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step 2 disease treatment > randoms part 4 > Flashcards

randoms part 4 Flashcards

(67 cards)

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1
Q

where does copper deposit in wilsons disease?

A

liver (also has mallory hyaline)
basal ganglia
cornea

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2
Q

pure motor hemiparesis stroke?

A

lacunar infarction - posterior limb

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3
Q

pure sensory stroke?

A

thalamus - VPL

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4
Q

ataxic hemiparesis stroke?

-lower extremities

A

lacurnar - anterior limb of internal capsule

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5
Q

dysarthia, clumsy hand syndrome stroke

A

lacurnar stroke - basis pontis

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6
Q

what are trihexyphenidyl and benzotropine?

A

anticholinergics used for parkinsons

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7
Q

anticholinergic quote

A

red as a beet, dry as a bone, hot as a hare, blind as a bat, mad as a hatter, full as a flask

-dry, urinary retension, constipation etc.

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8
Q

cavernous sinus thrombosis

A
  • bilateral periorbital edema, headache

- CN III, IV,V-1 V-2, VI

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9
Q

pronator drift signifies

A

UMN lesion

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10
Q

what is selegiline?

A

MAOB inhibitor

side effects are insomnia and confusion

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11
Q

what is entacopone tolcapone?

A

COMT inhibitor

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12
Q

Name some DA agonists?

A

bromocriptine, pramipexole, ropinirole, apomorphine

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13
Q

what is the bradykinesia of parkinsons

A

difficulty initiating movement, soft speech, festinating gait, small hand writing, decreased facial expression

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14
Q

what is cushing reflex?

A

HTN, bradycardia, decreased RR

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15
Q

BPPV

A
  • crystalline deposits in the semicircular canals that disrupt the normal flow of fluid in the vestibular system
  • recurrent brief episodes brought on by predictable head movements or position change.
  • dix-hall-pike maneuver will cause nystagmus
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16
Q

menieres

A

recurrent episodes of vertigo, preceeded by ear fullness and pain, unilateral hearing loss and tinnutus (rining)

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17
Q

ACA vs MCA stroke

A

ACA - leg more than arm weakness

MCA - arm, face, aphasia of dominant hemisphere

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18
Q

you had a stroke, now what med gets added

A

statin

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19
Q

carotid stenosis

A

70% endarterectomy

100% why bother

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20
Q

migraine ppx

A

propanolol or valproic acid

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21
Q

cluster ppx

A

verapamil, prednisone, valproate, ergotamine

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22
Q

aboritive therapy for a migraine?

A

triptan or ergotamine

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23
Q

tuberous sclerosis

A

sz, progressive psychomotor retatrdation, slowly progressive mental deterioration.

  • adenoma sebaceum, shagreen pathces, ash leaf (hypopigmented spots)
  • retinal lesions
  • cardiac rhabdomyomas
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24
Q

neurofibromatosis

A
  • neurofibromas
  • 8th cranial nerve tumors
  • cafe au lait
  • meningioma and glioma
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25
sturge-weber syndrome
port-wine stain sz homonymous hemianopsia, hemiparesis, mental subnormality.
26
treat essential tremor with
propanolol
27
how to treat restless leg syndrome
DA agonists - pramipexole
28
pericarditis EKG
PR segment depression | ST segment elevation in all leads
29
DHEA vs DHEAS
DHEA - ovaries and adrenals | DHEAS - adrenals only
30
FSH works on what cell
granulosa cell to promote aromatase to make estrogen
31
LH works on what cell
thecal cell to promote desmolase to convert cholesterol to androstenedione
32
verapamil side effect
constipation
33
hydralazine side effect
orthostatic hypotension | drug induced lupus
34
hydrochlorathiazide and glucose tolerance
deccreased glucose tolerance, increases TG and LDL
35
aortic stenosis can disrupt VWF multimers
this can cause AVM to bleed more, so angiodysplasia especially in the GI tract. painless bleeding, anemia
36
how to reduced HTN in order
- weight loss - DASH diet - exercise - sodium - alcohol
37
consolidate areas act as a?
physiologic shunt as v/q ratio is 0. ventilation ~ 0 perfusion remains intact
38
deadspace
volume of inhaled air not available for gas exchange - wasted ventilation - examples are a PE --> no perfusion, but ventilation is working, so waste
39
squamous cell a non-small cell lung cancer
PTHrP
40
small cell cancer
ACTH, ADH
41
what drugs lower mortality for a patient with chronic angina?
aspirin, beta blockers and nitroglycerin
42
do not give calcium channel blocker in CAD
do not lower mortality, they risk reflex tach - you could use verapamil or diltiazem as they dont affect , use for pts with severe asthma, or prinzmetal variant angine
43
beta blockers when not to use
severe asthma cant tolerate, causes bronchoconstriction
44
treatment of stable angina
aspirin, beta blockers and nitrates
45
treatment of unstable angina/non-st elevation MI
heparin, GPIIb/IIIa - to prevent a thrombus from forming as well as aspirin, beta blockers and nitrates
46
treatment of st elevation MI
PCI!! thrombolytics if you cant PCI | aspirin, beta blockers and nitrates, you can do heparin too, but after thrombolytics
47
contraindications to thrombolytics?
major bleeding, recent surgery
48
cannon A waves
third degree heart block | -atrial systole against a closed TV because the atrium and ventricles are completely out of sink
49
right ventricule infarction
st elevation in RV4, tachy because the RCA supplies the AV node
50
cause of systolic dysfunction
HTN --> heart dilates --> systolic dysfunction and low ejection fraction---> regurgitation
51
low CO in CHF will do what?
decreases perfusion pressure turning on the RAAS --> hy[onatremia, also increase sympathetic tone so SVR tries to clamp down
52
S4`
stiffened ventricle
53
S3
ventricle with turbulent blood flow while filling
54
what drugs to use for systolic dysfunction CHF?
``` ACE, ARB betablockers spirinolactone diuretics digoxin (controls symptoms but does not lower mortality) ```
55
mortality benefit in systolic dysfunction? what drugs what to do?
ACEI/ARBs, beta blockers, spirinolactone, eplerenone, hydralazine, nitrates, implantable defibrillator
56
drugs that benefit diastolic dysfuction CHF
beta blockers and diuretics
57
MS presentation
dysphagia and hoarsness from enlarged LA pressing on esophagus and laryngeal nerve AF from dilated LA hemoptysis -diastole -louder with increased preload (squating, leg raise) -softer with standing, valsalva -nitrates and handgrip have no effect
58
AS presentation
- congenital bicuspid valve or with age - systolic murmer - softer with standing or valsalva - louder with increased preload so squating or leg raise - hand grip increases afterload, decreases ejection of blood, so makes it softer
59
handgrip
handgrop increases afterload and delays emptying of the ventricle. the ventricle is more full and dilated
60
amyl nitratre
emptier ventricle, increases forward flow of blood
61
MR presentation
- dilation leads to MR - pansystolic murmur - hand grip will make it louder - amyl nitrate will make it softer - increasing preload with make it louder - decreasing preload will make it softer
62
AR presentation
- wide pulse presure - water hammer bounding pulses that you feel - pulsations in nail bed - head bobbing - diastolic decreasendo murmur - handgrip increases afterload make it louder/worse - valsalva and standing, decrease preload making it better
63
MVP
- usually aysmptomatic - assoc with ehrlos danlos, marfans - atypical chest pain, panic attacks, palpitations - dilate the ventricle less murmer, make ventricle smaller more murmer - handgrip will improve the mumur - standing or valsava will worse, since less preload - amyl nitrate will worsen - sqwuating or lef raise will improve
64
restrictive cardiomyopathy examples
sarcoid amyloid hemochromatosis (reversible) scleroderma
65
pt non compliant on anticoagulation, has hx of DVT, young? try?
rivaroxiban! direct factor 10a inhibitor
66
selective IgA deficiency is common in?
celiac | -so they may test negative for antibodies
67
patient with migraines
you can give an antiemetic as well such as prochlorpezine or metoclopramide

step 2 disease treatment (12 decks)

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