Deck 3 Flashcards by Jessica Pederson

how do you diagnose PCKD

abdominal ultrasound

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SBP xray findings

dilated loops of bowel and also air in colon in rectum

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what infection causes trismus

tetanus

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risk of SGLT2 inhibitors

euglycemic DKA, yeast infections

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common drugs that cause acute pancreatitis

anti epileptics, steriods, protease inhibitors, etc.

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what are some things that cause an exudate

infection, malignancy, PE, autoimmune,

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what can cause transudate effusion

cirrhosis, nephrotic syndrome, CHF

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BMP abnromalities in milk-alkali syndrome

high bicarb, hypercalcemia, hypophosphatemia (from intestinal binding) and hypomagnesia

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what are the main differences in athletets heart vs. HCM echo

athletes heart: mild LV enlargement, mild wall thickening vs. // HCM: small LV cavity size, moderate wall thickness

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how soon should a patient increase their hemoglobin after starting iron therapy

within 4 weeks, so if they dont improve in 4 weeks then its not iron deficienc

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cautions for opioids and renal insufficiency

metabolites are excreted by the kidney so they can accumulate better to use things like

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what drugs can you use in terms of opioids for renal insufficiency

fentanyl, methadone, buprenorphine, hydromorphone

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when do you typically start getting AMS from hyponatremia

<120-125

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acute digoxin toxicity signs

GI symptoms, lethargy, fatigue

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what leads in an RCA infarct

II, III, aVF

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what causes amaurosis fugax

this is vasculitis or blockage of the retinal artery from a cardioembolic source

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typical signs of necrotizing otitis exerna

granulation tissue along the floor of the ear canal

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what are the most common causes of referred otalgia

dental disease and TMJ

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which immunosuppresion medication causes tremor

calcineurin inhibitors, tacrolimus and cyclophosphamide

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what is seen on peripheral smear of CLL

mature lymphocytosis and smudge cells

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what does intensive DM therapy decrease/have no change with

decreases microvascular complications but does not have an affect on all cause mortality or macrovascular complications

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what is sodium like in primary polydipsia

it is extremely low because you are taking on too much water

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what is sodium like in diabetes insipidus

you get hypernatremia because no water is being kept, and the urine is extremely dilute

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compare aldosterone in primary adrenal deficiency vs. panhypopituitarism

in primary adrenal insufficiency you get no aldosterone because the adrenal gland is not working at all and in hypopituitarism you have normal aldosterone because it can be controlled by RAAS

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miliary TB signs chest XRAY

diffuse reticulnodular pattern

urine excretion of Ca in familial hypocalciuric hypercalcemia vs. parathy adenoma

in FHH there is minimal excretion because there is high PTH which causes increased reabosorption and in parathy adenoma there is high excretion because the kidneys are overloaded

why is FRC and RV high in ankylosing spondylitis

becaues of chest wall motion restriction so there is fibrosis which causes the lungs to stick to chest wall which increases volume

cause of decreased thyroid levels in acute illness

there is increased catabolism and so there is more glucocorticoids which causes decreased TRH feedback and then also there is less caloric intake so you have less energy to make proteins which decreases thyroglobulin

labratory signs of legionella

elevated sodium, transaminitis

do you need to stop isoniazid if it causes elevated liver enzymes

nope

what are the two primary manifestations of chagas disease

megagolon and esophagitis, cardiac disease (heart failure)

TSH in piuitary adenoma vs medication adverse effect

TSH in pit adenoma is low and in med side effect (risperidone) it is normal

which tremor/disease state gets better with voluntary movements

parkinson tremor

effect of caffeine/alcohol on physiologic tremor

increases in intensity

crystal shape in pseudo vs. regular gout

pseudo = rhomboid // reg= needle shaped

what is associated (in the joint) with pseudogout

chondrocalcinosis (calcium deposition along joint line)

signs of acute rejection on kidney biopsy

intimal arteritis and lymphocytic infiltration

main effect of nitrates on the heart

they are systemic venodilators so they cause decreased preload which lowers end diastolic volume

iron level in lead toxicity

high iron

late complications of pericarditis

hepatojugular reflux, JVD

small testes, gynecomastia, tall stature, infertility, decreased virulization

klinefelter

FSH and LH in klinefelter

elevated because no testosterone is being produced

low fecal elastase dx

chronic panc

what lab value is elevated in terms of lymphocytes in acute interstitial nephritis

eosinophilia

intitial pharmacotherapy for acute asthma exacerbation

SABA, anticholinergic, steroid

treatment of kaposi sarcoma from HIV superficial vs. visceral

superficial: antiretrovirals // visceral: systemic chemo

what should a patient also on isoniazid be put on

sideroblastic anemia peripheral smear

micro and normocytic anemia, basophilic stippling

signs of pagets disease of the bone

osteoclast dysfunction, hearing loss, headaches, back pain, bone pain

which nodules hot or cold are increased risk of malignancy

cold nodules

biggest risk of untreated hyperthyroidism

bone loss due to increased osteoclastic bone resorption

how do you prevent contrast kidney injury

you can do 0.9% IV fluids before contrast admin, avoid nephrotoxic agents

what to administer for warfarin induced bleeding

prothrombin concentrate or FFP

where do patients typically feel the pain for OA of the hip

groin, buttock, lateral hip

when is the stridor in tracheomalacia

expiratory stridor

what counts as low urine osmolality

<300

palpable thrill and harsh holosystolic murmur 4 days after MI

interventricular septum rupture

treatment of gastroparesis

metoclopromide or erythromycin

what is the cause of hyponatremia after marathon

loading of hypoosmotic fluid while losing salt from perspiration and ADH release

what does having a splenectomy put you at risk for

encapsulated bacteremia (strep pneumo, hib, neisseria meningitidis)

what else occurs with guillan barre along with paralysis typically

autonomic symptoms (bladder retention, arrythmias, tachycardia)

what effect does hepatorenal syndorome have on acid base status

it causes metabolic acidosis because you cant clear acids

what can happen after intubation

tracheal injury that causes a scar and resulting stenosis

what lab abnormalities cause calciphylaxis

hyperphosphatemia and hypercalcemia

BUN level in upper GI bleeds

elevated because hemoglobin breaks down and then the urea gets reabsorbed in the small intestine leading to elevated BUN

treatment of primary adrenal insufficiency

supplementation with glucocorticoids (hydrocortisone and prednisone) and mineralicorticoids (fludircortisone)

which is more common in alcoholics B12 or folate deficiency

folate

what vasculitis occurs secondary to HCV

mixed cryoglobulinemia syndrome

buprenorphine activity

it is a partial agonist

naloxone activity

this is a potent opiod antagonist

why do CKD patients have platelet dysfunction

because they have increased NO which

what is trastuzumab used for and what is the main AE

HER2 positive breast CA and main AE is cardiotoxicity

what infections are immunosuppressed people at risk of

PCP, CMV

diagnosis of PCP

sputum or BAL

what causes AKI with CHF exacerbation (cardiorenal syndrome)

because there is decreased CO, there is increased central venous pressure which backs up to the renal veins which in turn causes a dramatic decrease in GFR because nothing can be filtered.

why do diuretics help with GFR in CHF exacerbation

this is because they decrease CVP which leads to less of a backup in the kidneys

treatment of a patient with isolated facial swelling on an ARNI

ER because likely angioedema, IV epi,

what effect does spironolactone have on acid/base

metabolic acidosis

aldosterone effects on acid base

metabolic (contraction) alkalosis

cause of hammer/claw toes

can be due to chronic incorrect shoe size, or chronic uncontrolled diabetes

where are arterial ulcers

tips of toes, pressure points, lateral malleolus

what type of nephrotic syndrome do HIV patients get

focal segmental glomerulosclerosis due to direct infection of the podocyte

what is associated with pulsus paradoxus

cardiac tampanode, severe asthma, pericarditis

what paraneoplastic syndrome is associated with small cell lung cancer

lambert eaton, SIADH

consequence of acromegaly on heart

HTN, concentric LV hypertrophy --> diastolic dysfunction --> heart failure

what does dehydration do to hematocrit

causes elevated hematocrit bc this is a measure of the percent RBC in plasma and if youre dehydrated then you have greater percent compared to euvolumia

treatment of ITP

steroids if plts <30k, platelet transfusion <10k

Deck 3 Flashcards

(87 cards)