Medicine stuff 2 Flashcards
(103 cards)
1
Q
Proximal muscle weakness PLUS anxiety, palpitations/tachycardia, weight loss - think?
A
hyperthryroidism
2
Q
Treatment for PLT dysfunction?
A
DDAVP (desmopressin) - NOT platelet transfusion
3
Q
Alopecia, irregular menses, obesity - think?
A
PCOS
4
Q
Most common electrolyte abnormality in alcoholics?
Which can cause refractory what?
A
Hypomagnesiumemia
Hypokalemia
5
Q
Hypertension, hyperglycemia, weight gain - think?
A
Cushing
6
Q
Recurrent bacterial infections in ADULT - think?
Best test?
A
Common vaircable immunodeficinecy
Quant measurement of serum IgG showing sevrely reduced IgG and low IgA and/or IgM
7
Q
Study that randomizes to different interventions with additional study of 2 or more variables is what type of study?
A
Factorial design
8
Q
Two age range peaks for ulcerative colitis diagnosis?
A
15-40 and 50-80
9
Q
Chronic Hep C diagnosis (2 steps)?
A
Positive serologic Ab test AND hep C viral RNA
10
Q
Low platelets due to HIT - stop heparin and replace with what?
A
Alternate agent eg argabotran, fondaprinux, then when >150 go to warfarin
11
Q
Immobilization: hypo or hyper-calcemia?
A
HYPER, increased osteoclast activity
12
Q
ARP (attributable risk percent) equation?
A
ARP = (RR - 1)/RR
13
Q
Erythema nodosum, suspected sarcoidosis, but no resp sx - best test?
A
CXR!! even tho no sx
14
Q
What HgB level does Fe defic anemia become microcytic?
A
<10
15
Q
Painless hematuria, smoking history - think?
A
bladder cancer
16
Q
Most common extraskeletal complication of ankylosing spondylitis?
A
Anterior uveitis
17
Q
First step in suspected PE (esp. if pt in distress)?
A
Start anti-coag (heparin)
18
Q
Cardiolipin (anti-phospholipid) can give a false positive to what test?
A
RPR (syphilis)
19
Q
Acute, uncomplicated low back pain - tx?
Chronic?
A
NSAIDs and normal activity
PT
20
Q
Asymptomatic endometriosis - do what?
A
Observe
21
Q
Lung problem in systemic sclerosis?
A
ILD
22
Q
Numbness/pain in foot with clicking sensation between 3rd and 4th metatarsals?
Tx?
A
Morton neuroma
Conservative - metatarsal support and shoe inserts
23
Q
Virus that causes a transient arthritis with similar sx to RA?
A
Parvovirus B19
24
Q
GI sx and livedo reticularis post-vascular procedure - think?
If the GI prob is acute pancreatitis - tx?
A
Cholesterol embolism
Pain meds and IVF
25
COntact lens wearer with conjunctivitis sx BUT also has corneal involvement - think?
Organisms?
```
Keratitis
usually GNs (esp pseudomonas or serratia)
```
26
RA with neutropenia and splenomegaly - think?
Felty's syndrome (an autoimmune dz)
27
Name for when study population changes behaviour when they know they are being studied?
Hawthorne effect
28
Bite cells and Heinz bodies (RBC inclusions) - think?
G6PD defic
29
Elevated alk phos and mixed osteolytic and sclerotic bone lesions with focal enlargement of bones - think?
Tx?
Paget's dz of the bone
| Bisphosphonates
30
Age range for getting a statin with DM?
40-75
31
Most common casue of sudden cardiac arrest in immediate post MI period?
Reentrant ventricular arrythmias (v-Fib)
32
Ank spondy: HLA-B27 or x-ray to see sacroiliitis for diagnx?
Xray
33
LVV (low tidal volume vent) in ARDS avoids what?
overdistension of alveoli
34
Joints looks like inflammaorty arthritis but calcifcations seen on XRay - thikn?
pseudogout
| calcium pyrophopsphate dihydrate crystals (CPPD)
35
Monocular vision loss - with cherry red spot on macula?
With floaters?
With diffuse hemorrhages?
retinal ARTERY occlusion
vitreous hemorrhage or retinal detachment (curtain here from periphery)
retinal VEIN occlsion
36
Odds ratio is very close to relative risk if outcome is common or uncommon in the population?
uncommon
37
4 meds classes to think about with pill esophagitis?
tetracyclines, KCl, bisphosphonates, NSAIDs
38
How does sodium bicarb help TCA overdose?
alleviates depressant action on heart muscle sodium channels (NOT aiding excretion of TCA like acetaminophen)
39
Ho to work out number needed to treat from ARR?
NNT = 1/ARR
40
Abx for legionella?
FQs or Macrolides
41
Resp distress with NEURO abnormalities and PETECHIAL RASH 12-72 hours (and LONG BONE fracture)?
But more rapid onset and WITHOUT NEURO sx, patchy alveolar infiltrates?
Fat embolism
| Pulmonary contusion
42
```
DI vs SIADH
Hyponatremia and concentrated urine?
Hypernatremia and dilute urine?
Next step for DI?
Tx?
```
SIADH
DI (these findings rule out primary polydipsia)
Water deprviation test for DI for central vs nephro, if central then corrects 50% with desmopressin, no change if nephro
Intranasal desmopressin
43
Diagnostic imaging for suspected ureteral stones (pain on flank or abd radiating to groin with n/v)?
US or noncontrast CT
44
Kidney: increased ECM, BM thickening, mesangial expansion, fibrosis - caused by what underlying dz?
And if it were sclerosis of arterioles and glomerular capillary tufts - caused by?
DM
| HTN
45
H pylori associated cancers?
Gastric adenocarcinoma and MALT lymphoma
46
Very common GI prob found on endoscopy and associated with chronic constipation?
Best dietary intervention/lifestye mod?
Diverticulosis
| More fiber
47
HIV: CD4 count where live vaccines (MMR, varicella, zoster) are contraindicated?
So what vaccines for HIV pt with CD4 <200?
<200
| annual flu, Td if nec time-wise, varicella, pneumoccal PCV13 THEN PPSV23) and HBV
48
More likely to embolize to PE - distal/calf clots or proximal (femoral/popliteal/iliacs)?
Proximal
49
Fever in PE?
| Low O2 sat and Afib with PE are good or bad for prognosis?
Yes, low grade
| BAD
50
Latent TB in HIV positive: what size PPD induration?
| Tx?
```
>5mm
Isoniazid and pyridoxine for 9 mo
If active (sx) then 4 drug tx
```
51
Electrolyte abnormality that is an indicator of how bad CHF is?
hyponatremia
52
Reaction to nickel (like posion ivy) is what type of reaction?
Type IV hypersensitivity
| Low to mid -potency topical steroid
53
Do you need fever and/or leukocytosis for (lumbar) osteomyelitis?
NO
54
Urge incontinence - 1st line then 2nd line?
PFEs and bladder training
| Then oxybutynin
55
Psedomonas coverage ...
FQs (cipro)
| Pip-taz (zosyn), ceftazidime cefepime
56
Boerhave (esophageal tear) vs Mallory Weiss presentation?
Crepitus (pneumomediastium) in Boerhave and hematemesis in MW (MW only partial tear of mucosa at GE jxn)
57
Malaria prophylaxis - drugs and timing?
Chlorogquine, but if resistant area (likely) then mefloquine or others
2 weeks before until 4 weeks after trip
58
The marine bacteria associated with the ocean causing food borne illness in oysters and wound infections?
Disease of which organ increased risk?
vibrio vulnificus
| Liver
59
Actinic keratosis looks like (and can progress to) this skin cancer (scaly plaques)?
SCC
60
Hyperthyroid sx. Low RAIU hwo do you tell exogenous intake vs thyroidtits or iodide expsoure?
Get a serum thyroglobulin. Low in exogeonous use, high in others
61
Contraction alkalosis - from loss of fluid/acid/NaCL form vomiting - treat with?
NS
62
High output heart failure - think possibly?
AVF, can be result of trauma
63
COPD exacerbation tx (4 big ones)
```
O2 (target sats 88-92)
Inhaled bronchodilators
Systemic glucocorticoids
ABX (if 2 or more cardinal sx)
Tamiflu if flu
NPPV or intubation if fails
```
64
HIV:
| AMC prophylaxis - what CD4 count and what drug?
<50, azithro
65
Bloody diarrhea with no travel history (3)?
E Coli (EHEC) - MOST COMMON
Shigella
Campy
66
Which thyroid cancer involves calcitonin?
medullary
67
Which thyroid cancer has psammoma bodies?
papillary
68
Which thyroid cancer spread by blood?
follicular
69
Steven Johnsons vs TENs - differentiated by area of body affected but what numbers?
<10 SJS
10-30 overlap
>30 TENS
70
Aortic dissection - next steps if HD stable, then unstable?
If stable, CT angiography, if unstable then pericardioecentesis
71
Tighter the confidence interval the more ______ the result.
Precise
72
Strep sanguinis is a type of strep _______?
viridans
73
Involvement of mouth mucosa - Crohn's or UC?
Crohn's
74
Fever, tinnitus, tachypnea - OD of what?
aspirin
75
Non-EtOH fatty liver disease associated with what?
insulin resistance
76
Mild DM, rash, weight loss - think?
glucagonoma
77
Trypanosoma cruzi causes what dz?
Sx?
What continent?
Chagas
megaesophaus, megacolon, cardiac dysfunction
Latin America
78
Definitive diagnostic test for polymyositis?
| Showing what?
Muscle biopsy
| Mononuclear infiltrate surrounding necrotic and regenerating muscle fibers (yeah, whatever)
79
Elbow pain, reproducible on passive flexion or resisted extension - think?
lateral epicondylitis
80
Which meds to hold prior to stress test?
B-blockers, CCBs, nitrates
81
Painful monocular vision loss with a centrla "smudge", changes in color - think?
Associated with what dz?
Optic neuritis
| MS
82
Endocarditis associated with nosocomail UTI - bug?
enterococcus
83
Where's the birds beak in achalasia?
right next to the LES!
84
Ring enhancing lesions on MRI, HIV patient suggests?
| Prophylactic med?
toxo
| bactrim (like PCP)
85
Neutropenic fever - empiric abx choice?
make sure you conver GN and pseudomonas so pip-taz, cefepime or meropenem etc.
86
Uremia - diagnosed by clinical sx and also a high?
BUN
87
Cystic heptaic lesion with eggshell calcification and contact with dogs - think?
Organism?
Tx?
Hydatid cyst
Ecchinococcus granulosus
Surgery with abendazole
88
2 classes of drugs that can cause unsafe hypertension with sildenafil?
nitrates and a-blockers
89
D-xylose test used to test for what?
| And what result would you see?
Celiac dz
| Low urine output of D-xylose
90
acute diverticulitis imaging?
CT abd contrast
91
acute liver failure - 2 things required for diagnosis?
encephalopathy and impaired synthetic fxn (INR >1.5 or = 1.5)
92
devleoped countries, 80% of adrenal insufficinecy is casued by what?
autoimmune adrenalitis
93
Nephrtoic syndrome increases risk of what?
Atherosclerosis and thrombosis
| Hypoproteinemia causes liver to increase production of proteins AND lipids leading to hyperlipidemia
94
Drug to reverse antichlolinergic toxicity?
physostigmine, a cholinesterase inhinitor
95
Effect of raising a cutoff point on specigicity and sensitivity?
Spec up
| Sens down
96
Blood in the joint after ACL injury (T/F)?
True
97
```
Timing and vessel for these MI complications:
RV failure?
Pap muscle rupture?
Septum problem?
Free wall rupture?
```
acute (RCA)
acute and 3-5 days (RCA)
acute and 3-5 days (LAD apical, RCA basal)
5 days - 2 weeks (LAD)
98
Symptomatic primary hyperparathyroidism in a pt <50 - next step?
Surgery (parathyroidectomy)
99
Deformed feet, pain, effusion, in a patient with neuropathy (or high risk for neuropathy eg DM)?
Charcot joint (neurogenic arthropathy)
100
Diabetic neuropathy is an axonopathy of nerve fibers:
Large or small cause pain/parasthesias?
Large or small cause loss numbness, proprioception loss, relfex decr?
Small
| Large
101
Fever and sore throat in anthithyroid drug patient - what side effect?
Next steps?
Agranulocytosis
| Stop drug get WBC
102
Hep A vaccination recommended for which groups (3)?
MSMs, travelers, chronic liver dz
103
Hereditary hemochromatosis associated with what kind of joint pain?
pseudogout
