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Flashcards in UW 11 Deck (40)
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1
Q

What are complement levels in SLE kidney dz and post strep GN and why?

A

Low

Immune complexes deposit in renal glomeruli - damaging - activate complement

2
Q

Goodpasture’s syndrome MOA of kidney damage

A

Cytotoxic Abs

3
Q

Harsh crescendo-decrescendo murmur begins after S1, best heard at Left lower sternal border

A

HOCM

4
Q

HOCM murmur intensifies with?

A

Valsalva - decreased preload and decreased LV filling

5
Q

What is HOCM pathophys

A

Outflow obstruction due to hypertrophied interventricualar septum
SAM = systolic anterior motion of MV leaflets

6
Q

Signs of Magnesium toxicity

A

Decreased DTRs
Respiratory depression
Death by cardiac or respiratory arrest

7
Q

Tx of Magnesium toxicity

A

Immediate discontinuation

Admin Calcium gluconate

8
Q

Down syndrome Quad screen

A

High: B-hCG and Inhibin A
Low: MSAFP and Estriol

9
Q

Limb ischemia management

A

Immediate anticoagulation w heparin - IV bolus then continuous
Referral for emergency vascular surgery

10
Q

Differ bt infectious mono (IM) and strep

A

Mono = HSM, generalized LA

11
Q

Heme complication in IM

A

AIHA
Thrombocytopenia
- Cross reactivity of EBV induced abs against RBCs and platelets
- IgM cold agglutinin abs -> complement mediated destruction of RBCs

12
Q

When does AIHA present after IM?

A

2-3 weeks after onset of sx’s

13
Q

Back pain w paravertebral tenderness

A

Lumbago

14
Q

Who is doxycycline CI in?

A

Children < 8 yoa

Pregnant women

15
Q

PCP pneumonia - cause of hypoxia

A

Increased A-a Oxygen gradient from alveolar and interstitial inflammation -> V/Q mismatch

16
Q

Presentation and TX of Nonallergic rhinitis

A

Chronic rhinitis sx’s (nasal congestion, rhinorrhea, sneezing, postnasal drainage)
Tx with intranasal antihistamine (1st G) IN glucocorticoids

17
Q

Multiple System Atrophy

A

Shy-Drager syndrome

  1. Parkinsonism
  2. Autonomic dysfnc
  3. Neuro si’s
18
Q

Parkinsonism pt + Orthostatic HypoTN, impotence, incontinence

A

Multiple system atrophy = shy drager

19
Q

Familial dysautonomia

A

Riley-Day syndrome

  • AR, Ashkenazi Jews
  • Autonomic dysfnc + severe orthostatic HypoTN
20
Q

Electrolyte disturbances caused by Hypothyroidism

A

Hyperlipidemia
Hyponatremia
Elevated creatinine kinase

21
Q

Hypercholesterolemia effects in hypothyroidism

A

Decreased LDL receptor activity or receptors

Decreased lipoprotein lipase - hypertriglyceridemia

22
Q

What should be suspected in all smoke inhalation pts

A

Carbon monoxide poisoning

23
Q

Tx for CO poisoning

A

100% Oxygen nonrebreather

24
Q

Pathophysiology of cardiac tamponade

A

Fluid accumulation in pericardial cavity - increases intrapericardial pressure above diastolic ventricular pressure = restricts venous return to heart, lowers right and left ventricular filling
- Decreased Preload, SV, CO

25
Q

SBO Presentation

A

Vomiting
Abdominal discomfort

Mild/distal
- colicky pain, delayed vomiting, abd distension, constipation-obstipation, hyperactive bowel sounds, dilaed loops of bowel on AXR

26
Q

MCC of SBO

A

Adhesions

- Think post op abdominal surgery in adult, appendectomy

27
Q

What do occasional black or tarry stools indicate

A

GI bleed above Ligament of Treitz

28
Q

Complications with severe burn pts

A

SIRS - 1st week
Infx -> sepsis, septic shock
Pneumonia
Wound infxn

29
Q

Systemic Inflammatory Response Syndrome (SIRS)

A

Two of the four:

  1. Temp > 101.3 or < 95
  2. Pulse > 90
  3. Respirations > 20
  4. WBC > 12,000 or < 4,000 or 10% bands
30
Q

Tx for Bacillary angiomatosis

A

Oral Erythromycin

31
Q

Centrally-umbilicated dome shaped papules

A

Molluscum contagiosum

32
Q

Bright red, firm, friable exophytic nodule in HIV pt

A

Bacillary angiomatosis

33
Q

Indications for oxygen therapy in COPD

A
  1. PaO2 < 88%
  2. Hct >55%
  3. Cor Pulmonale
34
Q

Basal Ganglia hemorrhage Presentation

A

Hemiplegia
Hemi-sensory loss
Homonymous hemianopsia, Gaze palsy
Stupor and coma

35
Q

Cerebellum Hemorrhage Presentation

A
Facial weakness
Neck stiffness
Gaze palsy/Nystagmus
Gait ataxia
usually no hemiparesis
Stupor/coma - brainstem herniation
36
Q

Thalamus hemorrhage presentation

A
Hemiparesis
Hemi-sensory loss
Upgaze palsy
Nonreactive miotic pupils
Eyes deviate Twd hemiparesis
37
Q

Cerebral lob hemorrhage presentation

A
Ass'd w seizures
Contralateral homonymous hemianopsia (Occipital lobe)
Contralateral plegia/paresis (frontal)
Contralateral hemiparesis (Parietal)
Eyes deviate away from hemiparesis
38
Q

Pons Hemorrhage presentation

A

Deep coma
Total paralysis w/in mins
Pinpoint reactive pupils

39
Q

MC site of hypertensive hemorrhage

A

Putamen

- Lies next to internal capsule - CL dense hemiparesis

40
Q

Presentation of cerebellar hemorrhage

A

Occipital HA
Vomiting, dizziness
Gait ataxia
NO Hemiparesis