Flashcards in IM COMAT Deck (402)
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
HIV pt w/ back pain/night sweats/Fever. Dx?
S-Pep +>10% Plasma CellsHyperviscosityTx: Rituxumab +Plasma Phoresis
What is the most common cause of death in dialysis patients?
Cardiovascular disease*also the most common cause of death in renal transplant patients
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)
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
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
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)
Pansystolic murmur post MI...
Sign of DNA synthesis impairment
Hyper seg PMN
Giant Cell Sx...
Vasculitis,Fever, Anemia, ESR, Temporal HA
What vitamin deficiency commonly accompanies Carcinoid syndrome?
Vitamin B3 (Niacin) deficiency---Both serotonin and B3 are synthesized from tryptophan
What is the definition of Oligomenorrhea?
Menses occurring at infrequent intervals or more than 40 days or fewer than nine menses per year
When should valve replacement be considered in a patient with aortic stenosis?
aortic valve with an area less than 1 cm2
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
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
How is a latent TB infection treated?
Isoniazide for 9 months
Dx for AIHA
Coombs +IgM - ColdIgG - Warm
Dx for PNH
Flow Cytology, CD55- Cells
Walking on toes test nerve root ___
What supplementation is often used along side Isoniazid?
Pyridoxine - prevent peripheral neuropathy
What is the definition of neutropenia? what are chemotherapy patients at risk for?
absolute neutrophil count less than 500 cells/mm3Neutropenic fever
Dx for Hereditary Spherocytosis
Blood Smear + Osmo Fragility Test
Med for uncomplicated Pyleonephritis
What is the treatment of hyperkalemia?
C BIG K-Calcium, Bicarb/B-agonis, Insulin, Glucose, Kayexalate
What is the highest risk factor for cervical cancer?
Multiple sex partners - contracting HPV 16, 18, 45, 33, 58
What cardiac condition is related to a pattern of alternating amplitude of QRS complexes
Electrical Alternans - Cardiac tamponade
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
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