UWORLD Flashcards
Hazard Ratio
> 1 means treatment arm had higher incidence
< 1 means that treatment arm had lower incidence
When to do surgery on pt with asymptomatic hyperparathyroid
Ca >/= 1 above normal
< 50 yo
Bone mineral density < T - 2.5
Reduced renal fxn (GFR < 60)
Contraindications to liver transplant
Irreversible cardiopulmonary disease
Incurable or recent (< 5 years) malignancy outside the liver
Alcohol or drug abuse
Aortic dissection
Severe HTN, tearing pain to back/neck
Complications: Dissection into spinal arteries can cause spinal cord ischemia –> LE weakness; hemothorax (looks like pleural effusion on CXR); stroke, acute AR, Horner’s, acute MI, cardiac tamponade, abdominal pain, acute renal failure
Confirm dx with CT or TEE
Beta blocker OD
Bradycardia + hypotension (cardiogenic shock)
AV block
Diffuse wheezing
Delirium, seizures
Hypoglycemia
Treatment: atropine, IV fluids, then glucagon (if first 2 don’t work)
Wide vs narrow ventricular tachycardia
Wide complex tachycardia: sustained monomorphic v-tach (SMVT) treated with amiodarone IV if stable and electrical cardioversion if unstable
Narrow complex tachycardia: paroxysmal supraventricular tachy (PSVT) terminated by carotid massage
Don’t use digoxin for ventricular tach!
Treatment for atrial arrhythmias
Esmolol is ultra short acting beta blocker for rate control in aflutter or afib
Digoxin for rate control in aflutter or afib (esp if hypotension and/or heart failure)
Hyponatremia
Serum osmolality high (concentrated) = marked hyperglycemia or advanced renal failure
Urine osmolality low (dilute) = primary polydipsia, malnutrition (beer drinker’s potomania)
Urine sodium low (body hoding onto Na) = volume depletion, CHF, cirrhosis
Urine sodium high/normal = SIADH, adrenal insufficiency, hypothyroidism
CLL
Lymphocytosis usually found incidentally
Lymphadenopathy, splenomegaly, anemia, thrombocytopenia (poor prognosis)
Waldenstrom’s macroglobulinemia
Plasma cell neoplasm that invades BM, LN, spleen
Excessive IgM antibody in blood causes hyperviscosity
Increased size of spleen, liver, LNs
Tiredness due to anemia
Bleed/bruise easily
Night sweats
Headache and dizziness
Visual problems
Pain and numbness in extremities due to demyelinating sensorimotor neuropathy
Multiple Myeloma
Back pain anemia, renal dysfunction, elevated ESR, hypercalcemia
Central vs Nephrogenic DI
Central: decreased production of ADH; trauma, hemorrhage, infection and tumors
Nephrogenic: renal ADH resistance; hypercalcemia, hypokalemia, tubulointerstitial renal disease, meds (lithium, demeclocycline, foscarnet, cidofovir, amphotericin)
Tumor lysis syndrome
Low Ca
High phos
High K
High uric acid
Anti-pseudomonal drugs
Ciprofloxacin
