Miscellaneous 3 Flashcards
1
Q
clinical features of secondary syphilis
A
- maculopapular rash on trunk and extremities
- patchy hair loss
- diffuse LAD
- hepatitis, uveitis
- often don’t have history of genital lesion
2
Q
toxoplasma vs. PML
A
- CD4 count less than 100 in toxo, less than 200 in PML
- lesions with mass effect and edema in toxo, no mass effect or edema in PML
3
Q
Management of recurrent UTI
A
- postcoital or daily prophylactic abx
4
Q
first line meds for migraine ppx
A
- topamax
- depakote
- TCAs
- beta blockers
5
Q
Management of secondary parkinsonism from dopamine receptor antagonists
A
- switch to a low risk agent (anticholinergics don’t work well)
6
Q
Initial management of WPW
A
- exercise ECG OR EP study (either can identify patients at risk of sudden cardiac death)
7
Q
Measles clinical features
A
- “3 Cs” - cough, conjunctivitis, coryza
- koplik spots (white lesions on an erythematous base)
8
Q
Initial step in management of suspected measles
A
- airborne isolation (measles is highly infectious)
9
Q
Initial management of atrial flutter with RVR
A
Ablation (high success rate in atrial flutter)
10
Q
Management of dysphagia after a stroke
A
- modified barium swallow (oropharyngeal dysphagia common after CVA and other neurologic injury. Oropharyngeal dysphagia is best evaluated with a modified barium swallow)
11
Q
Management of patient with severe AS requiring emergent surgery
A
- surgery with invasive hemodynamic monitoring (ensures adequate intravascular volume, preload, and SVR)
12
Q
Management of GERD during pregnancy
A
Initial: lifestyle modification + antacids
Subsequent: PPI’s OR H2RAs
13
Q
Treatment of mild to moderate pulmonary hypertension in COPD
A
- just treat COPD (pulmonary vasoactive medications have not been shown to relieve PH associated with COPD)
- no need for RH cath
14
Q
CSF pattern in GBS
A
- albuminocytologic dissociation (high protein with normal (very low) WBC count)
15
Q
Systemic sclerosis clinical features
A
- Raynaud’s
- GI: acid reflux, esophageal dysmotility, dyspepsia
- skin findings: telangiectasia, digital ulcers, calcinosis cutis
16
Q
antibodies positive in systemic sclerosis
A
- antitopoisomerase
- anticentromere
17
Q
general term for antibodies in myositis
A
- antisynthetase antibodies
18
Q
Management of serotonin syndrome
A
First line: benzos
Second line: cyproheptadine
19
Q
Presentation of isopropyl alcohol ingestion
A
- AMS + elevated osmolar gap + normal anion gap + ketonuria-ketonemia
20
Q
methanol ingestion clinical features
A
- visual dysfunction + CNS depression
21
Q
brugada syndrome clinical features + EKG features
A
- syncope + SCD
- ST elevations + RBBB
22
Q
Lab features of infective endocarditis
A
- leukocytosis
- elevated ESR
- decreased complement levels
23
Q
Chronic constipation evaluation
A
IF alarm features – TSH, serum calcium before dietary modification
24
Q
Treatment options for traveler’s diarrhea
A
- quinolones
- azithromycin
- rifaximin
25
Red flags for elder abuse
- unexplained traumatic injuries
- pressure ulcers
- abrupt changes in financial status or ability to pay
- malnutrition
26
Electrolyte abnormalities commonly associated with hypomagnesemia
- hypocalcemia, hypokalemia
27
initial workup of suspected SVC syndrome
- CT chest
28
IPF clinical features
- nonproductive cough, progressive dyspnea + Right sided heart failure + pHTN + crackles
* clubbing
29
Only intervention that has been shown to improve survival in patients hospitalized with acute MI
PCI
30
NMS clinical features + causes
- fever + muscle rigidity + autonomic instability
- starting antipsychotics OR withdrawing dopamine agonists (either cause dopamine deficiency) (PD patients who stops taking carbodopa, levodopa)
31
Key feature of renal labs in multiple myeloma
- discrepancy between amount of proteinuria on dipstick and quantitative proteinuria
32
What is a peak pressure?
Measures the resistance to flow air delivered by ventilator and the amount of pressure needed to inflate the lung
33
Typical cause of increased peak pressure
mucous plug (need to suction)
34
Initial workup of cushing syndrome + caveat
- low-dose overnight dexamethasone suppression test
| * can't use if on OCP because OCP increase total cortisol, resulting in a false positive
35
GCA management
- steroids
| * aspirin (reduce risk of TIA and CVA)
36
Other features of schistosomiasis
- urticarial lesions, angioedema
| - eosinophilia
37
Hip osteoarthritis features
- morning stiffness + **groin pain + pain radiating to knee
38
occult hip fracture clinical features
- severe and acute pain with internal and or external hip rotation
39
AE of black cohosh
- hepatic injury
40
AE of St. John's wort
- hypertensive crisis
41
AE of kava
- severe liver damage
42
indications for PrEP
- high risk sexual behaviors or *IVDU
43
Ogilvie syndrome clinical features
- marked colon dilation without evidence of obstruction (autonomic nervous system dysfunction)
44
Ogilvie syndrome treatment
- supportive, serial abdominal exams, NG tube decompression, NPO
45
Vocal cord dysfunction clinical features and question stem
* describe patient diagnosed without asthma without typical symptoms (nighttime symptoms or response to beta-agonists and steroids)
- throat tightness, choking sensation, dysphonia, inspiratory wheezing, *psychosocial triggers
46
workup of suspected vocal cord dysfunction
- repeat spirometry with flow-volume loop
47
Management of Graves during pregnancy
- PTU during first trimester
| * methimazole during second and third trimesters
48
Sequelae of membranous nephropathy know
- VTE (renal vein thrombosis that can embolize, PE)
49
calcium and phos levels in secondary hyperparathyroidism from vitamin D deficiency
- PTH decreases urinary calcium excretion and increases urinary phos excretion, which normalizes serum calcium but lowers serum phos
50
Interstitial cystitis clinical features
- chronic pelvic pain + pain relieved with voiding
51
hydroxychloroquine and pregnancy
- safe for use and associated with improved outcomes in SLE
52
Initial workup of SLE
- check for antiphospholid antibodies at time of diagnosis of SLE in all patients, regardless of pregnancy or miscarriage history
53
Methanol toxicity
- AGMA + retinal toxicity
54
Isopropyl alcohol toxicity presentation
- elevated osmolar gap but NO increased anion gap metabolic acidosis
55
treatment of methanol toxicity
fomepizole
56
P falciparum malaria treatment
artemisinin
57
P vivax, ovale, or p malariae treatment
artemisnin + primaquine (also need to treat liver forms)
58
what are the SGLT2 inhibitors?
the -flozins
- canagliflozin
- dapagliflozin
- empagliflozin
59
Afferent pupillary defect
Swinging light test -- swinging light to unaffected eye causes only mild constriction of affected eye
60
malignant otitis externa
- severe infection of external ear canal also commonly seen in uncontrolled diabetics but due to a bacterial infection
61
pancreatic pseudocyst management in asymptomatic patient
Repeat imaging in 3-6 months
62
Type 1 cryoglobulinemia association
- heme diseases -- plasma cell dyscrasia and **CLL
63
timing of peripartum cardiomyopathy
- last month of pregnancy + up to 6 months postpregnancy
64
other term for labyrinthitis
vestibular neuritis (synonymous)
65
mixed cryoglobulinemia complement levels
- C4 low
| - C3 normal or mildly decreased
66
GLP-1 agonist drugs
exenatide, lixisenatide, liraglutide, albiglutide, dulaglutide, and semaglutide
67
DPP-4 inhibitor drugs
sitagliptin, saxagliptin, linagliptin, and alogliptin
68
keratosis pilaris presentation
- dry, rough patches and tiny bumps, often on the upper arms, thighs, cheeks or buttocks (similar to my upper arms)
69
GDMT steps
Step 1: ARB + beta-blocker + diuretic
Step 2: Aldactone
Step 3: SGLT2 inhibitor
70
chlamydia presentation
dysuria, discharge
71
When Rh immunoglobulin is indicated + timing of administration
- All RhD negative mothers, regardless of fetal blood type
- at about 28 weeks gestation (third trimester), and again shortly after delivery in the case of an RhD positive or RhD unknown baby.
72
bronchial breath sounds indicate
consolidation or compression of the lung
73
Indications for ICD in HOCM
1) history of cardiac arrest, VF, or VT
2) sudden death in one or more first-degree relatives
3) **LV wall thickness greater than 30 mm
4) unexplained syncopal eent
74
Classic presentation of reactivation TB
- upper lobe predominance with cavitation
75
age cutoff where EGD is required for dyspepsia
60
76
HCM vs athlete's heart
HCM = eccentric + greater than 15 mm in thickness
77
when to think about coronary artery dissections
- otherwise, healthy young women
78
when to recheck TTE after STEMI
3 months
79
Initial treatment of acute lumbosacral radiculopathy
- short course of NSAIDS
| - PT if no improvement
80
sweet syndrome medical term
acute febrile neutrophilic dermatosis
81
sweet syndrome clinical features
fever + an elevated white blood cell count + tender, red, well-demarcated papules and plaques that show dense infiltrates by neutrophil granulocytes on histologic examination.
