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Flashcards in IM COMAT Deck (402)
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1

What is the type of TB infection where the Xray findings shows 1- to 2-mm granulomas?What is a possible side effect?

Miliary TB - hematogenously disseminated tuberculosis--adrenal involvement in common=can cause ADRENAL INSUFFICIENCY

2

HIV pt w/ back pain/night sweats/Fever. Dx?

TB

3

Dx Waldenstrom

S-Pep +>10% Plasma CellsHyperviscosityTx: Rituxumab +Plasma Phoresis

4

What is the most common cause of death in dialysis patients?

Cardiovascular disease*also the most common cause of death in renal transplant patients

5

What is the most likely diagnosis:28 year old woman from Nigerial w 6 month history of persistent lower lumbar back pain, a/w low-grade fever, and night sweats. point tenderness over spinous processes of L4-L5

Tuberculous osteomyelitis (Pott disease)

6

A pt w chronic renal failure remains in the icu after a surgical procedure. The patient has diffuse microvascular bleeding from several puncture sites. Labs show normal PT/INR, aPTT, platelets.what is the cause?

Coagulopathy from uremia. ---uremia causes platelet dysfunction - poor platelet adhesion

7

What is the most appropriate initial Abx choice:85 year old nursing home resident w hx of CHF, dementia. Presents w 3 day hx of fever, productive cough, CXR shows right middle lobe consolidation

IV cefepime:---nursing home = pneumonia is nosocomial not CAP=high incidence of gram negative---age, med hx = high risk = hosptialization and IV cephalosporin

8

complaining of RUQ abdominal pain. BP 75/46, HR 165/min, RR 18/min, O2 sat 97%, Temp 103.5 F. Phys exam shows scleral icterus and tenting of the skin. Elevated WBC's

Ascending CholangitisCharcot's triad (RUQ pain, fever, jaundice) starting to progress to Reynold's Pentad (hypotension, altered mental status)

9

Pansystolic murmur post MI...

Septal rupture

10

Sign of DNA synthesis impairment

Hyper seg PMN

11

Giant Cell Sx...

Vasculitis,Fever, Anemia, ESR, Temporal HA

12

What vitamin deficiency commonly accompanies Carcinoid syndrome?

Vitamin B3 (Niacin) deficiency---Both serotonin and B3 are synthesized from tryptophan

13

What is the definition of Oligomenorrhea?

Menses occurring at infrequent intervals or more than 40 days or fewer than nine menses per year

14

When should valve replacement be considered in a patient with aortic stenosis?

aortic valve with an area less than 1 cm2

15

What is the diagnostic criteria for Amenorrhea1. primary2. secondary

1. Absence of menarche by the age of 162. Absence of menstruation for 3 or more months in women w normal past menses

16

What therapy provides the greatest benefit to a patient with chronic stable emphysema and a resting oxygen sat of 86%

Supplemental oxygen used continuouslysmoking cessation--only medical therapies shown to decrease mortality among COPD pts

17

How is a latent TB infection treated?

Isoniazide for 9 months

18

Dx for AIHA

Coombs +IgM - ColdIgG - Warm

19

Dx for PNH

Flow Cytology, CD55- Cells

20

Walking on toes test nerve root ___

S1

21

What supplementation is often used along side Isoniazid?

Pyridoxine - prevent peripheral neuropathy

22

What is the definition of neutropenia? what are chemotherapy patients at risk for?

absolute neutrophil count less than 500 cells/mm3Neutropenic fever

23

Dx for Hereditary Spherocytosis

Blood Smear + Osmo Fragility Test

24

Med for uncomplicated Pyleonephritis

Cipro

25

What is the treatment of hyperkalemia?

C BIG K-Calcium, Bicarb/B-agonis, Insulin, Glucose, Kayexalate

26

What is the highest risk factor for cervical cancer?

Multiple sex partners - contracting HPV 16, 18, 45, 33, 58

27

What cardiac condition is related to a pattern of alternating amplitude of QRS complexes

Electrical Alternans - Cardiac tamponade

28

How is the BUN/serum CR ratio interpreted?

BUN/Cr >20:1 = pre-renal disease (ie volume depletion, renal A stenosis)BUN/CR = normal or 10 to 15: 1 = ATN, AIN

29

Identify cause:72 year old man w severe pain and swelling in knees post surgery. Intracellular and extracellular weakly positive birefringent crystals in synovial crystals

Pseudogoutgout - NEGATIVELY birefringent crystals

30

What are the tuberculin reaction sizes and the related circumstance required for diagnosis of latent M tuberculosis infection

1. >5mm - HIV, close contact w TB pt, Fibrotic lesions on CXR2. >10mm - Recently infected (<2y), high risk medical conditions3. >15mm - low risk persons