More Misc Flashcards
(202 cards)
1
Q
Definition of AKI:
A
- Serum creatinine increase of 0.3+ in 48 hours
- Serume creatinine increase of 150% of baseline in 7 days
- Urine volume <0.5 mL/kg/hr
2
Q
RBC casts
A
acute glomerulonephritis
3
Q
Muddy brown or epithelial casts
A
ATN
4
Q
WBC casts
A
AIN or pyelonephritis
5
Q
Narrow waxy casts
A
chronic ATN/glomerulonephritis
6
Q
Broad waxy casts
A
ESRD
7
Q
Fatty casts “maltese crosses”, oval fat bodies
A
nephrotic
8
Q
eospinophils
A
ATN
9
Q
MC form of AKI
A
Prerenal
10
Q
Define acute tubular necrosis:
A
prolonged or severe ischemia caused by a prerenal condition, it eventually leads to an intrarenal processes
11
Q
Define tubulointerstitial nephritis
A
inflammatory of allergic response in interstitium with sparing of the glomeruli and blood vessels
12
Q
MCC of tubulointerstitial nephritis
A
drug hypersensitivity
13
Q
Tx tubulointerstitial nephritis
A
prednisolone x 1-2 weeks
14
Q
TINU syndrome
A
interstitial nephritis + uveitis
15
Q
BUN/Cr ratio: prerenal
A
> 20:1
16
Q
BUN/Cr ratio: intrarenal
A
<10:1
17
Q
BUN/Cr ratio: post-renal
A
early >20:1 and late <10:1
18
Q
MCC of ESRD?
A
DM
19
Q
CKD Stage 1
A
> 90
20
Q
CKD Stage 2
A
60-89
21
Q
CKD Stage 3
A
30-59
22
Q
CKD Stage 4
A
15-29
23
Q
CKD Stage 5
A
<15 or dialysis
24
Q
Glomerulonephritis AKA
A
nephritic syndrome
25
What kidney disease is associated with cola colored urine?
nephritic
26
MCC AGN worldwide?
IgA neuropathy (Berger's)
27
Young male presents within 24-48 hours after URI or GI infection with symptoms of nephritic syndrome?
IgA nephropathy (Berger's)
28
Dx of IgA nephropathy (Berger's)
+ IgA mesangial deposits on immunostaining
29
Tx Berger's
ACE +/- corticosteroid
30
Post-infectious glomerulonephritis MC after?
GABHS
31
2-14 year old boy with facial edema 3 weeks after strep with scanty, cola-colored/dark urine?
Post-infectious glomerulonephritis
32
Dx of post-infectious glomerulonephritis
increased ASO, low serum complement
33
kidney failure + hemoptysis
Good pasture's disease
34
nephritic syndrome gold standard
renal biopsy
35
Nephrotic CM
heavy protienuria (>3 g/d), hypoalbuminemia, hyperlipidemia, edema
36
MCC of nephrotic syndrome in kids
minimal change disease
37
MCC overall of nephrotic syndrome in adults?
DM
38
gold standard for nephrotic syndrome
24 hour urine protein collection
39
Tx nephrotic syndrome
ACE/ARB, loop for edema, statins for hyperlipidemia
40
Others in house have head cold?
bronchiolitis
41
CXR bronchiolitis
hyperinflation, patchy atelectasis
42
Bronchiolitis tx
no tx
43
Barky cough
croup
44
MC infection of middle respiratory tract in kids
croup
45
Laryngitis in older kids
croup
46
viral or bacterial? croup
viral
47
When are symptoms worse with croup?
night
48
Westley croup severity score?
Level of consciousness, cyanosis, stridor, air entry, retractions
49
Steeple sign
Croup
50
Tx mild croup
observe --> antipyretics, vaprizer, fluids
51
Tx croup with stridor at rest or signficant discomfort
oral dexamethasone x 1 dose OR
| racemic epinephrine for resp. distress
52
Whoop coughing
pertussis
53
Dx pertussis
Pertussis PCR
54
tx pertussis
Azithromycin
55
Extrinsic causes of pleural effusion are called?
transudative
56
Intrinsic causes of pleural effusion are called?
exudative
57
Transudative causes of pleural effusion?
liver disease/cirrhosis, cardiac disease/CHF, renal disease/chronic renal failure
58
Exudative causes of pleural effusion?
malignancy, pneumonia, TB, PE
59
Initial test for pleural effusion?
x-ray
60
Tx for pleural effusion?
thoracocentesis
61
Thoracocentesis procedure:
insert 1-2 intercostal spaces below height of effusion; not below 9th rib
62
Do you go above or below rib in thoracocentesis?
above
63
Thoracocentesis: pale yellow
usually transudative
64
Thoracocentesis: yellow-green
RA
65
Thoracocentesis: blood or red
malignancy or asbestosis
66
Thoracocentesis: brown, anchovy psate
amebic liver abscess
67
Thoracocentesis: black
aspergillus infection
68
Thoracocentesis: putrid odor
anaerobic abscess
69
Blunting of costophrenic angles
pleural effusion
70
3 d's of endometriosis
dysmenorrhea, dyschezia, dyspareunia
71
MC site for endometriosis?
ovary
72
Triad of endometriosis
pelvic pain; fixed and firm adnexal mass; tender nodularity in cul-de-sac and uterosacral ligaments
73
Endometriosis: US
ground glass appearance of implants
74
Tx: endometriosis
OCPs, medroxyprogesterone acetate; NSAIDs
75
MC type of benign ovarian tumor
epithelial
76
MC type of epithelial ovarian tumor
Serous
77
Best modality for assessing ovarian tumors
US
78
PROM definition:
at least 1 hour prior to active labor (at or after 37 weeks gestation)
79
Prolonged PROM:
18+ hours before onset of labor
80
Dx PROM:
avoid digital vaginal exam; sterile speculum exam and confirmation via nitrazine test (detects pH --> alkaline if amniotic) and fern test (detects salt crystals in amniotic fluid)
81
MC site of ectopic
Fallopian tube (specifically ampula)
82
Serum HcG should increase by at least
66% every 48 hours in the first 6-7 weeks after day 9
83
Progestrone in pregnancy
>25 normal
| <5 abnormal
84
Diagnosis of ectopic
US
85
When is ectopic suspected on US?
suspected if gestational sac is not seen within uterine cavity with serum HcG around 1200
86
Medical tx of ectopic
methotrexate (if stable and ectopic <3.5 cm)
87
surgical tx of ectopic
lapartomy (unstalbe0, laparoscopy (stable)
88
Define intrauterine fetal demise
fetal demise after 20 weeks, but before labor onset
89
Define premature labor
Of a viable infant >20 weeks to <37 weeks
| uterine contractions: 4 per 20 minutes or 8 per 60 and cervical changes (2 cm dilation or 80% effacement)
90
cause of neonatal morbidity and mortality
premature labor
91
Greatest RF of premature labor
previous pre-term labor
92
Meds for preterm labor
magnesium sulfate
93
MCC of acute pelvic pain
ovarian ruptured cyst
94
Pusus paradoxus is seen with ?
cardiac tamponade
95
pulsus paradoxus:
exaggerated >10 mmHg decease in SBP with inspiration
96
Cardiac tamponade tx:
pericardiocentesis
97
ortho hypotension tx
fludrocortisone +/- midodrine
98
hypovolemic shock: I
15% blood loss --> pulse and SBP normal
99
hypovolemic shock: II
15-30% --> tachy (>100) and SBP >100 mmHg
100
hypovolemic shock: III
30-40% --> tachy, decrease SBP (<100), confusion, decreased urine output
101
hypovolemic shock: IV
>40% --> tachy, decreased SBP, lethargy, no urine output
102
Only shock where we do NOT give large amounts of fluids
cardiogenic
103
Tx for cardiogenic shock
dobutamine, epinephrine
104
Warm shock
septic
105
MC type of distributive shock
septic
106
only shock with increased CO
septic shock
107
distributive shock tx
zosyn + ceftriaxone or imipenem; vasopressors
108
Analphylactic shock tx
Epi 0.3 IM of 1:1000 repeat q 5-10 min
If cardiovascular collapse, give epi 1 mg IV (1:10,000)
-Airway, diphenhydramine 25-50 mg IV, ranitidine, IV lfuids
109
What type of shock is associated with a biphasic phenomenon?
anaphylactic
110
Shock: brady and hypotension
neurogenic
111
MC route of osteomyelitis in childlren
hematogenous
112
MC organism for osteomyelitis
s. aureus
113
osteomyelitis organism pathognomonic for SCD
salmonella
114
MC site of osteo in kids?
hip
115
If x is normal, osteo is unlikely
ESR
116
Most sensitive test for osteo?
MRI
117
Gold standard for osteo?
bone aspiration
118
tx: acute osteo in <4 mo y/o
nafcillin or oxacillin + 3rd gen ceph
119
tx: acute osteo in >4 mo old: MSSA
nafcillin or oxacillin or cefazolin
120
tx: acute osteo in >4 mo old: MRSA
vanco or linezolid
121
Duration of tx for osteo:
4-6 weeks; with 2 weeks IV
122
SCD (salmonella) osteo tx
3rd gen ceph or FQ
123
MC organism of septic arthritis
s. aureus
124
MC site of septic arthritis
knee
125
Definitive test for septic arthritis
arthrocentesis
126
Arthrocentesis in spetic arthritis
WBC >50,000 (primary PMN)S; >2000 in prosthetic joint
| Cell count >2000
127
Septic arthritis: gram + cocci
nafcillin
128
Septic arthritis: gram - cocci or gonococcus
ceftriaxone
129
Septic arthritis: gram - rods
ceftriaxone + anti-pseudomonal
130
Septic arthritis: no organism seen
nafcillin or vanco + ceftriaxone
131
Compartment syndrome MC after fx of
long bone
132
Earliest indicator of compartment syndrome
pain on passive stressing
133
Compartment syndrome pressure?
>30-40 mmHg
134
Delta pressure compartment syndrome
DBP - measured compartment
| <20-30 = compartment syndrome
135
What is chronic mesenteric ischemia?
atherosclerosis of GI tract
136
Chronic mesenteric ischemia impacts what site most?
splenic flexure
137
CM chronic mesenteric ischemia?
chronic dull abdominal pain after meals ("intestinal angina"); weight loss
138
Test for chronic mesenteric sichemia?
angiogram
139
Tx chronic mesenteric ischemia?
bowel rest; surgical revascularization
140
Acute mesenteric ischemia mc d/t
embolus
141
CM acute mesenteric ischemia
severe abdominal pain out of proportion to PE; poorly localized pain; N/V/D
142
Test for acute mesenteric ischemia?
angiogram
143
Tx acute mesenteric ischemia?
surgical revascularization
144
Ischemic coliits is a form of?
mesenteric ischemia limited to the colon
145
Ischemic colitis mc d/t
hypotension or atherosclerosis involving SMA
146
ISchemic coliits is MC at
watershed areas
147
Ischemic colitis CM
LLQ pain with TTP, bloody diarrhea
148
Epiglottis MC d/t
HIB
149
RF for epiglottis in adults
DM
150
3 ds of epiglottis
dysphagia, droooling, distress
151
definitive dx of epiglotitis
laryngoscopy
152
thumb sign
epiglottitis
153
tx: epiglottitis
airway, supportive; dexamethasone
| Abx: ceftriaxone
154
ARDS is mc d/t
sepsis
155
3 components of ARDS
1) severe refractory hypoxemia = hallmark
2) bilateral pulmonary infiltrates on CXR (resembles CHF)
3) absence of cardiogenic pulmonary edema/CHF --> PCWP <18 (if >18, cardiogenic pulmonary edema)
156
ARDS: mild hypoxemia ABG
PaO2/FIO2 200-300
157
ARDS: mod hypoxemia ABG
PaO2/FIO2 100-200
158
ARDS: severe hypoxemia ABG
PaO2/FIO2 <100
159
Tx: ARDS
CPAP, PEEP
160
MCC of encephalitis
hsv-1
161
MC area of brain involved in encephalitis
temporal
162
CSF of encephalitis
lymphocytes, normal glucose, increased protein
163
Tx encephalitis
supportive care, seizure prophylaxis
| -Valacyclovir if HSV or unknown
164
Epidural hematoma MC after
temporal bone fx --> middle meningeal artery disruption
165
Hematoma associated with brief LOC --> lucid interval --> coma
epidural
166
Convex/lens shaped hematoma
epidural
167
Hematoma that does NOT cross suture lines
epidural
168
Hematoma d/t tearing of cortical bridging veins
subdural
169
hematoma d/t temporal bone fx
epidural
170
hematoma d/t middle meningeal artery disruption
epidural
171
hematoma d/t blunt trauma "contre-coup"
subdural
172
Concave (crescent shaped) hematoma
subdural
173
hematoma that can cross sturues
subdural
174
Tx of subdural hematoma
evacuate if massive or 5+ mm midline shift
175
thunderclap headache
subarachnoid
176
MC d/t berry aneurysm rupture
subarachonid
177
shows xanthochromia on LP
subarachnoid
178
intraparenchymal bleed
intracerebral
179
hematoma that we do NOT perform LP on
intracerebral
180
MC cause of GBS
campylobacter jejuni
181
DTR in GBS
decreased (LMN lesion)
182
CSF in GBS
increased protein with normal WBC
183
Tx GBS
plasmapheresis best if done early
184
HA worse with straining; tinnitus; visiual changes
pseudotumor cerebri
185
pseudotumor cerebri associated iwth what palsy
CN 6 (abducens): lat rectus muscle weakness --> limit of abduction (entropion)
186
Dx pseudotumor cerebri
CT scan --> LP
187
tx pseudotumor cerebri
acetazolamide
188
NPH
dilation of cerebral ventricles with normal opening pressures on LP
189
Classic triad of NPH
dementia, gait disturbance, urinary incontinence
190
Gait in NPH
shuffling gait "magnentc"
191
MRI/CT of NPH
enlarge centricles
192
LP of NPH
pressure normal
193
Test that helps confirm NPH
lumbar tap test: removal of up to 50 cc of CSF --> improvement 30-60 min after
194
TOC of NPH
ventriculoperitoneal shunt
195
Brain changes in AD?
cerebral cortex atrophy
196
Meds for alzheimers?
donepezil, tarine, rivastigmine, galantamine
| -Memantine
197
RF for vascular dementia?
HTN
198
Frontotemporal demenita associ with
marked personality changes
199
Pick bodies assoc w/
frontotemporal demensia
200
visual hallucinations --> type of dementia
diffuse lewy body
201
MC type of stroke
ISchemic
202
MC type of ischemic stroke
middle cerebral
