UW 13 Flashcards by Gaby Matamoros

Acute vs Chronic leukemias

They may look similar but Acute leukemia present with much obvious severe symptoms.

Pallor/Fatigue due to anemia
Bleeding do to thrombocytopenia

Ages:
ALL: <13yoa
AML: 13-40
CML: 40-60
CLL: >60

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Tear drop cell

Beta thalasemia and myelofibrosis

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Findings in Lymphocytic leukemia

Acute: lymphoblast

Chronic: Smudge cell

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CLL presentation

Lymphadenopathies (cervical, supraclavicular, axilary)
Hepatosplenomegaly
Mild anemia and thrombocytopenia
Often asymptomatic
Severe lymphocytosis and smudge cells

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Management of Urge incontinence

Life style modification and bladder training fisrts

Antimuscarinics (Oxybutinin) if trainning fails (SE: dry mouth, constipation, sedation)

Mirabegrom if oxybutinin not tolerated

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Diagnosis of widening mediastinum

Stable patients: CT angiogram

Unstable patients: surgery or transesophageal ecorcardiogram

Aortography (via femoral artery) no longer routinely used

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Nail changes in hyperthyroidsm

Onicolisis and clubbing

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Eye changes on hyperthyroidsm

Lid lag: allows for visualization of the sclera on downward gaze

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Endocrine changes in hyperthyroidsm

Hypercalcemia (increased bone turnover)
Hyperglycemia
Menstrual irregularities

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Symptoms of cataracts

Gradual loss of visual acuity
Halos, glare around light
Myopic shift (attenuates the difficulty in close vision in patients with preexisting presbyopia)

Usually ok indoors

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Risk factors for cataracts (6)

Age >60
DM
Glucorticoids
Smoking
HIV
Chronic sun light exposure

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Drusen (eye finding)

White or yellow spots usually found in cluster around the central retina due to age related macular degeneration.

Patients have difficulty with reading in both day and night. Does not cause excesive glare

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Flame hemorrhages (eye)

Hypertensive retinopathy

Associated with monocular acute vision acuity and field defects, headache and other neurological symptoms

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Mycroaneurism (eye)

Diabetic retinopathy

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Medications that improve survival in patients with Left ventricular dysfunction

ACEI/ARA II

B-blockers (metoprolol, carvedilol, bisoprolol) (pindolol, acetobulol should be avoided due to intrinsic sympathomimetic activity) Atenolol has not been studied

Aldosterone antagonist

Hydralazine and nitrates combined

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Contraindications for Bblockers in heart failure

Bradycardia

2nd and 3rd degree AVblock

Symptomatic hypotension

Asthma or reactive airway disease

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Endocrine effects of primary hypothyroidsm

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Low T3/T4 stimulates TRH secretion

TRH stimulates TSH and prolactin (headache and galactorrhea)

Elevated prolactin suppress FSH, LH and stroges

Carpal tunnel sd managment

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Splint
Corticosteroid injection
Surgery

Tocolytics (name, MAO and SE)

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Pg 348

Viral examthems dxx (7)

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pg 427

Viral examthems where fever is not the prodminant feature

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Rubella: low grade fever, lymphadenopaties (especially posterior cervical) maculopapular rash from head to toes

Parvo: low grade or absent. Slapped-cheek rash. Rash starts at the arms and spreads to chest and legs. Worsen with fever and sun exposure

High fever and rash that appears once fever is gone

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Roseola ifantum (Herpes 6 and 7)

Rash begins on trunk and spreads to face and extremities

OCPs cancer correlation

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Decreased risk of Endometrial and ovarian

Increased risk of breast and cervical cancer. (Risk normalizes after 10years of stopping OCPs

Drugs that prolong QT

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ABCDE

antiArrythmics (IA, III): sotalol, ibultilde, amiodarone quinidine, procainamide
antiBiotics: macrolides
antiCychotics: 
antiDepresats: TCAs
antiEmetics: Ondasetron

Normal duration of QT

<0.44sec or 440msec in men | <0.46 or 446 in women

Normal duration of PR

0.12-0.2 or 120 to 200msec

Normal duration of QRS

<0,12 or <120msec

Managment of Torsades

Magnesium Cardiovert if unstable IV isoproterenol and temporary peace maker if Magnesium is no effective Correct K Withdraw offending drugs

Sings and symptoms of alcohol withdrawal

Tremor Hypertension, tachycardia Agitation Malaise, nausea Delirum Tremens

Alcoholic hallucinations

12-24hrs since last drink | VIsual, auditory and tactile

Delirum tremens

48-96hrs since last drink Autonomic instability ( hypertension, tachycardia) Disorientation, agitation Hallucinations

Postoperative fever

0-6 hrs: transfution, anesthesia, tissue manipulation 24hrs-1w: nosocomial infections, SSI1 (GAS or C. perfringes), DVT, PE, MI 1w -1M: Nosocomial, catheter, SSI2 (not GAS not perfrignes), C. difficle, drug fever, DVT, PE, >1m: viral infections, indolent organism S. coag - is the most common organism for catether infections

Indication that an infection is from the catether when it comes to culture

Culture taking from the catether grows bacteria faster than other blood taken from a peripheral site at the same time

Efavirenz side effects

Used in HIV treatment is a reverse transcriptase inhibitor ``` Side effects in up to 50% of patients Dizziness Insomnia Vivid or bizarre dreams Depression Anxiety ```

Polyarteritis nodosa

Necrotizing vasculitis that presents with nodular rash, aneurysm formation and hematuria

Clinical presentation of abdominal aortic anurysm

Asymptomatic Abdominal, back or flank pain

Diagnosis of placenta previa

Abdominal ultrasound (high false positive rate) and then TVUS

Cocaine use disorder tratment

Psycotherapy and 12 steps groups

Migrane treatment (abortive vs. maintainace)

``` Abortive: Triptans Ergotamine Antiemetics NSAIDs (naproxen) Acetaminophen ``` ``` Maintaince: Topiramate Valproic acid Beta blocker TCAs ```

Sumatiptan MOA

Serotonin agosnist: Vasoconstriction 5-hydroxytryptamine Only one dose in 24hrs and do not mix with ergotamine

Treatment of Kawasaki disease

Aspirin | IV inmunoglobulin within 10 days of fever onset to prevent coronary art. aneurysm formation

Albumin to creatinine ratio

>300 mg/g is abnormal, reflects albumiuria

UW 13 Flashcards

(42 cards)