USMLE-Rx - Medicine Flashcards
(30 cards)
When should you prescribe a statin in the patient with DM?
In patients with diabetes aged 40-75 or age >30 with 15+ years of DM, or if they meet lipid-lowering criteria
What is Conn syndrome? What is the typical presentation?
Primary hyperaldosteronism, typically caused by an adrenal tumor. Presents as refractory hypertension and hypoK+
What is the diagnosis in this 56yo who presents with pancytopenia, fatigue, easy bruising, night sweats and splenomegaly? What is the 1st line therapy?
Hairy cell leukemia. Cladribine or pentostatin are 1st line (adenosine deaminase purine metabolism inhibitors).
What does purified protein derivative testing test for
Tb
What is the explanation for pulsus paradoxus blood pressure variability
The pathoogy of pulsus paradoxus is that inspiration increases RV filling which compresses the LV and reduces stroke volume
What are the most common sites of extrapulmonary involvment of coccidioidomycosis?
Skin and CNS
What does CREST syndrome stand for?
Calcinosis Raynaud's Esophageal dysmotility Scleroderma Telangiectasia
What antibody is elevated in CREST syndrome? What about diffuse scleroderma?
CREST - Anticentromere antibody or antinucleolar antibody
Diffuse scleroderma - Anti-Scl-70 (anti-DNA topoisomerase I)
What antibody is elevated in SLE?
Anti-Smith and anti-SSA (the latter also in Sjogrens)
What type of antibody is elevated in primary sclerosing cholangitis or small-vessel vasculitis?
ANCA (antineutrophil cytoplasmic antibody)
What kidney drugs cause hypokaliémie? Hyperkalemia?
Hypokaliémie can be caused by loop diuretics or thiazide diuretics
What type of pathology is associated with an S4 and a crescendo decrescendo systolic murmur that worsens with valsalva?
HOCM - abnormal mitral valve.
Which arrhythmia is most commonly found in the setting of HOCM? Which arrhythmias lead to sudden death?
A fib. Vtach and V fib cause sudden deaths.
How do you distinguish between post-strep glomerulonephritis and IGA néphropathie?
Timing: iga can be concurrent or shortly after illness whereas post strep is weeks later
Complement: C3 is low in post strep
What does Medicare part A cover
Hospital care, hospice, nursing home or home health care.
What does medicare part B cover?
Outpatient services, preventative care, clinical research, ambulance, medical equipment
What is medicare plan C cover?
C is for private coverage / medicare advantage programs
What treatment (in addition to blood pressure control) can slow the disease progression of ADPCKD
The most effective measure to slow disease progression in young patients with ADPCKD is tolvaptan, an ADH V2R receptor blocker.
What do you give for prophylactic of someone who has calcium oxalate stones?
Thiazide diuretic (reduces ca2 in urine by increasing calcium resorption)
What type of crystals are found in the setting of gout?
Urate crystals
When you see suspect a gastrinoma and angiofibromas, what blood test should you order?
This is MEN1 - think hypercalcemia from parathyroid adenomas
What is the window to administer tPA for stroke?
Less than or equal to 4.5hrs since last known well
Are PPD tests reliable for TB diagnosis in individuals who are HIV +ve?
No, not below 500 CD4
Tumor lysis syndrome: what is the constellation of metabolic disturbances)
hypoCa2+
hyper PO4
hyper K+
hyperuricemia
