Term
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Definition
| appendicitis sign: RLQ pain w/ deep palpation of LLQ |
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Term
person comes in with classic appenicitis symptoms, e.g. RLQ pain that started as dull abdominal pain, leukcytosis, Rovsing sign.
What is the first step in management? |
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Definition
immediate surgery. Doing ultrasound/other imaging delays treatment
CT or ultrasound is good practice for atypical presentation or women of childbearing age, or older adults (the latter because they have a higher rate of negative exploratory laparotomy)
women should be first evaluated for pelvic pathology w/ abdominal ultrasound |
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Term
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Definition
walled off inflammatory mass, usually without bacteria. Examples include:
- untreated appendicitis (>5 days; if this happens, don't do surgery, just give IV antibiotics, bowel rest, and delay appendectomy)
- diverticulitis
- spondylodiscitis (inflammation of disc and vertebra, may start in disc(children) or vertebra(adults) and spread to the other. a common symptom of sepsis) |
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Term
in alcohol withdrawal, when do seizures begin to appear?
hallucinations? |
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Definition
12-48 hrs after last drink
12-24 hrs |
|
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Term
| what is first line treatment of alchohol withdrawal? |
|
Definition
long acting benzos:
diazepam
lorazepam
chlordiazepoxide
these stimulate GABA to cause seadtion
diazepam and lorazepam are prefered in sick, hospitalized pts b.c. they have active metabolites and result in fewer recurrent symptoms |
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Term
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Definition
| benzodiazepine receptor antagonist; used for benzo overdose |
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Term
| antisiezure drug for alcohol withdrawal seizures? |
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Definition
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Term
| what must be ruled out before alcohol withdrawal can be diagnosed? |
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Definition
| electrolyte abnormalities, infection, hypoxia (all can cause seizures) |
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Term
| drug that can be used to treat depression and smoking cessation |
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Definition
bupropion
it is a dopamine and NorEp uptake inhibitor |
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Term
| class of antidepressants that have been used for chronic pain |
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Definition
| tricyclics (e.g. amitriptyline used for diabetic neuropathy and migraine prevention) |
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Term
| antidepressant used in depression w/ anorexia &/or insomnia |
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Definition
| mirtazapine (will increase appetite and cause weight gain as well as treating depression |
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Term
| painless bleeding from rectum in elderly patient |
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Definition
diverticulosis
diverticulitis is painful |
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Term
| where do diverticula herniate? |
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Definition
areas where vasculature penetrates bowel wall
this is why they can bleed so much |
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Term
most common site of diverticulosis?
most common site of bleeding diverticulosis? |
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Definition
sigmoid colon
right colon
have to do CT scan to see them (not seen well w/ plain xray) |
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Term
| complement factor decreased in SLE and poststreptococcal glomerulonephritis? |
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Definition
| C3; this is because immune complexes activate and deplete this complement factor |
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Term
what beta HCG level can you observe a pregnancy with a:
-transvaginal ultrasound?
-transabdominal ultrasound? |
|
Definition
- transvag: as low as 1500 IU/L
- transabdom: >6500 IU/L
if you can't see a pregnancy, check beta-HCG levels. Doubling every 48 hrs = normal pregnancy. Lower rate of rise = ectopic pregnancy |
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Term
|
Definition
cephalosporin for gonnorrhea (e.g. cefoxitin)
doxycycline for chlamydia
hospitalize and give parenteral for patients at risk for low compliance |
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Term
| result of giving beta blocker to a person with pheochromocytoma |
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Definition
rapid incrase in blood pressure. THIS IS EXTREMELY DANGEROUS!
this happens b.c. blocking hte beta receptors on the vasculature will cause increase in the alphas and vasoconstriction
labetalol, which is a dual alpha and beta blocker, can be used safely |
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Term
| what is slipped capital femoral epiphysis? |
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Definition
classically presents in obese adolescent males.
it is when the femoral epiphysis (head) slips out of the joint. presents with knee pain, loss of abduction and internal rotation of hip, and external rotation of the thigh while the hip is flexed. frog-leg lateral xray is diagnositc
TREAT with surgical pinning of the slipped epiphysis where it lies (to avoid avascular necrosis) |
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Term
| acute onset, bilateral patchy airspace disease on CXR, PCWP <18 (normal) or no evidence of increased LVEDP, PaO2/FiO2 < 200 |
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Definition
diagnostic criteria for ARDS
NOTE: FiO2 is 21% normally, can be as high as 100% if being given O2 supplementation |
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Term
| most common cause of short stature and pubertal delay? |
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Definition
constitutional growth delay:
- normal birth weight
- between 6 mo to 3 yrs the height growth velocity slows
- around 3 yrs, the child grows normally, but just at a lower percentage height
- bone age is delayed and pubertal signs will be absent |
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Term
| bias introduced by loss of followup |
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Definition
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Term
loss of vision ("curtain-like") with complaints of photopsia and/or floaters
can occur b.c. of trauma or myopia, causing fluid to separate the retinal layers |
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Definition
retinal detachment
this occurs in people between ages 40-70 |
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Term
| large volume, frequent, foul smelling stools that are difficult to flush |
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Definition
steatorrhea. Think chronic pancreatitis (alcoholic), pancreatic or bile duct obstruction (CF, cancer), bacterial overgrowth in small intestines (they will disrupt the micelles by digesting them), malabsorption (celiac, tropical sprue, whipples.
rarely lymphatic obstruction can cause this (congenital dysplasia or acquired) |
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Term
| skin area that never tans, scales when scraped, and has a spaghetti and meatballs appearance in a KOH prep |
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Definition
| Malasezzia furfur (aka Tinea versicolor) |
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