Uworld Block Mix 10/6/2018 Flashcards
Difference between Malignant Hyperthermia and Heat stroke
Malignant hyperthermia presents during SURGERY
Why do you have persistent epistaxis during exertional heat stroke?
complications of heat stroke include rhabdomyolysis and DIC–> which can leadd to coagulopathic bleeding, explaining the epistaxis.
68 m is in ICU after CABG. POst op day 1,nurse says he is confused and reduced urine output. Temp is 96F, Bp is 80/50, pulse is 118, RR is 18. Lungs are clear. Extremities cool. ECG shows nonspecific T-Wave change.s. Pulm Artery Cath readings - RA high pressure, RV high pressure, PCWP high pressure. What is the next step and why?
Echocardiogram. They have cardiac tamponade - The fluid is causing a severe impairment in venous return. So there is an equalization of increased pressure in the RA, RV and LA
33 Female has general tonic clonic seizure. She has schizophrenia and hasnt been on her meds in 3 weeks. Physical findings normal. Labs: Na 118 K 3.4 Ca 8.4 Serum Osmo 252 Urine Osom - 78 What is causing the electryolyt abnormalities? and why
Primary polydipsia
What would be CSF analysis if they have Guillan Barre Syndrome?
elevated Protein ONLY
72 year old man has elective inguinal hernia repair, and the next morning has severe right knee pain. He has HTN, COPD, mild aortic stenosis. The knee shows redness and swelling of the knee with limited due to pain. Atherocentisis shows WBC 30k, Neutrophils 90%, few rhomboid shaped crystals. What is associated with the current condition?
Meniscal Calcification - see chondrocalcinosis on imaging. Fever and Leukocytosos.
What heart sound would you see with an acute MI
S4
19 year old man comes has a persistent dry coughm sore throat, headaches, fatigue. He has a rash on his arms and legs. CXR shows interstitial markings and a small right pleural effusion. . What organsims is most likely causing this?
Mycoplasma Pneumonia
See Indolent headache, fever, dry cough, pharyngitis (sore throat), and macular/vesicular rash.
How do you differentiat Step Pneumo from Mycoplasma Pneumonia in terms of pneumonia?
Strep Pneumo presents more abruptly, has a PRODUCTIVE cough, and does NOT have pharyngitis or rash.
What findings would you find in CKD in terms of calcium levels being weird.
Phosphourous High
Calcouum low-normal
Increased PTH
CKD would have inadequat phos excretion, and low 1,25 hydroxy D
When you have hypercalcemia, but a SUPRESSED PTH level, what do you do first?
Measure PTHrP, 25hydroxyVD, and 1,25-dihydroxyVD
What is the underlying mechanism for hypoxemia in a patient with PJP pneumonia?
Ventilation perfusion mismatch- theres alveoli filled with fluid, thus causing right to left shunting, and no gas exchange as the blood bypasses
What is unique pathology of Membranoproliferative glomerlonephritis
Dense depisits of C3, caused by IgG antibodies (C3 nephritic factor) directed against C3 convertase of the ALTERNATIVE COMPLEMENT PATHWAY. Thus, there is persistent complement activation, more dense deposits, leading to kidney damage.
Whas is an association with Membranous Nephropathy
Adenocarcinoma, NSAIDS, hep B, and SLE
What is the clinical associations for Minimal Change
Nsaids and LYMPHOMA
