Medicine Qbank 2 Flashcards
(257 cards)
1
Q
risk factors for squamous cell caricoma
A
sun exposure! less important: arsenic, aromatic hydrocarbons, chronic osteomyelitis, chronic scars
2
Q
methotrexate AE
A
macrocytic anemia. folate may help. DMARD inhibits dihydrofolate reductase leads to heme tox, including also pancytopenia. other AE: nausea, stomatitis, hepatotox, interstitial lung dx and alopecia and fever.
3
Q
hydroxychloroquine AE
A
GI, visual disturbances, hemolysis in G6P def. (DMARD)
4
Q
cyclosporine AE
A
immunosuppressant: viral infection, lymphoma, nephrotox
5
Q
Azathioprine AE
A
pancreatitis, liver tox, dose-dependent bone marrow suppression
6
Q
best method of improved survival in COPD
A
supplemental oxygen (vaccines also help)
7
Q
indications for oxygen in COPD
A
PaO255, or evidence of for pulmonale
8
Q
enlargement and failure of the right ventricle of the heart as a response to increased vascular resistance or high blood pressure in the lungs
A
cor pulmonale
9
Q
most common cause of pneumonia in pt w/HIV
A
pneumococcus
10
Q
infections causing pancreatitis
A
CMV, legionella, aspergillus (uncommon)
11
Q
sulfonylureas AE
A
wt gain, hypoglycemia (generally added in metformin failure)
12
Q
TZDs AE
A
wt gain, CHF, edema, bone fracture, bladder cancer (low risk of hypoglycemia, can be used in renal insufficiency)
13
Q
Insulin AE
A
wt gain, hypoglycemia (added in metformin failure w/A1c>8.5)
14
Q
DPP-IVi AE (sitigliptin)
A
not much. wt neutral, low risk of hypoglycemia, can be used in renal insufficiency
15
Q
GLP-1 receptor agonist AE (exenatide, liraglutide)
A
associated w/acute pancreatitis. wt loss! low risk of hypoglycemia. possible second agent in metformin failure.
16
Q
acute onset back pain, positive straight leg raise
A
herniated disk. early mobilization, muscle relaxants and NSAIDs
17
Q
used in patients with osteoporosis and possible vertebral crush fractures
A
plain roentgenogram (x-ray)
18
Q
IgA anti-endomysial and anti-tissue transglutaminase antibodies
A
predictive of celiac (absent in selective IgA deficiency)
19
Q
worsening chest pain after endoscopy; left-sided pleural effusion
A
suspicious for esophageal rupture! water-soluble esophagram (may also see pneumothorax, pneumomedistinum)
20
Q
HBsAg
A
persists for six months in chronic HBV
21
Q
HBeAg
A
evidence of replication, increased infectivity (Immune tolerance and immune clearance phases, not later)
22
Q
Anti-HBe
A
marks decline of replication
23
Q
IgM anti-HBc
A
first antibody in acute infection
24
Q
IgG anti-HBc
A
indicated prior or ongoing infection
25
confirm inactive HBV carrier status
3 normal ALT levels and 2-3 normal HBV DNA tests over one year
26
high in tumor lysis syndrome
potassium, phosphate and urea. allopurinol may reduce acute irate nephropathy
27
granulomatous dz, hyperkalemia, hypoglycemia, eosinophila
adrenal insufficiency; normal anion gap acidosis (TB causes Addisons's!)
28
Calculate anion gap
Sodium - (Chloride+Bicarb). 12 is normal
29
tachycardia, hypertension, arrhythmias, high fever, tremor and lid lag
thyroid storm (can be postop, trauma, infection, iodine contrast or childbirth)
30
tachycardia, high fever, hypercarbia, muscle rigidity, elevated CK, hyperkalemia
malignant hyperthermia, tx dantrolene IV
31
euvolemic hyponatremia, decreased serum osmolarity, elevated urine osmolarity, high urine sodium
SIADH (fails to correct)
32
total body water overload, depleted intravascular volume, low urine sodium
low albumin, in advanced liver dz, particularly cirrhosis
33
ADH
acts on distal tubule to increase free water resorption. excess causes hyponatremia
34
associated with poor prognosis in PE
afib, low O2 sat
35
cardiac tamponade triad (and EKG)
distant heart sounds, hypotension and distanced neck veins; electrical alternans
36
vomiting and pain, not typically diarrhea, rapid onset (preformed toxin)
s.aureus
37
brief illness, watery diarrhea, cramps and fever, undercooked or unfridgerated food
c. perfringens
38
associated with shellfish, may cause invasive disease in immunocompromised or pts with liver dz
vibrio vulnificus
39
watery or bloody, undercooked beef, bovine feces
e. coli
40
bloody, associated with contaminated food, water outside of US
shigella
41
bloody, often in children and young adults, raw/undercooked meat
campylobacter
42
most common cause of bloody diarrhea w/o fever
e.coli
43
antibiotics in enterohemorrhagic e.coli
no! may increase risk of hemolytic uremic syndrome
44
high dose dexamethasone does not suppress plasma cortisol levels
ectopic ACTH syndrome
45
ACTH independent Cushing's
exogenous glucocorticoids, adrenal adenoma, or primary pigmented nodular adrenocortical hyperplasia
46
ACTH dependent Cushing's
ACTH-producing pituitary adenoma (cushing's dz), ectopic ATCH, ectopic corticotropin-releasing hormone
47
rapid onset hypertension, metabolic alkalosis, hyperglycemia, hyperkalemia, and proximal muscle weakness
cushing's syndrome from ectopic ATCH. malignancies (small-cell lung, pancreatic), does not suppress with high dose dexamethasone
48
loop diuretics (furosemide) AE
ototoxicity (reversible or irreversible hearing loss, tinnitus), esp. w/aminoglycosides or in pts with renal failure
49
hydrochlorothiazide AE
orthostatic hypotension, photosensitivity, hypercalcemia,
50
sildenafil (phosphodiesterase inhibitor) contrindications
pt on nitrates, with four-hour interval with alpha-blockers (doxasozin, for BPH) to avoid hypotension
51
odds ratio can be calculated, but incidence cannot
case-control study (two groups, one w/dz, comparison of exposure to risk factors)
52
s. bovis subtype associated with colon cancer
biotype 1, S gallolyticus
53
mammogram guidelines
women 50-75, every two years
54
pap smear guidelines
women 21-65, every three years
55
colonoscopy guidelines
50-75, every 10, or fetal occult blood every 1
56
lipid panel guideline
men over 35, every 5 years, women at increased risk at 45
57
hypertension screening
18+, BP every 2 years
58
DEXA guidelines
women +65, uncertain interval
59
antibiotics for human bite, "fight bite"
amoxicillin-clavulanate. polymicrobial coverage: gram positives, negatives and (beta-lactam producing) anaerobes.
60
clindamycin covers
gram-positives and anaerobes
61
ciprofloxacin cover
gram-positives and negative, not anaerobes
62
drug of choice for legionnaire's dz, outpatient CAP
erythromycin
63
causes red-orange discoloration of body fluids
rifampin. antibiotic, mycobacteria coverage (TB, leprosy), tick-bourne illnesses in pts who can't take doxycyline
64
inflammation, fibrosis and stricture of hepatic ducts in patients with UC (more often) and Crohn's
primary sclerosing cholangitis. see beading on imaging, onion skins on histology
65
fever, malaise, wt loss, neuropathy, arthralgias, livedo reticularis , renal dz, necrotic inflammation of medium-sized arteries
PAN, polyarteritis nodosa
66
primary biliary cirrhosis v. primary sclerosing cholangitis
PBC is women, 9:1. PSC is associated with UC
67
travel to endemic area followed by dysentery and RUQ pain
amebic liver dz! single cyst in right lobe of liver, protozoa: entameoba histolytic. Mexico!
68
signs of liver abscess after surgery, GI illness, acute appendicitis
pyogenic liver cyst. severe presentation
69
most beneficial therapy to reduce progression to diabetic nephropathy
blood pressure control
70
DM statin recommendations
all diabetes 40-75
71
hypercalcemia in paralysis
immobilization leads to osteoclast activation and hypercalcemia. tx bisphosponates
72
altered mentation, lethargy, weakness, hyperosmolarity, volume depletion, severe hyperglycemia without ketosis
HHS. serum glucose >600! when insulin is just controlled enough to prevent ketosis but not hyperglycemia
73
diarrhea, tricuspid murmur?
Carcinoid! Small intestine, proximal colon, or lung, mets to liver!
74
elevated urine 5-hydroxyindoleacetic acid, increased chromogranin A
confirm carcinoid dx
75
primary treatment for all prolactinomas
dopaminergic agents: bromocriptine, caberogoline). normalizes prolactin and reduces tumor size
76
most cellulitis
s. aureus
77
tx staph cellutlitis
IV hafcillin, cefazolin, vanc if MRSA
78
abnormal thyroid levels in acute severe illness (T3 lower than T4)
sick euthyroid (decreased calories + increased cytokines: IL1, IL6)
79
Rh-, HLA B27
ankylosing spondylitis, reactive arthritis, enteropathic spondylitis (UC, IBD, Crohn's), psoriatic arthritis, JIA
80
proteinuria, arthritis, wt loss, fatigue, rash, serotitis, neuro sx
SLE
81
painless subcutaneous nodules at pressure points (olecranon)
rheumatoid arthiritis, gout
82
associated w/PPi use, anti-histamines
c. diff
83
positive urea breath test
h. pylori (epigastric pain, early saiety)
84
c. diff test
assay for bacteria toxin A and B
85
steatorrhea, malabsorption, anti-tissue transaminase Ab
celiac
86
increased serum gastrin levels
gastroma, zollinger-ellison syndrome
87
GERD, diarrhea, and duodenal ulcers in young or med-age adults
zollinger-ellison syndrome
88
tx TCA OD
sodium bicarb (if QRS>100), benzos (if seizure)
89
tx anticholinergic OD (atropine, diphenhydramine)
physiostigmine
90
80% of US cirrhosis
HCV or EtOH cirrhosis
91
anasarca (generalized edema), ascites, thrombosis
nephrotic syndrome
92
paradoxical embolism
PFD, VSD allow embolus from venous circulation
93
lung lesion stable for >2 years
noncancerous (when no prior image available, get chest CT)
94
antinuclear antibodies
collagen vascular diseases, SLE, type 1 autoimmune hepatitis
95
anti-smooth muscle Ab, antiLKM
acute and chronic active hepatitis (highest in chronic active)
96
anti-smith
SLE (high specificity, but only present in 30-50%)
97
P-ANCA
churg-strauss, microscopic polyangitis
98
anti-mitochondrial Ab
90% of PBC
99
enthesitia
pain where tendons and ligaments connect to bones: heels, tibial tuberousities, iliac crests. In HLA-B27s: AS, psoriatic and reactive arthritis)
100
endotrachial tube misplacement v. tension pneumothorax
tension pneumo has significant hypotension
101
normal response to calcium infusion test
decreased urine phosphate excretion, 2/2 PTH inhbition (does not occur in hyperPTH)
102
calcium infusion test: sharp rise in gastrin
gastrinoma (pancreatic islet cell tumor) (also diarrhea, ulcers in multiple sites, thickened gastric folds on endoscopy)
103
hyperPTH, chronic atrophic gastritis, chronic PPI use
can lead to carcinoid tumors
104
HA, n/v, confusion, pink-red skin
CO poisoning. tx (O2 until CO levels drop below 10%)
105
fever, chills, flank pain, DIC, Coombs +, pink plasma, 1 hr after transfusion
acute hemolytic transfusion reaction, 2/2 ABO mismatch. (fluids, dopamine, mannitol, FFP for bleeding)
106
anaphylaxis, angioedema, respiratory depression after transfusion
IgA deficiency
107
fever, chills, and malaise I hour after transfusion
febrile non-hemolytic tranfusion reaction. supportive tx
108
70% of mitral stenosis causes
afib from left ventricular dilitation
109
hypopigmented scaling patches, grow in heat/humidity, KOH shows hyphae and yeast spaghetti and meatballs
tinea versicolor. tx selenium sulfide, ketoconazole,
110
herald patch, christmas tree patterned fawn ovals 2cm in diameter
pityriasis rosea
111
ring worm
tinea corpus
112
total depigmentation
vitiligo
113
common AE of Ca-channel blockers (-dipines)
peripheral edema (also dizziness, tachy/bradycardia, constipation, gingival overgrowth)
114
HPA axis
CRH from hypothalamus stimulaters ACTH from anterior pituitary, stimulates cortisol release from adrenal cortex, which inhibits CRH and ACTH
115
cortisol released in response to
stress, low glucose
116
cortisol fxn
stimulates glocose formation, suppresses immune responses, aid metabolism, decrease bone formation
117
high ACTH, low aldo, hyponatremia, hyperkalemia
primary adrenal insufficiency (note aldo comes from outer adrenal cortex)
118
Conn's syndrome
primary hyperaldosteronism: high aldo, high bicarb, low renin
119
dysphagia of solids and liquids
motility issue. dx w/barium swallow, +/- manometry
120
dysphagia of solids progressing to liquids
mechanical issue. dx with endoscopy, unless trauma/cancer, then barium swallow +/- endoscopy
121
nonspecific systemic symptoms and splenomegaly in HIV w/CD4
think MAC. tx azithromycin (prophylax under 50)
122
hypo or euthyroid, heterogenous iodine uptake
hashimoto's
123
hyperthyroid, diffuse increased uptake
+eye involvement, pretibial mixedema. Graves
124
hyperthyroid with patchy uptake
multinodular goiter
125
hyperthyroid, uptake in nodule only, thyrotoxicosis
toxic adenoma
126
for GI protection with ASA
famotide (pepcid, H2 antagonist)
127
to prevent and treat stomach ulcers (NSAID use)
omeprazole (first line), misoprostol (induces abortion, diarrhea. take 4x daily)
128
chronic active HBV
50% leads to cirrhosis, 50% of cirrotics get HCC
129
tx high viral load in HBV (HBeAg + and >20000, HBeAg - and >2000, or fibrosis on biopsy)
entecavir, tenofovir, PEG IFNaplha-2a
130
crypt abscesses
UC (also fever, colicky ab pain, blood in stoll)
131
pain, bullae and sores on breasts, butt, thighs or ab
warfarin necrosis
132
benign epithelial tumors in R. hepatic lobe
hepatocaricoma. rare, women, OCP
133
+PPD in HIV
>5mm, give isoniazid for nine months, w/pyridoxine to prevent necrosis
134
VIII + IX deficiency
hemophilia! X-linked, frequent hemarthrosis w/o trauma, hematuria w/normal renal fxn
135
AD, mucosal bleeding, menorrhagia
Von Willebrand dz, most common hereditary bleeding syndrome
136
binds to proteins, VIII in particular, platelets, and collagen exposed in endothelial cells
Von Willebrand factor
137
fast-growing volcanic nodule, low grade, originates from hair follicle
keratoacanthoma. tx like squamous cell carinoma
138
seborrhic keratosis
moles! explosion can mean occult malignancy (Leser-Trelat sign)
139
leser-trelat sign
mole explosion signalling GI adenocarcinomas (less so breast, lung, urinary cancers)
140
bronchial breath sounds, dull to percussion, egophany, whisper pectoriloquy
consolidation, as in CAP
141
tx paroxysmal nocturia hematuria
eculizumab (monoclonal Ab inhibits complement activation)
142
acute limb ischemia after MI
left ventricular thrombus
143
heel pain in the a.m.
plantar fasciitis
144
numbness or pain and clicking between 3rd and 4th toe (mulder's sign)
morton neuroma (not really a neuroma, a tissue thickening)
145
burning, numbness and aching in distal plantar surface of foot
tarsal tunnel syndrome
146
aztreonam covers
gram negatives, including pseudomonas
147
tx pulmonary abscess from anaerobic oral flora
clindamycin
148
acid-fast rods
mycobacteria (TB)
149
shoulder pain, Horner's syndrome, weak hand muscles, pain and paraesthias
Pancoast tumor, superior sulcus of lung. (also wt loss, supraclavicular lymph node enlargement
150
T score osteoporosis
Lower than -2.5
151
T score osteopenia
-1 to -2.5
152
increased alk phos and + GGT
liver. if GGT -, think bone
153
inhibits thromboxin A2 by inhibiting cycloxygenase 1
aspirin (anti-platelet)
154
blocks adenosine disphosphate receptors on surface of platelets
clopidogrel (anti-platelet)
155
activates antithrombin III, which inactivates IIa (thrombin), IXa and X
heparin
156
inhibits 3-hydroxy-3-methylglutonyl coenzyme reductase
statins
157
inhibits sythesis of vit. K-dependent coag factors
warfarin
158
K dependent coag factors
II, VII, IX, X, C & S
159
hypocalcemia w/normal or low PTH: surgical
parathyroidectomy, thyroidectomy, radical neck surgery
160
hypocalcemia w/normal or low PTH: autiimmune
polyglandular autoimmune syndrome
161
hypocalcemia w/normal or low PTH: infilterative dz
metastatic cancer, wilson's, hemochromatosis
162
hypcalcemia w/increased PTH
low vitamin D, CKD, sepsis, pancreatitis, tumor lysis syndrome
163
hypercalcemia + increased total protein
SPEP for MM
164
mucucutaneous lesions, flaccid bullae, IgG
pemphigus vulgaris (autoAb against desmoglein, an adehesion molecule)
165
pruritic papules on butt, elbows, knees, scalp, granular IgA deposits
dermatitis herpetiformis (associated with gluten sensitivity enteropathy
166
malcules, vesicles and bullae w/honey colored crust, leave red denuded areas when removed
bullous impetigo (staph, strep or both)
167
benign pruritic tense blisters, rarely oral
bulous pemphigoid (IgG + C3 in dermal/empidermal jxn)
168
variant (prinzmetal's) angina tx
Ca channel blockers (diltiazem), and nitrates. BBs worsen vasospasm, aspirin worsens vasospasm via prostacyclin activation
169
eval for bladder cancer
contrast CT, cytoscopy (in painloess hematuria, smokers, chemical exposures, cyclophosphamide)
170
gross hematuria, flank pain, kidney cysts, UTIs, stones
ADPCK. family history, ESRD by 60
171
bilateral hilar adenopathy +/- parenchymal reticular opacities
sarcoidosis!
172
TCA mechanism
inhibit fast Na channels in His-Purkinje system
173
TCA OD tx
bicarb if QRS>100. Increasing serum pH lowers drug affinity for Na channels
174
bicarb in aspirin OD
urine alkalinization increases sacycilate excretion
175
occupies mast cell and basophil receptors oin drug-induced hypersensitivity rxn
IgE
176
polymorphous maculopapular rash 24hrs after amoxicillin or other antibiotics
in mono! EBV
177
progressive hip or joint pain w/out restricted movemnt in SLE, steroid use, alcoholism, or hemoglobinopathies
avascular necrosis of femoral head
178
most common testicular cord stroma tumor
Leydig cell: prinicple source of testorsterone, can also make estrogen. makes estrogen in tumor, suppressing LH/FSH. gives adults gynocomastia (rare) and children precocious puberty (common)
179
tumor w/increased bHCG
choriocarcinoma
180
tumor w/increased AFP or bHCG
teratoma
181
tumor with normal or elevated bHCG
seminoma
182
tumor w/increased AFP
yolk sac tumor
183
low back pain, decreased mobility, pain w/standing, walking and lying down; tenderness at affected level
acute compression fracture
184
onset at acute event, pain relieved with rest, paraspinal pain, but not with vertebral palpation
ligamentous back sprain
185
low PaCO2
respiratory alkalosis
186
expected PaCO2 in respiratory compensation for primary metabolic acidosis
1.5*(bicarb) +8
187
Mensa
used to prevent hemorrhagic cystis caused by chemo drugs (like cyclophosphomide)
188
important in probenecid therapy (gout)
adequate hydration to prevent uric acid kidney stones
189
multiple ring-enhancing lesions in HIV pt
toxoplasmosis!
190
toxoplasmosis tx
sulfadiazine and pyrimethamine
191
toxoplasmosis prophylaxis
trimethoprim-sulfamethazole
192
cerebral cysts, +/- scolex
neurocysticercosis, from tenia solium (pork tapeworm) eggs. common cause of aquired epilepsy in poor countries
193
HPV vaccine recommedations
11-21 for men, 11-26 for women
194
Pap recommendations
every three years in twenties, every three years from 20-65 or every five years if combo HPV test
195
Pap in HIV
twice in first year, then annually
196
Pap in immunocompromised
annually after 21
197
acanthosis nigricans associated dz
insulin resistance (DM, PCOS), GI cancer
198
multiple skin tags associated dz
insulin resistance (DM, PCOS), pregnancy, perianal in Crohns
199
porphyria cutanea tarda, palpable purpura associated dz
HCV
200
dermatitis herpaformis associated dz
celiac
201
sudden onset psoriasis, recurrent zoster, disseminated molluscum contagiosm
HIV
202
severe seborrheic dermatitis associated dz
HIV, Parkisons (dandruff)
203
pyoderma gangreosum associated dz
IBD
204
retrosternal pain triggered by hot or cold foods, relieved by nitrates and Ca channel blockers
diffuse esophageal spasm , dx w/manometry
205
100% sens and spec for AAA
ultrasound
206
leading cause of ESRD in US
DM. HTN is second
207
kidney biopsy: intimal thickening, luminal marrowing of renal arterioles w/sclerosis
HTN nephropathy
208
kidney biopsy: increased extracellular matrix, basement membrane thicking, mesangial expansion, fibrosis
DM nephropathy
209
deficiencies in celiac
D,K, B12, calcium, folate and zinc
210
blindness, dry skin, impaired immunity
vitamin A deficeincy
211
total parental nutrition deficincies
zinc, selenium
212
from nuts, meat, fish; deficiency causes cardiomyopathy
selenium (low in TPN)
213
alopecia, skin lesions, abnormal taste, impaired wound healing
zinc deficeincy (TPN, malabsorption)
214
tx symptomatic premature atrial beats
BBs. Alcohol and tobacco are risk factors
215
HIV derm condition, can cause disseminated/prolonged illness in CD4 counts
molluscum contagiosum. (poxvirus)
216
young female athlete w/anterior knee pain when squatting, running, prolonged sitting, using stairs
patellofemoral syndrome (dx w/patellofemoral compression test)
217
anterior knee pain in athletes, episodic with pain and tenderness at inferior patella
patellar tendonitis, "jumper's knee"
218
anterior knee pain in preadolescent athletes w/recent growth spurts; tenderness and swelling at tibial tubercle, relieved with rest.
Osgood-Schlatter disease
219
punched out erosions with a rim of cortical bone
gouty arthritits
220
periarticular osteopenia and joint margin erosions
RA, also the joints are warm; wrists, MCP and PIPs
221
normal joint space with soft tissue swelling
infective arthritis. cell count >50,000
222
calcification of cartilaginous structures
pseudogout
223
narrowed joint space, osteophyte formation,
osteoarthritis
224
hypothyroid metabolic abnormalities
hyperlipidemia! also hyponatremia, elevated CK and trasaminases.
225
presents w/R-sided heart failure (edema, ascites, JVP), midsystolic sound, hepatic congestion (cardiac cirrhosis)
constrictive pericarditis. also pericardial knock, pericardial calcification on CXR
226
swelling and edema in lower extremities, with normal JVP
inferior vena cava obstruction
227
elevated upper body venous pressure, with facial swelling, and distented veins in neck or chest wall
superior vena cava syndrome
228
effective in preventing PCP, toxo, nocardiosis, UTUs in transplant patients
trimethoprim-sulfamethazole
229
common occupation for liver cyst
sheep farmer! echinococcous. (also from dogs). hyatid cysts, may have daughter cysts.
230
risk factors for pulmonary aspergillus
TB (likes cavitations for fungal balls!). Also, sarcoidosis, bronchiecttasis, bronchoial cysts and bullae, neoplasm
231
lower lung pneumonia, can progress to abscess and empyema with chest wall extension and rib osteomyelitis
actinomyces
232
rapidly developing hyperandrogenation with virilization
androgen secreting neoplasm of ovaries (high testosterone) or adrenals (high DHEAS)
233
most common valvuar abnormality in patients with infective endocarditis
mitral valve dz
234
low back and leg pain, worse with lumbar extension, persists while standing still
lumbar stenosis (degenerative, "neurogenic claudication")
235
test gives similar measures when repeated
reliable (validity and accuracy must be compared to some gold standard)
236
pleural plaques on imaging, normal FEV1/FEC ratio
asbestosis
237
elevated PCWP in the setting of dyspnea
confirms cardiac origin of symptoms
238
pt with suspected sarcoid deteriorates after immunosuppressive therapy
histoplasmosis (esp in Mississippi and Ohio river valley)
239
hyperbilirubinemia w/ elevated AST & ALT
viral, autoimmune, drug, ischemia, or alcoholic hepatits; hemachromotosis
240
hyperbilirubinemia w/normal liver enzymes
Dubin-Johnson sydrome (AR hepatocyte defect, black liver pigmentation, no gallbladder visualization), Rotor's syndrome (AR hepatocyte defect, normal liver and gallbladder).
241
hyperbilirubinemia w/elevated alk phos only
gallstones, cholestatis of pregancy, malignancy, cholangiocarcinoma, PBC, PSC
242
evaluate hyperbilirubinemia w/elevated alk phos only
ultrasound for gallstones!
243
most common complication of PUD
hemorrhage. perforation, penetration, and obstruction also occur
244
bone marrow transplant pt with lung and intestinal symptoms at 45 days
CMV; causes oneumonitis, upper and lower GI ulcers, bone marrow suppression, arthralgais, mylagias and esophagitus. dx with broncheolar lavage
245
skin rash always, intestine, liver and lung (bronchiolitis obliterans) involvement in bone marrow transplant pt
GVHD
246
mass in anterior mediastinum
thymoma (young woman, myasthenia gravis), retrosternal thyroid, teratoma, lymphoma
247
mass in posterior mediastinum
all neurogenic tumors (mingocele, eneteric cysts, lymphomas, diaphragmatic hernias, esophageal tumors, and aortic aneurysms). dx with MRI
248
mass in middle mediastinum
bronchiogenic cysts (bening), tracheal tumors, pericardial cysts, lymphoma, aortic arch aneurysm)
249
kidney disease plus upper and lower respiratory disease
Wegner's (granulomatosis with polyangitis). dx with C-ANCA + and tissue biopsy; tx high dose steroids and cytotoxic agents
250
kidneys in granulomatosis with polyangitis
rapidly progressive glomerularnephritis: renal insufficiency, microscopic hematuria, and RBC casts
251
ascending aortic aneurysms are due to
cystic medial necrosis or connective tissue disorders
252
descending aortic aneurysms are due to
atherosclerosis
253
widened mediastinum, increased aoritc knob, tracheal deviation
thoracic aortic aneurysm
254
maintaining normal pH in COPD (gradual increases in PCO2 resulting in respiratory acidosis)
increased renal bicarb retention
255
firstline tx for sleep apnea
wt loss, avoiding sedatives and etoh, avoiding supine position
256
strongest predictors of AAA rupture
large diameter, rapid expansion, and cigarette smoking
257
indications for AAA repair
>5.5 cm, or presence of symptoms (abdominal, back or flank pain, limb ischemia)
