Med 1 Flashcards
(214 cards)
1
Q
2 hour cutoff for impaired glucose tolerance
A
140
2
Q
preDM indication for metformin
A
impaired FG and Impaired glucose tolerance
3
Q
tx DKA vs HHS
A
DKA: insulin drip
HHS: IV fluids
4
Q
statin indication if no DM
A
if 10 yr risk>7.5%
5
Q
cutoff hyperlipidemia
A
total cholesterol 200
6
Q
LVH with EKG
A
S1 + R5 = >35
7
Q
QT cutoff math
A
70 bpm, qt<.4
for every 10 bm, subtract .02
8
Q
vitamin D cutoff
A
30
9
Q
t wave inversion =
A
ischemia
10
Q
q’s in V1-V4
part of heart and artery
A
anterior
LAD
11
Q
q’s in I, AVL, maybe 5 or 6
heart and artery
A
lateral
circumflex coronary artery
12
Q
q’s in II, III, AVF
heart and artery
A
inferior leads = inferior
RCA or descending branch.
13
Q
large R, ST depression in V1,V2
heart and artery
A
posterior
RCA
14
Q
normal PR
A
less than .2 (less than 1 big box)
15
Q
normal QRS
A
less than .12 (3 boxes)
16
Q
Saag cutoff and significance
A
1.1
Greater is portal htn.
17
Q
2 types microscopic colitis
A
Lymphatic and collagenous.
18
Q
Sensitivity =
A
Tp/sick
19
Q
Specificity =
A
Tn/healthy
20
Q
Lrs of 2,5,10 increase dz by
A
15, 30, 45
21
Q
Stage 2 htn (2)
A
Greater than 160 sys or 100 dia
22
Q
Sirs (4) include number necessary
A
2 of: Fever WBC Tachypnea or paco2 less than 32 Tachycardia
23
Q
Sepsis (2)
A
Sirs + source of infection
24
Q
Severe sepsis
A
Sepsis + hypotension or lactic acidosis
25
Septic shock
Severe sepsis despite aggressive fluids
26
If rta, urine gap is
A positive number.
27
Osm equation
2Na + glucose/18 + BUN/2.8
28
Osm gap normal
10
29
Osm gap significance
Alcohols
30
Normal range for blood osm
275-295
31
Cutoff urine k for hypokalemia investigation
20
Above suggests renal losses
32
Migraine prophylaxis tx
Propranolol if more than 2 a week.
33
RTA type 1
location
urine pH
tx
distal tubule
>5.5
bicarb
34
RTA type 2
location
tx
proximal tubule
| thiazide
35
RTA type 4
hallmark
tx
hyperkalemia (classically hyporeninemic hypoaldosteronemic diabetic)
fludrocortisone
36
Cutoff for concerning PSA velocity
Greater than .75
37
P waves change shape
More than vs less than 100
More than 100 = multifocal atrial tachycardia
| Less than 100 = wandering pacemaker
38
20 to 40 BPM with wide qrs
Ventricular escape
39
Pause than long qrs
Ventricular escape
40
No p wave or p wave inverted following.
Junctional rhythm
41
Tachycardia like sinus 160 to 200
Svt
42
Tactile fremitus (2)
Increased if lobar
| Decreased if effusion
43
side effect of niacin besides pruritis (2 labs)
+glucose
| +uric acid
44
side effect fibrates
+myositis with statins
45
side effect cholestyramine
flatus and abd. cramping
46
problem with ezetimibe.
well tolerated and nearly useless
47
normal R wave progression in precordial leads
gets bigger 1-5
| interrupted in RVH. V1 R ends up being bigger than S. V6 S wave ends up being bigger than R.
48
2 drugs you may NOT use in hypertrophic cardiomyopathy but you may use in dilated cardiomyopathy.
Digoxin and spironolactone.
49
5 indications for dialysis
Aeiou
```
Acidosis
Electrolytes
Intoxication
Overload
Uremia
```
50
Metabolic acidosis
Determining appropriate resp compensation
Appropriate pco2 = 1.5hco + 8
51
3 work ups for acid base
Check ag
Check compensation
Check delta gap
52
Strep pneumo vaccines before and after 65.
Before equals one dose plus another 5 years later. After 65 is just one dose.
53
pleural fusion analysis
| 2 labs
in exudate or pseudoexudate
protein >3
LDH>200
54
pleural fusion analysis
| transudate vs pseudoexudate (CHF)
cholesterol <50 is the hallmark of true transudates
55
Lab difference in primary vs secondary hyperPTH
2 has low calc, high phosphate.
56
Electrolyte that parallels vitamin d
Calcium
57
Ca normal value range
8.4 to 10.2
58
Normal phosphorus range
3.0 to 4.5
59
Find out 24 hour urine protein quickly
Urine albumin/creatinine ratio
60
Calculating delta gap
Corrected hco3 (25) should = hco3 actual + delta anion gap
61
Expected renal compensation for a respiratory acid base disorder (2)
HCO3 up 1 down 2
Acute up 1 per 10 mmhg co2 up. Down 2
Chronic up 4 per 10 mmhg co2
62
2 side effects acetazolamide
Hypokalemia
| Metabolic acidosis
63
Cutoff for concerning K level in urine
20
64
tx acute ex CHF
LMNOP (Loop diuretics, Morphine, Nitrates, Oxygen, Positioning/Pressors
65
Use of spironolactone in chf (what classes of chf)
Class 3 or 4 only
66
Urine na >40 type of arf
Postrenal
67
Fena cut offs (3)
Less than 1 prerenal
Greater than 2 renal
Greater than 4 postrenal
68
Rbc casts
Glomerulonephritis
69
recurrent sinopulmonary infections in adults
normal # B cells, decreased output of B cells (abs)
+giardiasis, risk of lymphoma
CVID
70
tx CVID
IVIG
71
hypomagnesemia causes
gland disorder
lyte change
hypoPTH
| +Ca renal loss
72
2 CV changes with hypercalcemia
short QT
| HTN
73
test to locate pheochromocytoma outside of adrenals
MIBG scanning
74
criteria for O2 use in COPD (2)
pO2 below 55
sat below 88%
60 and 90 if right sided heart failure signs
75
pneumonia pathogen associated with hoarseness
Chlamydophila
76
tx of wpw
procainamide
| NOTHING to slow AV node
77
SVT 1st tx
carotid massage
78
electrical alternans association
tamponade
79
if you suspect pe, 1st step
give heparin
80
2 pressures w/pulmonary wedge pressure
| pulmonary htn vs chf
pwp normal if pulmonary htn
| high if chf
81
low glucose in transudative effusion
RA
82
Persistent ST elevation 1mo after MI + systolic MR murmur?
ventricular wall aneurysm
83
cannon a-waves (2)
vfib or 3rd degree heart block
84
best prognostic indicator COPD
FEV1
85
acute clubbing in COPD
lung malignancy
86
asthma person with normalizing (lower going up) pco2
danger. intubate.
87
thermophillic actinomyces with patchy lower lobe inflitrates
hypersensitivity pneumonitis (farmer's lung)
88
lung cancer with peripheral cavitation and distant mets
large cell
89
antimitochondrial ab
pbc
90
dx of prinzmetal's angina
ergonavine stimulation test
91
SEM louder w/ valsalva, softer w/ squatting or handgrip.
HOCM
92
old smoker with COPD
| pneumonia pathogen
H. flu
| tx with 2nd, 3rd gene cephalosporins
93
HAART started (2, cd4 count and viral load)
CD4 less than 350
Or
Viral load greater than 55k
94
aids drug w/pancreatitis
didanosine
95
HS rash, fever, n/v, muscle aches, SOB in 1st6wks. D/C and never use again! AIDS drug
abacavir
96
AIDS drug
| Nephrolithiasis and hyperbilirubinemia
indinavir
97
Sleepy, confused, psycho AIDS drug
efavirenz
98
AIDS patient with MS-like presentation
PML (JC polymoma virus)
99
paralysis, ileus, ST depression, U waves.
hypokalemia
100
most common cause type 1 & 2 RTA (1 each)
lithium
| myeloma
101
electrolytes in types 1 & 2 RTA (1)
hypoK
102
tx for RTA types 1,2,4
bicarb
diuretic
fludrocortisone
103
main problem in type 1 or 2 RTA (2)
type 1 cannot excrete H+
| type 2 cannot reabsorb HCO3
104
definition ARF
greater than 25% or 0.5 rise in creatinine over baseline.
105
confusion, pericarditis, itchiness, increased bleeding
uremia
106
nephritis 1-2 days vs 1-2 weeks after infection
Berger's
| Post SC GN
107
Cardiac patient s/p ticlopidinew/ renal failure, MAHA, ↓plts, fever and AMS.
TTP
108
tx TTP
plasmaphoresis
don't give platelets
109
neurologic and renal symptoms, fever, thrombocytopenia,
| and microangiopathic hemolytic anemia
TTP
110
substance increased in B12 anemias
methylmalonic acid
111
2 bleeding factors not made by liver
8, vWF
| made in endothelium
112
thrombotic skin necrosis with hemorrhage
| following administration of warfarin is a sign of
protein C or S deficiency
113
acute tx (2) for gout
Indomethacin + colchicine (steroids if kidneys suck).
114
anti-RNP
MCTD
115
thyroid cancer:
| Spreads via blood, must surgically excise whole thyroid!
follicular (but papillary is most common type)
116
size cutoff for excising adrenal nonfunction nodule
6 cm
117
Sestamibi scan.
used to locate parathyroid adenomas
118
EEG 3 Hz spike-and-wave.
absence
| tx: ethosuccimide
119
EEG triphasic bursts
CJD
120
EEG diffuse background slowing
delirium
| psychosis has no EEG change
121
EEG hypsarrhythmia
infantile spasms
| tx with ACTH
122
test of choice for GERD
24 pH monitoring
123
best test for zollinger-ellison syndrome
secretin stimulation test
124
toxicity of carbepenems
seizures
125
hallmark high lab of PCP
LDH
126
most common EKG change in PE
nonspecific ST-T changes.
| more common than S1Q3T3
127
definition ARDS
pO2/FIO2 ratio below 200
FIO2 of room air = .21 or the fraction of oxygen
128
migratory superficial thrombophlebitis
| name and sign of?
Trousseau's Syndrome
| Pancreas or other cancer
129
5 days - 3 months post-MI
| persistent ST-segment elevation and deep Q waves in same leads
ventricular aneurysm
130
vitamin that reduced morbidity, mortality in measles
vitamin A
131
umbilicated vesicular rash over atopic dermatitis
eczema herpeticum
132
main side effect of lamotrigine (and 2 indications)
bipolar and epilepsy
| major side effect = rash
133
prevention of chlamydial conjunctivitis vs gonococcal (ophthalmia neonatorum) to neonates
```
chlamydia = prenatal testing
gonoccal = erythromycin
```
134
phenelzine, class
MAO inhibitor (anti-depressant)
135
HIV-related nephropathy
FSGS
136
Case control vs retrospective cohort
Case control. Have group look back on risk factors
ret cohort. Review past records to study incidence
137
blood abnormality with obstructive sleep apnea
polycythemia
138
most serious side effect of hydroxyxhloroquine
retinopathy
get eye exam q6 mo.
139
D-dimer cutoff for excluding PE
500
140
elderly patient with anemia, renal failure and hypercalcemia
multiple myeloma
141
rapidly progressing dementia
| sharp complexes on EEG
Creutzfeld-Jacob dz
142
D-xylose test
test for small bowel malabsorption (celiac, for example), esp. proximal small bowel
143
dacrocystitis
infection of lacrimal sac
144
chalazion vs hordolum
```
chalazion = hard painless nodule (granuloma or meibomian gland)
hordeolum = abscess of upper/lower eyelid
```
145
first calculaton with hypernatremia, hypokalemia
aldosterone/renin ratio
146
tx of chorioamniotis (2)
```
abx
delivery (NOT C-SECTION)
```
147
diabetic patient with sudden vision loss with floaters
vitreous hemorhage
148
most significant reversible cause pancreatic cancer
smoking
149
drug for hairy cell leukemia
cladribine (purine analog)
150
electrolyte contraindication for succinylcholine
hyper K (or risk for hyper K = burn/crush, etc
151
antidote for mg toxicity
ca gluconate
152
angular chelisos, glossitis, anemia, seborrheic dermatitis
vitamin deficiency?
B2 riboflavin
153
cheilosis w/ mood changes (irritability, confusion, depression)
vitamin deficiency?
B6 pyridoxine
154
fena greater than 2?
| less than 1?
greater than 2 = ATN
| less than 1 = prerenal
155
#1 risk factor for emphysematous pyelonephritis
DM
156
tx of duodenal hematoma from blunt abdominal injury
suck and drip
157
most common cause of Guillian Barre Syndrome
campylobacter jejuni infection
158
criteria for SBP dx or peritonitis
WBC above 250
159
most common location choriocarcinoma metastasis
lungs
160
tx for HIV needles stick
immediate 3 drug therapy
161
etiology of lytic lesions in cancers
+PTHrP
162
cutoff of gestational age with lung immaturity requiring investigation
less than 34 weeks
163
2 types of monitoring if on amiodarone
hepatic
| thyroid
164
hallmark rhythm of digitalis toxicity
atrial tachycardia
| due to +ectopy and +vagal tone
165
risk if asymptomatic UTI not treated in pregnant pt
becomes pyelonephritis
166
pseudocyesis
fake pregnancy, a conversion disorder
167
what to do if find a diastolic murmur on PEx
work it up!
168
protein cutoff for transudates vs exudates
+ than 3 g/dl (>.5 of serum) in exudates
169
LDH in exudates vs transudates
+ than 200 IU/L (>.6 or serum) in exudates
170
pH cutoff for exudates
acid in exudates (below 7.2)
171
class of medications to + appetite in hospice care
progesterone analogs
172
tx for fibromuscular dysplasia
angioplasty w/stent placement
173
GGT and ferritin levels in alcoholic liver dz (2)
increased
174
HCM maneuver to increase murmur
decrease preload (make LV smaller) = valsalva
175
pain on palpation of heels, iliac crests, tibial tuberositios
enthesitis
| (inflammation of tendon attachments) - common feature of ankylosing spondylitis
176
2 side effects lithium
nephrogenic diabetes insipidus
| hypothyroidism
177
cor pulmonale
isolated right heart failure, typically due to lung dz
178
anatomical location where DHEAS is produced (specific for)
adrenals
179
traveler w/pneumonia and hyponatremia
or liver disfunction, AMS, diarrhea too
legionella
180
initial tx of SIADH (if not severe enough for hypertonic IVF)
fluid restriction
181
Ab diff. in Waldenstom's macroglobinuria vs multiple myeloma
IgM in Waldenstrom's
| IgG or IgA in MM
182
besides IgM, other hallmark of Walderstrom's
hyperviscosity
183
liver dz assoc with ulcerative colitis
PSC
184
hallmark of histology of IBD
neutrophilic cryptitis
185
artery and nerve at risk with supracondylar humerus fx
brachial artery, median nerve
186
tx of anti-phospholipid ab
LMW heparin
187
2 causes of exertional syncope besides vtach
outlet obstruction:
aortic stenosis
hypertrophic cardiomyopathy
188
ACTH levels and cortisol levels in adrenal insufficiency (caused bu abruptly stopping steroids)
both low
189
contraindication for raloxifene
hypercoagulation (hx of DVT)
190
timing of ETOH withdrawl
1-2 days
191
toxicity with prolonged or high doses nitroprusside
cyanide
192
inheritance of hypertrophic cardiomyopathy
AD
193
sequelae for CF in adulthood as males
infertility (no vas)
194
renal artery stenosis effect on aldersterone
a form of secondary hyperaldosteronism
195
colonoscopy scheduled for UC
8 years after dx, then 1-2 years after
196
immunosupressant that gives hepatotoxicity, diarrhea, leukopenia
azathioprine
197
side effect mycophenolate
bone marrow suppression
| M = Marrow
198
malaria prophylaxis if pregnant
mefloquine
199
type of poisoning with almond scent
cyanide
200
type of test for HIV screening
Ab and Ag
| RNA only for +suspicion w/negative test
201
Antidote for anticholinergic meds
Physostigmine
202
electrolyte causing refractory hypoK in an alcoholic
Hypomagnesemia
203
if a relative risk =4, what is the attributable risk %
75%
RR-1/RR
204
biggest cause of B12 deficiency
pernicious anemia
205
MCHC level in spherocytosis
increased
206
medical tx of prolactinoma
cabergoline (dopamine agonist)
207
cutoff for hypertensive urgency
180/120
| malignant htn is end-organ damage
208
tx for electrical abnormalities in TCA overdose
sodium bicarb
209
sx of retinitis in HIV pt (HSV vs CMV)
CMV retinitis is painless
210
abd. pain on one side, fever, gross hematuria
Renal Vein Thrombosis
211
Renal Vein thrombosis most associated w/what glomerular pathology?
membranous
212
COPD home O2 requirements include SaO2 less than 88 and Ht, PaO2 cutoffs are?
55!
Ht >55
PaO2
213
kussmaul's sign
rise in JVP on inspiration. Sign of RHF
214
area of pathology in each of these:
lambert-eaton syndrome
myasthenia gravis
dermatomyositis
pre-synaptic membrane
post-synaptic membrane
muscle fibers
