dz).
42
What causes diastolic dysfunction? (what is the mechanism?)
impaired myocardial relaxation or increased LV wall stiffness (decreased compliance) leads to increased LV end-diastolic pressure -- the increase in pressure is transmitted to the left atrium and pulmonary veins and capillaries, causing pulm congestion, dyspnea, and exercise intolerance
43
List the components of Light's criteria.
1. Protein (pleura)/protein (serum) >0.5
2. LDH (pleural)/LDH (serum) >0.6
3. LDH > 2/3rds the upper limit of normal serum LDH
Exudative effusions meet at least ONE of these.
44
What should be tried in pts with acute COPD exacerbation before endotracheal intubation?
noninvasive positive-pressure ventilation.
(invasive ventilation may be required in hypercapnic pts w/ poor mental status, hemodynamic instability, or profound acidemia [pH < 7.1])
45
What are the complications of positive pressure ventilation?
alveolar damage
pneumothorax
hypotension
46
If an endotracheal tube shifts into the right main-stem bronchus, what would happen? (signs of presentation?)
atelectasis of the left lung can result.
pts w/ atelectasis present w/ cough, dyspnea, and decreased oxygen saturation.
NO hypotension or serious vital sign derangements occur.
47
What is the new name for Wegener granulomatosis? and how do you diagnose it?
Granulomatosis with polyangiitis.
| Dx is made by antineutrophil cytoplasmic Ab (ANCA) positivity. (proteinase 3-ANCA aka c-ANCA)
48
What are the clinical manifestations of Granulomatosis with polyangiitis?
Upper resp: sinusitis/otitis, oral or auditory canal ulcers, saddle-nose deformity.
Lower resp: lung nodules/cavitation; dyspnea, cough and hemoptysis.
Renal: rapidly progressive glomerulonephritis, with hematuria, non-nephrotic-range proteinuria, and renal insufficiency
(they may also have systemic sxs, leukocytosis, and anemia of chronic dz)
49
Where are bronchogenic cysts found vs where are thymomas found?
bronchogenic cysts are in the MIDDLE mediastinum.
| thymomas are found in the ANTERIOR mediastinum.
50
How do you tx beta-blocker overdose?
IV fluids and atropine initially. In pts w/ refractory hypotension, you give IV GLUCAGON next. (glucagon increases intracellular levels of cAMP and can be used in beta blocker and CCB toxicity)
51
When a pt has pneumonia in one lung, how does position (right vs left side) affect oxygenation?
alveolar consolidation in pneumonia causes hypoxemia due to right-to-left intrapulmonary shunting. When the pts lies on the side with pneumonia, gravity induces an increase in blood flow to that lung, where there is markedly reduced ventilation (V) due to alveolar consolidation -- this results in a more profound V/Q mismatch, increased right-to-left intrapulmonary shunting, and worsening hypoxemia.
52
What side effects can result from Oxytocin given to induce labor? (especially if too much is given?)
Hyponatremia
Hypotension
*Uterine Tachysystole* -- abnormally frequent contractions (>5 contractions in 10 minutes averaged over a 30-minute period)
(also increase the risk of tetanic contractions, which are intense or prolonged contractions, particularly at higher doses)
53
When is a PPD test considered positive in an HIV pt? do you treat for latent TB?
when induration is >/= 5 mm.
Pts w/ no manifestations of active TB are treated for latent TB with 9 months of ISONIAZID + Pyridoxine (to prevent isoniazid-induced peripheral neuropathy).
54
What is the preferred HIV screening test?
HIV p24 antigen and antibody test.
| recommended for all pts age 15-65 regardless of risk factors
55
What is the standard of care for pts found to have Familial Adenomatous Polyposis (FAP)?
Frequent screening colonoscopies starting in childhood, and Elective proctocolectomy.
(pts should also undergo regular screening for upper GI tract tumors)
56
A pericardial effusion appears as an enlarged cardiac silhouette ("water bottle" shaped) with clear lung fields on CXR. What physical exam findings do you expect (2)?
diminished heart sounds on auscultation
| nonpalpable point of maximal impulse
57
How does Neuroleptic Malignant Syndrome (NMS) present? and what is the proposed mechanism that causes it?
NMS is characterized by SEVERE MUSCULAR RIGIDITY, delirium, autonomic instability (tachycardia/arrhythmias, labile BP, tachypnea, diaphoresis), mental status changes, and HIGH FEVER. Serum CK and WBC count may also be elevated.
It is thought to be due to dysregulation of DOPAMINE caused by D2 receptor antagonism (which occurs w/ the use of most antipsychotics).
58
What improves mortality when managing pts with ARDS on mechanical ventilation?
using lung protective strategies such as Low tidal volume ventilation -- this decreases the likelihood of overdistending alveoli
59
Replenishing folic acid w/o vitamin B12 supplementation in strict vegetarian pts (may also be alcoholics) corrects the megaloblastic anemia but leads to rapid progression of what symptoms?
Neurologic symptoms! including loss of proprioception and vibration sense, mostly in the lower extremities (due to a defect in myelin formation in the dorsal columns)
60
What's the best imaging modality to dx fibroids? also what can their presenting symptom be?
Fibroids (leiomyomata uteri) are best diagnosed on Ultrasound of the pelvis. They may present w/ urinary stress incontinence due to direct pressure on the bladder from an irregularly enlarged uterus.
61
Pt presents w/ early-onset HTN, bilateral palpable abdominal masses, and a father that died suddenly... you suspect? and how do you diagnose it?
Polycystic Kidney Disease! (autosomal dominant)
Dx with Abdominal Ultrasound
-pts may also present w/ hematuria, proteinuria, or progressive renal insufficiency
-extrarenal complications include Cerebral Aneurysms
62
What are the signs and symptoms of a heat stroke? what is the underlying pathophys?
Temp > 40C (105 F) (may cause rhabdomyolysis), altered mental status, hypotension, tachycardia, and tachypnea -- pts may have moist or dry skin and often are not volume depleted.
In a heat stroke, the thermoregulatory center fails to dissipate heat at the rate necessary to maintain a euthermic state.
63
How does ovarian failure present? (hormone levels?)
amenorrhea and signs of estrogen deficiency (vaginal dryness) -- there are increased levels of FSH and LH due to lack of feedback inhibition from estrogen (increased GnRH secretion too).
(may occur secondary to chemotherapy).
64
What are the characteristic features of thyroid storm?
tachycardia, HTN, cardiac arrhythmias (eg, A fib), and fever up to 40-41C (104-106 F.
Also may see anxiety, altered mentation, seizure, severe nausea, vomiting, hepatic dysfunction, tremor, lid lag, and goiter.
It is usually triggered by a specific event (eg, thyroid or non-thyroid surgery, trauma, infection) in pts w/ undiagnosed or inadequately tx'd hyperthyroidism.
Confirm with thyroid function tests and symptomatically tx with beta blockers.
65
What is interstitial cystitis (painful bladder syndrome)?
more often in women, associated w/ psych disorders (anxiety) and pain syndromes (fibromyalgia).
characterized by bladder pain w/ filling and relief w/ voiding, increased frequency and urgency, dyspareunia.
Dx clinically -- bladder pain w/ no other attributable causes for >6 wks, Normal UA
66
Pt presents w/ myalgias, proximal muscle weakness, elevated serum creatine kinase. She has fatigue and delayed DTRs, but is an otherwise healthy young woman. What is the most likely cause of her mypopathy?
Hypothyroid myopathy
67
What is Ichthyosis vulgaris? tx?
a chronic, inherited skin disorder characterized by diffuse dermal scaling -- the skin appears dry and rough w/ horny plates resembling fish or reptile scales.
Tx w/ emollients, keratolytics, and topical retinoids.
68
Young female w/ decreased/absent peripheral pulses, discrepancies of BP (arm vs leg), and arterial bruits. what do you suspect?
Takayasu's arteritis
69
What is chondrocalcinosis? what is it associated w/?
Chondrocalcinosis is calcification of hyaline and/or fibrocartilage seen on x-ray. Associated with the deposition of Calcium pyrophosphate crystals (pseudogout)
70
Brain death is a clinical diagnosis... what are the characteristic findings? What may still be present?
characteristic findings are absent cortical and brain stem functions (absent pupillary light rxn and oculovestibular rxn, no spontaneous respiration at Pco2 values >/= 50). The spinal cord may still be functioning so DTRs may be present!
71
Medically ill pts who develop comorbid depression can benefit from what tx?
antidepressant meds and psychotherapy -- improve their quality of life.
support groups may be a helpful adjunct to depression tx, but in severe depression they are not inadequate along!
72
an intrauterine pregnancy should be seen w/ transvaginal US at serum beta-hCG levels of what?
1500-2000 IU/L
73
What ECG findings do ventricular aneurysms present with? and in what time frame do they present as a post-MI complication?
Ventricular aneurysms present w/ persistent ST-segment elevation after recent MI and deep Q waves in the same leads.
VAs occur 5 days - 3 months post-MI.
74
When should anti-D immune globulin be administered in Rh (D)-negative women in pregnancy?
28-32 weeks gestation.
| again within 72 hours of delivery if the baby is found to be Rh (D) positive.
75
When is routine GBS rectovaginal screening performed?
35-37 weeks gestation.
76
HIV pt w/ CD4 < 50; nonspecific systemic symptoms of fever, cough, abdominal pain, diarrhea, night sweats and weight loss; in the presence of splenomegaly and elevated alkaline phosphate. What do they most likely have? What should they have received for prophylaxis?
Disseminated Mycobacterium avium complex (MAC) infection.
| HIV pts w/ CD4 < 50 should receive AZITHROMYCIN PROPHYLAXIS. (1st line tx = clarithromycin or azithromycin)
77
What infection is a significant risk factor for membranous nephropathy?
Hepatitis B infection
78
What people are most likely to get Focal Segmental Glomerulosclerosis (a nephrotic syndrome)?
African Americans, HIV infection, Heroin use, and morbid obesity
79
What is the most common etiology for primary adrenal insufficiency (see hyperpigmentation w/ primary)?
autoimmune adrenalitis
80
What are the 3 most common causes of Vitamin K deficiency?
Inadequate dietary intake, intestinal malabsorption, or hepatocellular disease causing loss of storage sites.
*an acutely ill person w/ underlying liver dz can become vitamin K deficient in 7-10 days
81
How can iron deficiency anemia be differentiated from thalassemia (both have decreased MCVs)?
iron deficiency anemia has an ELEVATED red cell distribution width (RDW), which is typically >20%
82
What is a hyphema?
a pooling or collection of blood within the anterior chamber of the eye (between the cornea and the iris)
83
How does a splenic abscess usually present? What are risk factors for it?
Classic Triad: fever, leukocytosis, and LUQ abdominal pain
Pts may also develop left-sided pleuritic chest pain, left pleural effusion, and splenomegaly.
Risk factors: Infection (eg, infective endocarditis!) w/ hematogenous spread, immunosuppression, IV drug use, trauma, and hemoglobinopathies
84
What are the 3 diagnostic requirements for Acute Liver Failure?
1. severe acute liver injury (ALT and AST often >1000)
2. signs of hepatic encephalopathy (confusion, asterixis)
3. synthetic liver dysfunction (INR >/= 1.5)
85
How does the body compensate for chronic hypercapnia (such as in COPD pts)?
pts w/ COPD have chronic hypoventilation resulting in a chronic respiratory acidosis -- to compensate, the kidneys increase bicarbonate retention, creating a secondary metabolic alkalosis
86
What physical exam findings do you see in herpes simplex keratitis?
corneal vesicles and dendritic ulcers!
pts typically complain of pain, photophobia, blurred vision, tearing and redness
May have a hx of prior episodes, usually the recurrences are precipitated by excessive sun exposure, outdoor occupation, fever or immunodeficiency.
87
What is the most common form of nephrotic syndrome in pts w/ Hodgkin lymphoma?
Minimal change disease.
overall, membranous glomerulopathy is the most common form of nephrotic syndrome associated w/ malignancies -- but these are usually Solid cancers!
88
Pt presents with acute, symmetric arthralgia/arthritis specifically in the hands (MCP and PIP joints), wrists, knees and feet; fever, fatigue, diarrhea, and a nonspecific rash. She works as a school teacher. What does she most likely have and how do you test for it?
Parvovirus B19 infection!!!
Dx with Parvovirus B19 IgM antibodies
89
What is the most common cause of resistant HTN? What physical exam finding is often present?
```
Renovascular HTN (renal artery stenosis)
Continuous abdominal bruit is highly suggestive of renovascular disease.
```
90
What is the most common source of symptomatic pulmonary embolisms?
the proximal (thigh) deep veins of the leg -- iliac, femoral, popliteal.
91
What are the mainstays of primary prophylaxis for esophageal variceal hemorrhage?
endoscopic variceal ligation or administration of a nonselective beta blocker, like propranolol or nadolol
(nonselective beta blockers reduce portal venous pressure by blocking the adrenergic vasodilatory response of the mesenteric arterioles, which results in unopposed alpha-adrenergic tone, vasoconstriction, and reduced portal blood flow)
92
What are the "4 T's" of anterior mediastinal masses?
Thymoma
Teratoma (+ other germ cell tumors)
Thyroid neoplasm
Terrible Lymphoma
93
What neuroimaging finding is most likely seen in pts with schizophrenia?
enlargement of the lateral cerebral ventricles
94
What is a significant difference seen between loss of consciousness due to seizure vs due to syncope?
Generalized seizures almost always have a delayed return to baseline neurologic functioning due to a postictal state of transient confusion, lethargy, and/or focal neurologic deficits.
Syncope is a transient LOC w/ loss of postural tone followed by immediate spontaneous return to baseline neurologic function.
95
What do you see w/ glomerular hematuria?
usually causes microscopic hematuria, but gross hematuria may also be present.
urine studies reveal proteinuria, dysmorphic RBCs or RBC casts.
usually due to glomerulonephritis or basement membrane disease.
96
What do you see with IgA nephropathy/what is it?
the most common glomerulonephritis in adults
It is typified by hematuria starting within 5 days of an upper respiratory or pharyngeal illness (source of hematuria is glomerulus)
97
What reduces the risk of ovarian cancer?
OCPs
98
If an ovarian mass is discovered in a post-menopausal pt, what should you do next?
serum CA-125 level!
Elevations are caused by common gyn conditions, such as leiomyomata and endometriosis, that are more likely found in premenopausal pts -- therefore the specificity of CA-125 levels is much greater in post-menopausal women.
99
What is amiloride?
```
Amiloride is a K+ -sparing diuretic.
it is in the same class as spironolactone, eplerenone, and triamterene.
```
100
What is otosclerosis? What do the rinne and weber tests show?
Otosclerosis is a common cause of conductive hearing loss in adults (20s-30s, f > m). It occurs when the stapes footplate becomes fixed to the oval window and sound can no longer be amplified in that ear.
Since it is conductive hearing loss, Rinne test in the affected ear shows bone conduction > air conduction; and the Weber test lateralizes to the affected ear (bc the affected ear cannot hear the ambient noise of the room).
101
Name this lesion. Multiple or isolated lesions usually occur on the lower extremities. They are nontender, discrete, firm, and hyperpigmented nodules that are usually < 1 cm in diameter. **They may dimple in the center when they are pinched!!
Dermatofibroma
102
How does vitreous hemorrhage in the eye present? What is the most common cause?
Vitreous hemorrhage typically presents w/ sudden loss of vision and onset of floaters. The fundus is hard to visualize on exam.
The most common cause is Diabetic Retinopathy.
103
What is a potential complication of thoracic aortic aneurysm surgery that presents w/ abrupt onset of b/l flaccid paralysis and loss of pain/temp sensation, w/ preservation of vibration and proprioception?
Anterior spinal cord INFARCTION
the anterior spinal artery, which supplies the anterior 2/3rds of the spinal cord, is particularly dependent on blood supply from the radicular arteries that originate from the thoracic aorta -- thoracic aortic surgery can result in reduced blood flow through the radicular arteries and lead to Anterior spinal cord infarction.
104
crescendo-decrescendo systolic murmur along the left sternal border w/o carotid radiation
murmur of HOCM, which is interventricular septal hypertrophy
