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OBGYN, PSYCH, PEDS > IM 2 > Flashcards

IM 2 Flashcards

(70 cards)

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1
Q

compare CML to LR

A

LR has HIGH alk phsophatase score, greater proption fo late neutrophil precursors, lack of absolute basophilia

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2
Q

tx of hepatic encephalopathy

A

lactulose

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3
Q

AMS, nystagmus and ataxia in alcoholic

A

thiamine deficiency with wernicke encephalopathy

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4
Q

why glucagon in tx of BB or CCB OD

A

incrased cAMP, corrects refractory hypotension if pt doesn’t initially respond to atropine and fluid boluses

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5
Q

phenytoin toxicity

A

horizontal nystagmus, ataxia, N/V, AMS

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6
Q

old person on a medication with recent addition and now new sx

A

think medication interaction

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7
Q

isolated thyrombocytopneai, mucocutaneous bleeding, easy bruising, IgG autoantibodies against platelet membrane glycoproteins

A

ITP

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8
Q

ADAMTS13

A

TTP = thrombocytopenia + MAHA

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9
Q

degeneration of GABA producing neurons in caudate nucleus and putamen

A

HD

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10
Q

rectangular, envelope-shaped calcium oxalated crystals in pt with AMS

A

eythlene glucol poisoning

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11
Q

pt presents with concern of dropping left face. how to differentiate peripheral vs central nerve lesions?

A 
central = upper facial muscles are spared due to compensation from the unaffected hemisphere
peripheral = bell palsy = weakness of the entire half of the face
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12
Q

screening and dx test for MM

A 
screen = serum or urine protein electrophoresis, free light chain analysis
diagnosis = BM biopsy
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13
Q

following MI, develops sx of HF, refractory angina, ventricul arrythmias, functional MR, mural thrombus and ECT shows persistent ST elevation and deep Q waves

A

ventricular aneurysm, late MI complication

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14
Q

presentation of MR after MI

A

due to papillary muscle rupture, 2-7 days post MI, presents dramatically with acute, severe MR (hypotension, pulmonary edema, cardiogenic shock)

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15
Q

what are untreated hyperthyroid pts at risk of?

A

rapid bone loss from increased osteoclastic activity, cardiac tachyarrhythmias, including afib

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16
Q

microcytic anemia, HTN, neprhopathy, hyperuricemia, basophillic stippling on peripher smear

A

lead toxicity, tx is EDTA chelation

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17
Q

anti-TPO antibodies

A

Hashimoto’s thyroiditis; also associated with increased risk of miscarriage

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18
Q

anti-mitochondrial Ab

A

primary biliary cholangitis

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19
Q

phenytoin can lead to megaloblastic anemia and gingival hyperplasia due to impaired absorption of _____

A

folic acid

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20
Q

vitamin B1

A

thiamine

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21
Q

HIV pt with severely advanced disease (CD4<100) and lung symptoms

A

progressive disseminated histoplasmosis; get urine or serum histoplasma antigen assay

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22
Q

fevers, chills, malaise, weight loss, cough, dypsnea, mucocutaneous lesions, LAD in pt with HIV

A

disseminated histoplasmosis; tx is amphotericin

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23
Q

HTN, mild hypernatremia, metabolic alkalosis, suppressed plasma renin activity

A

primary hyperaldosteronism

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24
Q

how to distinguish benzos from opioid OD

A

benzo = lack of severe respiratory depression and pupillary constriciton

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25
leaning on elbows, decreased sensation over the 4th and 5th fingers, weak grip
ulnar entrapment
26
antiGBM
goodpasture's syndrome
27
hemolysis (elevated bili and LDH), cytopenias, hypercoagulable state (venous thrombosis), flow cytometry with absence of CD55 and CD59
paroxysmal noctural hemoglobinuria
28
____ is an impt cause of RHF, characterized by progressive peripheral edema, scites, elevated JVP, pericardia knock, and pericardial calcifications
constrictive pericarditis
29
middiastolic sound
pericardial knock
30
fever, generalized muscle rigidity, autonomic instability, mental status changes
neuroleptic malignant syndrome - typically due to dopamine antagonists
31
why infxns in MM
hypogammaglobulinemia
32
in what cond'ns should hospitalized pts be taken off metformin
acute renal failure, liver failure, or sepsis; all increase risk of lactic acidosis
33
monotherapy for bipolar
lithium, valproate, quetiapine, lamotrigine
34
recommended therapy for severe bipolar
dual therapy = lithium/valproate + second generation like quetiapine/lamotrigine
35
first line tx for mania
olanzapine (antipsychotic), lithium, valproate (anticonvulsant mood stabilizer)
36
this antipsychotic can be administered IM and has acute onset of action, making it ideal for tx of acutely manic/behavioral agitationJJj pts
olanzapine
37
these two rxs can be used for tx of drug-induced parkinsonism (type of EPS)
benztropine and amantadine
38
what type of EPS does propranolol tx
akathisia
39
what class of psychiatric rx can lead to galactorrhea, menstrual irregularities and infertility?
antipsychotics (block dopamine 2 receptors, leading to resultant prolactin increase)
40
name some antipsychotics
haloperidol, fluphenazine, risperidone, paliperidone, aripiprazole
41
MUDPILES
``` Methanol Uremia DKA Paraldehyde Isoniazide Lactic acidosis Ethylene glycol (anti-freeze; see crystals) Salicylates ```
42
Non Gap Acidosis
Diarrhea (poop out bicarb = metabolic acidosis) Abuse/overuse of diuretics RTA
43
numbness, prolonged QT
hypocalcemia
44
bones, stones, groans, shortened QT
hypercalcemia
45
what to check if concerned about CO poisoned?
carboxyhemoglobin, tx is 100% O2
46
young person who clots
Factor V Leiden
47
normal platelets but increased bleeding and PTT
vWD
48
tx of burns, doesn't penetrate eschar, can cause leukopenia
silver sulfadiazene
49
this topical rx for burns also doesn't penetrate eschar, but causes hypokalemia and hyponatremia
silver nitrate
50
of the three topical tx for burns, this one does penetrate eschars
mafenide `
51
what will kill you from electrical burn
arrhytmia, look at EKG
52
urine + for blood but no RBCs
myoglobinuria, MUST CHECK K in evaluation of rhabdo as arrhtyhmia can kill you
53
GCS < 8
intubate
54
trauma, blood at urethra, high-riding prostate
evaluate with retrograde urethrogram, followed by retrograde cystogram if negative.
55
bugs of nec fasc
strep and clostridium
56
POD 3-5 with fever
pneumonia, UTI
57
POD 1 with fever
atelectasis, nec fasc, malignant hyperthermia
58
POD 7 with fever, salmon colored fluid from incision
dehiscence, return to OR
59
post gyn surgery with unexplained fever
think about thrombophlebitis, given heparin and abx
60
is a person with a crhonic ulcer at risk of squamous cell carcinoma due to continual skin remodeling?
yes
61
popcorn calcification in lung
hamartoma, benign
62
what do we give octreotide for
carcinoid, VIPoma, bleeding varices
63
RUQ pain, high bili and alk phos
choledocolithiasis
64
large hydatid liver cyst + eosinophilia
echinococcus, albendazole and surgery to remove entire cyst (the other liver cyst with entamoeba histolytica you do not drain/do surgery)
65
IBD that involves terminal ileum, can mimmic appendicitis, skip lesions, transmural inflammation, fistulae, biopsy with granulomas
chrons
66
IBD with continuous lesions, associated with pANCA, increased risk of colon cancer and primary sclerosing cholangitis, tx with colectomy
UC
67
get this test if pt with known vascular disease c/o butt, thigh and calf pain with walking
ABI, nl is < 1
68
pituitary adenoma, parathyroid hyperplasia, pancreatic | islet cell tumor.
MEN 1
69
neck mass anterior to SCM
brachial cleft cyst
70
what type of rx to avoid in pt with BPH
anticholinergics, make urinary retention worse

OBGYN, PSYCH, PEDS (8 decks)

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