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Internal Medicine > Deck 5 > Flashcards

Deck 5 Flashcards

1
Q

pharmacotherapy for COPD exacerbation

A

inhaled bronchodilators (albuterol/ipratropium), IV methylprednisolone (solumedrol), ABX

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2
Q

signs of beta blocker toxicity

A

hypotension, bradycardia, bronchospasm, altered mental status, seizures, hypoglycemia

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3
Q

FEV1/FVC ratio in restricted lung disease

A

normal

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4
Q

decreased FEV1/FVC ratio

A

obstructive

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5
Q

estrogen effect on thyroid hormone metabolism

A

it increases Thyroglobulin productin which causes decreased T4/T3 and therefore an increased TSH

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6
Q

calcium and phosphate level in pagets disease

A

normal only alk phos is elevated

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7
Q

what else can give you asterixis

A

hyperuricemia

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8
Q

indications for urgent dialysis

A

AEIOU: A: acidosis <7.1, E: electrolyte abnormalities I: ingestion of toxins O: volume overload U: uremia

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9
Q

when do papillary muscles rupture after acute MI

A

within 3 days

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10
Q

when does the IV septum rupture after acute MI

A

within 3-5 days

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11
Q

when do pts. get free wall rupture after acute MI

A

within 5 days or up to 2 weeks

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12
Q

when do pts. get ventricular aneurysms after MI

A

up to several months later

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13
Q

what is the cause of aKI after itiation of loop diuretics for COPD/CHF

A

they lower CO via decreased preload therefore decreased renal hypoperfusion so its a prerenal AKI

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14
Q

adverse effect of beta blockers on weight

A

weight gain and worsening glucose tolerance

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15
Q

platelet levels in antiphospholipid syndrome

A

lower because the antipholpholipid ab

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16
Q

what is superior vena cava syndrome

A

this is when you have venous congestion of the head neck and upper extremities due to obstruction of the SVC to the RA

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17
Q

signs of superior vena cava syndrome

A

edema of the upper extremities and face, prominant veins on chest and face, JVD

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18
Q

what are the most common causes of SVC syndrome

A

malignancy

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19
Q

intial eval of acromegaly

A

IGF-1 level

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20
Q

first line eval for patients with chronic insomnia

A

sleep diary

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21
Q

what type of thyroid disorder do patients when they have an acute illness

A

euthyroid sick syndrome

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22
Q

what is urine sodium like in a patient who is hyponatremic

A

it will be low so <20mEq/L

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23
Q

how do you dx entamoeba histolytica

A

stool pcr or serology

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24
Q

when do you need to do a proctocolectomy for FAP

A

late teens or early 20s

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25
Q

diagnosis of chronic pancreatitis

A

CT scan and MRCP

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26
Q

what do patients do to decrease pain levels in chronic pancreatitis

A

lean forward

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27
Q

CSF analysis of a patient with guillain barre

A

elevated protein but normal everything else

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28
Q

tuberculous meningitis CSF

A

low glucose, high protein moderate WBCs

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29
Q

bacterial meningitis CSF

A

low glucose, high protein, High WBCs

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30
Q

what is dobutamine

A

beta 1 agonist

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31
Q

dobutamine effect on the heart

A

positive inotropic effect and positive chronotropic effect

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32
Q

dobutamine effect on end systolic volume

A

decrease LV End systolic volume

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33
Q

what is the dx of a patient with a cough so bad they throw up or get a rib fracture

A

this is pertussis

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34
Q

what is the first thing you should do if a patient has a likely stroke

A

ABCs and then noncontrast CT

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35
Q

most common signs of post concussive syndrome

A

headache, sleep disturbance, mood changes

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36
Q

signs of DIC

A

low platelets, elevated PT/PTT,

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37
Q

how many ring enhancing lesions are in toxo

A

there are multiple

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38
Q

how any ring enhancing lesions in CNS lymphoma

A

1

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39
Q

what does the plateau pressure reflect in

A

elastic pressure which reflects the compliance

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40
Q

what do you use to treat nocardia

A

TMP-SMX

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41
Q

why do patients with sepsis get hypoglycemia

A

increased tissue glucose use

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42
Q

what type of murmur do you hear in acute aortic dissection

A

acute aortic regurg which is an early diastolic murmur

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43
Q

why do patients with sarcoid get hypercalcemia

A

this is because the granulomas produce 1-alpha hydroxylase which converts vitD to active calcitriol which in turn increases renal Ca absroption

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44
Q

PTH level in sarcoid

A

PTH is low which causes more Ca get excreted from the urine

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45
Q

lab abnormalities in CMV

A

they are elevated

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46
Q

clinical manifestations of paroxysmal nocturnal hemoglobinuria

A

hemolysis, cytopenias, venous thrombosis

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47
Q

echo findings of a patient with cadiomyopathy due to viral myocarditis

A

dilated ventricles with diffuse hypokinesis

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48
Q

pain onset for varicella zoster

A

can occur before the rash

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49
Q

what is associated with contact use for keratitis infection

A

pseudomonas

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50
Q

what is pulmonary arterial pressure like in ARDS

A

it is increased because of hypoxic vasocontriction to pooly airated lung parenchyma

51
Q

what does ECG show in Hypertrophic cardiomyopathy

A

it shows t wave inversions

52
Q

medication triggers for patients with asthma

A

aspirin, beta blockers, ACEs

53
Q

initial test for likely DVT

A

compression ultrasound

54
Q

what is bicarb like in compensated respiratory alkalosis

A

it should be low

55
Q

clinical signs of hemophilia

A

hemarthroses, IM hematomas, GI/GU bleeding, intracranial hemorrhage

56
Q

physical exam findings in severe AS

A

pulsus parvus et tardus (delayed carotids), late peaking systolic murmur, soft and single S2

57
Q

beta agonits effect on potassium

A

they cause low potassium because there is an intracellular shift

58
Q

CMV colitis diarrhea blood or no blood

A

bloody diarrhea

59
Q

signs of cholesterol emboli

A

blue toe syndrome, livedo reticularis, intenstinal ischemia, AKI etc.

60
Q

does a fib have p waves

A

NO

61
Q

signs of multifocal atrial tachycardia on EKG

A

> 3 different P wave forms, and atrial rate >100

62
Q

does COPD cause clubbing

A

NO

63
Q

what are the most common causes of clubbing

A

occult malignancy, restrictive lung disease, CF, R-L cardiac shunt

64
Q

what do pericardial calcifications represent on xray

A

contrictive pericarditis

65
Q

sharp x and y descents on central venous tracing

A

constrictive pericarditis

66
Q

what is cor pulmonale

A

this is right heart failure due to a pulmonary issue

67
Q

what prophylaxis do all HIV patients need to be on

A

TMP-SMX

68
Q

what is electrical alternans

A

this is when there are varying heights of the QRS complex most notable on V1

69
Q

what does electrical alternans indicate

A

cardiac tampenode

70
Q

why do people with CF get diabetes

A

because of pancreatic destruction

71
Q

adverse effect of erythropoietin stimulating agents

A

hypertension

72
Q

what drugs are used for rhythm control in afib

A

flecainide and propafenone

73
Q

what are the 4 main infectious causes of bloody diarrheas

A

entemeba histolytica, shigella, EHEC, campylobactor

74
Q

signs of gabapentin overdose

A

encephalopathy, myoclonus

75
Q

creatine kinase in polymyalgia rheumatica

A

normal!

76
Q

leukocytes in leukemia

A

they can be normal or elevated or decreased

77
Q

can gonorrhea cause pharyngitis

A

yes, from oral sex

78
Q

which myopathies are painful

A

statin induced and hypothyroid

79
Q

CK and ESR in glucocorticoid myopathy

A

normal!

80
Q

what kind of hypertrophy happens in severe aortic regurgitation

A

eccentric hypertrophy

81
Q

what is the compliance like in eccentric hypertrophy

A

it is increased compliance due to dilation of the chamber

82
Q

treatment of hypercalcemia

A

saline plus calcitonin and then bisphosphonates

83
Q

what is a retrospective cohort study

A

this is where you have a group and look at people who have the risk factor vs. those who dont and then compare disease occurance

84
Q

what is a case control study

A

this is where you compare diseased cases vs. non disease cases and see what risk factors there are

85
Q

what autoantibodies are present in autoimmune hepatitis

A

anti-smooth muscle

86
Q

treatment of chest pain due to cocaine use

A

benzos, cath if STEMI, nitro, CCB

87
Q

what does it usually mean if a patient has unintentional weight gain

A

hypothyroid

88
Q

what drugs can cause hypothyroidism

A

amiodarone, lithium

89
Q

what is amiloride

A

this is a potassium sparing diuretic that blocks ENaC

90
Q

what are the main causes of nephrotic syndrome

A

membranous nephropathy, minimal change disease

91
Q

what results from spinal stenosis

A

compression of lumbar nerve roots

92
Q

what is pseudoclaudication

A

this is from compressed nerve roots due to spinal stenosis causes pain when walking because of lumbar extension

93
Q

what is the pathophysiology of acute chest syndrome

A

vasoocclusion in pulmonary microvasculature

94
Q

what is the post exposure prophylaxis for neisseria meningitidis

A

rifampin or ceftiraxone

95
Q

signs of bronchiectasis

A

chronic daily production of voluminous thick mucus with exacerbations +/- hemoptysis

96
Q

how do you dx bronchiectasis

A

high res CT

97
Q

manifestations of leprosy in the skin

A

macular anesthetic skin lesions and painful nerves with sensory loss

98
Q

dx of leprosy

A

full thickness biopsy

99
Q

CLL lab values

A

dramatic lymphocytosis, thrombocytopenia, anemia

100
Q

how do you dx CLL

A

flow cytometry

101
Q

G6PD signs of hemolytic anemia

A

hyperbilirubinemia, hemoglobinuria (positive urine dip for blood but no RBCs

102
Q

what is the cause of hemolytic anemia in G6PD

A

oxidative injury

103
Q

in secondary adrenal insufficiency what is the aldosterone level like

A

normal because this is primarily controlled by RAAS

104
Q

what arrythmia is most common for digoxin toxicity

A

atrial tachycardia with AV block

105
Q

what age do pts get splenic sequestration crises with sickle cell disease

A

young children

106
Q

what is a delayed hemolytic transfusion reaction

A

this is when a patient has a reaction days later due to antibody production from memory b cells

107
Q

urine sodium in SIADH

A

it is high because there is decreased aldosterone due to there being less RAAS activated?

108
Q

volume status of SIADH patients

A

euvolumic

109
Q

cause of repeat chlamydia infections

A

reinfection from an untreated parner

110
Q

what parasite goes to the muscles

A

trichinella

111
Q

what other organ does ascariasis harm

A

the lungs

112
Q

what is melanosis coli

A

this is dark brown pigmentation of the colon

113
Q

what causes melanosis coli

A

laxative overuse (senna

114
Q

what is seen on xray of a patient with alpha1 antitrypsin deficiency

A

emphysematous changes ( like large air spaces)

115
Q

what is prophyria cutanea tarda

A

this is blistering of sun exposed skin (back of hands, forearms face)

116
Q

lab abnormalities of porphyria cutanea tarda

A

iron overload (bc not being used), mildly elevated liver enzymes

117
Q

what is associated with acquired prophyria cutanea tarda

A

hepatitis C, HVI, excess alc, estrogen use, smoking

118
Q

how to dx lumbar spinal stenosis

A

mri

119
Q

treatment of ethylene glycol

A

fomepizole

120
Q

symptoms of milk-alkali syndrome

A

constipation, polyuria, polydipsia, neuropsych sx

121
Q

describe the ECG of supraventricular tachy

A

buried P waves, constant RR interval

122
Q

treatment of supraventricular tachycardias

A

vagal maneuvers or adenosine to help unmask the P waves and ID what type of arrythmia is going on

123
Q

why do patients with multiple myeloma get recurrent infections

A

because they have infiltration into the bone marrow so normal lymphocytes cant make the normal amount of abs

124
Q

treatment of bacterial meningitis in immunocompromised patients

A

cefepime, vanc, amp

Internal Medicine (6 decks)

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