Term
| infection that causes post uveitis (as opposed to ant) |
|
Definition
|
|
Term
| symptom specific to Parkinson's and not the other Parkinsonian syndromes |
|
Definition
|
|
Term
| cause of palpitations over 15 mins |
|
Definition
|
|
Term
| 2 Tx for Idiopathic edema |
|
Definition
| lie down, compression stockings |
|
|
Term
|
Definition
| estrogen - ~with mensturation |
|
|
Term
| 3 characteristics of Idiopathic Edema |
|
Definition
| hot weather, positional, females |
|
|
Term
| respiratory symptoms d/t Cirrhosis |
|
Definition
| Plathypnea + Orthodeoxia d/t pulmonary A-V fistula and Portopulmonary shunts |
|
|
Term
|
Definition
| collapsing focal segmental glumerulosclerosis |
|
|
Term
| 3 renal histologic path findings in DM |
|
Definition
| thickening of GBM, mesangial sclerosis, arterial sclerosis |
|
|
Term
| renal path in Wegener's and microscopic polyangiitis |
|
Definition
| Pauci-immune necrotizing GN |
|
|
Term
| predisposing factor to Superior Mesenteric Artery syndrome |
|
Definition
|
|
Term
| 3 risk factors for Stress Incontinence |
|
Definition
| childbearing, gynecologic surgery, menopause |
|
|
Term
| 1st line Tx for Stress Incontinence |
|
Definition
|
|
Term
| Most efficient Tx for Stress Incontinence |
|
Definition
|
|
Term
| most important indicator of prognosis in elderly living in geriatric setting |
|
Definition
|
|
Term
| 3 drugs that cause Vit B6 (Pyridoxine) def |
|
Definition
| Isoniazid, L-Dopa, Penicillamine |
|
|
Term
| 5 symptoms of Vit B6 (Pyridoxine) def |
|
Definition
| Glossitis, Stomatitis, Seborrheic Dermatitis, Cheilosis, Iron def Anemia |
|
|
Term
| 5 symptoms of Cyanide poisoning |
|
Definition
| eye irritation, tachypnea, confusion, skin flushing, tachycardia |
|
|
Term
| combination Tx for Cyanide Poisoning |
|
Definition
|
|
Term
| which medicine are the elderly less sensitive to |
|
Definition
|
|
Term
| 4 reasons for inc drug interactions in the elderly |
|
Definition
| inc Fat, dec Albumin, dec Elimination of drugs (hepatic+renal), dec Volume distribution (dec TBW) |
|
|
Term
| cause of urinary incontinence that occurs randomly w/o any stress |
|
Definition
|
|
Term
| 2 1st line Tx of Urinary Incontinence |
|
Definition
| behavioral +/- biofeedback |
|
|
Term
| 2nd line Tx for urinary incontinence |
|
Definition
| oxybutinin, tolterodine (anticholinergics), DDAVP |
|
|
Term
| 2 steps in the workup for urinary incontinence with abrupt symptoms or suprapubic pain |
|
Definition
| urine cytology + cystoscopy |
|
|
Term
| workup for long standing urinary incontinence in the female |
|
Definition
| no need for further workup - start Tx |
|
|
Term
| workup for long standing urinary incontinence in the male |
|
Definition
| urodynamics (obstruction) |
|
|
Term
| 3 possible causes of sudden dec mental status in a patient with cirrhosis |
|
Definition
| dec elimination of drugs (opiates), subacute bacterial peritonitis, hepatic encephalopathy |
|
|
Term
| 2 risk factors for IHD more significant in females than males |
|
Definition
|
|
Term
| primary/secondary prevention for IHD equally efficient in males and females |
|
Definition
|
|
Term
| condition for which Aspirin is effective as primary prevention in females and condition for it is not |
|
Definition
| effective as primary prevention for stroke in females, but not for MI |
|
|
Term
| comparison of 4 measures of outcome in females vs. males |
|
Definition
| females have more perioperative mortality, lower graft patency rate, less angina relief, same 5-10 yr mortality rate |
|
|
Term
| Tx of ACS - females vs. males |
|
Definition
| females Treated less frequently |
|
|
Term
| exercise ECG for IHD in females vs. males |
|
Definition
|
|
Term
| mortality for MI in young females vs. young males |
|
Definition
|
|
Term
| 3 1st line Tx for SVC syndrome |
|
Definition
| conservative: diuretics, incline head, low sodium intake |
|
|
Term
| 2nd line Tx for SVC syndrome |
|
Definition
|
|
Term
| how do you diagnose SVC syndrome |
|
Definition
| clinically - no need for imaging |
|
|
Term
| 2 findings in the physical examination of SVC syndrome |
|
Definition
| dilated neck veins, colleteralization on ant chest wall |
|
|
Term
| MCC of SVC syndrome and 7 other causes |
|
Definition
| MCC - SCC of lung + SCLC, other: lymphoma, aortic aneurysm, thyromegaly, fibrosing mediastinitis, thrombosis, histoplasmosis, Behcet |
|
|
Term
| MC complication of SAH at day 4-14 and its combination Tx, which drug is contraindicated |
|
Definition
| cerebral vasospasm, CCB + peripheral vasopressor to increase MAP, nitroprusside contraindicated |
|
|
Term
| 5 immediate mgmt steps for elevated ICP |
|
Definition
| VP shunt, hyperventilation, mannitol, sedation, induced hypernatremia (hypertonic saline) |
|
|
Term
| whats the next step if LP+ for blood in suspicion of SAH |
|
Definition
|
|
Term
| what is the diagnostic test for SAH 3 days after start of symptoms |
|
Definition
| LP for blood - xanthochromia |
|
|
Term
| what 2 maneuvers worsen the headache in SAH |
|
Definition
| bending forward and exertion |
|
|
Term
|
Definition
|
|
Term
| after anoxic brain injury, when can Px be given to the family, in what condition and what is it? |
|
Definition
| after 72 hrs if patient unresponsive to noxious stimuli and lacks brain stem reflexes or has an extensor motor response (decerebrate). Px 0-3% of neurologic recovery |
|
|
Term
| 4 signs of poor prognosis 1-3 days after anoxic brain injury |
|
Definition
| no brain stem reflexes, myoclonus, no response on somatosensory evoked potentials, serum Neuron-Specific-Enolase > 33 |
|
|
Term
| 2 Tx of anoxic brain injury |
|
Definition
| sedation + muscle relaxation and reduction of body temp to 33 for 12-24 hrs |
|
|
Term
| 3 criteria to determine brain death and stop life support |
|
Definition
| unresponsive to all external stimuli, absent brain stem reflexes, apnea test |
|
|
Term
| definition of Vegetative state and 4 positive signs that are present despite common belief |
|
Definition
| lacks meaningful responses to stimuli but has spontaneous mvmnts, independent respiration, autonomic function and is awake |
|
|
Term
| Px of cardiac arrest by type of predisposing arrhythmia |
|
Definition
| VT>VF>Pulseless Electrical Activity>Asystole |
|
|
Term
| MC mechanism for cardiac arrest |
|
Definition
|
|
Term
| 2 cases where Cardiogenic Shock occurs w/o coronary artery disease: |
|
Definition
| Takatsubu, LV apical ballooning |
|
|
Term
| what % of patients with cardiogenic shock have involvement of the left main coronary artery |
|
Definition
|
|
Term
| what is the MC coronary artery pathology in Cardiogenic Shock |
|
Definition
|
|
Term
| 5 risk factors for Cardiogenic Shock in acute MI |
|
Definition
| age, female, DM, prior MI, ant MI |
|
|
Term
| what type of MI is more common in Cardiogenic shock |
|
Definition
|
|
Term
| 3 factors in combination defining Cardiogenic shock |
|
Definition
| cardiac index < 2.2 L/min/m2, SBP<90, PCWP>18 |
|
|
Term
| Tx of metabolic acidosis (pH<7.2) in the setting of septic shock |
|
Definition
|
|
Term
| what is the predictor of survival in septic shock |
|
Definition
| the time interval btwn hypotension and administration of Abx |
|
|
Term
| 1st line Tx in septic shock |
|
Definition
| norepinephrine + dopamine |
|
|
Term
| 2 indications for Phenylephrine (alpha agonist) |
|
Definition
| correct hypotension after anaesthesia, 2nd line in septic shock |
|
|
Term
| 6 CIs for Succinylcholine |
|
Definition
| Hyperkalemia, acute renal failure, crash injury, muscular dystrophy, rhabdomyolysis, tumor lysis syndrome |
|
|
Term
| 2 complications of auto-PEEP |
|
Definition
| hypotension (dec preload), pneumothorax |
|
|
Term
| 3 step Tx of air build-up in auto-PEEP |
|
Definition
| disconnect ventilator, sedation, replug ventilator so only it provides ventilation |
|
|
Term
| when does auto-PEEP occur |
|
Definition
| asthma/copd - assist control + hyperventilation |
|
|
Term
| a sign that patient is not ready for spontaneous breathing |
|
Definition
|
|
Term
| 4 conditions for performing extubation |
|
Definition
| patient not sedated heavily, responds to commands, pH>7.35, SaO2>90% in FiO2<50% |
|
|
Term
| 2 volume controlled methods |
|
Definition
|
|
Term
| whats the difference btwn SIMV and assist control? whats common? |
|
Definition
| SIMV doesnt interfere with spontaneous breath, where as assist control gives a set volume. both will interfere without a spontaneous breath occuring |
|
|
Term
| indication for non invasive ventilation |
|
Definition
| acute exacerbation of COPD with pH 7.25-7.35 |
|
|
Term
| 5 contraindications to non invasive ventilation |
|
Definition
| facial surgery or trauma, upper airway obstruction, unstable hemodynamics, severe encephalopathy, cardiac/respiratory arrest |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| which cause of ARDS has higher mortality rates, direct or indirect lung injury? |
|
Definition
|
|
Term
| ARDS survivors regain pulmonary function within |
|
Definition
|
|
Term
| 3 step Tx for ARDS + 3 alternative unproven methods |
|
Definition
| mechanical ventilation - low tidal vol (less than 6 ml/kg), fluid restriction + diuretics to maintain low left atrial pressure, prone position, high PEEP, ECMO |
|
|
Term
| 7 conditions associated with ALI/ARDS |
|
Definition
| severe sepsis, bacterial pneumonia, aspiration, drug overdose, multiple bone fractures, chest contusion, multiple transfusions (TRALI) |
|
|
Term
| 2 characteristics of Decompression sickness |
|
Definition
| occurs in >7 meters deep, develops within 8-12 hrs |
|
|
Term
| 2 1st line Tx for Decompression sickness and 2nd line |
|
Definition
| lie horizontally, 100% O2 and hyperbaric O2 chamber |
|
|
Term
| 2 CIs to hyperbaric O2 Tx |
|
Definition
| pneumothorax and a Hx of Bleomycin Tx |
|
|
Term
| 4 risk factors for high altitude sickness |
|
Definition
| rate of ascent, previous episode, exertion, young |
|
|
Term
| prophylaxis for high altitude sickness |
|
Definition
| acetazolamide/dexamethasone |
|
|
Term
| Tx for high altitude sickness (4) |
|
Definition
| rest, acetazolamide, O2, descent |
|
|
Term
| a person with bilateral crakles and dyspnea after 1 day climb - high altitude pulmonary edema? |
|
Definition
| no, occurs 2-4 days after start of ascent |
|
|
Term
| a person climbing mount everest and has been in camp at 15,000 ft for the past 8 days. today, crackles and dyspnea - high altitude pulmonary edema? |
|
Definition
| no, doesn't start after 4-5 days at the same height |
|
|
Term
| risk factors for high altitude pulmonary edema (7) |
|
Definition
| previous episode, rapid ascent, RTI, cold temp, exertion, cardiopulmonary abnormality, male |
|
|
Term
| 5 s/s of high altitude pulmonary edema |
|
Definition
| cough, hemoptysis, crakles, tachypnea, tachycardia |
|
|
Term
| Tx of high altitude pulmonary edema (5) |
|
Definition
| descent, O2, inhaled beta agonists, CCBs, NO |
|
|
Term
| prophylaxis for high altitude pulmonary edema |
|
Definition
|
|
Term
| what is the time constraint for gastric decontamination? |
|
Definition
|
|
Term
| 3 options for Gastric decontamination. which is the TOC? |
|
Definition
| syrup of ipecac, activated charcoal (TOC - least invasive), gastric lavage (most ~ with aspiration) |
|
|
Term
| 3 lab signs for propylene glycol poisoning |
|
Definition
| inc anion gap, inc osmolal gap, inc lactate |
|
|
Term
| 3 lab signs for methanol poisoning |
|
Definition
| inc anion gap, inc osmolal gap, normal lactate and ketones |
|
|
Term
| 3 lab signs of salicylate poisoning |
|
Definition
| inc anion gap, normal osmolal gap, respiratory alkalosis |
|
|
Term
| 6 s/s of lithium poisoning |
|
Definition
| nephrogenic DI, inc chloride, vomiting, ataxia, encephalopathy, mvmnt disorders |
|
|
Term
| 4 Tx options for lithium poisoning |
|
Definition
| hydration, bowel irrigation, endoscopy, hemodialysis |
|
|
Term
| MCC of poisoning, 2nd MCC? |
|
Definition
|
|
Term
| MC pharmaceutical cause of fatal poisoning |
|
Definition
|
|
Term
| MCC of fatal poisoning overall |
|
Definition
|
|
Term
| what is the pathognemonic symptom of Ciguatera poisoning (fish in Florida)? |
|
Definition
| reversal of hot/cold perception |
|
|
Term
| how does mercury poisoning damage the fetus |
|
Definition
|
|
Term
| which type of mercury is benign and which is poisonous |
|
Definition
ethylmercury -safe, in vaccinations
dimethylmercury - lethal |
|
|
Term
| how do you diagnose mercury poisoning from chronic exposure |
|
Definition
|
|
Term
| what is the inheritance pattern of chronic granulomatous disease? |
|
Definition
| 70% x-linked, 30% autosomal recessive |
|
|
Term
| a patient with chronic granulomatous disease is susceptible to which 4 organisms |
|
Definition
| catalase +: staph. aureus, Burkholderia cepacia, aspergillus, chromobacterium violaceum |
|
|
Term
| what is the etiology of CGD |
|
Definition
| mutations in NADPH oxidase |
|
|
Term
|
Definition
|
|
Term
| 4 conditions that cause massive splenomegaly |
|
Definition
| CLL, autoimmune hemolytic anemia, lymphoma, myelofibrosis (extramedullary hematopoiesis) |
|
|
Term
| 3 conditions that cause only mild splenomegaly |
|
Definition
| portal hypertension, cirrhosis, right heart failure |
|
|
Term
| 7 signs that suggest malignancy in lymphadenopathy |
|
Definition
| age>50, site-supraclavicular, diameter>2cm, area>2.25 cm2, consistensy-hard (except in lymphoma b/c of rapid growth), fixed, non-tender |
|
|
Term
| general symptom in von Willerbrand Disease and 3 specific examples |
|
Definition
| mucosal bleeding (primary hemostasis): menorrhagia, post-dental procedure bleeding, epistaxis |
|
|
Term
| 4 signs that may raise suspiscion for vWD in females |
|
Definition
| iron def. anemia, need for blood transfusion, clots>1 inch in diameter during menses, frequent tampon change |
|
|
Term
| which 3 drugs cause photoallergy/phototoxicity (non immunologic mechanism) |
|
Definition
| fluoroquinolones, sulfonamides, sulfanylurea |
|
|
Term
| DRESS (drug reaction with eosinophilia and systemic symptoms) is a hypersensitivity syndrome that occurs with the following 8 drugs |
|
Definition
| phenytoin, carbamezapine, barbiturates, lamotrigine, minocycline, dapsone, allopurinol and sulfonamides |
|
|
Term
| 8 s/s of DRESS and their timeline |
|
Definition
pruritic rash, fever, facial edema, lymphadenopathy, leukocytosis, hepatitis, nephritis, pneumonitis
2-8 wks after starting drug and continue several wks after stopping |
|
|
Term
| what is the mortality rate in DRESS and what is a common sign present |
|
Definition
|
|
Term
|
Definition
| stop offending drug and start steroids |
|
|
Term
| definition of anaphylactoid drug reaction |
|
Definition
| the drug directly induces mast cell degranulation - not IgE mediated, therefore doesn't require previous exposure |
|
|
Term
| drugs that cause anaphylactoid reaction |
|
Definition
| NSAIDs, radiocontrast media |
|
|
Term
| drugs that cause IgE mediated drug reaction |
|
Definition
| penicillin, muscle relaxants |
|
|
Term
| what is telogen effluvium |
|
Definition
| hair loss d/t stress, synchronous hair death |
|
|
Term
| what happens to P2 and A2 in ASD |
|
Definition
|
|
Term
| which 3 cardiac abnormalities cause a holosystolic murmurs |
|
Definition
| VSD, tricuspid reg, mitral reg |
|
|
Term
| which drug dec the intensity of MR and VSD |
|
Definition
|
|
Term
|
Definition
|
|
Term
| what happens to S2 in VSD |
|
Definition
|
|
Term
| what is the pattern of the atrial pressure graph in TR |
|
Definition
| prominent c and v waves and a sharp y descent |
|
|
Term
| what do the letters a,c,x,v,y represent in the atrial pressure graph |
|
Definition
| Atrial contraction, ventricular Contraction, atrial relaXation, Venous filling, atrial emptYing |
|
|
Term
| what extra heart sounds present in mitral valve prolapse |
|
Definition
| midsystolic click followed by late systolic murmur |
|
|
Term
| how does standing affect the murmur in mitral valve prolapse |
|
Definition
| dec preload -> murmur longer and closer to S1 |
|
|
Term
| how does squatting affect the murmur in mitral valve prolapse |
|
Definition
| inc preload -> murmur shorter |
|
|
Term
| how does early Abx, within 48 hrs, affect acute s.pyogenes pharyngitis (3) |
|
Definition
| shortens symptoms duration, dec transmission, dec RF rates |
|
|
Term
| how does Dx of acute S.Pyogenes pharyngitis differ in adults and children |
|
Definition
adults - rapid strep test only
children - if rapid strep test -, perform culture to limit spread |
|
|
Term
| what do the letters a,c,x,v,y represent in the atrial pressure graph |
|
Definition
| Atrial contraction, ventricular Contraction, atrial relaXation, Venous filling, atrial emptYing |
|
|
Term
| what extra heart sounds present in mitral valve prolapse |
|
Definition
| midsystolic click followed by late systolic murmur |
|
|
Term
| how does standing affect the murmur in mitral valve prolapse |
|
Definition
| dec preload -> murmur longer and closer to S1 |
|
|
Term
| how does squatting affect the murmur in mitral valve prolapse |
|
Definition
| inc preload -> murmur shorter |
|
|
Term
| timeline of acute sinusitis |
|
Definition
|
|
Term
| what 2 maneuvers worsen the headache in acute sinusitis |
|
Definition
| lying down and bending forward |
|
|
Term
| when do you treat acute sinusitis with Abx (2) |
|
Definition
| adults over 7-10 days, children over 10-14 days |
|
|
Term
| what is the Abx Tx for acute sinusitis - 3 lines |
|
Definition
1st line Amoxicillin 500mg 1X3/d
2nd line (failure or Abx exposure in the month prior) - Fluoroquinolone
3rd line - sinus drainage (Abx failure) |
|
|
Term
| additive Tx of acute sinusitis if patient has Hx of allergy or chronic sinusitis |
|
Definition
|
|
Term
| what are the causes for long lasting anosmia (5) |
|
Definition
| severe respiratory infection, common cold, pneumonia, influenza, HIV |
|
|
Term
| what % of patients regain sense of smell after losing it in trauma |
|
Definition
|
|
Term
| age related macular degeneration is associated with what blood finding |
|
Definition
|
|
Term
| 3 characteristics of loss of vision in AMD |
|
Definition
| painless, billateral, central |
|
|
Term
|
Definition
| Vit C, E, betacortone, zinc |
|
|
Term
|
Definition
|
|
Term
| 3 secondary causes of restless leg syndrome |
|
Definition
| renal disease, neuropathy, iron def |
|
|
Term
| Tx of restless leg syndrome (2) |
|
Definition
| pramipaxole, ripinirole - dopaminergic |
|
|
Term
|
Definition
|
|
Term
| what is the symptom of RLS |
|
Definition
|
|
Term
| what is the mortality rate ~ with Delirium |
|
Definition
|
|
Term
| what is the incidence of delirium in the ICU |
|
Definition
|
|
Term
| in which dept. is delirium the 2nd most common |
|
Definition
| orthopedic dept. (after ICU) |
|
|
Term
| characteristics of BPPV symptoms (2) |
|
Definition
| symptoms last 1 min and provoked by positional change |
|
|
Term
|
Definition
| repositioning, the Epley maneuver, to remove Otoconia (calcium carbonate crystals) from the semicircular canal |
|
|
Term
| which is the MC affected semicircular canal in BPPV |
|
Definition
|
|
Term
| what 3 types of nystagmus are more likely in central vs. peripheral vertigo |
|
Definition
| spontaneous, vertical, gaze-evoked |
|
|
Term
| 2 characteristics of the nystagmus in peripheral vertigo |
|
Definition
| provoked by positional changes, can be inhibited by visual fixation |
|
|
Term
| what 4 symptoms, except nystagmus, are ~ with central vertigo |
|
Definition
| hiccups, diplopia, neuropathy, dysarthria |
|
|
Term
| what 2 lines of prophylaxis are there for Vaso-vagal syncope |
|
Definition
1st line: volume expansion and counterpressure maneuvers
2nd line: fludrocortisone, beta blockers or vasoconstrictors |
|
|
Term
| vaso vagal syncope ~ with 3 patient characteristics |
|
Definition
|
|
Term
|
Definition
| rewarming in warm water (37-40) |
|
|
Term
| immediate complication of frostbite Tx and what sould raise suspiscion |
|
Definition
| compartment syndrome - should be suspected if cyanosis persists after Tx |
|
|
Term
| 3 long term complication of frostbite |
|
Definition
| epiphyseal damage, skin carcinoma, nail deformities |
|
|
Term
|
Definition
|
|
Term
| 4 characteristics of Toxic shock syndrome |
|
Definition
| - blood cultures, S.Aureus, lack of primary infection site, diffuse rash |
|
|
Term
| whats important to do before Dx of Toxic shock syndrome |
|
Definition
| R/O rockymountain spotted fever, measles and leptospirosis by serology |
|
|
Term
| which 3 drug groups could percipitate heat stroke |
|
Definition
| anticholinergics, antiparkinsonian, diuretics |
|
|
Term
| what is the mechanism of death from the initial blast in radiation bioterrorism |
|
Definition
| shockwave and thermal damage |
|
|
Term
| what is the subsequent damage, after the initial blast, in radiation bioterrorism called and what is it(3)? |
|
Definition
| acute radiation syndrome: BM suppression, GI malabsorption and translocation of flora, neurologic damage |
|
|
Term
| what are possible symptoms after exposure to less than 2 Gy radiation |
|
Definition
|
|
Term
| 3 step Tx of radiation bioterrorism |
|
Definition
1. removal of clothing
2. CBC every 6 hrs for 24 hrs for BM suppression
3. supporative: GM-CSF and blood transfusions |
|
|
Term
| 3 examples of organophosphates |
|
Definition
|
|
Term
| 11 symptoms of cholinergic crisis d/t organophosphate poisoning |
|
Definition
| miosis, rhinorrhea, salivation, lacrimation, bronchospasm, nausea, vomiting, diarrhea, muscle fasiculations, central apnea, status epilepticus |
|
|
Term
| 3 step Tx of cholinergic crisi d/t organophosphate poisoning |
|
Definition
1. atropine 2-6 mg IV or IM
2. Oxime (pralidoxime - frees cholinesterase)
3. anticonvulsants - BZD |
|
|
Term
| 9 organisms with bioweapon potential |
|
Definition
| C.Tularensis, anthrax, smallpox, botolium, y.pestis, lassa, rift valley, ebola, yellow fever |
|
|
Term
| 3 major forms of anthrax infection |
|
Definition
| cutaneous, GI and inhalational |
|
|
Term
| 2 CXR findings in inhalational anthrax |
|
Definition
| widened mediastinum, pleural effusion |
|
|
Term
| what is the infective dose for anthrax |
|
Definition
|
|
Term
| post exposure Tx with Abx for anthrax effective within |
|
Definition
|
|
Term
| what are 2 methods of transmission of the botolinium toxin in bioterrorism |
|
Definition
| aerosol, food - not water b/c most places use choloride |
|
|
Term
| what can be done to inactivate the botolinium toxin |
|
Definition
| heating for 5 mins to a temp > 85c |
|
|
Term
| why should the time interval of contamination and infection in botolinium be short? |
|
Definition
| rate of environmental decay rate of 1% per min |
|
|
Term
| what are the y.pestis buboes |
|
Definition
| enlarged lymph nodes containing the proliferating bacteria, painful |
|
|
Term
| what are 2 manifestations of y.pestis infection |
|
Definition
| buboes and pneumonia-like illness |
|
|
Term
| 2 Tx options for y.pestis |
|
Definition
| Doxycycline or aminoglycosides |
|
|
Term
| 4 mgmt steps for massive hemoptysis |
|
Definition
1. lie on bleeding side
2. intubation with the largest possible endotracheal tube to allow for suctioning (dual lumen preferable)
3. fix coagulation abnormalities
4. if failure - embolization by angiography |
|
|
Term
| definition of chronic cough |
|
Definition
|
|
Term
|
Definition
| asthma, GERD, post-nasal drip, drugs |
|
|
Term
| 7 characteristics of breat cancer ~ with pregnancy (during or within 1 year of) vs. standard disease |
|
Definition
1. needle Bx non-diagnostic
2. worse prognosis
3. 30% estrogen + vs. 70%
4. larger tumor size
5. + axillary lymph nodes
6. HER2+
7. progressive stage at presentation |
|
|
Term
| 3 step mgmt of pain in the terminally ill |
|
Definition
1. determine the correct dose by a 48 hr patient-controlled trial
2. administer analgesic according to trial
3. provide immediate-release preparation for breakthrough pain |
|
|
Term
| Tx of depression in the terminally ill - 2 approaches |
|
Definition
1. Px several months - antidepressants + psychostimulants
2. Px few days/wks - psychostimulants |
|
|
Term
| 12 risk factors for postoperative pulmonary complications |
|
Definition
1. URTI
2. age>60
3. COPD
4. ASA>=2
5. functionally dependent
6. CHF
7. albumin < 3.5 g/dl
8. FEV1< 2L
9. maximum voluntary ventilation < 50% expected
10. peak expiratory flow < 100L or 50% of expected
11. PCO2>45
12. PO2<50 |
|
|
Term
| 6 items on the Revised Cardiac Risk Index - tool for calculating cardiovascular risk in non-cardiac surgery |
|
Definition
1. high risk surgical procedure: vascular, intraperitoneal, intrathoracic
2. IHD: Hx of MI, angina, nitrogylcerin, + exercise test, pathological Q waves
3. CHF: LVF by physical exam, nocturnal dyspnea, pulmonary edema, S3, billateral rales
4. cerebrovascular disease: TIA, CVA
5. DM: insulin
6. Chronic renal insufficiency: Cr>2 |
|
|
Term
| 4 interpertation categories of the Revised Cardiac Risk Index |
|
Definition
| 3 and over - 10%, 2- 5%, 1- 1%, 0- 0.5% |
|
|
Term
| DVT in pregnancy - which side MC, what % have factor V leiden |
|
Definition
|
|
Term
|
Definition
| clexane and switch to UFH 4 wks prior to delivery |
|
|
Term
| 2 conditions considered to be CI for pregnancy - absolute |
|
Definition
| PAH, eisenmengers syndrome |
|
|
Term
| 2 conditions considered to be relative CI for pregnancy |
|
Definition
| previous peripartum cardiomyopathy, valvular heart disease - especially MS |
|
|
Term
| 9 conditions more prevalent in females than males |
|
Definition
| HTN, autoimmune, depression, anxiety, eating disorders, bariatric surgery, obesity, osteoporosis, alzheimers |
|
|
Term
| what is a risk factor for IHD in females but not in males |
|
Definition
|
|
Term
|
Definition
| type 3 hypersensitivity reaction, complement against complex of Ab+drug |
|
|
Term
| when does serum sickness occur |
|
Definition
| 1-2 wks after initial exposure to drug |
|
|
Term
|
Definition
| fever, urticaria, lymphadenopathy, inflammatory arthritis, glomerulonephritis |
|
|
Term
| 4 drugs that cause serum sickness |
|
Definition
| streptokinase, vaccines, therapeutic Abs, penicillin |
|
|
Term
| 4 drugs that bind albumin, are active in their unbound state and therefore are in toxic levels in hypoalbuminemia (such as in cirrhosis) |
|
Definition
| phenytoin, warfarin, valproic acid, amiodarone |
|
|
Term
| how is digoxin eliminated |
|
Definition
| excreted in the kidney by an efflux pump - p glycoprotein |
|
|
Term
| 4 drugs that inhibit p-glycoprotein and can cause digoxin toxicity |
|
Definition
| amiodarone, verapamil, diltiazem, clarithromycin |
|
|
Term
| what are the normal levels of digoxin |
|
Definition
|
|
Term
| 7 s/s of digoxin toxicity |
|
Definition
| lethargy, delirium, atrial tachycardia, av block, ventricular tachy and fibrillation, bradycardia, hyperkalemia |
|
|
Term
| when do you treat digoxin toxicity with Fab? |
|
Definition
| levels>10 ng/ml or complete av block |
|
|
Term
| what Tx is not an option in digoxin toxicity and why |
|
Definition
| hemodialysis, high MW and VoD |
|
|
Term
| what Tx decreases incidence of malaria by 50% |
|
Definition
|
|
Term
| whats the preventive Tx for a mother infected with malaria from infecting her fetus |
|
Definition
| 2 doses of antimalarial drugs |
|
|
Term
| how is DALY - disability adjusted life years calculated |
|
Definition
| sum of the years literally and practically taken by the disease |
|
|
Term
| the MCC of DALY loss in developed countries |
|
Definition
| depression, after which IHD/CVA/Alzheimers |
|
|
Term
| the MCC of DALY loss and mortality in developing countries |
|
Definition
|
|
Term
|
Definition
| low sodium and effective osmolality (measured osmolality - serum urea)>275 |
|
|
Term
| what is the most common cause of death in patients presenting to the hospital with upper GI bleeding? |
|
Definition
| decompensation from other underlying illnesses |
|
|
Term
| what is the mgmt of patients who had just undergone endoscopic treatment of their bleeding peptic ulcer? |
|
Definition
| it depends on whether the the ulcer is clean based (no vessels seen), 1 day of hospitalization, or bleeding/visible vessel in which case rebleeding is frequent, especially in the first 3 days |
|
|
Term
| what is the mgmt of aspirin in a patient on it who presents with GI bleeding |
|
Definition
| it is stopped, the bleeding treated, and within 7 days of treatment the aspirin is reinstated |
|
|
Term
| what is the role of Abx in the treatment UGIB associated with cirrhosis |
|
Definition
| it is given prophylactically (ceftriaxone) to avoid septic complications |
|
|
Term
| in which aspect is distal splenorenal shunt in Child-Pugh class A or B cirrhotic patients better that TIPS (transjugular intrahepatic portosystemic shunt)? |
|
Definition
| it is associated with lower rates of repeat intervention |
|
|
Term
| 3 of the MCC of small intestinal bleeding in the adult |
|
Definition
| vascular ectasias, tumors (e.g., adenocarcinoma, leiomyoma, lymphoma, benign polyps, carcinoid, metastases, and lipoma), and NSAID-induced erosions and ulcers |
|
|
Term
|
Definition
|
|
Term
| 2 treatment options for LGIB from colonic diverticula |
|
Definition
| Intraarterial vasopressin or embolization by superselective technique |
|
|
Term
| HEMATEMESIS IS ALWAYS AN UGIB (above the ligament of treitz) |
|
Definition
|
|
Term
| what is the first step in the workup of a patient with hematochezia and hemodynamic instability |
|
Definition
| gastroscopy before colonoscopy |
|
|
Term
| what is the next step in the workup of a patient < 40, with LGIB and hemodynamically stable |
|
Definition
| sigmoidoscopy except in a number of exceptions where colonoscopy is indicated: abundant bleeding, iron def. anemia, colon cancer in the family |
|
|
Term
|
Definition
| no source has been identified by routine endoscopic and contrast x-ray studies (it can be occult) |
|
|
Term
| what is the initial step in the workup of massive obscure GIB? what about non-massive? |
|
Definition
angiography
video capsule endoscopy |
|
|
Term
| what is another option that may be considered in non-massive obscure GIB? |
|
Definition
| push endoscopy/pediatric endoscopy that can reach up to the jejunum |
|
|
Term
| which measurement predicts hepatic failure? |
|
Definition
|
|
Term
| how do you treat acute symptomatic hyponatremia? |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
| Three days of investigation, including at least 2 days' incubation of cultures |
|
|
Term
| 3 organisms to suspect with FUO and headaches |
|
Definition
| Cryptococcus neoformans, Mycobacterium tuberculosis, and travel-acquired trypanosomes - perform LP |
|
|
Term
| MCC of FUO in elderly, MC infection in this age group |
|
Definition
|
|
Term
| 3 of the MC drugs that cause FUO |
|
Definition
| b-lactam, phenytoin, quinidine |
|
|
Term
| what is the effect of grapefruit juice on P450 |
|
Definition
|
|
Term
| who can receive the live attenuated vaccine for influenza |
|
Definition
| Healthy, nonpregnant adults aged less than 50 years without high-risk medical conditions |
|
|
Term
|
Definition
Pulmonary
Bronchogenic carcinoma and other neoplasms
Lung abscesses, empyema, bronchiectasisChronic interstitial pneumonitis, Cystic fibrosis
Chronic obstructive lung disease
Sarcoidosis
Gastrointestinal
Inflammatory bowel disease
Sprue
Neoplasms: esophagus, liver,
bowel
Cardiovascular
Cyanotic congenital heart disease
Subacute bacterial endocarditis
Infected arterial graftsa
Aortic aneurysmb
Aneurysm of major extremity arterya
Patent ductus arteriosusb
Arteriovenous fistula of major extremity vessela
Thyroid (thyroid acropachy)
Hyperthyroidism (Graves' disease) |
|
|
Term
| what does not cause clubbing |
|
Definition
|
|
Term
| causes of erythema nodosum |
|
Definition
| infections (e.g., hepatitis C, tuberculosis, streptococcal, Mycoplasma pneumoniae, Yersinia, and Epstein-Barr virus), Coccidioides immitis, sarcoidosis, autoimmune disorders (e.g., inflammatory bowel disease or Behçet's disease), pregnancy, medications (sulfonamides, oral contraceptives, bromides), vaccinations, and cancer |
|
|
Term
| treatment of methanol poisoning |
|
Definition
| bicarbonate, alcohol dehydrogenase inhibitors (alcohol, femipazole), folic acid, hemodialysis |
|
|
Term
| treatment of ethylene glycol intoxication |
|
Definition
| Thiamine, folinic acid, magnesium, and high-dose pyridoxine to facilitate metabo-lism. Ethanol or fomepizole |
|
|
Term
| when would you give alcohol or femipazole to a patient with ethylene glycol intoxication |
|
Definition
| AGMA, crystalluria or renal dysfunction, ethylene glycol level >3 mmol/L (20 mg/dL), and for ethanol-like intoxication or increased osmolal gap if level not readily obtainable |
|
|
Term
| 3 metabolic disturbances in aspirin intoxication |
|
Definition
| Hypoglycemia, hypocalcemia, hypokalemia |
|
|
Term
| indications for hemodialysis in aspirin intoxication |
|
Definition
| coma, cerebral edema, seizures, pulmonary edema, renal failure, progressive acidbase disturbances or clinical toxicity, salicylate level >7 mmol/L (100 mg/dL) following acute overdose |
|
|
Term
| treatment of cyanide poisoning |
|
Definition
| High-dose oxygen. IV hydroxocobalamin or IV sodium nitrite and sodium thiosulfate |
|
|
Term
drugs that cause methemoglobinemia?
treatment? |
|
Definition
dapsone, local anesthetics, nitrates, primaquine-type antimalarials, sulfonamides
methylene blue |
|
|
Term
| what acid-base disturbance does iron intoxication cause |
|
Definition
|
|
Term
| what is the treatment of serotonin syndrome |
|
Definition
| cyproheptadine - serotonin receptor antagonist |
|
|
Term
| what is the treatment to prevent arrhythmias in tricyclic antidepressants intoxication (Amitriptyline, doxepin, imipramine) which elongates QT and PR |
|
Definition
|
|
Term
| in digoxin intoxication, what are the indications for Digoxin-specific antibody fragments? |
|
Definition
| hemodynamically compromising dysrhythmias, Mobitz II or third-degree atrioventricular block, hyperkalemia (>5.5 meq/L; in acute poisoning only |
|
|
Term
| how do you treat bradyarrhythmias in digoxin intoxication |
|
Definition
| atropine, dopamine, epinephrine, or external cardiac pacing |
|
|
Term
| how do you treat tachyarrhythmias in digoxin intoxication |
|
Definition
| magnesium, lidocaine, or phenytoin |
|
|
Term
| how do you treat hypotension and symptomatic bradycardia in CCB intoxication |
|
Definition
calcium and glucagon
High-dose insulin (with glucose and potassium to maintain euglycemia and normokalemia), intravenous lipid emulsion therapy, electrical pacing, and mechanical cardiovascular support for refractory cases |
|
|
Term
| how do you treat BB intoxication |
|
Definition
glucagon
High-dose insulin (with glucose and potassium to maintain euglycemia and normokalemia), electrical pacing, and mechanical cardiovascular support for refractory cases |
|
|
Term
| how do you treat torsades de pointes caused by antipsychotic intoxication |
|
Definition
| Magnesium, isoproterenol, and overdrive pacing |
|
|
Term
|
Definition
| tricyclic antidepressants, phenothiazine, amiodarone, quinidine |
|
|
Term
| drugs that do not need adjustment of dose d/t CKD |
|
Definition
| Fusid, ketoconazole, ceftriaxone, azithromycin, erythromycin, nafcillin, penicillin VK, doxycycline, clindamycin, linezolid, chloramphenicol, atrovastatin (lipitor), lansoprazole, omeprazole, dopamine |
|
|
Term
| electrolyte disturbance that causes muscle weakness |
|
Definition
|
|
Term
| decreased diffusion in COPD |
|
Definition
|
|
Term
| cyclosporine + statins --> myositis |
|
Definition
|
|
Term
| prolonged rescusitation with low BP may lead to elevated transaminases over 1000 |
|
Definition
|
|
Term
| obstruction of the biliary tree is not associated with elevation of transaminases over 1000 |
|
Definition
|
|
Term
|
Definition
| erythromycin, grapefruit juice, amiodarone, cimetidine, verapamil/deltiazam, clarythromycin, ketoconazole |
|
|
Term
|
Definition
| tegretol, rifampin, babiturates, phenytoin |
|
|
Term
| adverse effects of cyclosporine |
|
Definition
| HTN, ARF, gingival hyperplasia, hypertrichosis, tremor, seizures, PCP, electrolytes |
|
|
Term
| gas gangrene not associated with trauma |
|
Definition
|
|
Term
|
Definition
glucose - 40-70
protein 15-50
pressure 50-180
RBC - 0
WBC 0-5
PMN - 0 |
|
|
Term
| when do you draw blood for prognosis in aspirin/acetaminophen intoxication |
|
Definition
| initially at 4 hours from ingestion and then every 2 hrs |
|
|
Term
| what is the treatment of aspirin intoxication |
|
Definition
stomach lavage with saline
active carbon
sodium bicarbonate - alkylates the urine
hemodialysis
fluids and glucose |
|
|
Term
| 2 anticonvulsants that do not need lab follow up |
|
Definition
|
|
Term
| which intoxication requires dialysis |
|
Definition
|
|
Term
| what electrolyte abnormality is associated with rapid correction of Vit B12 |
|
Definition
|
|
Term
| what is the first treatment in a patient coming in confused, lung cancer, hypercalcemia |
|
Definition
|
|
Term
| the only patients who do not receive ampicillin empirically for meningitis |
|
Definition
| Immunocompetent children >3 mo and adults <55 |
|
|
Term
| when to stop statin inm the asymptomatic patient |
|
Definition
|
|
Term
| how do you continue antilipid therapy after stopping statins for the first time |
|
Definition
give either pravastatin or fluvastatin
less likely that a second muscle toxicity will occur |
|
|
Term
| how do you treat if muscle toxicity occurs after switching to pravastatin/fluvastatin |
|
Definition
|
|
Term
| תרופות שגורמות לפנקריאטיטיס |
|
Definition
• AZA- עד 15 אחוז ממקרים
• תיאזיד
• סטרואידים |
|
|
Term
|
Definition
• היפוקלמיה
• היפונתרמיה
• היפרקלצמיה
• דלקת ראות אאזונופילית
• טרמובציטופניה |
|
|
Term
|
Definition
• מפחית אשפוזים על ידי המרצת כיווץ מיוקרד, משפר התרוקנות חדר, כלומר מגביר CO וEF
• בAVN יש לו השפעות וגאליות. ביתר המיוקרד מעורר הפרעות קצב. הכי שכיח זה VPB וברדיקרדיה.
• גם שומר על קצב וגם יונוטרופי חיובי
• צניחות ST DOWNSLOPING-
• בהרעלה נראה av junctional tachycardia עם PR מוארך, ברדיקרדיה וייתכן טכיקרדיה
• אמיודורון מעלה רמת דיגוקסין
• בנוכחות היפוקסיה, היפוקלמיה, היפרנתרמיה,היפומגנזמיה, וחמצת סכנה לאריטמיה. כמו כן בעת אי ספיקת כליות, גיל מבוגר, תת פעילות של בלוטת התריס ומלא תרופות שונות כמו אמיודורון |
|
|
Term
| 5 דברים שלא ידעתי על אמיודרון |
|
Definition
יחד עם לידוקאין מעלה סיכוי לאסיסטולה
• אפידידימיטיס
מחמיר טוקסיות של דיגוקסין
• היפרפיגמנטיציה
• פוטוסנסטיביות |
|
|
Term
| תופעות לוואי של ציקלוספורין |
|
Definition
• נפרוטוקסי
• פרכוסים
• יל"ד
• זיהומים –בעיקר PCP
• TTP |
|
|
Term
| תופעות לוואי של דוקסיציקלין |
|
Definition
• ורטיגו
• פוטוטוקסיות
• כיבים בושט
• הפטוטוקסיות
• שקיעה בשיניים ועצמות של ילדים ועוברים ולכן לא נותנים לרוב בהריון או לילדים קטנים-בשימוש ממושך
• פטרת וגינלית |
|
|
Term
| גורמים שמעלים סיכון למיופתיה בשימוש בסטטינים |
|
Definition
• גיל מבוגר
• אי ספיקת כליות
• תרופות אנטיפונגליות
• תרופות מדכאות חיסון
• שבריריות
• אריטרומיצין
• שילוב עם פיברטים
• מיץ אשכוליות |
|
|
Term
| סטטינים והפרעה בתפקודי כבד |
|
Definition
• גורם להשפעה אידיוסינכרטית משולבת הפטוסלולרית/כוליסטטית
• רמות של אנזימי כבד הפטוסלולרים יש לבדוק
o לפני התחלת טיפול
o אחרי חודשיים-3
o ואחר כך פעם בשנה |
|
|
Term
|
Definition
• קריאטנין מעל 1.5 בגברים או 1.4 בנשים
• אי ספיקת לב
• הדמיה עם חומר ניגוד
• חולים קשים מאוד
• חמצת |
|
|
Term
|
Definition
• TCA
• סוטלול
• אריטרומיצין
• קווינידין
• אמיודרון-אבל פחות שכיח |
|
|
Term
|
Definition
| מתבטא במאקרוגלוסיה, בעיות לב (restricitive cardiomyopathy)/כליה/GI (תת ספיגה)/כבד, carpal tunnel syndrome ולזיות בעור (פפולות שעוותיות). |
|
|
