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A Medicine Study Session > Life Study > Flashcards

Life Study Flashcards

(72 cards)

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1
Q

Long term use if immunomodulator medications increases the risk of ______

A

Lymphoma

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2
Q

A chronic inflammatory skin disorder that often starts in infancy and persists into adulthood. Characterized by pruritus leading to lichenification.

A

Atopic Dermatitis = Eczema

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3
Q

What is the atopic triad

A

Asthma, eczema, and allergic rhinitis

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4
Q

What is the first line therapy for eczema

A

Topical corticosteroids

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5
Q

What type of hypersensitivity reaction is contact dermatitis

A

Type IV

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6
Q

What is the first line treatment for contact dermatitis

A

Topical corticosteroids and allergen avoidance

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7
Q

What is a common chronic inflammatory skin disease that may be caused by a hypersensitivity reaction to Malassezia further (found in sebum and hair follicles)

A

Seborrheic dermatitis

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8
Q

Cradle cap is associated with which diagnosis

A

Seborrheic dermatitis in infants

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9
Q

Which patients are at most risk for developing severe cases of seborrheic dermatitis

A

HIV/AIDS and Parkinson’s pts

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10
Q

What is the treatment for seborrheic dermatitis

A

Selenium sulfide or zinc pyrithione shampoos for scalp and topical antifungals and/or topical corticosteroids for skin

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11
Q

What is the first line treatment for cradle cap

A

Routine bathing and application of emollients

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12
Q

Altered consciousness or lamentation suggests what in terms of localization

A

Bicerebral hemispheres

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13
Q

Localization of gaze preference

A

Ipsilateral frontal lobe

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14
Q

Localization of left hemi neglect

A

Right parietal cortex

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15
Q

Localization of left homonymous hemianopsia

A

Right cerebral hemisphere, posterior to optic chiasm in parietotemporal or occipital lobe

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16
Q

Localization of left hemiparesis (face, arm, and leg)

A

Right subcortical area, usually posterior limb of internal capsule

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17
Q

Localization of left hemibody sensory loss (equal face, arm, leg)

A

Posterior limb of internal capsule or thalamus

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18
Q

What are the 3 stroke types

A

Ischemic stroke- occlusion 85%
Hemorrhagic stroke- bleed into brain10%
Subarachnoid hemorrhage- bleed around brain 5%

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19
Q

How to differentiate hemorrhagic vs ischemic stroke

A

Imaging - CT or MRI

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20
Q

What is the risk of stroke associated with TIA

A

5% within 2 days, 10% within 3 mo.

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21
Q

What labs are needed in possible acute stroke assessment

A

CBC, Chemistries, PT/INR, PTT, cardiac biomarkers

–> r/o infection, metabolic abnormalities and assess for contraindications to tPA

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22
Q

For which type of stroke do you give tPA

A

Ischemic

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23
Q

Why should permissive hypertension be allowed in most stroke cased

A

Increases blood flow to the penumbra and reduces permanent damage

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24
Q

What is the BP criteria for the administration of tPA in acute ischemic stroke

A

<= 185/110

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25
When should BP be lowered in treatment of acute ischemic stroke, pre tPA
At BP between 185/110 and 220/120 * do not use tPA if greater than 220/120 * *DOC: nicardipine, labetalol
26
To where does impaired insight localize
Frontal lobes
27
To where does memory impairment localize
Hippocampi of medial temporal lobes
28
To where does difficulty with calculations localize
Dominant parietal lobe
29
What does back pain with valsalva maneuver suggest in terms of localization
Suggests nerve root compression as source, e.g. disc herniation
30
Decreased senstaion of the lateral foot localizes to where
S1 dermatome innervated by fibers from ipsilateral S1 nerve root
31
Ankle reflex is associated with spinal reflex arc. This arc is conducted by fibers from which nerve roots
S1 and S2
32
Positive straight leg raise suggests radiculopathy where
L5 and/or S1
33
What is the most common cause of radiculopathy
disc herniation
34
Patellar (knee) reflex is conducted by fibers from which nerve roots
L3 and L4
35
Sciatic nerve compression is associated with which nerve roots
L4-S3
36
Metastasis to bone is most common with which tumors
Breast, lung, thyroid, renal, and prostate
37
What is Cushings Response
A triad of symptoms associated with increased intracranial pressure including hypertension, bradycardia, and irregular respirations
38
what are Chyene-Stokes respirations
Variable respiratory rate associated with periods of apnea. **may be due to bilateral deep brain lesions or congestive heart failure most ofen
39
What are the signs of a basilar skull fracture
Raccoon sign Battle Sign (postauricular hematoma) CSF rhinorrhea CSF otorrhea
40
Where does diffuse hyperreflexia localize to
Upper motor neuron--> corticospinal tract-->bilateral brain lesions or increased ICP
41
Describe decerebrate posturing
Arm is rigidly extended and internally rotated, wrist is flexed, and leg is extended
42
Describe decorticate posturing
leg is extended, arm is flexed and adducted over chest
43
What are some risk factors for intracranial aneurysm
- Polycystic kidney disease - fibromuscular dysplasia - AV malformation - Connective tissue disorder - Aortic Coarcation - Cigarette smoking - Family hx
44
What are the percentages of locations of cerebral aneurysms by artery
1. Anterior communicating 40% 2. Posterior communicating 30% 3. Middle cerebral 20% 4. Basilar 10%
45
What are the major complications associated with Subarchnoid hemorrhage
- rebleeding - vasospasm - seizures - hyponatremia - hydrocephalus - cardiac arrhythmias, MI
46
What is the acute management of subarchnoid hemorrhage
- Consult neurosurgery if aneurysm present - dark quiet room in ICU - elevated HOB >30 degrees - ECG monitoring - neuro checks - IV normal saline - stool softner, antiemetic, narcotic, sedative - H2 blocker - DVT prophylaxis SCDs NO ANTICOAGS - fosphenytoin for seizure prophylaxis
47
Where does decreased consciousness localize to
Brainstem or bicerebral process
48
Where does CN3 palsy w/ dilated pupil localize to
ipsilateral upper midbrain | **dilation think compression
49
Where does decerebrate posturing localize to
Contralateral upper midbrain
50
Where does Cheyne Stokes respirations localize to
upper midbrain
51
What are the symptoms of C6 radiculopathy
- weak wrist extensors & brachioradialis | - weak biceps
52
What are the symptoms of radial nerve palsy
- weak wrist extensors and brachioradialis | - normal biceps
53
How to differenitiate radial nerve palsy from C6 radiculopathy
C6 radiculopathy has weak biceps | Radial nerve palsy has normal biceps
54
What is the difference between massive and submassive pulmonary embolism
Hemodynamic stability. Massive = high-risk = unstable (hypotension for >15 or that requires vasopressors or other support & does not have alternative cause) = more likely to die from obstructive shock (risk elevated 2-72 hrs post PE) Submassive = intermediate risk = stable w/ associated right heart strain **UpToDate: Overview of acute pulmonary embolism in adults
55
What is the timeline for an adjustment disorder diagnosis
start within 3 months of stressor and do not last more than 6 months (bereavement or co-occuring psychiatric disorder excluded) Adjustment disorder is depressed mood charaterized by depressive symptoms that start within 3 months of an identiable stressor
56
What do you call the symptoms of an adjustment disorder without an identifiable stressor
Subsyndromal Depressive Disorder
57
How do you define a dysthymic disorder
Depressed mood most of the day, more days than not, for at least 2 yrs without a symptom free period of more than 2 consecutive months. Depressed mood + At least 2 symptoms must be present: -appetite change - sleep change - decreased energy - decreased self-esteem -poor concentration &/or difficulty making decisions - hopelessness **Also not better explained by alterative diagnosis
58
Antidepressant therapy has been associated with increased risk of suicidal thoughts/behaviors in which populations
- Children - Adolescents - Young Adults to 24 yrs * *No change in SI for adults 25-64 yrs * *Decreased SI for 65+ yrs
59
True or False: The risk of depression relapse increases after each subsequent major depressive episode
True
60
What is the recommended first line therapy for allergic rhinitis
Intranasal corticosteroid monotherapy | ** combination with oral antihistamine is not recommended b/c data does not show marked improvement with dual therapy
61
Which drugs have high level of evidence for causing microscopic colitis
- NSAIDs (including aspirin) - PPIs - Sertraline - Acarbose - Ticlopidine
62
What is the first line management of ganglion cyst
Watchful waiting: 50% resolve spontaneously Additional tx indicated if: - significant pain, numbness, weakness, cosmetic desire Additional tx: 1) aspiration (85% recurrence rate), 2) excision (10-15% recurrence)
63
What affect on hemoglobin A1c does education with diabetic educator typically produce
0.2-0.8 reduction
64
Having a dog in the home reduces which allergy in newborns/children
Eggs
65
How can risk of food allergy be reduced in infants
Induction of peanut-containing foods when solids are started
66
Which class of antihypertensives is least likely to exacerbate erectile dysfunction
Angiotensin receptor blodkers (ARBs)
67
What organism causes bullous impetigo
S. aureus - treatment with bactrim, small lesions poss. mupirocin
68
What is the treatment for bullous impetigo in children under 8 yrs
Bactrim | caused by s. aureus, may consider mupirocin in small lesions
69
Why is tetrcycline avoided in children under 8 yrs
It causes teeth staining
70
Which of the following is a contraindication to statin use? A. current pregnancy B. chronic hepatitis C infection C. end stage renal disease D. Myositis associated with creatine kinase level five times upper limit of normal E. transaminitis due to nonalcoholic staetohepatitis
Current pregnancy - contraindicated in lactation as well due to fetal anomalies
71
What are the criteria for diagnosis of diabetes
- Hemoglobin A1c >/=6.5% - fasting glucose >/=126 - 2 hr plasma glucose >/=200 on GTT - Random plasma glucose >/= 200 w/ symptoms
72
What electrolyte derangements are associated with tumor lysis syndrome
- Hyperkalemia - Hyperuricemia - Hyperphosphatemia - Hypocalemia (due to calcium binding with free phosphorous)

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