Medicine Flashcards
(115 cards)
1
Q
Complications of acute pancreatitis:
A
Pleural effusion, ARDS, Ileus, renal failure
2
Q
SBP dx via:
A
Temp >100, ascitic fluid with PMN count >250, SAAG > 1.1
3
Q
Factitious diarrhea 2/2 laxative abuse has following lower GI endoscopy findings:
A
Brown discoloration of colon and shiny lymph follicles/pale patches
4
Q
GI bleeding will ??? BUN/Cr ratio
A
Increase
5
Q
Steatorrhea 2/2 ZES occurs via?
A
Inactivation of pancreatic enzymes due to increased stomach acid production (gastrin producing pancreatic tumor)
6
Q
Dx tests for acute Hep B infection?
A
HBsAg and anti-HBc
7
Q
Active esophageal varices bleeding med? Non bleeding varices med for ppx?
A
Octreotide. Beta blockers
8
Q
Triad of Pellagra:
A
Diarrhea, dermatitis, dementia
9
Q
Pellagra is deficiency of ???
A
Niacin
10
Q
Lab findings of every chronic inflammatory dz?
A
Anemia and reactive thrombocytosis
11
Q
Gallstone med for pts with symptomatic/functional GB and poor surgical candidate
A
Ursodeoxycholic acid (also used to tx PBC)
12
Q
Wilsons dz is aka ???
A
Hepatolenticular degeneration
13
Q
Hx of travel, bloody diarrhea and liver cyst: due to what organism?
A
Entamoeba histolytica
14
Q
Hx of dog contact, liver cyst with eggshell calcifications. Likely organism?
A
Echinococcus granulosus (hydatid cyst)
15
Q
Hyperpigmented nodule that dimples in center when pinched around edges. Most commonly on LE. Dx?
A
Dermatofibroma
16
Q
Sensorineural hearing loss that occurs with aging
A
Presbycusis
17
Q
Pt with epigastric pain, vision loss, optic disc hyperemia, and increased anion gap metabolic acidosis. Likely poison?
A
Methanol intoxication
18
Q
??? damages the eyes, ??? damages the kidneys
A
Methanol; Ethylene glycol
19
Q
Tx of organophosphate poisoning?
A
Atropine
20
Q
Pt with HA, N/V, Ab pain, confusion, and PINKISH-RED skin hue. Likely poisoning?
A
Carbon monoxide
21
Q
Ethylene glycol tx?
A
Fomepizole or ethanol
22
Q
Tx of diphenhydramine overdose?
A
Physostigmine
23
Q
Pt with hallucinations, agitation, pupillary dilation, vertical nystagmus. Likely poisoning?
A
Phencyclidine intoxication
24
Q
Vomiting and non bloody diarrhea devoid of fecal leukocytosis in absence of fever is highly indicative of ???
A
VIRAL gastroenteritis
25
Suspect a GI bleed when pt has anemia, elevated ???, and normal ???
BUN; Cr
26
Asterixis and increased DTRs are signs of ???
Hepatic encephalopathy
27
These meds can precipitate hepatic encephalopathy?
Benzos
28
Pt presents with appendicitis symptoms and bloody diarrhea. Stool exam reveals gram negative coccobacilli on CIN agar and serotype 0:3. Likely organism?
Yersinia enterocolitica
29
Acute alcoholic hepatitis tx?
Steroids, IVF, enteral nutrition
30
Underlying cause of Wilsons dz?
Decreased copper excretion
31
What electrolyte abnormalities are hallmark of refeeding syndrome?
HYPOkalemia, HYPOphosphatemia, and HYPOmagnesemia. All due to increased insulin
32
Dx test of choice for PUD/H.Pylori?
Serologic testing for antibodies
33
Tx of H.Pylori?
PPI and either 1) clarithromycin & amoxicillin, or 2) clarithromycin & metronidazole
34
Tx of SBP?
3rd gen cephalosporins like cefotaxime
35
Fe deficiency anemia has ??? iron/ferritin; ACDz has ??? iron/ferritin
Low/low; low/high
36
T or F: Dx of contact dermatitis via serum IgE
False. Patch testing is correct test
37
Pt falls, presents with externally rotated and shortened leg. Likely Dx?
Femoral neck fracture
38
SJS vs TEN: ??? involves 30% BSA and 2 mucosal sites
SJS; TEN
39
Generally, ??? affects extensor surfaces, and ??? affects flexor surfaces
Psoriasis; eczema
40
Hypopigmented/scaley macules with hyphae on KOH prep. Tx is selenium sulfide. Dx?
Tinea versicolor via Malassezia furfur
41
Fungal infection forming scaly circular patches with central clearing. Tx with ketoconazole, terbinafine, miconazole. Dx?
Tunes corporis. Via trictophyton dermatophyte
42
If suspecting melanoma, evaluate via ??? biopsy
Excisional
43
Blistering skin lesions and nodular liver. Liver bx significant for intracellular crystals. Dx?
Porphyria cutanea tarda
44
Tx of refractory/fistulizing Crohns dz?
Infliximab IV; a TNF alpha antibody
45
Confirm pancreatitis with ???
Abdominal CT (shows calcifications)
46
Ranson criteria 0 hours from onset of pancreatitis:
Age >55, WBC >16000, Glucose >200, LDH >350, AST >250
47
Ranson criteria for 48 hours after onset of pancreatitis:
Ht fall by >10%, BUN increase by >5, calcium
48
Foul smelling, fatty diarrhea that is nonbloody, onset after camping. Dx? Tx?
Giardia, Metronidazole
49
Pt returns from Caribbean trip and develops fevers, polyarthralgia, lymphopenia, thrombocytopenia. Likely Dx?
Chikungunya
50
Cat scratch fever is caused by ??? and tx with ???
Bartonella henselae, azithromycin
51
Sex worker with fever, chills, tenosynovitis, polyarthralgia, and PUSTULAR lesions on trunk/extremities. Cultures are negative for organisms. Likely Dx?
Disseminated gonococcal infection
52
Neuroimaging CT shows ring enhancing lesions. Dx is toxoplasmosis: tx now? Ppx?
Sulfadiazine and pyrimethamine; TMP-SMX
53
Tx of cryptococcal meningitis?
Amphotericin B with flucytosine
54
Pt is scheduled for splenectomy, vaccination against encapsulated organisms should be given when?
2 wks before or after splenectomy
55
Pt with cough, has pulmonary nodules with cavitations. Culture yields branching/filamentous PARTIALLY acid fast bacteria. Dx? Tx?
Nocardia; TMP-SMX
56
Tx of CMV? Tx of HSV?
Ganciclovir or Foscarnet; acyclovir or valcyclovir
57
Drug of Choice for human and dog bites?
Amoxicillin-clavulanate
58
Pt over 65 with loss of CENTRAL vision. Dx?
Age related macular degeneration
59
Painful glaucoma that is an emergency?
Closed angle glaucoma
60
Loss of visual acuity 2/2 lens opacification. Pts c/o glare and difficulty driving at night. Dx?
Cataract
61
Sudden, transient/temporary monocular vision loss 2/2 retinal ischemia from a cholesterol emboli. Dx?
Amaurosis fugax ("curtain falling down")
62
CMV retinitis presents when CD4 is
Yellow-white patches of retinal opacification and retinal hemorrhages
63
Fundoscopy of HSV retinitis reveals:
Pale, peripheral retinal lesions and central necrosis of retina
64
Central retinal vein occlusion has classic "blood and thunder" appearance on fundoscopic exam:
Optic disc swelling, retinal hemorrhages and dilated veins, cotton wool spots.
65
Central retinal artery occlusion is described on fundoscopic exam as:
Optic disc pallor, cherry red fovea, boxcar segmentation of blood in retinal veins
66
Age related decrease in lens elasticity that leads to difficulty with near vision. Dx?
Presbyopia
67
Inflammatory changes in medial region of eye, near lacrimal sac*
Dacrocystitis
68
Strict vegetarian with anemia and neurologic complications(memory loss, dementia, irritability, loss of vibration/proprioception in LE) due to ???
Vitamin B12 deficiency
69
Most common cause of malignancy-associated SIADH?
Small cell lung cancer
70
Cavitary lung lesions and hypercalcemia. Dx?
Squamous cell carcinoma
71
Pt with new onset seizures and CT scan shows cysts with scolices. Dx? Tx?
Neurocysticercosis by T. Solium worm. Prednisone, phenytoin, albendazole
72
Tx for young pt with atypical or "walking" PNA?
Macrolide (erythromycin, clarithromycin, or azithromycin) or doxycycline
73
What organism can causes concurrent fever, PNA symptoms, gastroenteritis and neuro symptoms?
Legionella
74
CMV vs. HSV esophagitis:
CMV ulcers- large/shallow/linear
HSV ulcers- small/deep/circular
*both will have multinucleated giant cells with nuclear inclusions
75
First line tx of impetigo?
Topical mupirocin
76
Test of choice to Dx MS?
MRI
77
Pronator drift is a specific finding for ??? damage
UMN
78
??? presents in young, obese women with HA, vision changes, and pulsatile tinnitus. Also papilledema and elevated opening pressure during LP. Tx?
Idiopathic intracranial HTN (pseudotumor cerebri). Acetazolamide
79
Alcoholic pt with AMS, gait instability, nystagmus, conjugate gaze palsy. Dx?
Wernicke's encephalopathy 2/2 thiamine deficiency
80
What has greatest accuracy in confirming Dx of Parkinson's dz: PE, imaging, or labs?
Physical exam: want 2/3 of rest tremor, rigidity, bradykinesia
81
Pt with parkinsonism and autonomic dysfunction. Dx?
Shy-Drager syndrome (multi system atrophy)
82
Suspect ??? In an HIV pt with focal neurologic signs and multiple NON-enhancing lesions in white matter, with no evidence of mass effect
Progressive multifocal leukoencephalopathy
83
Acute exacrbations of MS are tx with?
Corticosteroids
84
??? cause HA, hypothyroidism, adrenal failure, and diabetes insipidus due to mass effect on hypothalamus
Craniopharyngiomas
85
Tx of pulmonary HTN 2/2 LV dysfunction?
Loop diuretic + an ACE inhibitor or an ARB
86
Hypoxia in pts with PNA occurs due to an increase in ???
Alveolar-arterial oxygen gradient
87
Meds that trigger bronchoconstriction in pts with asthma?
Aspirin and beta blockers
88
Management of Pts with a persistent tachyarrhythmia and hemodynamic instability? Same but hemodynamically stable?
Immediate sync DC cardioversion.
| Vagal maneuvers or IV adenosine
89
Most beneficial therapy to reduce progression of diabetic nephropathy?
Strict BP control, target is 130/80
90
Target BP for DM pts?
140/90
91
Pts with hypoalbuminemia can have decreased ???
Serum calcium
92
All DM pts age 40-75 should be on ??? to decrease risk for CAD
Statin
93
Pt with low T3, normal T4 and TSH, presenting during an acute/severe illness. Dx?
Sick euthyroid syndrome (aka low T3 syndrome)
94
CSF analysis of GBS patient?
High Protein, normal glucose/WBC/open press
95
Empiric ABX tx of bacterial meningitis in an infant?
Ampicillin and gentamicin (be a GENT and AMP kids defense)
96
Mono characteristic features (4):
Lymphadenopathy, pharyngitis with tonsillar exudate, Splenomegaly, subclinical hepatitis (LFTs)
97
SIADH: ??? serum sodium, ??? urine
Low; highly concentrated (hi spec grav)
98
??? Is a consequence of rapid Overcorrection of hyponatremia with hypertonic Saline.
Central Pontine Myelinoysis
99
Opioid inTOXICication:
Pupillary constriction, respiratory depression , hypotension/Bradycardia
100
Opioid toxicity tx?
Naloxone
101
NFB type 2: involves 2 ??? and defect in ??? 22, and has classic NFB skin finding of ???
Ears/Schwannomas; chromosome; cafe au lait spots
102
NMS presents with:
| tx:
AMS, hyperthermia, HTN/tachycardia, rigidity. Tx:BROMOCRIPTINE
103
NMS is caused by deficiency in dopamine, which is seen:
By antipsychotic meds or withdrawal of dopaminergic meds
104
Test of choice in Dx of Cushing's syndrome?
24 hr urine cortisol
105
Most reliable way to difftiate bwn pituitary and ectopic ACTH secretion?
Inferior petrosal sinus ACTH
106
Etiology of exophthalmos in Graves dz?
TSH ab activate fibroblasts and T lymphocytes to deposit GAG
107
Gas gangrene from Clostridium perf., which is an ??? gram ??? rod
Anaerobic ; Positive
108
Cellulitis lacks signs of ??? production, and usually caused by ??? and ???
Gas; strep pyo & staph aureus
109
??? presents with Parkinsons, urogenital dysfunction, and orthostatic hypotension
Multiple System Atrophy
110
Pt with CKD: best DM med? Worst DM med?
Glipizide (repaglinide/meglitinide if sulfa allergy); metformin (lactic acidosis)
111
MEN 2A or Sipple's syndrome classic presentation:
Medullary thyroid carcinoma, pheochromocytoma, HPTH
112
Blood on UA, but absence of RBCs on microscopy: suspect??
Myoglobinuria (likely 2/2 Rhabdomylosis)
113
AFib most commonly caused by ectopic foci within ???
Pulmonary veins
114
Atrial flutter commonly involves a reentrant circuit around the ???
Tricuspid annulus
115
Initial DMARD of choice of pts with active RA?
Methotrexate
