Flashcards in Random5 Deck (95):
post traumatic shoulder pain w/ limited active abduction - think?
rotator cuff tear
rotator cuff tear, typical trauma --> ?
fall on an outstretched arm
signs of rotator cuff tear? (3)
- drop arm sign
- weakness w/ external rotation (passive range nL)
- pain worsened by raising arm overhead or w/ ext rotation
treatment of rotator cuff tear?
surgery w/ best results if performed w/in 6 wks of injury
MSK suggestions of a pancoast tumor? (4)
- shoulder pain
- radicular pain radiating to wrist
- atrophy of muscles
- compressive symptoms (ie edema)
infant nL @ birth but graudally dev apathy, weakness, hypOtonia, large tongue, sluggish movement, abdominal bloating, difficult breathing, jaundice, hypOthermia, umbilical hernia, refractory macrocytic anemia - think
causes of floppy baby syndrome (2)?
- Werdnig-Hoffman syndrome
Werdnig Hoffman syndrome is?
- AR disorder
- Degeneration of ant. horn cells and cranial motor nuclei
- symp prior to 6mo (ie generalized m. weakness, hypOtonia, hypermobility of joints, absent tendon relfexes, fasiculation of tongue, etc)
m. weakness, atrophy of distal m. of upper and lower extremities, inc tone, testicular atrophy, and baldness - think?
Myotonic congenital myopathy
nikolsky sign is?
top layer of skin slips away from lower layers when slightly rubbed
nikolsky sign is positive w? (3)
- Scalded skin syndrome (Staph aureus - exfoliative toxin)
- Toxic epidermal necrolysis
- Pemphigus vulgaris (absent in bullous pemph)
complication of kawasaki disease (2)?
- Coronary artery aneurysms
What should be done at time of dx and post kawasaki disease?
reye syndrome is?
hepatic encephalopathy due to aspirin use in children during influenza or varicella infx
sickle cell pt w/ stroke, treatment?
- Exchange transfusion (to dec # of sickle RBCs)
- Continue hydroxyurea
*Note: this does not reverse stroke, prevents any further strokes
*note: fibrinolytic therapy not likely to help bc 2ndary to sludging of sickle cell not thrombus/emboli
twisting force w/ foot fixed --> popping sound, what injured?
palpable locking, catching, clicking when joint is internally or externally rotated and is then flexed or extended -- think?
forceful hyperextension of knee or noncontact torsional injury during deceleration --> ?
blow to the lateral knee or forceful leg abduction -->?
Medial collateral ligament tear
patellofemoral pain syndrome presents? (3)
- chronic ant. knee pain
- worsened by activity or prolonged sitting/flexion
- crepitus w/ motion of patella
gold standard confirmatory test for HIT?
Serotonin release assay
necrotic lesions at heparin injection sites --> think?
HIT (Ab mediated)
supracondylar fracture concern for entrapment of what? (2)
- Brachial artery
- Median nerve
anti-topoisomerase 1 antibody?
Primary biliary cirrhosis
Anti-smooth muscle Ab?
salvage therapy is?
treatment for a disease when a standard treatment fails
treatment for a disease when a standard treatment fails is called?
adjuvant therapy is?
treatment given in ADDITION to standard therapy
(ie radical prostatectomy + radiation at same time)
treatment given in addition to standard therapy is?
consolidation therapy is?
therapy given after induction therapy to further reduce tumor burden (consolidate our gains)
induction therapy is?
an initial dose of a treatment to rapidly kill tumor cells and send pt into remission
initial dose of a treatment meant to kill tumor and cause remission?
therapy given after induction therapy to further reduce tumor burden?
maintenance therapy is?
given after induction and consolidation therapies to kill any residual tumor cells and keep pt in remission
neoadjuvent therapy is?
a treatment given BEFORE the standard therapy for a particular disease
a treatment given before the standard therapy for a particular disease is?
initial treatment for DKA?
- nL saline
- IV regular insulin
- correct electrolyte abnl
- treat precipitating cause
DKA requirements for dx?
- blood gluc >250
- serum pH
most appropriate next step in management of progressive pain in pt w/ prostate CA and bony mets after androgen ablation (orchiectomy)?
- early satiety
- postprandial fullness
treatment of pts w/ diabetic gastroparesis?
- optimize DM control
- dietary modifictation (small frequent meals, inc fiber)
- meds to improve gastric emptying (ie metoclopramide)
prokinetic and antiemetic med to help w/ diabetic gastroparesis?
what meds can help w/ diabetic gastroparesis?
- Metoclopramide (prokinetic, antiemetic)
- Erythromycin (prokinetic properties; used for acute exacerbations)
- Cisapride (prokinetic, but risk of cardiac arrhythmias and death)
acute inflammatory arthritis + chondrocalcinosis - think?
pseudogout (Ca pyrophosphate dihydrate crystal arthritis)
calcification of articular cartilage
*found w/ pseudogout
anti-dss DNA Ab specific for?
anti smith Ab specific for?
anti-histone Ab is sensitive marker for what?
(less so for minocycline-induced)
anti-cyclic citrullinated Ab is specific for?
paget disease of bone due to?
osteoclastic bone resorption --> focal enlargement, weakness, or fracture of bone
frontal bossing, headaches, hearing loss, bowing long bones, bone pain w/ inc alk phos and nL Ca and phosphate - think?
Paget's disease of bone
main treatment for paget's disease of bone?
what are pts w/ acromegaly most likely to die from?
acute back pain w/ point tenderness after lifting suggests?
vertebral compression fracture
pain pattern w/ compression fracture?
pain w/ standing, walking, or lying on back
positive straight leg raise test indicates?
nerve root compression --> herniated disk, radiculopathy, etc
low back pain + neurological symptoms worse w/ spinal extension (ie walking, standing) but improved w/ leaning forward or lying down -- think?
lumbar spinal stenosis
treatment of alcohol withdrawal?
- IV lorazepam preferred in hospital setting & those w/ liver disease (intermediate duration)
megacolon + cardiac disease - think?
Chagas disease (trypanosoma cruzi)
severe hyperCalcemia (>14) treatment?
- nL saline + calcitonin
- Avoid loop diuretics (unless vol overloaded)
- bisphosphonates (takes a few days)
loss of fetal station - think?
painless vag bleeding on membrane rupture + fetal sinusoidal heart tracing (brady) - think?
most common type of spinocerebellar ataxia?
ataxia & dysarthria + scoliosis & hammertoes + concentric hypertophic cardiomyopathy - think?
(neuro + skeletal + cardiac)
most common cause of death in pts w/ friedreich ataxia?
cardiomyopathy or respiratory complications
pronator drift sensitive and specific finding for?
Pyyramidal/corticospinal tract disease (UMN)
signs of drug induced hyperammonemia (ie valproate)?
-encephalopathy (confusion, lethargy, etc)
- Neuromuscular findings (bradykinesia, asterixis, etc)
major complication concern for parapharyngeal space infx? (2)
- erosion into carotid artery
- jugular thrombophlebitis
most feared complication of a retropharyngeal abscess?
spread of infx into mediastinum --> acute necrotizing mediastinitis
chest pain due to coronary vasospasm?
variant angina (Prinzmental)
greatest risk factor for variant (prinzmental) angina?
transient chest pain occur at night w/ transient ST elevations - think?
variant (prinzmental) angina
treatment of prinzmental (variant) angina?
- elimination of risk factors (ie smoking)
- Ca channel blockers
- Alternatively, nitrates
meds to avoid in variant (prinzmental) angina?
- nonselective Beta blockers (ie propranolol)
what is a calcitonin producing tumor?
medullary thyroid cancer
Treament for guillen-barre?
IVIG or Plasmapheresis
cyclosporine and pyridostigmine can treat?
riluzole used in treatment of?
what type of meds may help with the passage of a kidney stone?
Alpha 1 receptor blockers (ie tamsulosin)
anticholinergic --> urinary what?
- can use to treat overactive bladder (inc bladder capacity)
bethanechol is? can treat what nephro stuff?
treat urinary retention or atonic bladder
maj subarchanoid hemorrhage complication in first 24 hrs if left untreated?
rebleeding (maj cause of death w/in 24hrs of presentation)
maj subarchanoid hemmorhage complication in 3-10days post?
Vasospasm (maj cause of morbidity and death)
Prophylaxis for subarachnoid hemorrhage pts to prevent vasospasm?
prophylaxis for subarachnoid hemmorrhage pts to prevent vasospams
when do you see todd's palsy?
- weakness one side of body for up to 48 hrs post seizure
n/v, pneumobilia, hyperactive bowel sounds, and dilated loops of bowel -- think?
gallstone ileus --> mechanical SBO
firstline treatment for OCD ?
high dose SSRIs and/or exposure and response CBT
young obese F w/ headache w/ nL imaging and inc ICP (ie papilledema) -
Pseudotumor cerebri (benign intracranial HTN)
treatment for pseudotumor cerebri
- weight reduction
-if weightloss doesn't work --> Acetazolamide
eye surgery if refractory to both
maj complication of pseudotumor cerebri?
spinal cord compression what initial treatment?