Rapid Review Flashcards
(243 cards)
1
Q
ECG pattern in A flutter
A
sawtooth
2
Q
Unstable angina (definition)
A
New or worsening angina w/ no increase in troponins
3
Q
Antihypertensive for a diabetic patient w proteinuria
A
ACEi or ARB
4
Q
Beck triad for cardiac tamponade
A
Hypotension, distant heart sounds, JVD
5
Q
Drugs that slow heart rate (4)
A
B-blockers, CCB, digoxin, amiodarone
6
Q
Hypercholesterolemia treatment that causes flushing & pruritis
A
Niacin
7
Q
Murmur - HOCM
A
Systolic ejection murmur along lateral sternal border, increases with decreased preload (Valsalva)
8
Q
Murmur - aortic insufficiency
A
Diastolic decrescendo, low-pitched, blowing, loudest when sitting up; increases with increased after load (handgrip)
9
Q
Murmur - aortic stenosis
A
Systolic crescendo/decrescendo murmur that radiates to neck; increases with increased preload (squatting)
10
Q
Murmur - mitral regurg
A
Holosystolic murmur, radiates to axilla; increases with increased after load (handgrip)
11
Q
Murmur - mitral stenosis
A
Diastolic, mid to late, low-pitched murmur; opening snap
12
Q
Treatment for a fib & a flutter (stable, then unstable)
A
Stable: rate control w/ B-blocker or CCB
Unstable: cardiovert
13
Q
Treatment for v-fib
A
Immediate defibrillation
14
Q
Dressler syndrome
A
Autoimmune reaction with fever, pericarditis, elevated ESR 2-4 weeks post-MI
15
Q
Treatment for: IVDU + JVD + holosystolic murmur at LSB
A
Treat existing heart failure, then replace tricuspid valve
16
Q
Diagnostic test for HOCM
A
Echo (thickened LV wall & outflow obstruction)
17
Q
Pulsus paradoxus, & associated dz
A
Decrease in SBP >10mmHg with inspiration. Cardiac tamponade
18
Q
Classic ECG findings in pericarditis
A
Low voltage, diffuse ST segment elevation
19
Q
Surgically correctible causes of HTN (8)
A
Renal artery stenosis, aortic coarct, pheo, Conn syndrome, Cushing syndrome, unilateral renal parenchymal disease, hyperthyroidism, hyperPTH
20
Q
Evaluation mode for pulsatile abd mass + bruit
A
Abdominal US & CT
21
Q
Indications for surgical correction of AAA
A
> 5.5 cm, rapidly expanding, symptomatic, ruptured
22
Q
Treatment for Acute Coronary Syndrome
A
Morphine, Oxygen, Nitro, ASA, B-blockers, clopidogrel, heparin
23
Q
Metabolic syndrome - definition
A
Abdominal obesity, high TG, low HDL, HTN, insulin resistance, prothrombotic or proinflammatory states
24
Q
Signs of active ischemia during stress testing
A
Angina, ST segment changes, hypotension
25
ECG findings suggesting MI (3)
ST segment elevation, flattened T waves, Q waves
26
Coronary territories in MI
Anterior wall (LAD/diagonal), inferior (PDA), posterior (LCX/oblique, RCA/marginal), septal (LAD/diagonal)
27
Common sx of silent MI
CHF, shock, AMS, fatigue, heartburn, SOB, neck/jaw pain, indigestion
28
Diagnostic test for PE
CT pulmonary angio
29
Protamine is for...
Heparin reversal agent
30
Which coag measure does warfarin affect
Prothrombin time
31
Endocarditis prophylaxis regimes
Oral surgery - amoxicillin
| GI/GU surgery - none
32
Virchow triad
Hypercoagulability, stasis, endothelial damage
33
Most common cause of hypertension in young women
OCPs
34
Most common cause of HTN in young men
EtOH
35
Figure 3 sign on CXR
Aortic coarctation
36
Water-bottle-shaped heart
Pericardial effusion - look for pulses paradoxus
37
Waxy, stuck-on skin lesion
SK
38
Red plaques with silvery-white scales and sharp margins
Psoriasis
39
Pearly-colored papule with translucent surface and telangiectasias
BCC - most common skin cancer
40
Honey crusted skin lesions
Impetigo (staph, strep)
41
Febrile pt w diabetes presents w red, swollen, painful leg & intact pulses
Cellulitis
42
+Nikolsky sign, flaccid blisters
Pemphigus vulgaris
43
-Nikolky sign, tense blisters
Bullous pemphigoid
44
What to check when you find acanthosis nigricans in obese patient
Blood glucose
45
Dermatomal distribution of painful vesicles
Varicella zoster
46
Flat-topped, itchy, violet papules
Lichen planus
47
Iris-like targetoid lesions
Erythema multiforme
48
Christmas tree pattern of rash + herald patch
Pityriasis rosea
49
Flat, hypopigmented lesions on chest & back; KOH shows "spaghetti and meatballs"
Tinea versicolor
50
Characteristics of melanoma
Asymmetry, Border irregularity, Color variation, Diameter (large), evolution
51
Premalignant lesion caused by sun exposure that leads to SCC
AK
52
Crusting vesicles in all stages of healing
Varicella
53
Cradle cap (real name)
Seborrheic dermatitis
54
Associated w propionibacterium acnes & changes in androgen levels. Treatment of last resort?
Acne vulgaris. Oral isotretinoin. Needs monthly blood tests and 2x contraception
55
Painful, recurrent vesicular eruption of mucocutaneous surfaces
Herpes simplex
56
Inflammation and epithelial thinning of anogenital area, predominantly in postmenopausal women
Lichen sclerosus
57
Exophytic nodules on skin with scaling or ulceration
Squamous Cell Carcinoma, 2nd most common skin cancer
58
Most common cause of hypothyroidism in USA
Hashimoto thyroiditis
59
Lab findings in Hashimoto thyroiditis
high TSH, low T4, +TPO
60
Exophthalmos, pretibial myxedema, low TSH
Graves dz
61
Most common cause of Cushing Syndrome
Iatrogenic corticosteroid administration (2nd most common is Cushing dz)
62
Post thyroidectomy pt with hypocalcemia
Iatrogenic hypoparathyroidism, low PTH, high phos
63
Stones, bones, groans, psychiatric overtones
Hypercalcemia
64
HTN, hypoK, metabolic alkalosis
Hyperaldosteronism (1˚, caused by Conn syndrome or bilateral adrenal hyperplasia)
65
Tachycardia, highly variable BP, HA, diaphoresis, AMS, panic sx
Pheochromocytoma
66
First step in treating pheo
A-blockers (phenoxybenzamine)
67
Lithium use + increased urination
Nephrogenic DI
68
Treatment of central DI
DDVAP
69
Posted patient in pain + hyponatremia + 130/85
SIADH
70
Antidiabetic agent associated w lactic acidosis
Metformin
71
Pt w weakness, nausea, vomiting, wt loss, skin pigmentation. Hyponatremia, hyperkalemia. treatment?
1˚ adrenal insufficiency. Tx: Exogenous corticosteroids & mineralocorticoids, IV fluids
72
Goal HbA1c in T2DM
<7.0
73
Treatment of DKA
Fluids, insulin, electrolyte repletion
74
Bone pain, hearing loss, increased alk phos
Paget's
75
Increased IGF-1
Acromegaly
76
Galactorrhea, amenorrhea, bitemporal hemianopsia
Prolactinoma
77
Elevated serum 17-hydroxyprogesterone
CAH (21-hydroxylase deficiency)
78
Pancreas, pituitary, & parathyroid tumors
MEN1
79
Most common cancer in men, most deadly cancer in men
Prostate, lung
80
% of cases within 1 standard deviation? 2SD? 3SD?
68% 95.4% 99.7%
81
Most common cause of SBO in its with no history of abdominal surgery
Hernia
82
Most common bacteria - diarrhea
Campylobacter
83
Most common bacteria - recent abx
C diff
84
Most common bacteria - camping
Giardia
85
Most common bacteria - picnic/mayonaise
S aureus
86
Most common bacteria - travelers diarrhea
Enterotoxigenic Escherichia
87
Most common bacteria - uncooked burger
E coli O157:H7
88
Most common bacteria - fried rice
Bacillus cereus
89
Most common bacteria - poultry/eggs
Salmonella
90
Most common bacteria - seafood
Vibrio, HepA
91
Most common bacteria - diarrhea in AIDS pt (3)
Isospora, cryptosporidium, MAC
92
Most common bacteria - pseudoappendicitis (2)
Yersinia, campylobacter
93
Cancer screening in Ulcerative Colitis
Colonoscopy every 1-2 years starting 8 years after dx
94
Extrainestinal manifestations of IBD (5)
Uveitis, ankylosing spondylitis, pyoderma gangrenous, erythema nodosum, 1˚ sclerosing cholangitis
95
Medical treatment of IBD - acute & chronic
Chronic 5-ASA agents, acute add steroids
96
30yoM with UC, new jaundice, pruritus, fatigue
1˚ sclerosing cholangitis
97
Mallory-Weiss tear
Superficial tear in esophageal mucosa
98
Boerhaave Syndrome
Full-thickness esophageal rupture
99
Charcot triad
Fever, jaundice, RUQ pain/Murphy's sign
100
Reynolds pentad
Fever, jaundice, RUQ pain/Murphy's sign, shock, AMS
101
Hepatic encephalopathy tx (3)
Decrease protein intake, lactulose, rifaximin
102
Occupational exposure to HepB
IVIG + vaccine if non-immune
103
Classic causes of drug-induced hepatitis
TB meds (rifampin, isoniazid, pyrazinamide), APAP, tetracyclines
104
Hernia type most at risk for incarceration
femoral
105
Abdominal pain out of proportion to exam
Mesenteric ischemia
106
Watery diarrhea, dehydration, muscle weakness, flushing - dx & tx?
VIPoma. Replace fluids & electrolytes, octreotide, resection)
107
Causes of microcytic anemia (5)
Iron deficiency, lead poisoning, anemia of chronic disease, sideroblastic anemia, thalassemia
108
Precipitants of hemolytic crisis in G6PD Deficiency
Sulfa, fava beans, infections, nitrofurantoin, dapsone, isoniazid, antimalarials (quinines)
109
Most common inherited hypercoagulability dz
Factor V leiden
110
Most common inherited bleeding d/o
vWD
111
Diagnostic test for spherocytosis
Osmotic fragility
112
Pure RBC aplasia
Diamond-Blackfan anemia
113
Anemia + absent radii/thumbs, hyper pigmentation, cafe-au-lait spots, microcephaly, pancytopenia
Fanconi anemia
114
Meds (4) & viruses (4) that lead to aplastic anemia
Meds: Chloramphenicol, sulfa, radiation, chemo
Viruses: ParvoB19, EBV, HIV, Hepatitis
115
Polycythemia vera vs 2˚ polycythemia labs: Hct, RBC, O2 sat, Epo
Polycythemia vera: high hct & RBC, normal O2, low EPO
| 2˚ polycythemia: high hct, RBC, EPO, low O2 sat
116
TTP pentad
LMNOP - low platelets, MAHA, Neuro sx, "Obsolete" renal fxn, Pyrexia
117
HUS triad
Anemia (MAHA), thrombocytopenia, acute renal failure
118
Treatment for TTP
Large-volume plasmapheresis, corticosteroids, anti platelet drugs
NO platelet transfusion - they'll just get shredded
119
Treatment for ITP in children
Observe. May need IVIG or corticosteroids
120
Labs in DIC: fibrin split products, d-dimer, fibrinogen, plt, hct
```
Split: elevated
D-dimer: elevated
Fibrinogen: low
Plt: low
Hct: low
```
121
Med for hemophilia A
Desmopressin
122
Med for von Willebrand disease
Desmopressin (or FFP, cryoprecipitate)
123
Urine finding in multiple myeloma
Bence-jones protein
124
Reed-sternberg cells
Hodgkin Lymphoma
125
Anterior mediastinal masses
Thymoma, thyroid cancer, teratoma, terrible lymphoma
126
Ferritin
Iron stores. High in anemia of chronic disease, low in iron deficiency
127
Tumor lysis syndrome electrolytes
Low Ca2+
| High PO4, uric acid, K+
128
Bacterial causes of PNA in neonates (3)
GBS, listeria, e. coli
129
Bacterial causes of PNA in adults 40-65 (3)
S. pneumo, H. flu, Mycoplasma
130
Asplenic pts are particularly susceptible to (4)
Encapsulated organisms - pneumococcus, meningococcus, H. flu, klebsiella
131
Causes of ring-enhancing brain lesions (5)
Abscess, toxo, metastasis, lymphoma, AIDS, neurocysticercosis
132
Causes of meningitis in neonates (3). Treatment?
GBS, listeria, E. coli. [Amp + cefotaxime] or [amp + gent]
133
Causes of meningitis in infants (3). Treatment?
S. pneumo, H. flu, N. meningitidis. [vanc + ceftriaxone]
134
Sx of Lyme disease (6)
Erythema migrant, arthralgias, migratory polyarthropathies, facial nerve palsy, myocarditis, 3˚ heart block
135
SIRS criteria
Temp
Tachypnea
Tachycardia
WBC
136
Endocarditis exam findings (6)
Fever, murmur, Osler nodes, splinter hemorrhages, Janeway lesions, Roth spots
137
Bacteria in burn victim infections
Pseudomonas
138
Migraine prophylaxis (4)
Antihypertensives, antidepressants, anticonvulsants, dietary changes
139
Treatment of prolactinoma
Dopamine agonists (bromocriptine, cabergoline)
140
Crescentic brain bleed
Subdural hematoma; bridging veins
141
Lens-shaped brain bleed; lucid interval
Epidural hematoma; middle meningeal artery
142
Albumoniocytologic dissociation
Guillain-barre - elevated CSF protein without elevated WBC
143
First line med for status epilepticus
IV benzos
144
Confusion, ophthalmoplegia, ataxia
Wernicke encephalopathy, 2/2 thiamine deficiency
145
Treatment for ALS
Riluzole
146
Mainstay for Parkinson's treatment
Carbidopa/levodopa
147
Hyperphagia, hyper sexuality, hyperorality, hyperdocility
Kluver-Bucy syndrome (amygdala)
148
Chromosomal pattern of complete molar pregnancy
46, XX
149
Teratogenic abx
Tetracycline, fluoroquinolones, aminoglycosides, sulfonamides
150
Medical treatment for postpartum hemorrhage (1)
Oxytocin
151
PCOS therapy (2)
Weight loss, OCPs
152
Medical treatment for endometriosis (3)
OCPs, danazol, GnRH agonists
153
Increased vaginal discharge with petechial patches in upper vagina & cervix - cause?
Trichomonal vaginitis
154
Tx for bacterial vaginosis
Oral metronidazole
155
Bloody nipple discharge
Intraductal papilloma
156
Nipple itching, burning & erosion
Paget's disease of the breast - malignant
157
Urge incontinence treatment
Anticholinergics (oxybutynnin) or beta-adrenergic (metaproterenol)
158
Most common cause of female infertility
Endometriosis
159
ASCUS x 2 - now what?
Colposcopy & endocervical curettage
160
Breast cancer type that increases future risk of invasive carcinoma in BOTH breasts
Lobular carcinoma in situ
161
Kid with nontender abdominal mass, elevated VMA & HVA
Neuroblastoma - look for metastases
162
Most common type of tracheoesophageal fistula
Esophageal atresia with distal tracheoesophageal fistula - presents w inability to pass NGT
163
Contraindication to TDaP
Encephalopathy within 7 days of last TDaP - switch to just Td vaccines
164
Contraindication to rotavirus vax
Personal hx intususception
165
Meconium ileus causes (2)
CF, hirschprung disease
166
Bilious emesis after first feed
Duodenal atresia
167
2mo baby w nonbilious projectile emesis
Pyloric stenosis. Hydrate, replete lytes. Pyloromyotomy to fix problem
168
Infant w high fever, breaks, then rash. What is he at increased risk for?
Febrile seizure. Roseola (HHV6 & 7)
169
1-3mo kid with recurrent severe infections
Bruton's agammaglobulinemia - occurs earlier than T-cell immunodeficiencies (where sx start around 6mo)
170
Reye syndrome
Microvesicular fatty liver infiltration & mitochondrial damage causes fulminant liver failure
171
Other cancer associated with retinoblastoma
Osteosarcoma
172
First line tx otitis media
Amoxicillin x 10 days (then augmentin if failed)
173
Muscle rigidity, autonomic instability, fever, confusion, elevated CPK
Neuroleptic malignant syndrome
174
Side effects of atypical antipsychotics (3)
Wt gain, T2DM, QT segment prolongation
175
IV haldol then eyes are stuck looking sideways - dx & tx
Acute dystonia; diphenhydramine or benztropine
176
Treatment of acute mania
Lithium + atypical antipsychotic
177
Exudative pleural effusion criteria
Pleural/serum protein > 0.5
| Pleural/serum LDH > 2/3
178
Causes for exudative pleural effusion
Leaky capillaries 2/2 inflammation - malignancy, TB, bacterial or viral infection, PE with infarct, pancreatitis
179
Causes of transudative pleural effusion
Intact capillaries, increased hydrostatic pressure - heart failure, liver dz, kidney dz, protein-losing enteropathy
180
Dyspnea, hilar LAD, increased ACE, hyperCalcemia
Sarcoidosis, noncaseating granulomas
181
Honeycomb pattern on best imaging - dx & tx
Interstitial lung disease; supportive care
182
SVC syndrome treatment
Radiation & endovascular stenting
183
Acid-base derangement in Pulmonary Embolism
Respiratory alkalosis with hypoxia & low PaCO2
184
NSCLC associated with hypercalcemia
Squamous cell carcinoma (ectopic PTHrP)
185
Lung cancer associated with SIADH
Small cell lung cancer (ectopic ADH)
186
Lung cancer associated with Lambert Eaton
Small cell lung cancer
187
Lung cancers related to cigarettes (2)
SCLC, squamous cell carcinoma
188
Treatment for all (even small) spontaneous pneumothoraces
Supplemental O2
189
Hypoxemia & pulmonary edema with normal PCWP
ARDS
190
Sequelae of asbestos exposure (4)
Pulmonary fibrosis, pleural plaques, bronchogenic carcinoma (mass in lung field), mesothelioma (pleural mass)
191
Silicosis causes increased risk for what type of infection?
Mycobacterium tuberculosis
192
Causes of hypoxemia (4)
R>L shunt, hypoventilation, low FiO2, diffusion defect, V/Q mismatch
193
CXR: cardiomegaly, prominent pulmonary vessels, Kerley B lines, bats-wing appearance of hilarious shadows, perivascular & peribronchial cuffing
Pulmonary edema
194
Treatment of hypernatremia
NS if unstable vitals
| D5W or 0.45%NS to replace free water loss
195
DDX hypotonic hypervolemic hyponatremia (5)
Cirrhosis, heart failure, nephrotic syndrome, AKI, CKD
196
Treatment of hyperK
Calcium glutinate, bicarb, insulin + glucose, kayexalate
197
First-line tx for severe hyperCalcemia
IV fluids
198
Muscle spasms from tapping face or inflating BP cuff
Hypocalcemia
199
Acid base disturbance in salicylate ingestion
Gap metabolic acidosis (late) ; early primary respiratory alkalosis
200
Acid base disturbance in pregnancy
Respiratory alkalosis
201
RTA with abnormal H+ secretion & nephrolithiasis
Type 1 RTA (1 H, type 1)
202
RTA with abnormal bicarb reabsorption & rickets
Type 2 RTA (bi-carb, bi = 2, type 2)
203
RTA with low Aldosterone
Type 4
204
AKI with BUN:Cr > 20:1
Prerenal AKI
205
Muddy brown casts
Acute tubular necrosis
206
Drowsiness, asterixis, nausea, pericardial friction rub
Uremic syndrome 2/2 renal failure
207
Hematuria, HTN, oliguria, RBC casts
Neprhitic syndrome
208
Glomerulonephritis + deafness
Alport Syndrome
209
Glomerulonephritis + hemoptysis (2)
Goodpasture Syndrome
| Wegener's GPA
210
Proteinuria, hypoalbuminemia, edema, hyperlipidemia, thrombosis
Nephrotic syndrome
211
Waxy urine casts & maltese crosses (lipiduria)
Nephrotic syndrome
212
Most common form of nephrotic syndrome in adults
FSGS
213
Best test for nephrolithiasis
Non-contrast CT
214
US shows bilateral enlarged kidneys with cysts. Dx? What else to look for?
ADPKD. Check for brain aneurisms
215
BPH treatment options
Terazosin, finasteride, TURP
216
Most common type of bladder cancer
Transitional cell carcinoma
217
Hematuria, flank pain, palpable flank mass
Renal cell carcinoma
218
Most common type of testicular cancer
Seminoma (germ cell tumor)
219
Testicular cancer associated w high beta-hCG
Choriocarcinoma
220
Side effects of corticosteroids (6)
Acute mania, immunosuppression, thin skin, easy bruising, osteoporosis, myopathies
221
APAP overdose treatment
N-acetylcysteine
222
Benzo overdose treatment
Flumazenil (monitor for seizures)
223
NMS & malignant hyperthermia treatment
Dantrolene
224
Malignant HTN treatment
Nitroprusside
225
A-fib stabilization
Rate control, rhythm conversion, anticoag
226
Treatment for SVT (stable & unstable)
Stable: rate control w carotid massage or vagal maneuver. 2nd line: adenosine
Unstable: cardiovert (synchronized)
227
Causes of drug-induced SLE
INH, penicillamine, hydrazine, procainamide, chlorpromazine, methyldopa, quinidine
228
Macrocytic, megaloblastic anemia with neuro sx
B12 deficiency
229
Burnt patient with flushed skin, oral SaO2, elevated carboxyhemoglobin. Tx?
100% O2 (consider hyperbaric O2 if severe or pregnant)
230
Blood in urethral meatus, high-riding prostate
Bladder rupture or urethral injury
231
Test to r/o urethral injury
Retrograde cystourethrogram
232
Fluid repletion in burn victims - calculation
24h fluids = 4 x kg x %BSA
233
Acceptable urine output in trauma pt vs stable pt
Trauma: 50 cc/hr
Stable: 30 cc/hr
234
Spinal injury + hypotension + bradycardia
Neurogenic shock
235
Cushing triad - elevated ICP
Hypertension, bradycardia, abnormal respirations
236
Shock: low CO, low PCWP, high PVR. Tx?
Hypovolemic shock. Fluid/blood repletion
237
Shock: low CO, high PCWP, high PVR. Tx?
Cardiogenic shock. Inotropes (dobutamine)
238
Shock: high CO, low PCWP, low PVR. Tx?
Distributive (septic or anaphylactic) shock.
Septic: fluids & abx
Anaphylactic: 1:1000 epi, diphenhydramine
239
Pt with chest trauma was stable, suddenly dies. Why?
Air embolism
240
Distended neck veins, hypotension, diminished heart sounds. Dx? What other telltale symptom?
Cardiac tamponade. Pulsus paradoxus
241
Blunt or penetrating abdominal trauma + hemodynamically unstable. What's next?
Ex lap
242
Head trauma with immediate LOC, then Lucent period, then rapid deterioration
Epidural hematoma
243
Expanding neck mass after recent surgery - what's next
Wound exploration, hematoma evacuation
