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VIII Flashcards

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1
Q

development of palpable mass in epigastrium after acute pancreatitis in recent past

A

pancreatic pseudocyst

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2
Q

clinical signs of hereditary hemochromatosis

A

hyperpigmentation
arthralgia, arthropathy
elevated hepatic enzymes with hepatomegaly, cirrhosis
increased risk hepatocellular CA
DM, secondary hypogonadism and hypothyroidism
restrictive or dilated cardiomyopathy

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3
Q

what infections are those with hereditary hemochromatosis more likely to contract

A

Listeria

Vibrio vulnificus and Yersinia enterocolitica

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4
Q

what mutations occur in hereditary hemochromatosis

A

C282Y, H63D

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5
Q

what can occur if correct hyponatremia too fast

A

osmotic demyleination

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6
Q

what can occur if correct hypernatremia too fast

A

cerebral edema

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7
Q

bradycardia, AV block, hypotension and diffuse wheezing

A

beta blocker OD

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8
Q

what to do with beta blocker OD patient

A

O2 and IV atropine and then glucagon because it increased cAMP

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9
Q

signs of wilsons

A

tremor, rigidity, depression paranoia and catatonia

will have mallory bodies in liver Bx

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10
Q

Dx of wilsons

A

measure ceruloplasmin— low

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11
Q

Tx for empyema

A

surgery

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12
Q

viral myocarditis most likely due to

A

coxsackie B virus

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13
Q

herpes zoster opthalmicus

A

dendriform corneal ulcers and vesicular rash in trigeminal distribution

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14
Q

what will Ca and phosphate levels be in chronic kidney disease

A

high phosphorus from retention
low Ca from dec intestinal absorption from dec active Vit D
increased PTH because of low Ca
all in all causes secondary hyperparathyroidism

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15
Q

sudden onset photopsia and floaters

A

retinal detachment

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16
Q

anemia of chronic disease MCV, iron, TIBC ferritin and transferrin levels

A 
MCV normal/ low
iron low
TIBC low
ferritin normal/ high
transferrin normal/low
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17
Q

anemia from iron deficiecny

MCV, iron, TIBC, ferritin, transferrin levels

A 
MCV low
iron low
tibc high
ferritin low
transferrin low
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18
Q

which drugs can cause esophagitis

A

tetracycline
aspirin and NSAIDs
Alendronate
KCl, quinidine and iron

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19
Q

most important risk factor for squamous cell CA

A

sunlight

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20
Q

production of angiotensin II causes what

A

vasoconstriction of afferent and efferent arterioles increasing renal vascular R and net decrease in blood flow
vasoconstricts efferent more so maintain GFR
stimulates resorption in proximal tubules and increases secretion aldosterone from adrenals– decreased sodium delivery to distal tubule increasing Extracell volume

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21
Q

CHF what happens to RAAS

A

increases Renin to increase angiotensin II to maintain kidney function and increase CO

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22
Q

Hawthorne effect

A

tendency of the study population to affect the outcome since they are aware that they are being studied

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23
Q

sample distortion bias

A

estimate of exposure and outcome association is biased because the study sample is not representattive of the target population

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24
Q

confounding bias

A

one or more variables associated independently with both exposure and outcome

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25
manifestations paroxysmal nocturnal hemoglobinuria
hemolysis- fatigue cytopenias venous thrombosis
26
what cutaneous lesions are found with Primary Biliary Cirrhosis
xanthelasma
27
Tx for paroxysmal nocturnal hemoglobinuria
iron and folate supplementation | eculizumab
28
labs for intravascular hemolysis
anemia with low haptoglobin and an elevated bilirubin and LDH
29
when do those not working in high risk environment and no risk factors have to be treated for + ppd
>15mm
30
what patients need to be treated for tb when ppd >5mm
HIV recent contacts with known tb cases nodular or fibrotic changes on CX organ transplants
31
when to use oseltamivir fo rinfluenza
``` age >65 pregnant COPD, CV, renal or hepatic chronic illness immunosuppression morbid obesity native americans nursing home or chronic care facility ```
32
skin lesion in leprosy
insensate hypopigmented plaque | progressive peripheral nerve damage causing muscle atrophy
33
confirm Dx leprosy
acid fast bacilli on skin biopsy
34
ethnicity to think leprosy
asian
35
Tx for visual Sx of giant cell arteritis
high dose corticosteroids and oral therapy with slow taper over the course of months
36
Tx CMV retinitis
ganiclovir or foscarnet
37
Dx amebic liver abscess
stool examination for trophozoites, serology and liver imaging
38
Tx amebic liver abscess
metronidazole
39
what can cause malignant biliary obstruction
cholangiocarcinoma pancreatic or hepatocellular carcinoma metastatic CA
40
middle ear disease
get tinnitus but not vertigo
41
Tx for agitation in elderly
low dose haloperidol | atypicals: quetiapine or risperidone
42
what cause bacillary angiomatosis
bartonella, gram neg bacillus
43
Tx bacillary angiomatosis
erythromycin
44
definition of pulsus paradoxus
exaggerated fall in systemic BP >10mmHg
45
pulsus paradoxus is found in what conditions
cardiac tamponade but also can happen in severe asthma or COPD
46
Tx toxic megacolon
IV fluids, broad spectrum antibiotics and bowel rest | if IBD induced megacolon then use IV corticosteroids
47
cerebellar dysfunction signs in alcoholic
gait instability, truncal ataxia, dysdiadachokinesia, hypotonia and intention tremor
48
most common cause of bicuspid aortic valve in developed countries? non developed?
developed- bicuspid aortic valve | non developed- rheumatic heart disease
49
Becks triad
cardiac tamponade - hypotension - distended neck vv - muffled heart sounds
50
what happens to preload, SV and CO in cardiac tamponade
all decrease
51
why does inspiration worsen cardiac tamponade
because that increases venous return but the heart cannot accommodate to the increase fluid because restricted
52
fixed upper airway obstruction
laryngeal edema | will flatten inspiratory and expiratory flow curves
53
causes of erythema nodosum
strep infection most common | sarcoidosis, TB, histo, IBD
54
value for pulmonary hypertension
>25
55
management pulmonary HTN
loops and ACEI
56
Type 2 HIT
autoimmune from autoAb against heparin platelet factor 4 complexes
57
how to Dx type 2 HIT
serotonin release assay
58
Tx for type 2 HIT
stop heparin and start alternative anticoagulants like direct thrombin inhibitors
59
what cutaneous lesions are found with Primary Biliary Cirrhosis
xanthelasma
60
common extracolonic manifestations of IBD
erythema nodosum, pyoderma gangrenosum, eouscleritis, arhtritis, cholangitis
61
which marker is + in Ulc Colitis
p ANCA
62
HLA B27
ankylosing spondylitis | also assoc with UC
63
low pcwp and high mixed venous O2 saturation
septic shock
64
what decreases intensity of mitral prolapse
squatting from standing because increases preload
65
behcets
recurrent oral ulcers plus 2+: - recurrent genital ulcers - anterior uceitis - erythema nodosum
66
ethnicities of behcets
turkish, asian, middle eastern
67
most common occular manifestation of giant cell arteritis
anterior ischemic optic neuropathy
68
Tx for visual Sx of giant cell arteritis
high dose corticosteroids and oral therapy with slow taper over the course of months
69
Tx for Dx of familial colonic polyposis (auto dom)
procto-colectomy
70
what causes conjugated hyperbilirubinemia
hepatocellular injury, decreased bilirubin excretion in bile canaliculi, intrahepatic cholestasis or extrahepatic cholestasis from biliary obstruction
71
elevated alkaline phosphatase out of proportion to the transaminases suggests what
intrahepatic cholestasis or biliary obstruction
72
what can cause malignant biliary obstruction
cholangiocarcinoma pancreatic or hepatocellular carcinoma metastatic CA
73
what can cause false positive VDRL
Antiphospholipid Ab syndrome
74
Tx antiphospholipid Ab syndrome pregnant lady
low molecular weight heparin
75
S4 heart sounf at end of diastole is associated with what
L ventricular hypertrophy from prolonged HTN
76
definitive Tx for acute popliteal artery occlusion
surgical embolectomy
77
Dx imaging for zenkers diverticulum
contrast esophagram
78
signs of zenkers diverticulum
``` elderly dysphagia regurg foul smelling breath aspiration occasionally palpable mass ```
79
travelers diarrhea with persistent non bloody watery diarrhea >2 weeks
cryptosporidium
80
cerebellar dysfunction signs in alcoholic
gait instability, truncal ataxia, dysdiadachokinesia, hypotonia and intention tremor
81
young female with history of trigeminal neuralgia
MS

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