Misc Info PANCE Flashcards

(163 cards)

1
Q

Pyloric stenosis labs

A

Dehydration
Hypochloremic
Hypokalemic
Metabolic alkalosis
High bicarb

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2
Q

What tumor in MG

A

Thymoma

Descending weakness

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3
Q

When do you see ureteropelvic junction obstruction

A

Peds

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4
Q

TX for epididymitis

A

Cef and doxy

Cipro if older

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5
Q

Primary amenorrhea

A

Abscence of menarche at 15
+secondary sex characteristics

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6
Q

Uterine leiomyomata tx

A

GNRH antagonist
Leuprolide

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7
Q

Zoster most common location

A

Torso

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8
Q

Lower limb Measurement

A

ASIS to Medial malleolus

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9
Q

Allergic rhinitis tx

A

2nd gen antihistamine
nasal steroid

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10
Q

Schwanoma location

A

Cerebellopontine angle

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11
Q

Meningioma more common in who

A

women

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12
Q

What S/S wont primary TB likely have

A

Dyspnea

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13
Q

Describe giant cell arteritis physical findings

A

tender, nodular, pulsless vessel

age 50-80

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14
Q

Epstein barr transmission

A

oral secretions

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15
Q

Acid base disorder of metformin

A

Lactic acidosis

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16
Q

Dose of amox for under 5

A

90mg/kg/day

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17
Q

cancer assosicated with lambert eaton

A

Small cell

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18
Q

Does tennis elbow need imaging

A

no, unless there is a complication

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19
Q

MCC of otitis externa

A

Pseudomonas

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20
Q

ECG change with hypercalcemia

A

Short QT

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21
Q

ECG change with hypocalcemia

A

Long QT

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22
Q

Lung tumor and hyper calcemia think what lab

A

PTHp

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23
Q

In advanced CKD what diuretic

A

Loop is better than HCTZ

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24
Q

Likely exam finding i boerhaave vs mallory weiss

A

Boerhaave will have chest pain

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25
Pulse finding in Aortic stenosis
Pulsus tardus Slow or delayed carotid upstroke
26
Things that make you think bone cancer
Pain at night Alk phos up with normal ggt
27
Odd things about osteosarcoma
Shoe size increasse after puberty Hearing loss
28
St depression numbers
0.05mv in 2 contiguous leads
29
How does BB affect the heart
Reduces the effects of circulating catecholamines
30
Transient synovitis is worse when
worse in morning after rest (same as JRA)
31
Gilberts disease
Conjugation problem Mildly reduced UDP (poor bili conjugation) Usually asymptomatic but can be triggered by stress ie marathons etc Transient jaundice slightly high unconjugated bili (normal lft's)
32
Choledocolythiasis
Common bile duct obstruction High conjugated bili ERCP
33
Ear infections and pacifiers
can increase ear infections
34
Acute bronchitis MCC
Virus
35
Lyme prophylaxis after tick bite
200mg doxy one time
36
ecg change associated with dig tox
av blocks
37
U wave
Hypokalemia U wave
38
Q wave
Prior MI
39
T wave inversion
Ischemia
40
Hyperkalemia in CKD s/s
Muscle weakness, Nausea Arrhythmias palpitations
41
What common disorders can you see hypokalemia in
Diabetes Hypothyroid
42
DM Prevetion
Daily foot exam Yearly MD foot exam Yearly eye exam Yearly UA
43
Tx for Heavy OB bleeding
TXA
44
Most aggressive melanoma
Nodular Melanoma has high rate of mets most aggressive
45
Bipolar treatment
Lithium first line Carbamazepine 2nd
46
Disease associated with Giant cell arteritis
Polymyalgia rheumatica
47
Diaper rash that wont get better
zinc deficiency
48
Invasive lobular vs invasive ductal carcinoma breast cancer
Ductal has a palpable mass Ductal MC (75%)
49
Gold standard for bladder cancer
cystoscopy
50
PKU foods
Avoid Red meat, milk, grain, vegetables (rash on flexors, knees, elbows,) Musky urine smell
51
When to test TPO
Hypothyroid Test TSH first Then T4 Then TPO
52
Lyme disease stage times
Stage 1 - immediate Stage 2 - after months (12 weeks) Stage 3 - 1 year
53
Lyme disease stage 1
Mild, flu like symptoms Single target lesion (erythema migrans)
54
Lyme disease stage 2
After months Rash with multiple lesions Join, muscle, msk aches HA, fatigue
55
Lyme disease stage 3
after a year Neuropsych symptoms Rheum symptoms (MSK, joint, muscle aches remain)
56
Orthostatic hypotension and infection
It can increase infection
57
Type 1 DM can be seen in what common disorder
Thyroid Graves or hashimoto
58
Where do you see a nidus
Osteoid osteoma (gets better quick with NSAIDS
59
Type of picornavirus
Coxsackie
60
Type of flavivirus
West nile, yellow fever, dengue
61
Difference between tietze and costocondritis
Tietze will have palpable edema
62
G6PD bili labs
G6PD causes hemolysis - too much unconjugated bili in blood UDP can only conjugate the normal amount so that keeps conjugated at a normal level but still leaves too much unconjugated in blood Hemolysis will show increased hemoglobin in urine Unconjugated Bilirubin up Conjugated bilirubin down Urine hemoglobin up
63
Meningitis prophylaxis for contacts
Rifampin
64
What can myopia lead to
(nearsightedness) Glaucoma Retinal Detachment
65
Riedel thyroiditis
Wood like, firm, hard mass, doesn't move
66
Pretibial myxedema is associated with
Hyperthyroid
67
Viral bronchiolitis tx
Supportive Saline flush Nasal flush bulb suction
68
Type of stone associated with UTI
Struvite
69
WHen is IV pyelogram used
Almost never, outdated
70
When don't we use CT urogram
Peds due to radiation
71
What is first line in bedwetting over 5
UA rule out pathologic causes
72
First step when suspected CAUTI
Remove catheter After cultures
73
OA imaging findings
Joint space narrowing osteophytes Sclerosis
74
RA imaging findings
periarticular erosions
75
Risk factor for neisseria meningitis
Smoking
76
TMS in schizophrenia works for what S/S
hallucinations
77
Diphenhydramine MOA
Blocks histamine receptor sites
78
What is PCT dysfunction (kidney)
Fanconi syndrome SUgar and protein are lost in urine
79
Patho for Asthma
Chronic inflammation superimposed bronchospasm
80
Where in brain does NPH occur
Corona Radiata Drink corona, get wet wacky and wobbly
81
MC viral conjuntivitis
Adenovirus
82
MC arrhythmia after cardiac surgery
AFIB
83
What do SERM, aromatse and tamoxifen target
estrogen and progesterone receptors Don't work on trile negative
84
Varicose vein tx
Supportive (stockings, elevation etc) Laser Stripping
85
Pseudotumor cerebri tx
Acetazolamide Shunt if tx fails (idiopathic intracranial HTN) CSF pressure increase without cause Papilledema Cranial nerve 6 palsy (diplopia)
86
Next step if UTI treatment with ABX fails even though susceptible
CT Think obstruction (ABX cant reach bacteria)
87
Overdose with agitation and "bug" hallucination
think cocaine
88
Dubin johnson has elevated what
coproparphoryin Increased total bili increased Conjugated bili (mildly) Normal LFT's Transport problem Bili gets conjugated at normal rate but then builds up Black liver on biopsy
89
What common meds are colorectal cancer protective
ASA Cox 2 inhibitors
90
How does theophyline affect ECT
lowers seizure threshold (contraindicated)
91
Meds contraindicated in ECT
Theophylline BB Lidocaine DM meds insulin
92
What is serous otitis media associated with
Eustachian tube dysfunction
93
Cell count in Appendicitis
Elevated WBC Elevated Neutrophils Elevated Bands (left shift)
94
Gestational DM tx
Lifestyle and diet Insulin Glyburide Metformin (all 3 considered first line)
95
Sarcoidosis common findings
INcreased ACE Increased Calcium Bilateral hilar lymphadenopathy non-Caseating granulomas Dry cough Lupus perino (Face rash) Erythema nodosum
96
Lofgren syndrome
Sarcoidosis Triad Erythema nodosum bilateral hilar lymphadenopathy polyarthralgia with fever
97
Infant with painless blood in stool (flecks)
Meckles diverticulum Tec 99 scan Surgery
98
Pituitary tumor tx
Bromocriptine first (dopamine agonist) Surgery if needed
99
TPA absolute contraindications (7 of them)
Prior intracranial hemorrhage Brain AV malformations Brain cancer/tumor Ischemic stroke with last 3 months Aortic dissection Active bleed, bleeding dialysis cath Significant trauma within 3 months
100
Boerhaave imaging
Water soluble esophagram
101
Can ECT be used on adolescents
Yes, same as adults
102
What can OSA lead to?
Pulmonary HTN
103
Decreasing what electrolyte can help with reducing calcium stones
Sodium
104
Brown sequard
ipsilateral (same side) Motor, vibratory, proprioception deficiencies contralateral Pain and temp deficiencies penetrating trauma to spinal cord Deficiencies below injury
105
Von willebrand
MC heritable bleeding disorder Factor 8 Young Females Gum teeth bleeding, epistaxis, bleeding Heavy menstruation desmopressin Von willie factor Factor 8
106
PE tx
LMWH Heparin
107
Turner syndrome
Females missing an X (normal female is XX) Short, webbed neck, Coarctation, horsehoe kidney, ovarian failure Lack of secondary sex charcterisitcs Labs - Low estrogen, High FSH, LH 45X or 46XX, 46XY
108
Klinefelters
Males with extra X (normal males are XY) Tall, thin, Gynecomastia, small testes high testicular cancer, breast cancer Labs Low testosterone, High FSH,LH, Estradiol Tx Testosterone may help 47XXY
109
Fragile X
Autism related Males Large ears, large testes long narrow face poor intellect
110
Down
Trisomy 21 MC genetic disorder Flat face, epicanthal folds, simian crease brushfield spots (spots on iris) AV septal defects, TOF,PDA Hirschsprung, early onset alzheimer's
111
Hypersensitivity reactions Type 1
IgE (histamine) Anaphylaxis insect bites, stings allergic dermatitis peanut allergy Eosinophils
112
Hypersensitivity reactions Type 2
Cytotoxic Antibodies attack one place, one type of cell MG, Graves, Goodpastures Bullous pemphigoid, pemphigus bulgaris Graft vs host, Transfusion reaction IgG and IgM
113
Hypersensitivity reactions Type 3
Immune complex reaction Attack all over body, widespread Lupus, Rheumatic fever, RA Polyarteritis nodosa Post strep acute glomerular nephritis IgG and IgM
114
Hypersensitivity reactions Type 4
T Helper cells No antibodies Delayed, takes a while to see Anything that makes a granuloma ie sarcoidosis, TB, Fungal pneumonia Erythema multiform, Scarlet fever, TB skin test Poison Ivy, Contact irritant (non allergic)
115
Aspergillosis
Fungal infection Garden and house plants, soil, compost Type 1 hypersensitivity (IgE) occurs in Asthma, Bronchiectasis and CF patients Coughing up brown mucous plugs Septa hypah with 45 degree branching Steroids itraconazole Chest physio Voriconazole
116
Stemi elevation numbers According to the American College of Cardiology/American Heart Association guidelines for STEMI
New ST elevation at j point in 2 contiguous leads 1 millimeter elevation in any two contiguous leads, except leads V2 or V3, where the elevation must be 2 mm in men or 1.5 mm in women. Men >2 mm elevation in V2,V3 >1mm in all other leads Females >1.5 mm elevation in V2,V3 >1mm in all other leads New LBBB
117
Labs in osteoporosis
All normal If acute fracture Alk phos up
118
Labs in pagets
High alk phos Everything else normal
119
Calcium phospahte relationship
opposites If calcium is up Phos is down
120
Potassium and Magnesium relationship
Same if one is down, they are both down
121
MC location for ectopic
Ampulla
122
When can resume sex after chlamydia
7 days after treatment
123
What is affrim test for
Vaginosis
124
Chlamydia first line tx
doxy
125
What can pathogen cause PDA at birth
TORCH viruses
126
WHat to look for with hyperemesis gravida
Molar pregnancy
127
Post partum endometriosis tx
Clinda and genta (broad spectrum)
128
MC risk of Placenta Previa
Multiparity
129
Balanitis tx
Clotrimazole (common in diabetics)
130
Septic Abortion tx
Unasyn (amp/sulbac) Evacuate uterine contents
131
What anti coag is best in pregnancy
LMWH (reduces mortality)
132
Chorioamnionitis tx
Give ABX as soon as possible even before birth
133
Lagopthalmos
Eye lid inability to close (bells palsy)
134
Otosclerosis associations
Pregnancy Women conductive Hearing loss Autosomal dominant disorder
135
Peritonsilar abscess first line
I&D
136
GIant cell arteritis diagnosis
Biopsy
137
MC otitis media bacteria
Strep Pneumo Amoxicillin
138
Key difference between croup and epiglottitis exam
Epiglottitis patients appear toxic Croup patients do not
139
Diarrhea with conjunctivitis think
Adenovirus
140
Acute angle glaucoma tx
Timilol Apraclonidine pilocarpine iridotomy
141
Acute bacterial parotitis tx
Unasyn (ampicillin sulbactam)
142
Tonsillar abscess MC bacteria
Strep Pyogenes (Group A)
143
Conductive hearing loss findings
Bone conduction is longer than air (sound waves can't get in) Weber goes towards the wax blockage
144
Ramsey hunt
Zoster Oticus Facial nerve Facial paralysis Ear pain vesicles in and around ear canal Valacyclovir and prednisone
145
Dendritic lesion on eye
Herpes Keratitis
146
Oppositional defiant disorder
Bad kid (not criminal)
147
Conduct disorder
Criminal kid leads to antisocial personality when older
148
What is avoided in anorexia/bulimia due to seizure risk
Wellbutrin (bupropion)
149
When do you see kidney scarring
HIV Focal sclerosing glomerulonephritis
150
Primary hyperparathyroidsim
overproducing PTH Breaking down bone Releasing calcium High PTH, High Calcium
151
Secondary Hyperparathyroidism
Chroniclly low clacium (can be due to lifestyle) constantly producing PTH to compensate High PTH low calcium
152
Tertiary Hyperparthyroidism
High PTH High Calcium High Phosphate (phos should be low due to opposite of calcium but kidney isn't working to remove it)
153
Primary prevention
implementing something before any evidence that a disease exists Exercise, low fat diet, well lit house to reduce risk of fracture Colon cancer at 40
154
Secondary prevention
Have disease (diagnosed) Make sure through screening you don't become symptomatic no symptoms Osteoporosis - dexa scan, calcium, vitamin D etc USPTF Screening tests, statins, doac with afib DM foot exam
155
Tertiary Prevention
intervention after disease and symptoms Prevent disease from worsening Chronic HTN - ACE Disease treatment
156
Hep B sero
Surface antigen positive (infected) Acute or chronic If core antibody is positive IgM is acute, IgG is chronic Surface antigen negative look at surface antibody if positive (vaccinated) Past infection (recovered) Surface antibody and core both positive Surface antigen, antibody, core all neg (unvaccinated)
157
calcium and magnesium relationship
Same, One up both up
158
Rotor Syndrome
Transport problem like dubin johnson Mild elevation in conjugated and unconjugated bili No black liver on biopsy
159
GCS General numbers
Eyes 1-4 Verbal 1-5 Motor 1-6
160
GCS eyes
1-4 No eye opening = 1 To pain = 2 To verbal = 3 Spontaneous = 4
161
GCS Verbal
1-5 No response = 1 Incomprehensible sounds = 2 Inappropriate words = 3 Confused = 4 Oriented = 5
162
GCS motor
1-6 No motor response = 1 Extension to pain = 2 Flexion to pain = 3 Withdrawals from pain = 4 Localizes Pain = 5 Obeys commands = 6
163
Hyperkalemia Wave progression
Hyperacute T wave, Widening QRS Flattening P wave (prolonged PR) Sine Wave