NBMEs Flashcards
(176 cards)
1
Q
CMV in HIV
A
immunocompromised pts, severe UC, organ/bone marrow transplants, HIV/AIDs. colitis, retinitis, esophagitis, enceph, pneumona. Intracell inclusion bodies
2
Q
DKA
A
ketones: beta hydroxybutyric acid, acetoacetic acid, acetone
3
Q
mucor / rhizopus
A
immunocompromised- systemic ampho B w/ debridement . sinus cavity, orbits, lungs.
4
Q
brain death
A
neuro exam and apnea test. absent CN reflexes, lack response to painful stim, absence resp drive. EEG can be used when uncertain
5
Q
-pril
A
prevent conv ang 1 to ang 2 which decreases aldo in adrenal cortex. leads decreased vasoconst. throughout body.
6
Q
worsening COPD
A
would have worse SOB, dyspnea, wheezing
7
Q
transfusion related lung injury
A
fever, cyanosis, hypo, hypoxema, b/l pulm infil. activation of neutrophils in pulm vasc by ABs
8
Q
warfarin
A
a fib and known atrial thrombus for i. stroke. vs asprin prevents arterial thrombotic CVA
9
Q
prednisone side effect
A
delayed wound healing, impaired lipid met, insulin res, osteo, weight gain, htn, adrenal suppression. i. production of t lymph
10
Q
bactrim, antithyroid meds (methimazole) psychs such as clozapine, sulfasalzine (chrones) can cause?
A
neutropenia
11
Q
HFrEF meds
A
b adrenergic antag, RAAS i such as ACE i, diurect
12
Q
diltiazem and verapamil
A
both reduce HR and BP. D rate control, Verap does HTN
13
Q
downs quad screen
A
increase bhcg, increase inhibin A, decrease afp, decrease estriol; increase in afp would be NTD and gastro
14
Q
seratonin syndrome
A
acute confusion, autonomic hyperactivity (hyperthermia, tachy, htn), NM excitability . serotonergic antidepressents, lithium, triptans, zofran, ecstacy can incerase risk ; cyproheptadine is antidote!
15
Q
E. histolytica
A
bloody diarrhea w/ hepatic abscess . frequent in resource poor areas. check stool. give metro and tinidazole and paromomycin/iodoquinol
16
Q
A
16
Q
WPW
A
conduction through accessory pathway. palpitations, light headed, syncope, scd. AV blockers shoudl be avoided;
SHORTENED PR AND UPSTROKE OF QRS. give procanamide
17
Q
LR
A
18
Q
umbilical hernia
A
hypothyroid, beckwith wiedemann, tri 18 and 21, Ehlers. resolve by 3
19
Q
pericarditis
A
sharp chest pain worse with lying supine. ST elevation and PR depression. . low voltage QRS. can have high ESR and CRP
20
Q
cardiac tamponode
A
= pressure of four chambers. impaired diastolic filling. from large effusion. Beck triad (hypotension , JVD, distant heart sounds). pt will not be hemodynamically stable
21
Q
quality improvmement
A
improve the system and standardize it! plan - do - study-act cycle
22
Q
pneumo jirovecii
A
give prophy of bactrim with cd4 under 200. atovaquone and pentamidine are second line agents
23
Q
renal artery stenosis, and what do you NOT give
A
causes secondary HTN and act of RAAS. Ace i can be considered for uni stenosis but can lead to kidney failure in setting of b/l
24
AIN
HS to meds. rash, increased creatinine, eosinophiluria
25
ATN
muddy brown, ischemic or nephro insult. hypotension rhabdo.
26
myotonic dystrophy
27
how to correct hyponatremia
3% hypertonic saline. HYPERNATREMIA give 0.45% saline. and 0.9% saline w/ hypovolemic hypoosmolar hyponatremia w/o acute neuro sx
28
post op HTN causes
pain, bladder overdistension, n/v, hypoxia, hypercapnia, shivering, hypervolemia (noxious stimuli)
29
polycythemia vera
30
secondary polycythemia
obst pulm dz, OSA, cyanotic HD, decrease oxygenation to tissues -> increase EPO from kindeys (EPO SYNTHESIS OF RBC WHERE POLY VERA INCREASES ALL HEMATOLOGIC CELL LINES)
31
heriditary spherocytosis
tx w/ splenectomy and choly
31
fetal heart tracing
110-160 beats/min w/ 6-25 bpm of variability and spon. accelerations
32
pityriasis rosea
33
hyperplastic dystrophy
inflammation of vulva. lichen sclerosis, dermatitis, or chronic irritation. SQUAMOUS CELL CAN BE EXOPHYTIC
34
campylobacter
fecal oral. gastroenteritis . fever , abd pain, bloody diarrhea. can have reactive arthririts with HLA B27 or GB syndrome
35
agranulocytosis
neutrophil count less than 100.
36
spinal stenosis
LE pain exacerbated by extension of hip and spinal column and relieved by flexion
37
subacute de quervain thyroiditis
ibuprofen, preceeded by viral infection.
38
neonatal meningitis
e coli (g+), listeria (g-), GBS (g+); OUTSIDE OF NEONATAL PERIOD S. PNEUMO IS THE MOST COMMON CAUSE
39
neuropathic arthropathy/ carcot joint
40
CML
41
parvo while preg what do you check
42
carotid artery dissection. minor trauma or mech event such as exercise/coughing
headache, jaw, face pain, neuro deficits. CT/MR angio. common cause stroke in 4th-5th decade - ass w/ underlying CT disorder
43
non tender genital ulcer
44
ITT analysis
45
aortic insuff
decrescendo diastolic murmur at 3rd intercostal on right
46
meta analysis
performed to combine results of mulitple studies w same ?. useful for overcoming limitations of constituent studies w.in meta analysis. reduces risk of type 2 error
47
carcinoid tumors
neuroendo tumors found in GI tract secrete seratonin, histamine, bradykinin, prostaglandins, substance p and chromogranin
48
recurrent migraine tx
beta adrenergic blocking drugs such as propranolol, antidepressants (TCAs or SNRI), anticonvulsants (topiramate, valproate). NSAIDS and triptans for abortive measures
49
growth plates are at....
metaphysis and epiphysis
50
lack spleen. what encaps org do you need vax for
S. pneumo, hinflu, n meningitidis. other encaps are klebsiella and psuedamonas
51
direct abdominal trauma -> pancreatitis!
increased amylase and lipase. pain radiates to back. n/v. can be complicated by necrosis, hemorrhage, abscess, pseudocysts. can be more common w/ pts w/ hx gallstones, AUD, trauma, hypertriglyceridemia, hypercalcemia.
52
cardio shock first meds
dobutamine or dopamine. presents w/ end organ damage, hypotension, and acute decomp HF. can use NE w/ other inotropic agents
53
arterial occlusion/compartment syndrome
54
tracheitis, bacterial
s. pneumo, h. influ, s. aureus; CXR peribronchial cuffing and tracheal air column w/ irregular borders.
55
chronic transplant nephropathy
months to years. cd4 T lympho against donor peptides such as MHC. arteriosclerosis and sm. m prolif w/ parenchymal fibrosis and atrophy of organ. BUT HTN IS LEADING CAUSE KIDNEY FAILURE IN NORMAL POP.
56
perc neph tube
57
AV steal syndrome
hemodialysis comp involving reversal of blood flow in artery distal to AV fistula. pallor, paresthesia, pain sx wouldn't be localized to specific fingers
58
preeclampsia
hypercoaguability , vasospasm, and endothelial dysfunction. proteinuria, peripheral edema, end organ dysfunction.
59
bacterial tracheitis, bronchioloitis, laryngotracheobronchitis
bacterial tracheitis - s. pneumo, h. influ, s. aureus, bronchioloitis- LRT infants young kids - RSV wheezing and low fever, laryngotracheobronchitis - croup, URI barking cough, stridor fever - rac epi
60
Tertiary hyperparathyroidism - CK failure
61
primary hyperparathyroidism
from parathyroid adenoma - if pt has kidney dz it likely isn't this!
62
acute adrenal insufficiency
hypotension in pt who has received large volume of IV fluid + vasopressors. Admin IV glucocordicoids
63
when to do emergency hemodialysis
64
RV infarctions can lead to cardiogenic shock, what do you do?
give IV crystalloids b/c they are preload dependent.
65
risk factor for isoimmunization to Kell AB
- previous blood transfusion
- fetal blood antigens during delivery
66
amaurosis fugax
transient unilateral painless vision loss - retinal ischemia. precedes RAO. Do carotid duplex US
67
phentermine
non RX diet pill. increases NE . can get HTN emergency. give VI NA nitro
68
ASD
fixed S2 - most common ostium secundum, although ostium primum also common and ass. w/ downs . severe defects -> pulm HTN and eisenmenger syndrome w/ reversal of L-> R shunt.
69
what to give to delay nephropathy ?
ACE i .
70
osteomyelitis
71
MS
opening snap w/ diastolic rumble loudest over heart apex. can be long term complication of rheumatic heart disease caused by group a strep infections. if severe - LA enlargement, cardio pulm edema, and arrythmias (a fib and flutter)
72
73
ITT
74
laxative use w/ bulimia
potassium and bicarb wasting - hypokalemia and met acidosis
75
RLS
decreased ferratin, iron supplements improve sx . can also give dopamine agonist such as ropinirole
76
pneumothorax
chest pain, hemo instability. auscultation would show hyperresonance. and absent breath sounds.
77
marfans
aortic root dilation , aortic aneurysm, aortic dissection.
78
HIIT
heparin potentiates action of antithrombin III . HIIT is ab mediated rxn to heparin platelet factor 4 complexes . stop heparin and administer direct thrombin thrombin or xa inhibitor
79
inguinal hernia -> SBO
air fluid levels in setting of dilated small bowel loops . exam: abd. tenderness, distension, percussion, high pitched hyperactive bowe (borborygmi).
80
inhalent
81
HTN CV disease
ECG a fib and LV hypertrophy - then likely heart failure do echo
82
angioedema
decreased c2 and c4, decreased c1esterase i. usually self resloves BUT antihistamines and epinepherine can be given. next step is to STOP Ace inhibitors
83
glomeruloinephritis
slow progression such as an ace inhibitor - decreases ang 2 production (this causes relative efferent arteriole dilation and reduces systemic HTN). THIS REDUCES DAMAGE TO CAPILLARIES ADN HYPERFILTRATION INJURY
84
foot drop
complication of diabetes. also have trauma, nerve transection, fib head fx, prolong psi on nerve. peroneal n. - ankle dorsiflexion and eversion
85
pulm HTN
86
insulinoma
pancreatic islet cell tumor - if pt has recurrent hypoglycemia after fasting/exercise think this. do 72 hr fasting measurement of insulin and glucose. can do surg resection or diazoxide to decrease production in interim.
87
sickle cell and the spleen
- slenectomy used after splenic sequestration crises to prevent recurrence
- kids use pen or amox as prophylaxis plus give vaccines when pt has functional asplenia
88
bicuspid aortic valve
signs/sx of aortic stenosis, and left sided diastolic HF.
89
HOCM
left ventricle thick / stiff. outflow obstruction and diastolic dysfunction. ECG can show LV hypertrophy large s waves in right precordial leads adn increased r wave amp in v6
90
ACD
normal to high ferritin and low iron / obviously chronic disease. microcytosis
91
iron deficiency
microcytic, low ferritin, low iron, sometimes high transferrin or TIBC
92
gastric carcinoma
Pernicious anemia is an autoimmune condition where the body's immune system attacks the stomach cells that produce intrinsic factor, a protein necessary for absorbing vitamin B12.
93
old person w/ confsion and hypernatremia?
likely inadequate free water intake. common in elderly. use 0.9% saline to correct. dont exceed Na reduction more than 10 meq/day - or get cerebral edema
94
94
teratoma
dont do US biopsy - can leak problems into gut. do surgical removal "ovarian cystectomy"
95
- can get kidney failure or primary amyloidosis. get amyloid in mesangium. large protein and plasma lipids filtered into urine. UA shows proteinuria, oval fat bodies, foamy dark urine. But no blood, RBC, or WBC or casts.
96
RA markers
97
hypothyroid labs
98
cushing labs
increased cortisol, truncal weight gain, striae, m. weakness, fatty deposites. VS HTN and hypokalemia and hyperglycemia
99
sarcoidosis
100
ARR & NNT
101
temporal arteritis
102
flat foot
103
PVD
104
arterial occlusion
105
ABI
106
determine risk of diabetic nephropathy
increased BM permeability and increased GFR . begins as microalbuminuria and progresses to macroalbuminuria then end stage renal disease . ACE i can decrease progression
107
medullary thyroid carcinoma
diagnose with thyroid us and biopsy
108
diarrhea / vomiting
109
vibrio vulnificus
110
ATN
renal tubular epithelial cells & pigmented granular casts (muddy brown)
111
molar pregnancy
112
av block
congenital av block rare complication that can affect children born to mothers of sle/sjogrens . fetal av node and myocardium to maternal autoAB
113
anaphylaxis
epinepherine and isotonic fluids
114
TTP
115
spinal muscle atrophy
116
muscular dystrophy
duchenne: x recessive - presents in toddlers
myotonic : adults with myotonia - handshake patient grip
117
tinea capitus
118
RCC - metastatic locations
lung, brain, bone
119
cardiogenic shock
hypotension, cool/pale extremities, JVD, pulm edema
NSAID increase risk ACS and MI
120
multiple cholesterol emboli
aortic aneuyrm , levedo reticularis, petechiae, renal dysfunciton.
121
hemophilia A
male babies born to moms w/ fam hx of x linked - screened for low / absent factor VIII conc after birth
122
graves labs
increased t3 and t4, decreased tsh, presence tsh AB
123
length bias
124
phase trial
1 - small # healthy to see if intervetion safe 2. small group w disease determine if effective 3. large # compare new intervention w/ another 4. postmarketing surveillance after drug has been approved
125
MM
prolif of plasma cells - make monocolonal immunoglobina which lead renal failure. risk encapsulated organismns
126
encaps organisms
s. pneumo, h. influ, e. coli, n. meningitidis, s. typhi, klebsiella, GBS
127
blighted ovum
fertilized egg implants into endo lining but embroy doesn't develop b/c chrom abnormalities. US - empty gestational sac
128
Leishmaniasis
sand fly - cutaneous lesion erythematous can ulcerate and become wart like . hyperkeratotic eschar
129
pseudogout
calcium pyrophosphate crystalline dep - manifest after trauma, surgery, exertion
130
AVNRT
normal hearts, provoked by alcohol, caffeine, exertion, stress, sympathomimetic meds regular rhythem with onset and termination ; while multifocal atrial tachy is irregularly irregular
131
whipple disease
malabsorption , cardiac sx, arthralgias, neuro symptoms. tx ceftriaxone for 2 weeks w/ daily bactrim
132
urodiol, ursodeoxycholic
inhibits cholesteral secretion into bile - improves biliary excretion. treats biliary colic, biliary cirrhosis, and intrahepatic cholestasis of pregnancy
133
biliary atresia
underdev. of extrahepatic biliary system = abdominal US first
134
lithogenic bile
135
postpartum thyroiditis -
symptomatic pts 0 treat with oral beta adrenergic blocker
136
137
uterine fibroids
estrogen sensitive ; uterine bleeding between menses. heavy / long periods.
138
ca 19-9
pancreatic cancer
139
medullary thyroid cancer
parafollicular cells - calcitonin use calctonin to watch for residual disease or mets.
140
post hoc
141
TCA
142
vwf
normal platelet count and PT time. decreased VIII and increased bleeding time. can lead to long PTT but it can be normal
143
ITP
mucocutaneous bleeding and thrombocytopenia. AB destruction of platelets, bone marrow biopsy demonstrate increased number megakaryocytes.
144
agranulocytosis
145
felty syndrome
poorly controlled RA w/ splenomegaly and neutropenia. peripheral smear. exclude LGL leukemia. rituximab targeting cd20
146
nissen fundoplication
147
cirrosis
increased vasodilatory compounds. release of ADH , retention of free water, and hyponatremia.
148
prerenal injury
149
sensitivity / specificity
150
empyema vs chylothorax
chylo would have high triglycerides . white milky appearance. empyema is bacterial infeciton side effect of bacterial pneumo
151
labs for pancreatitis
causes pancreatitis: gallstones, alcohol, trauma, hypertriglycerides, hypercalcemia
152
only tx before court order above parents if life threatening
would need to do court order then chemo for cancer.
153
ALS signs
154
PPD
155
tx entamoeba
156
ALL
leukemia from lymphoid or myeloid cells.
157
scoliosis
defined lateral curve greater than 10 degrees. mild (angles less 30) dont often progress and no sx
158
cancer bone pain
- gabapentin not great for bones
- tramadol interacts with opiod receptors and can affect morphine
-radiation can be helpful
159
kid hypoglycemic for after school x country - t 1 diabetic
NPH lasts 12-24 hours. peak activity 4-12 hrs
160
adjustment vs acute stress
acute stress is intrusive thoughts that change arousal/reactivity w/in 1 mo of a traumatic event. usually violent event
161
cefoxitin
give for inguinal hernia strangulation . necrotic bowel, sepsis, septic shock .
162
renal artery stenosis
doppler us or MR angio
163
pertussis vs mycoplasma
myco would have cough, fever, chills, SOB - cxr multifocal infiltrates . remember phases of pertusses catarrhal - fever rhino and cough. paroxysmal vioent coughing paroxysmal - wks to months
164
cryptorchidsm
increased risk test cancer and infertility
165
medical abortion
166
pancreatic adeno
initial diagnosis is made with CT or MRI .e ndo biopsy can be uses for suspicious masses but they use US
167
adrenal crisis
168
10 year old w/ mid systolic ejection murmur at LSB with S4
LVHypertrophy
169
heart failure w/ ischemic heart disease and htn
170
spinal cord compression
171
alpha and beta
172
AS
173
hydroxychloroquine
ass w/ retinal toxicity and permanent vision loss. baseline optho exam should be initially done before tx.
