Medicine Flashcards
(292 cards)
1
Q
what heme illness chromosome 22
A
CML: BCR-ABL
2
Q
pt with clinical features of Ankylosing spondylitis, next best test to confirm dx?
A
X ray of SI joints
3
Q
patient with kidney biopsy with intimal thickening nad luminal narrowing or renal arterioles with evidence of sclerosis–MCC?
A
HTN
4
Q
when vaccinate patients undergoing splenectomy?
A
14 days before or after surgery
5
Q
Tactile fremitus increase or decrease in pleural effusion?
A
Decrease!
6
Q
who is at risk of anaphylaxis s/p transfusion?
A
pts who are IgA deficient because they have anti-IgA IgG antibodies
7
Q
definitive dx of Wegener’s
A
bx of site of active disease
8
Q
Thyroid cancer that spreads via lymph and has psammoma bodies
A
Papillary
9
Q
The cancer that spread via blood, have to excise the whole thyroid
A
Follicular
10
Q
Associate with and MEN2, amyloid and calcification
A
Medullary
11
Q
What type of cancer does Hashimoto’s predispose to
A
Thyroid lymphoma
12
Q
First best test for pheochromocytoma
A
urine and plasma free metanephrines
13
Q
First best test for primary aldosteronism
A
Plasma aldosterone to renin ratio
14
Q
First best test for adrenocortical carcinoma
A
urine 17-ketosteroids
15
Q
First test for cushing syndrome
A
Overnight one mg dexamethasone test
16
Q
Management of a less than five centimeter and nonfunctional adrenal nodule
A
Observing CT scans every six months
17
Q
Management a greater than 6 cm or functional adrenal module
A
Surgical excision
18
Q
how dx suspicious nodules for hyperPTH?
A
FNA or sestamibi
19
Q
breast cysts that are painful and change with menses, dx?
A
fibrocystic change
20
Q
mgmt fibrocystic change
A
restrict caffeine, take vit e, wear a supportive bra
21
Q
mgmt DCIS
A
Excision With clear margins or simple mastectomy of multiple lesions [ no node sampling] and adjuvant radiation therapy
22
Q
mgmt LCIS
A
More often bilateral. Consider bilateral mastectomy only if positive family history hormone sensitive or prior history of breast cancer
23
Q
Mgmt IDC or lobular carcinoma
A
If small and away from nipple, can do a lumpectomy with axillary node sampling. Adjuvant radiation therapy. Chemo if node positive. Tamoxifen relaxes an estrogen receptor positive
Or
Modified radical mastectomy with axillary node sampling without adjuvant radiation therapy
24
Q
Management for Paget’s disease of the breast
A
Mammogram to find the mass
25
Management of basal cell carcinoma
Shaver punch fancy that surgical removal Mohs
26
Management of squamous cell carcinoma
Excisional biopsy at Edge of lesion, then wide local excision. Can use radiation for tough locations
27
Management of melanoma
Treatment with excision, 1 cm margin if less than one millimeter thick, 2 cm margin if 1-4 mm thick. 3 cm margin if >4 millimeter thick
28
Sarcoma typically spread first
lungs, hematogenously
29
treatment for oral squamous cell cancer
XRT or radical dissection
30
tx laryngeal cancer
laryngoscope laser or resection
31
MC salivary gland tumor?
pleomorphic adenoma, benign but recurs
32
Dx diaphragmatic hernia prenatally, mgmt?
plan delivery at hospital with ECMO, let lungs mature 3-4 days and then do surgery
33
Baby is born w/ respiratory distress w/ excess drooling.
| •Best diagnostic test?
TE-Fistula
| Place feeding tube, take xray, see it coiled in thorax
34
Gastroschisis assoc with other disease?
not usually
35
Defect lateral (usually R) of the midline, no sac.
gastroschisis, see high maternal AFP
36
assoc with congenital umbilical hernias?
Assoc w/ congenital hypo-thyroidism. (also big tongue)Repair not needed unless persists past age 2 or 3.
37
complications of pyloric stenosis
Hypochloremic, met alkalosis
38
tx pyloric stenosis
Immediate surg referral for myotomy
39
2wk old infant w/ bileous vomiting. The pregnancy was complicated by poly-hydramnios. dx? assoc with
Intestinal atresia or annular pancreas
assoc with downs
40
1 wk old baby w/ bileous vomiting, draws up his legs, has abd distension.
Malrotation and volvulus*Ladd’s bands can kink the duodenumDoesn’t rotate 270 ccw around SMA
41
A 3 day old newborn has still not passed meconium.
| –DDX? (name 2)
Meconium ileus-consider CF if +FH*gastrograffin enema is dx & txHirschsprung’s-DRE explosion of poo. bx showing no ganglia is gold standard
42
A 5 day old former 33 weeker develops bloody diarrhea
NEC
43
A 2mo old baby has colicky abd pain and current jelly stool w/ a sausage shapend mass in the RUQ
Intussusception*Barium enema is dx and tx
44
Hyperacute Rejection-
Vascular thrombosis w/in minutes
| –Caused by preformed antibodies
45
Acute Rejection-
Organ dysfunction (incrGGT or Cr depending on organ) w/in 5days –3mo. Due to T-lymphocytes.
–Technical problems common in Liver 1stcheck for biliary obstruction w/ U/S then check for thrombosis by Doppler.
–In heart, sxscome late, so check ventricular bxperiodically.
–Txw/ steroid bolus and antilymphocyteagent (OKT3)
46
Chronic Rejection
Occurs after years. Due to T-lymphocytes.
| –Can’t treat it. Need re-transplantation.
47
Merperidine: side effects
Norperidine metabolite can lower seizure threshold esp in pts w/ renal failure.
48
Succinylocholine side effects
Can cause malignant hyperthermia, hyperK (not for burn or crush victim
49
Rocuronium side effects
Sometimes allergic rxn in asthmatics
50
Halothane side effects
Can cause malignant hyperthermia (dantroline Na), liver toxicity.
51
risk with raloxifene?
increases risk of DVT
52
MC heart defect in Downs
complete AV septal defect
53
treatment for extrapyramidal side effects
Benztropine or antihistamines
54
Abx for human bite
Amoxicillin-clavulonate
55
pt with back pain with red flags or sciatica, next step in mgmt
ESR and plain films
56
what type of thyroid cancer does mantle radiation predispose to?
papillary
57
HTN predisposes to what kind of intracerebral hemorrhage
basal ganglia
58
Contralateral hemiparesis and hemisensory loss, homonymous hemianopsia, gaze palsy
Basal ganglia hemorrhage
59
what is cardiac index, how is it changed in heart failure?
= cardiac output / body surface area, decreased in heart failure because of decreased forward flow
60
what type of anemia does lead poisoning cause?
microcytic
61
what does an inspiratory hold measure?
pulmonary compliance
62
patient who recently travelled to mexico with fever, double vision and painful swelling around his eyes, pain in neck and jaw muscles, eosinophilia--dx?
trichinellosis
63
pt with chondrocalcinosis, mild hepatomegaly and DM--dx?
hemochromatosis
64
leukocyte alkaline phosphatase score is usually high in what condition?
leukomoid reactions
65
strongest influence on long-term prognosis s/p STEMI is what?
time to return of coronary blood flow
66
what GI disorder that causes flatulance and malabsorption can be seen in patients with systemic sclerosis
SIBO
67
best mgmt of patient with fulminant liver failure
put on transplant list ASAP
68
pt with pancreatitis who likely has gallstones: what imaging modality
RUQ US!
69
how long do patients with mono have to avoid contact sports?
at least 3 weeks
70
treatment for spinal epidural abscess
abx and emergent spinal decompression
71
methimazole side effect
agranulocytosis
72
pt with sickle cell with nocturia?
hyposthenuria
| -can't concentrate urine, 2/2 blood sickling in vasa recta
73
73 yo man recently started on amitriptyline with ab pain and suprapubic tenderness
do a urinary cath, likely urinary retention 2/2 amitriptyline
74
patient with RBC casts, proteinuria, palpable purpura, low complement, anti-HCV positive
dx?
mixed essential cryoglobulinemia
75
tx of patient with SIADH who is symptomatic
hypertonic saline
76
1st step in mgmt of patient with suspected variceal hemorrhage
volume resuscitation, IV octreotide and Abx
77
what are the best lifestyle modifications to decrease HTN?
```
weight loss (#1)
DASH diet
```
78
pt with upper body edema and weight loss and plethoric, dark appearance, what should you think of?
SVC syndrome
79
cancer pt with pain who hasn't taken narcotics, first line pain med?
short acting morphine
80
patient s/p stroke with hemianesthesia and athetosis: location of stroke?
thalamus
81
AIDS patient with widespread pale, peripheral lesions and central necrosis of the retina: dx?
HSV
CMV retinitis is PAINLESS
82
immigrant with weight loss, fever, cough, nausea and adrenal calcs bilaterally: dx
TB
MCC adrenal insufficiency in developing countries
83
what cranial nerve is responsible for corneal sensation?
trigeminal
84
ddx tinea corporis from secondary syphilis
tinea corporis: ring-shpaed scaly patches with central clearing and distinct borders
secondary syphilis is usually maculopapular and involves palms and soles
85
mgmt of premature atrial beats
observation
| benign
86
L sided varicocele that fails to empty when the patient is recumbent: consider what diagnosis?
RCC
87
Dx: mediastinal mass with elevated bHCG and AFP
nonseminomatous germ cell tumors
88
first degree heart block mgmt?
if no QRS prolongation: no further eval
if QRS eval: conduction delay below AV node, need electrophys workup
89
do rimantadine and amantadine work against flu b?
no, only flu A
90
HA, fever, periorbital edema, vomiting: what should you worry about?
cavernous sinus thrombosis
| ddx orbital cellulits, CST cellulitis extends beyond the orbital septum
91
facial swelling, bilateral lower-extremity edema, massive proteinuria, nephrotic syndrome
dx?
AA Amyloidosis
Colchicine for preventation and treatment
92
propylthiouracil (PTU) and methimazole (MMI) MC side effects
agranulocytosis
discontinue if pt has a fever and sore throat or WBC count less than
93
idiopathic intracranial hypertension Tx
Acetazolamide is first
| inhibits choroid plexus carbonic anhydrase
94
what labs look at before starting someone on BP meds
UA
EKG
chemistry panel
lipid profile to risk stratify
95
genetic inheritance of HOCM
AD
96
hydatid cyst, what organism
echinococcus granulosus
97
pt with WPW who develops AFib--tx?
procainamide!
98
diabetic pt with elevated LFTs and normal serology, hepatic fullness: Dx?
NASH, 2/2 insulin resistance
99
pt with dysarthria and R hand weakness, likely etiology of stroke?
HTN
100
CURB-65
Confusion
Uremia (BUN >20)
Tachypnea RR >30
HYPOtension, BP 65
101
HIT immune mediated?
YES: type 2: antibodies against heparin-platelet factor 4 complexes
102
HOCM mitral valve abnormality
abnormal mitral leaflet motion
103
malignancy associated ACTH production associated with what kind of cancer?
SCLC
104
how monitor HBV infection
ALT and HbEAg q 3-6 months
105
pt with an unexplained elevated CK level, next best test?
TSH
106
treatment for Sanford type B aortic dissection
Labetalol
do NOT give Heparin
107
MC complication with TPN
central line infection
108
Pt with non-Hodgkins lymphoma with painless ulcer on foot, recently had chemo: best tx?
anti-pseudomonal PCN because patient is immunosuppressed
109
```
CSF
WBC 25
PMNs 5%
Glucose 65
RBC 700
Protein 120
```
Dx?
HSV encephalitis
110
```
CSF
WBC 1100
PMNs 80%
Glucose 12
RBC 200
Protein 300
```
Dx?
Low glucose, elevated protein, PMNs
Acute bacterial meningitis
111
```
CSF
WBC 120
PMNs 10%
Glucose 10
RBC 100
Protein 80
```
Dx?
Lymphs, decreased glucose, increased protein
Chronic bacterial meningitis due to TB
112
#1 cause of spinal stenosis
OA of the spine
113
pseudoclaudication
lower extremity pain that occurs with walking and does not improve with sitting or resting (this is how you differentiate it from true caludication)
MCC is spinal stenosis which is usually 2/2 OA
114
what kind of hormone is ACTH
polypeptide hormone
115
causes of labor protraction
power
passenger
pelvis
116
define labor arrest
once true labor has begun
no change in dilation over 2 hours or no change in descent in over 1 hour
tx = augment labor, then C section
117
active phase of labor, definition and times
3-4 cm to full dilation
dilated >1cm and hour
118
thoracentesis with > 4gm protein, dx?
TB
119
patient with cancer who has headache worse when they lean forward: dx?
SVC syndrome
120
what level BUN in pts with uremia?
100 mg/dL
121
diabetic moms: what risk to fetal lungs?
increased risk of respiratory distress because insulin causes cellular hypertrophy at the expense of cellular maturation
122
what ABI values suggest peripheral arterial dz
0.4-0.9
123
Calcium 14.1, phos 2.8 in old man with recent lethargy and weight loss
hypercalcemia of malignancy
124
anti-mitochondrial antibodies
associated with PBC
125
anti-smooth muscle antibodies
associated with autoimmune hepatitis
126
tx neurogenic bladder
cholinergic agonist ex. bethanechol
127
tx urge incontinence
muscarinic antagonist
| oxybutynin
128
SAAG cutoff for portal HTN
1.1
129
pt with CHF sx s/p URI
myocarditis, can cause dilated cardiomyopathy
130
unilateral upper lobe infiltrate and hilar adenopathy DX
TB
131
A Fib associated with what thyroid dz
hyperthyroidism
132
poor prognostic indicator for astrocytomas
anaplasia
133
MC presentation of CLL
lymphocytosis and painless LAD
smudge cells
assoc with ITP and Autimmune hemolytic anemia
134
tx CLL
Rituximab, anti CD 20
135
who needs abx prior to dental procedures
prosthetic heart valves
prior history of un-repaired congenital heart dz
history of infective endocarditis
136
best way to increase fertility in overweight PCOS patients
weight loss
137
pancreatic cancer pt with elevated TBili and pruritis -- tx?
endocopic stent placement
ursodeoxycholic acid only works in patients with INTRAhepatic bile duct obstruction
138
multiple myeloma causes what kind of renal damage
renal tubule damage due to toxic effect of light chain casts
139
tx for agitation due to delirium
haldol
NOT benzos, those increase delirium
140
LGSIL and positive or uknown HPV status
colpo and bx
141
LGSIL and negative for HPV 16 and 18
repeat cotesting in 1 year (preferred)
OR
colposcopy and biopsy
142
vaginal normal ph
3.8-4.2
143
vaginal irritation and pH of 4, dx?
Candida
BV and Trich elevate pH
144
pt s/p MI who has a new holosystolic rupture
rupture of IV septum
145
characteristics of DIC
thrombocytopenia
decreased fibrinogen
increased INR
146
breast cancer screening recs
q 2 yrs over 50 yo
147
cremasteric reflex: what is it? when useful?
elevation of testes in response to touching inner thigh
absent in almost all pts with testicular torsion
148
pain relief with elevation of testicle associated with what dx?
Prehn's sign
| assoc with epididymitis
149
Pancost tumor, what association?
SMOKING
| not TB since TB doesn't cause tumors!
150
MCC AR
aortic root dilation or bicuspid aortic valve
151
CSF
nml WBC
elevated portein
nml glucose
GBS
152
presentation of oral herpes in a kid?
herpes gingivostomatitis
| vesicular eruptions on the anterior oral mucosa and perioral region, kids are sick with a fever
153
ovalo macrocytes and PMNs with reduced segmentation are associated with what illness?
myelodysplastic syndrome
154
impetigo: bug, tx and MC complication
Staph A and group A strep
topical mupirocin
post-strep glomerulonephritis
155
what drug hasten COPD exacerbation recovery
glucocorticoids
156
chemo pt with WBC of 600, s/p transfusion 1 week prior dx?
bacterial infxn
157
tx of diabetic ulcer that isn't gangrenous but invades muscle
debridement
158
mgmt DKA in kids
1: 10mL/kg isotonic fluid over one hour
2: insulin + isotonic fluids with K supplementation
159
Efavirenz side effect
insomnia, vivid dreams
160
lamivudine side effect
hepatotox
161
initial tx of urge incontinence
bladder training
| more freq urination
162
leukocytoclastic vasculitis aka
HSP
163
tx Barthoin gland abscess
I and D
164
what migraine meds do you NOT want to use together
ergots and triptans
165
KD tx
IVIG and ASA
166
cause of carpal tunnel in hypothyroidism
accumulation of matrix substance
167
cause of carpal tunnel in pregnancy
accumulation of fluid
168
cause of carpal tunnel in RA
tenosynovial inflammation
169
women at what weeks gestation are candidates for steroids
24-34 weeks
170
kid with a 3-day fever followed by blanching, eryhtematous macular rash, dx?
roseola infantum HHV-6
171
Tx for DIC
plasmapheresis
172
what does sotalol predispose to?
torsades
173
what complication is common s/p coil for SAH
rebleed in first 24 hours
| vasospasm 3 days out
174
mgmt of pt with NSCLC with a single brain met
resect the met
175
tx Lewy body dementia
Rivastigmine or other Ach-ase inhibitors
176
MC bug causing brain abscess s/p URI
viridans group strep
177
Stroke location:
unilateral motor impairment
no sensory or cortical deficits
no visual field abnormalities
Posterior limb of internal capsule, lacunar infarct
178
Stroke location:
contralateral somatosensory and motor deficit
conjugate eye deviation Toward side of infarct
homonymous hemianopsia
aphasia (dominant hemisphere)
hemineglect (non-dominant hemisphere)
MCA
179
Stroke location
- contralateral somatosensory adn motor deficit, predominantly in lower extremity
- abulia (lack of will or initiative)
- dyspraxia, emotional disturbance, urinary incontinence
ACA
180
Stroke location
- alternate syndromes with contralateral hemiplegia and ipsilateral CN involvement
- possible ataxia
vertebrobasilar system lesion supplying the brainstem
181
site of hemorrhage
contralateral hemiparesis and hemisensory loss
homonymous hemianopsia
gaze palsy
basal ganglia
182
site of hemorrhage
no hemiparesis
facial weakenss
ataxia and nystagmus
occipital headache and neck stiffness
cerebellum
183
site of hemorrhage
deep coma and total paralysis within minutes
pinpoint reactive pupils
Pons
184
etiology of normal pressure hydrocephalus
decreased CSF absorption
185
treatment for restless leg syndrom
Dopamine agonist like pramipexole
186
best diagnostic test for delirium in edlery
UA and serum electrolytes
187
what is pronator drift specific for?
UMN lesion
188
fixed dilated pupil: what type of injury to CN III
compression, can also cause parasympathetic injury.
due to P Comm aneurysm or uncal herniation
189
Down and out pupil in a diabetic: what type of injury
ISCHEMIC injury to somatic fibers
normal light and accomodation reflexes
190
best med to treat parkinson's tremor
trihexyphenidyl (anticholinergic)
191
what neuro test can you do in a brain dead pt
deep tendon reflexes because relate to spinal cord not brain
192
patient has parkinsonism, autonomic dysfunction and diffuse neuro signs
dx?
multiple system atrophy
aka Shy Drager
Tx: IV volume expansion, anti-parkinsons drugs
Ddx: Familial Dysautonomia: autonomic dysfunction in jewish kids with severe orthostatic hypotension
193
Tx for Lambert Eaton
plasmapheresis + immunosuppressive drug tx
194
what type of drug is Selegine
MAO-B used to treat Parkinsons
195
bilateral trigeminal neuralgia can be the first sign of what illness?
MS
196
intense ipsilateral retroocular pain and Horner's = what dx?
Cluster HA
197
tx acute cluster HA attack
100% O2 and subQ sumatriptan
198
tx opiod OD / delerium
naloxone
199
medulloblastoma: infra or supra tentorial
supra
200
when do endarterectomy
stenosis greater than 70%
201
Ddx Werdnig Hoffman vs. infant botulinum
WHD: hypotonic at birth, affected by 6 months, + family history since AR. supportive tx
Botulism: often s/p honey, supportive tx and watch respiratory status
202
tx organophosphate poisoning
Atropine and Pralidoxamine
203
cause of charcot joint
nerve damage!
204
Tx of hepatic encephalopathy
supportive tx first: K, electrolyte disturbances, albumin. Then lactulose to get rid of some of the ammonia
TIPS is for complications of portal HTN, not hepatic encephalopathy!
205
AIDS patient with exophytic purpuric skin rash , and liver lesions that hemorrhage on bx
Bartonella
tx: ABX
206
who gets PPSV23 first before PCV13?
heart or lung dz
diabetes
smoking
chronic liver disease
get PPSV23 first, then PCV 13 and PPSV23 at age 65
207
dense, patchy lung infiltrates + abdominal tenderness in a patient who had a bone marrow transplant
CMV
208
what tx for beta thal minor?
none
209
patient with pale, voluminous, greasy and foul smelling stools
ddx
pancreatic insufficiency MCC 2/2 alcohol abuse
bile salt dysfunction
impaired intestinal epithelium
210
side effect of bactrim
hyperkalemia
211
urinary retention from anticholinergic drugs is a result of what?
detrusor inactivity
212
what drug to stimulate appetite in cancer patients
progesterone analog
213
mgmt of Hep C in pregnancy
give Hep A and B vaccine
214
side effect of isoniazid
acute hepatitis`
215
drugs of choice for hypercalcemia of malignancy
bisphosphonates like zolendronic acid or pamidronate
216
treatment of dermatitis herpetiformis
dapsone
217
side effect of HCTZ
hyperglycemia
increased LDL cholesterol
plasma triglycerides
hypoK, hypoNa, increased Ca
218
how ddx chlamydia vs. gonorrhea urethritis in men
gram stain
| won't see chlamydia, will see neisserria
219
name 3 causes of increased BUN/Cr ratio
renal failure
GI bleed
steroid administration
220
symmetric and circumferential narrowing of the esophagus with dysphagia for solids, no weight loss: DX
stricture
221
tiotroprium and ipratroprium are what kinds of drugs?
muscarinic antagonist
222
next step if FAST inconclusive
DPL
223
mgmt of hypercalemia if >14
normal saline and calcitonin
NO furosemide unless CHF bc can worsen volume depletion
224
hepatojugular reflex reflects what?
failing R heart
225
do pts with sickle cell trait have findings on a peripheral smear?
NO
226
heinz bodies, what dz
oxidated hemoglobin from G6PD
227
tx for diabetic gastroparesis
metoclopramide
228
what do WBC casts indicate?
interstitial nephritis and pyelo
229
what do broad and waxy casts indicate?
chronic renal failure
230
tx for TCA toxicity
if QRS >100, give sodium bicar
231
when prophylax HIV patients against MAC
CD4
232
next best step Gastric adenocarcinoma found on bx
CT scan for staging
233
Hep C is associated with what skin disorder?
porphyria cutanea tarda
234
tx cellulitis
nafcillin or cefazolin
235
mgmt hyperplastic colon polyps
non-neoplastic
| no further workup
236
what abx can cause acute renal failure
aminoglycosides: amikycin, gent, tobra
237
tx acute vs chronic prostatitis
acute: bactrim or cipro x4-6 weeks
chronic: cipro
238
gum hypertrophy in a transplant pt, what drug?
cyclosporine
239
diarrhea, leukopenia and hepatotox in a transplant pt, caused by what drug?
azathioprine
240
bone marrow suppression in a transplant pt, drug cause?
mycophenolate
241
erythematous lesions with sandpaper texture: dx?
actinic keratoses
242
Ddx for anterior mediastinal mass
thymoma
teratoma
thryoid neoplasm
terrible lymphoma
243
what vaccinations do HIV positive pts need?
Hep A and B
flu
pneumococcus
244
what bug causes erysipelas
Group A beta hemolytic strep
245
pyoderma gangrenosum is associated with what illness?
IBD, esp crohn's
246
what do you have to test for before starting a patient on methotrexate?
hep B
hep C
TB
247
best test to demonstrate volume depletion
elevated BUN: Cr ratio (not Hct, because that could actually be elevated in a dehydration state due to hemoconcentration)
248
tx for type IV RTA
Fludrocortisone
249
tx for Goodpasture's nephritic
plasmapheresis to get off excess antibodies
250
who gets amyloid nephrotic syndrome
tx?
pts with chronic inflammatory diseases like RA, IBD
tx is transplant bc otherwise it recurs
251
Aspirin leads to what acid base disorder? what's the pH?
respiratory alkalosis and then anion gap metabolic acidosis (lactate)
pH is close to 7.40
252
what electrolyte changes would you see in a patient with Addison's
```
hyper K (bc no aldo)
hypo Na (because no mineralcorticoids)--look this up
```
253
carotid endarterecomy recommended with carotid stenosis of what levels?
symptomatic men and women: 70-99% stenosis
men with asymptomatic stenosis of 60-99%
254
most important prognostic indicator in acute liver failure
PT
255
bradycardia, hypotension, wheezing, hypoglycemia, delirium, seizures, cardiogenic shock: dx? tX?
BB overdose
tx: IV fluids and atropine, then IV glucagon if profound or refractory hypotension
256
how dx C Diff
stool toxin
257
RA drug that can cause oral ulcers
methotrexate
258
1st line tx for OA
acetaminophen
259
what kind of drug is ondansetron
serotonin antagonist
260
how treat anemia of chronic disease
treat underlying illness
261
MC complication of peptic ulcer dz
hemorrhage
262
tx febrile neutropenia in a cancer pt
pip-taxo, cefepime, meropeneum
need an anti-pseudomonal
263
Dx Hep B tests during window period
HBsAg and Anti-HBc
264
all patients with chronic liver dz should be immunized against
Hep A and B
265
patient with h/o asthma or chronic rhinosinusitis with nasal polyposis: dx?
aspirin-exacerbated respiratory disease
pseudo-allergic drug reaction
266
what kind of kidney injury does acyclovir cause
renal tubular obstruction
| 2/2 crystals that precipitate
267
pt with MGUS, next step
skeletal survey to rule out multiple myeloma
268
abnormal D xylose test indicates what illness
Celiac
269
Cause of systemic HTN in throtoxicosis
hyperdynamic circulation from increased myocardial contractility and HR
270
Meniere's is a dz of what part of the ear?
INNER ear
271
MC underlying valve abnormality associated with patients with infective endocarditis?
MR
272
dendritic corneal ulcer is due to what
VZV
273
how ddx methanol vs. ethylene glycol poisoning
both cause AGMA with increased serum osms
methanol--> blurry vision
ethylene glycol--> kidney damage (stones)
274
tx for ethylene glycol poisoning
Fomepizole
275
treatment for Hep B
Tenofavir or entecavir
276
osteomalacia: what pathophys?
impaired osteoid matrix mineralization
277
how does acute pancreatitis cause hypotension
increased vascular permability
278
is it okay to practice procedures on dead patients?
yes as long as you get family's permission
279
patient with a painful red eye and opacification and ulceration of the cornea
contact lens associated keratitis, mostly due to pseudomonas or serratia
medical emergency, broad spectrum Abx
280
MC site of spinal arthritis in RA
C-spine
281
middle ear effusion without an acute infection: dx?
serous otitis media
sx: dull tympanic membrane, hypomobile
282
L hemipleiga
| R ptosis and eye deviation to R and down: what kind of stroke?
Webber's aka PCA paramedian branch stroke to midbrain
283
Falling to the left
| R ptosis and eye deviation to R and down: what kind of stroke?
Benedikt's
PCA or paramedian branches of basilar artery to tegmentum of midbrain
284
pure motor or pure sensory stroke
basal ganglia lacunar stroke
ex: clumsy hand syndrome, ataxic hemiparesis
285
toxo treatment
sulfadiazine and pyrimethamine
286
meningitis vaccine: what age?
| booster?
11-12
16-21
287
unilateral motor deficit
mild dysarthria
no visual, sensory or higher cortical dysfunction
pure motor hemiparesis
lacunar infarct in the posterior limb of the internal capsule
288
unilateral numbness, parasthesias, and hemisensory deficit involving the face, arm, trunk and leg
pure sensory stroke
stroke int eh VPL nucleus of the thalamus
289
weakness that is more prominent in the lower extremity, along with ipsilateral arm and leg incoordination
ataxic-hemiparesis
lacunar infarct in the anterior limb of the internal capsule
290
hand weakness, mild motor aphasia, no sensory abnormalities
dysarthria clumsy hand syndrome
lacunar stroke at the basis pontis
291
hemisensory loss with severe dysesthesia of the affected area: lesion in what side of the brain?
thalamus
292
medical tx for descending aortic dissection
labetalol NOT nifedipine
