Flashcards in hammer28 Deck (50):
What is the first line treatment for urge incontinence?
Behavioral modification and adult diapers
What is the treatment for PPD + with negative CXR?
INH for 9 months
What is the best imaging modality for osteomyelitis when MRI is not available?
Triphasic nuclear scan
What coagulation factor is affected with NSAID use?
Bleeding time. Decreased thromboxane A2.
What should you suspect in elderly women with new onset ascites?
What are blood findings in CML?
LOW leukocyte alkaline phosphatase score, basophilia, elevated leukocytes >200,000
What neurological signs can be present in lumbar stenosis?
Weakness and Romberg
What is chronic atrophic gastritic with pernicious anemia associated with?
Elevated serum gastrin levels
What is Ptyrisasis rosacea associated with and what is the treatment?
HHV 7, 6, 8 and H1N1. Topical corticosteroids to relieve pruritis
Which symptoms of sarcoidoss are associated with high resolution rates?
Erythema nodosum, hilar adenopathy and arthriits
What is the appropriate term for skin tags?
Achrocordons. Pedunculated, small, fleshy lesions
What is the cause of hypercalcemia in sarcoidosis?
Granulomatous inflammation leading to increased Vitamin D production.
What are the findings in pure red cell aplasia? WHat is the next step? What conditions is it associated with?
Absent reticulocytes and erythrocyte precursors. DO a CT scan for thymoma. Congenital Blackfan Diamond, Parvovirus B19
Where is chloroquine first line malaria prophylaxis? What is first line in Brazil?
Caribbean, Mexico, Argentina, CostaRica, Elsalvador Paraguay. Atovaquone-proguanil
What is the cause and treatment for breast milk jaundice?
Glucuronyl transferase inhibitor in breast milk. D/c breast milk for 48 hours and continue afterwards.
What are the symptoms of Gardner syndrome
colon cancer before 50y ,epidermal inclusion cysts, numerous colonic polyps, congenital hypertrophy of retinal pigment epithelium
What viruses cause Bells palsy (CN 7)?
EBV, HSV, Lyme disease
What is the findings in adrenoleukodystrophy?
X linked disease with peroxisomal membrane protein defect that leads to very long faty acid chain accumulation in organs. Has neurological deficits that starts with weakness and spasticity and worsens and adrenal deficits and doesn't respond to cosyntropin stimulation test.
What is the treatment for bipolar disorder if patient has renal failure?
Valproate instead of Lithium
What is the treatment for diarrhea predominant IBS in those where initial management didn't work?
Loperamide or diphenoxylate or alosetron (seretonin antagonist). Tegaserod
What is the best initial step in treating a person with suspected aortic dissection? Best imaging modalities?
Labetalol. TEE, MRI, Spiral CT with contrast
What is the most common cause of death of infant botulism? Treatment in less than 1 year olds? Greater than 1 year old?
Respiratory failure. Human derived botulinim immunoglobulin. Equine serum botulism antitoxin.
What are the findings in non proliferative diabetic retinopathy? Proliferative DR?
Dilation of venis, microaneurysms, retinal edema, retinal hemorrhages. Hard exudates and cotton wool spots. Proliferative one is more advanced with neovascularization.
How do you diagnose tinea corporis? When is Wood's light useful for diagnosis?
KOH application. Yeast infections, bacteria or dermatophytes.
What is the differential diagnosis of middle mediastinal mass?
Bronchogenic cyst, bronchogenic tumor, aortic aneurysm, lymphoma
What is the presentation of keratoacanthoma? What is treatment?
Rapidly enlarging crateriform nodule with central keratotic plug. Excise because of similarity with SCC.
What symptoms are present in Goodpastures?
lower respiratory symptoms (hemptysis) + renal symptoms (Hematuria) (often with URI). Glomerular basement membrane
What symptoms are present in Wegner's ?
upper (sinusitis) + lower respiratory symptoms + renal involvement. c ANCA
What is absorbed in terminal illeum?
Bile salts, B12
What is the organism involved and presentation of erthytrasma? What is seen under Woods light? Treatment?
Cornybacterium minutissum. Well demarcated red brown patches and macerated plaques. Coral red fluorescence caused by coproporphryin III
What is the presentation of McCune Albright syndrome?
Polyostotic fibrous dysplasia. Precocious puberty, multiple cystic bone lesions, and cafe au lait spots.
What is the most common cutaneous malignancy?
Basal cell carcinoma.
What is the first step to identify CSF leak?
Beta 2 transferrin in the fluid. IF not do cisternogram
What are autopsy findings of SIDS?
Diffuse intrathoracic petichae or pulmonary edema
What is the treatment for H pylori that doesn't initially respond to amoxicillin, omeprazole and clarithromycin?
Bismuth, metronidazole, tetracycline
What substance is depleted in acetaminophen toxicity?Why is LFTs elevated?
Glutathione. Because now mercapturic acid accumulates since it can't be excreted with glutathione and damages the liver.
What are the classic findings in craniopharyngioma?
Heave calcifications, unilocular or multiclocular cysts, viscous yellow fluid
What is the presentation of HIV myelopathy?
Microscopic vacuolysis of the posterior and lateral columns just like B12 peripheral neuropathy
What is the lifelong treatment for antiphospholipid syndrome?
Warfarin with INR between 2 - 3
Where is arterial notching seen in coarctation?
What is the genetic defect in ADPolycystic Kidney Disease? Which genes are affected? Which is the most common extrarenal manifestation?
Epithelial cell differentiation .Polycystin 1 and 2. Hepatic cysts
What are the most common causes of congenital cataracts?
Congenital rubella or galactosemia
What are risk factors for gastric adenocarcinoma?
H pylori, pernicious anemia, intake of nitroso rich food
What is a side effect of orlistat?
Fat soluble vitamin malabsorption sinc eit is a lipase inhibito
What are the three organisms that are suspected in an asplenic child with infection?
Strep PNA (most common), HIB, Neisseria meningitidis
What isi the difference between albinism and vitiligo? What diseases is vitiligo associated with?
Albinism can't produce melanin and vitiligo is autoimmune destruction of melanocytes. Hashimotos thyroididts and pernicious anemia
When is UNsynchronized cardioversion indicated?
Pulseless ventricular tachycardia and vfib
What is the indication to test for growth factor?
If chronological age and bone age do not line up and there is a drop in the growth curve. IGF1 and IGF Binding protein
What are side effects of Rifampin?
Hepatitis, p450 induction, red orange secretions