Flashcards in hammer32 Deck (52):
What supplementation will help renal patients the most?
Calcium supplementation b/c they lose it through secondary hyperparathyroidism,
What is migratory thrombophlebitis , which condition is it associated with and what is the next step in management?
Thrombosis of superficial veins and DVT. Associated with visceral malignancy particularly pancreatic adenocarcinoma and colon carcinoma so do an abdominal CT scan.
What meds cause third degree AV block?
Digoxin, BB and CCB
What is the w/u of NPH?
Ct withOUT contrast followed by LP
How do BB treat social phobia performance type?
By blocking autonomous response such as tremors and palpitations
What is acute prostatitis treatment?
Fluoroquinolones for 4 to 6 weeks
Which lymph nodes does anal cancer metastasize in? Rectal cancer?
Anal cancer - inguinal lymph nodes. Rectal cancer - internal lymph nodes.
What are the characteristics of tuberculoid (paucibacillary) leprosy?
Vigorous cellular immune response
Positive lepromine skin test
Bacilli sometimes not found in skin smears
Few skin lesions
Hypopigmented macules with dry scaly center and erythematous borders
Thickened nerves with anesthetic skin
What is the treatment for tuberculoid (paucibacillary) leprosy?
Rifampin + Dapsone for 6 months
What is the treatment for lepromatous (multibacillary) leprosy?
Rifampin + Clofazimine + Dapsone for 12 months
What are the characteristics of lepromatous (multibacillary) leprosy?
Minimal cellular immune response
Negative lepromine skin testt
Bacilli found in skin smears
Skin symmetrically and extensively affected
Lesions with poorly defined borders
Less nerve involvement with minimally compromised sensation
What is the p/t of chancroid?
Painless genital ulcers with irregular borders and inguinal lymph involvement. Azithromycin or ceftriaxone.
What is the treatment for pericarditis?
NSAIDS such as Ibuprofen (NOT acetaminophen). Colchicine for recurrent pericarditis.
What is the presentation of necrobiosis lipoidica?
Red yellow plaque with violaceous borders. Plaques become atrophic and flat. Associated with Diabetes.
What is the presentation and treatment of Felty syndrome?
Rheumatoid arthritis, splenomegaly, neutropenia (absolute neutrophi lcount < 1500). Methotrexate, penicillamine, sulfasalazine, gold
What are the criteria for admission for PNA?
Major crieteria - ARDS, Septic shock
3 minor criteria for ICU admission - RR>30, PaO2/FiO2 < 250, Multilobar infiltrate, Confusion, BUN > 20, leukopenia, thrombocytopenia, hypotension, hypothermia
What is the breakdown of CURB 65?
Blood urea nitrogen > 19 mg per dL
Respiratory rate ≥ 30 breaths per minute 1
Systolic blood pressure < 90 mm Hg or Diastolic blood pressure ≤ 60 mm Hg
Age ≥ 65 years
What are the recommendations for CURB65 scores?
CURB-65 score Recommendation†
0 & 1 Low risk; consider home treatment
2 Short inpatient hospitalization or closely supervised outpatient treatment
3 and above Severe pneumonia; hospitalize and consider admitting to intensive care
What is the management for a confirmed adenoma in a patient?
Immediate full screening colonoscopy
What is the recommended treatment for postmenopausal women with Primary hyperparathyroidism?
Estrogen-progestin replacement to decrease serum calcium and increase bone density
What is the presentation and management of basilar skull fracture?
CSF ottorhea, rhinorrhea, periorbital brusing (racoon eyes) and hematoma. Assess integrity of cervical spine by extending CT scan to include the hear.
What is the optimal management for children who swallowed a foreign object?
Rigid bronchoscopy under general anesthesia. Flexible bronchoscopy is for adults.
What is the presentation and treatment of autoimmune hepatitis?
Extrahepatic autoimmune disease (thyroid, ITP etc), hypergammaglobulinemia, positive ANA and ASMA. Low dose prednisone
What is the criteria for patients to receive pavalizumab for RSV prophylaxis?
History of bronchopulmonary disease, premature birth, hemodynamically significant heart diseae
What causes 80% of common bile duct strictures?
Laparoscopic or open cholecystectomy
What is the p/t of Gaucher disese?
AR. Lysosomal storage disease. 25% painless hepatosplenomegaly, bone abnormalities of various degrees, High risk of splenic infarction, growth delay and pulmonaryinfarction. Treatment is Glucocylceramidase replacement
What it the p/t of SBP?
Abdominal pain, fever, AMS and increaseing ascites. US guided abdominal paracentesis showing neutrophil count > 250. Cefotaxime and Albumin
What is the presentation of Osler-Weber-Rendu syndrome?
AD condition with Hereditary hemorrhagic telangectasia, epistaxis and iron deficiency anemia
What are the most common tumors that metastasize to bone?
Breast, Prostate and Lung
What is a side effect of propranolol?
What is the order of drugs for status epilepticus to prevent seizure recurrence?
Benzodiazepine, IV phenytoin, phenobarbital, midazolam or propofol
What are the BAL findings in Amiodarone toxicity?
Foamy macrophages, directly toxic, alters phospholipid bilayer
What are the lab findings in corticosteroid induced myopathy?
Normal muscle enzymes, normal EMG, no inflammation or necrosis on muscle biopsy just non specific atrophy
What is the pathophysiology behind corticosteroid induced myopathy?
Catabolic effect on skeletal muscle, interferes with IGF I signalling, increasing muscle degradation via ubiquitination
What is the presentation of laryngomalacia?
congenital softening of the tissues of the larynx (voice box) above the vocal cords. This is the most common cause of noisy breathing in infancy
What are extrarenal manifestations of ADPKD?
Intracranial berry aneurysms, cardiac valvular disease (most common cause of death), hepatic cysts and colonic diverticula
Which congenital disease is associated with explosive BM after rectal exam?
What radiation dose can a pregnant woman receive without sideeffects?
Less than 5 rads
What genes have mutations in familial melanoma? Basal cell carcinoma?
What is the criteria for proceeding with thoracotomy after hemothorax?
>1500 ml drained after initial placement or >=20ml/kg or shock/persistence after draining 3ml.kg.hr
What is the mechanism of acyclovir?
Nucleoside analogue that inhibits DNA synthesis by inhibiting viral DNA polymerase
What are findings in Werdnig Hoffman syndrome )Spinal muscular atrophy I)?
SMN gene mutation in blood, perineural denervation, normal motor conduction
What is the difference between strabismus and pseudostrabismus?
Pseudostrabismus has symmetric corneal reflex while strabismus has asymmetric corneal reflex. Reassurance.
What is the w/u of S3 in children and young adults?
What is the gram staining of Chlamidya?
Gram negative obligate intracellular microorganisms that preferentially infect squamocolumnar epithelial cells
What is the first line treatment for premenstrual dysphoric disorder?
What is the #1 and # cause of meningties with VP shunts?
Staph epidermidis is number 1 and staph aureus is No. 2
What is the p/t of Cushings triad?
Hypertension, bradycardia and irregular breathing. Lower intracranial pressure by elevating head of the bed, hyperventilation, Mannitol, surgical decompression, Burr holes.
What is the presentation of Mirrizzi syndrome?
Compression of common bile/hepatic duct by a gallstone
What is the presentation of Lofgren syndrome?
self limiting acute sarcoidosis in caucasians, preseting with fever, symmetric polyarthritis, b/l hilar fullness, erythema nodusum, anterior uveitis
What is the presentation and finding of prostatic abscess?
Repeat UTIs that get better with antibiotics until it is stopped. Tender prostate with a fluctuant mass.