KP Teil 1 Flashcards
(362 cards)
1
Q
PAVK Fontaine Stage I
A
Asymptomatic
2
Q
PAVK Fontaine Stage IIa
A
Claudication >200m pain-free walking
3
Q
PAVK Fontaine Stage IIb
A
Claudication <200m pain-free walking
4
Q
PAVK Fontaine Stage III
A
Ischemic rest pain
5
Q
PAVK Fontaine Stage IV
A
Trophic changes (ulcers/gangrene)
6
Q
Ratschow Test Procedure
A
Leg elevation for 2 min → observe pallor → sitting position → observe venous filling time
7
Q
Normal Ratschow Findings
A
Redness returns in 5s, venous filling in 20s
8
Q
Pathologic Ratschow Findings
A
Delayed color return/venous filling (indicates PAVK)
9
Q
6Ps of Acute Limb Ischemia
A
Pain, Pallor, Pulselessness, Paresthesia, Paralysis, Prostration
10
Q
PAVK Diagnostic Workup
A
ABI, duplex ultrasound, angiography (CT/MRI/DSA)
11
Q
ABI Interpretation
A
Normal: 0.9-1.2, Mild: 0.75-0.9, Moderate: 0.5-0.75, Severe: <0.5, Mediasklerosis: >1.3
12
Q
PAVK Conservative Treatment
A
Smoking cessation, exercise training, antiplatelets (ASA/clopidogrel)
13
Q
PAVK Medical Therapy Stage I
A
Statins + ACE inhibitor/CCB
14
Q
PAVK Medical Therapy Stage II
A
Add antiplatelet (ASA/clopidogrel)
15
Q
PAVK Medical Therapy Stage III
A
Add prostaglandins (if revascularization not possible)
16
Q
PAVK Revascularization Options
A
PTA with stenting, bypass surgery (venous/artificial graft)
17
Q
Fogarty Thrombectomy
A
Balloon catheter technique for arterial embolus removal
18
Q
Acute Arterial Occlusion Causes
A
80% embolic (cardiac source), 20% thrombotic (atherosclerosis)
19
Q
Leriche Syndrome Triad
A
Buttock claudication, impotence, absent femoral pulses
20
Q
Compartment Syndrome Signs
A
6Ps + tense swelling, pain with passive stretching
21
Q
Reperfusion Syndrome Patho
A
Ischemia >6h → cellular necrosis → toxin release → edema → compartment syndrome
22
Q
Reperfusion Syndrome Management
A
Fasciotomy, hydration, alkalinize urine, monitor electrolytes
23
Q
Mesenteric Ischemia Symptoms
A
Severe abdominal pain out of proportion to exam, diarrhea, later peritonitis
24
Q
Mesenteric Ischemia Diagnosis
A
CT angiography (gold standard)
25
Subclavian Steal Mechanism
Subclavian stenosis proximal to vertebral artery → reversed vertebral flow → cerebral hypoperfusion
26
Subclavian Steal Symptoms
Arm claudication, vertebrobasilar insufficiency (dizziness, visual changes)
27
Takayasu Arteritis Features
Pulseless disease, young women, granulomatous vasculitis of large arteries
28
Venous Thrombosis Signs
Meyer, Homans, Pay signs; swelling, warmth, erythema
29
Virchow's Triad
Stasis, endothelial injury, hypercoagulability
30
DVT Complications
PE, post-thrombotic syndrome, phlegmasia cerulea dolens
31
Wells Score for DVT
Active cancer (1), paralysis (1), recent immobility (1), tenderness (1), swelling (1), collateral veins (1), alternative diagnosis (-2)
32
DVT Treatment
Anticoagulation (DOACs/LMWH/warfarin), compression stockings
33
PE Wells Score Criteria
Clinical DVT signs (3), PE more likely (3), HR>100 (1.5), immobilization (1.5), prior VTE (1.5), hemoptysis (1), malignancy (1)
34
PE Diagnostic Approach
Wells score → D-dimer → CT pulmonary angiogram
35
PE ECG Findings
S1Q3T3 pattern, right heart strain (RBBB, T inversions V1-V4)
36
Massive PE Features
Hypotension, RV dysfunction, elevated troponin/BNP
37
PE Treatment
Hemodynamically unstable: thrombolysis (alteplase). Stable: anticoagulation
38
Anticoagulation Duration PE
3-6 months (longer if recurrent/unprovoked)
39
ACS Types
STEMI, NSTEMI, unstable angina
40
STEMI ECG Criteria
ST elevation ≥1mm in 2 contiguous leads (≥2mm V1-V3), new LBBB
41
NSTEMI Biomarkers
Troponin elevation without ST elevation
42
MI Location: Anterior
V1-V4 (LAD occlusion)
43
MI Location: Inferior
II, III, aVF (RCA occlusion)
44
MI Location: Lateral
I, aVL, V5-V6 (LCx occlusion)
45
MI Location: Posterior
Tall R waves V1-V2, ST depression (reciprocal changes)
46
MI Complications
Arrhythmias, cardiogenic shock, rupture (free wall/VSD/papillary muscle)
47
MI Reperfusion Therapy
Primary PCI (within 120min) or fibrinolysis (if PCI unavailable within 120min)
48
Fibrinolytic Agents
Alteplase, tenecteplase, streptokinase
49
Post-PCI Medications
DAPT (ASA + P2Y12 inhibitor), statin, beta blocker, ACE inhibitor
50
Cardiogenic Shock Criteria
Hypotension (SBP<90), signs of hypoperfusion, PCWP>15, CI<2.2
51
VF Treatment
Immediate defibrillation (200J biphasic), CPR, epinephrine, amiodarone
52
Asystole/PEA Treatment
CPR, epinephrine q3-5min, identify/treat underlying cause
53
Bradycardia Algorithm
Atropine 0.5mg IV, transcutaneous pacing, dopamine/epinephrine infusion
54
AV Block Types
1st: PR>200ms, 2nd Type I: Wenckebach, 2nd Type II: Mobitz, 3rd: Complete dissociation
55
AV Block 3° Treatment
Temporary then permanent pacemaker
56
Atrial Fibrillation Types
Paroxysmal (<7d), persistent (>7d), long-standing persistent (>1y), permanent
57
AF Stroke Risk (CHA2DS2-VASc)
C: CHF (1), H: HTN (1), A2: Age≥75 (2), D: DM (1), S2: Stroke/TIA (2), V: Vascular disease (1), A: Age 65-74 (1), Sc: Sex female (1)
58
AF Rate Control Agents
Beta blockers, non-DHP CCBs (diltiazem/verapamil), digoxin
59
AF Rhythm Control Agents
Flecainide, propafenone, amiodarone, dofetilide
60
AF Ablation Indications
Symptomatic AF refractory to meds, contraindications to meds
61
AF Anticoagulation Options
DOACs (apixaban/rivaroxaban), warfarin (INR 2-3)
62
WPW ECG Findings
Short PR, delta wave, wide QRS
63
WPW Dangerous Scenario
AF with preexcitation (risk of VF)
64
VT Types
Monomorphic, polymorphic, torsades
65
Torsades de Pointes Causes
Long QT, hypokalemia, hypomagnesemia, drugs
66
Torsades Treatment
Magnesium sulfate, correct electrolytes, pacing
67
HFrEF Definition
LVEF <40% with HF symptoms
68
HFpEF Definition
LVEF ≥50% with HF symptoms + diastolic dysfunction
69
HF Medical Therapy
ACE-I/ARB/ARNI, beta blocker, MRA, SGLT2i, diuretics
70
ARNI Drug Example
Sacubitril/valsartan (replaces ACE-I in chronic HF)
71
Cardiac Resynchronization
Biventricular pacing (LV lead via coronary sinus), indicated for EF<35% + QRS>120ms + LBBB
72
ICD Indications
Primary prevention: EF≤35% (ischemic) or ≤30% (non-ischemic)
73
Aortic Dissection Types
Stanford A (ascending aorta - surgical), Stanford B (descending - medical/TEVAR)
74
Aortic Dissection Symptoms
Tearing chest/back pain, pulse deficits, neurologic symptoms
75
Marfan Syndrome Criteria
Ghent criteria: aortic root dilation + ectopia lentis + systemic features
76
Acute Limb Ischemia Rutherford I
Viable: no sensory/motor loss, audible Doppler signals
77
Acute Limb Ischemia Rutherford IIa
Marginally threatened: minimal sensory loss, no motor loss
78
Acute Limb Ischemia Rutherford IIb
Immediately threatened: sensory + motor loss, no Doppler signals
79
Acute Limb Ischemia Rutherford III
Irreversible: profound sensory/motor loss, rigid muscles
80
Carotid Stenosis Symptoms
Amaurosis fugax, hemispheric TIAs, stroke
81
Carotid Endarterectomy Indications
Symptomatic >50%, asymptomatic >60% stenosis
82
Venous Ulcer Features
Medial malleolus, irregular borders, weeping, hemosiderin staining
83
Arterial Ulcer Features
Lateral/distal sites, punched-out appearance, pale base
84
Diabetic Foot Ulcer Prevention
Offloading, glycemic control, regular foot exams
85
Critical Limb Ischemia
Rest pain >2 weeks, ulcers/gangrene, ankle pressure <50mmHg
86
Thromboangiitis Obliterans
Buerger's disease: smoking-related, young males, distal vessels
87
Raynaud Phenomenon
Vasospastic attacks (pallor → cyanosis → erythema)
88
Vasculitis with Pulmonary-Renal
Granulomatosis with polyangiitis (c-ANCA/PR3)
89
Giant Cell Arteritis Symptoms
Headache, jaw claudication, visual loss, elevated ESR
90
Giant Cell Arteritis Treatment
High-dose steroids (prednisone 1mg/kg), temporal artery biopsy
91
Polyarteritis Nodosa Features
Medium vessel, hepatitis B associated, mononeuritis multiplex
92
Kawasaki Disease Criteria
Fever >5d + 4/5: conjunctivitis, oral changes, rash, extremity changes, cervical LAD
93
Kawasaki Treatment
IVIG + high-dose ASA
94
Hypertensive Emergency Features
BP >180/120 + end-organ damage (encephalopathy, renal failure, pulmonary edema)
95
Hypertensive Emergency Drugs
Labetalol, nicardipine, clevidipine, nitroprusside
96
Hypertensive Urgency
Severe HTN without end-organ damage → oral agents
97
Primary Aldosteronism Screening
Elevated aldosterone/renin ratio
98
Pheochromocytoma Triad
Headache, sweating, tachycardia + HTN
99
Pheochromocytoma Diagnosis
24h urine metanephrines, plasma free metanephrines
100
Pheochromocytoma Pre-op Prep
Alpha blockade (phenoxybenzamine) 7-14d before beta blockade
101
Cushing Syndrome Features
Central obesity, moon face, buffalo hump, striae
102
Cushing Diagnostic Tests
1mg dexamethasone suppression test, late-night salivary cortisol
103
Conn Syndrome
Primary hyperaldosteronism → HTN + hypokalemia
104
Addison Disease Symptoms
Fatigue, hyperpigmentation, hyponatremia, hyperkalemia
105
Addison Crisis Treatment
Hydrocortisone IV, fluid resuscitation
106
SIADH Criteria
Hyponatremia + euvolemia + urine osmolality >100 + urine Na >20
107
SIADH Treatment
Fluid restriction, demeclocycline, vaptans in severe cases
108
Diabetes Insipidus Types
Central (ADH deficiency) vs nephrogenic (ADH resistance)
109
Diabetes Insipidus Tests
Water deprivation test, desmopressin trial
110
Hyperthyroidism Causes
Graves, toxic MNG, thyroiditis, toxic adenoma
111
Graves Disease Features
Diffuse goiter, ophthalmopathy, dermopathy, TRAb+
112
Thyroid Storm Criteria
Fever, tachycardia, CNS dysfunction, GI symptoms + hyperthyroidism
113
Thyroid Storm Treatment
PTU, iodide, beta blockers, steroids, cooling
114
Hypothyroidism Symptoms
Fatigue, cold intolerance, weight gain, bradycardia
115
Myxedema Coma
Hypothyroidism + altered mental status + hypothermia → levothyroxine IV + steroids
116
Thyroid Nodule Workup
TSH → ultrasound → FNA if suspicious features
117
Thyroid Cancer Types
Papillary (most common), follicular, medullary, anaplastic
118
Medullary Thyroid Cancer Markers
Calcitonin, CEA, RET proto-oncogene
119
Adrenal Incidentaloma Workup
Hormonal evaluation + imaging features
120
Pituitary Adenoma Types
Prolactinoma (most common), GH (acromegaly), ACTH (Cushing)
121
Prolactinoma Treatment
Dopamine agonists (cabergoline), surgery for resistant cases
122
Acromegaly Diagnosis
Elevated IGF-1, failed glucose suppression test
123
Acromegaly Treatment
Surgery (transsphenoidal), somatostatin analogs, GH receptor antagonist
124
Diabetes Diagnostic Criteria
Fasting glucose ≥126, random ≥200, A1c ≥6.5%, + symptoms
125
DM Complications
Microvascular (retinopathy, nephropathy, neuropathy), macrovascular (CAD, PAD, stroke)
126
DKA Diagnostic Criteria
Glucose >250, pH <7.3, bicarbonate <15, ketonemia/uria
127
DKA Treatment
IV fluids, insulin drip, potassium repletion
128
HHS Features
Glucose >600, no significant ketosis, higher mortality than DKA
129
Chronic Kidney Disease Stages
G1-G5 by GFR, A1-A3 by albuminuria
130
CKD Complications
Anemia, mineral bone disorder, fluid overload
131
ESRD Treatment Options
Hemodialysis, peritoneal dialysis, transplantation
132
Dialysis Access Types
AV fistula (best), AV graft, tunneled catheter
133
AKI Types
Prerenal (hypoperfusion), intrinsic (ATN), postrenal (obstruction)
134
ATN Urine Findings
Muddy brown casts, FE Na >2%, urine osmolality ~300
135
Prerenal AKI Urine Findings
Bland sediment, FE Na <1%, urine osmolality >500
136
GN Nephritic Syndrome
HTN, hematuria, mild proteinuria, RBC casts
137
GN Nephrotic Syndrome
Heavy proteinuria (>3.5g), hypoalbuminemia, edema, hyperlipidemia
138
Minimal Change Disease
Most common pediatric nephrotic syndrome, responds to steroids
139
Membranous Nephropathy
PLA2R antibodies, adult nephrotic syndrome, may need rituximab
140
Post-Strep GN
Nephritic syndrome 1-2 weeks after strep infection, low C3
141
IgA Nephropathy
Most common GN worldwide, hematuria after URI, mesangial IgA deposits
142
Goodpasture Syndrome
Anti-GBM antibodies, pulmonary hemorrhage + RPGN
143
ANCA Vasculitis Types
MPO (p-ANCA), PR3 (c-ANCA), granulomatosis with polyangiitis
144
RPGN Types
Anti-GBM, ANCA, immune complex, pauci-immune
145
UTI Classification
Cystitis (dysuria), pyelonephritis (flank pain/fever), prostatitis
146
Pyelonephritis Treatment
IV antibiotics (ceftriaxone/piperacillin-tazobactam) if severe
147
Prostatitis Types
Acute bacterial (fever, tender prostate), chronic pelvic pain syndrome
148
Nephrolithiasis Types
Calcium oxalate (most common), struvite (infection stones), uric acid
149
Stone Management
<5mm likely pass, >10mm need intervention (lithotripsy, ureteroscopy)
150
BPH Medical Therapy
Alpha blockers (tamsulosin), 5-ARIs (finasteride)
151
Prostate Cancer Screening
PSA + DRE (shared decision making age 55-69)
152
Prostate Cancer Staging
TNM, Gleason score (grade group), PSA
153
Testicular Cancer Markers
Seminoma: PLAP\nNon-seminoma: AFP, β-hCG, LDH
154
Testicular Cancer Treatment
Radical orchiectomy, RPLND for bulky nodes, chemo for metastatic
155
Bladder Cancer Risk Factors
Smoking, aniline dyes, schistosomiasis (squamous cell)
156
Bladder Cancer Presentation
Painless hematuria (most common), irritative voiding symptoms
157
RCC Classic Triad
Flank pain, hematuria, palpable mass (late finding)
158
RCC Paraneoplastic Syndromes
Erythrocytosis (EPO), hypercalcemia (PTHrP), hypertension (renin)
159
RCC Treatment
Partial/radical nephrectomy, targeted therapy (VEGF inhibitors)
160
Wilms Tumor Features
Pediatric abdominal mass, WT1 mutation, triphasic histology
161
Anemia Classification
Microcytic (Fe deficiency, thalassemia), normocytic (anemia of chronic disease), macrocytic (B12/folate)
162
Iron Deficiency Labs
Low ferritin, high TIBC, low serum iron, microcytic anemia
163
IDA Treatment
Oral iron (ferrous sulfate), IV iron if malabsorption
164
Anemia of Chronic Disease
Low serum iron, low TIBC, normal/high ferritin
165
Thalassemia Features
Microcytosis out of proportion to anemia, target cells, elevated HbA2 (beta thal minor)
166
B12 Deficiency Causes
Pernicious anemia (anti-IF antibodies), vegan diet, ileal resection
167
B12 Deficiency Neurologic
Dorsal column (vibration/proprioception loss), subacute combined degeneration
168
Folate Deficiency Causes
Poor diet, alcoholism, methotrexate, pregnancy
169
MAHA Causes
TTP, HUS, DIC, mechanical heart valve, malignant HTN
170
TTP Pentad
Fever, MAHA, thrombocytopenia, neurologic symptoms, renal failure
171
TTP Treatment
Plasmapheresis, steroids, caplacizumab
172
HUS Types
STEC (Shiga toxin), atypical (complement dysregulation)
173
HUS Treatment
Supportive (STEC), eculizumab (atypical)
174
DIC Labs
Low platelets, prolonged PT/PTT, low fibrinogen, high D-dimer
175
DIC Treatment
Treat underlying cause, replace platelets/coagulation factors
176
ITP Diagnosis
Isolated thrombocytopenia, normal other blood counts
177
ITP First-line Treatment
Steroids, IVIG for severe bleeding
178
Heparin-induced Thrombocytopenia
Type II: platelet drop >50%, thrombosis, anti-PF4 antibodies
179
HIT Treatment
Stop heparin, start non-heparin anticoagulant (argatroban)
180
Von Willebrand Disease
Most common inherited bleeding disorder, mucocutaneous bleeding
181
VWD Treatment
Desmopressin (type 1), vWF concentrates (severe cases)
182
Hemophilia A
Factor VIII deficiency, X-linked
183
Hemophilia B
Factor IX deficiency, X-linked
184
Hemophilia Treatment
Factor replacement, emicizumab prophylaxis
185
Leukocytosis DDx
Infection, inflammation, malignancy, medications, stress
186
Leukemoid Reaction
WBC >50k with left shift, non-malignant cause
187
AML Features
Auer rods, myeloblasts ≥20%, t(8;21), inv(16), APL (t15;17)
188
APL Treatment
ATRA + arsenic trioxide (high cure rate)
189
CML Features
Philadelphia chromosome t(9;22), BCR-ABL1, basophilia
190
CML Treatment
TKIs (imatinib, dasatinib), alloSCT for resistant cases
191
ALL Features
Lymphoblasts, TdT+, pediatric peak
192
ALL Treatment
Multi-agent chemo (pediatric >90% cure)
193
CLL Rai Staging
0: lymphocytosis only, I: +LAD, II: +splenomegaly, III: +anemia, IV: +thrombocytopenia
194
CLL Treatment
Watchful waiting early stage, BTK inhibitors (ibrutinib), venetoclax
195
Hodgkin Lymphoma Features
Reed-Sternberg cells, CD15/CD30+, bimodal age
196
Hodgkin Treatment
ABVD chemo ± radiation
197
Non-Hodgkin Lymphoma Types
DLBCL (most common), follicular, mantle cell, Burkitt
198
DLBCL Treatment
R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, prednisone)
199
Multiple Myeloma Features
CRAB (hyperCalcemia, Renal failure, Anemia, Bone lesions), M spike
200
Myeloma Diagnostic Criteria
Clonal plasma cells ≥10% or plasmacytoma + CRAB or biomarkers
201
Myeloma Treatment
Proteasome inhibitors (bortezomib), IMiDs (lenalidomide), stem cell transplant
202
MGUS
Monoclonal protein <3g/dL, <10% plasma cells, no end-organ damage
203
Polycythemia Vera
JAK2 V617F, elevated Hct, pruritus after shower
204
PV Treatment
Phlebotomy, hydroxyurea, aspirin
205
Essential Thrombocythemia
JAK2/CALR/MPL mutations, platelet >450k, thrombosis/bleeding
206
ET Treatment
Aspirin, hydroxyurea if high risk
207
Myelofibrosis Features
Leukoerythroblastic smear, teardrop cells, extramedullary hematopoiesis
208
G6PD Deficiency
X-linked, hemolysis with oxidant stress (fava beans, sulfa drugs), Heinz bodies
209
HS Features
Spherocytes, increased MCHC, splenomegaly, improved after splenectomy
210
Sickle Cell Crisis Types
Vaso-occlusive, aplastic, sequestration, hemolytic
211
SCD Treatment
Hydration, pain control, hydroxyurea, transfusions
212
Transfusion Reactions Types
Acute hemolytic, febrile non-hemolytic, allergic, TRALI, TACO
213
Febrile Non-Hemolytic Reaction
Anti-leukocyte antibodies, fever/chills during transfusion
214
TRALI
Acute lung injury within 6h, non-cardiogenic pulmonary edema
215
TACO
Fluid overload, hypertension, dyspnea during transfusion
216
Blood Product Shelf Life
RBCs: 42 days, Platelets: 5 days, FFP: 1 year frozen
217
Platelet Transfusion Threshold
<10k prophylactic, <50k for procedure/surgery, <100k CNS surgery
218
FFP Indications
Coagulopathy with bleeding, warfarin reversal, DIC
219
Cryoprecipitate Contents
Fibrinogen, factor VIII, vWF, factor XIII
220
Warfarin Reversal
Vitamin K (slow), FFP/PCC (rapid)
221
DOAC Reversal Agents
Idarucizumab (dabigatran), andexanet alfa (anti-Xa inhibitors)
222
Neutropenic Fever Management
Broad-spectrum antibiotics (piperacillin-tazobactam), add vancomycin if line infection
223
FUO Definition
Fever >38.3°C for >3 weeks, no diagnosis after 1 week of evaluation
224
FUO Categories
Classic (infections, malignancies, autoimmune), nosocomial, neutropenic, HIV-associated
225
Endocarditis Major Criteria
Positive blood cultures, vegetations on echo, new regurgitation
226
Endocarditis Minor Criteria
Fever, vascular phenomena, immunologic phenomena, predisposing condition
227
Endocarditis Treatment
Culture-directed antibiotics (often 4-6 weeks), surgery for complications
228
Tuberculosis Diagnosis
AFB smear/culture, nucleic acid amplification, interferon-gamma release assay
229
TB Treatment
RIPE (rifampin, isoniazid, pyrazinamide, ethambutol) x 2mo → RI x 4mo
230
Latent TB Treatment
Isoniazid x 9mo or rifampin x 4mo
231
Malaria Species
P. falciparum (most severe), P. vivax (hypnozoites), P. ovale, P. malariae
232
Severe Malaria Features
Cerebral malaria, renal failure, acidosis, hypoglycemia, severe anemia
233
Malaria Treatment
Artemisinin-based combination therapy (ACT), IV artesunate for severe
234
HIV Window Period
Time from infection to detectable antibodies (2-4 weeks)
235
HIV Diagnostic Tests
4th gen Ag/Ab combo (detects p24 antigen), PCR for early detection
236
ART Initiation Criteria
All patients regardless of CD4 (treat immediately at diagnosis)
237
Opportunistic Infections by CD4
<200: PJP, <100: toxoplasmosis, <50: CMV, MAC
238
PJP Prophylaxis
TMP-SMX (Bactrim), dapsone if allergic
239
CMV Retinitis Treatment
Valganciclovir, ganciclovir intravitreal implant
240
HSV Encephalitis
Temporal lobe involvement on MRI, acyclovir treatment
241
Varicella-Zoster Treatment
Acyclovir, valacyclovir (famciclovir for VZV)
242
EBV Complications
Splenic rupture, airway obstruction, HLH
243
CMV Colitis
Immunocompromised, biopsy shows owl's eye inclusions
244
Clostridioides difficile Toxins
Toxin A (enterotoxin), toxin B (cytotoxin)
245
CDI Treatment
Oral vancomycin or fidaxomicin (metronidazole only for mild if others unavailable)
246
Sepsis Criteria
SOFA score ≥2 from baseline + infection
247
Septic Shock
Sepsis + vasopressors needed to maintain MAP ≥65 + lactate >2
248
Sepsis Management
Early antibiotics, fluid resuscitation, source control
249
ARDS Berlin Criteria
Acute onset, bilateral opacities, PaO2/FiO2 ≤300, not fully explained by cardiac failure
250
ARDS Treatment
Low tidal volume ventilation (6ml/kg), prone positioning, PEEP
251
COPD GOLD Stages
Based on FEV1: I >80%, II 50-79%, III 30-49%, IV <30%
252
COPD Treatment
Bronchodilators (LAMA/LABA), steroids for exacerbations, oxygen if hypoxemic
253
Asthma Severity Classification
Intermittent vs persistent (mild/moderate/severe)
254
Asthma Treatment
Step-up therapy: SABA → ICS → LABA → biologics
255
Asthma Exacerbation Treatment
SABA, systemic steroids, oxygen, magnesium/heliox if severe
256
Pneumonia CURB-65
Confusion, Urea >7, RR ≥30, BP <90, age ≥65
257
CAP Typical Pathogens
S. pneumoniae, H. influenzae, M. catarrhalis
258
CAP Atypical Pathogens
Mycoplasma, Chlamydia, Legionella
259
CAP Treatment
Beta-lactam + macrolide or respiratory fluoroquinolone
260
HAP/VAP Pathogens
Pseudomonas, MRSA, Gram-negatives
261
HAP Treatment
Antipseudomonal beta-lactam + vancomycin/linezolid if MRSA risk
262
Tuberculous Pleural Effusion
High protein, lymphocytic, low glucose, high ADA
263
Parapneumonic Effusion Stages
Uncomplicated, complicated, empyema
264
Empyema Treatment
Antibiotics + chest tube drainage ± fibrinolytics, VATS if persistent
265
PE Risk Stratification
Hemodynamically unstable (high risk), RV dysfunction/biomarkers (intermediate), neither (low)
266
PE Treatment
Anticoagulation (DOACs), thrombolysis if massive, thrombectomy if contraindications
267
Pneumothorax Types
Primary spontaneous (young tall males), secondary (underlying lung disease), tension
268
Tension Pneumothorax Signs
Hypotension, tracheal deviation, absent breath sounds, hyperresonance
269
Tension Pneumothorax Treatment
Immediate needle decompression (2nd ICS MCL) then chest tube
270
Interstitial Lung Disease Types
IPF (usual interstitial pneumonia), NSIP, hypersensitivity pneumonitis
271
IPF Treatment
Antifibrotics (pirfenidone, nintedanib), lung transplant
272
Hypersensitivity Pneumonitis
Antigen exposure (bird fancier's, farmer's lung), granulomas on biopsy
273
Bronchiectasis Causes
Post-infectious, CF, ciliary dyskinesia, ABPA
274
Bronchiectasis Treatment
Airway clearance, antibiotics for exacerbations, macrolides for anti-inflammatory
275
CF Diagnostic Test
Sweat chloride >60, CFTR mutation analysis
276
CF Complications
Respiratory failure, pancreatic insufficiency, diabetes, infertility
277
OSA Diagnosis
Polysomnography (AHI ≥5 + symptoms)
278
OSA Treatment
CPAP, weight loss, mandibular advancement devices
279
GERD Complications
Esophagitis, Barrett's esophagus, strictures
280
Barrett's Esophagus Surveillance
Regular endoscopy with biopsy (every 3-5 years)
281
Peptic Ulcer Disease Causes
H. pylori, NSAIDs, Zollinger-Ellison
282
PUD Complications
Bleeding, perforation, obstruction
283
H. pylori Diagnostic Tests
UBT, stool antigen, biopsy (histology/rapid urease)
284
H. pylori Treatment
PPI + clarithromycin + amoxicillin/metronidazole (14 days)
285
IBD Types
Crohn's (transmural, skip lesions, anywhere), UC (mucosal, continuous, colon only)
286
UC Extraintestinal Manifestations
PSC, arthritis, uveitis, erythema nodosum
287
CD Extraintestinal Manifestations
Arthritis, uveitis, erythema nodosum, ankylosing spondylitis
288
IBD Treatment
5-ASAs (UC), steroids, immunomodulators (azathioprine), biologics (anti-TNF)
289
Diverticulitis Hinchey Stages
I: pericolic abscess, II: distant abscess, III: perforation with purulent peritonitis, IV: fecal peritonitis
290
Diverticulitis Treatment
Uncomplicated: oral antibiotics (cipro + metro). Complicated: IV antibiotics ± drainage/operation
291
Acute Pancreatitis Causes
GET SMASHED: Gallstones, Ethanol, Trauma, Steroids, Mumps, Autoimmune, Scorpion, Hyperlipidemia, ERCP, Drugs
292
Pancreatitis Severity Criteria
Ranson's, Atlanta, BISAP
293
Pancreatitis Complications
Pseudocyst, necrosis, abscess, ARDS, DIC
294
Pancreatic Cancer Features
Painless jaundice, Courvoisier's sign, Trousseau's syndrome
295
Cirrhosis Complications
Variceal bleeding, hepatic encephalopathy, HRS, HCC
296
HE Grading
I: mild confusion, II: lethargy, III: stupor, IV: coma
297
HE Treatment
Lactulose, rifaximin, correct precipitating factors
298
HRS Types
Type 1: rapid progression, Type 2: more indolent
299
HRS Treatment
Vasoconstrictors (terlipressin) + albumin, liver transplant
300
Variceal Bleeding Treatment
Octreotide, antibiotics, band ligation, TIPS if refractory
301
Wilson Disease Features
Kayser-Fleischer rings, low ceruloplasmin, high urine copper
302
AIH Diagnosis
Elevated IgG, ANA/SMA+, interface hepatitis on biopsy
303
PBC Diagnosis
AMA+, elevated ALP, biopsy shows florid duct lesions
304
PSC Features
Beaded bile ducts on ERCP, associated with UC
305
Gallstone Types
Cholesterol (most common), pigment (black/brown)
306
Cholecystitis Treatment
Antibiotics (piperacillin-tazobactam), cholecystectomy
307
Cholangitis Triad
Fever, jaundice, RUQ pain (Reynolds' pentad adds shock + AMS)
308
Cholangitis Treatment
ERCP + antibiotics (broad-spectrum including anaerobes)
309
Appendicitis Features
Periumbilical → RLQ pain, McBurney's point tenderness
310
Appendicitis Alvarado Score
Migration, anorexia, nausea/vomiting, tenderness, rebound, fever, leukocytosis, left shift
311
Small Bowel Obstruction Causes
Adhesions (most common), hernias, malignancy
312
SBO vs LBO
SBO: earlier vomiting, less distension. LBO: later vomiting, more distension
313
Volvulus Types
Sigmoid (elderly, coffee bean sign), cecal (younger)
314
Mesenteric Ischemia Types
Arterial (embolic/thrombotic), venous, non-occlusive
315
HCC Surveillance
Ultrasound ± AFP every 6 months in cirrhosis
316
HCC Diagnosis
Triphasic CT/MRI showing arterial enhancement + washout
317
HCC Treatment
Resection/transplant if early, TACE/sorafenib if advanced
318
Liver Transplant Criteria
MELD score ≥15 (exception: HCC within Milan criteria)
319
Colon Cancer Screening
Colonoscopy (gold standard), FIT, CT colonography
320
Colon Cancer Staging
TNM, most important is depth of invasion + nodes
321
Colon Cancer Treatment
Surgery ± adjuvant chemo (FOLFOX/CAPEOX) for stage III
322
Rectal Cancer Treatment
Neoadjuvant chemoradiation → surgery → adjuvant chemo
323
Carcinoid Syndrome
Flushing, diarrhea, wheezing (from serotonin secretion)
324
GIST Features
CD117 (c-kit) positive, treatment with imatinib
325
GERD Treatment
PPI, H2 blockers, lifestyle modifications
326
Esophageal Cancer Types
Adenocarcinoma (Barrett's), squamous (alcohol/tobacco)
327
Achalasia Features
Dysphagia to both solids/liquids, bird's beak on barium
328
Achalasia Treatment
Pneumatic dilation, Heller myotomy, POEM
329
Zenker Diverticulum
Pulsion diverticulum at Killian's triangle, food regurgitation
330
Mallory-Weiss Tear
Upper GI bleed after retching, longitudinal tear at GEJ
331
Boerhaave Syndrome
Esophageal rupture after vomiting, surgical emergency
332
Diverticular Bleeding
Painless hematochezia, usually right-sided diverticula
333
Upper GI Bleed Causes
PUD, varices, Mallory-Weiss, gastropathy
334
Lower GI Bleed Causes
Diverticulosis, angiodysplasia, colitis, hemorrhoids
335
GI Bleed Management
Resuscitation, PPI for PUD, octreotide for varices, endoscopy
336
Peritonitis Types
Primary (spontaneous bacterial), secondary (perforation), tertiary (persistent)
337
SBP Diagnosis
Ascitic fluid PMN >250, no surgical source
338
SBP Treatment
Cefotaxime, albumin for creatinine >1
339
Adrenal Insufficiency Causes
Primary (Addison's), secondary (pituitary), tertiary (hypothalamic)
340
Addisonian Crisis
Hypotension, hyponatremia, hyperkalemia, hypoglycemia
341
Addison's Treatment
Hydrocortisone + fludrocortisone
342
Pheochromocytoma Rule of 10s
10% bilateral, 10% malignant, 10% extra-adrenal, 10% familial
343
Pheochromocytoma Diagnosis
24h urine metanephrines, plasma free metanephrines
344
Hyperparathyroidism Types
Primary (adenoma), secondary (renal failure), tertiary (autonomous after long 2°)
345
Hypercalcemia Causes
Malignancy, hyperparathyroidism, vitamin D excess
346
Hypercalcemia Treatment
IV fluids, bisphosphonates, calcitonin if severe
347
Hypocalcemia Symptoms
Chvostek's, Trousseau's, perioral numbness, seizures
348
Hypocalcemia Treatment
Calcium gluconate IV if acute, vitamin D + oral calcium chronic
349
SIADH vs Cerebral Salt Wasting
Both hyponatremia: SIADH euvolemic/high ADH, CSW hypovolemic/low ADH
350
Diabetes Insipidus Diagnosis
Water deprivation test: no urine conc in DI, responds to desmopressin in central DI
351
Pituitary Apoplexy
Headache, visual changes, hypopituitarism - neurosurgical emergency
352
Prolactinoma Treatment
Dopamine agonists (cabergoline), transsphenoidal surgery if resistant
353
Acromegaly Diagnosis
Failed glucose suppression test, elevated IGF-1
354
Acromegaly Treatment
Surgery, somatostatin analogs, GH receptor antagonist
355
Cushing's Diagnosis
1mg dexamethasone suppression test, midnight salivary cortisol
356
Empty Sella Syndrome
Asymptomatic or headache, pituitary flattened on MRI
357
Hypopituitarism Order of Loss
GH > FSH/LH > TSH > ACTH > ADH
358
Thyroid Storm Treatment
PTU, beta blockers, iodide, steroids, cooling
359
Myxedema Coma
Hypothyroidism + coma → levothyroxine IV + steroids
360
Thyroid Nodule Workup
TSH → ultrasound → FNA if suspicious features
361
Medullary Thyroid Cancer
Calcitonin-producing, RET proto-oncogene, MEN2 association
362
Graves Ophthalmopathy
"Proptosis, lid retraction, diplopia - treat with steroids
