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1
Q

painless mas que drena pus en mandibula + previous dental work + bacilos filamentosos Gram positivos

dx? tx?

A

Actinomyces

tx
amoxicilina, si hay alergia usar doxicilina o clindamicina

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2
Q

causa #1 de metatasis osteoBlastica ?

A

Prostata cancer

In most patients with metastatic prostate cancer, the digital rectal examination (DRE) reveals asymmetric areas, indurations, or frank nodules within the prostate, but the absence of findings on DRE alone does not exclude prostate cancer.

importante: osteoBlastica (aka esclerotica) significa formacion de hueso nuevo, mientras q osteoClatica (vista en mieloma multiple por ejemplo) se ven como huecos por destrucción de hueso

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3
Q

tincion Plata de Metenamina +

patogeno?

A

Pneumocystis jirovecii

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4
Q

Clusters of nonpainful raised, rough-textured genital lesions that whiten after application of acetic acid

dx? causa etiológica?

A

condylomata acuminata,

etiologia: virus papiloma humano 6 y 11 (se presentan con: condiloma acuminata aka verrugas anogenitales y coilocitos -tipo de celula-)

WHITEN AFTER APPLICATION OF ACETIC ACID

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5
Q

cupping of the optic nerve+raised intraocular pressure+narrowing of visual fields bilaterally

dx?

A

glaucoma angulo abierto

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6
Q

antibiotico Cloranfenicol, tiene como efectos adversos?

A

Pancitopenia
Aplastic anemia
gray baby syndrome

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7
Q

tx gas gangrene?

A

pip/tazo + clindamicina

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8
Q

enfermedad aranazo de gato

tx inmunocompetente?
tx inmunocomprometido?

A

tx

inmunocompetente: azitromicina

inmunocomprometido: eritromicina o doxiciclina

biopsia: granulomas estrellado

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9
Q

reynauds phenomenon primario

tx?

A

nifedipina oral o algun otro bloqueador canal de calcio due to vasodilatory effect

Nailfold capillary microscopy can help distinguish primary RP from secondary disease. While primary RP is caused by idiopathic vasospasms of the digital arteries and arterioles and is not associated with vascular changes seen on nailfold capillary microscopy, patients with secondary RP typically have structural vascular changes caused by the underlying disease (e.g., systemic sclerosis), such as enlargement and/or loss of capillaries.

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10
Q

Prophylactic antimicrobial therapy for patients with chronic granulomatous disease?

A

TMP-SMX and itraconazole

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11
Q

biopsia de piel: células fusiformes e infiltrado linfocítico

dx, tx?

A

kaposi sarcoma

tx: interferon alfa

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12
Q

What is the most important prognostic factor in predicting melanoma metastasis?

A

Depth of invasion (Breslow thickness)

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13
Q

lyme
cual es el screening y cual es el confirmatorio

A

elisa: screening

western bloc: confirmation

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14
Q

carcinoma de colon

signo radiologico y donde es mas comun verlo?

A

signo de la mordedura de manzana

sigmoids

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15
Q

Uterosacral ligament nodularity
dx?

A

endometriosis

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16
Q

pt con AIDS + acid fast bacilli+ dolor de estomago/diarrea

dx? tx?

A

Mycobacterium avium complex infection

azitromicina o claritromicina + etambutol

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17
Q

en que momento se hace el swab rectovaginal para group B estreptococo en embarazada?

A

36-38 s

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18
Q

What pharmaceutical therapy is recommended for prophylaxis of non-bleeding esophageal varices?

A

Non-selective β-blockers (e.g. propranolol, nadolol)

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19
Q

What is the likely causative organism in a male that presents with dysuria, urinary frequency, and mucopurulent discharge? Gram stain and urine culture are negative

oatigeno y tx?

A

Chlamydia trachomatis

tx:
Doxicilina 7 dias
azitromicina VO una dosis

azitromicina es el tx en embarazo también

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20
Q

What is the likely diagnosis in a multiparous woman presenting with palpable, tender mass on the anterior vaginal wall & postvoid dribbling, dysuria, and dyspareunia?

patologia y metodo dx?

A

Urethral diverticulum}}

dx: MRI pelvis

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21
Q

a painless penile lesion followed by suppurative lymphadenopathy 2–4 weeks after the initial lesion has healed

dx?

A

lymphogranuloma venereum

causada x Chlamydia L1-L3

tx: doxiclina/azitro

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22
Q

alcohol withdrawal delirium

tx?

A

benzodiazepines IV

ocurre 72-96 horas después de abrupt alcohol cessation

sx: sympathetic overstimulation+altered mental status+hallucinations

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23
Q

methylmalonic acid levels

usado para? como esta en cada uno?

Study These Flashcards
A

usado para distinguir entre causas de anemia megaloblastica

Acido folio: metilmalonico NORMAL+homocisteína aumentada

b12 deficiente: metilmalonico AUMENTADO+homocisteina aumentada

24
Q

con que se tiene que dar el metrotexate oara prevenir mielosupresion?

Study These Flashcards
A

LEUCOVORINA (replenishes folate levels and therefore prevents the development of myelosuppression in patients receiving metrotexate, trimpetropim,
pirimetamina (usado en toxoplasmosis))

What type of anemia results from methotrexate use? Megaloblastic (macrocytic) anemia

Methotrexate can result in pulmonary fibrosis and ultimately restrictive lung disease

25
improve exercise tolerance and reduce the frequency of anginal episodes in patients with stable angina que medicamento es?
Atenolol Like other β-blockers, atenolol relieves anginal pain by decreasing heart rate and cardiac contractility, which reduces myocardial oxygen demand
26
metodo confirmatorio de endometriosis y como se ve?
laparoscopia muestra lesiones rojo-azuladas. ////////////// extra: en ultrasonido se puede ver quistes ováricos de chocolate también se puede ver nodularidad de ligamento uterosacro
27
triada de vasospastic angina (Prinzmetal angina)
reversible ST elevations, normal troponin levels cardiac angiography showing ≤ 30% coronary artery blockage Vasospastic (Prinzmetal) angina is associated with Raynaud's and migraine; they all involve hyperactivity of smooth muscle
28
como esta la eritropoyetina en policitemia vera?
decreased
29
asymmetric patchy loss of vibration sensation and proprioception, and features of sensory ataxia. dx y anticuerpos?
dx: small cell lung cancer anti-Hu antibody
30
cuando se considera rompimiento prematuro de membranas?
before 37 weeks' gestation
31
greatest risk of testorsterone therapy?
eritrocitosis que puede llevar a trombos
32
quien secreta la hCG?
sincitiotrofoblastos
33
dx de Acute limb ischemia?
Angiografía por Sustracción Digital is the best confirmatory test to diagnose acute limb ischemia 6 Ps: pain, pallor, pulselessness, paralysis, paresthesia, and poikilothermia.
34
como los nitrates mejoran el dolor de angina?
venous vasodilation decreased end-diastolic pressure decreased preload improved myocardial perfusion
35
What hematologic pathology is characterized by normocytic anemia with a low reticulocyte count in preterm infants?
Impaired production of erythropoietin (EPO) leads to of anemia of prematurity
36
Which antipsychotic medication occasionally causes hypothermia by disrupting thermoregulation and the body's shivering mechanism?
Fluphenazine
37
murphy sign + dx?
colecistitis aguda
38
What is the likely diagnosis in a child with Down syndrome that presents with urinary incontinence, ataxia, neurological deficit, upper motor neuron symptoms (leg spasticity, hyperreflexia, Babinski, clonus)? dx, en q enfermedades se presenta, tx?
Atlantoaxial instability Atlantoaxial instability may be seen in patients with Down syndrome, rheumatoid arthritis. tx: surgical fusion of C1 and C2
39
que causa la ciclofosfamida y como se previene?
Ciclofosfamida causa cistitis hemorragica / cancer de vejiga prevention: Mesna aka Mercatoptan sulfonato
40
que efecto adverso psiquiatrico produce el tx con levo-dopa para Parkinson?
psychosis and hallucinations (usually visual). The risk for developing psychiatric symptoms during tx w levodopa increases with age, other psychiatric conditions, long duration of levodopa treatment, and high doses.
41
Leukocyte alkaline phosphatase activity para que sirve?
Leukocyte alkaline phosphatase activity aka LAP score sirve para distinguir entre leukemoid reaction de chronic myeloid leukemia en leukemia: LAP score AUMENTADO CML: LAP score DISMINUIDO
42
irregular swelling in the scrotal region that enlarges on standing or with a Valsalva dx?
dx: Varicocele Varicocele is most noticeable with standing and improved with lying supine
43
familia de virus a la que pertenece Molluscum contagiosum?
poxvirus
44
What is the most accurate way to estimate gestational age?
coronilla-rabadilla en primer trimestre con ultrasonido a partir de semana #13 se usa largo del femur, largo biparietal y circunferencia abdominal como metodos estimadores de edad gestaciónal
45
después de un infarto con que medicamentos debe irse el pt?
1. aspirina+clopidogren x 12 m (doble antiagregado): reduces mortality and the risk of developing subsequent ischemic episodes and stent thrombosis. 2. IECA 3. B bloq 3. Estatina alta dosis 4. Nitrates
46
cuales son las 4 características mas improtantes de DRESS sd?
DRESS sd: 1. rash morbiliforme 2. fiebre 3. edema 4. eosinofilia
47
most common cause of gallbladder metastases?
melanoma
48
diarrea sanguínolenta + heces show organisms w ingested erithrocytes dx, tx?
intestinal amebiasis by Entamoeba histolytica (Entamoeba Eats Erythrocytes) tx: metronidazol Entamoeba histolytica can cause amebic liver abscess, which are described as having "anchovy paste" consistency
49
deficit en movimientos oculares + inestabilidad postural + demencia dx?
parálisis supranuclear progresiva hummingbird in MRI (mesencefalo atrofico con puente normal)
50
tx barrett esofágo?
ablacion con radiofrecuencia barrett esofago: esophageal squamous epithelium is replaced by columnar epithelium and goblet cells (intestinal metaplasia). Considered a precancerous condition for esophageal adenocarcinoma (asociado a fumado, GERD, afecta lower 1/3 del esofago).
51
tmp smx es profilaxis en las infecciones relacionadas a hiv, a cuales?
Pneumocystis jirovecii pneumonia toxoplasmosis
52
laboratorio que indica mal pronostico en icc?
Hiponatremia. A decrease in serum sodium is therefore closely associated with a decrease in CO in patients with heart failure. Disminución de cardiac output --> ADH increased --> increased free water reabsorption --> hiponatremia
53
paciente con depresion + obesidad + quiere dejar de fumar tx?
Bupropion IMPORTANTE: baja el seizure treshold. CONTRAINDICADO en eating disorders and seizure disorders No produce disminución del libido Which antidepressant is likely to be useful for patients with primary complaints of low energy, impaired concentration, hypersomnia, and weight gain? Bupropion
54
intoxication presents as respiratory and CNS depression, bradipnea, pinpoint pupils, and decreased gag reflex?
opioids
55

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