Flashcards in UWorld Deck (20)
When TPN has to be given in central line
TPN risks to know
TPN must be given in central line if >48h
central line infection--highest risk
Cholestasis--risk if >2 weeks of TPN. higher risk of cholelithiasis then.
lesion, often foot, of Pseudomonas
progress from small erythematous macule to large, NONTENDER, necrotic nodule
Suspect when immunocompromsed (eg radiation)
-how to measure bedside without BP cuff
tamponade. inspiration causes increased preload to R side, pushing into L side's filling
Loss of palpable radial pulse during inspiration
(or >10mmHg lower BP during inspiration)
AFib risk score, nonvalv anticoag
-what scores to give what tx
Vascular (PAD, MI, aortic plaque)
1--none, aspirin, or oral anticoag
New baby of diabetic mother
-most likely complication after birth?
respiratory distress (RDS from low surfactant from lung immaturity)
also: limb, cardiac issues
ABI values for PAD
what can cause possible false elevation
severe ischemia: <0.4
Diabetics with calcified noncompressible vessels
What if you see hyperCa to 14.0?
If hyperCa >12, then think malignancy, esp PTH-rp of squamous cell of lung
You also see low phosphate
Primary hyperparathyroidism would go up to 12 usu, and not severely sx.
Gastric bypass and RUQ pain
-think what, do what
Higher risk (40% chance) of gallstones soon after surgery/ b/c of concentration of bile
-ppx with Urso acid 6 mo
-or take out gallbladder if sxs before surgery
How does GI bleed cause hepatic encephalopathy?
-how to know by labs?
High nitrogen state. Digested blood is source of urea, and it reabsorbed in intestine during Upper GI Bleed.
You will see elevated BUN/Cr ratio (>20)
Initially N/V/Diarrhea. Upper GI bleed. Hematemesis and melena. Then hypovolemic shock
can occur with 10 tablets only
ACL vs meniscus
Meniscal tear: twisting on uneven ground.
-immediate pain, but usu not severe enough to limit mobility
-Effusion on 2nd day, common
-locking, instability sensation, painful squatting, can limit joint extension.
-Tenderness at joint line, and locking/clicking
rapid onset hemarthrosis, does not limit joint extension
How to use urine Na for determining dehydration
Decrase urine Na (Urine Na <20) supports hypovolemia in pt
Sickle cell pt in septic shock
-what bug most likely
Strep pneumo (encapsulated)
which is why must get pneumococcal vaccine, ad
Who needs abx ppx for dental procedures? (3)
high risk: prosthetic heart valves, hx of IE, unreparied congenital heart dz
Give single dose Amox (or azithro)
No ppx for: bicuspid aortic valve, acquired aortic valve dz, acquired mital valve dz (including MVP)
Hookworm (or other worm) infection:
typical vignette to know
Chronic diarrhea, recently came from poor country
Had an unexplained dry cough for a while, resolved
CBC shows eosinophilia (>3%)
Fe deficiency anemia
Hemoptysis in children
which is MCC
1. Bronchiectasis, usu from CF
2. Resp infection (local trauma, inflamm). Usu small-volume blood
3. Foreign body
CF Bronchiectasis MCC
OCPs reduce risk of what cancer(s)?
increase risk of what 2 things?
Ovarian and Endometrial
DVT, hepatic adenoma
Diarrhea and heart arrythmia, think what
Diarrhea can cause HypoK and hypoMg. If pt already long QT, then can cause torsades
Remember Mg for Torsades
Long QT: what values