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1

2 hour cutoff for impaired glucose tolerance

140

2

preDM indication for metformin

impaired FG and Impaired glucose tolerance

3

tx DKA vs HHS

DKA: insulin drip
HHS: IV fluids

4

statin indication if no DM

if 10 yr risk>7.5%

5

cutoff hyperlipidemia

total cholesterol 200

6

LVH with EKG

S1 + R5 = >35

7

QT cutoff math

70 bpm, qt<.4
for every 10 bm, subtract .02

8

vitamin D cutoff

30

9

t wave inversion =

ischemia

10

q's in V1-V4

(part of heart and artery)

anterior
LAD

11

q's in I, AVL, maybe 5 or 6

(heart and artery)

lateral

circumflex coronary artery

12

q's in II, III, AVF

(heart and artery)

inferior leads = inferior

RCA or descending branch.

13

large R, ST depression in V1,V2

heart and artery

posterior

RCA

14

normal PR

less than .2 (less than 1 big box)

15

normal QRS

less than .12 (3 boxes)

16

Saag cutoff and significance

1.1
Greater is portal htn.

17

2 types microscopic colitis

Lymphatic and collagenous.

18

Sensitivity =

Tp/sick

19

Specificity =

Tn/healthy

20

Lrs of 2,5,10 increase dz by

15, 30, 45

21

Stage 2 htn (2)

Greater than 160 sys or 100 dia

22

Sirs (4) include number necessary

2 of:
Fever
WBC
Tachypnea or paco2 less than 32
Tachycardia

23

Sepsis (2)

Sirs + source of infection

24

Severe sepsis

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