UW 5 Flashcards by Nadia Mahmud

Pt returns from developing country w/sx’s of malabsorption

Giardiasis

Empiric tx w/Metronidazole

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Maintenance tx of pts with Bipolar Disorder

Post first episode - at least 1 year from time of remission
Pts w/2+ episodes = long term/lifetime tx, esp with FHx
Pts w/hx of 3+ relapses = lifetime

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Single episode of major depression tx

Antidepressant for 6 months

Monitor pt’s response

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Complicated Diverticulitis and Tx

Diverticulitis + Abscess, perforation, obstruction, or fistula formation

Fluid < 3cm = IV Abx and observation
Surgery if sx’s worsen
Fluid > 3cm = CT-guided drainage
if not controlled by 5th day - surgery for drainage and debridement

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Dx for leprosy

Skin Bx shows acid fast bacilli

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What do blood cultures show in leprosy?

Nothing. they are negative

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Asian patient, insensate, hypopigmented patch of skin

Leprosoy = affects peripheral nerves and skin

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Fetal Hydantoin syndrome

Anticonvulsant exposure - phenytoin, carbamezapine
Small body size
Microcephaly
Digital/Nail hypoplasia
Midfacial hypoplasia
Hirsutism
Cleft palate and lip
Rib abnormalites

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Fetal Alcohol Syndrome

Midfacial hypoplasia
Microcephaly
Stunted growth
CNS - hyperactivity, MR, learning disability
NO cleft palate/excess hair

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Electrolyte derangements in loops?

HypoKalemia

HypoMaGnesemia

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Cardiac patient develops v tach - what to consider

Assess stability

2. Measure serum electrolytes

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Missed Abortion

Fetal loss with retained POC
Closed cervix
IU fetal death < 20 wks

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Presentation of missed abortion

Minimal sx’s
Light vaginal bleeding
Decreased preg s’s - nausea, breast tenderness

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Management of missed abortion

Asses fetal heart tones
Pelvic exam for cervix and vaginal bleeding
Dx w TV US

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Tx for Missed abortion

Hemodynamically unstable, heavy bleeding: D&C

Hemodynamically stable, mild bleeding: expectant management, PGs or D&C

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Presentation of placental abruption

Sudden onset bleeding
Abd Pain
Hypertonic/tender uterus

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US of placental abruption

Retroplacental hemorrhage

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Presentation of uterine rupture

Sudden onset bleeding
Constant abd pain
Cessation of CTX 
Palpable fetal parts
Fetal deterioration

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Uterine Atony

Postpartum complication
MCC of painless hemorrhage post delivery
Poor uterine tone

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Manifestations of hyperestrogenism in Cirrhosis

Gynecomastia
Palmer Erythema
Spider angiomas
Testicular atrophy
Decreased body hair - males

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Manifestations of portal HTN in Cirrhosis

Caput medusae
Esophageal varices
Hemorrhoids

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Pt presents with double vision, jaw pain after eating and change in voice after talking for long period of time? Best next test?

Myasthenia Gravis

CT of chest - check for thymoma

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First line tx for specific phobia

Behavioral thearpy

Systemic desensitization

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Neonate with delayed passage of meconium

Hirschsprung

2. Meconium ileus

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Meconium ileus: level of obstruction and meconium consistency

Ileum | Inspissated

Free air above liver

Intestinal perforation | Emergency surgery

What dz is ass'd with meconium ileus

Cystic Fibrosis

Hirschsrpung: level of obstruction and meconium consistency

Rectosigmoid | Normal

Complications seen with CF

Opacification of all sinuses Recurrent sinopulmonary infxn Bronchiecstasis Sensorineural hearing loss from frequent aminoglycoside tx

Dz ass'd with hirschsrung

Down's | Hypothyroidism

SIADH

Hypotonic Hyponatremia Euvolemia

Plasma and urine osmolality with SIADH

Low plasma osmolality < 280 | High urine osmolality > 100-150

NSAIDs impact on ADH

Potentiates action of ADH, causing SIADH

WHy is pain decreased with eating in duodenal ulcer?

Pain worse on empty stomach b/c of unopposed acidic fluid emptying into duodenum

Best long-term sx relief for duodenal ulcer

H.Pylori eradication

Ascertainment bias is a type of what kind of bias?

Selection bias

Types of Bias occur with inappropriate selection or poor retention of subjects

Ascertainment/Sampling bias Nonresponsive bias Berkson bias - hospital based subjects only Prevalance/Neyman bias - diseased pts die early/recover Attrition bias

What is reporting bias

Subject is reluctant to report exposure due to stigma about exposure - sexual behavior, drug use

Eye lesion seen w NF Type I

Optic glioma - slowly progressive unilateral visual loss, dyschromatopsia, esophthalmos

MC glomerular dz in Hodgkins

Minimal Change Dz

MC glomerular dz in solid cancers

Membranous | Lung, colon, prostate, breasts

Glomerular dz ass'd with Hep B and Hep C

Membranoproliferative

Glomerular dz ass'd with NSAIDs

Minimal change

Who gets a Pneumococcal polysaccharide vaccine (PPSV)

``` All adults >65 = 1X Adults < 65 w: Chronic lung dz Chronic Cardiovascular dz DM Chronic liver dz Smoker Alcoholic Cochlear implant CSF leak Immunocompromised Asplenia ```

Diabetic pts get what vaccines

Influenza Td booster or TdaP Pneumococcal

When is tetanus-diptheira toxoid booster given?

Every 10 yrs after 18

Do Adults get TdaP?

Yes. 1x for all adults

What is pilonidal dz?

Acute pain and swelling of midline sacrococcygeal skin and subcutaneous tissue = infxn of pilonidal cyst

Perianal Abscess

Anal pain | Tender, erythematous bulge at anal verge

Where is coccyx in relation to anus

At least 5 cm above anus

Presentation of suppurative hidradenitis

Multiple painful nodules and pustules of axilla and groin

Presentation of Kawasaki dz

``` Fever >5 days and - BL nonexudative conjunctivitis - Mucositis - injected lips, pharynx, strawberry tongue - Erythematous polymorphous rash - Extremity changes - Cervical LA, one > 1.5 cm Irritability ```

Tx for Kawasaki

ASA IVIG Baseline Echo, repeat in 6-8 wks

Fever and Rash in peds DDX

Scarlet fever | Kawasaki

Tx for acute bacterial rhinosinusitis

Amoxicillin-Clavulanic acid

Seborrheic dermatitis

Chronic, inflammatory papulosquamous dz Transparent to yellow papules scaling plaques

MC areas affected in seborrheic dermatitis

Eyebrows Nasolabial folds Bases of eyelashes Paranasal skin

Infants with scaly scalp that improves with baby shampoo

Seborrheic dermatitis | also called cradle cap

Atopic dermatitis

Recurrent, pruritic, eczematous eruption Flexural and extensor surfaces affected Scaling red papules

What is ass'd with pseudogout?

Chondrocalcinosis

PTs w dysphagia w/liquids and solids at onset

Motility disorder

Dx test for motility disorder

1. Barium swallow | 2. Manometry

Which pancreatic cancer is ass'd with steatorrhea

Pancreatic head tumors

UW 5 Flashcards

(63 cards)