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Ramahi Flashcards

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1
Q

Tx for hyperkalemia

A

Ca gluconate
Insulin, albuterol, kayexalate
Dialysis

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2
Q

Most common lung cancer of non-smokers =

A

Adenocarcinoma

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3
Q

Most common location of lung adenocarcinoma =

A

Peripheral lung

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4
Q

Most common sites of met for lung adenocarcinoma =

A

Liver
Bone
Brain
Adrenals

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5
Q

Pleural effusion characteristics of lung adenocarcinoma =

A

Exudative effusion with high hyaluronidase

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6
Q

Location of SCC lung cancer =

A

Central

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7
Q

Paraneoplastic syndrome of SCC lung cancer =

A

Parathyroid like hormone causing low parathyroid levels and high calcium

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8
Q

Features of Pancoast Tumor

A 
Caused by small cell SCC
Shoulder pain
Ptosis
Constricted Pupils
Facial Edema
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9
Q

Lambert Eaton Syndrome

A

Paraneoplastic syndrome from small cell carcinoma causing ptosis improving after 1 minute of upward gaze

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10
Q

Dx in old smoker with Na 125, moist mucus membranes, and no JVD =

A

SIADH from SCLC

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11
Q

Features of NSCLC =

A

Very aggressive
Peripheral location
Cavitation

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12
Q

Tx for small cell and non small cell lung cancer:

A

Small cell = chemoradiation

Non-Small Cell = surgery

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13
Q

Causes of ARDS:

A 
Gram negative Sepsis
Gastric Aspiration
Trauma
Low Perfusion
Pancreatitis
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14
Q

Dx of ARDS:

A

Bilateral
PaO2/FiO2 > 200 (means it’s acute)
PCWP is <18 (meaning pulmonary edema is non-cardiac)

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15
Q

Tx for ARDS:

A

PEEP

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16
Q

Systolic ejection murmur, louder with squatting, and softer with valsalva:

A

Aortic Stenosis

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17
Q

Murmur for HOCM:

A

Systolic ejection murmur which is louder with valsalva and softer for squatting or hard-grip

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18
Q

What does valsalva do?

A

Decreases preload

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19
Q

Murmur features of mitral valve stenosis:

A

Late systolic murmur with a click
louder with valsalva and hand-drip
Softer with squatting

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20
Q

Features of mitral regurg murmur:

A

Holosystolic murmur

Radiates to axilla

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21
Q

Holosystolic murmur with late diastolic rumble =

A

VSD

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22
Q

Continuous machine like murmur =

A

PDA

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23
Q

Wide Fixed and Split S2 =

A

ASD

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24
Q

Rumbling diastolic murmur with an opening snap, LAE, and A-fib =

A

mitral stenosis

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25
Blowing diastolic murmur with widened pulse pressure =
Aortic Regurg
26
Dx with bad breath and snacks left over in mouth in the morning:
Zencker's
27
Zenker's a true or false diverticulum =
False--only has mucosa
28
Achalasia has dysphagia to??
Liquids and solids
29
Dx in patient with dysphagia worse with hot and cold liquids and chest pain that feels like an MI with no regurgitation =
Diffuse esophageal spasm
30
Tx of diffuse esophageal spasm =
CCB or nitrates
31
Medical therapy for gastric varices:
Octreotide | Somatostatin
32
When to band esophageal varices:
Only when they are symptomatic
33
Acid reflux pain after eating and when lying down with no risk factors for GERD =
Look for hiatal hernia
34
Treatment for hiatal hernia =
``` Sliding = tx symptomatically Paraesophageal = treat with surgery ```
35
Work up for patient with MEG pain worse with eating and takes NSAIDs:
Gastric ulcers: Barium swallow first EGD with biopsy second
36
When surgery is indicated for gastric ulcers =
Persistence following maximal medical treatment
37
Blummer's Shelf =
Mets felt on DRE | often gastric cancer
38
Gastric lymphoma (not MALT) associated with:
HIV patients
39
Dx in patient with foamy pee, enlarged rugae, and edema =
Mentrier's Disease (protein losing enteropathy)
40
Gastric varices caused by:
Splenic vein thrombosis | which is common after chronic pancreatitis
41
H pylori most associated with which ulcers?
Duodenal
42
Best dx test for HP?
CLO test following EGD
43
Treatment of duodenal ulcers positive for HP?
PPI Clarithromycin Amoxicillin for 2 wks
44
What to suspect if duodenal ulcer doesn't heal with maximal therapy? Next Steps?
ZES Secretin stimulation test / octreotide testing
45
Syndrome gastrinomas are associated with?
MEN1
46
Features of MEN1?
Parathyroid adenoma Pancreatic NE tumors Pituitary
47
Dx in patient with bilious vomiting, post-prandial pain, and recently lost 200lbs on Biggest Loser =
SMA syndrome
48
Pathophys of SMA syndrome =
3rd part of duodenum compressed by AA and SMA
49
Tx for SMA syndrome =
restoring weight and nutrition Can do roux-en-y
50
Complications of pancreatitis:
Hemorrhage Abscess ARDS Pseudocyst
51
Whipple for panc cancer is indicated when...
No mets outside of abdomen No extension into SMA or portal vein No liver mets No peritoneal mets
52
What is Whipple's Triad:
Associated with insulinoma Hypoglycemic Sx BS < 45 Sx resolve with glucose
53
Labs for insulinoma:
C-peptide
54
Sx associated with glucagonoma:
Hyperglycemia Diarrhea Weight loss Necrolytic migratory erythema
55
Symptoms and issue with somatostatinoma:
commonly malignant Malabsorption Steattorhea (Exocrine pancreas malfunction)
56
VIPoma sx:
Watery Diarrhea Flushing Hypokalemia
57
Tx of VIPoma:
Octreotide
58
Tx of carcinoid syndrome:
Octreotide
59
Dx, w/u, and tx in patient with RUQ pain, fever, jaundice, decreased BP, and AMS:
Ascending cholangitis US / ERCP Tx with ECRP and cholecystectomy
60
2 most important types of choledochal cysts and how to tx:
Type 1 - Fusiform dilation or CBD; tx with excision of cyst Type 4 - the worst kind; "Caroli's Dz," cysts in the intrahepatic ducts; tx with liver transplant these are peds dz's
61
Risk factors for cholangiocarcinoma:
Slerosing Cholangitis | Liver flukes
62
Tx for cholangiocarcinoma:
Tx with surgery +/- radiation
63
Sign of EtOHic hepatitis:
AST is 2x ALT
64
LFTs associated with viral hepatitis:
ALT > AST and both are in the 1000's
65
Elevated AST and ALT following CT surgery:
Shock liver
66
Tx of hepatic encephalopathy:
Lactulose
67
Risk factors for hepatocellular carcinoma:
Chronic HepB > HepC Cirrhosis for any reason Aflatoxin Carbon tetrachloride
68
Dx of HCC:
High AFP | Follow up with CT/MRI
69
Tx of HCC:
Resection if single Rads or cryoablation for palliation of mutliple
70
Tx of hepatic adenoma:
Stop OCP Resect if large, causing hemorrhage, or pregnancy is desired.
71
Focal nodular hyperplasia tx =
None
72
3 most common organisms of pyogenic liver abscess:
E coli Bacterioides Enterococcus
73
Ptn presents with RUQ pain, profuse sweating and rigors, and palpable liver:
Entamoeba histolytica
74
Cansoni Skin Test:
Positive skin test seen in patients with Echinococcal liver cysts due to high levels of IgE
75
Tx for echinococcal cysts:
Albendazole and surgery to remove entire cyst since rupture can cause anaphylaxis
76
Post splenectomy tx:
Aspirin if platelets high Prophylactic PCN 3 vaccines
77
Signs, dx, and tx of hereditary spherocytosis:
sxs of hemolytic anemia, elevated retic count, and osmotic frag test. prone to gallstones. spherocytes on smear, Splenectomy
78
Nutritional deficit in patients with serotonin syndrome:
Niacin (5HT and niacin both made from tryptophan)
79
symptoms of niacin deficiency:
Diarrhea Dementia Dermatitis
80
Surgery to perform if tumor in serotonin syndrome is >2cm, at the base of the appendix, or with positive lymph nodes: Otherwise...
Hemicolectomy appendectomy
81
Threshold for treatment of Ogilvie's =
>10cm distension Decompression with NG tube and neostigmine or colonic decompression
82
Side effect of neostigmine:
Bradycardia (cholinergic)
83
Imaging of sigmoid volvulus =
Coffee bean

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