QBANK CARDS Flashcards by Jaz C

AVNRT
Atrioventricular Nodal Re entrant Tachycardia

Most common form of paroxysmal Supra ventricular Tachycardia (SVT)
Caused by a reentry mechanism do to presence a dual electrical pathway (slow & fast pathway) in the AV node.
Vagal maneuvers increase parasympathetic tone which will cause temporary slowing of conduction in the AV node and an increase in the AV node refractory period leading to termination of AVNRT.

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Urine Incontinence

STRESS
URGENCY
MIXED
OVERFLOW

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Urine Incontinence /Stress/Tx

Leaking with valsalva
Lifestyle modification
Pelvic floor exercises
Pessary
Pelvic floor surgery

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Urine Incontenence / Urgency / TX

Sudden, overwhelming or frequency need to void.
Tx: - lifestyle modification
- bladder training
- antimuscarinic drugs

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Urine Incontinence/ Mixed /Tx

Feature stress and urgency
Tx: variable depends on predominant symptom.

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Urine Incontinence / Overflow / Tx

Constant involuntary dribbling and incomplete emptying
Tx: - Identification and correction of underlying cause
- Cholinergic agonists
- intermittent self catheterization

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Detrusor over activity

By Parasympathetic
Need to void + loss of urine
Tx:
OXYBUTYNIN
Decrease Ach activity (help increase bladder capacity and decrease detrusor contraction) decrease sense of urgency

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If patient can’t tolerate antimuscarinic treatment due to the side effects ( dry mouth, constipation, blurry vision )

MIRABEGRON
BETA adrenergic agonist

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Essential tremor

Tx: 1) BB (propanolol)
2) Anticonvulsants (Primidone)
- Howerver non selective Beta blocker are relatively contraindicated in patients with reactive airway disease
(Asthma, COPD, Heart block )
PRIMIDONE

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Clozapine

Agranulocytosis (neutropenia)
Weight gain
Metabolic syndrome
Seizures
Ileus
Myocarditis
Hypothyroidism

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Topical glucocorticoid (eye drops)
Systemic glucocorticoid

Can raise IOP ( Intraocular pressure )

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Lhermitte Sign

Neuropathic pain
With neck movement

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Fetal Hydrops

Inmune -> Rh Alloinmunization
Non inmune -> Parvovirus B19
-> Fetal Aneuploidy
-> Cardiovascular abnormalities
-> Thalassemia (Hb Barts)

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OAG (open angle glaucoma)

Insidious loss of peripheral vision related to atrophy of the optic nerve head.
Signs: enlargement of the optic cup and increase cup disc ratio (cupping of optic disc) late finding.
- patient with steroid induced OAG, may develop central blurriness due to central edema.
- Chronic use of glucocorticoid
=> Cataracts

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Hereditary Spherocytosis

Clx: hemolytic Anemia
Jaundice
Splenomegaly
Lab:
⬆️ MCHC
(-) COOMBS Test
Spherocytosis on peripheral smear
⬆️ Osmotic fragility on acidify glycerol lysis test
Abnormal eusin -5 maleimide biding test

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Beck triad

Hypotension
JVD
Decreased heart sounds

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Pulsus Paradoxus

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SBP ⬇️ > 10mmHg
During Inspiration

Baclofen

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Tx for spasticity
Enhance of CNS inhibitory neurotransmitter (GABA)
Agonist of GABA -B Rc

Child Pugh

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Ascitis
Bilirrubin
Clotting (Pt)
Diet (serum albumin)
Encephalopathy (presence or absence )

Child Pugh mortality of 40% predictable with

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Bilirrubin >2mg/dL
Albumin <3g/dL
PT >16sec
Encephalopathy

Child Pugh mortality 80-85 %

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3 of this present:
Bilirrubin >4mg/dL
Albumin <2g/dL
PT >16sec
Encephalopathy
Ascitis
AMONIA alone is 150mg/dL
Mortality close to 100% if all exist

Tizanidine

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Alpha 2 adrenergic agonist
Also improves spasticity
Perhaps by decreasing alpha motor neuron excitability

Gabapentin

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Neuropathic pain
Ex Pt with MS
Not effective for spasticity

Modafinil

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Inhibit Dopamine transporters to increased arousal and can be used to improve fatigue
In Pt with MS

Pramipexole

Dopamine Agonist Tx restless leg syndrome No improve spasticity

Oxybutynin

Blocks M3 Rc at the bladder Preventing detrousor contractions Often used to treat urge incontinences which commonly occurs as a result of a MS

Hypovolemia

Decreases renal perfusion Activation of RAAS

Hypovolemia -> RAAS Activation

Aldosterone stimulates aggressive Na re absorption in the collecting tubules in effect to sustain blood volume. Consequently most pt with Hypovolemia (unless taking diuretics or experiencing renal impairment)have decrease urine sodium The fractional excretion of sodium (ratio of sodium clearance to renal creatinine clearance ) Is tipically <1%

Anion gap metabolic acidosis

Methanol Uremia Diabetes ketoacidosis Propylene glycol / paraldehyde Isoniazid / Iron Lactic acidosis Ethylene glycol (antifreeze) Salicilate (aspirin)

Complications of positive pressure ventilation

Alveolar Damage Pneumothorax Hypertension

Intermittent Asthma

Caused by leukocytes-induced acute and reversible bronchoconstriction

Cerebellar Hemorrhage Risk Factors

HTN Antithrombic tx (warfarin, aspirin) Cerebral amyloid angiopathy

Cerebellar Hemorrhage Manifestations

Headaches, nausea, vomiting Ipsilateral ataxia, dysarthria, vertigo Nystagmus Cranial neuropaties

Loperamide

OTC antidiarrheal med Stim Mu Opiod Rc in the GI tract and reduces peristalsis.

Loperamide overdose (opiod intoxication)

In high dose can cross BBB producing opiod like symptoms such as : Respiratory depression and…

Naloxone

Opiod antagonist to be adm to restore adequate ventilation Rest of Tx : primarily supportive

Skin MRSA infection Tx

Clindamycin Doxy Linezolid TMP-SMX

Most common complication after a Post-ERCP

Acute Pancreatitis

Pituitary Apoplexi

Thunder clap headache Is a rapid onset <1Hr often associated and abnormal mental status When associated with hypotension (central adrenal insufficiency) Billatersl visual field deficit ( compression of the optic chiasm) Ophthalmoplegia ( oculomotor nerve III)

Genetic mutation alters control of inteacellular calcium Triggered by volatile anesthetics Succinylcholine Excessive Heat

Malignant hyperthermia

Genetic mutation alters control of inteacellular calcium Triggered by volatile anesthetics Succinylcholine Excessive Heat

Malignant hyperthermia

Malignant Hyperthermia Tx

- Resp / Vent Support - Imediato cassation on causative anesthetic - Dantrole

QBANK CARDS Flashcards

(42 cards)