Term
| What type of acid-base disturbances does aspirin overdose cause? |
|
Definition
| Respiratory alkalosis & metabolic acidosis |
|
|
Term
| What IV fluid may be used to expedite the elimination of aspirin in overdose? |
|
Definition
| Bicarbonate alkalinization of urine speeds excretion |
|
|
Term
| Which type of acid-base disturbance does COPD & asthma most often cause? |
|
Definition
|
|
Term
| What type of acid-base disturbance do opioids, benzodiazepines, barbiturates and alcohol usually cause? |
|
Definition
|
|
Term
| What is the classic cause of hyponatremia in a pregnant patient about to deliver? |
|
Definition
| Oxytocin (anti-diuretic hormone-like effect) |
|
|
Term
| Which type of IV fluid should never be used in a hypernatremic patient? |
|
Definition
|
|
Term
| What are the classic signs and symptoms of hypokalemia? |
|
Definition
| Muscular weakness (paralysis, ventilatory failure, ileus, hypotension), loss of/flattening of T waves, appearance of U waves, PVCs, tachyarrhythmias |
|
|
Term
What are the classic EKG findings of hypokalemia? (which two waves are abnormal?) |
|
Definition
| Loss or flattening of T waves; appearance of U waves |
|
|
Term
| How are serum potassium levels affected by alkalosis (increasing pH)? |
|
Definition
| Values will be lowered as K+ shifts into cells and H+ shifts out |
|
|
Term
| How are serum potassium levels affected by acidosis (decreasing pH)? |
|
Definition
| Values will be higher as K+ shifts out of cells and H+ into cells |
|
|
Term
| When hypokalemia persists despite treatment which other electrolyte should be checked/suspected? |
|
Definition
| Magnessium; with low magnessium lvls the body cannot retain K effectively |
|
|
Term
| What are the signs and symptoms of hyperkalemia? |
|
Definition
| Weakness and paralysis may occur as with hypokalemia; more reliable findings are tall & peaked T waves, wide QRS, increased PR interval, loss of P waves, and a sign-wave-appearing EKG pattern. |
|
|
Term
| What are the two cardiac conduction anomalies most concerning when a patient is hyperkalemic? |
|
Definition
| Asystole and ventricular fibrillation |
|
|
Term
| Pts taking digitalis should have which commonly reviewed electrolyte closely monitored? |
|
Definition
| Potassium (especially in pts who are also on diuretics) |
|
|
Term
| Beta-blockers are known to have what effect on serum potassium? |
|
Definition
| Increase K serum lvls (hyperkalemia) |
|
|
Term
| NSAIDs are known to have what effect on serum potassium? |
|
Definition
| Increased K serum lvls (hyperkalemia) |
|
|
Term
| ACIs are known to have what effect on serum potassium? |
|
Definition
| Increased K serum lvls (hyperkalemia) |
|
|
Term
| Beta-blockers, ACIs, and NSAIDs all have in common the potential to increase which commonly measured electrolyte? |
|
Definition
|
|
Term
| Severe tissue destruction, as is the case with a burn or severe trauma, commonly results in elevation of which electrolyte? |
|
Definition
|
|
Term
| What should be suspected if an asymptomatic patient has hyperkalemia? |
|
Definition
| Lab test error due to hemolysis of RBCs; repeat the test |
|
|
Term
| What are the treatments for symptomatic pts with hyperkalemia (or even pts w/o s(x)s with K >6.5) and consequently cardiac arrhythmias and aberrations of the EKG? |
|
Definition
| IV calcium gluconate (protects heart); sodium bicarbonate (shifts K intracellularly); glucose with insulin (glucose causes intracellular shift of K) |
|
|
Term
| What commonly used HTN drug can be used to treat cases of acute hypo-kalemia? |
|
Definition
|
|
Term
| What are the two "signs" of hypocalcemia? |
|
Definition
| Chvostek's sign and Trouseau's sign |
|
|
Term
| Describe Chvostek's sign: |
|
Definition
| tapping on facial nerve causes facial tettany |
|
|
Term
| Describe Trouseau's sign: |
|
Definition
| inflation of a BP-cuff causes distal limb spasm |
|
|
Term
| What is the classic EKG aberration of hypocalcemia? |
|
Definition
|
|
Term
| A pt with asymptomatic hypocalcemia requires what additional lab value to determine if the measure calcium levels are accurate? |
|
Definition
| Albumin levels (for every 1gm/dL decrease in albumin below 4gm/dL calcium will be 0.8gm/dL higher than measured) |
|
|
Term
Hypocalcemia resulting 24-48 hours after birth with tetanny is concerning for what congenital condition? |
|
Definition
|
|
Term
| Like potassium hypocalcemia is often resistant to correction when what other electrolyte deficiency is present? |
|
Definition
|
|
Term
| What is the most common cause of out-patient hypercalcemia? |
|
Definition
|
|
Term
| What is the most common cause of in-patient hypercalcemia? |
|
Definition
|
|
Term
| What congenital disease is characterized by short fingers, short stature, mental retardation, normal levels of parathyroid hormone, and hypocalcemia? |
|
Definition
|
|
Term
| Vit A and D toxicity have what effect on serum calcium? |
|
Definition
| Increased lvls; hypercalcemia |
|
|
Term
| Which IV fluid is the first choice for trauma pts? |
|
Definition
|
|
Term
| In treating an acutely ill alcoholic what vitamin should always be given before any IV glucose and why? |
|
Definition
| Thiamine; if glucose is given first Wernicke's encephalopathy may be induced |
|
|
Term
| T or F: Relative risk values can be determined from both prospective and retrospective studies. |
|
Definition
| False; relative risk may only be calculated from prospective studies |
|
|
Term
| What equation expresses relative risk? |
|
Definition
|
|
Term
| What equation expresses sensitivity? |
|
Definition
|
|
Term
| What equation expresses specificity? |
|
Definition
|
|
Term
| What equation expresses positive predictive value? |
|
Definition
|
|
Term
| What equation expresses negative predictive value? |
|
Definition
|
|
Term
| What equation expresses odds ratio? |
|
Definition
|
|
Term
| What equation expresses attributable risk? |
|
Definition
|
|
Term
| From what types of studies is the value for odds ratio determined? |
|
Definition
|
|
Term
| What are mean, median, and mode? |
|
Definition
| Mean (average value); median (middle value); mode (most freq. value) |
|
|
Term
| When is the Chi-square test utilized? |
|
Definition
| when comparing percentages or proportions |
|
|
Term
| When is the T-test utilized? |
|
Definition
|
|
Term
| When is the ANOVA (analysis of variance) test utilized? |
|
Definition
| when comparing 3 or more means |
|
|
Term
|
Definition
| Stating there is a difference when none exists |
|
|
Term
|
Definition
| State there is NO difference when in fact there is a difference |
|
|
Term
| What are the Vitamin K dependent blood clotting factors? |
|
Definition
| II, VII, IX, X, protein C, protein S |
|
|
Term
| What clotting study is used to assess heparin? |
|
Definition
|
|
Term
| What clotting study is used to assess warfarin? |
|
Definition
|
|
Term
| In what time frame after starting warfarin therapy does thrombocytopenia usually occur? |
|
Definition
| 3-7 days after initiation |
|
|
Term
| How is low molecular weight heparin measured clinically? |
|
Definition
| there is typically no lab study to follow use of low molecular weight heparin as it has no effects on PT or PTT (special test, anti-Xa, can be used) |
|
|
Term
| Both Hemophilia A and B prolong which coagulation study? |
|
Definition
|
|
Term
| Liver disease will affect primarily which coagulation study? |
|
Definition
|
|
Term
| Deficiencies of which blood factors increases a pts risk for DVT? |
|
Definition
antithrombin III, protein C, protein S (factor V as well?) |
|
|
Term
| Homan's sign is the classic sign for what? |
|
Definition
|
|
Term
| How is heparine overdose (meaning a PTT (2) elevation far above therapeutic range) reversed? |
|
Definition
|
|
Term
| What are the two most common causes of cor pulmonale? |
|
Definition
|
|
Term
|
Definition
| RV failure due to a primary disease of the lungs |
|
|
Term
| How are restrictive cardiomyopathy and constrictive myocarditits different? |
|
Definition
| Restrictive cardiomyopathy: inherent disease of cardiac tissue (sarcoidosis, amyloidosis, etc). Constrictive myocardititis is secondary to inflammation and contracture of pericardium. |
|
|
Term
| What types of medications should be avoided in a pt with 1st degree heart block? |
|
Definition
| beta-blockers and calcium channel blockers |
|
|
Term
| Which ACLS drugs are used for tachyarrhythmias? |
|
Definition
P.A.L. Procainamide Amiodarone Lidocaine |
|
|
Term
| The acronym TORCH represents five common causes of ventral septal defects. What does each letter stand for? |
|
Definition
| T: toxoplasma, O: other, R: rubella, C: cytomegalovirus, H: herpes |
|
|
Term
| Atherscleorsis is involved in what percentage of deaths in the US? |
|
Definition
|
|
Term
| Use of Wood's Lamp, which causes the hair to fluoresce indicates which fungus? |
|
Definition
|
|
Term
| What topical drug is used to treat scabies? |
|
Definition
|
|
Term
| Which strains of HPV most commonly cause cutaneous warts? |
|
Definition
|
|
Term
| Which three drug classes are most commonly associated with photosensitivity? |
|
Definition
| tetracyclines, phenothiazides, OCP |
|
|
Term
| How can pemphigus vulgaris (more threatening) be differentiated from bullus pemphigoid? |
|
Definition
| Pemphigus vulgaris first presents w/ peri-oral lesions, & demonstrates IgG antibodies to desmoglein III. Bullus pemphigoid presents similarly w/o necessity of peri-oral lesions first. |
|
|
Term
| How are both pemphigus vulgaris and bullus pemphigoid treated? |
|
Definition
|
|
Term
| What cutaneous "rash" is often associated with celiac sprue? |
|
Definition
|
|
Term
| Which two vitamin deficiencies can commonly cause stomatitis? |
|
Definition
| B-complex (riboflavin, niacin, pyridoxine) and vitamin C |
|
|
Term
| What lab test should be ordered in type II diabetic pts who frequently become hypoglycemic? |
|
Definition
| C-peptide: produced with indogenous insulin but not with exogenous insulin. |
|
|
Term
| What serum glucose level is diagnostic of DM after an over-night 8-hour fast? |
|
Definition
| greater than or equal 126 mg/dL |
|
|
Term
| A random glucose level greater than what value is also diagnostic of DM? |
|
Definition
|
|
Term
| During the 2-hour glucose tolerance test what load of glucose is used, and what must the value be for DM daignosis? |
|
Definition
| 75g of glucose; equal to or more than 200 mg/dL |
|
|
Term
| How can hemoglobin A1C be converted into an average daily serum glucose level? |
|
Definition
| by multiplying the factor by 20 |
|
|
Term
| When a type II diabetic is in a non-ketotic hyperglycemic hyperosmolar state (high blood gluc. w/ increased solutes) what is the first treatment of choice? |
|
Definition
| fluids, fluids, fluids, and then subsequently insulin and electrolyte replacement |
|
|
Term
| What are the concerns with administration of beta-blockers to diabetics? |
|
Definition
| the drugs may mask the cardinal signs of hypoglycemia; tachycardia and diaphoresis (catecholamine release) |
|
|
Term
| Which viruses account for the most common causes of sudden hearing loss? |
|
Definition
| mumps, measles, rubella, influenza, chickenpox, and adenovirus |
|
|
Term
| Otitis externa is most commonly caused by what bacterium? |
|
Definition
|
|
Term
| Pseudomonas aeruginosa is the most common bacterial culprit of cutaneous infections after burns. What are the classic characteristics of this infection? |
|
Definition
| fruity smell with a blue-green appearance |
|
|
Term
| What is the threshold for hypothermia? |
|
Definition
|
|
Term
| What is the difference between Cushing syndrome and Cushing disease? |
|
Definition
| Cushing syndrome: secondary cause. Cushing disease: ACTH secreting pituitary adenoma |
|
|
Term
| What are the common signs of hypoadrenalism (Addison disease)? |
|
Definition
hypotension hyponatremia hypoglycemia hyperpigmentation hyperkalemia N/V/D, abd pain, fever, acidosis, shock |
|
|
Term
| What is the most common cause of acute hypoadrenalism? |
|
Definition
| iatrogenic (secondary to corticosteroid administration) |
|
|
Term
| How is hypoadrenalism diagnosed? |
|
Definition
| ACTH stimulation test is performed |
|
|
Term
| What are the signs and symptoms of hyperparathyroidism? |
|
Definition
| Same as for hypercalcemia; bone, groans, and psychiatric overtones |
|
|
Term
| What are the ages of precocious puberty? |
|
Definition
| younger than 8 for females and 9 for males |
|
|
Term
| What are the signs and symptoms of Conn syndrome (hyperaldosteronism)? |
|
Definition
| the opposite as for hypoaldosteronism; HTN, hypokalemia, hypernatremia, edema, weakness |
|
|
Term
| What is the most common cause acute hyperaldosteronism? |
|
Definition
| typically secondary disease, CHF (or any other condition which reduces renal perfussion) |
|
|
Term
| Which type of hepatitis is most commonly associated with food-borne outbreaks? |
|
Definition
|
|
Term
| Which hepatitis B antigen is found in only pts who have been infected by the pathogen? |
|
Definition
| HBcAg (hepatitis B core antigen) |
|
|
Term
| What is the significance of HBeAg and HBeAb? |
|
Definition
| HBeAg is only found in actively infective pts; HBeAb is only found in a pt which has mounted an effective immunological response |
|
|
Term
| Which hepatitis virus is found only in conjunction with hepatitis B? |
|
Definition
|
|
Term
| In which pt demographic is hepatitis E most concerning? |
|
Definition
| pregnant women, who are at significantly increased risk of fatality |
|
|
Term
| Which disease is characterized by the deposition of copper into tissues? |
|
Definition
|
|
Term
| In Wilson's disease, in which copper is over depostited into tissues, which serum protein is deficient or absent? |
|
Definition
|
|
Term
| What are the classic symptoms of Wilson's disease (copper deposition)? |
|
Definition
| elevated LFTs, CNS disturbances, psychiatric manifestations, Kayser-Fleischer rings in eye |
|
|
Term
| Copper depositions within the eye in Wilson's disease are called what? |
|
Definition
|
|
Term
| In liver failure hepatic encephalopathy is most commonly due to what? |
|
Definition
| hyperammonemia (may be treated with antibiotics to kill bowel flora which reduces ammonia production) |
|
|
Term
| Which blood enzyme is classically elevated with biliary disease? |
|
Definition
|
|
Term
| What are the four F's of bile duct obstruction? |
|
Definition
| female, forty, fertile, and fat |
|
|
Term
| What is Courvoisier's sign? |
|
Definition
| jaundice with palpably enlarged gallbladder (sign of pancreatic cancer) |
|
|
Term
| Which antibody is typically seen in cases of primary biliary cirrhosis? |
|
Definition
| anti-mitochondrial antibodies |
|
|
Term
| What two conditions cause 80% of cases of pancreatitis? |
|
Definition
| alcohol consumption & gallstones |
|
|
Term
| What is Grey Turner's sign? |
|
Definition
| blue-black flanks as a marking of acute pancreatitis |
|
|
Term
|
Definition
| blue-black umbilicus as a marking of acute pancreatitis |
|
|
Term
| What is the most common cause of chronic pancreatitis in the U.S.? |
|
Definition
|
|
Term
| T or F: Alcoholism is a greater risk factor for pancreatic cancer than smoking. |
|
Definition
| False: alcohol consumption does increase the risk for pancreatic cancer but smoking does more so |
|
|
Term
| What are the differences between a Mallory-Weiss esophageal tear verses a Boorhave tear? |
|
Definition
| Mallory-Weiss tears are superficial tears while Boorhave tears extend the full-thickness of the esophagus |
|
|
Term
| Which water-soluble contrast die is used for GI studies when a bowel perforation is in question? |
|
Definition
|
|
Term
| What congenital GI anomaly is seen in children as evident by the "double bubble" sign? |
|
Definition
|
|
Term
| What is the alternative name for Conn's syndrome? |
|
Definition
| primary hyperaldosteronism |
|
|
Term
| What are the differences in Right Ventricule changes seen in chronic verses acute cor pulmonale? |
|
Definition
chronic - RV hypertrophy acute - RV dilation |
|
|
