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Flashcards in UW 8 Deck (51):
1

Causes of acute viral arthritis

Parvo B19
Hep B
Hep C
HIV
Rubella

2

Parvo B19 Adult presentation

Polyarticular, symmetric arthritis
Peripheral joints - hands, wrists, knees, ankles
Fever
Fatigue
Diarrhea

3

Dx for Parvo B19

Anti-B19 IgM abs in serum
Within 10-15 days

4

Morning stiffness in RA

Lasts more than 1 hour

5

Risk factor for brain abscess

Cyanotic congenital heart disease - tet of fallot
Recurrent sinusitis

6

Presentation of medulloblastoma

HAs = morning/nocturnal
Cerebellar dysnfnc - Ataxia, incoordination

7

When do we do peritoneal lavage

To detect intraperitoneal bleeding in BAT when US for fast exam not available

8

OCPs are protective against what?

Endometrial cancer
Ovarian cancer
Reduction in benign breast disease

9

Risk factors with OCPs

Venous thromboembolism
HTN
Hepatic Adenoma
Stroke/MI (Rare)

10

Best initial test in preconception counseling w patient at risk for thalassemia

CBC

11

Best initial test in African for preconception counseling

Hemoglobin electrophoresis with CBC

12

Difference b/t Ehlers-Danlos and Marfans

ED: no tall stature, lens dislocation, pectus carinatum

Marfans: Fibrillin-1 mutation, tall, long thin extremities, joint hypermobility, aortic root dilation

13

Are gallstone radio-opaque or radiolucent?

Radiolucent - Cholesterol and mixed stones = majority

14

Confirmatory test for ALL

Bone Marrow BX

15

When do we do ERCP

Recurrent pancreatitis
draining pancreatic pseudocysts

16

PT presents with severe epigastric pain radiating to back. Next step?

Check amylase and lipase levels
THen CT

17

Where do we see spinothalamic tract lesions

Contralateral loss of pain and temp
Start 2 levels below the level of the lesion

18

Right sided lateral spinothalamic tract lesion at T10 presents with what deficit?

Left sided loss of pain and temp beg at T12

19

MGUS v MM
What is next best step in management in pt with monoclonal spike on protein electrophoresis

MGUS - no renal insufficiency, hypercalcemia, anemia, lytic bone lesions

Do metastatic skeletal bone survey

20

Pt suspected of MM - next step

Serum immunoelectrophoresis

21

When do we order bone scan in MM

Never.
MM causes lytic lesions in bone - not seen on bone scan
- must do skeletal survery = xray for lytic lesions

22

Presentation of fat embolus

Severe respiratory distress
Petechial rash
Subconjuctival hemorrhage
Tachycardia
Tachyypnea
Fever

23

When does fat embolus occur

12- 72 hours after injury

24

Pt w cholelithiasis refuses cholecystectomy - TX?

Ursodeoxycholic acid

25

Acute otitis media in children Tx?

Oral Amoxicillin 10 days

26

Tx for Vaginismus

Relaxation
Kegel exercises
Insertion of dilators, fingers for desensitization

27

Hormones in Turner syndrome

Ovarian dysgenesis ->
LOW estrogen = unable to menstruate
Poor ovarian function = HIGH FSH bc lack of negative feedback

28

TX for placenta previa with stable mother and fetus at term

Scheduled C section

29

Causes of Immediate (w/in hrs) post-op fever (>100.4)

Prior Infxn/trauma
Inflammation during surgery
Malignant Hyperthermia
Meds
Blood products given during surgery

30

Causes of acute post op fever
When and what

Within first week
Nosocomial Infxn
PE

31

Causes of subacute post of fever
When and what

More than 1 week
Drug fever
Surgical site infxn
PE

32

What is SIBO

Small intestinal bacterial overgrowth

33

What are some causes of SIBO

Anatomic - strictures, surgery
Motility disorders - DM, scleroderma
Others - ESRD, AIDS, cirrhosis

34

What are si/sx's of SIBO

Abdominal pain
Diarrhea
Bloating
Excess flatulence
Malabsorption
Wt loss
Anemia
Nutritional deficiency

35

How do we Dx SIBO

Endoscopy w jejunal aspirate
Hydrogen breath test w lactulose = rapid lactulose metabolism causes early peak in hydrogen

36

How does serum sickness present

Young children
Post Tx of viral infxn w/abx
Fever
Urticaria
Arthralgias

37

What drugs MC cause serum sickness

PCN
Amoxicillin
TMP-SMX
Cefaclor

38

Young boy presents with URI. Treated w PCN and improves. 10 days later, fever, skin rash, fleeting joint pain in LE, urticaria, palpable LNs. MCC?

Serum Sickness

39

How does Rheumatic fever present?

Polyarthritis
Carditits
Erythema marginatum rash
Subcutaneous nodules
Chorea

40

Infective endocarditis

Fever
Bacteremia
Heart murmur
Osler nodes - fingers and toes
Janeaway lesions

41

Hereditary spherocytosis Presentation

Hemolytic anemia
Jaundice
Splenomegaly

Autosomal Dominant

42

Labs of Hereditary spherocytosis

Increased MCHC
Increased osmotic fragility
Spherocytes on PS
Negative Coombs
Abnormal eosin-5-maleimide binding test

43

ABO Incompatibility (isoimmune hemolytic dz of NB) and AIHA Presentation

Decreased Hb
Increased LDH
Hyperbilirubinemia
Positive Coombs

44

Coombs tes in Ab mediated hemolysis

Positive Coombs test

45

Polyarticular symmetric arthritis of acute onset and short duration + low grade fever

Viral arthritis

46

Viral Infxn that cause arthritis

Parvo
Hepatitis
HIV
Mumps
Rubella

47

What inflammatory markers may be elevated in viral arthritis?

Rheumatoid factor
ANA

48

Infant hypoxia that fails to improve w inhaled oxygenation

Congenital heart defect
- May need PGE2 to keep PDA patent

49

Congenital heart defects that depend on PDAs

Coarctation of aorta
Transposition of Great arteries
Hypoplastic left heart syndrome
TAPVR
Tricuspid Atresia

50

Presentation of Behcet's syndrome

Recurrent oral ulcers + 2 of:
- Recurrent genital ulcers
- Anterior/Posterior uveitis
- Skin lesions like: Erythema nodosum, acneiform ondules, papulopustular lesions
- Retinal vascularization
- Positive pathergy test

51

How does Erythema nodosum present

Painful
Nodular
Areas of hyperpigmentation