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Flashcards in Test Deck (126)
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1
Q

TB effusions breakdown?

A

EXUDATIVE

  • High protein levels (>4)
  • Lymphocytic leukocytosis
  • Low glucose levels (500)
  • low pH
2
Q

Empyema has high amount of what type of cells in effusion fluid?

A

neutrophils

3
Q

reactive nonstress test (pregnancy)

A
  • baseline fetal HR 110-160
  • Mod variability (6-25/min)
  • > =2 acceleration in 20 min each peaking >-15/min above baseline and lasting >=15 sec
4
Q

HSV encephalitis findings in CSF?

A
  • lymphocytic predominance
  • WBC elevated, but not severely
  • inc protein
  • elevated RBC count (high)
  • nL glucose
5
Q

Acute bacterial meningitis CSF pattern?

A
  • HIGH WBCs (1000s)
  • Neutrophil predominence
  • low glucose
  • elevated protein
6
Q

Chronic bacterial meningitis (ie TB) CSF findings?

A
  • inc WBCs (100s)
  • Lymphocytic predominence
  • Very low glucose
  • inc protein
7
Q

neurogenic claudication is?

A

low extremity pain w/ extension of spine (walking, prolonged standing, etc)

8
Q

neurogenic claudication (pseudoclaudication) - think?

A

spinal stenosis

9
Q

pain on walking and prolonged standing w/ relief w/ leaning forward or walking up hill, think?

A

spinal stenosis

10
Q

ACTH is what type of molecule

A

polypeptide

11
Q

Calcitrol is what type of molecule?

A

Sterol vitamin

12
Q

Cortisol is what type of molecule

A

steroid hormone

13
Q

name some arachidonic acid derivatives?

A
  • leukotrienes

- prostaglandins

14
Q

AA derived hormone examples?

A
  • serotonin
  • NE
  • Epi
15
Q

amniotomy is aka?

A

artificial rupture of membranes

16
Q

> =2 on CHADVASC w/ afib treat how?

A

oral anticoagulants

17
Q

1 on CHADVASC w/ afib treat how?

A

none, aspirin, or oral anticoagulants – discretionary

18
Q

prophylaxis against MAC for CD4

A

Azithromycin

19
Q

headache worse when leaning forward - think?

A

SVC syndrome

20
Q

facial and upper extremity swelling, JVD, no peripheral edema, headache worse when leaning foward - think?

A

SVC syndrome

21
Q

most common cause of SVC syndrome?

A

malignancy (lung or lymphoma)

22
Q

Primary treatment for malignancy related SVC syndrome?

A

radiation therapy

23
Q

concern for aspiration pna do what?

A
  • diet modification
  • elevated head of bed
  • jejunal feeding can dec aspiration risk, but others (NG tube, PEG actually INC risk of aspiration)
24
Q

greater than 250 neutrophils in ascitic fluid is?

A

Spontaneous bacterial peritonitis

25
Q

subepidermal cleavage is?

A

bullous pemphigoid

26
Q

intraepidermal clevage is?

A

pemphigus vulgaris

+acantholysis

27
Q

neurodermatitis?

A

skin picking disorder

28
Q

Ab against hemisdesmosomes?

A

bullous pemphigoid

29
Q

Ab against desmosomes?

A

–> acantholysis

Pemphigus vulgaris

30
Q

treatment of bullous pemphigoid?

A

high potency topical glucocorticoids

31
Q

brain mets look like what on MRI?

A

peripheral, circumscribed, enhancing lesions w/ vasogenic edema surrouding

32
Q

tension pneumothorax cardiovascular effect?

A

HypOtension due inc intrathoracic pressure –> DEC Venous return

33
Q

evidence of denervation think what type of gen neuro disease?

A

LMN disease

m. atrophy, fasciculations

34
Q

hyperreactive reflexes, UMN or LMN?

A

UMN

35
Q

muscle atrophy, UMN or LMN?

A

LMN

36
Q

complex seizures involve?

A

loss of consciousness

37
Q

partial seixure involve

A

seizure activity w/in focal area of brain

38
Q

Initial treatment for stable monomorphic V tach?

A

Loading dose of IV Amiodarone

39
Q

adenosine used to treat what cardiac issue?

A

Supraventricular tachycardia

40
Q

Pt w/ chest pain, hematemesis, SOB, L pleural effusion, post esophageal procedure – think?

A

esophageal rupture

41
Q

Associated w/ esophageal rupture (2)?

A
  • pleural effusion (esp L)

- Pneumomediastinum –> mediastinitis

42
Q

chronic pancreatitis usually due to?

A

alcoholism

43
Q

simple non invasive test for Peripheral vascular disease?

A

Ankle brachial Index

1 - 1.3 = nL
0.4 - 0.9 = PVD

44
Q

pts w/ strep gallolyticus endocarditis should also have what done?

A

Colonoscopy

45
Q

strep gallolyticus infx inc risk for what two things?

A
  • endocarditis

- colorectal cancer

46
Q

most common organisms that can cause epiglottitis in adults (esp unvax)?

A

Hib

Step pyogenes

47
Q

rupture of maternal dcidual vessels –>?

A

placental abruption

48
Q

vaginal bleeding + hypertonic, distended, tender uterus – think?

A

placental abruption

49
Q

substances that inc risk of placental abruption?

A

cocaine

tobacco

50
Q

painless vaginal bleeding after ROM - think?

A

vasa previa

51
Q

painful 3rd trimester bleeding?

A
  • placental abruption

- uterine rupture

52
Q

painless 3rd trimester bleeding?

A
  • vasa previa

- placenta previa

53
Q

risky sex –> papule –> painless ulceration w/ painless inguinal denopathy – think?

A

syphilis

54
Q

painful ulcer + painful lymphadenopathy - think?

A

Chancroid (h. ducreyi)

55
Q

painless genital ulcer w/ red, beefy base and NO adenopathy - think?

A

Granuloma inguinale (Klebsiella caused)

56
Q

differences b/t granuloma inguinale and syphilis caused chancre?

A

S: adenopathy & ulcer will resolve on own w/o treatment (moving to 2nd stage of syphilis)

GI: NO adenopathy, will NOT resolve w/o abx

57
Q

recurrent sinopulmonary and GI infx beginning after 6mo w/ small tonsils suggests?

A

X-linked agammaglobulinemia (Bruton’s)

58
Q

x-linked aggamaglobulinemia due to? causes?

A

defect in tyrosine kinase –> prevents dev of mature B cells

–> dec immunoglobulins and B cells (nL T cells) & NO response to vax

59
Q

treatment of x-linked agammaglobulinemia?

A

monthly IVIG

+/- prohylactic abx (only if IVIG not protective enough)

60
Q

what vaccines are contraindicated in x-linked agammaglobulinemia?

A

LIVE vax

can give others, but won’t generate meaningul Ab response

61
Q

which bugs associated w/ complement deficiencies?

A

disseminated bacterial infx particularly w/ ENCAPSULATED bacteria (ie strep pneumo, neisseria)

62
Q

which ingx associated w/ CGD?

A

recurrent skina nd pulm infx w/ CATALASE-positive org (staph, serratia, etc)

63
Q

adenosine deaminase deficiency effects what cells?

A

impaires T cell dev –> SCID

64
Q

most common predisposing factor for acute bacterial sinusistis?

A

Viral upper respiratory infx

65
Q

First line treatment for acute bacterial sinusisits?

A

Amoxicillin w. clavulanic acid

66
Q

low PCWP, low RA pressure, inc SVR, and low mixed oxygen venous sat – what type of shock?

A

Hypovolemic

67
Q

inc RA pressure, inc PCWP, inc SVR, dec mixed venous osxygen sat - what type of shock?

A

cardiogenic

68
Q

slight dec RA pressure and PCWP, dec SVR, inc mixed venous oxygen sat - what type of shock?

A

Septic shock

69
Q

nL avg RA pressure?

A

4mm Hg

70
Q

nl avg PCWP pressure?

A

9mm Hg

71
Q

RA pressure and PCWP pressure can indicate what overall vascular situation?

A

preload

72
Q

SVR indicates what greater vascular situation?

A

afterload

73
Q

most common bacterial infx for kids w/ CF?

A

staph aureus! (20)

74
Q

First line antiHTN meds in pregnancy?

A
  • Beta blocker (labetalol)
  • Methyldopa
  • Hydralazine

*Calcium channel blockers (nifedipine) – other 3 more common

75
Q

contradindicated HTN meds in pregnancy?

A
  • ACE inhibitors
  • ARBs
  • Aldosterone blockers
  • Furosemide
  • Direct renin inhibitors (aliskiren)
76
Q

most common septic arthritis organisms birth - 3mo old?

A
  • staph
  • GBS
  • Gram neg bacilli
77
Q

abx for septic arthritis birth - 3mo old?

A
  • antistaph agent (ie nafcillin or vanco)
    AND
  • Gentamicin or cefotaxime (cover for gram negs)
78
Q

Most common septic arthritis organisms >3mo?

A
  • staph
  • strep A
  • Strep pneumo
79
Q

abx for septic arthritis >3mo?

A

Nafcillin clinda, cefazolin, or vanco

80
Q

gradual loss resulting in tunnel vision think?

A

open angle glaucoma

81
Q

cupping of optic disc - think?

A

open angle glaucoma

82
Q

retinal detachment presents how?

A

unilateral blurred vision that progressively worsens

83
Q

retina hanging in vitreous w/ unilateral blurred vision that has progressively been worsening?

A

retinal detachment

84
Q

macular degeneration effects where in the vision?

A

central vision

85
Q

distorted vision and central scotoma - think?

A

macular degernation

86
Q

multiple sores in macular region w/ central scotoma?

A

atrophic macular degernation

87
Q

new blood vessels in retina that are bleeding or scarring the retina w/ central scotoma think?

A

exudative macular degeneration

88
Q

sudden, unilateral visual impairement usually noted upon waking in the morning - think?

A

Central retinal vein occlusion

89
Q

disc swelling, venous dilation and tortuiosity, retinal hemorrhages, and cotton wool spots - think?

A

central retinal vein occlusion

90
Q

microaneurysms, hemorrhages, exudates, and retinal or macular edema - think?

A

simple retinopathy

91
Q

microaneurysms, hemmorrhages, macular edema, w/ cotton wool spots think?

A

preprolierative retinopathy

92
Q

microaneurysms, hemorrhages, macular edema, exudates w/ newly formed vessels think?

A

proliferative or malignant retinopathy

93
Q

n/v, abd pain, diffuse muscle aches w/ dilated pupils, yawning, piloerections, and lacrimation - think?

A

heroin withdrawal

94
Q

inc appetite, hypersomnia, fatigued, irritable, severe depression - think?

A

stimulant withdrawal

(ie cocaine, meth)

95
Q

epigastric pain w/ high BMI, ALT >150 and elevated alk phos – think?

A

gallstone pancreatitis

96
Q

hydrocele?

A

fluid collection w/in processus or tunica vaginalis

97
Q

communicating vs non communicating hydrocele?

A

diff is whethere procesus vaginalis has obliterated or not

comm: PV NOT obliterated (so fluid can communicate w/ peritoneal fluid still - still a track there)

non comm: PV obliterated (canNOT communicate b/c no track, so just a fluid collection)

98
Q

mass transilluminates in scrotum think?

A

hydrocele

99
Q

treatment of hydrocele in infant?

A

reassure and observe, most will sponaneously resolve by 1yo

100
Q

communicating hydrocele at 18 mo - treat?

A

surgical repair

communicating hydroceles that persist beyond 12mo of age are unlike to self resolve and –> inc risk of indirect inguinal hernia

101
Q

1 episode of MDD that responds to acute treatment - how long due you treat for?

A

continue antidepressent for 4-9 months (continuation phase)

102
Q

When do you choose maintenance phase for depression treatment and how long is it?

A

Maintenance treatment is 1-3 yrs on stable regimen

For:

  • recurrent MDD (multi epi)
  • chronic epi (>=2yrs)
  • strong fam hx
  • severe epi (ie suicide attempt)
103
Q

when do you keep pts on antidepressants indefinitely?

A

Pt w/ hx of highly reccurent (>= 3 epi)

very severe, chronic maj depressive episodes (last a long time w/ severe symp - ie suicide attempt)

104
Q

diff dx for t wave inversion? (5)

A
  • MI
  • Myocarditis
  • Old pericarditis
  • Myocardial contusion
  • Digoxin toxcitiy
105
Q

best treatment for acute low back pain likely due to disk herniation?

A

early mobilization and NSAIDs

- get back to daily activities ASAP

106
Q

what type of gait in parkinson’s disease?

A

hypokinetic w. narrow base and stooped posture w/ short steps that cause shuffling

107
Q

waddling gait –?

A

muscular dystrophy due to weakness of gluteal m.

108
Q

acute COPD exacerbation treat w/?

A
  • O2
  • short acting bronchodilators (b2 adrenergic agonist or anticholinergic agent)
  • SYSTEMIC steroids
  • abx as needed
109
Q

sialadenosis is?

A

benign, noninflammatory swelling of the salivary glands (non tender)

110
Q

what is sialadenosis associated w/

A
  • advanced liver disease

- malnutrition (DM, bulemia, etc)

111
Q

submandibular glandular swelling and pain w/ meals - think?

A

salivary gland stone

112
Q

initial treatment of dermatitis herpetiformis?

A

Dapsone

113
Q

atrophy of caudate nucleus - think?

A

huntington’s

114
Q

huntington typical finding on CT?

A

atrophy of caudate nucleus

115
Q

diffuse atrophy of cerebral cortex feature of what disease?

A

alzheimer’s

116
Q

atrophy of lenticular nucleus feature of?

A

Wilson’s disease

117
Q

Atrophy of front and/or temporal lobes is a feature of ?

A

Pick’s disease

118
Q

Alzheimer’s finding on CT head?

A

diffuse atrophy of cerebral cortex

119
Q

bone pain + headache + unilateral hearing loss + femoral bowing - think?

A

Paget disease of bone

120
Q

paget disease of bone due to?

A

osteoclast dysfunction –> inc bone breakdown and turnover

121
Q

mosaic pattern of lamellar bone - most common?

A

Paget disease of bone (osteoclast dysfunction)

122
Q

steatorrhea can –> bone pain, why?

A

stetorrhea –> malabsorption of vit D –> vid D deficiency –> 2ndary hyperparathyroidism (low Ca, low phos, high PTH) –> osteomalacia

123
Q

urine hydroxyproline is from?

A

breakdown of collagen

124
Q

what are levels of urine hydroxyproline in paget’s disease?

A

elevated

125
Q

paget disease serum Ca and Phosphate levels are?

A

NORMAL

126
Q

high alk phos, high urine hydroxyproline, nL Ca and phos - think?

A

Paget disease of bone