Random mix Flashcards
(190 cards)
1
Q
Most common cause of death in dialysis patients
A
Cardiovascular disease
2
Q
Eye dysfunction in NF T1
A
Optic giloma
3
Q
Associated neoplasms of Lynch syndrome
A
Colorectal
Endometrial
Ovarian
4
Q
MEN1 associated neoplasms
A
Parathyroid adenomas
pituitary adenomas
pancreatic adenomas
5
Q
Initial symptomatic treatment for hyperthyroidism
A
Propranolol
6
Q
When to use PTU?
A
Treat hyperthyroidism in cases when radio ablation is contraindicated (pregnancy)
7
Q
Cause of pulmonary edema in the setting of aortic dissection
A
Aortic regurg
8
Q
Chronic rhino sinusitis, asthma, aspirin or NSAID induced bronchospasm
A
Aspirin-Exacerbated respiratory disease.
Nasal polyps
Bilateral nasal obstruction, discharge and anosmia
9
Q
Causes of renal transplant dysfunction early post-op
A
Ureteral obstruction, acute rejection, cyclosporine toxicity, vascular obstruction, acute tubular necrosis
10
Q
What test to get if patient has hypertension and hypokalemia
A
plasma aldosterone/renin ratio
Suspicion of primary hyperaldosteronism
If PAC/PRA >20
11
Q
Amiloride
A
potassium-sparing diuretic
12
Q
Common causes of hyperkalemia
A
acute or chronic kidney disease
medications
Disorders impairing the renin-angiotensin axis
13
Q
Aspirin intoxication acid-base disorder
A
mixed respiratory alkalosis and metabolic acidosis
14
Q
Exertional heat stroke vs. heat exhaustion
A
Exertional heat stroke- thermoregulation failure
Heat exhaustion- inadequate fluid and salt replacement W/ NO CNS dysfunction
15
Q
Pathophys of nephritic syndrome
A
primary damage to glomeruli
16
Q
Causes of nephritic syndrome
A
Poststrep glomerulonephritis IgA nephropathy Lupus MPGN rapidly progressive glomerulonephritis
17
Q
Anasarca, pulmonary and facial edema, hypertension, abnl UA with proteinuria and hematuria
A
Nephritic syndrome
18
Q
Painful nodules in the armpit that progress to abscesses
A
Hidradenitis suppurativa
inflammatory occlusions of folliculopilosebaceous units
19
Q
Treatment for uric acid kidney stones
A
alkalization of urine (potassium citrate)
Low-purine diet
Allopurinol
20
Q
AKI acid/base disturbance
A
Non-anion gap metabolic acidosis (impaired acid excretion)
OR
Anion gap acidosis (retention of unmeasured uremic toxins)
21
Q
Criteria for ATN
A
- BUN:Cr::20:1
- Urine osm 300-350
- Urine Na >20
- FENa >2%
- Muddy brown casts
22
Q
Muddy brown casts
A
ATN
23
Q
RBC casts
A
Glomerulonephritis
24
Q
WBC casts
A
Interstitial nephritis and pyelo
25
Fatty casts
Nephrotic syndrome
26
Broad and waxy casts
Chronic renal failure
27
Drugs that cause acute interstitial nephritis
Penicillins
TMP-SMX
Cephalosporins
NSAIDs
28
Common complication of nephrotic syndrome
- Coagulopathy (renal vein thrombosis)
- Protein malnutrition
- iron-resistant microcytic hypo chromatic anemia
- Vit D deficiency
- decreased thyroxine levels
- Increased susceptibility to infection
29
Progression of DM kidney injury
1. glomerular hyperfiltration
2. Glomerular BM thickening
3. Mesangial expansion
4. nodular sclerosis
30
Treatment for kidney stones
hydration, analgesics and alpha blockers
| relaxes ureteral muscle
31
URI 4 days ago, young male, gross hematuria
IgA nephropathy
| normal serum complement
32
Timing of post infectious GN
10-21 days
-children
33
Post infectious GN labs
- Low C3
| - Elevated anti-streptolysin O or anti-DNAse B
34
Most common cause of ascites
Cirrhosis
| Hep C and Alcoholic liver dz
35
Level of G6PD activity during attack
may be normal
36
Most common cause of spontaneous deep intracerebral hemorrhage
Hypertensive vasculopathy
Most frequently effecting basal ganglia, cerebellar nuclei, thalamus and pons
37
Cause of subarachnoid hemorrhage
berry aneurysms
38
Treatment of metabolic alkalosis
Normal saline
| determine if responsive or not
39
Causes of saline resistant metabolic alkalosis
- primary hyperaldo
- Cushing's syndrome
- severe hypokalemia (
40
fever, chills and malaise w/in 1-6 hrs of transfusion
febrile non hemolytic transfusion.
can be avoided by leukoreduction.
41
decrescendo early diastolic murmur
aortic regurgitation
42
Most common causes of aortic regurg
Developed countries-biscupid valve
Developing countries- rheumatic heart disease
43
sensitive lab test for hypovolemia in pt on diuretics
BUN/Cr ratio
looking for (>20:1) pre renal azotemia
44
Young obese female with headache and normal neuroimaging and elevated CSF
Pseudotumor cerebri
45
Treatment for pseudo tumor cerebri
weight reduction and acetazolamide
Shunting or opt nerve sheath fenestration to prevent blindness
46
Diagnosis of myasthenia gravis
Bedside edrophonium test, ice pack test
- Ach receptor antibodies
- CT scan of chest for thymoma
47
physical exam findings in renovascular disease
resistant HTN
asymmetric renal size
abdominal bruit
48
Localized pain on anteromedial tibia after trauma with neg callous stress test
pes anserinus pain syndrome
49
Location of coccidioides
southwest
50
autoantibodies to RBCs + pallor, jaundice, splenomegaly
| positive coombs test
Autoimmune hemolytic anemia
51
Peripheral vision loss, cupping of optic disc
open angle glaucoma
tx: timolol drops
52
Effects of IGF-1
excessive growth of bone and soft tissue
53
Leading cause of death in acromegaly
cardiovascular
54
Hypertension, palpable bilateral abdominal masses and microhematuria
AD polycystic Kidney disease
55
Common complication of ADPKD
- intracranial berry aneurysm
- hepatic cysts (most common!)
- valvular heart dz
- colonic civerticula
- abdominal wall inguinal hernia
56
rapid onset hirsutism
Androgen secreting neoplasm
test for testosterone and DHEAS
- elevated T w/ nl DHEAS (OVARIAN)
- elevated DHEAS (ADRENAL)
57
rapid onset hirsutism w/ elevated testosterone and nl DHEAS
OVARIAN TUMOR
58
Rapid onset hirsutism with elevated DHEAS
Adrenal tumor
59
what insulin for DKA?
regular insulin IV
60
Goals of treatment of DKA
1. restore intravascular volume (NS)
2. correction of hyperglycemia (regular insulin)
3. correction of electrolytes (K+)
4. treatment of precipitating factors like infection
61
Treatment for hypercalcemia
Severe (>14)- NS+calcitonin
| Bisphosphonates for long term
62
Characteristics of HHS
Hyperglycemia
increased serum osm
little or no ketonemia or acidosis
gradual onset
63
cause of milk-alkali syndrome
excess intake of calcium and absorbable alkali.
Thiazide, ACE I, NSAIDs
64
Anti-TPO and anti-thyroglobulin antibodies
Hashimoto's
65
positive urinary cyanide nitroprusside test
cystinuria
66
UA with hexagonal crystals
cystinuria
67
AL amyloidosis associated conditions
multiple myeloma
| Waldenstrom macroglobulinemia
68
AA amyloidosis associated conditions
RA
IBD
chronic infection (osteomyelitis, TB)
69
Flank pain, low-volume voids +/- occasional high vol voids, renal dysfunction
Obstructive uropathy
70
Eye injury with contact lens
ulcers
| Keratitis--Pseudomonas
71
Hip pain, limited internal rotation and abduction, normal XR and inflammatory markers.
Osteonecrosis (aseptic necrosis) of femoral head
72
Causes of hypercalciuria
idiopathic, hyperPTH, dehydration, prolonged immobilization
73
Cause of nephrolithiasis in pts with Crohn
Increased absorption of oxalate
74
NNT
1/ARR
75
Primary medication for COPD
anti-cholinergic (ipratropium and tiotropium)
76
Bright red, firm, friable, exophytic nodules in HIV pt
Bacillary angiomatosis
77
Signs of oropharyngeal dysphagia
difficulty initiating swallow, coughing, choking, nasal regurgitation
78
Diagnosis of oropharyngeal dysphagia
video fluoroscopic modifica barium swallow
79
Chalazion
painful swelling that progresses to nodular rubbery lesion on eyelid
80
beta-D-Glucan test
test for fungi
81
post-transplant pt with respiratory failure, dry cough, and fever
PCP
82
Indications for carotid endarterectomy
Men: 60-99% stenosis if asymp
Women: 70-99% stenosis
83
Cause of bullies pemphigoid
IgG autoantibodies against hemidesmosome and BM
84
First line treatment for Bullous pemphigoid
High-potency topical glucocorticoid (clobetasol)
85
Risk factors for idiopathic intracranial hypertension
Overweight women of childbearing age
| medications (tetracyclines, hypervitaminosis A, isotretinoin)
86
Treatment for acute MS exacerbation
glucocorticoids (IV methylprednisolone)
Or plasmapheresis if steroids do not work
87
Treatment for metastatic bone cancer
Bisphosphonates (zoledronic acid)
88
Use dependence with antiarrhymitcs
enhanced pharmacologic effects of a drug during faster heart rates.
89
Highly use dependent antiarrhythmic
Class 1 (flecanide) and class 4 (CCB)
leads to widened QRS
90
pain in groin that radiates to thigh. Worse with activity. decreased internal and external rotation of hip. No redness or warmth or tenderness to joint.
Osteoarthritis
91
Osteonecrosis pain
Constant
92
Cutaneous larva migrans source
walking barefoot on beach
| Hookworm larvae
93
Diseases associated with vitiligo
autoimmune disorders (SLE, thyroid, pernicious anemia, addison disease)
94
Clinical features of glucocorticoid-induced myopathy
progressive proximal msk weakness and atrophy w/o pain
Nl ESR and CK
95
Most common pulmonary complication of scleroderma
interstitial fibrosis
96
trihexylphenidyl
anticholinergic med for parkinsons and drug induced EPS
97
Pt with NSTEMI with pulmonary edema needs
IV furosemide
98
Pt with NSTEMI with unstable sinus bradycardia
IV atropine
99
Pt with NSTEMI with persistent severe pain
IV morphine
100
Pt with NSTEMI w/ pain, hypertension, or HF
IV nitro
101
Tx for SVT
adenosine or vagal maneuvers
102
Fourth heart sound causes
Ventricular hypertrophy
| Acute MI
103
Association with cryoglobulinemia
hep C
| IgM against anti-hepatitis C virus IgG
104
ADAMTS13
Thrombi thrombocytopenic purpura
105
urine positive for prussian blue stain
hemosiderin
106
diagnosis of obstructive ureterolithiasis
US or spiral CT
107
Test for EBV
heterophiles antibody test
108
most common thrombophilia
Factor V Leiden
Activated protein C resistance
109
RBC casts, proteinuria and low serum C3
post-strep GN
110
inflammatory arthritis, splenomegaly, ulcerating skin lesions and neutropenia
Felty syndrome
common in pts w/ RA
111
isolated elevated alk phos
Paget's disease of the bone
Normal Ca and phos
elevated bone turnover markers: procollagent type 1 N propertied, urine hydroxyproline
112
travel diarrhea >2wks
Cryptosporidium, cystoisosporia, cyclospora, giardia
113
clinical manifestations of waldenstrom macroglobulinemia
Hyperviscosity syndrome (diplopia, tinnitus, HA), Neuropathy and hepatosplenomegaly, anemia, thrombocytopenia
114
elevated IgM with hepatosplenomegaly
Waldenstrom macroglobulinemia
115
elevated IgG, IgA and hypercalcemia
Multiple myeloma
116
elevated IgM with no end organ effects
MGUS
117
Are deep diabetic wounds mono microbial or polymicrobial
Poly
118
Treatment for symptomatic SIADH
Hypertonic saline
| Vaptains
119
Middle aged woman with widespread pain, fatigue and cognitive/mood disturbances
Fibromyalgia
120
Treatment for Fibromyalgia
Exercise w/ aerobic conditioning
121
Fever, severe focal spinal pain, neurologic deficits
spinal abscess
122
Causes of hypokalemia
- increased entry into cells
- renal potassium wasting
- GI loss
123
Effect of beta-adrenergic agonists on potassium
Shift potassium into cells
Hypokalemia
124
Fixed, dilated pupil that is "down and out" with no accommodation
compression of CNIII
125
Ptosis and down and out gaze with normal light and accommodation reflexes
diabetic CN III neuropathy
126
Test with high sensitivity for CHF
BNP
127
Dipyridamole and adenosine use in diagnosis of CAD
Coronary vasodilators
lead to coronary steal
128
unexplained elevation of serum CK and myopathy
Hypothyroid
| polymyositis
129
cause of secondary bacterial pneumonia
S. aureus
130
Tx for TTP
plasma exchange
131
```
Thrombocytopenia
Hemolytic anemia
Renal insufficiency
Neurologic changes
Fever
```
Thrombotic thrombocytopenic purpura
Normal PT
132
Drop in plts >50% or new thrombus w/in 5-10 days of heparin initiation
HIT
133
Recurrent infection, osteolytic bone lesions, weight loss, fatigue
Multiple myeloma
134
Multiple myeloma labs
normocytic anemia
renal insufficiency
-hypercalcemia
135
Indications for HAV vaccine
Chronic liver dz
Men who have sex with men
IV drug users
136
Indication for HPV vaccine
all pts age 11-26
137
Complications of mono
autoimmune hemolytic anemia (IgM cold agglutinin ab) and thrombocytopenia
138
Treatment for HBV
Entecavir and tenofovir
139
Groin pain on weight bearing, pain on hip abduction and internal rotation.
Avascular necrosis
140
Treatment for urge incontinence
- bladder training
- kegels
- antimuscarinic drugs (oxybutynin)
141
Treatment for SVT causing hemodynamic instability
Synchronized cardioversion
142
Middle 28 yo woman with difficulty swallowing, weakness worse in evenings, and severe dyspnea
Myasthenia crisis
143
Precipitating factors for myasthenic crisis
Infection or surgery, Pregnancy, tapering immunosuppressive drugs, Medications (ahminoglycosides, BB)
144
Signs and symptoms of myasthenic crisis
ptosis, diplopia
fatiguable chewing, dysphagia, nasal speech
proximal limb weakness
respiratory muscle weakness
145
Effect modification
external variable positively or negatively impacts effect of a risk factor on the disease of interest
146
Treatment for Guillain-Barre
IV immunoglobulin OR plasmapheresis
147
Diagnosis of Guillain-Barre
LP w/ elevated protein and nl WBC
148
elderly pt with dramatic leukocytosis (primarily lymphocytes), hepatosplenomegaly, lymphadenopathy and anemia/thrombocytopenia
CLL
149
Diagnosis of CLL
Flow cytometry
150
Best initial treatment for migraine
Prochlorperazine (IV antiemetic) PLUS NSAIDs
151
Papule with indented center everywhere but palms and soles
Molluscum contagiosum (Poxvirus)
*consider testing for HIV*
152
Salvage therapy
treatment for a disease when standard therapy fails
153
Neoadjuvant
treatment given before standard therapy
154
Timing of gait impairment in NPH
early
155
Episodic vertigo, sensorineural hearing loss, tinnitus
Meniere disease
156
Initial test for lupus
ANA
157
Most common cause of lower Gi bleed
Diverticulosis (bleeding most commonly from right colon)
*painless*
158
OSA effect on kidneys and electrolytes
kidneys increase bicarb reabsorption and decrease Cl reabsorption to compensate for metabolic alk
159
what part of spine effected by RA
Cervical
160
Young pt with chronic back pain that improves with NSAIDS
inflammatory process
| Consider AS
161
Most common extraarticular manifestation of ankylosing spondylitis
Anterior uveitis (iritis)
also look for dactylitis
162
treatment for febrile neutropenia
anti-pseudomonad agent (cefepime, meropenem, pip/tazo)
163
Which test to use to test for syphilis
Nontreponemal (VDRL) (more false neg rates)
FTA-ABS (highest sensitivity)
164
Asymmetric resting tremor 4-6 Hz associated with rigidity
first presentation of Parkinson's dz.
165
Treatment for younger pts with parkinson's and mainly a tremor
Trihexyphenidyl
166
Causes of chronic cough
- upper-airway cough syndrome (postnasal drip)
- asthma
- GERD
167
treatment of upper-airway cough syndrome
Chlorpheniramine
blocks H1 receptors, histamine release from mast cells, limits secretory response to inflammatory cytokines
168
Vaccines for pts post splenectomy and timing
PCV13, meningococcal, H influenza type B
14 days before or after splenectomy
169
Treatment for aspiration pneumonia
Clindamycin
Metronidazole + amox
Amox/clavu
Carbapenem
170
Brain death characteristic findings
absent cortical and brain stem functions
171
Does brain death eliminate DTR?
NO spinal cord might still work
172
when to get booster meningococcal vaccination
age 16-21 if vaccinated pre 16th b-day
173
Live attenuated vaccines
- polio (PO)
- measles/mumps/rubella
- rotavirus
- nasal influenza
- yellow fever
- varicella
174
hypertension, bradycardia, respiratory depression
Cushing reflex
brainstem compression
175
Brown-Sequard syndrome effect on pain
contralateral loss of pain and temp
176
first line for chemo induced n/v
ondansetron
177
Treatment for botulism
equine serum heptavalent botulinum antitoxin
178
Cause of osteomyelitis by puncture wound
Pseudomonas aeruginosa
179
5-HIAA tests for...
carcinoid
180
treatment for carcinoid
octreotide
181
episodic flushing and wheezing, diarrhea, valvular heart disease with tricuspid regurg
Carcinoid syndrome
182
treatment for chronic low back pain
exercise therapy
intermittent NSAIDs
maybe TCAs or duloxetine
183
Diagnosis of pancreatic cancer
US
| then CT
184
Treatment for hairy cell leukemia
Cladribine
185
Antibiotic treatment for human bites
Amox/clauv
186
Treatment for ALS
Riluzole (glutamate inhibitor)
187
Treatment of graves dz
thyroidectomy
| radioactive iodine W/ steroids if eye issues
188
Treatment for acute glaucoma
mannitol, acetazolamide, timolol, pilocarpine
189
Medications to avoid with acute glaucoma
atropine
190
how to diagnose parkinson's
Physical exam
| Tremor, rigidity, bradykinesia, postural instability
