hammer4 Flashcards
What are the lung findings of patients with pleural effusion?
Decreased breath sounds, decreased tactile fremitus, dullness to percussion. Shift away from mediastinum
What are the lung findings of patients with lobar pneumonia with consolidation?
Increased breath sounds, increased tactile fremitus, dullness to percussion. No Shift from mediastinum
What is the hallmark damage in status epilipticus and other prolonged seizures? What is the pathophysiology?
Cortical laminar necrosis due to excitatory cytotoxicity
What are the risk factors for toxic megacolon? How is it diagnosed? Management?
IBD or C diff infection. Dx - systemic toxicity, bloody diarrhea, abdominal distension/peritonitis, marked distension of abdominal imaging. Mgmt - Bowel rest, NG suction, abx. +/- corticosteroids id IBD-associated.
When is the onset of gonococcal conjuctivitis? What are the symptoms and treatment?
2 - 5 days. Marked eye swelling, profuse purulent discharge, corneal edema/ulceration. IV/IM CTX or Cefotaxime
When is the onset of chlamidyal conjuctivitis? What are the symptoms and treatment?
5 - 14 days. Eyelid swelling; chemosis; watery, BLOODY, or mucopurulent eye discharge. Oral erythromycin.
How does NSAID cause hyperkalemia? What about K+ sparing diuretics like Amilioride?
Impaired local prostaglandin synthesis reduces renin and aldosterone secretion. Block the epithelial sodium channel or aldosterone receptor
What is the mechanism of Heparin induced thrombocytopenia and what does it lead to?
Conformational change in platelet surface antigen (platelet factor 4), forms IgG antibody that coats platelets causing thrombocytopenia 2/2 macrophage consumption and thrombus formation (arterial and venous after platelet activation)
What is sialadenosis and what causes it?
Benign, non inflammatory enlargement of the salivary glands. Seen in patients with advanced liver disease (alcoholics) as well as a variety of dietary and nutritional disorders.
What is the etiology of ascites with SAAg > 1.1? SAAG
SAAG > 1.1 indicates polar hypertension (cardiac ascites, cirrhosis) while SAAG
What is unique about a crossectional study?
Snap shot study that looks at both outcome and exposure
What is the presentation of obstructive uropathy 2/2 nephroctomy for example?
Flank pain, low voids with periods of high voids
What are the clinicial features of CLL? How is it diagnosed? What is a major complication?
Lymphadenopathy, Hepatosplenomegaly, Mild Thrombocytopenia and anemia. Severe lymphocytosis and smudge cells and flow cytometry showing clonality of mature B cells. No Bx. Infection.
What type of amnesia is associated with isolated impairment of autobiographhical memory? What is it characterized by?
Dissociative amnesia characterized by travelling or wandering in a dissociated state
What is the presentation of choriocarcinoma? Where does it usually spread to? What is seen on x-ray and how is disease diagnosed?
Irregular vaginal bleeding, enlarged uterus, pelvic pain. Irregular bleeding past 8 weeks. Mets to the lungs showing worsening pulmonary function and even hemoptysis. Multiple nodules on the lungs on CXR. Measure quantitative Bhcg.
What and where is the most common location of pediatric brain tumors? What symptoms are associated with a supratentorial tumor? What is the second most common tumor and where?
CNS tumors, astrocytoma. Seizure, weakness, sensory changes. Medulooblastoma in posterior fossa, arise from cerebellar vermis and present with vomiting, headaches and ataxia.
What complications are associated with a pneumothorax?
HYPOtension, tachycardia, absent breath sounds, JVP
What causes cyanide toxicity and what are the symptoms?
Treatment with nitroprusside especially in people with underlying renal insufficiency. AMS, lactic acidosis, seizures, coma
What class of drugs is Buproprion and when is it contraindicated?
NDRI, prior hx. of seizures, bulimia, anorexia
What symptoms are associated with acute-angle closure glaucoma?
Severe eye pain, halos, dilated pupils and poor response to light, unilateral orbitofrontal headache, unilateral eye pain with conjuctival injection
What is the most common etiology of urethritis in men ? What caused it if you can’t see it on gram culture and how would you diagnose it?
Neisseria gonorrhoeae. Chlamidya tracomatis. Nucleic acid amplification test on first catch urine sample w/o precleaning.
What is pseudocyesis?
Psychiatric illness where the patient presents with nearly all signs and symptoms of pregnancy with negative US and negative pregnancy test
What is the most common cause of conductive hearing loss in 20s and 30 year olds? What will Weber test show?
Otosclerosis. Laterizes to the affected ear when fork is placed in midline
What is the presentation of an infant with galactosemia? What enzyme is deficiency?
Failure to thrive, Bilateral cataracts, jaundice, hypoglycemia. Galactose-1-phosphate uridyl transferase deficiency.
