World9 Flashcards
(100 cards)
1
Q
Bypass surgery can cause symptomatic gallstones, but what causes the gallstones
A
rapid weight loss promotes gallstone formation
2
Q
patient with hypocalcemia and hyperphosphatemia in the setting of CKD has what
A
secondary hyperparathyroidism
- causes parathyroid hyperplasia
- causes renal osteodystrophy on bone
3
Q
when do you perform large-volume abdominal paracentesis
A
if patient is symptomatic
- SOB
- abdominal pain
4
Q
first step in spontaneous bacterial peritonitis
A
abs not abdominal paracentesis
5
Q
type II renal tubular acidosis
A
impaired renal bicarbonate
hypokalemia
non-anion gap metabolic acidosis
6
Q
what causes constrictive pericarditis
A
result of acute pericarditis
7
Q
Jaundice, decreased appetite with weight loss, abdominal discomfort, fullness in right upper quadrant … has?
A
pancreatic cancer
- Elevation of bilirubin and alkaline phosphatase implies a cholestatic cause of jaundice, which can be caused by blockage of the common bile duct by a pancreatic mass.
- gallbladder neoplasms –> less likely jaundice b/c bile can pass through the common bile duct.
8
Q
What type of knee injury causes impairment of extension of the knee, instability, and exacerbation of pain with squatting
A
meniscal tears
9
Q
valgus instability indicates
A
medial collateral ligament
10
Q
Interleukin-1 receptor antagonists are useful in the treatment of
A
rheumatoid arthritis
11
Q
pulsatile abdominal mass
A
abdominal aortic aneurysm
12
Q
when do you repair an abdominal aortic aneurysm
A
size greater than equal to 5.5 cm
13
Q
What is the only thing increased in hypovolemic shock
A
systemic vascular resistance
14
Q
which type of shock only has elevated cardiac index
A
septic shock
15
Q
hemodynamically stable patient with widened mediastinum
A
transesophaglea echo or
CT scanning
16
Q
unstable patient with widened mediastinum
A
ex. thoracotomy
17
Q
clinical feature of lymphatic obstruction
A
marked thickening and rigidity of skin
- uncommon cause of edema
18
Q
hypovolemic hyponatremia triggers what
A
ADH secretion
- decreased serum osmolality
- decreased urine sodium (less 20)
19
Q
Common cause of osteomyelitis/ septic arthritis in sickle cell
A
Staph aureus
salmonella
20
Q
When is abs prophylaxis not recommended for dental procedure
A
mitral valve prolapse
rheumatic fever
ASD
bicuspid aortic valve
21
Q
treatment for extrapyramidal symptoms from antipsychotic medications
A
anticholinergic
diphenhydramine
22
Q
Dilated bowel can mean
A
small bowel obstruction
23
Q
what statin medication adverse effect give you leukocytosis
A
no
24
Q
the most effective treatment for benign paroxysmal positional vertigo
A
Epley maneuver
25
humeral midshaft fracture most like to damage what
radial nerve
26
treatment for advanced pancreatic cancer
endoscopic common bile duct stent
27
Large unilateral pleural effusion without evidence of infection
malignancy should be suspected
28
low acetylcholine activity--> neuro
alzheimer
29
Eosinophlic inclusions in neurons of the substantial nigra
Lewy body dementia
30
Loss of dopamine-producing cells
parkinsons
31
when does dementia occur in Parkinson's
later in disease course
32
patient with a combination of renal failure, hypercalcemia,and anemia should be evaluated for?
multiple myeloma
33
ER, physical violent person, next step
physical restraints and emergency haloperidol or Benz
34
Cardiac tamponade causes equilibration of what pressures
diastolic pressures
35
pathology in Meckel diverticulum
ectopic gastric mucosa
36
difference between autoimmune hemolysis and DIC
DIC will have elevated fibrinogen and increase INR.
| DIC = microangiopathic hemolytic anemia
37
how often do you get a lipid profile
every 5 years
38
potential compilation of thoracentesis
hemothorax
| - decreases left ventricular preload
39
clinical findings for testicular torsion
acute scrotal pain
tenderness
bell-clapper deformity
loss of the cremasteric reflex
40
transient inguinal bulge on Valsalva maneuver
hernia
41
most common cause of nephrotic syndrome in adults, particularly African Americans
focal segmental glomerulosclerosis
42
When do seizures typically occur in juvenile myoclonic epilepsy
occur upon awakening
43
lab values for complicated effusions
low glucose
low pH
high protein
44
2 most common organism for brain abscess are
viridian's streptococci
| Staphylococcus aureus
45
renal vein thrombosis is most commonly associated with what nephrotic syndrome?
membranous glomerulopathy
46
define oliguria
<250 mL urine in 12 hours
47
what should be performed in all patients with oliguria and acute renal failure due to suspected bladder outlet obstruction
urgent bladder scan and catheterization
48
what causes heat exhaustion
inadequate fluid and salt replacement
49
what causes extensional heat stroke
thermoregulation failure
50
what is the difference between heat exhaustion and exertional heat stork
Exertional heat stroke has CNS dysfunction (altered mental status)
51
What is the most common cause of abnormal hemostasis in patients with chronic renal failure? treatment?
platelet dysfunction
| DDAVP
52
clinical features of minimal change disease
NSAIDs
| lymphoma
53
elevated endolymphatic pressure
Meniere disease
54
bitter almond breath
cyanide poisoning
55
bony pain mets from cancer. treatment?
radiation therapy is faster
| bisphonates (Etidronate disodium) has a slower onset
56
can you get a macular skin rash with mycoplasma pneumonia
yes
57
first line treatment for beta blocker overdose
IV fluids and atropine
| IV glucagon if refractory hypotension
58
what are the 3 categories of lead toxicity
nonspecific (fatigue, irritability, insomnia)
neuropsychiatric (peripheral neuropathy, neurocognitivie deficits)
GI manifestations
59
Damage of one eye (the sympathetic eye) after a penetrating injury to the other eye? pathophysiology of this?
Sympathetic ophthalmia
| immunologic mechanism involving the recognition of 'hidden' antigens
60
Reagin-mediated disease
IgE-mediated
61
circulated immune complexes can affect the eye in what disease
SLE
62
Elbow held in extension, passive flexion of the wrist reproduces the patient's pain?
lateral epicondylitis (tennis elbow)
63
when you see first degree AV block, what should you do?
CHECK QRS duration
normal = observation
prolonged = electrophysiology testing
64
how do you treat bradycardia with hypothermia
hypothermia correction should correct heart
65
most common cause of bloody diarrhea in absence of fever is?
E. coli
66
targeted INR value for Warfarin
between 2-3
67
is Sporothrix Schenichkii purulent?
nope
68
Post-op patient with unexplained fever, diffuse RUQ abdominal pain, leukocytosis, normal liver/alk phos levels
Acalculous cholecystitis
69
What is contraindicated in lye (sodium hydroxide) ingestion
activated charcoal
70
What has low Leukocyte alkaline phosphatase levels
CML
71
First line pharmacotherapy options for alcohol use disorder
acamprosate and naltrexone
| acamprsate is better if the patient has liver disease
72
Treatment for body dysmorphic disorder
SSRI
| CBT
73
old lady on Benzo for sleep, next step
stop Benz then reassess, no need to start another drug just yet
74
Patient's psychiatric symptoms (anxiety, psychosis, insomnia), autonomic instability (hyperthermia, hypertension, tachycardia), short-term memory impairment, rigidity, dystonia, and focal seizure following a flu-like prodrome
autoimmune encephalitits
75
difference between meningitis and encephalitis
encephalitis has cognitive dysfunction
76
alcohol withdrawal, what type of benzodiazepines
short acting ATOM
77
Someone who presents with PCOS type symptoms with myopathy and bruising has what
Cushing syndrome
78
Upper GI series shows a crockscrew-shaped and rightward displaced deodenum
midgut volvulus (intestinal malrotatio)
79
first-line interventions for initial gout attack
alcohol cessation and weight loss
80
What is the strongest risk factor for superior pulmonary sulcus
smoking (not family history)
81
What murmur is best heard with the patient sitting up, leaning forward, and holding the breath in full expiration
aortic regurgitation
82
most likely diagnosis? child with cough, runny nose, and oral vesicles
viral pharyngitits
| reassurance and observation
83
which type of shock has mixed venous oxygen saturation
septic shock
84
Patient has a impaired wound healing and kidney failure?
Granulomatosis with polyangiitis (necrotizing vasculitis)
85
Peripheral blood smear shows signs of dysplasia, including oval macrocyte and hypo segmented/hypogranulated neutrophils? how to make diagnosis
myelodysplastic syndrome
| bone marrow biopsy is required for diagnosis
86
fevers, chronic diarrhea, abdominal pain, weight loss, been passing gas, and malordorerous discharge from vagina?
Crohn's with fistula formation
87
Tumor lysis syndrome
hypocalcemia
hyperphosphatemia
hyperkalemia
elevated uric acid levels
88
bad side effect of chemotherapy
neutropenia
| signs of sepsis is much more subtle
89
pathophys for diabetic ketoacidosis
fatty acids breaks down to ketones in the liver
90
Are focal neurologic deficits common in subarachnoid hemorrhage
nope
| Thunderclap headache
91
When do you use Pentamide with steroids for PCP
allergies to TMP-SMX
92
What complication occurs 5days to 2weeks after acute MI
rupture of ventricular free wall
- profound shock
- rapid progression to pulseless electrical activity and death
93
clinical feature of theophylline toxicity
central nervous system (headache, insomnia, seizure)
GI (nausea, vomiting)
cardiac toxicity (arrhythmia)
94
what type of gait is found in Parkinson's
Hypokinetic gait
| suffering gait
95
pharmacotherapy for patients who have recurrent stroke already on aspirin therapy
aspirin plus dipyridamole OR clopidogrel
96
conductive hearing loss
Rhine: bone conduction is greater than air conduction
Weber: lateralizes to affected ear
97
Sensorineural hearing loss
Rhine: air conduction is greater than bone (normal)
Weber: lateralizes to unaffected ear
98
2 things to thing about in a house fire
hydrogen cyanide toxicity (more worried about, more fatal)
| carbon monoxide
99
Treatment for cyanide toxicity
hydroxocobalamin or sodium thiosulfate
100
What causes methemoglobinemia?
exposure to oxidizing agents (dapsone, topical/local anesthetics)
