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ICM Final
ICM FInal
149
Medical
Professional
11/07/2011

Additional Medical Flashcards

 


 

Cards

Term
Acute respiratory failure define
2 type
Definition
Decreased O2 or Increased CO2 due to airway issues
Hypercapnic Respiratory Failure: Increased CO2 with normal or decreased O2
Non-hypercapnic Respiratory Failure: decreased O2, normal/decreased CO2
Term
Blue Bloaters
Definition
Bronchitis
Cyanotic, productive cough x 3 months
TONS OF MUCUS
60/60 club. 60%O2, 60%CO2
smoker
Term
Pink Puffer
Definition
Emphysema
smoker or alpha1 antitrypsin deficiency in young
DESTRUCTION of alveolar walls
Barrel chest - increased AP diameter
Flattened diaphragm
Term
5 Findings in Consolidation Pneumonia
Definition
(1) Dullness on percussion
(2) Increased fremitus
(3) E to A changes
(4) Decreased breath sounds
(5) Whispered pectoriloquy over consolidation
Term
Gallop + Rales = ?
Definition
CHF
Term
A-a gradient Equation Normal?
Definition
Normal 10-20 150- [pO2 + pCO2/0.8)]
Term
Lethargy in SOB pt
Definition
WARNING SIGN - -- impending respiratory failure, ultimate respiratory arrest -- cardiopulmonary arrest
Term
arrhythmia jumps or skips
Definition
Extra systoles
Term
arrhythmia independent of exercise or excitement, anemia, febriles states, hypoglycemia, anxiety (3)
Definition
A fib
A fluter
Thyrotoxicosis
Term
"Atacks" develop rapidly, but not sudden.
Definition
hemorrhage, hypoglycemia, adrenal medullary tumor
Term
arrythmias Sx on standing
Definition
postural hypotension
Term
arrhythmia rate is normal and regular rhythm
Definition
Anxiety (by exclusion)
Term
Mid systolic click
Definition
Mitral valve prolapse
Term
Goal timeline of MI tx
Definition
within 90 minutes - lowers mortality at 24 hours and 30 days
Term
MI tx at 1-2 hours?

MI tx at 2-12 hours?
Definition
1-2: substantial myocardial salvage - affects survival and LV function
2-12: modest benefit, improved electrophysiologic stability
Term
Atypical sx of MI
Definition
dyspnea, syncope, confusion, stroke, fatigue, generalized weakness, N/V
Term
Role of EKG in AMI***
Definition
ESTABLISHES CRITERIA THAT DICTATES THERAPEUTIC INTERVENTION!

Do serial EKGs = 1/2 pts EKG is normal at first, then changes
Term
AMI pt with systolic BP >90 give what med?
Definition
Nitroglycerin
Term
5 Contraindications to thrombolytic therapy in AMI pt
Definition
(1) Recent major surgery - 10 days
(2) Cerebrovascular disease
(3) Recent GI/GU bleeding - 10 days
(4) Recent trauma - 10 days
(5) Hypertension, systolic >190, diastolic >110
Term
Positive tests in post-streptococcal glomerulonephritis? (6)
Exam findings? (2)
Definition
(1) anti-streptolysin O (ASO)
(2) anti-DNase B
(3) anti-hyaluronidase
(4) anti-streptokinase
(5) Elevated C3
(6) Normal C4

Elevated BP, Peripheral edema
Term
WBC cast?
Definition
Pyelonephritis
Term
RBC cast?
Definition
Glomerulonephritis
Term
False + hematuria
Definition
Semen, alkaline urine >9 pH, contamination
Term
False - hematuria
Definition
Vitamin C - if dipstick is negative, you can believe it. rare to have false -
Term
Dipstick for blood +
Micro for blood -
Definition
Hemoglobinuria/Myoglobinuria
Term
Renal failure + Deafness
Definition
Alports Disease
X linked hereditary nephritis
Term
+family hx of hematuria
No renal failure
Definition
Thin Basement membrane disease
autosomal dominant - benign familial hematuria
Term
Berger's Disease
C' level?
Definition
aka IgA nephropathy
IgA deposits in BM
COMPLEMENT LEVELS NORMAL
Term
Goodpasture triad
Definition
(1) glomerulonephritis
(2) Pulmonary hemmorrhage
(3) anti-GBM antibodies
Term
Urethral irritation + no discharge
Definition
Chlamydia
Term
Penile discharge +
pain with ejaculation, pain in back, deep pelvic pain, perineal pain

Dribbling or hesitancy
Definition
Chronic prostatitis
Term
Reiter Syndrome tetrad
Definition
(1) Arthritis
(2) Urethritis
(3) Conjunctivitis
(4) Dermatitis
Term
Painful Ulcer on penis
Definition
herpes, chancroid
Term
PainLESS ulcer on penis + painLESS lymphendopathy
Definition
Syphillis
Term
Genital vesicles
Definition
herpes
Term
BEST TEST for lab analysis of uretral discharge***
Definition
Nucleic Acid Amplification
Term
Penile discharge + joint pain or rash
Definition
Disseminated gonnorrhea
Term
Urethral discharge gram stain = gram negative intracellular diplococci
Definition
Gonnorrhea
Term
Painless papule with tender lymph nodes
Definition
Lyphogranuloma venereum (LGV)
chlamydia types L1-L3
Term
Painful ulcer with tender lymph nodes
Definition
Chancroid
Hemophilus ducreyi
Term
Labs of Sickle Cell ***
Definition
ANEMIA!!!!! + Reticulocytes
Term
Most common bug for Septicemia in sicklers
Definition
Strep pneumo
Term
Most common bug for meningitis in sicklers
Definition
Strep pneumo
Term
Most common bug for Osteomyelitis in sicklers***
Definition
Salmonella
Term
Most common bug for Pneumonia in sicklers
Definition
Mycoplasm pneumo
Term
Tetrad of Tetrology of Fallot
Definition
(1) Pulmonary Stenosis
(2) RV hypertrophy
(3) Overriding Aorta
(4) Ventricular septal defect
Term
Blue Babies?
Definition
T names
Right- to- left shunts
Tetrology of Fallot
Transpostition of Great vessels
Tricuspid Atresia
Truncus Arteriosus
Total Anomalous Pulmonary Venous Return
Term
CXR of tetrology of fallout
Definition
Boot shaped heart
Term
CXR -- egg on a string, narrow mediastinum
Definition
Transposition of Great Vessels
Term
Pink Babies
Definition
D names
Left to right shunts
ventricular septal DEFECT
atrial septal DEFECT
patent DUCTUS arterioles
Term
Femoral pulses weaker than radial pulse
Definition
Coarctation of Aorta
Term
DiGeorge Syndrome Findings
Definition
CATCH 22 --- 22q11.2 Deletion
Cardiac defects
Abnormal facial features
Thymic hypoplasia
Cleft palate
Hypocalcemia
Term
Rose colored spots on soft palate/ Forchheimer spots
Definition
Congenital Rubella Syndrome

neonatal = intrauterine growth restriction, microcephaly, microphthalmia, B/T cell deficiencies
Term
Short girl with web neck, coarctation of aorta
Definition
Turner's
Term
5 Jones Criteria for Rheumatic Fever
Definition
(1) Polyarthritis
(2) Carditits
(3) Chorea
(4) Erythema marginatum
(5) Subcutaneous nodules
Term
Kawasaki acute sx
Kawasaki subacute sx
Tx?
Definition
Acute: fever (UO), conjunctival erythema, strawberry tongue, giant cell artery aneuryms

Sub acute: Dequamationof skin, thrombocytosis, onset of aneuryms

Tx: IV Ig, aspirin in acute phase
Term
GC Tx
Definition
Cefriaxone 250 mg IM single dose

Azithromycin 1gm orally in single dose
Term
Rule of Two's
Definition
How to determine tx in pediatric asthma
If daytime sx occurring two or more times per week
Or Nighttime sx two or more times per month
Need Anti-inflammatory medication
Term
UL absent breath sounds, persistent wheezing unresponsive to drugs
Definition
Foreign body aspiration
Term
Radiograph for foreign body?
Definition
Expiratory lateral decubitus chest radiographs
Term
See nasal polyposis - think what?****
Definition
Cystic Fibrosis
Term
What week gestation does kid have surfactant?
Definition
34 weeks
Term
Ground-Glass haze in lung surrounding air filling bronchi ****
Definition
Acute Respiratory Distress Syndrome
Term

Transient Tachympnea of newborn (TTN)?

Tx? 

Definition
self-limiting condition characterized by tachypnea, mild retractions, hypoxia, and occasion grunting Tx on if cyanotic with 30% O2
Term
Litterer-Siwe Disease / Histiocytosis X
Characteristic?
Include in what dDx?
Definition
Characterized by hemorrhagic or petechial lesions
Include in dDX of Atopic Dermatitis
Term
Morning Stiffness, Symmetic swelling of joints
Definition
Rheumatic Disease
Term
Looks like Rheumatoid + Back Pain
Definition
Spondyloarthritis
Term
Osteophite on Xray
Definition
Osteoarthritis
Term
Morning stiffness + pain wakes you up at night
Definition
Ankylosing Spondylitis
Term
Bamboo spine
Definition
Ankylosing Spondylitis
Term
Thumb & Pinky swollen
Definition
DO THOROUGH SKIN EXAM
Psoriatic Arthritis
Term
Nail pits + urethritis
Definition
Psoriatic Arthritis
Term
Person from minnesota or from scandenavian descent
Definition
Giant Cell ARteritis

Temporal biopsy
BLINDNESS!! - occlusion of opthalmic artery
Term
20 yo Asian Female
Definition
Takayasu's Arteitis
Pulseless disease
Term
Nasal Septal perforation
Bloody/serous nasal discharge
Definition
Wegener Granulomatosis
c-ANCA
Term
Palpable purport + bowel intussusception
Granulocytes and WBC debris in vessel wall
IgA deposits in skin
Definition
Henoch-Schoenlein Purpura
Term
What makes you think vasculitis?
Definition
Palpable purpura
unexplained pulmonary infiltrates
Hematuria
mono neuritis
Digital/limb ischemia
Stroke like syndrome in young pt
Unexplained visual change with elevated ESR (giant cell)
Term
Beck's Triad of Tamponade
Definition
(1) Hypotension
(2) JVD
(3) Distal heart sounds
Term
Chest pain worse with respiration and laying flat
Definition
Acute pericarditis
Term
Paradoxical pulse define
disease?
Definition
Define - 10mm drop in systolic BP with inspiration
Chronic pericarditis
Term
JVD with + Kussmauls sign
Edema
Definition
Chronic, Constrictive Pericarditis
Term
Heart failure + suggestion of liver failure
Definition
chronic, Constrictive Pericarditis
Term
AIDS pt with effusion and tamponade
Definition
HIV Pericarditis
Term
"Immigrant from India/Mexico with gradual onset of heart or liver failure"
Definition
TB caused Constrictive Pericarditis
Term
Low voltage QRS complexes
Definition
Tamponade
Term
Buerger's Disease
Definition
Peripheral arterial insufficiency due to smoking!!!!
Term
Leriche Syndrome
Definition
Aortoiliac occlusive diease
Buttock, hip, thigh pain
Erectile dysfunction
Term
Gold standard for dx of PVD
Definition
Angiography
Term
Pt has intermittent claudication - include what in you dDx****
Definition
Lumbar Spinal Stenosis
Term
4 Steps of Pulmonary Exam ***
Definition
(1) Inspect
(2) Palpate
(3) Percuss
(4) Auscultate
Term
What do you do with pt with Pneumonia + leukopenia**
Definition
HOSPITALIZE
Bad sign
Term
Most common cause of pericarditis?
Definition
Neoplasm
Term
What do you hear with pericarditis?
Definition
Friction Rub louder when leaning forward
Term
Gram- bacilli pneumonia in alcoholics
Definition
Klebsiella
Term
3 Most common bug causes of pneumonia
Definition
Strep pneumo
Haemophilus influenza
Moraxella catarrhalis
Term
multiple lung cavities...think?
Definition
septic emboli
DKA, mental status changes
Term
Chicken farmer in midwest, Ohio, Michigan, Indiana with pneumonia
Definition
Histoplasmosis
Term
FEV1/FVC ratio Increased
DLCO decreased
Definition
Interstitial Lung Disease (pulmonary fibrosis)
Term
Histological hallmark of IPF (idiopathic pulmonary fibrosis)
Definition
Usual Interstitial Pneumonia (UIP)
Term
"Honeycomb fibrosis"
Definition
UIP
indicates idiopathic pulmonary fibrosis
Term
Virchow's Triad
Definition
(1) Stasis
(2) Injury
(3) Hypercoagulability
Term
Unexplained dyspnea, tachycardia
R/O?
Definition
PE
Term
Hypoxemia + Hypocapnia = ****
Definition
pulmonary embolus
Term
paO2/FiO2 = 250
Definition
ALI
Term
paO2/FiO2 = 180
Definition
ARDS
Term
UNDERLYING MECHANISM OF ARDS?******
Definition
PERMEABILITY EDEMA
Term
"Mom gives kid apple juice - scream in pain"
Definition
Mumps
Term
CSF has mononuclear pleocytosis ***
Definition
Mumps
Term
Mumps maximum period of infectiousness
Definition
Via respiratory droplets (P2P)
1-2 days before, and 5 days after parotid swelling
Term
Mumps vaccine
1st dose?
2nd dose?
Definition
1: 12-15 months
2: 4-6 years
Live vaccine - no immunosuppresed
HIV who are fairly health, still get vaccine - benefits out weight vaccine risks
Term
10 day old with SEZIURES!...think?
Definition
HSV - herpes
Term
Eastern coastal, Southeastern, and western states with rash
May- October
Definition
Rocky Mountain spotted fever
Term
Rash starts peripherally and spreads to entire body including palms and soles****
Definition
Rocky Mountain Spotted fever
Term
Most common cause of pneumonia in:
Neonates?
3-12 months?
12-60 months?
5-18 years?
>18 years?
Definition
Neonates = Group B Strep
3-12 months = RSV
12-60 months = Respiratory virus
5-18 years = M. pneumonia
>18 years = M. pneumonia
Term
Croup bug?
Definition
Parinfluenza
Term
Herpangina bug?
Definition
Coxsackie A
Term
Bullous myringitis (ear drum thing) bug?
Definition
Mycoplasma Pneumonia
Term
Conjunctivitis + sore throat = ?
Definition
Adenovirus
Term
Child with
HA + N/V/abd pain + sore throat = ?
Definition
Strep until proven otherwise
Term
***Sore throat + drooling + respiratory difficulties = ?
Definition
Epiglottitis
Term
Hot potato Voice = ?
Definition
Peritonsilar abscess or lingular tonsillits
Term
Uvula deviated =
Definition
peritonsilar abscess
Term
Cicumoral pallor + rash = ?
Definition
Scarlet Fever
Term
Rash on trunk = SPARES PALMS AND SOLES
Definition
Scarlet Fever
Term
Ampicillin or Amoxicillin give what rash?
Definition
maculopapular rash
Term
Centor Criteria for Strep Troat
Definition
(1) No cough
(2) Febrile
(3) Anterior Lymphadenopathy
(4) Exudate
Term
Pyuria + bacteriuria + WBC casts =
Definition
pyelo
Term
Pyuria + bacteriuria only =
Definition
cystitis
Term
pyuria without bacteriuria
Definition
Chylamydia
Term
Tx of Uncomplicated UTI
complicated?
Definition
3 days of TMP-SMX
Pain relief with Pyridium for 2 days ONLY!

complicated = 7 days of tx
Term
Fundoscopic Acute hypertensive damage
Definition
Papilledema, fundal hemorrhage, vasospasm
Term
Fundoscopic Chronic hypertensive damage
Definition
AV nicking, silver wiring, arteriolar aneurysms, cotton-wool exudates
Term
Define Hypertensive Urgency
Definition
Diastolic >115 NO END ORGAN DAMAGE
Term
Equation of MAP
Definition
MAP = diastolic BP + [(systolic-diastolic) / 3]
Term
Renal biopsy shows what in PSGN
Definition
IgG and C3 pattern, sub epithelial deposits "humps"
Term
Leads for Anterior Infarct STEMI
Definition
V1,2,3,4
Term
Leads for Lateral Infarct STEMI
Definition
I, AVL
Term
Leads for Inferior Infarct STEMI
Definition
II,III,AVF
Term
Leads for Posterior Infarct
Definition
ST depression in V1,V2
Term
EKG changes in INJURY
Definition
ST Elevation
Term
EKG changes in ISCHEMIA
Definition
inverted T wave
Term
EKG changes in INFARCTION
Definition
Q waves
Term
Murmur with Ejection Click
Definition
Aortic Stenosis
Term
Murmur with Mid systolic click
Definition
Mitral Valve Prolapse
Term
Murmur with Opening Snap
Definition
Mitral Stenosis
Term
Continuous machine like murmur
Definition
Patent Ductus Arteriosus
Term
2 murmurs intensified by Valsalva Manuever
Definition
(1) MVP
(2) Hypertrophic Cardiomyopathy
Term
Murmur that decreases with hand grip
Definition
Hypertrophic Cardiomyopathy
Term
Normal Pressure Values?
Wedge =
Right Atrium =
Pulm. Artery =
Left Ventricle =
Definition
Wedge = <12
RA = <5
PA = <25/10
LV = <130/10
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