Term
| neck pain + fever + limited neck mobility 2/2 pain = |
|
Definition
|
|
Term
|
Definition
| inability to open mouth normally |
|
|
Term
| tx retropharyngeal abscess |
|
Definition
drainage
broad spectrum abx |
|
|
Term
|
Definition
|
|
Term
|
Definition
vesicles on tonsils and soft palate
sore throat, fever, dysphagia |
|
|
Term
|
Definition
|
|
Term
| unilateral nasal discharge + sore throat symptoms? |
|
Definition
|
|
Term
|
Definition
| aspirin exacerbated respiratory disease |
|
|
Term
|
Definition
1. nasal polyps
2. chronic rhinosinusitus
3. bronchospasm or congestion after taking aspirin or an NSAID |
|
|
Term
| juvenile nasal angiofibroma? |
|
Definition
rare
benign tumor
epistaxis
nasal obstruction and drainage
always in teen males |
|
|
Term
|
Definition
| tumor in nose with unilateral nasal obstruction +- epistaxis |
|
|
Term
|
Definition
in pregnant women
highly vascularized nasal granuloma that is usually on the septum and causes lots of nose bleeds during pregnancy |
|
|
Term
|
Definition
|
|
Term
| what causes acute angle closure glaucoma |
|
Definition
| closer or a pre-existing narrow anterior chanber angle |
|
|
Term
| signs/sx of acute angle closure glaucoma |
|
Definition
acute onset of severe eye pain
blurry vision
N/V
usually after pullary dilation (like in movie theatrr) |
|
|
Term
| what does the eye look like on exam in acute angle closure glaucoma |
|
Definition
unreactive pupil
red eye
steamy cornea |
|
|
Term
| management of acute angle closure glaucoma |
|
Definition
acetazolamide initially
laser peripheral iridotomy |
|
|
Term
| major features of open angle glaucoma |
|
Definition
slow onset
gradual loss of peripheral vision
tunnel vision
permanently increased intraocular pressure
"cupping" of optic disc |
|
|
Term
| slit lamp exam shows flare and cells |
|
Definition
|
|
Term
| other major characteristic of uveitis |
|
Definition
| constricted pupil with limited light response |
|
|
Term
| what type of test will reveal and abrasion of the cornea |
|
Definition
| slit lamp with fluorescein |
|
|
Term
| who gets acute closure glaucoma |
|
Definition
|
|
Term
| what infections do ppl with hereditary hemochromatosis get? |
|
Definition
listeria monocytogenes
yersinia
vibrio vulnificus |
|
|
Term
| systemic symptoms of hereditary hemochromatosis |
|
Definition
joint pain that is severe and worse in am
gray skin
hepatomegally
DM
dilated cardiomyopathy
hypogonadism
hypothyroid |
|
|
Term
| What is the inheritance pattern of hereditary hemochromatosis |
|
Definition
|
|
Term
|
Definition
occular lesions seen in endocarditis
retinal hemorrhages with white pale centers |
|
|
Term
| initial tx of endocarditis |
|
Definition
|
|
Term
| elevated conjugated vs unconjugated bilirubin |
|
Definition
elevated conjugated bilirubin: hepatobiliary disase, liver cirrhosis etc
elevated unconjugated: rapid hemolysis, enzyme def like gilberts |
|
|
Term
| What is the enzyme def in Gilberts syndrome |
|
Definition
| UDP glucuronyl transferases |
|
|
Term
| Clinical manifestations of Gilberts syndrome |
|
Definition
icterus
mostly unconjugated hyperbilirubinemia (there is SOME functioning enzyme, but not much)
malaise, fatigue, abdo discomfort
can be asymptomatic until there is an exacerbation |
|
|
Term
| what can exacerbate gilberts |
|
Definition
| exacerbated by hemolysis, fasting, consumeing fat free diet, physical exertion, fever, stress, fatigue |
|
|
Term
| which of the cirgler najjar syndromes is more severe |
|
Definition
|
|
Term
| major characteristics of crigler najjar type 1 |
|
Definition
severe jaundice
neuro sx 2/2 kernicterus
hi indirect bilirubin
presents in infancy |
|
|
Term
| liver enzymes in crigler najjar type 1 |
|
Definition
|
|
Term
| histology in crigler najjar type 1 |
|
Definition
|
|
Term
| tx of crigler najjar type 1 |
|
Definition
phototherapy
plasmapheresis
liver transplant is the only cure |
|
|
Term
| major characteristics of crigler najjar type 2 |
|
Definition
milder than type 1
survival into adulthood
no kernicterus or neuro sx |
|
|
Term
| tx difference between type 1 and type 2 crigler najjar |
|
Definition
type 2 phenobarbital will decrease hyperbilirubinemia
type 1 will not respond to phenobarbital |
|
|
Term
|
Definition
may not need treatment
can use phenobarbital or clofibrate at times when bilirubin is high |
|
|
Term
| who gets acalculous cholecystitis |
|
Definition
pt with:
1. extensive burns
2. severe trauma
3. prolonged TPN
4. prolonged fasting
5. mechanical ventilation |
|
|
Term
| chronic foot fungal infection followed by lower limb cellulitis. what is it and how do we treat it |
|
Definition
chronic foot fungal infections can increase the risk for bacterial cellulitis.
if cellulitis develops use IV nafcillin, cefazolin
OR if worried about MRSA use vanco |
|
|
Term
|
Definition
|
|
Term
| how does oral glucose tolerance test work |
|
Definition
give 75 g glucose load with glucose testing every 30-60 min for 2 hours
over 200 = DM
140-199 = impaired glucose tolerance |
|
|
Term
| best lab test for pts with androgen producing adrenal tumors |
|
Definition
|
|
Term
| PE shows fullness and tenderness along midline below umbilicus |
|
Definition
|
|
Term
| What drugs can cause urinary retention |
|
Definition
|
|
Term
| what diagnoses urinary retntion |
|
Definition
| postvoid redisual bladder colume greater than 50mL |
|
|
Term
| def of resistant hypertension |
|
Definition
| persistent hypertension on 3+ antihypertensives of different classes, one being a diurectic |
|
|
Term
| what type of bruit seen in renal artery stenosis |
|
Definition
| continuous abdominal bruit |
|
|
Term
| what are some indications (outside of uncontroled htn) that a pt has a renovascular cause of htn (like renal artery stenosis) |
|
Definition
1. all the same risk factors for artherosclerosis
2. serum creat inc over 30% from baseline after startine ACEI or ARB
3. htn with flash pulmonary edema
4. htn in pts with diffuse artherosclerosis
5. htn after age of 55
6. asymmetric kidney size
7. continous abdominal bruit |
|
|
Term
| what intervention has the greatest effect of on COPD survival once pts get hypoxemia |
|
Definition
| long term supplemental o2 therapy |
|
|
Term
| major features of dequervain tneosynovitis |
|
Definition
| 1. in new mothers who hold infants with thumb outstretched |
|
|
Term
| what tendon is effected in dequervains |
|
Definition
|
|
Term
| best way to test for dequervaines tenosynovitis |
|
Definition
1. tenderness elicited with direct palation of the radial side of wrist at base of hand
2. finkelsteins test: pt holds their thumb in their other fingers (like during a time out in a thumb war) then the physician ulnarflexes to stretch out the tendon. this elicits pain |
|
|
Term
|
Definition
| pain oer palmer aspect of 1st metocarpophalangeal jt and thumb is locked in flexion |
|
|
Term
| flexor carpi radialis tenosynovitis |
|
Definition
pain with radial flexion of the wrist
tenderness over trapezium |
|
|
Term
| how is lung compliance, supplemental o2 response and A-a gradient in pt with pulmonary edema |
|
Definition
compliance dec
o2 response would be high (aka supplemental o2 would help correct hypoxemia
A-a gradient would be high |
|
|
Term
|
Definition
used to classify a fluid as exudative
1. pleural fluid protein:serum protein > .5
2. pleural fluid LDH: serum LDH >.6
3. pleural fluid LDH > 2/3 upper limit of normal for serum LDH |
|
|
Term
labs in primary hypoparathyroidism
what else has similar labs |
|
Definition
hi P
lo Ca
chronic renal failure |
|
|
Term
| causes of primary hypoparathyroidism |
|
Definition
1. post surgical
2. congenital absence of parathyroid glands
3. autoimmune
4. defective calcium sensing receptor on parathyroid glands |
|
|
Term
|
Definition
| autoimmune polyglandular endocrinopathy candidiasis ectodermal dysplasia |
|
|
Term
|
Definition
| pts with mucocutaneous candida in a setting of autoimmune endocrine issues |
|
|
Term
| LFT in ischemic hepatic injury |
|
Definition
massive increase in AST and ALT
milder increase in bilirubin and AP |
|
|
Term
| what hemostatic problems seen in pts with chronic renal failure |
|
Definition
platelet dysfuncion
low Hgb from low erythropoeitin |
|
|
Term
| what are PT PTT and platelet count in pts with platelet dysfxn 2/2 CKD |
|
Definition
|
|
Term
| what is elevated in pts with platelet dysfxn 2/2 CKD |
|
Definition
|
|
Term
| tx of choice in pts with platelet dysfxn 2/2 CKD |
|
Definition
|
|
Term
| how does DDAVP help pts with platelet dysfxn 2/2 CKD |
|
Definition
| increases the release of factor VIII and von willebrand factor multimers |
|
|
Term
| most common malignancies seen associated with dermatomyosytosis |
|
Definition
| ovarian, breast, lung, feamale urogenital cancers |
|
|
Term
| how does a lung consolidation present? |
|
Definition
| dullness to percussion bronchial breath sounds, egophony |
|
|
Term
|
Definition
| increased resonance of voice sounds over lungs |
|
|
Term
|
Definition
|
|
Term
|
Definition
proximal mm weakness
wt gain
psych issues (sleep disturbances, depression and psychosis) |
|
|
Term
| causes of cushings syndrome |
|
Definition
adrenal cortical hyperpasia
ACTH producing pituitary adenoma
ectopic ACTH
exogenous steroids |
|
|
Term
| which cause of cushings sydrome is considered cushings DISEASE |
|
Definition
| ACTH producing pituitary adenoma |
|
|
Term
| how to lower ammonia in pt with hepatic encephalopathy |
|
Definition
lactulose orally or enema
rifaximin if lactulose doesnt work |
|
|
Term
| tx of amebic liver abscess |
|
Definition
|
|
Term
| diagnostic criteria for ARDS |
|
Definition
1. acute onset
2. bilateral patchy airspace on CXR
PCWP <18 (aka not pulm edema/congestion)
3. PaO2/FiO2 < 200 |
|
|
Term
| who gets nodular glomerulosclerosis |
|
Definition
|
|
Term
| What increases the murmur heard in hypertrophic cardiomyopathy |
|
Definition
|
|
Term
| how does valsalve increase hypertrophic cardiomyopathy murmur |
|
Definition
| decreases venous return and preload |
|
|
Term
|
Definition
| proportions that indicate the chance of an event occuring int he treatment arm as compared to the change of the event occuring in the control arm |
|
|
Term
| steatorrhea + severe intermittent epigastric pain = |
|
Definition
|
|
Term
| what causes the bleeding in mallory weiss tears |
|
Definition
| ruptured submucosal arteries of the distal esophagus and proimal stomach |
|
|
Term
| management of mallory weiss tears |
|
Definition
bleeding may stop spontaneously
may give vasopresson
may do electrocautery if it doesnt stop |
|
|
Term
|
Definition
| stress ulcers that develop 2/2 severe and prolonged physiological stress. it is usually seen in an icu or burn setting |
|
|
Term
|
Definition
| cns stimulants like methylphenidate |
|
|
Term
| imaging findings in cervical spondylosis |
|
Definition
osteoarthritic changes
bony spurs
sclerotic facet joints
narrowing of disk space
hypertrophic vertebral bodies |
|
|
Term
|
Definition
| means severe cervical strain |
|
|
Term
|
Definition
|
|
Term
| are bony spurs a good dx for spondylosis? |
|
Definition
| no, lots of old ppl have them asymptomatically. not very specific. |
|
|
Term
| insanely high ast and alt (like in the thousands) |
|
Definition
acute liver injury
if AST>ALT maybe alcoholic
more likely drug induced liver damage |
|
|
Term
| how does nonalcoholic steatohepattis manifest |
|
Definition
| mild asymptomatic inc in ast and alt |
|
|
Term
| eye problem associated with neurofibromatotis |
|
Definition
|
|
Term
|
Definition
slow progressive unilateral visual loss
pallor of the optic disk |
|
|
Term
|
Definition
damage bilat to retina
inherited degenerative eye disease
often leads to blindness
fundus shows pigment deposits in retina |
|
|
Term
|
Definition
parathyroid
pituitary
enteropancreatic |
|
|
Term
|
Definition
medullary thyroid
pheochromocytoma
parathyroid |
|
|
Term
|
Definition
medullary thyroid
pheochromocytoma
mucosial intestinal neuromas
marfinoid habitus |
|
|
Term
| major signs and sx of wallendstroms macroglobinemia |
|
Definition
1. hepatosplenomegally
2. lymphadenopathy
3. fatigue, anemia, inc blood viscosity
4. bleed/bruise tendency
5. night sweat
6. HA, dizzy
7. visual issues
8. pain in numbness in extremities |
|
|
Term
| why pain and numbness in extremities in wallendstroms macroglobinemia? |
|
Definition
| demyelinating sensorimotor neuropathy |
|
|
Term
| major diff twix wallendstroms and multiple myeloma |
|
Definition
|
|
Term
| signs of the increase in blood viscosity in wallendstroms |
|
Definition
|
|
Term
|
Definition
like an abdominal lymphoma
mostly IgA (type A heavy chain disease)
abdo pain, diarrhea, steatorrhea, wt loss |
|
|
Term
| pathology of heavy chain disease (type A) |
|
Definition
| jejunal mucosa inflitrated with plasmacytoid cells |
|
|
