emma holliday Flashcards
(116 cards)
1
Q
meds to hold before stress test
A
BBs
CCBs
2
Q
MC cause of death post MI
A
arrhythmias
Vfib
3
Q
persistent ST elevation ~1 mo after MI and systolic MR murmur
A
ventricular aneurysm
4
Q
cannon A waves post MI
A
AV dissociation
V fib or 3rd degree heart block
5
Q
CP at rest/night, migraine HA
A
Prinzmetals!
dx ergonovine
tx CCB/nitrates
6
Q
causes of dilated cardiomyopathy
A
viral etoh (reversible!) cocaine chagas idiopathic
7
Q
causes of diastolic HF
A
HTN
amyloid
hemochromatosis (reversible!)
8
Q
drugs that improve survival in HF
A
ace-i
BBs
spironolactone in class III/IV
9
Q
drugs that improve sx in HF
A
dig (sx and hosp)
lasix (sx)
10
Q
pleural effusion w/low glucose
A
RA
11
Q
pleural effusion with high lymphocytes
A
TB
12
Q
pleural effusion with blood
A
malignant or PE
13
Q
transudative pleural effusion
A
CHF
nephrotic
cirrhotic
14
Q
dx of ARDS
A
PF < 200
B/L alveolar infiltrates on CXR
PCWP < 18
15
Q
indications to start O2 in COPD
A
PaO2 < 55
SpO2 < 88
16
Q
new clubbing in COPD
A
hypertrophyic osteoarthropathy!
get a CXR - most likely underlying malignancy
17
Q
asthma tx pathway (OP)
A
albuterol –> add inhaled CS –> add long acting B-ag –> add montelukast and oral steroids
18
Q
upper lung nodule with eggshell calcifications
A
silicosis
get yearly TB test
give INH for 9 mos if >1cm
19
Q
lower lobe reticulonodular process with pleural plaques
A
asbestosis
MC cancer = bronchogenic carcinoma
20
Q
patchy lower lobe infiltrates, thermophilic actinomyces
A
hypersensitivity pneumonitis
21
Q
popcorn calcification
A
hamartoma
22
Q
adenocarcinoma of lung
A
MC in non smokers
peripheral!
mets to liver, bone, brain, adrenals
effusion: exudative with high hyaluronidase
23
Q
squamous cell paraneo
A
PTHrP
low P, high Ca
24
Q
small cell paraneo
A
SIADH
Lambert Eaton
Pancoast
25
Crohn's buzzwords
fistulae
granulomas
transmural
26
Q fever
coxiella burnetti
assoc with cows
give doxy
27
franciella tularensis
assoc with rabbits
| give streptomycin, gentamycin
28
rifampin SEs
orange
| CYP450 inductino
29
INH SEs
peripheral neuropathy and sideroblastic anemia - give pyridoxine
hepatitis with mild LFT bump
30
pyrazinamide SEs
benign hyperuricemia
31
ethambutol SEs
optic neuritis
| vision abnormalities
32
tx of endocarditis
strep viridans: PCN
| staph: naf+ gent or vanc
33
zidovudine SEs
GI
leukopenia
macrocytic anemia
34
didanosine SEs
pancreatitis
| peripheral neuropathy
35
abacavir SEs
HS rash, fever, N/V, muscle aches, SOB in 1st 6 weeks
D/C AND NEVER USE AGAIN
36
indinavir SEs
nephrolithiasis and hyperbili
37
efavirenz SEs
sleepy, confused, psycho
38
HIV post exposure ppx
AZT
lamivudine
nelfinavir
39
when to add steroids for PCP PNA
PaO2 < 70
| Aa gradient > 35
40
CMV diarrhea in HIV
blood diarrhea
| tx: ganciclovir, foscarnet
41
MAC diarrhea
diarrhea, wasting, fevers, night sweats
tx: clarithro, ethambutol, rifampin
azithro ppx
42
crypto diarrhea
dog poo, swimming pools
watery with mucus!
acid fast oocysts
43
HIV with multiple ring enhancing lesions
toxo!
| pyrimethamine sulfadiazine + folate
44
HIV with one ring enhancing lesion
CNS lymphoma, assoc with EBV
| tx: HAART
45
HIV with meningitis sx
think crypto
india ink
ampho --> fluconazole maintenance
46
HIV with hemisensory loss, visual impairment, Babinskis
PML/JC virus
| brain biopsy!
47
immune suppressed with cavitary lung dz and weight loss
| partially acid fast G+ aerobes
nocardia
| tx: bactrim
48
neck/face infection with draining yellow material, G+ anaerobes
actinomyces!
| tx: PCN
49
risk of fast correction of hypoNa
central pontine myelinolysis
50
risk of fast correction of hyperNa
cerebral edema
51
type I RTA
distal, can't excrete H
lithium, SLE, sickle
hypoK
tx: replete K, oral bicarb
52
type II RTA
proximal, can't reabsorb HCO3
Fanconi, myeloma, amyloid
hypoK
tx: replete K, mild diuretic
53
type IV RTA
diabetes, Addisons, sickle
hyper K, hyperCl
tx: fludrocortisone
54
muddy brown casts w/ ampho, AG, cisplatin, or ischemia
ATN
| give fluids
55
protein, blood, eos in urine w/ bactrim
AIN
| stop offending agent + steroids if no improvement
56
tx rhabdo
bicarb (prevent precipitation)
57
envelope crystals on UA
ethylene glycol intox
| tx: dialysis or NaHCO3
58
cyclophosphamide SE
hemorrhagic cystitis
59
hematuria 1-2 d after URI
Bergers (IgA)
60
hematuria 1-2w after strep
PSGN
| get ASO titer
61
hematuria + hemoptysis
Goodpasture
| Ab to collagen IV
62
hematuria + deafness
Allport
| XLR in collagen IV
63
Wegeners
dx: biopsy
tx: steroids or cyclophosphamide
64
Churg Strauss
dx: lung bx
tx: cyclophosphamide
65
PAN
no lung involvement
| tx: cyclophosphamide
66
foley + alkaline pee and stones
struvite stone
| proteus! kleb, staph, pseudo
67
stone + bowel resection for volvulus
pure oxylate stone
68
stone + leukemia/chemo
uric acid stone
| tx: alkalinize urine, hydrate
69
proteinuria + heroin/HIV
FSGS
| limited response to steroids
70
proteinuria + hepatitis
MPGN
71
anemia + mycoplasma + cyanosis of fingers/ears/nose
cold AIHA
| no steroid response
72
anemia + PCN/ceph/sulfa/rifampin/cancer
warm AIHA
| steroids then splenectomy
73
dark urine in AM, Budd Chiari, weird thromboses
PNHH
defect in PIG-A, complement lysis
increased risk for aplastic anemia
74
ITP tx
prednisone
then splenectomy
IVIG if plt < 10k
ritux
75
recurrent epistaxis, normal plts, increased bleeding time and PTT
VWD
DDAVP for bleeding or pre op
replace fVIII
76
factors depleted in cirrhosis
1st: VII --> PT increase
2nd: viii and vWF
77
causes of DIC
sepsis, rhabdo, adenocarcinoma
pancreatitis, snake bites
tx of m3 aml
78
HIT tx
stop heparin
reverse warfarin with vit K
start lepirudin/other anticoag
79
clots on heparin
AT III deficiency
80
leser trelat
eruption of multiple seb keratoses
| paraneo: GI, breast, lung, GU
81
porphyria cutanea tarda
skin blistering in sunlight
| uroporphyrinogen decarboxylase deficiency
82
behcet's
genital and oral ulcers
| ocular, GI, lung involvement possible
83
thyroid storm tx
PTU
iodine
propranolol
84
MC thyroid ca
papillary
psammoma bodies
lymph metastasis
85
follicular thyroid ca
blood spread
| excise whole thyroid
86
medullary thyroid ca
MEN: look for pheo, hyperca
87
hasimotos and thyroid
predisposes for thyroid lymphoma
88
screening of adrenal insufficiency
cosyntropin stimulation test
89
tx of Addison's
saline resuscitation
| dexamethasone and fludrocortisone replacement long term
90
MEN1
parathyroid hyperplasia
pancreatic islet tumors
pituitary adenomas
91
MEN2A
medullary thyroid ca
pheo
parathyroid
92
MEN2B
medullary thyroid ca
pheo
marfans
93
MCC of death in DM
CV disease
94
tx subarachnoid hemorrhage
nimodipine to reduce ischemic stroke
95
L hemiplegia/hemisensory
R MCA stroke
96
L hemiplegia/hemisensory + confusion, behavior
R ACAstroke
97
L hemiplegia + R ptosis
R Webber's stroke (midbrain)
98
falling to L and R ptosis
R Benedikt's stroke (PCA or basilar)
99
tx of partial seizures
carb or phenytoin
| then vpa or lamictal
100
tx generalized seizures
vpa
| then lamictal/carb/phenytoin
101
3 hz spike and wave
absence sz
| ethosux
102
diffuse background slowing on EEG
delirium
103
hypsarrhythmia
infantile spasms
| tx ACTH
104
tx pseudotumor cerebri
weight loss
acetazolamide
shunt or optic n sheath fenestration
105
tx myasthenia
IVIG/plex acute
pyridostigmine, GCs/azathioprine, thymectomy chronic
AVOID AGs and BBs
106
dysphagia in HIV
candida
HSV
CMV
107
whipples dz
T whipplei
malabsorption diarrhea
weight loss, jt pain
108
>20% blasts
acute leukemia
109
CALLA or TdT
ALL
110
auer rods, myeloperoxidase, esterase
AML
| risks; radiation, downs, myeloprolif
111
tartrate resistant acid phosphatase, decreased monos, CD11, CD22
hairy cell
| tx cladirbine
112
ALL tx
danorubicin, vincristine, pred
intrathecal MTX if CNS recurrence
BM txp
113
AML tx
danurubin + araC
| if M3 give TRA
114
bone pain, punched out lesions on XR, hyper CA
```
MM
SPEP
BM b
BM txp, pred
hydrataion and furosemide then bisphosphonates
```
115
dizziness, HA, hearing/vision probs, monoconal IgM
Waldenstrom
116
IG spike found incidentally
MGUS
