random6 Flashcards
(158 cards)
1
Q
fetal anemia presents w/?
A
sinusoidal fetal heart tracing w/ no variability
2
Q
fetal head compression –>?
A
early decelerations
3
Q
early decels due to?
A
fetal head compression
4
Q
placental insufficiency –>?
A
late decelerations
5
Q
late decels due to?
A
placental insufficiency
6
Q
variable decels due to?
A
compression of umbilical cord
7
Q
compression of umbilical cord –?
A
variable decels
8
Q
rotavirus vax contraindicated if?
A
- Hx of intussusception
- Hx of uncorrected congenital malformations in GI tract (ie Meckel’s)
- SCID
- anaphylaxis to vax ingredients
9
Q
loss of pain and temp in cape distribution (along dermatomes) - think? issue where?
A
syringomyelia
- distrubance of crossing spinothalamic tracts at the ant commisure
10
Q
ursodeoxycholic acid can be used for?
A
prophylactically prevent gallstones (esp after gastric bypass)
11
Q
risk of esophageal variceal bleed –> med treatment?
A
Non-selective B-Blocker (ie propranolo or nadolol)
- reduces portal venous pressure —> dec risk of hemorrhage
12
Q
dec appetite, abd discomfort, abdominal fullness, now w/ painless jaundice – think?
A
Pancreatic CA
- even w/ elevated bili and alk phos bc can be due to mass in panc blocking bile
13
Q
iron toxicity –> ?
A
Early:
- n/v/d - hemorrhagic (BRB v and dark green stools) –> hypovolemic shock
Late:
- severe lactic acidosis
- hepatotoxicity
- organ failure
14
Q
new onset seizures can make you worry for what?
A
Brain tumors
15
Q
most common adult brain CA?
A
Astrocytomas (specifically glioblastoma multiforme which is type grade IV)
16
Q
what effects prognosis of astrocytomas most?
A
degree of anaplasia (atypia, mitoses, neovascularity or necrosis)
17
Q
common first line therapy for CLL?
A
Rituximab (monoclonal Ab against CD20 on B lymphocytes)
18
Q
monoclonal Ab against CD20 is what med to treat what?
A
- Rituximab
- CLL
19
Q
Imatinib inhibits what and is for what disease?
A
- Inhibits product of BCR-ABL tyrosine kinase fusion
- CML
20
Q
BCR-ABL - think?
A
CML
21
Q
arm twitching - think?
A
simple partial seizure
22
Q
dx of brain abscess uses what imaging?
A
gadolinium enhanced brain MRI
23
Q
nL serum osmolality?
A
285 - 295
24
Q
most common bacteremia in sickle cell pts?
A
Strep pneumo
can cause sepsis
25
what do you use for empiric abx in febrile sickle cell pt?
1) 3rd gen cephalosporin (ie ceftriaxone)
| 2) add vanco if concern for meningitis or osteoarticular infx
26
who received abx prophylaxis b4 dental appts? (3)
High risk pts for bad outcomes w/ IE:
- prosthetic valves
- prior hx of IE
- unrepaired congenital heart disease
27
acute dystonic reaction treat w/?
anticholinergics
- diphenhydramine
- benztropine
- trihexyphenidyl
28
halperidol can cause what via dopamine receptor antagonism?
acute dystonia (EPS, ie torticollis)
29
treatment of epi ovarian CA?
exploratory laparotomy and tumor debulking followed by platinum based chemo
30
PCOS wants to get preggers treat?
1) weight los
2) clomiphene
and/or metformin
31
vertigo is?
sensation of spinning
32
presyncope is?
feeling like one is about to faint
33
disquilibrium is ?
sense of imbalance
34
sensation of spinning?
vertigo
35
feeling like one is about to faint?
presyncope
36
sense of imbalance?
disequilibrium
37
injury to the radial nerve may cause?
wrist drop due to weakness of the extensor muscles
38
test for intact sensation of radial nerve by?
testing dorsal surface of hand
39
oblique fracture of middle humerus most at risk of what being damaged?
radial nerve (travels in spiral groove along dorsal aspect)
40
supracondylar fracture of humerus worry what is being injured?
median n.
41
abduction and adduction of fingers controlled by?
ulnar nerve
42
weakness of elbow flexion and forearm supination - think?
injury to musculocutaneous nerve
43
palliative treatment of pancreatic adenocarcinoma causing extrahepatic cholestatis?
First line: endoscopic stent placement
2nd: surgical bypass
44
ursodeoxycholic acid is the only FDA approved treatment for what?
primary biliary cirrhosis
| (doesn't change mortality, just symp help)
45
malignant pleural effusions appear how?
- exudative
| - low pH (
46
absent p waves w/ irregularly, irregular QRS complexes?
atrial fibrillation
47
rate control meds for a fib?
1) beta blockers (adrenergic antagonists) - ie metoprolol or exmolol
2) non-dyhyidrophyridine Ca channel blockers - ie diltiazem or verapamil
48
dementia w/ early onset ataxia, urinary incontinence and dilation of ventricles on neuroimaging?
NPH
49
finding on neuroimaging for NPH?
dilated ventricles
50
round, eosinophilic, intracytoplasmic inclusions w/in neurons of substantia nigra - is?
Lewy body dementia
51
pt w/ multiple myeloma w/ renal issues but no proteinuria - where is kidney issue?
Renal tubular damage (from monoclonal light chains clogging tubules -> casts & toxicity)
(proteinuria would be seen if it was in the glomerulus)
52
slow rise in creatinine in pt w/ severe HTN and recurrent flash pulm edema - think?
Renal artery stenosis
53
4 big trinucleotide repeat disorders?
Fragile X
Friedrich ataxia
Huntington
Myotonic dystrophy
"X-Girlfriend's First Aid Helped Ace My Test!"
54
friedreich ataxia symp?
- kyphoscoliosis
- muscle weakness
- loss of DTR, vib and proprio
- staggering gait
- hammer toes or high instep (pes cavus)
- DM
- nystagmus
- dysarthria
- -> hypertrophic cardiomyopathy
55
fragile X features?
- intellectual disability
- autistic features
- elongated face w/ large ears
- enlarged testes
- delayed milestones
- macrocephaly
- hypotonia
56
first line treatment of acute sundowning w/ agitation ?
Antipsychotic (ie haloperidol)
57
nL cardiac output?
5 L/min
58
nL RA pressure ?
0-8
59
nL RV pressure?
15-25/3-12
60
nL pulm artery pressure?
15-25/8-15
61
Right heart pressures elevated w/ nL to low PCWP in a pt w/ hypoxia, tachypnea, and tachycardia - think?
PE
62
palpable purpura, proteinuria, and hematuria -- think?
Mixed cryoglobulinemia
| can also have arthralgias, hapatosplenomegaly, and hypocomplementemia
63
confirmatory finding for mixed cryoglobulinemia?
circulating serum cryoglobulins
64
what is a common underlying infx found w/ pts w/ mixed cryoglobulinemia?
HCV
65
what should pts w/ mixed cryoglobulinemia be tested for?
HCV Ab
66
trendelenburg sign caused by?
weakness in gluteus medius and minimus m.
| potentially bc of superior gluteal n. dysfunction
67
superior gluteal nerve dysfunction can lead to what sign?
```
Trendelenburg sign
(bc of weakness of gluteus minimus and medius m.)
```
68
complicated diverticulitis w/
IV abx and observation
worsening symp --> surg
69
complicated diverticulitis w/ >3cm abscess treatment?
CT guided percutaneous drainage
if after 5 dys symp not controlled --> surgical drainage and debridement
70
complicated diverticulitis w/ fistuala, perforation w/ peritonitis, obstruction or recurrent attacks - treatment?
Sigmoid resection
71
med to close PDA?
Indomethacin
72
med to keep open PDA?
Prostaglandin E1
73
avoid lithium use in pts w/ what organ issues?
renal disease pts
74
avoid valproate in pts w/ what organ issues?
liver disease pts
75
most effective med to treat bipolar depressive episode?
lamotrigine
76
most significant side effect of lamotrigine?
Steven Johnson syndrome
77
Acute behavioral agitation in manic episode -- treat?
Antipsychotic (1st or 2nd gen)
- lithium, valproate, carbamazepine would take too long
78
Treatment for anorexia? (3)
- CBT
- Nutritional Rehab
- Olanzapine if no response to above
79
Treatment for Bulimia (3)?
- CBT
- Nutritional Rehab
- SSRI (fluoxetine), of in combo w/ above
80
Binge eating disorder treatment (4)?
- CBT
- Behavior weight loss therapy
- SSRI
- Lisdexamfetamine, topiramate
81
difference b/t bulimia and binge eating disorder?
Bulimia compensates for the binging w/ purging of some type --> maintenance of nL weight
Binge eating disorder just binges --> becomes overweight
82
difference b/t anorexia and bulimia?
anorexia
83
treatment of serious iron poisoning?
Deferoxamine
84
radioopaque tablets on xray in child w/ low HCO3, hypotension, hematemesis, abd pain, and cool extremities --think?
Iron poisoning --> shock
give IV resuscitation and deferoxamine
85
What is used in TCA or aspirin overdose?
Sodium bicarb
86
Torsades de points due to prolonged QT interval give?
Mag sulf
87
Severe lithium toxicity - treat?
Hemodialysis
88
moderate to severe lead poisoning give?
Calcium EDTA
89
child w/ irritability, poor appetite, headaches, abdominal pain, and anemia - toxin is?
Lead poisoning
90
mild to moderate lead poisoning treat w/?
Oral succimer
91
Acetaminophen toxicity treat w/?
N-acetylcysteine
92
abd pain, hematemesis, shock, and metabolic acidosis after a child ingests something radioopaque - think?
Iron overdose!
93
pt on TPN w/ epigastric and RUQ pain - likely?
gallstones due to gallbladder stasis
94
why does an ileal resection contribute to formation of gallstones?
Decreased enterohepatic circulation bile acids --> altered hepatic bile composition --> supersaturation w/ cholesterol --> gallstones
95
incred RBC destruction inc risk of what type of gallstone?
pigmented
96
what is cause of inc dev of cholestrol gallstones in pregnancy?
- Estrogen-induced inc in chol secretios
| - Progesterone causes a) reduction in bile acid and b) slows gallbladder emptying
97
when is Anti - D immune globulin (RhoGAM) administered?
In Rh- women at:
- 28 wks
- or 2/in 72 hrs of any procedure where feto-maternal blood may mix (ie abortion, amniosentesis, delivery, trauma etc)
98
difference b/t shin splints and stress fracture?
no tibial tenderness on palpation w/ shin splints
99
shin splints aka?
medial tibial stress syndrome
100
pain at specific area that inc w/ jumping or running w/ local swelling and point tenderness to palpation - think?
stress fracture
101
best imaging for stress fracture?
MRI or bone scan
102
marfans is due to mutation of what?
fibrillin 1 gene
103
homocystinuria caused by?
cystathionine synthase deficiency
104
fibrillin 1 gene mutation -->?
marfans
105
cystathionine synthase deficiency -->?
homocystinuria
106
defective collagen production -->?
Ehlers-Danlos
107
Ehlers-Danlos due to?
collagen production defect
108
Klinefelter due to?
nondisjunction resulting in an extra X chromosome
109
upward lens dislocation - think?
marfans
110
downward lens dislocation think?
homocystinuria
111
first marker to appear in serum in acute hep B infx?
HBsAg (4-8 wks after infx)
112
2nd marker in HBV that appears around when clinical symp appear and elevation of aminotransferase levels?
IgM anti-HBc
113
what is best test to diagnose new infx of Hep B (pick 2 markers)
HBsAg
IgM anti-HBc
b/c HBsAg is first marker to dev and IgM anti-HBc may be only marker apparent during window period
114
transaminase levels >25 times nL limit w/ ALT>AST - think?
Viral Hepatitis
115
best test for HAV?
Anti-HAV (IgM)
| IgM Ab to HAV
116
Anti-HAV (IgG) positive indicates (2)?
- Prior HAV infx
OR
- Prior HAV vaccination
117
HBsAg is and indicates?
- antigen found on surface of HBV
| - Indicates HBV infx (can't tell if acute or chronic)
118
Anti-HBs is and indicates?
- Ab to HBsAg
| - Indicates immunity to HBV (recovered or immunized)
119
What will you never see if you've only been vaccinated against HBV?
HBeAg
120
What may be only positive marker during infx window period of HBV?
IgM anti-HBc
121
IgM Anti-HBc indicates?
acute/recent infx
122
IgG Anti-HBc indicates?
prior exposure or chronic incx
123
Positive for: HBsAg, HBeAg, IgM Anti-HBc -- means?
acute HBV infx
124
Positive for Anti-HBe and IgM Anti-HBc - means?
Window period
125
Positive for HBsAg, HBeAg, and IgG Anti-HBc - means?
Chronic HBV w/ high infectivity (bc HBeAg pos)
126
Positive for HBsAg, Anti-HBe, and IgG-Anti HBc - means?
Chronic HBV w/ low infectivity (bc Anti-HBe pos)
127
Positive for Anti-HBs, Anti-HBe, and IgG Anti-HBc - means?
Recovered from HBV infx
128
Positive Anti-HBs only means?
HBV immunized
129
which illicit drug can cause vertical nystagmus?
PCP
130
what do you use for treatment of severe psychomotor agitation due to PCP use?
Benzo
131
Initial treatment of AOM?
10 day course of oral high dose Amoxicillin
132
If pt returns w/in 1 month w/ AOM post initial treatment, now treat w/?
Oral Amoxicillin and clavulanic acid (to fight presumably a strain w/ beta lactamase resistence)
133
common bugs --> AOM?
- Strep pneumo
- nontypeable Haemophilus
- Morazella catarrhalis
134
IE w/ nosocomial UTI - what bug?
enterococcus ( U heart trees)
135
fanconi anemia caused by?
defect in DNA repair --> chromosomal breaks
136
benzene exposure can cause what blood issue?
aplastic anemia
137
iability to palpate PMI consistent w/?
large pericardial effusion
138
pulsus bisferiens (biphasic pulse) seen with?
- AR (+/- AS)
- HOCM
- Large PDA
139
post cardiac cath worry for?
cholesterol emboli
140
cholesterol emboli post cardiac cath --> what manifestations? (3ish)
- SKIN: Livedo reticularis, blue toe syndrome
- AKI
- GI: pancreatitis, mesenteric ischemia
141
pt w/ RA has inc risk of what type of bone issues? (3)
- Osteopenia
- Osteoporosis
- Bone fractures
142
paget's disease of bone -- aka?
osteitis deformans
143
osteitis deformans - aka?
paget's disease of boen
144
osteitis fibrosa cystica aka?
Von Recklinghausen disease of bone
145
osteitis fibrosa is?
excessive osteoclastic resorption of bone --> replacement w/ fibrous tissue (brown tumors)
146
osteitis fibrosa cystica is seen in pts w/ what additional disease?
- parathyroid carcinoma
| - primary, 2ndary, tertiary hyperparathyroidism (ie renal disease)
147
anti-CCP Ab -thnk?
RA
148
fibrous obliteration of small bile ducts w/ concentric replacement by connective tissue in an onion skin pattern -- think?
Primary SCLEROSING cholangitis
149
onion skin pattern in liver biopsy - think?
primary sclerosing cholangitis
150
Meniere disease due to?
excess endolymphatic fluid pressure in inner ear
151
triad in meniere disease?
- vertigo
- hearing loss
- tinnitus
152
oscillopsia?
sensation of objects moving around in visual field when looking in any direction
- seen w/ aminoglycoside toxicity esp gentamicin
153
contraindications for breastfeeding? (7)
- active untreated TB (can start post 2wks of treatment)
- Maternal HIV
- Herpetic breast lesions
- Varicella infx
154
preferred confirmatory test for giardia?
stool antigen assay (direct immunofluorescence or ELISA)
155
nitrates primary anti-ischemic effect is?
Systemic venodilation --> lower preload --> lower LVEDV --> dec myocardial O2 demand by reducing wall stress
*they also vaso dialate coronary a., but above is main effect
156
dark brown discoloration of the colon w/ lymph follicles shining through as pale patches - think?
melanosis coli
| - seen w/ laxative use
157
pigment in the macrophages of the lamina propria can indicate?
melanosis coli
| - seen w/ laxative use
158
alcoholism can cause what heart condition?
dilated cardiomyopathy --> SOB, S3, bibasilar cracks, low ejection fraction, etc.
