RANDOM Flashcards
(14 cards)
Why do trimethoprim and cimetidine cause an increase in serum creatinine without affecting GFR?
Both trimethoprim and cimetidine inhibit creatinine secretion in the renal tubules, leading to a false elevation in serum creatinine.
🔸 No actual decline in GFR — kidney function remains stable.
📝 Think: “Blocked exit, not broken filter.”
What is Allergic Bronchopulmonary Aspergillosis (ABPA) and how is it diagnosed?
Immunologic lung disorder due to hypersensitivity to Aspergillus fumigatus.
🧬 Common in asthma and cystic fibrosis patients.
📍 Symptoms: Recurrent low-grade fever, wheezing, productive cough, hemoptysis.
🔍 Diagnosis:
Positive skin prick test
Elevated IgE
Positive Aspergillus antibodies
📝 Think: Asthma + Aspergillus = ABPA
How is polycythemia defined and what are its main categories?
Polycythemia is defined as:
🔹 Hemoglobin > 16 g/dL in women
🔹 Hemoglobin > 16.5 g/dL in men
It is categorized into:
Primary: due to intrinsic bone marrow disorders (e.g., polycythemia vera)
Secondary: due to increased erythropoietin (e.g., hypoxia, tumors)
📝 Think: Elevated Hb → Check marrow vs. EPO!
What are the strongest predictors of AAA expansion and when is repair recommended?
Top predictors of AAA expansion/rupture:
🔸 Large aneurysm diameter
🔸 Rapid rate of expansion
🔸 Active cigarette smoking (🚬 = highest risk)
Repair recommendation:
➡️ Refer for AAA repair if asymptomatic and diameter > 5.5 cm
📝 Think: “Big, fast, and smoking = danger. >5.5 cm? Time for repair.”
How can contrast-associated AKI be prevented in patients with chronic kidney disease?
risk is higher with intraarterial (not IV) contrast in CKD patients.
Prevention includes:
🔸 Use smallest contrast volume
🔸 Hold NSAIDs
🔸 Optimize volume status:
— IV normal saline (if euvolemic)
— Diuretics (if volume overloaded)
📝 Think: “Less contrast, no NSAIDs, right fluids = kidney protection”
When is venom immunotherapy indicated, and how effective is it?
Indicated for patients with:
🔸 History of systemic reaction to insect sting
🔸 Positive venom-specific IgE
Effectiveness:
➡️ Reduces risk of anaphylaxis recurrence from 60% → 5%
📝 Think: “Sting + Systemic Rxn + IgE = Immunotherapy saves!”
How is dyspepsia evaluated based on age and clinical features?
🔹 Most cases of dyspepsia have no clear cause, but can indicate serious conditions like malignancy or peptic ulcer.
Age ≥60: Start with upper GI endoscopy
Age <60 (no red flags):
🔸 Test for H. pylori
🔸 Or trial of acid suppression
📝 Think: “60 and up? Scope it out. Under 60? Test or treat.”
What type of blood product should be given to a patient with IgA deficiency?
Patients with IgA deficiency are at risk for anaphylactic reactions to standard plasma-containing blood products.
Safe options:
🔹 Use washed red blood cells (RBCs)
🔹 Or IgA-deficient plasma products (if plasma is needed)
🔹 Ensure pretransfusion notification to blood bank
📝 Think: “No IgA? Wash it away.”
Which blood product modifications are needed for patients at risk for graft-versus-host disease or CMV?
🔹 Irradiated RBCs → For patients at risk of transfusion-associated graft-versus-host disease
(e.g., bone marrow transplant recipients)
🔹 Leukoreduced RBCs → To reduce CMV transmission
(e.g., transplant candidates, AIDS patients)
📝 Think: “Irradiated for immune mismatch, leukoreduced for virus catch.”
What are the key features and treatment of pericardial tamponade?
Cause: Fluid in the pericardium → impairs ventricular filling → hypotension
Classic signs:
🔹 Pulsus paradoxus
🔹 Rapid “x” descent in neck veins
🔹 Hypotension, tachycardia
Treatment:
➡️ Pericardiocentesis (urgent fluid removal)
📝 Think: “Full sac, flat heart—drain to restart.”
What is Enteropathy-Associated T Cell Lymphoma (EATL), and how does it present?
EATL is a rare, aggressive T-cell lymphoma linked to poorly controlled celiac disease.
Presentation:
🔹 Abdominal pain, B symptoms
🔹 Hepatosplenomegaly, ascites
🔹 GI bleeding, bowel obstruction/perforation
Diagnosis:
➡️ Confirmed by pathology of resected tumor
Treatment:
➡️ Combination chemotherapy
Prognosis: Poor
📝 Think: “Celiac + noncompliance = T-cell trouble.”
How is acute lumbosacral radiculopathy managed and when is MRI indicated?
Low back pain + radiating pain/numbness in dermatomal pattern (commonly L5/S1)
Initial treatment:
🔹 Activity modification
🔹 NSAIDs → effective in ~90%
MRI is indicated if:
🔸 Neurologic deficits (e.g., weakness, bowel/bladder issues)
🔸 Suspected infection or malignancy
🔸 No improvement with initial management
📝 Think: “Leg pain track? Treat with NSAIDs. No improve or red flags? Then scan.”
How does thalassemia trait differ from iron deficiency anemia?
Thalassemia trait:
🔹 Microcytic, hypochromic anemia
🔹 Normal/increased iron & ferritin
🔹 Mild anemia with normal RDW
🔹 Diagnosed with hemoglobin electrophoresis
🆚 Iron deficiency anemia:
🔸 Low iron/ferritin, increased RDW
📝 Think: “Small cells, but iron’s fine? Suspect thalassemia.”
What causes central hypothyroidism and what is the key precaution before starting treatment?
Back (Answer):
Causes of Central Hypothyroidism:
🔹 Pituitary/hypothalamic lesions
🔹 Intracranial radiation
🔹 Infiltrative disorders
🧠 Often coexists with other pituitary hormone deficiencies
⚠️ Caution:
Treating hypothyroidism before ruling out/treating adrenal insufficiency may trigger adrenal crisis
📝 Think: “Check cortisol before giving thyroid hormone!”
