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Flashcards in General Internal Medicine Deck (442)
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1

overall prevalence of PAD in pt iwth Age 5-69 with DM.tob/age>70

29%

2

Pt with PAD risk factors and suspect PAD wtd?

Ankle brachial index
N- >1
1.3=arterosclerosis

3

68yo M p.w intermittent claudication of legs - quit smoking 10ya - BP left arm 128/84, BPR R arm 134/82 BP RLE 128.80 - ABI =

128/138=0.92
(choose higher UE SBP) LE/UE SBP

4

If equivocal ABI (0.9->1)

Excercise ABI

5

How to manage PVD

modify risk factors (BP, gluc, chol)
Anti plt agens ASA+- palvix
Treat claudication - supervised exc program>cilostazol>pentoxyifylline

6

Whatd medicatio nused in PAD reduced coronary events regardly of BP effect

ACEi

7

T/F - Pt with PAD aggressive control of hyperlipiddemia with statin drug a/w reduced overall mortality

T

8

T/F - Pt with PAD aggressive control of hyperlipiddemia with statin drug a/w reduced vascular mortaility

T

9

T/F - Pt with PAD aggressive control of hyperlipiddemia with statin drug a/w reduced cornoary events

T

10

DM goals

LDL<140/80 with PAD

11

Pt with sudden onlset pain in foot, discoloration of oot h/o afib - petal and poterior tibila pulses not felt wtd?

arteriogram r/o embolic event from afib

12

Pt wit sudden onset black/blue toes, pulses felt, had cardiac cath earlier and BP elevated wtd?

Adequate BP control

13

Metabolic syndrome

Obestiy waist in males 40" (>35 asian)
35" in femael (31" asian)
TGA
Low HDL 140.85
FBS >100
Tx: Diet, exercise, drugs

14

Which antilipid medication woudl tx component of metabolic syndrome

Fibrate

15

Obesity leading cause of death in US

BMI
Normal 19-25
overweight >25
Obeste stage I >30
stage II >35
Morbid obesity >40

16

Complications of obesity

Type II DM
Ca endometrial>breast>postate>colon
ele LDL, TGA dec HDL
inc'd CAD risk, SCD
OA
NASH
OSA
FSG
(NOT OSTEOPOROSIS - protective)

17

45yo F gaining wight - BMI 31 FBS 105 wtd?

reduce caloric intake 500 to 1000 cal/day

18

Pt BMI 32 on red caloric intake 3 months later with BMI 31 - what med for long term use

Orlistat
Lorcaserin
Phentermine topirate

19

Indications for bariatric surgery

BMI>35 with DM/hyperchol or HTN or CHF or OSA
BMI>40 with no other conditions

20

Bariatric surgery reduces mortality?

T

21

Post gastric bypass surgery - next day with horizontal nystagmus and opthalmoplegia dx?

Thiamine deficiency

22

Post bariatric surgeryc/o wk and dark colored urine, tenderness of back muscles - U dip stick + blood no RBCs dx?

Rhabdomyolysis

23

Post bariatric srugery 3 days later with tachcardia nad tachypnea

PE

24

Post gastic bypass 2 days later with RR 22, HR 120, tmep 100.8 dx?

Anastomatic suture /stable leak - gastrograffin study needed

25

Long term deficit post bariatric surgery

Vit D, B12, copper, iron

26

38yo F BMI 40 bariatric surgery 5ya fo rphysical - Hg 10.5, MCV 105 plt 115, retic 1%

check B12/cyanocobalamin

27

34yo F roux en y surgery 8 monts ago - BMI dropped 40 to 28 - now BMI up to 35 - c/o heartburn

dx? Gastrogastic fistula

28

35yo F post bariatric surgery BMI 40-25 in 6 montsh - no ids - nauseous and bloating wtd?

preg test

29

Waist to hip ratio >0.9 in men >0.85 W risk factor

at any rate

30

Inc'd waist to hip ratio considered CAD risk factor in what grop of patients -

older age