Term
| Coxiella burnetti causes what condition and is seen in what profession? |
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Definition
Q fever
seen in vets and those that work in their offices. |
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Term
___ ulcers get worse when eating
___ ulcers get better when eating |
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Definition
gastric gets worse
duodenal gets better. duodenal may get worse in the middle of the night.
duodenal is much more common
gastric is associated w/ H pylori |
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Term
| tumors in the duodenum or pancreas produce too much gastrin, which causes gastric ulcers. |
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Definition
| Zollinger Ellison Syndrome |
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Term
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Definition
Fava beans
Dapsone
macrobid
primaquin |
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Term
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Definition
essentially all antiarrhythmics
fluoroquinolones
Fluconazole
macrolides
HIV drugs
metronidazole
hydrocodone
Zofran
antipsychotics |
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Term
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Definition
Head= 9%
Each arm = 9% (4.5% for front and back)
each leg = 18% (9% for front and back)
Anterior and posterior trunk = 18% each (9% for upper and lower halves)
Genitals = 1% |
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Term
MI location based on leads
V3-V4
II, III, aVF
V5, V6, I, aVL |
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Definition
V3-V4: anterior- LAD
II, III, avF: inferior- RCA
V5-aVL: lateral- circumflex
"Anterolateral" = LAD + Circumflex |
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Term
Limping kids;
1) occurs in kids with short stature. Begins as painless limp after activity. may progress to mild pain in the anterior thigh or knee. younger kids. dx and tx?
2) tall or fat kid presents with limp and pain referred into the thigh and knee. pain w/ internal rotation of the hip. prompt may mention abnormal Klein's line. older kids |
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Definition
1) Legg-Calve-Perthes (AVN of femoral head). self healing, but refer to ortho.
2) SCFE - immediate surgical fixation |
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Term
| How to differentiate histo vs cocciodiodes on exam? |
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Definition
histo will discuss Midwestern distribution
coccidiodes will be in the southwest |
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Term
| Lung cancers based on location: two peripheral tumors, two central tumors |
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Definition
Lung cancer is a HASSLE
Peripheral tumors: A and L (on outside of "HASSLE"- adenocarcinoma, large cell carcinoma
Central tumors: SS - squamous cell and Small cell |
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Term
Spinal nerve distribution:
Thumb
2-3 fingers
4-5 fingers
Groin
Upper thigh
anterior thigh
Back of thigh
Front, upper shin |
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Definition
Thumb: C5-6
2,3 fingers: C6-7
4-5 fingers: C7-T1
Groin: S2
upper outer thigh: L1-2
Anterior thigh: L2-3
Back of thigh: S1-2
Front, upper shin: |
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Term
Autoimmmune Liver Diseases:
1) chronic thickening of bile duct walls. 80% of cases are associated with IBD. 10-30% of patients will develop cholangiocarcinoma. Only tx is liver transplant. No distinct antibodies associated with it. mostly seen in men.
2) 80% femal. associated wtih +AMA 95% of the time. elevated alk phos mroe than transaminases. tx is ursodiol
3) usually woman. +ANA and ASMA. elevated transaminases. tx is prednisone and DMARDs |
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Definition
1) PSC
2) PBC
3) Autoimmune hepatitis |
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Term
| Recurrent PUD in a patient not taking NSAIDs and with negative H. pylori, think? |
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Definition
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Term
| Asymptomatic chronic elevation of inndirect bilirubin. normal direct bili and LFTs otherwise. |
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Definition
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Term
| Charcot's triad (fever, jaundice, and RUQ pain) and Reynold's pentad (Fever, jaundice, RUQ pain, AMS, hypotensino) should make you think? |
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Definition
| Cholangitis (infx of common bile duct). has high mortality rate due to sepsis. needs brouad spectrum IV abx |
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Term
| Male patient with UC presents with elevated alk phos, jaundice, pruritis. dx? |
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Definition
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Term
Imaging study of choice for each
1) liver
2) gallbladder
3) pancreas |
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Definition
1) US
2) US, then HIDA
3) CT |
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Term
| Components of Ranson's criteria |
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Definition
for necrotizing pancreatitis (bad prognosis)
Age >55
WBC >16K
Blood sugar >200
LDH >350
AST >250
low serum calcium |
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Term
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Definition
IV hydration is mainstay
remain NPO
pain control
alcohol avoidance |
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Term
| #1 reason for chronic pancreatitis |
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Definition
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Term
| marker for pancreatic cancer |
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Definition
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Term
| Kayer-Fleischer ring on eye exam (ring around cornea/iris). Increased urine copper and low serum ceruloplasmin. can lead to cirrhosis, neuro issues, and kidne failure. dx and tx? |
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Definition
Wilson's disease - copper overload
penicillamine and copper chelation |
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Term
| If test question suggests fecal impaction, what is the most appropriate next step |
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Definition
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Term
| 2 most common reasons for toxic megacolon |
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Definition
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Term
| microcytic anemia in pt >50 is ___ until proven otherwise |
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Definition
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Term
Colon cancer screening guidelines:
1) Non-AA, no risk factors
2) AA
3) 1st degree relative or 2+ 2 degree relatives w/ colon cancer
4) IBD
5) Familial adenomatous polyposis |
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Definition
1) 50 y/o
2) AA: 45 y/o
3) AA: 35, non-AA: 40
4: 8 years after dx, regardless of race
5) 12 y/o |
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Term
Hep B antibodies:
Hep B S Ag
Hep B S Ab
Hep B core
Hep BeAg
Hep BeGb |
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Definition
S Ag: ongoing infection
S Ab: immunity
Core (Ab or Ag): exposure to hep B in past (not vaccine)
BeAg: active infection
BeAb: active infection but low transmission possibility |
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Term
| hallmark is pancytopenia. often due to aumotimmune diseases or medications/chemo. dx via bone marrow bx |
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Definition
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Term
| caused by a mutation in JAK2 gene. causes overabdundance of RBCs. HA, tinnitus, blurred vision, general pruritis, ertyhtromelalgia, splenomegaly |
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Definition
Primary polycythemia vera
tx: phlebotomy, hydroxyurea |
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Term
| overabundance of RBCs caused by decreased oxygenation (OSA, COPD, hihg CO levels, smokers). no splenomegaly |
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Definition
| secondary polycythemia vera |
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Term
Blood cancers:
1) Associated with philadelphia chromosome. gradual onset with recurrent infections preceding dx.
2) associated with smudge cells. B cells. gradual onset with preceding infection. most common type of leukemia
3) Seen in adults 60+. associatd with pancytopenia with inreased Blast cells and Auer rods
4) childhood cancer. accounts for 80% of childhood leukemias. also associated with blasts.
5) Associated with bence jones protein, lytic lesions, pathologic fractures. seen most commonly in older AA males
6) seen in 15-35 y/o. associated with painless LAD in the neck and B symptoms. Reed sternberg cells. good prognosis
7) associated with widespread painless LAD. often spreads to stomach. May mention B lymphcytes. poor prognosis |
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Definition
1) philadelphia chromosome: CML
2) Smudge cells: CLL
3) Auer rods, blasts, adults: AML
4) ALL- kids
5) Multiple myeloma
6) Hodgkin's lymphoma
7) NHL |
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Term
Anemias:
1) microcytic. assocoiatd with blood loss or poor diet
2) Microcytic. seen in metiterranean descent. MCV markedly low. may be associated with target cells
3) microcytic. lead posioning. may be associated with episodic paralytic ileus
4) Microcytic anemia with low iron, low-normal TIBS and ferritin.
5) Macrocytic anemia associated wtih paresthesias in sock/glove distribution, glossitis, AMS. positive schilling's test. elevated MMA and homocysteine
6) macrocytic anemia associated with howell-jolly bodies. often due to alcoholism, malnutrition, pregnancy, drugs
7) microcytic anemia seen in asians. major form is associated with fetal hydrops |
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Definition
1) iron def
2) B thalassemia minor (major is Cooley's anemia)
3) Aplastic anemia
4) Anemic of chronic dz
5) B12 deficiency/pernicious anemia
6) folate deficiency
7) alpha thalassemia (minor form has no symptomsm) |
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Term
| If question mentions heinz bodies, think? |
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Definition
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Term
Coagulopathies:
1) self-limited, mild. isolated thrombocytoenia after virual illness. no tx unless plts drop below 50K. then can do prednisone/IVIG
2) seevere. associated w/ AMS, schistocytes, helmet cells, and marked thromboyctopenia. usually precipitated by pregnancy, estrogen, plavix. needs emergent plasmapheresis
3) inherited clotting disorder that causes hypercoagulability. tx is anticoagulation
4) Inherited bleeding disorder that is generally mild and is assocoiated with bleeding gums, menorrhagia, epistaxis, post-op bleeding. Common.
5) bleeding disorder associated wtih spontaneous hemarthrosis. caused by factor VIII deficiency
6) presents wtih bleeding after surgery or menorrhagia in an Ashkenazi Jew. fairly mild. factor XI deficiency |
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Definition
1) ITP
2) TTP
3) Factor V Leiden
4) Von Willebrand's disease
5) hemophilia A. hemophilia B is the same but factor IX def
6) hemophilia C. |
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Term
| General rule for head imaging: ____ for HAs, ____ for everything else |
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Definition
| MRI for HA, CT w/o contrast for everything else |
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Term
Types of strokes:
1) causes contralateral whole body weakness. gaze will deviate toward infarcted side. Associated with amaurosis fugax and horner's sign.
2) causes contralaterl paralysis and sensory loss of leg > arm. Pt may lack concern that somethign is wrong
3) causes contralateral motor and sensory deficits. gaze deviation toward infnarcted side. HOMONYMOUS HEMIANOPSIA. may cause speech issues and confusion. the "bad" stroke
4) causes bilateral weakness, ataxia, vision changes, pinpoint pupils
5) causes occipital lobe effects (speech, visiion issues) and brainnstem effects (nerve palsy) |
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Definition
1) Carotid artery occlusion
2) Anterior cerebral artery
3) MCA
4) Vertebrobasilar artery
5) PCA |
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Term
| 69 y/o male presents with sudden onset numbness and paralysis of the R arm and leg. exam reveals global aphasia nd homonymous hemianopsia w/ gaxe deviation to the left. which artery? |
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Definition
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Term
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Definition
CT first
then MRI
US of carotids |
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Term
| When to give thrombolytics for stroke (general principles) |
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Definition
Symptoms <4.5 hrs
BP <185/110
no acute bleeding risk |
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Term
Hemorrhage types:
1) occurs suddenly without warning, often during activity. rapid neuro deficit. Bad headache, then becomes obtunded
2) Most commonly traumatic related to head injury. "worst HA of my life" or "thunderclpa HA." May mimic meningitis
3) Bleeding between the dura and arachnoid membranes. conCAVE lesion on brain CT. Pt initially lucid but then developes HA and confusion. also seen in shaken baby syndrome.
workup? |
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Definition
1) intracerebral hemorrhage
2) SAH
3) Subdural hemorrahge
Workup for hemorrhage:
1) CT first to look for bleed source
2) Cerebral angiography is gold standard to determine source of bleed
will need neurosurgery referral for clipping |
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Term
1) difficulty retracting foreskin
2) retracted foreskin gets stuck behind glans. very painful. can cause arterial occlusion |
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Definition
1) phimosis
2) paraphimosis |
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Term
Long-term poorly controlled HTN can cause what kind of cardiomyopathy?
1) Dilated
2) hypertrophic
3) restrictive |
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Definition
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Term
| If EKG mentions a delta wave, think ? |
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Definition
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