Deck 5 Flashcards
(124 cards)
1
Q
pharmacotherapy for COPD exacerbation
A
inhaled bronchodilators (albuterol/ipratropium), IV methylprednisolone (solumedrol), ABX
2
Q
signs of beta blocker toxicity
A
hypotension, bradycardia, bronchospasm, altered mental status, seizures, hypoglycemia
3
Q
FEV1/FVC ratio in restricted lung disease
A
normal
4
Q
decreased FEV1/FVC ratio
A
obstructive
5
Q
estrogen effect on thyroid hormone metabolism
A
it increases Thyroglobulin productin which causes decreased T4/T3 and therefore an increased TSH
6
Q
calcium and phosphate level in pagets disease
A
normal only alk phos is elevated
7
Q
what else can give you asterixis
A
hyperuricemia
8
Q
indications for urgent dialysis
A
AEIOU: A: acidosis <7.1, E: electrolyte abnormalities I: ingestion of toxins O: volume overload U: uremia
9
Q
when do papillary muscles rupture after acute MI
A
within 3 days
10
Q
when does the IV septum rupture after acute MI
A
within 3-5 days
11
Q
when do pts. get free wall rupture after acute MI
A
within 5 days or up to 2 weeks
12
Q
when do pts. get ventricular aneurysms after MI
A
up to several months later
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
14
Q
adverse effect of beta blockers on weight
A
weight gain and worsening glucose tolerance
15
Q
platelet levels in antiphospholipid syndrome
A
lower because the antipholpholipid ab
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
17
Q
signs of superior vena cava syndrome
A
edema of the upper extremities and face, prominant veins on chest and face, JVD
18
Q
what are the most common causes of SVC syndrome
A
malignancy
19
Q
intial eval of acromegaly
A
IGF-1 level
20
Q
first line eval for patients with chronic insomnia
A
sleep diary
21
Q
what type of thyroid disorder do patients when they have an acute illness
A
euthyroid sick syndrome
22
Q
what is urine sodium like in a patient who is hyponatremic
A
it will be low so <20mEq/L
23
Q
how do you dx entamoeba histolytica
A
stool pcr or serology
24
Q
when do you need to do a proctocolectomy for FAP
A
late teens or early 20s
25
diagnosis of chronic pancreatitis
CT scan and MRCP
26
what do patients do to decrease pain levels in chronic pancreatitis
lean forward
27
CSF analysis of a patient with guillain barre
elevated protein but normal everything else
28
tuberculous meningitis CSF
low glucose, high protein moderate WBCs
29
bacterial meningitis CSF
low glucose, high protein, High WBCs
30
what is dobutamine
beta 1 agonist
31
dobutamine effect on the heart
positive inotropic effect and positive chronotropic effect
32
dobutamine effect on end systolic volume
decrease LV End systolic volume
33
what is the dx of a patient with a cough so bad they throw up or get a rib fracture
this is pertussis
34
what is the first thing you should do if a patient has a likely stroke
ABCs and then noncontrast CT
35
most common signs of post concussive syndrome
headache, sleep disturbance, mood changes
36
signs of DIC
low platelets, elevated PT/PTT,
37
how many ring enhancing lesions are in toxo
there are multiple
38
how any ring enhancing lesions in CNS lymphoma
1
39
what does the plateau pressure reflect in
elastic pressure which reflects the compliance
40
what do you use to treat nocardia
TMP-SMX
41
why do patients with sepsis get hypoglycemia
increased tissue glucose use
42
what type of murmur do you hear in acute aortic dissection
acute aortic regurg which is an early diastolic murmur
43
why do patients with sarcoid get hypercalcemia
this is because the granulomas produce 1-alpha hydroxylase which converts vitD to active calcitriol which in turn increases renal Ca absroption
44
PTH level in sarcoid
PTH is low which causes more Ca get excreted from the urine
45
lab abnormalities in CMV
they are elevated
46
clinical manifestations of paroxysmal nocturnal hemoglobinuria
hemolysis, cytopenias, venous thrombosis
47
echo findings of a patient with cadiomyopathy due to viral myocarditis
dilated ventricles with diffuse hypokinesis
48
pain onset for varicella zoster
can occur before the rash
49
what is associated with contact use for keratitis infection
pseudomonas
50
what is pulmonary arterial pressure like in ARDS
it is increased because of hypoxic vasocontriction to pooly airated lung parenchyma
51
what does ECG show in Hypertrophic cardiomyopathy
it shows t wave inversions
52
medication triggers for patients with asthma
aspirin, beta blockers, ACEs
53
initial test for likely DVT
compression ultrasound
54
what is bicarb like in compensated respiratory alkalosis
it should be low
55
clinical signs of hemophilia
hemarthroses, IM hematomas, GI/GU bleeding, intracranial hemorrhage
56
physical exam findings in severe AS
pulsus parvus et tardus (delayed carotids), late peaking systolic murmur, soft and single S2
57
beta agonits effect on potassium
they cause low potassium because there is an intracellular shift
58
CMV colitis diarrhea blood or no blood
bloody diarrhea
59
signs of cholesterol emboli
blue toe syndrome, livedo reticularis, intenstinal ischemia, AKI etc.
60
does a fib have p waves
NO
61
signs of multifocal atrial tachycardia on EKG
>3 different P wave forms, and atrial rate >100
62
does COPD cause clubbing
NO
63
what are the most common causes of clubbing
occult malignancy, restrictive lung disease, CF, R-L cardiac shunt
64
what do pericardial calcifications represent on xray
contrictive pericarditis
65
sharp x and y descents on central venous tracing
constrictive pericarditis
66
what is cor pulmonale
this is right heart failure due to a pulmonary issue
67
what prophylaxis do all HIV patients need to be on
TMP-SMX
68
what is electrical alternans
this is when there are varying heights of the QRS complex most notable on V1
69
what does electrical alternans indicate
cardiac tampenode
70
why do people with CF get diabetes
because of pancreatic destruction
71
adverse effect of erythropoietin stimulating agents
hypertension
72
what drugs are used for rhythm control in afib
flecainide and propafenone
73
what are the 4 main infectious causes of bloody diarrheas
entemeba histolytica, shigella, EHEC, campylobactor
74
signs of gabapentin overdose
encephalopathy, myoclonus
75
creatine kinase in polymyalgia rheumatica
normal!
76
leukocytes in leukemia
they can be normal or elevated or decreased
77
can gonorrhea cause pharyngitis
yes, from oral sex
78
which myopathies are painful
statin induced and hypothyroid
79
CK and ESR in glucocorticoid myopathy
normal!
80
what kind of hypertrophy happens in severe aortic regurgitation
eccentric hypertrophy
81
what is the compliance like in eccentric hypertrophy
it is increased compliance due to dilation of the chamber
82
treatment of hypercalcemia
saline plus calcitonin and then bisphosphonates
83
what is a retrospective cohort study
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
what is a case control study
this is where you compare diseased cases vs. non disease cases and see what risk factors there are
85
what autoantibodies are present in autoimmune hepatitis
anti-smooth muscle
86
treatment of chest pain due to cocaine use
benzos, cath if STEMI, nitro, CCB
87
what does it usually mean if a patient has unintentional weight gain
hypothyroid
88
what drugs can cause hypothyroidism
amiodarone, lithium
89
what is amiloride
this is a potassium sparing diuretic that blocks ENaC
90
what are the main causes of nephrotic syndrome
membranous nephropathy, minimal change disease
91
what results from spinal stenosis
compression of lumbar nerve roots
92
what is pseudoclaudication
this is from compressed nerve roots due to spinal stenosis causes pain when walking because of lumbar extension
93
what is the pathophysiology of acute chest syndrome
vasoocclusion in pulmonary microvasculature
94
what is the post exposure prophylaxis for neisseria meningitidis
rifampin or ceftiraxone
95
signs of bronchiectasis
chronic daily production of voluminous thick mucus with exacerbations +/- hemoptysis
96
how do you dx bronchiectasis
high res CT
97
manifestations of leprosy in the skin
macular anesthetic skin lesions and painful nerves with sensory loss
98
dx of leprosy
full thickness biopsy
99
CLL lab values
dramatic lymphocytosis, thrombocytopenia, anemia
100
how do you dx CLL
flow cytometry
101
G6PD signs of hemolytic anemia
hyperbilirubinemia, hemoglobinuria (positive urine dip for blood but no RBCs
102
what is the cause of hemolytic anemia in G6PD
oxidative injury
103
in secondary adrenal insufficiency what is the aldosterone level like
normal because this is primarily controlled by RAAS
104
what arrythmia is most common for digoxin toxicity
atrial tachycardia with AV block
105
what age do pts get splenic sequestration crises with sickle cell disease
young children
106
what is a delayed hemolytic transfusion reaction
this is when a patient has a reaction days later due to antibody production from memory b cells
107
urine sodium in SIADH
it is high because there is decreased aldosterone due to there being less RAAS activated?
108
volume status of SIADH patients
euvolumic
109
cause of repeat chlamydia infections
reinfection from an untreated parner
110
what parasite goes to the muscles
trichinella
111
what other organ does ascariasis harm
the lungs
112
what is melanosis coli
this is dark brown pigmentation of the colon
113
what causes melanosis coli
laxative overuse (senna
114
what is seen on xray of a patient with alpha1 antitrypsin deficiency
emphysematous changes ( like large air spaces)
115
what is prophyria cutanea tarda
this is blistering of sun exposed skin (back of hands, forearms face)
116
lab abnormalities of porphyria cutanea tarda
iron overload (bc not being used), mildly elevated liver enzymes
117
what is associated with acquired prophyria cutanea tarda
hepatitis C, HVI, excess alc, estrogen use, smoking
118
how to dx lumbar spinal stenosis
mri
119
treatment of ethylene glycol
fomepizole
120
symptoms of milk-alkali syndrome
constipation, polyuria, polydipsia, neuropsych sx
121
describe the ECG of supraventricular tachy
buried P waves, constant RR interval
122
treatment of supraventricular tachycardias
vagal maneuvers or adenosine to help unmask the P waves and ID what type of arrythmia is going on
123
why do patients with multiple myeloma get recurrent infections
because they have infiltration into the bone marrow so normal lymphocytes cant make the normal amount of abs
124
treatment of bacterial meningitis in immunocompromised patients
cefepime, vanc, amp
