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1

brain mets usually treated with

multiple lesions: radiation therapy to improve neurologic function and prevent decline

surgical removal for single operable lesions

2

HIT 1 vs 2

1 has over 100,000 platelet count, no thrombosis, observe

2 has thrombosis and 30-55,000 platelet count, STOP heparin

3

drug associated with TTP

quinine

4

Fanconi anemia

hyperpigmentation
short stature
upper limb anomalies
hypogonadism
microcephaly

get bone marrow transplant early

5

bone marrow biopsy in aplastic anemia will show

fat and stroma

6

pure red blood cell aplasia goes with

thymoma

7

tumor lysis syndrome

hyperphosphatemia
hypocalcemia
hyperuricemia

normalize electrlytes,
give rasburicase and IV fluids and diuretics

8

differentiating DIC from HUS/ TTP

typically HUS/ TTP have normal to minimally prolonged PT and PTT, plus normal d-dimer and fibrinogen levels

9

autoimmune hemolytic anemia presents with

sudden onset dark urine
jaundice
increased indirect bilirubin

spherocytes may appear

10

rx for polycythemia vera

phlebotomy
aspirin
plus hydroxyurea if over 60 or had thrombosis/ other CV risk factors

11

marker of paroxysmal nocturnal hematuria

CD55/59 deficiency
prone to thromboses (can be painful skin lesions)

12

IgA type heavy chain disease

middle eastern descent
abdominal mass
malabsorption syndrome
mesenteric lymph nodes, looks like lymphoma

13

chronic lymphocytic leukemia treatment

stage 0-1 do nothing. (just lymphocytosis or enlarged nodes, no symptoms)

stage 2,3,4 fludarabine.

14

differentiate CML from polycythemia vera

CML has low alk phos

15

abx for neutropenic host with fever

cefepime, broad coverage and action against pseudomonas

16

pt with hypothyroid and megaloblastic anemia

suspect pernicious anemia (association between autoimmune disorders)

17

what red blood cells go with RA?

microcytosis due to anemia of chronic disease

18

what hormone goes with teratoma?

decreased TSH (thyroid over 50% of dermoid then it's called struma ovarii)

19

you're thinking lichen sclerosis. What next?

punch biopsy to rule out vulvar cancer

then give topical steroids

20

mechanical complicataions of acute MI by timing

acute- right ventricular failure
up to 3-5 days papillary muscle rupture
- IV septum rupture (with shock)

5 days to 2 weeks- free wall rupture (pericardial effusion with tamponade)
up to several months- left ventricular aneurysm (thin and dyskinetic myocardial wall)

21

cancer with highest incidence in men

prostate

22

neuroleptic malignant syndrome vs serotonin syndrome

CPK is high, and diarrhea

not in serotonin

23

murmurs where more blood makes them better (less murmur)

HOCM

mitral valve prolapse (big valves; fill heaert more and they fit together better)

24

the only valve problem where we use balloon instead of replacement

mitral stenosis

25

most specific sign of right sided infarction

ST elevation in right-sided V4

26

restrictive heart disease associations

amyloid- neuropathy. Do fat pad bx
sarcoid- pulmonary disease. do endomyocardial bx
hemochromatosis- cirrhosis or bronze diabetes. ferritin check

27

lupus with pericardial knock, what do you do?

pericardiectomy

28

treatment for OCD

fluoxetine and fluvoxamine - SSRIs

29

coarctation of aorta findings

upper/ lower extremity pulse delay
HTN in UE and hyptension in LE

xray: posterior rib notching

30

old thigh injury think

acquired AV fistula
--> increased cardiac preload