UWorld Educational Objectives Flashcards
(299 cards)
1
Q
tx for hyperthyroid induced tachysystolic afib
A
beta-blockers
2
Q
Can hyperPTH cause hypertension
A
Yes, a rarer cause of secondary HTN
3
Q
HOCM murmur is where
A
LLSB
4
Q
Most common cause of constrictive Pericarditis in the third world
A
TB
5
Q
Common causes of constrictive pericarditis
A
Radiation therapy, viral infections, and Cardiac surgery
6
Q
CHF in young patient
A
Consider viral myocarditis from coxsackie B
7
Q
First line medical tx for HOCM
A
Beta-blocker or non-dihydropyridine CCB like diltiazem
8
Q
tx for aortic regurg.
A
decrease afterload, dihydropyridine CCB or ACEi
9
Q
When does mitral stenosis usually present
A
in pregnancy
10
Q
What are reversible risk factors for PACs
A
tobacco and alcohol
11
Q
tx in symptomatic PACs
A
beta-blockers
12
Q
Tx for cardiac tamponade
A
Massive volume resuscitation and emergency pericardiocentesis
13
Q
First line tx for PVCs symptomatic
A
beta-blockers
14
Q
First study for AAA
A
abd. u/s
15
Q
Mitral prolapse murmur softened with what maneuvers
A
Softened with increased preload
16
Q
Diagnostic criteria for ARDS
A
Acute onset; Bilateral patchy airspace disease on CXR; PCWP<200
17
Q
First line tx for Cocaine induced cardiac ischemia
A
Benzos, nitrates, and aspirin. (Nitrates help vasodilate the coronaries)
18
Q
MItral stenosis patients develop what
A
They develop afib from the L atrial dilation
19
Q
HOCM inheritance
A
Aut. Dom.
20
Q
When does ventricular free wall rupture occur
A
3-7 days post-anterior wall MI
21
Q
What meds to hold before stress testing
A
Inotropes like digoxin and beta-blockers
22
Q
What blood vessels supply the different areas of the heart
A
Inferior wall: R coronary artery >>> L circumflex Anterior Wall: L anterior descending Lateral Wall: LAD and L circumflex Right ventricle: RCA Posterior wall: RCA
23
Q
Lone afib tx
A
Aspirin, if they dont have stroke, tia, DM, HTN, HF, Age>75, or valvular heart dz. Hence no one is on aspirin therapy.
24
Q
CK-MB or troponin for immediate MI recurrence
A
CK-MB, because it returns to normal in 2 days, troponin is more specific but is present for 10 days
25
Dresslers syndrome
Improved leaning forward. Tx with NSAIDs. Avoid anticoagulation to prevent hemorrhagic pericardial effusion
26
Megaesophagus, megacolon, and cardiac dysfunction
Chagas dz
27
Amiodarone side effects
Pulm fibrosis, thyroid (hypo or hyper), hepatotoxcity, corneal deposits, and skin discoloration
28
Loop diuretics electrolyte effects
HypoK and HypoMag
29
Tx WOlf-Parkinson-White patients
Avoid AV nodal blockers like beta-blockers, CCBs, digoxin, and adenosine because of increased conductance through the accessory pathway
30
One of the most deadly consequences of aortic dissection
Cardiac tamponade
31
Most common cause of daeth with acute MI
Reentrant ventricular arrhythmia (vetricular fibrillation)
32
Treating strep viridans endocarditis
IV pencillin G or IV ceftriaxone
33
Tx congenital long QT syndrome
beta blockers
34
Post-MI persistent ST elevations
Ventricular Aneurysm
35
Dipyramidole effect on stress testing
Coronary steal: it diverts blood to the healthy tissues because it dilates all the vessels but the diseased vessels are already maximally dilated so you get less perfusion
36
Premature atrial beats tx and f/u
they are benign and need nothing
37
Thiazides bad side effects
Hyperglycemia, hyperTGs, inc. LDL, hypoNa/K and hyperCa
38
Surgery for AAA
>5cm, symptomatic, rapid rate of growth
39
Best way to slow AAA progression
smoking cessation
40
What lowers preload-meds
nitrate and diuretics
41
Heat stroke definition
temp >105
42
Can cocaine cause STEMIs
yes
43
Pathology of HTN emergency
fibrinoid necrosis of small arterioles
44
Papilledema on ophthalmoscopy in HTN >200
Confirms the diagnosis
45
Digitalis toxicity heart effects
A.fib and AV block (from increased ectopy and vagal tone, respectively)
46
Mobitz type II origin
His Purkinje fucked up
47
Long term prognosis in STEMI most effected by
time to coronary blood flow restoration
48
best tx for ventricular tachycardia
Amiodarone or lidocaine
49
What to avoid in variant (printzmetal's angina)
beta blockers and aspirin because they promote vasoconstriction
50
BP >30 mmHg between arms and tearing chest pain
Aortic dissection
51
tests for suspected aortic dissection
TEE!!!!! or CT with contrast
52
Drug for stable angina and HTN
beta-blockers
53
Quickest drug to relieve pulm. edema
nitroglycerin
54
Causes of pulsus paradoxus
Cardiac tamponade, tension pneumothorax, severe asthma
55
aortic dissection EKG
normal
56
Before TEE for aortic dissection, do what first
control HTN
57
what is tilt table testing
used to dx vasovagal syncope: pt strapped in goes from supine to standing position very quickly
58
TB pleural effusion is notable for what
High adenosine deaminase concentration
59
Causes of ARDS
sepsis, severe infection, extreme bleeding, toxic ingestions, burns
60
theophylline toxicity chracaterized heavily by
excess epinephrine: GI upset, headache/insomnia, arrhythmia
61
Theophylline and erythrmoycin/ciprofloxacin
Those antibiotics increase the plasma concentration by decreasing clearance leading to toxicity
62
INtermittent hemoptysis with mobile cavitary lesion in lung
Aspergilloma
63
Inpatient tx for CAP
levofloxacin for antipneumococcus. O/p therapy azithro or doxy
64
Dx PCP
bronchoalveolar lavage
65
what do you fear most with bronchiectasis
fatal hemoptysis
66
Clubbing and sudden-onset joint arthropathy in a chronic smoker
Hypertrophic osteoarthropathy: often associated with lung cancer
67
Characteristic extrapulmonary manifestation of Mycoplasma pneumonia
erythema multiforme
68
Mild hemoptysis in pts with smoking history
chronic bronchitis
69
DLCO in emphysema and chronic bronchitis
low in emphysema and normal in chornic bronchitis
70
Postpartum woman with pulm. symptoms and multiple nodules on xray
Suspect choriocarcinoma, elevated beta-hCG confirms diagnosis
71
Second episode of clot tx
Lifetime coagulation
72
Nonseminomatous GCTs markers
AFP and beta-hCG
73
WHAT HAPPENS when you lay on side of consolidation
can get arteriovenous shunting and hypoxia
74
Most common causes of SVC syndrome
small cell lung cancer and non-Hodgkin's lymphoma
75
Tube thoracotomy indications
effusion pH <60
76
When to do embolectomy for PE
if there is a contraindication to fibrinolysis
77
what decreases mortality in COPD
home oxygen and smoking cessation
78
sweat chloride test is positive if
Cl>60
79
muscle side effect of cocaine
rhabdo
80
What level CPK needed to cause ATN in rhabdo
CPK >20,000 U/L
81
What can raise the left mainstem bronchus and cause a persistent cough
Enlarged left atrium from mitral stenosis from rheumatic fever
82
Old person with PNA, abdominal pain, confusion, and hyponatremia
Legionella pneumonia
83
A1AT deficiency organs affected
lungs and liver
84
Legionella key
ABDOMINAL PAIN/GI COMPLAINTS and CONFUSION
85
Anaerobic lung infection tx
Clindamycin
86
Aspirin allergy
Pseudo-allergic reaction: avoid NSAIDs and use leukotriene receptor antagonists
87
When to use thrombolytics in PE
When there is hemodynamic instability. R ventricluar strain is a relative indication
88
Histoplasma environment
Mississippi or Ohio River valleys and Central America where there is lots of bird or bat shit
89
Sarcoid extrapulmonary manifestations
Skin: erythema nodosum Eyes; uveitis
90
new clubbing in COPD patients
new lung cancer
91
PCP CXR findings
bilateral diffuse interstitial infiltrates beginning in the perihilar region is characteristic
92
A-a gradient in restrictive diseases
Wider due to lower DLCO and V/Q mismatch
93
difference between neuromuscular diseases and restrictive lung disease
DLCO normal in neuromuscular disease
94
Blastomycosis geography
Great lakes, mississippi, and ohio river valley
95
Skin and bone lesions, productive cough from the midwest
Blastomycosis
96
blastomycosis tx
itraconazole or amphotericin B
97
Allergic rhinitis tx
H1 receptor antagonists decrease nasal inflammation and post-nasal drip
98
Hypercalcemia and what GI complaint
Constipation, can be severe
99
Hypercalcemia presentation
Severe constipation, anorexia, weakness, renal tubular dysfunction, and neurologic symptoms
100
When to suspect ischemic colitis
Patients with evidence of atherosclerotic vascular disease, presenting with abd. pain followed by bloody diarrhea with minimal abd. exam findings. Splenic flexure most commonly affected.
101
Tx for asymptomatic diverticulosis
high-fiber diet
102
First step in mgmt of patients with dyspepsia <45 years with no alarm sxs
Noninvasive tests for H. pylori
103
dx esophageal spasm
manometry
104
Zinc deficiency sxs
alopecia, skin lesions, abnormal taste, and impaired wound healing
105
dx of achalasia
manometry, endoscopy to r/o malignancy
106
explain d-xylose test
D-xylose is purely absorbed without digestion needed, so it tests the integrity of the gut mucosa. Will have low urine excretion with bacterial overgrowth and celiacs, but overgrowth will normalize with abx
107
skin finding and celiacs
dermatitis herpetiformis
108
carcinoid triad
flushing, wheezing, diarrhea
109
what to supply carcinoid syndrome with
niacin; used up in formation of 5-HT
110
MEN I associated diseases
Primary hyperPTH, pituitary tumors, enteropancreatic tumors
111
Suspect crohn's in....
young patient with chronic diarrhea, abd. pain, and weight loss
112
what drug causes digoxin toxicity
verapamil
113
risk factors for polyp developing into malignancy
Villous adenoma, sessile adenoma, and size>2.5 cm
114
Whipple's disease histology
PAS-positive material in the lamina propria of the small intestine
115
Whipple's disease presentation
arthralgias, weight loss, fever, diarrhea, and abd. pain
116
UC extraGI manifestations
PSC, uveitis, erythema nodosum, and spondyloarthropathy
117
Severe complications of UC
toxic megacolon and colon cancer
118
Which IBD improves with Cigarette smoking (decreased likelihood)
Smoking associated with Crohn's
119
Screening for UC
yearly colonoscopies 8-10 yrs after diagnosis
120
Dx whipple's
Upper IG endoscopy and biopsy small intestine
121
LES in diffuse esophageal spasm
Normal relaxation response
122
When to tx chronic hep B
persistently eelvated ALT, detectable serum HBsAg, HBeAg, and HBV DNA with interferon or lamivudine
123
recurrent pancreatitis with no known cause w/u
ERCP
124
non-alcoholic fatty liver disease pathophys
insulin resistance increases rate of lipolysis and elevating the circulating insulin levels
125
liver metastases
GI tract, lung, breast
126
chronic liver disease vaccinations
hep A and B
127
Hydatid cyst cause
Echinococcus granulosus
128
AST and ALT lels in alcoholic liver disaease
<500 IU/L almost always
129
Risk factors for cholangiocarcinoma
PSC patients who smoke and have UC
130
pancreatic cancer risk factors
FH, chronic pancreatitis, smoking, diabetes, obesity, high fat diet. NOT ALCOHOLISM
131
best test for acute panceatitis
serum amylase and lipase
132
chronic Hep A infection presentation
DOESN'T EXIST
133
first step in acute renal failure
foley catherization is a critical first step to r/o post-renal obstructions
134
RFs for non-alcoholic steatohepatitis
obesity, diabetes, hyperlipidemia, TPN, some meds
135
tx for asymptomatic esophageal varices
non-selective beta-blockers
136
30% of hemochromatosis patients die from this
HCC
137
ADPKD presentation
intermittent flank pain, hematuria, UTIs, and nephrolithiasis
138
HIV kidney disease
collapsing focal and segmental glomerulosclerosis
139
FSGS presentation
nephritic range proteinuria, azotemia, normal sized kidneys
140
tx for dehydration
NSS
141
most common nephropathy with carcinoma
membranous nephropathy
142
Hodgkin's lymphoma kidney disease
Minimal change disease
143
most common cause of renal vein thrombosis in patient with nephrotic syndrome
membranous glomerulonephritis (it is the most common one)
144
fibromuscular dysplasia angiogram
string of beads
145
IgA nephropathy presentation
MCC of glomerulonephritis in adults, recurrent gross hematuria, 1-3 days after upper respiratory infection. Serum complement levels are normal
146
Major toxicity of azathioprine
dose-related diarrhea, leukopenia, hepatotoxicity
147
major toxicity of mycophenolate
Bone Marrow suppression. M for marrow and mycophenolate.
148
RHabdo signs
Disproportionate elevation in creatinine as compared with BUN, positive blood on dipstick but no RBCs
149
tx for rhabdo
aggressive IV hydration, alkalinize urine, forced mannitol diuresis may be required
150
MC presentation of cryoglobulinemia
palpable purpura, glomerulonephritis, non-specific systemic symptoms, arthralgias, hepatosplenomegaly, peripheral neuropathy, and hypocomplementemia. Most patients also have Hep C
151
classic findings in amyloidosis histology
renal amyloid deposits that show apple-green birefringence under polarized light after staining with congo red
152
acute post-strep glomerulonephritis presentation
10-20 days after strep throat or skin infection. Hematuria, HTN, red cell casts, and mild proteinuria
153
Goodpasture's tx
emergent plasmapheresis
154
wegener's tx
cyclophosphamide and steroids in combo
155
when to image pyelo
if it doesnt respond after 48-72 hrs of abx
156
most common drug cause of priapism
prazosin
157
MCC of abnormal hemostasis in CRF patients and tx
platelet dysfunction, tx with DDAVP (release VIII and vWF multimers). Do not use PLATELETS!
158
EPO side effects
HTN worsening, HA, flu like symptoms
159
tx for hepatorenal syndrome
liver txp
160
woman with chronic headaches with painless jaundice
analgesic nephropathy (papillary necrosis)
161
MCC of drug induced CRF
analgesic nephropathy (papillary necrosis and chronic tubulointerstial nephritis)
162
Analgesic abuse causes
premature aging, atherosclerosis, and urinary tact cancer
163
Alport's presentation
recurrent hematuria, sensorineural deafness, FH of renal failure
164
hep B ifxn and nephrotic syndrome
membranous glomerulonephritis
165
acute tx of hypercalcemia
IV NSS followed by loop diuretic, then bisphosphonates, then calcitonin, then dialysis
166
primary hyperTH urine presentation
normal or eleavated urinary calcium excretion
167
succinylcholine bad side effect
life-threatening hyperK
168
severe hyperNa
0.9% Na
169
mild hyperNa
D51/2NS
170
vomitizing leads to what disturbance
hypochloremic metabolic alkalosis with hypoK
171
most common drug causes of hyperK
ACEIs, spironolactone, trimethoprim!
172
lithium and what kidney dysfunction
nephropgenic DI, tx with salt restriction and cease lithium
173
hypocalcemia common presentation
Hypeactive deep tendon reflexes in patients undergoing major surgery and requiring lots of transfusions
174
lactic acidsosi in patients with atherosclerosis or afib
unrecognized bowel ischemia
175
type 4 RTA presentation
diabetic patient with non-anion gap metabolic acidosis, persistent hyperK and renal insufficiency
176
aspirin intoxication presentation
triad of fever, tinnitus, and tachypnea
177
common acid-base disorder after a GTC seizure
postictal lactic acidosis that resolves in 60-90 minutes
178
AVN of femoral head presentation
progressive hip/groin pain without restriction of motion and normal radiographs early on. MRI is gold standard dx.
179
RA with septic arthritis cause
Staph aureus
180
subacromial bursitis presentation
pain with active range of shoulder motion, passive itnernal rotation and forward flexion elicits tenderness. caused by repeititive overhead motions.
181
Page disease (osteitis deformans) blood work
normal serum calcium and phosphate levels and increased alk phos and urinary hydroxyproline levels
182
tx for lupus nephritis
immunosuppressants
183
test for temporal arteritis
elevated ESR and temporal artery biopsy
184
dermatomyositis presentation
violaceous rashes on face with periorbital edema and proximal muscle weakness, ovarian cancer as well.
185
viral arthritis presentation
symmetric small joint inflammatory arthritis, resolves within 2 months. ANA and RF positive possibly.
186
disseminated gonoccocemia
high fever, chills, tenosynovitis, migratory polyarhtrlagias and asmall number of hemorrhagic pustular lesions ont he extremities
187
bone metastases prez.
progressive pain worsened at rest
188
dx of polymyositis or dermatomyositis
muscle biopsy
189
polycythemia vera and what rheum disease
gout
190
AVN of bone risk factors
chronic steroids and chronic alcohol abuse
191
hyperthyroid myopathy
progressive proximal muscle weakness
192
OA presentation
age>50, crepitus, bony enlargement, bony tenderness, lack of warmth/morning stiffness
193
ankylosing spondylitis presentation
seronegative spondyloarhtorpathy in men<40 yrs, low back pain worst in morning improving over the day
194
ankylosing spondylitis extraspinal manifestation
anterior uveitis
195
prosthetic joint septic arthritis
staph aureus
196
hydroxychloroquine side effect
retinopathy
197
osteomylelitis risk groups
IV drug users and diabetics
198
fibromyalgia tx
amitryptyline and cyclobenzaprine to restore phase 4 sleep
199
OA affects what joints
DIP joints
200
reactive arthritis presentation
seronegative from enteric or GU infection, may include urethritis, conjunctivis, mucocutaneous lesions, ethesitis, and asymmetric oligoarthritis, NSAIDs are first line
201
RA spine problem
cervical spine C1-C2 instability subaxial subluxation
202
De Quervain tenosynovitis prez
new mothers who hold babes with thumb outstretched
203
methotrexate SEs
stomatitis, nausea, anemia, and hepatotoxicity. tx with folate
204
systemic sclerosis antibodies
ANA and anti-topoisomerase-I
205
sjogren antibodies
anti-RO and LA (SSA and SSB, respectively)
206
Hyperparathyroidism and rheum
pseudogout
207
disseminated gonococcus infexion prez
triad of polyarthralgias, tenosynovitis, and vesiculopustular skin lesions
208
serum sickness-like from drugs presntation
1-2 weeks after penicillin, amoxicillin in setting of viral illness. Fever, urticarial rash, polyarthralgia, and LAD
209
serum sickness preesntation
non-human proteins lead to immune compelx mediated hypersensitivity, resolves with withdarwal of ofending agent, not a true drug allergy
210
erythema nodosum presentation
painful, subQ, pretibial nodules. seen in sarcoid, TB, histo, recent strep, IBD
211
distinguish the leg claudications
both worse pain with walking, neurogenic remains painful standing still, and neurogenic has normal ABI and arterial pulses
212
ruptured baker's cyst
can look like DVT
213
methotrexate blood effect
macrocytic anemia
214
behcet's syndrome presentation
recurrent oral and genital ulcers, skin lesions, most common in turkish, asian, and arabs
215
artery complications of giant cell or temporal arteritis
aortic aneurysms
216
psoriatic arthritis presentation
DIPs, morning stiffness, deformity, dactylitis, nail infolvement. tx with NSAIDs, anti-TNF agents, and methotrexate, NO STEROIDS
217
Cyclophosphamide side effects
long term leads to acute hemorrhagic cystitis and bladder carcinoma
218
HLA-B27
PAIR: Psoriatic arthritis, ankylosing spondylitis, IBD, reitiers?.
219
IBD and ankylosing can have what antibody in common
p-ANCA espite no vasculitis
220
most common causes of cellulitis
group A strep and staph aureus
221
parvovirus presentation
MCP, PIP, wrist, and ankle arthritis.
222
Anti-B19 IgM
Parvovirus. diagnostic
223
CREST syndrome presentation
Calcinosis cutis (Ca in skin), raynaud, esophageal dysmotility, sclerodactyly, and telangiectasis
224
Exercise and fibromyalgia pain
WoRSENS IT!
225
Fibromyalgia presentation
fatigue, IBS, depression w/o any joint swelling or muscle weakness
226
anserine bursitis presentation
sharply localized pain over the anteromedial part of the tibial plateau just below the joint line of the knee. Valus stress test fails to reproduce the pain, ruling out damage to the medial collateral ligament, radiographs are classically normal.
227
viral arthritis vs RA
acute onset, lack of elevated inflammatory markers, and resolution w/i two months
228
ankylosing spondylitis and fractures
increaed risk for dz >2 decades.
229
secondary amyloidosis cause
chronic systemic inflammation as may occur in autoimmune disorders, chronic infections, IVDA
230
amyloidosis presentation
nephrotic syndrome, hepatomegaly, cardiomyopathy, pseudohypertrophy of muscles, and peripheral neuropathy
231
Paget's disease pathophys
osteoclast dysfunction leading to mosaic pattern of lamellar bone, incr. alk phos, and characteristic xray findings like femoral bowing. bone and joint pain, skeletal deformities, and hearing loss are common sxs
232
SIAD presentaiton
hypotonic hyponatremia with euvolemia. Low plasma osmolality (100-150 mOsm/kg) is diagnostic in suspected patients
233
dx of acromegaly
GH levels following oral glucose load, no suppression of GH levels following oral glucose load
234
tx hyperthyrodism
propranolol genreally used for sx relief until underlying cuase is identified and definitively treated
235
most important causes of thyrotoxicosis with low radioactive iodine uptake
subacute painless thyroiditis; subacute granulomatous thyroiditis; iodine-induced thyroid toxicosis; levothyroxine overdose; struma ovarii (thyroid tissue in ovaries)
236
osteomalacia electrolytes
low or low-normal serum calcium, low serum phosphate, and increased serum PTH
237
adrenal insufficiency and calcifications in adrenal glands is...
adrenal TB
238
primary adrenal insufficiency MCC in developed countries
autoimmune adrenalitis
239
factitious thyrotoxicosis presentation
hyperthyroid sxs, but no goiter or exophthalmos, low TSH and elevated T3 and T4. decreased diffusely iodine uptake by thyroid. biopsy shows follicular atrophy.
240
most thyroid nodules are
benign colloid nodules
241
hypophoshatemic rickets presentation
normal serum ca, normal alk phos, normal vit.d, low phospahte
242
preferred tx for graves' disease
radioactive iodine therapy
243
contraindications to radioactive iodine tx
pregnancy and very severe ophthalmopathy
244
what ratio for primary hyperaldo plasma aldo:plasma renin activity
ratio >30 suggests primary aldo. can't suppress it with NSS or oral salt solution also supports priamry. then use CT to look for adrenal adenoma
245
early side effect of radioactive iodine tx
initial worsening of hyperthryoid sxs
246
pH effect affecting calcium
alkalosis leads to increased albumin binding of Ca leading to decreased ionized calcium.
247
hashimoto's antibodies
Anti-TPO
248
rapidly developing hyperandrogenism
androgen-secreting neoplasm of ovary or adrenal. testosterone for ovarian source and DHEAS for adrenal source.
249
toxic nodule presentation
radioactive iodine uptake in nodule with suppression of uptake in the rest of the gland. NO INFILTRATIVE OPHTHALMOPATHY.
250
MEN type 1
The 3 P's: pituitary adenoma, pancreatic islet cell tumor, and hyperPTH. Tumor suppressor gene Menin.
251
MEN type 2 inheritance
aut. dom.
252
MEN type 2a and 2b both share
Medullary carcinoma of the thyroid and pheochromocytoma
253
MEN type 2a unique
Primary hyperPTH (hyperplasia)
254
MEN type 2b unique
mucosal neuromas and marfanoid habitus
255
MEN type 2
2a: medullary thyroid cancer; pheo; primary PTH hyperplasia
2b: medullary thyroid cancer; pheo; mucosal neuromas and marfarnoid habitus
256
bones and hyperthryoid patients
rapid bone loss from increased osteoclastic activity
257
vit D toxicity
hyperCa, constipation, abd. pain, weight loss, polyuria, polydipsia. (ALL SIGNS OF HYPERCALCEMIA)
258
cause of graves ophthalmopathy
proptosis 2/2 autoimmune lymphocytic infiltration of the extraocular muscles resulting in fibroblast proliferation, hyaluronic acid deposition, edema, and fibrosis
259
most common thyroid malignancy
papillary carcinoma of the thyroid
260
when to suspect TSH adenoma
high T3/T4 with normal or high TSH
261
fever and sore throat in patient taking antithyroid drugs
agranulocytosis, stop drugs and check WBCs
262
CRF and calcium metabolism
hypocalcemia, hyperphosphatemia, and increased PTH are characteristic of secondary hyperPTH
263
tx DM gastroparesis
Reglan, bethanechol, and erythromycin
264
MEN IIa syndrome cause
RET proto-oncogene mutation, total thyroidectomy indicated
265
high estrogen production in young males with secondary inhibition of LH and FSH
leydig cell tumor
266
best screening test for suspected adrenal insufficiency
cosyntropin (analog ACTH) stimulation test
267
what is elevated in medullary thyroid cancer
serum calcitonin
268
hypoPTH presentation
low ca and elevated phos with normal renal function.
269
using viagra and an alpha-blocker
keep them 4 hrs apart due to risk of hypotension
270
tx of paget's
asymptomatic: no tx. Symptomatic: oral or IV bisphosphonates
271
PTH in most patients with hyperCa of malignancy
mostly suppressed
272
Serum calcium in primary hyperPTH vs. hyperCa of malignancy
higher in Malignancy
273
primary hyperaldo presentation
young patient with HTN, muscle weakness, and numbness with high aldo/renin ratio
274
differentiating folicular cancer from adenomas
invasion of the capsule and blood vessels
275
which thyroid cancer metastasizes often
follicular thyroid cancer because it invades the blood vessels
276
Alanine turns into what in gluconeogenesis
pyruvate
277
Sheehan's syndrome typical presentation
Failure to lactate and other features of pituitary hormal deficiency. overt DI is uncommon.
278
HLD, unexplained hypoNa and elevated serum muscle enzymes means you should do...
thyroid function tests (hypothyroid)
279
androgen producing adrenal tumors test
elevated serum DHEA-S levels
280
Hashimoto's and cancer
Increased risk of thyroid lymphoma
281
Antithyroid drug therapy serious side effect
Agranulocytosis
282
MCC of congenital adrenal hyperplasia
21-hydroxylase deficiency
283
When to do parathyroidectomy in asymptomatic patients with primary hyperPTH
serum ca >1 mg/dL above upper limit of normal; high urinary calcium 24 hr >400 mg, young age <50, BMD less than T-2.5 at any site; reduced renal function
284
tx for prolactinoma
bromocriptine or cabergoline
285
tx for central DI
desmopressin which is administered intranasally
286
genrealized resistance to thyroid hormones presentation
high serum T4 and T3 with normal/mildly elevated TSH evels with hypothyroid sxs
287
sick euthyroid syndrome
Pt with acute, severe illness with fall in T3 but normal T4 and TSH
288
MCC of death in acromegaly
cardiovascular
289
bartter's syndrome presentation
hypoK, urine chloride >20 mEq/L, met. alkalosis, normal BP
290
screening for microalbuminuria
spot urine collection for microalbumin/creatinine ratio
291
rickets is characterized by
defective mineralization of both bone and growth plate cartilage
292
aldosterone secretion in central adrenal insufficiency
It is relatively preserved, does not rely on ACTH as much. Angiotensin II is a main driver. absence of ACTH does not lead to zona glomerulosa atrophy
293
tenosynovitis presentation
swelling over involved tendon, linked to gonococcus, pain swelling and decreased range of motion, can treat with NSAIDs,
294
Kussmaul's sign
Paradoxical rise in JVP on inspiration due to decreased R ventricular filling. Can be seen in constrictive pericarditis, restrictive cardiomyopathy, cardiac tamponade
295
ABPA leads to what
bronchiectasis
296
Treatment for Toxoplasmosis
Prevention: Bactrim. Active disease: Pyrimethamine
297
Normal human serum osmolality
285-295 mOsm/L
298
Preventing Pneumocystis
Pentamidine...or Bactrim....???
299
Buerger's disease
Also known as Thromboangiitis obliterans. Recurring inflammation and thrombosis of small and medium arteries and veins of the hands a nd feet strongly associated with smoking tobacco.
