inclusion bodies in hepatocytes, MCC alcoholic hepatitis >>> PBC, NASH, Wilsons and HCCA

Set 7 Flashcards by Matthew Mollman

IBD, hypotension, tachycardia, leukocytosis, fever? Dx?

MC toxic megacolon (vs. abscess but no cardio sx)

Dx = abd xray

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8 drugs that cause HYPERkalemia

nonselective BB, ACEI/ARB, Spironolactone, cyclosporine, digoxin, NSAIDs, heparin, succinylcholine

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painful eye, erythema, visual disturbances, severe HA, b/l periorbital edema and cranial nerve deficits (ocular)

cavernous vein thrombosis (2/2 orbital cellulitis)

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UTI in indwelling catheter with ALKALINE urine pH

alkaline, think proteus mirabilus (produces urease)

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Tx TIA

start ASA +/- dipyridamole

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immediate complication (w/in 3days) of SAH, Tx?

vasospasm –> tx = dihydropyridine CCB

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palatal ulcers, HSM, pancytopenia in patient from missouri

disseminated histoplasmosis

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50 yo w/ dysphagia and neck mass when eating? Tx?

zenker’s diverticulum (above UES)

tx = excision and cricopharyngeal myotomy

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D-xylose test used for…(2), how to differentiate

tests for intactness of GI mucosa –> Celiac d/s and bacterial overgrowth. If pt improves after abx, then it was bacterial overgrowth

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fever + abrupt onset sharply demarcated w/ raised borders, red, edematous tender skin lesions?

erysipelas, MCC GAS > s aureus

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group a strep =

strep pyogenes

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Mallory bodies

inclusion bodies in hepatocytes, MCC alcoholic hepatitis&raquo_space;> PBC, NASH, Wilsons and HCCA

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SE cyclophosphamide (2)

hemorrhagic cystitis, bladder cancer

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pleural effusion in cirrhotic ascites patient? Tx?

hepatic hydrothorax 2/2 small diaphragmatic defects

Tx = thorocentesis, salt restriction, diuretics, TIPS last resort

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Best tx for young parkinson’s patient with tremor as main sx

trihexyphenidyl (anticholinergic)

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drugs precipitating G6PD deficiency hemolytic episode (6)

“hemolysis IS PAIN”

Isoniazid, Sulfonamides, Primaquine, Aspirin, Ibuprofen, Nitrofurantoin

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Prussian blue detects… used often for…

detects iron, often used to dx hemolysis

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E- abnormalities in alcoholics

low K, Mg, phos (low mg causes refractory low k)

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management of cold hand without radial pulse

immediate heparin and sgy consult for embolectomy

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pain b/w 3rd and 4th toes that is reproduced with palpation and makes a clicking sensation? Tx?

Morton neuroma = mechanically* induced degenerative neuropathy seen in runners
Tx = orthotics +/- steroid injections, last resort sgy

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3 drugs for tx gastroparesis

metoclopramide (DA antagonist)
bethanechol (anti-muscaranic)
erythromycin (motilin inducer)

SE methotrexate (3), routine testing, prophylaxis

SE = mouth ulcers, hepatotoxic, myelosuppressive

CBC q3mo, prophylaxis = folate

PAS positive, 2 diseases?

whipple’s = foamy macrophages in intestinal LP

alpha-1 AT deficiency = globules in liver

Tx heparin and warfarin reversal

heparin = protamine sulfate
warfarin = FFP 1st then vit K

no meconium in first 48 hrs, 2 ddx and ass. d/s?

hirschsprungs --> Downs | meconium ileus --> CF

5 dx criteria metabolic syndrome?

``` 3+ needed: abd obesity (>40in or 35in) fasting BG >100 BP> 13/80 TG>150 HDL (<50 female) ```

AST and ALT in alcoholics

AST: ALT 2:1 | <500

40 yo with rash on palms, soles and trunk. 2 ddx, differentiate b/w them? Tx?

RMSF = periph-->central. Tx doxy or chloramphenicol in prengancy) secondary syphilis = central-->periph. Tx IV benzathine PCN weekly x3

Causes of pancreatitis "get smashed"

Gallstones, Ethanol, Trauma, Steroids, Mumps, Autoimmune ds, Scorpion sting, Hypercalcemia/triglyceridemia, ERCP, Drugs

Tx cryptococcal meningitis in AIDs?

amphotericin B + flucytosine

Spherocytes on blood smear, 2 ddx? differentiate?

Hereditary spherocytosis = negative direct coombs | AIHA = positive direct coombs

After pt travels to mexico 2mo ago, develops watery diarrhea and liver abnormalities? Tx?

``` Amebic abscess (E. histolytica) Tx ORAL metronidazole. only drain if that FAILS ```

earliest manifestations of alzheimers vs NPH vs Lewy Body

Alzheimer = memory+visuospatial NPH = gait Lewy Body = visuospatial

metoclopramide MoA, uses and SEs?

a DA antagonist used for anti-emetic, promotility and allodynia but it is NOT (for whatever reason) an antipsychotic like other DA antagonists SE = EPS

Severe dysesthesia, hemianesthesia and athetosis

thalamic nucleus (VPL nucleus transmits SENSORY)

Criteria for mild vs. severe pre-eclampsia

both >20wks gestation Mild = >140/90, proteinuria >0.3g/d, +/- edema severe = >160/110, >5g/d, oliguria, transaminitis, thrombocytopenia, pulmonary edema

Tx mastitis

- dicloxacillin or cephalosporin + analgesics | - continue to breast feed from BOTH breasts

Tx hypernatremia

no AMS = oral free water mild/moderate AMS = IV D5W or 1/2NS 12mEq/d severe = same but at rate of 1mEq/hr if HYPOVOLEMIC --> always use NS (or isotonic solution) to restore perfusion 1st

small bleeds at gray-white matter jxn?

DAI

ddx osmolar gap MA, tx?

methanol (eye problems), ethanol, ethylene glycol (causes hypocalcemia and ca-oxalate stones) Tx = fomepizole +/- sodium bicarb

clear, abundant stringy cervical mucus, which phase of cycle?

ovulatory/follicular/proliferative --> ferning on slide, pH >6.5. Allows penetration by sperm (vs thicker, acidic luteal phase that is hostile)

3 drug classes causing hyperkalemia

ACEI, NSAID, K-sparing diuretics

digital clubbing and acute-onset arthropathy? a/w? Dx?

hypertrophic osteoarthropathy, often a/w lung cancer, TB, bronchiectasis or emphysema --> Get CXR

Tx TCA OD? MoA?

Sodium bicarb --> alleviates depressant effect on sodium channels which narrows the QRS and prevents arrhythmia

FSGS a/w 4 populations

blacks, obese, IVDU, HIV

menstrual/lower ab pain 2 weeks into cycle, ddx?

Mittelschmerz - midcycle pain 2/2 ovulation | ovarian torsion --> medical emergency! (N/V, adnexal mass, radiating pain)

congenital HIV prevention?

Ziduvodine through pregnancy/labor, and give to baby for 6 wks. --> better also C-section, no breast feeding

W/u hirsuitism in pregnancy

US: no mass--> CT abd to look for adrenal mass b/l cystic mass --> theca lutein cysts, r/o high BhCG -b/l solid mass --> pregnancy luteoma, benign unilateral solid mass --> surgery to r/o malignancy

Sign of MgS overdose in pre-eclampsia, tx?

hyporeflexia, RR8, abnormal VS | Tx = calcium gluconate and d/c MgS

Lower abd pain that radiates, at onset of period, dx? MoA? Tx?

primary dysmenorrhea 2/2 increased prostaglandin breakdown of endometrium. Tx NSAIDs or OCPs