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STEP2: Tidbits > TEST8 > Flashcards

TEST8 Flashcards

(42 cards)

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1
Q

Which part of spinal cord results in PARAPLEGIA, BLADDER/FECAL INCONTINENCE, ABSENT SENSATION from nipple downwards?

A

UPPER THORACIC SPINAL CORD (T4 = NIPPLE)

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2
Q

Which part of spinal cord results in ABSENT SENSATION FROM UMBILICUS downwards?

A

LOWER THORACIC SPINAL CORD (T10 = UMBILICUS)

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3
Q

Lesion of POSTERIOR FOSSA causes what sx?

A

N/V + ataxia

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4
Q

Typical presentation of MYELODYSPLASTIC SYNDROME?

Pt age, CBC panel, blood smear

A

Elderly

PANCYTOPENIA + macro-ovalocytic anemia (Elevated MCV, but not hypersegmented)

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5
Q

What is the mainstay Tx for VARICEAL BLEEDING?

A

OCTREOTIDE = SST analog

Inhibits vasodilator hormones -> Indirectly leads to splanchnic vasoconstriction + Decreased portal flow

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6
Q

What is the cutoff value of INR for transfusing FRESH FROZEN PLASMA (FFP)?

A

INR>1.6

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7
Q

What is the cutoff value of PLT transfusions?

A

PLT

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8
Q

What diagnostic tests should ALL cirrhosis pts undergo? Why?

What surveillance test should all cirrhosis pts undergo?

A

1) ESOPHAGEAL ENDOSCOPY - Because esophageal varices = major cause of morbidity/mortality that occurs in 50% of pts
2) Ultrasound surveillance for HEPATOCELLULAR CARCINOMA +/- aFP every 6mo

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9
Q

What is the PRIMARY prevention of VARICEAL HEMORRHAGE?

A

NON-SELECTIVE BETA BLOCKERS

Repeat EGD every year

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10
Q

What is the best anti-malaria chemoprophylaxis for short-term travelers to Sub-saharan Africa, southeast Asia?

A

Africa, Southeast Asia = high rates of chloroquine-resistant P falciparum
CHEMOPROPHYLAXIS with “MAD” - MEFLOQUINE, ATOVAQUONE-PROGUANIL, DOXYCYCLINE

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11
Q

What is the most commonly used anti-malaria chemoprophylaxis for travelers to Korea peninsula, Mexico?

A

Highest rates of P. ovale and vivax

Chemoprophylaxis with PRIMAQUINE

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12
Q

MRI: Multiple, hypodense, NON-ENHANCING lesions with no mass effect
Immunocompromised pt with HIV CD4Ct

A

PROGRESSIVE MULTIFOCAL LEUKOENCEPHALOPATHY

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13
Q

What is seen on imaging studies of AIDS Dementia?

A

CORTICAL/SUB-CORTICAL ATROPHY + secondary ventricular enlargement

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14
Q

When a SLE pt starts HYDROXYCHLOROQUINE therapy (TNF and IL-1 suppressor), what evaluation should be done periodically?

A

EYE EXAM

AE = retinopathy

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15
Q

LAB signs of ALCOHOLIC HEPATITIS:

A
  1. AST:ALT>=2
  2. Macro-ovalocytic anemia - MCV>100
  3. LOW PLT
  4. Slight ELEVATED INR
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16
Q

What distinguishes METABOLIC ALKALOSIS of SURREPTITIOUS VOMITING vs DIURETIC/GITELMAN/BARTTER?

A

Distinguish by URINE CL-
Vomiting = Saline-responsive MA = hypovolemia = HYPOCHLOREMIC = LOW URINE Cl-

Diuretic/Bartter/Gittelman = NORMOTENSIVE and HIGH URINE Cl-

Saline-resistant MA = EXCESS MINERALOCORTICOID = Increased H+/K+ loss and Increased Na+ retention = INCREASED EXTRACELLULAR VOLUME = INCREASED Na+/Cl- diuresis = HIGH URINE Cl-

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17
Q

What is the pharmacotherapy for RESTLESS LEG SYNDROME?

Study These Flashcards
A
  1. FIRST LINE = DOPAMINE agonists (PRAMIPEXOLE)**

2. ALPHA-2-DELTA CALCIUM channel ligands (GABAPENTIN, enacarbil)

18
Q

What is the non-pharmacotherapy therapy of PSVT (HR between 160-220 generally due to re-entry in AV node)?

What is the pharmacotherpy?

Study These Flashcards
A

DECREASE AV NODE CONDUCTIVITY by INCREASING VAGAL TONE (Vagal maneuvers - valsalva, carotid sinus massage, immersion in cold water)

PHARM: ADENOSINE

19
Q

Diseases that generally cause Mitral valve prolapse (4)

Study These Flashcards
A

MARFAN
EHLER DANLOS SYNDROME
MUSCULAR DYSTROPHY
GRAVES DISEASE

20
Q

Criteria for Long term O2 therapy

Study These Flashcards
A
  1. PaO2 55%, or POLYCYTHEMIA VERA
21
Q

Female pt with acute HIRSUTISM:

Which hormone can STIMULATE ERYTHROPOIESIS by suppressing hepcidin -> Increases HGB? Which pathology is thus associated?

Study These Flashcards
A

Female pt: TESTOSTERONE

Associated with hyper-androgenism (either OVARIAN or ADRENAL GLAND)

22
Q

How do you distinguish between HYPERANDROGENISM (ovarian source) and HYPERANDROGENISM (Adrenal source)

Study These Flashcards
A

OVARY: Elevated testosterone + NORMAL DHEAS

ADRENAL: Elevated testosterone + ELEVATED DHEAS

23
Q

PROLONGED PTT + FALSE POSITIVE VDRL + THROMBOCYTOPENIA + recurrent miscarriages = ?

Tx = ?

Study These Flashcards
A

ANTI-PHOSPHOLIPID SYNDROME

Tx = Low dose ASA + LMWH

24
Q

HYPERCALCEMIA + NORMOCYTIC ANEMIA + renal insufficiency (bence jones proteins) + PROTEIN GAP (total protein - albumin >4) = ?
Screening test?
How is diagnosis confirmed?

Study These Flashcards
A

MULTIPLE MYELOMA
M-spike SPEP

Confirmation: Bone marrow biopsy (>10% clonal cells)

25
What is the PRIMARY INTERVENTION to slow decline of DIABETIC NEPHROPATHY?
INTENSIVE BP CONTROL to target BP of 140/90 **Use ACE inhibitors/ARBs
26
What are the radiologic hallmark abnormalities of ASBESTOSIS - progressive dyspnea + clubbing + end-inspiratory crackles What is the associated occupational exposure?
INTERSTITIAL FIBROSIS + PLEURAL PLAQUES** Asbestos exposure - plumbers, shipyard workers, construction workers
27
What is the cutoff value for normal JVP?
5
28
What is the management for a pt with amitryptiline-induced urinary retention (SUPRAPUBIC FULLNESS + ABDOMINAL PAIN)?
URINARY CATHETERIZATION + D/c amitriptyline
29
What is an UPRIGHT ABDOMINAL X-RAY generally used for?
ILEUS SMALL BOWEL OBSTRUCTION TOXIC MEGACOLON
30
SIGNS of acute abdomen (e.g. BOWEL PERFORATION or MECHANICAL OBSTRUCTION)
GUARDING Absent bowel sounds (PERFORATION) GI Sx: Mod-severe abdominal pain, N/V DILATED BOWEL LOOPS WITH AIR FLUID - imaging
31
BRIGHT RED FRIABLE EXOPHYTIC NODULES in HIV infected pt = ?
BACILLARY ANGIOMATOSIS
32
NORMAL CSF GLC + ELEVATED CSF PROTEIN + ELEVATED CSF WBC (LYMPHOCYTES) Ct + FEVER/ AMS/ AGITATION/SEIZURES What is the most common etiological microbe? Empiric Tx while waiting for PCR?
ASCEPTIC (VIRAL) ENCEPHALITIS HSV IV ACYCLOVIR - empiric tx after LP results Confirm diagnosis - CSF viral DNA PCR
33
What is the main distinguish factor between CRYPTOCOCCAL MENINGOENCEPHALITIS and HSV ENCPHALITIS?
CRYPTOCOCCAL MENINGOENCPHALITIS = MARKEDLY ELEVATED opening pressure HSV encephalitis = nl opening pressure
34
CSF LOW Glc + CSF ELEVATED PROTEIN (>250mg) + CSF ELEVATED WBC Ct (neutrophil predominance) = ? What is the empiric Tx?
BACTERIAL SEPTIC MENINGITIS Empiric Tx = IV Ceftriaxone + Vancomycin Ampicillin if age>50yo
35
What is used to treat ALCOHOL WITHDRAWAL in hospitalized pts?
CHLORDIAZEPOXIDE (LLIBRIUM)
36
HIGH-VELOCITY EYE INJURY (drilling, hammering, grinding) - Greater probability of globe penetration + FOREIGN BODY** formation than low-velocity eye injury What is the next step of management?
FLUORESCEIN application -> Wood's lamp/slit lamp exam
37
How does an UPPER AIRWAY OBSTRUCTION (larygnospasm during extubation) cause NEGATIVE PRESSURE PULM EDEMA?
UPPER AIRWAY OBSTRUCTION - Inspiration against obstruction -> large negative intrathoracic pressure -> Non-cardiogenic pulm edema
38
2 Days after intubation, pt presents with high-grade fever. What does pt have?
VENTILATOR-associated PNEUMONIA
39
EXQUISITE TENDERNESS to gentle percussion over involved vertebra in IVDU/SICKLE CELL/ IMMUNOSUPPRESSED pt/ RECENT DISTANT SITE INFN (e.g. UTI) has highest suspicion for __?
OSTEOMYELITIS
40
What is the confirmatory diagnostic test for OSTEOMYELITIS?
MRI
41
What are the drugs that cause ACUTE INTERSTITIAL NEPRHITIS (fever, rash, arthralgia, eosinophilia in urine and blood, hematuria)? Tx?
``` 6P's: P - pee diuretics (thiazide) P - PPI P - pain analgesics (NSAIDS) P - rifampin, phenytoin P - Penicillins, cephalosporins, sulfa P - alloPurinol ```
42
How does ACUTE INTERSTITIAL NEPHRITIS present? What does UA show?
FEVER + MACULOPAPULAR RASH + RENAL FAILURE UA: WBC Casts + EOSINOPHILS

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