Term
| Presenting features of PE |
|
Definition
| dyspnea, excentuated S2, hemoptysis, JVD, chest pain |
|
|
Term
| o2 and co2 and acid/base in pe |
|
Definition
lo O2 lo CO2
respiratory alkalosis |
|
|
Term
|
Definition
S1Q3T3
large S in I
large Q in III
inverted T in III |
|
|
Term
|
Definition
R atrial dilatation
mccullens sign |
|
|
Term
|
Definition
either nothing
possibly hamptons hump |
|
|
Term
|
Definition
if unstable: IVF, vasopressor, mechanical vent, thrombolytics
if stable: LMWH then hep or warfarin longterm |
|
|
Term
|
Definition
3 mo if PE was provoked
6 mo if unprovoked
for life if more than one event |
|
|
Term
|
Definition
1. PE most likely
2. HR over 100 or hx of DVT/PE
3. Immobile
4. Hemoptysis/Cancer |
|
|
Term
|
Definition
D dimer neg rules out
if positive you can do spiral ct to confirm |
|
|
Term
|
Definition
1. postbrandial >126 x 2
2. fasting + sx >200 x 2
3. hbaic > 6.5 |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
checking for renal damage
microalbunuria 30-300 : start acei
macro: >300 |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| at what a1c do you start insulin |
|
Definition
|
|
Term
| dosing units of insulin for first time user |
|
Definition
kg/2 = # of units
half of the units are long acting
half split into three doses with meal |
|
|
Term
| dosing insulin in hosp if not a first time user? |
|
Definition
.3 U/kg if pt is lean
.4 if normal weight
.5 if obese
.6 if very obese |
|
|
Term
|
Definition
|
|
Term
| onset and duration of short acting insulin |
|
Definition
|
|
Term
| onset and duration of intermediate acting insulin |
|
Definition
onset 1-2 hours
can last up to 12 hours |
|
|
Term
| how long does long acting insulin last? |
|
Definition
|
|
Term
| goal for random glucose in dm |
|
Definition
|
|
Term
| metformin lab abnormality |
|
Definition
|
|
Term
|
Definition
| dec glu prod by liver and inc insulin sensitivity |
|
|
Term
|
Definition
| acute heart or kidney decomp, ARF, |
|
|
Term
| which dm drug causes edema |
|
Definition
|
|
Term
|
Definition
liver fail, hep b, hep c
chf |
|
|
Term
|
Definition
| activate PPARs dec insulin resistance |
|
|
Term
| what are the sulfonylureas |
|
Definition
| glyburide, glipizide, glimepriride |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| which can cause pancreatitis |
|
Definition
|
|
Term
|
Definition
| glp agonist to inc insulin secreation |
|
|
Term
|
Definition
1. nonblanchable erythema with skin intact
2. superficial/partial thickness skin loss (blister or abrasion)
3. full thickness loss (extends to fascia)
4. necrosis, damage to mm bone, tendon, joint |
|
|
Term
| equation for renal compensation for respiratory acidosis |
|
Definition
if acute: increase 1 bicarb for every ten increase in CO2
if chronic: increase 3 bicarb for every ten increase in CO2 |
|
|
Term
| equation for repiratory comp for metabolic acidosis |
|
Definition
| pCO2 = (1.5 x HCO3) + 8 +- 2 |
|
|
Term
|
Definition
| coronary stent that secretes paclitaxel or sirolimus |
|
|
Term
| long term management in pt with a drug eluting stent or bare metal stent? how are the risks different? |
|
Definition
BMS has higher risk of recanalization due to scar formation.
DES has a higher risk of thrombosis.
Both are treated with aspirin, clopidogrel and coumadin long term. |
|
|
Term
| correcting Ca for hypoalbuminemia |
|
Definition
| every drop in albumin of 1, add .8 to calcium |
|
|
Term
|
Definition
| FWD = .6(wt in kg) * ((current Na/140) -1) |
|
|
Term
| What physiologically is causing dec O2 sat in PE? |
|
Definition
|
|
Term
| what causes alveolar hypoventilation |
|
Definition
| obstructive lung disease and obesity |
|
|
Term
| is septic arthritis monoarticular or poly |
|
Definition
|
|
Term
| what type of arthritis in sarcoid |
|
Definition
|
|
Term
| how does viral arthritis px |
|
Definition
| symmetric small joint inflammatory arthritis. resolves in 2 mo. nsaid tx only. |
|
|
Term
|
Definition
|
|
Term
| what lab value is the best indicator of orthostatic intol |
|
Definition
|
|
Term
| hiatal hernia complication |
|
Definition
| barretts esophagus and then adenocarcinoma of stomach |
|
|
Term
| what results in a narrowed confidence interval |
|
Definition
| increased number of participants in study |
|
|
Term
|
Definition
| when an external variable positively or negatively impacts the effect of a risk factor on the disease of interest. |
|
|
Term
|
Definition
granulation of external ear
usually in elderly dm
due to pseudomonas
ear pain and drainage
facial nerve damage |
|
|
Term
| complications of malignant otitis externa |
|
Definition
| osteomyelitis of skull base and cn damage |
|
|
Term
| lytic lesion at bone epiphysis |
|
Definition
|
|
Term
| other features of giant cell bone cancer |
|
Definition
benign but locally aggressive
in young ppl
pain and swelling at joint |
|
|
Term
| pathology of giant cell bone cancer |
|
Definition
osteoclast giants
polygonal, round, oval or elongated monomuc |
|
|
Term
|
Definition
popliteal synovial cyst
swelling medial knee
2/2 degen joint disease |
|
|
Term
|
Definition
overuse injury in kids who grow too pfast.
knee xr shows avulsion of apophysis of tibial tubercul |
|
|
Term
|
Definition
parathyroid cancer --> hi pth
brown tumors
salt and pepper skull, bone cysts
also especially on raidal aspect of middle fingers |
|
|
Term
| xr findings of osteoarthritis |
|
Definition
| joing space narrow, subchondral sclerosis |
|
|
Term
|
Definition
pain esp at night
nsaids work well
sclerotic, cortical lesion
central nidus of lucency |
|
|
Term
|
Definition
|
|
Term
| acute GVHD after bone marrow transplantation looks like _____ and is the result of _____ |
|
Definition
skin and gi issues
donor T cells |
|
|
Term
| best test of lactose intol |
|
Definition
|
|
Term
| what is osmotic gap in osmotic diarrhea |
|
Definition
|
|
Term
| what qualifies as first degree AV block |
|
Definition
| PR interval over 5 small boxes (from beginning of P to beginning of R) |
|
|
Term
| pt on mechanical vent has low co2 and o2. how do you fix |
|
Definition
add peep
or if fio2 is less than 40, you can inc it to 40 |
|
|
Term
| what should fio2 be below at all times |
|
Definition
|
|
Term
what lung gas measurement do you see in restrictive lung disease
why |
|
Definition
increase a-a grad
paco2 may be ok
due to v1 mismatch |
|
|
Term
| infection of submandibular space complication |
|
Definition
| ludwigs angina. can get to tissue surrounding airway |
|
|
Term
| infection of parapharyngeal space |
|
Definition
| erosion of carotid artery and jugular thrombophlebitis |
|
|
Term
| what space connects to mediastinum |
|
Definition
|
|
Term
| tx dermatitis herpetiformis in celiacs |
|
Definition
|
|
Term
| most commonly why do ppl have allergy to blood products give? |
|
Definition
| they are iga deficient so they have anti IgA ab |
|
|
Term
| result of mismatched abo blood |
|
Definition
|
|
Term
| management of stroke in sickle cell pt |
|
Definition
| exchange transfusion + continue hyrdoxyurea |
|
|
Term
| lab changes in CKD hyperparathyroidism vs primary hyperparathyroidism |
|
Definition
both hi PTH
CKD: hi phos, lo ca, lo d)
can get hi ca in later later tertiary stages
primary CKD: hi Ca, kidney stones, etc |
|
|
Term
| sx of drug induced esophagitis |
|
Definition
retrosternal cp
epigastric burning
swallowing discomfort |
|
|
Term
| causes of drug induced esophagitis |
|
Definition
tetracyclines
aspirain and many nsaids
aledronate
potassium chloride
quinidine
Fe |
|
|
Term
| What type of kidney issues do ppl with hodgkins lymphoma have |
|
Definition
|
|
Term
| what kind of kidney issues do ppl with carcinomas have |
|
Definition
|
|
Term
| is minimal change disease nephrotic or nephritic |
|
Definition
|
|
Term
| what type of bruit seen in renal artery stenosis |
|
Definition
|
|
Term
| what bp is found in pt with renal artery stenosis |
|
Definition
they have htn
they also may have different pressures on each artm (higher on left |
|
|
Term
|
Definition
1. Nephritic Syndrome
2. Type 4 Collagen issue
3. Split BM
4. Occular disturbances
5. Deafness
6. X linked dominant |
|
|
Term
|
Definition
1. Nephritic syndrome
2. IgA overproduced
3. Deposits on Mesangium
4. URI, gastroenteritis, pharyngitis
5. glomerulonephritis
6. sx overlap with henoch schoenlein
7. most common cause of nephritis |
|
|
Term
| major features of nephritic syndrome |
|
Definition
1. inflammatory
2. proteinuria < 3.5
3. rbc casts
5. htn
6. hi nitrogen in blood
7. oliguria
8. hematuria |
|
|
Term
| post-strep glomerulonephritis |
|
Definition
1. post GAS pharnygitis
2. neutrophils
3. children
4. edema
5. IF granular
6. lumpy bumpy
7. subendothelial deposits |
|
|
Term
|
Definition
1. Rapidly progressing glomerulonephritis
2. nephritic
3. poor prognosis
4. fibrin and C3B deposits
5. goodpastures
6. wegeners
7. microscopic polyangitis
8. crecents |
|
|
Term
|
Definition
1. Primary type = AL (Ig light chain)seen in Multiple myeloma or AA (liver protein)
2. Secondary = from RA or TB
3. Nephrotic syndrome
4. green apple biferengence
5. congo red stain |
|
|
Term
| diabetic glomerulonephropathy |
|
Definition
1. nephrotic syndrome
2. Kammelsteil wilson nodules
3. nonenzymatic glycosylation of arterioles and BM
4. mesangium expansion
5. type 4 collagen deposits
5. hyaline arthersclerosis |
|
|
Term
| Focal Segmental Glomerulonephosis |
|
Definition
1. Nephrotic
2. in IV drug users and those with Aids
3. hyaline and segmental sclerosis
4. poor prognosis
5. microscopic hematuria
6. some proteinurea
7. little IF
6. EM shows epithelial damage |
|
|
Term
| Membranoproliferative glmomerulonephritis |
|
Definition
1. two types
2. Type 1 = split gbm due to mesangium
granular IF
subendothelial deposits
seen in Hep C
Type 2 = C3nephritic factor
high density deposits |
|
|
Term
|
Definition
1. nephrotic
2. thick glomerular bm
3. spike and dome
4. HepB
5. lupus
6. gold
7. solid tumors |
|
|
Term
|
Definition
1. Nephrotic
2. on EM see podocyte effacement
3. Normal on LM
4. some loss of albumin
5. tx with steroids
6. may be post infection
7. seen in hodgkins lymphoma
8. loss of negative charge |
|
|
Term
| nephrotic syndrome in general |
|
Definition
1. proteinuria > 3.5
2. hyperlipidemia
3. edema
4. fatty casts
5. thromboembolism
6. inc risk of infection |
|
|
Term
| Pagets disease of bone features |
|
Definition
1. normal ca and phosphate
2. high AP and urinary hydroxyproline
3. skull bone resoprtion and slcerosis
4. due to osteoclastic bone resorption causing woven bone
5. esp femur, axial skeleton, skull
6. skull hypertrophy --> deafness
7. elevated c and p telopeptide and hydroxyproline and deoxypridinoline |
|
|
Term
| ca, p and ap in hyperparathyroidism |
|
Definition
|
|
Term
| hi ca, normal p, normal AP? |
|
Definition
|
|
Term
|
Definition
nv
anion gap metabolic acidosis
epigastric pain
hyperemic optic disk
hypokalemia from vomiting |
|
|
Term
|
Definition
|
|
Term
| causes of anion gap metabolic acidosis |
|
Definition
Methanol poison
Uremia
Diabetic ketoacidosis
Propylene glycol
Isoniazid
Lactic acidosis (from metformin)
Ethanol poisoning
Salisylates |
|
|
Term
|
Definition
HBc is not detected
but HBcAg detected in gap period |
|
|
Term
| what two test for pt with acute hep b sx |
|
Definition
|
|
Term
| Lab studies in DKA vs HHGS (hyperosmolar hyperglycemic state seen in T2DM) |
|
Definition
DKA
1. glucose 250-500
2. bicarb < 18
3. AGAP > 8-12
4. serum osmolality < 320
5. ketones in blood
HHGS
1. Glucose > 600
2. Osmolality > 320
3. Bicarb > 18
4. Normal AGAP
5. no ketones |
|
|
Term
| what TB drug changes fluids to red |
|
Definition
|
|
Term
| age of giant cell arteritis |
|
Definition
|
|
Term
|
Definition
new onset headache
jaw claudication
visual loss (retinal artery ischemia)
polymyalgia rheumatic sx
bruits around vessels that come off aorta |
|
|
Term
| discoloration of lymph follicles in dark brown discolored colon |
|
Definition
| bisacodyl (antrhaquinon containing laxative) |
|
|
Term
| herpes simplex keratitis feature |
|
Definition
pain
photophobia
blurred vision
tearing
redness
past episodes
corneal vesicles and dendritic ulcers |
|
|
Term
| herpes zoster opthalmicus |
|
Definition
fever
malaise
burning
itching
vesicular rash and dendritic ulcers
but less of the vision loss changes seen in herpes simplex keratitis |
|
|
Term
|
Definition
| antithyroid peroxidase ab |
|
|
Term
| antibodies in graves disease |
|
Definition
| TSI (thyroid stimulating immunoglobulins) |
|
|
Term
| tx uncomplicated mild to moderate pyelo |
|
Definition
|
|
Term
| tx uncomplicated severe pylo |
|
Definition
| ceftriaxons, cipro, tmpsmx IV |
|
|
Term
| what constitutes complicated pyelo |
|
Definition
| indwelling urinary catheter, urinary obstruction, hospital acquired, immunosuppressed etc |
|
|
Term
| tx mild to mod complicated pyelo |
|
Definition
| IV ceftriaxone or cefepime |
|
|
Term
| tx severe complicated pyelo |
|
Definition
| amp-sulbactam, ticar clav, pip tazo, carbapenems, aztreonam |
|
|
Term
|
Definition
ceftriaxone +- gentamicin
aztreonam |
|
|
Term
| how long do you continue oral abx for uti after in hospital tx |
|
Definition
|
|
Term
| intense focal vertebral pain wo neurological pain |
|
Definition
| vertebral compression fractures |
|
|
Term
| ligamentous sprain of back |
|
Definition
traced to specific event
more painful with movement
feels better in morning |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
used in exercise stress test
induces coronary steal
causes coronary vasodilation but if cad present theyre already maximally dilated so the blood flows to on diseased areas and the diseased areas falter causing symptoms.
also used as antiplatelets |
|
|
Term
gynecomastia
spider nevi
emphysema
PAS + |
|
Definition
|
|
Term
|
Definition
nonketotic hyperosmolar syndrome
seen in T2DM |
|
|
Term
sx of NKHS
serum osmolality |
|
Definition
glucose in urinalysis
may have recent infection or stressor
causes hi stress hormones
osmotic diuresis --> dehydration
osmolality >320
AMS --> confusion --> coma
intraocular hypotension from hyperosmolarity |
|
|
Term
|
Definition
maximum pressure measured as tidal volume is being delivered in intubated pt. measured via inspiratory hold.
is the resistive pressure + plateau pressure, where plateau pressure is elastic pressure + PEEP |
|
|
Term
| what does peak pressure tell us about a pt |
|
Definition
elevated peak pressure with normal plateau pressure: bronchospasm, mucus plug, biting ET tube.
elevated peak pressure with elevated plateau pressure: pneumo, PEdema, pneumonia, atelectasis, right mainstem intubation |
|
|
Term
| what bp med cases the most peripheral edem? |
|
Definition
|
|
Term
| what arrythmia seen in dig toxicity? |
|
Definition
| atrial tachycardia with AV block |
|
|
Term
what does dipstick show in UTI
what do they indicate |
|
Definition
nitrates and esterase
esterase indicates pyuria |
|
|
Term
|
Definition
| quinidine, procainamide, disopyramide |
|
|
Term
|
Definition
| lidocaine, mexiletine, tocainide |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
| ibutilide, sotalol, bretylium, amiodarone, doetilide |
|
|
Term
|
Definition
| ccb (verapamil, diltazem) |
|
|
Term
| What channels do each class effect? |
|
Definition
|
|
Term
| What does sodium channel blocking do to AP? |
|
Definition
1. decreases slope of phase zero
2. increase threshod for firing abnormal pacemaker cells |
|
|
Term
|
Definition
| 1. decrease slope of phase zero thru dec cAMP and dec Ca |
|
|
Term
| Of the class 1 agents, which dissociated from NA channel slowest |
|
Definition
|
|
Term
|
Definition
|
|
Term
| Wchich prolong PR interval |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| which give ade HA and tinnitus |
|
Definition
|
|
Term
| which causes reversible SLE sx |
|
Definition
|
|
Term
| which contraindicated post MI |
|
Definition
|
|
Term
|
Definition
|
|
Term
| which is esp useful post MI, why |
|
Definition
| IB preferentially affects ischemic purkinge and vent tissue |
|
|
Term
| whats useful in vtach that progresses to VF |
|
Definition
|
|
Term
| which prolongs refractory period in AV node |
|
Definition
|
|
Term
|
Definition
| pulmo fibrosis, hepatotoxitiy, hypo/hyperthyroidism |
|
|
Term
| which causes contsip, flushing, edema, CV effects |
|
Definition
|
|
Term
|
Definition
| inc K+ out of cells to hyperpolarize |
|
|
Term
|
Definition
|
|
Term
| whcih is used in refractory SVT |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| What part of axial skeleton effected in RA |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
antiCCP
hi IgM rhematoid factor
hi CRP and ESR |
|
|
Term
| loss of pigmentation around orifaces |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
depressed mental ststus
dec bowel sounds
hypotension
bradycardia
miosis |
|
|
Term
| most common arryythmia post CABG |
|
Definition
|
|
Term
| management of afib post cabg |
|
Definition
if hemodynamically stable: amiodarone or quinidine
if unstable: cardioversion |
|
|
Term
| fungus ball that rolls around in lungs, with fragmented septae |
|
Definition
|
|
Term
| features of temporal arteritis |
|
Definition
PMR
claudication
hi ESR
HA, scalp pain
visual loss
subclavicular bruit |
|
|
Term
| dark brown discoloration of colon with lymph follicles shining as pale patches (meanosis coli) |
|
Definition
| abuse of antraquinone laxatives like bisacodyl |
|
|
Term
| herepes simplex keratitis vs herpes xoster opthalmicus |
|
Definition
both have vesicular rash and dendtiric corneal ulcers.
zoster is more in elderly.
both have burning and itching, zoster is more on skin tho. |
|
|
Term
|
Definition
| antithyroglobulin in hashimotos |
|
|
Term
| tx of uncomplicated pyelo |
|
Definition
1. mild to mod: tmpsmx, cipro
2. severeL ceftriax, cipro, tmpsmx iv |
|
|
Term
|
Definition
1. mild to mod: ceftriax, cipr, cefepime iv
2. severe: amp-sul, tic-clav, pip-tazo, carbapenem, aztreonam +- genta |
|
|
Term
|
Definition
| ceftriax +- genta, aztrea |
|
|
Term
|
Definition
|
|
Term
| intense, focal vertebral pain WO neuro sx |
|
Definition
| compression fracture from vertebral body demineralization from old age probs |
|
|
Term
|
Definition
used as antiplatelet
also used to dx angina pectoris
vasodialates coronaries, but cant vasodialate diseased ones so the healthy ones steal blood from diseased ones and cause sx (coronary steal) |
|
|
Term
|
Definition
|
|
Term
| eye changes in non-ketotic hyperglycemia |
|
Definition
| blurred vision from intraocular hypotension 2/2 hyperosmolarity |
|
|
Term
| using peep and peak in ventilation |
|
Definition
1. Peak = plateau + resistive pressure
2. Plateau is result of compliance
3. Plateau = compliance (aka elastic pressure) + PEEP
4. High peak pressure with normal plateau = mucus plug, obstruction, biting tube, bronchospasm
5. hi peak pressure + high plateau pressure = pneumothorax, pneumonia, atalectasis, R mainstem intubation, pulmonary edema |
|
|
Term
| What bp med causes significant edema |
|
Definition
|
|
Term
| what arrythmia seen in dig toxicity |
|
Definition
| atrial tachy with AV block |
|
|
Term
| what does atrial tachycardia with av block look like on EKG |
|
Definition
150-250 bpm (slower than flutter at 250-350)
P waves present, but look different |
|
|
Term
| how does sublingual nitroglycerin help in angina |
|
Definition
vasodialate veins, arterioles, and coronaries.
systemic venodia dec preload and LVEDV and dec wall o2 demand and stress. also dec afterload. |
|
|
Term
| what type of hypersensitivity in drug induced rash |
|
Definition
|
|
Term
| when is opening snap heard? |
|
Definition
|
|
Term
| features of mitral stenosis |
|
Definition
opening snap
diastolic
best heard with pt lying on side and held expiration |
|
|
Term
| what pco2 indicates asthma attack going bad |
|
Definition
|
|
Term
| features of osteoarthritis in hpi |
|
Definition
worse with activity
morning stiffness
tenderness and limited ROM |
|
|
Term
|
Definition
| narrowing of joint space with osteophyte formation |
|
|
Term
| hepatorenal syndrome general features |
|
Definition
decreased GFR w/o any known cause
seen in end stage liver disease
probs due torenal vasoconstriction
does not respond to saline bolus |
|
|
Term
| hepatorenal syndrome types |
|
Definition
1: raipdly progressive
2: moer slowly, death usually due to infection and hemorrhage |
|
|
Term
| ultimate tx of hepatorenal syndrome |
|
Definition
| dialysis, liver transplant |
|
|
Term
|
Definition
|
|
Term
| 5 common ade of amiodarone |
|
Definition
thyroid
hepato
corneal deposits
check lft, tft, pft
skin change (blue grey)
pulmonary fibrosis |
|
|
Term
| what fluid do you give in dehyrdation hypernatremia |
|
Definition
|
|
Term
| tx of mild vs severe hypovolemic hypernatremia |
|
Definition
iv saline if severe
if mild can do 5 dextrose wtih .45 saline |
|
|
Term
| what abx causes hyperkalemia |
|
Definition
|
|
Term
| dx test for bronchiectasis |
|
Definition
|
|
Term
| PCWP in ARDS vs PEdema from fluid overload |
|
Definition
PCWP > 18 means pulmonary edema probs from cardiac issue
PCWP < 18 means ARDS |
|
|
Term
|
Definition
hyperkalemia
succinylcholine --> hyperkalemia --> arrythmias |
|
|
Term
| what HIV drug causes crystal induced nephropaty |
|
Definition
| indinavir (protease inhibitor) |
|
|
Term
| pemphigus vulgaris vs bullous pemphigoid |
|
Definition
PV is the blistering skin peeling disease with IgG in epipdermis
BP is pruritic with tense blisters, IgG and C3 at dermal epidermal junction |
|
|
Term
| triple and quadruple therapy for h pylori pud |
|
Definition
1. triple: amoxicillin, ppi, clarithromycin
2. quadruple: bismuth, metronidazole, tetracycline and PPI. |
|
|
Term
| What electrolyte changes are seen in CKD |
|
Definition
hi K
lo Ca
hi P
Metabolic acidosis |
|
|
Term
| What EKG changes seen in CKD due to the lo Ca and hi K |
|
Definition
short PR
long QT
peaked T waves |
|
|
Term
|
Definition
|
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