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Flashcards in Rapid Review Deck (109):
1

classic ECG finding in atrial flutter

sawtooth P waves

2

definition of unstable angina

angina that is new, is worsening, or occurs at rest

3

antihypertensive for a diabetic patient with proteinuria

ACEI

4

Beck's triad for cardiac tamponade

hypotension, muffled heart sounds, JVD

5

drugs that slow heart rate

beta- blockers, calcium channel blockers, digoxin, amiodarone

6

hypercholesterolemia treatment that leads to flushing and pruritis

niacin

7

murmur- hypertrophic obstructive cardiomyopathy (HOCM)

a systolic ejection murmur heard along the lateral sternal border that increase with decreased preload (valsalva)

8

murmur- aortic insufficiency

Austin Flint murmur, a diastolic, decrescendo, low-pitched, blowing murmur that is best heard sitting up; increases with increased afterload (handgrip maneuver)

9

murmur- aortic stenosis

systolic crescendo/decrescendo murmur that radiates to the neck; increases with increase preload (squatting maneuver)

10

murmur- mitral regurgitation

holosystolic murmur that radiates tot he axilla; increases with increase afterload (handgrip maneuver)

11

murmur- mitral stenosis

diastolic, mid- to- late, low- pitched murmur preceded by an opening snap

12

treatment for atrial fibrillation and atrial flutter

if unstable, cardiovert. If stable or chronic, rate control with CCBs or beta blockers

13

treatment for ventricular fibrillation

immediate cardioversion

14

Dressler syndrome

autoimmune reaction with fever, pericarditis, and increased ESR occurring 2-4 weeks post MI

15

IV drug use with JVD and a holosystolic murmur at the left sternal border. Treatment?

Treat existing heart failure and replace the tricuspid valve

16

Diagnostic test for hypertrophic cardiomyopathy

echocardiogram (showing a thickened left ventricular wall and outflow obstruction)

17

pulsus paradoxus

a decrease in systolic BP of more than 10mm Hg with inspiration; seen in cardiac tamponade

18

classic ECG findings in pericarditis

low- voltage, diffuse ST- segment elevation

19

definition of hypertension

BP> 140/90 mm Hg on 3 separate occasions 2 weeks apart

20

eight surgically correctable causes of hypertension

renal artery stenosis, coarctation of aorta, pheochromocytoma, Conn's syndrome, Cushing's syndrome, unilateral renal parenchymal disease, hyperthyroidism, hyperparathyroidism

21

evaluation of a pulsatile abdominal mass and bruit

abdominal ulstrasound and CT

22

indications for surgical repair of abdominal aortic aneurysm

>5.5 cm, rapidly enlarging, symptomatic, or ruptured

23

treatment for acute coronary syndrome

ASA, heparin, clopidogrel, morphine, O2, sublingual nitrogen, IV beta-blockers

24

metabolic syndrome

abdominal obesity, high triglycerides, low HDL, hypertension, insulin resistance, prothrombotic or proinflammatory states

25

Appropriate diagnotic test for a 50yo man with stable angina who can exercise to 85% of maximum predicted heart rate

exercise stress treadmill with ECG

26

Appropriate diagnotic test for a 65yo woman with left bundle branch block and severe osteoarthritis who has unstable angina

pharmacologic stress test (dobutamine echo)

27

target LDL in a patient with diabetes

28

signs of active ishemia during stress testing

angina, ST-segment changes on ECG, or decrease in BP

29

ECG findings suggesting MI

ST-segment elevation (depression means ischemia), flattened T waves, and Q waves

30

coronary territories in MI

anterior wall (LAD/diagonal)
inferior wall (PDA)
posterior wall (left circumflex/oblique, RCA/marginal)
septal wall (LAD/diagonal)

31

A young patient with angina at rest and ST-segment elevation with normal cardiac enzymes

Prinzmetal's anging

32

common symptoms associated with silent MIs

CHF
shock
altered mental status

33

diagnostic test for pulmonary embolism (PE)

spiral CT with contrast

34

protamine

reveres effects of heparin

35

prothrombin time

coagulation parameter affected by warfarin

36

young patient with a family history of sudden death collapses and dies while exercising

hypertrophic cardiomyopathy

37

endocarditis prophylaxis regimens

oral surgery-amoxicillin for certain situations; GI or GU procedures- not recommended

38

Virchow's triad

stasis, hypercoagulability, endothelial damage

39

MCC htn in young women

OCPs

40

MCC HTN in young men

excessive EtOH

41

Figure 3 sign

aortic coarctation

42

Water-bottle-shaped heart

percardial effusion- look for pulsus paradoxus

43

"stuck on" appearance

seborrheic keratosis

44

red plaques with silvery-white scales and sharp margins

psoriasis

45

MC type of skin cancer; the lesion is a pearly-colored papule with a translucent surface and telangiectasias

basal cell carcinoma

46

honey-crusted lesions

impetigo

47

febrile patient with a history of diabetes presents with a red, swollen, painful lower extremity

cellulitis

48

positive Nikolsky sign

pemphigus vulgaris

49

negative Nikolsky sign

bullous pemphigoid

50

55-year old obese patient presents with dirty, velvety patches on the back of the neck

acanthosis nigricans. check fasting blood glucose to rule out diabetes

51

dermatomal distribution

varicella zoster

52

flat- topped papules

lichen planus

53

iris- like target lesion

erythema multiforme

54

lesions characteristically orrutting in a linear pattern in areas where skin comes into contact with clothing or jewelry

contact dermatitis

55

presents with a herald patch, christmas-tree pattern

pityriasis rosea

56

pinkish, scaling, flat lesions on the chest and back; KOH prep has a 'spagghetti-and-meatballs' appearance

tinea (pityriasis) versicolor

57

four characteristics of a nevus suggestive of melanoma

asymmetry, border irregularity, color variation, and large diameter

58

a premalignant lesion from sun exposure that can lead to squamous cell carcinoma

actinic keratosis

59

"dewdrops on a rose petal"

lesions of primary varicella

60

cradle cap

seborrheic dermatitis
treat conservatively with bathing and moisturizing agents

61

associated with propionibacterium acnes and changes in androgen levels

acne vulgaris

62

painful, recurrent vesicular eruption of mucocutaneous surfaces

herpes simplex

63

inflammation and epithelial thinning of the anogenital area, predominantly in postmenopausal women

lichen sclerosus

64

exophytic nodules on the skin with varying degrees of scaling or ulceration; the second most common type of skin cancer

squamous cell carcinoma

65

MCC hypothyroidism

Hashimoto thyroiditis

66

Lab findings in Hashimoto thyroiditis

High TSH, low T4, anti-TPO abs

67

Exophthalmos, pretibial myxedema, and decreased TSH

Graves' disease

68

MCC Cushing syndrome

iatrogenic corticosteroid administration. second most common cause is Cushing disease

69

a patient presents with signs of hypocalcemia, high phosphorus, and low PTH

hypoparathyroidism

70

"stones, bones, groans, psychiatric overtones"

signs and symptoms of hypercalcemia

71

a patient complains of headache, weakness, and pulyuria; examination reveals hypertension and tetany. Labs show hypernatremia, hypokalemia, and metabolic alkalosis

primary hyperaldosteronism (due to Conn's syndrome or bilateral adrenal hyperplasia)

72

a patient presents with tachycardia, wild swings in BP, HA, diaphoresis, AMS, and a sense of panic

pheochromocytoma

73

which should be used first in treating pheochromocytoma, alpha or beta antagonists?

alpha antagonists (phentolamine and phenoxybenzamine)

74

A patient with a history of lithium use presents with copious amounts of dilute urine

nephrogenic diabetes insipidus (DI)

75

Treatment of central DI

Administration of DDAVP and free- water restriction

76

A postoperative patient with significant pain presents with hyponatremia and normal volume status

SIADH due to stress

77

An antidiabetic agent associated with lactic acidosis

Metformin

78

A patient presents with weakness, nausea, vomiting, weight loss, and new skin pigmentation. Labs show hyponatremia and hyperkalemia. Treatment?

primary adrenal insufficiency (Addison disease). Treat with glucocorticoids, mineralocorticoids, and IV fluids

79

Goal HbA1C for a patient with DM

80

Treatment of DKA

fluids, insulin, and electrolyte repletion (eg K+)

81

Why are beta blockers contraindicated in diabetics?

they can mask symptoms of hyperglycemia

82

How do you interpret the following 95% CI for RR of 0.582 (0.502, 0.637)

These data are consistent with RRs ranging from 0.502 to 0.673 with 95% confidence (ie we are confident that the true RR will be between 0.502 and 0.637 95 out of 100 times)

83

Bias introduced into a study when a clinician is aware of the patient's treatment type

observational bias

84

bias introduced when screening detects a disease earlier and thus lengthens the time from diagnosis to death

lead-time bias

85

if you want to know if geographical location affects infant mortality rate but most variation in infant mortality is predicted by SES, then SES is a

confounding variable

86

the proportion of people who have the disease and test positive is the

sensitivity

87

sensitive tests have few false negatives, and are used to rule ___ a disease

out

88

PPD reactivity is used as a screening test because most people with TB (except those who are anergic) will have a positive PPD. Highly sensitive or specific?

Highly sensitive for TB (screening tests with high sensitivity are good for diseases with low prevalence)

89

chronic diseases such as SLE- higher prevalence or incidence?

higher prevalence

90

epidemics such as influenza- higher prevalence or incidence?

higher incidence

91

what is the difference between incidence and prevalence?

Prevalence is the percentage of cases of disease in a population at 1 snapshot in time. Incidence is the percentage of new cases of disease that develop over a given time period among the total population at risk.

92

cross- sectional survey- incidence or prevalence?

prevalence

93

cohort study- incidence or prevalence?

incidence and prevalence

94

case- control study- incidence or prevalence?

neither

95

describe a test that consistently gives identical results, but the results are wrong

high reliability (prevision), low validity (accuracy)

96

difference between a cohort and a case- control study

cohort studies can be used to calculate RR, incidence, and/or odds ratio (OR). Case- control studies can be used to calculate an OR, which is an estimate of RR when the disease prevalence is low.

97

Attributable risk?

difference in risk in the exposed and unexposed groups (ie the risk that is attributable to the exposure)

98

relative risk?

incidence in the exposed group divided by incidence in the non-exposed group

99

the results of a hypothetical study found an association between ASA intake and risk of heart disease. How do you interpret an RR of 1.5?

in patients who took ASA, the risk of heart disease was 1.5 times that of patients who did not take ASA

100

Odds ratio?

In cohort studies, the odds of developing the disease in the exposed group divided by the odds of developing the disease in the non-exposed group.

In case- control studies, the odds that the cases were exposed divided by the odds that the controls were exposed.

In cross- sectional studies, the odds that the exposed group has the disease divided by the odds that the non-exposed group has the disease

101

The result of a hypothetical study found an association between ASA intake and risk of heart disease. How do you interpret an OR of 1.5?

In patients who took ASA, the odds of acquiring heart disease were 1.5 times those of patients who did not take ASA.

102

In which patients do you initiate colorectal cancer screening early?

Patients with IBD; those with familial adenomatous polyposis (FAP)/ hereditary nonpolyposis colorectal cancer (HNPCC); and those who have first- degree relatives with adenomatous polyps (

103

The most common cancer in men and the most common cause of death from cancer in men

prostate is the most common cancer in men. Lung cancer causes more deaths

104

percentage of cases within 1 SD of the mean? 2 SDs? 3 SDs?

68%, 95.4%, 99.7%

105

birth rate?

number of live births per 1000 population in 1 year

106

mortality rate?

number of deaths per 1000 population in 1 year

107

neonatal mortality rate?

number of deaths from birth to 28 days per 1000 live births in 1 year

108

infant mortality rate?

number of deaths from birth to 1 year of age per 1000 live births (neonatal and postnatal mortality) in 1 year

109

maternal mortality rate

number of deaths during pregnancy to 90 days postpartum per 100,000 live births in 1 year