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1
Q

Transudative effusions:

  • pH
  • protein
  • LDH
A

7.4 - 7.55

low pleural/serum protein (<0.5) AND

low pleural/serum LDH (<0.6) AND

Pleural LDH < 2/3 upper limit of normal serum LDH

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2
Q

Exudative effusions:

  • pH
  • protein
  • LDH
A

7.3 - 7.45

high pleural/serum protein (>0.5) OR

high pleural/serum LDH (>0.6) OR

Pleural LDH > 2/3 upper limit of normal serum LDH

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3
Q

indications for TB pleural effusion

A
  • adenosine deaminase

- protein >4

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4
Q

complicated vs uncomplicated bacterial pleural effusions

  • pH
  • glucose
  • WBCs
  • LDH
A

uncomplicated (pH >7.2)
complicated (pH <7.2)

uncomplicated (glucose >60)
complicated (glucose <60)

uncomplicated (WBCs <50,000)
complicated (WBCs >50,000)

uncomplicated (LDH <1,000)
complicated (LDH >1,000)

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5
Q

hypovolemic shock:

  • preload
  • PCWP
  • CI
  • SVR
A
  • preload: decreased
  • PCWP: decreased
  • CI: decreased
  • SVR: increased (sympathetic NS increased)
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6
Q

Cardiogenic shock

  • preload
  • PCWP
  • CI
  • SVR
A
  • preload: increased
  • PCWP: increased
  • CI (decreased)
  • SVR (increased)
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7
Q

obstructive shock

  • preload
  • PCWP
  • CI
  • SVR
A
  • preload: increased
  • PCWP: decreased
  • CI: decreased
  • SVR: increased
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8
Q

distributive shock

  • preload
  • PCWP
  • CI
  • SVR
A
  • preload: decreased
  • PCWP: decreased
  • CI: increased (can decreased in LATE septic shock)
  • SVR: decreased
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9
Q
  • preload: decreased
  • PCWP: decreased
  • CI: decreased
  • SVR: increased (sympathetic NS increased)
A

hypovolemic shock

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10
Q
  • preload: increased
  • PCWP: increased
  • CI (decreased)
  • SVR (increased)
A

cardiogenic shock

- MI

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11
Q
  • preload: increased
  • PCWP: decreased
  • CI: decreased
  • SVR: increased
A

obstructive shock

- PE

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12
Q
  • preload: decreased
  • PCWP: decreased
  • CI: increased
  • SVR: decreased
A

distributive shock

- sepsis

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13
Q

complications within 3-5 days after MI

A

papillary muscle rupture

interventricular septum rupture

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14
Q

complications within 5 days - 2 weeks after MI

A

free wall rupture

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15
Q

complications several months after MI

A

left ventricular aneurysm

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16
Q

hallmark of left ventricular aneurysm after MI

A

deep Q waves and persistently elevated ST segments

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17
Q

biopsy findings with microscopic colitis

A

mononuclear infiltrate within lamina propria

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18
Q

two types of microscopic colitis

A

1) collagenous
- thickened subepithelial collagen band

2) lymphocytic
- intraepithelial lymphocytes

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19
Q

pharm tx for hepatic encephalopathy

A

lactulose (reduce serum ammonium)

rifamixin (non-absorbable antibiotic)

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20
Q

causes of bloody ascites

A

trauma
malignancy
TB (rarely)

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21
Q

causes of milky ascites

A

chylous (rich in triglycerides, due to presence of thoracic or intestinal lymph in abdominal cavity)

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22
Q

causes of turbid ascites

A

possible infection

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23
Q

causes of straw color ascites

A

more likely benign causes

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24
Q

neutrophils >250/mm3 in ascites

A

bacterial perotonitis

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25
calculating SAAG
serum albumin - ascites albumin
26
SAAG >1.1 causes | higher protein in the serum
portal hypertension - cardiac ascites - cirrhosis - Budd chiari
27
SAAG <1.1 causes | higher protein in the ascitic fluid
- TB - peritoneal cancer - pancreatic - nephrotic syndrome
28
breastfeeding (lactation failure) vs breast milk jaundice
breastfeeding: age <1 week - insufficient intake of breast milk causing delayed stooling and and increase in enterohepatic circulation of bilirubin breast milk: age >1 week - increased B-glucuronidase in the breast milk causing increased deconjugation of intestinal bilirubin and increased enterohepatic circulation
29
treatment for breastfeeding jaundice
increase frequency of breastfeeding
30
drugs that do not show up on a USD because they're synthetic
``` hydrocodone hydromorphone oxycodone fentanyl meperidine methadone tramadol ```
31
rash/steven johnson syndrome is an AE of lamotrigine
dont forget
32
HMOs - providers elligible - referalls?
limited # providers requires referral
33
PPOs - providers elligible - referalls?
out of network allowed (more exensive) no referrals necessary
34
EPOs - providers elligible - referalls?
limited # providers requires referral **same thing as HMO, but network is smaller**
35
POS - providers elligible - referalls?
out of network allowed requires referral
36
TX molluscum contagiosum
liquid nitrogen (cryotherapy)
37
Henoch Schonlein Purpura sx
- palpable purpura on thighs, ankles, butt - hematuria - arthralgias - abdominal pain/intussusception - 1/3 boys have scrotal pain from localized vasculitis
38
tx Henoch Schonlein Purpura
mild: supportive severe: systemic glucocorticoids
39
erythematotelangiectatic rosacea and tx
fair skinned individuals flushing tx: avoidance of triggers
40
papulopustular rosacea
papules and pustules tx: topical metronidazole
41
seborrheic dermatitis tx
antifungals
42
rapid onset severe psoriasis | - underlying condition?
HIV
43
severe seborrheic dermatitis | - underlying condition?
HIV Parkinson's
44
pyoderma gangrenosum | - underlying condition?
IBD
45
early decelerations in FHM
head compression
46
variable decelerations in FHM
cord compression
47
late decelerations in FHM
uteroplacental insufficiency
48
begins rolling
4 months
49
transfers objects hand to hand
6 months
50
says dada and mama
9 months
51
3 finger pincer grasp
9 months
52
2 finger pincer grasp
12 months
53
throws ball
12 months
54
runs and kicks a ball
18 months
55
builds a tower of 2-4 cubes
18 months
56
10-25 word vocab
18 months
57
walks up down stairs with both feet on each step
2 years
58
walks up down stairs with alternating feet
3 years
59
builds a tower of 6 cubes
2 years
60
vocab >50 words
2 years
61
follows 2 step commands
2 years
62
100% intelligible speech
4 years
63
tricycle
3 years
64
copies a circle
3 years
65
copies a cross
4 years
66
copies a square
5 years
67
skips
5 years
68
counts to 10
5 years
69
completes toilet training
5 years
70
speech 75% intelligible
3 years
71
B2 (riboflavin) deficiency sx
angular chelosis seborrheic dermatitis normocytic anemia

Maddy Step 2 (2 decks)

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