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Set 5 Flashcards

1
Q

hypopigmented spots, axillary freckles, skin nodules, lisch nodules

A

NF 1 or 2

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2
Q

heart sound in MI

A

4th heart sound = atrial gallop (diastolic dysfxn and stiff LV)

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3
Q

Tx bradycardia

A

IV atropine (muscarinic antagonist –> decreases vagal influence on SA node) then transcutaneous pacing

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4
Q

amylase in left-sided pleural effusion (3)

A

esophageal rupture, pancreatitis (or ruptured pseudocyst), or cancer

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5
Q

Tx prinzmetals angina

A

CCBs and/or nitrates

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6
Q

infant with central vs. peripheral cyanosis

A

central = hypoxemia in arteries suggesting CHD (ex perioral cyanosis but warm extremities)

peripheral = low cardiac output causing low blood flow/ excessive vasoconstriction –> normal PaO2, cold, cyanotic distal extremities

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7
Q

macrocytic anemia, leukopenia, thrombocytopenia and decreased segmentation of PMNs

A

myelodysplastic syndrome

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8
Q

Deficiency seen in carcinoid syndrome

A

Niacin (its precursor, tryptophan, gets all used up to make serotonin)

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9
Q

MRI shows butterfly appearance with central necrosis

A

GBM

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10
Q

MRI shows heterogenous, serpiginous contrast enhancement

A

high grade astrocytoma

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11
Q

SLE patient taking hydroxychloroquine, what test does she need to have?

A

eye exams q6mo looking for retinopathy and/or corneal damage

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12
Q

akathisia vs. dystonia vs. tics vs. myoclonus vs. chorea

A
  • akathisia - restlessness
  • dystonia - sustained muscle contraction - twisting, repetitive movements, or abn postures. focal or diffuse. ex. torticollis
  • athetosis - slow, writhing movements. ex. huntington’s. rett’s syndrome.
  • tics - repetitive movements or vocalizations. ex. tourette’s
  • myclonus - jerking movements
  • chorea - brief, irreg, flowing movements
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13
Q

What is a sestamibi scan for?

A

direct treatment in patients with hyperPTH either sx or asx with Ca>11, GFR<60 +/- osteoporosis

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14
Q

Esophageal tests algorithim for ordering if broad ddx

A

Barium esophagram then EGD then esophageal motility

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15
Q

Esophageal varices vs Mallory-Weiss Tears?

A

varices = VEINS (2/2 portal HTN)

MWT = ARTERIES (2/2 mucosal tears from heaving)

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16
Q

HIV drug causing hypersensitivity syndrome

A

abacavir (NRTI)

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17
Q

Eggshell calcification of hepatic cyst? Tx?

A

hydatid cyst = Echinococcus (via dog exposure)

Tx = Careful surgical drainage w/ albendazole

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18
Q

At what cutoff is it ok to give bicarb for metabolic acidosis?

A

pH <7.2, ie severe

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19
Q

Proximal muscle weakness + elevated CK? Tx?

A

dermato/polymyositis

Tx HIGH dose steroids (vs PMR)

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20
Q

CI of triptans (3)

A

uncontrolled HTN, CAD, Pregnancy

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21
Q

HIV drug causing hematuria w/ crystal-induced nephropathy

A

Indinavir (Protease Inhibitor)

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22
Q

Calcium levels in alkalosis, why?

A

decreased due to higher affinity of albumin for calcium

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23
Q

abnormality in coagulation profile in lupus

A

prolonged PTT 2/2 anticardiolipin Ab

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24
Q

Lip telangiectasias, epistaxis and polycythemia with normal WBC and plts

A

Hereditary telangiectasia aka Osler-Weber-Rendu

= AVMs occur primarily in mucus membranes, skin and GI tract but also liver, lung and brain

25
Liver mass histology with atypically enlarged hepatocytes containing glycogen and lipid deposits
hepatic adenoma
26
heberden nodes and bouchard nodes
OA = osteophyte formation in DIP and PIP respectively
27
Tx cerebral hemorrhage while on warfarin
d/c warfarin, ASA and other anticoagulants | give FFP and Vit K
28
Muscles+nerves involved in arm abduction
supraspinatous (suprascapular n) --> 1st 15 deg deltoid (axillary n) --> 15-90 deg trapezius (CN 11) and serratus anterior (LTN) --> lift above horizontal
29
Calcified adrenal glands =
primary adrenal insufficiency caused by TB (granulomas cause hypercalcemia)
30
Tx sarcoidosis
steroids (if sx)
31
Tx Li-induced DI
amiloride and NS (nephrogenic DI, diuretic actually induces retention in other tubules)
32
Elderly patient who is slow moving, depressed and signs of dementia? Dx?
pseudodementia (2/2 depression = psychomotor retardation) | Dx = dexamethasone suppression test, 50% are abnormal
33
1st line tx osteoarthritis
TYLENOL (not NSAIDs due to higher SE profile)
34
Older patient with AMS, muscle twitching and sharp waves on EEG
think CJD
35
Bacillary angiomatosis bug, type and tx
Bartonella henselae = gram - bacillus | Tx = erythromycin (macrolide)
36
Tx ascitis
Na/H2O restriction --> spironolactone --> loop diuretic --> paracentesis
37
Diabetic with ear drainage? Dx, tx?
malignant otitis media = pseudomonas Can cause CN palsies --> requires CT/MRI Tx = IV ciprofloxacin
38
2 drugs that help with cachexia in cancer patients
``` 1st = progestin 2nd = steroids (more SE) ```
39
Use of primidone? SE
mainly 2nd line tx for essential tremor (its an anticonvulsant) SE = precipitates acute intermittent porphyria
40
Pregnant mom at 30wks develops intense pruritis, skin lesions, hyperbilirubinemia, increased bile acids and transaminitis? Dx? Tx?
Intrahepatic Cholestasis of pregnancy major = increased bile acids in serum Tx = ursodeoxycholic acid > hydroxyzine or cholestyramine. Deliver baby when lungs are mature.
41
high fevers, chills, tenosynovitis, migratory polyarthralgias, pustules on extremities and NEGATIVE blood cx
disseminated neisseria gonorrhea
42
Tx PCP in AIDS
IV bactrim +/- oral steroids
43
Tx strep throat
Penicillin or amoxicillin, if pcn allergy then erythromycin
44
Ca, K, phos, uric acid in tumor lysis syndrome? por que? Tx?
``` increased K, Phos and uric acid (protein degredation) decreased Ca (released phos bind Ca) Tx = allopurinol (decreased urate nephropathy) ```
45
Elderly gets pneumonia after URI, CXR demonstrates multiple thin-walled cavities?
Staph aureus! only bug that causes post-viral URI necrotizing pulmonary bronchopneuonia with abscesses (cavities)
46
Pencil in cup deformity
Psoriatic arthritis (distal phalangie resorption)
47
fever, chills, sore throat, "hot potato" voic, deviated uvula? Tx?
Peritonsillar abscess | Tx = aspirate abscess and IV abx +/- sgy
48
KID with sore throat gets abx, then 1 week later develops rash, arthralgias, LAD and fever?
Drug hypersensitivity (type 3) reaction similar to serum-sickness; can occur after treating viral infxn with abx
49
Tx SIADH?
mild = water restriction, incr. salt intake (2nd line democlocycline) severe (<120) = hypertonic saline (3%)
50
Traztuzumab use? SE?
HER2/NEU antibody | SE = cardiotoxic --> get echo before starting
51
2 immune-COMPLEX mediated nephropathies? which has a lower C3 level?
PSGN and MPGN | MPGN has lower C3 (seen in SLE, HIV, HBV, HCV)
52
non-anion gap metabolic acidosis and hyperkalemia in diabetic with renal insufficiency
RTA type 4 = aldosterone deficiency or renal tubule insensitivity
53
Tx giardia
metronidazole
54
Iron, TIBC, ferritin and % transferrin sat in iron deficiency anemia?
Increased TIBC | All others decreased
55
Tx human bite
Augmentin (amoxicillin+clavulanate)
56
Hyperglycemia, necrotizing dermatitis and diarrhea/weight loss? Dx?
glucagonoma triad | dx = hyperglycemia and incr. glucagon, tumor on CT
57
Difference b/w arthritis in SLE vs. RA
SLE arthritis is NOT deforming (and thus no permanent)
58
Tx MS acute attack vs. relapsing-remitting vs. progressive?
``` acute = steroids relapse-remit = IFN-beta, glatiramer acetate progressive = immunosuppressants (cyclosporine, MTX, mitoxantrone) ```

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