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jmanderson's version from 2017-09-02 16:40

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Question Answer
mcc hyperPTH (high Ca, lo P, h/o thyroid ca)parathyroid adenoma
pth adnema labs ca, phigh ca, low p
dx middle age woman, sebacious vessels and rhionphyma on face w/ spicy foodrosacea
rosacea txmetronidazole gel and po tetra
dx xmas tree pattern and herald patchpityriasis rosea
dx febrile sz <2 y/o with stomach cramps and mucous/blood diarrheashigella
blood or nonbloddy diarrhea- norwalk, rotavirus, enterovirusnonbloody
most senstive test for vegetations of infective endocarditisTEE (not TTE)
best test for checking >3/6 diastolic murmurTTE
DOSE DEPENDENT s/e of clozapinesz
LIFE THREATNING s/e of clozapinelow wbc
EMTALA act in non-emergencdoesn't apply
dx- child loss of early motor skills, HSM, MR, cherry red spotneimann pick
dx- same as neimann pick w/o HSMtay sach
dx- same as neimann pick w/ HSM, bone, and CNSgaucher
dx- iron stores, liver dz, dm, bronze skin, decreased libido, cmp, impotencehemochromatosis (bronze db)
hemochromatosis (bronze db) labs fe, ferritin, transferrin sat, TIBChigh Fe, ferritin and transferrin sat; low TIBC
w/u if pancreatitis doesn't resolveCT to check pseudocystsi, necrosis, hemorrhage
dx- abd pain, psych sx, urine aminolevulinic acid, porphobilinogenacute intermittent porphyria
dx- flushing, abd pain, diarrhea, 5HIAAcarcinoid mets to liver
dx- s/sx polymyosisitis, anti-jo, rash, shawl signdermatomyositis
mc RF for dementiaage
next step- acetabular fxr no response to closed reductionCT to check complications (open v closed)
blood type gastric ulcerA (gAstric)
blood type duodenal ulcerO (duOdenal)
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Question Answer
mgmt- transudative pleural effusiontap
dx- s/sx right HF, holosytolic murmur @ LLSB inc w/ inspirationtricuspid regurge
ocd s/sx with awarenessocd
ocd s/sx w/o awarenessocpd
copd maintenance rxLABA (salmeterol, formeoterol) + ICS (budesonide, beclomethasone, fluticasone)
w/u test in all syncopal ptsekg (r/o arrhythmia)
w/u for vasovagal syncope with (-) ekgtilt table
dx- ekg w/ 3+ diff p wave morphs w/ HR>100Multifocal atrial tachy
dx- ekg w/ 3+ p wave morphs w/ HR<100wandering pacemaker
knock knees q angleincreased q angle (genu valgum)
dx- baby with cryptorchidism, hypoplastic lungs, heart murmur, bulging abdprune belly synd
NF II unique s/sb/l acoustic neuroma
NF I unique s/sfreckling in axilla/groin, lisch nodules (iris hamartomas), bony lesions
tuberous sclerosis unique s/sash leaf, sz, eyes, heart
dx- prutitis, jaundice, bead like inflammation of ductPSC
dx- pruritis, RUQ pain, fatigue, no bead like on ductPBC
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Question Answer
next step- high cortisol, low acthct scan (adrenal cushing's)
mgmt- gastroschisisurgent surgery
a/w other congenital d/o- gastroschisis or omphaloceleomphalocele
cortisol and acth in adrenal insuffboth low
mcc adrenal insuffsecondary (steroid w/d)
primary adrenal insuff k, na, and pigmenthigh k, low na, pigmented
bg in adrenal insufflow
dx- pt in hosp w/ nl tsh and t4, low rT3!euthyroid sick syndrome. self-resolve
confirm euthyroid sick synd withrT3
dx- hypert4 -> hypot4 painFULdequervain's
dx- hypert4-> hypot4 painLESS, recoverssilent lymphocytic thyrotoxicosis
dx- hypert4 -> hypot4 stays lowhashimoto's
labs- tsh, t4 and raiu in factitious (exogenous t4)low tsh, low t4, low raiu
mgmt hypert4 non emergent with tachyBB -> ptu/mmz -> steroids
dx- low/nl pth, low ca, high phypopth
dx- low ca and low pvit d def
mgmt- turner syndrome human growth hormone, estrogen
dx- kid w/ hematuria, htn, proteinuria, rbc casts s/p impetigopsgn
mgmt- sigmoid voluvlussigmoidoscopy (dx and tx)
dequervain thyroiditis akasubacute granulomatous thyroiditis
subacute lymphocytic thyroiditis vs de quervain'slymphocytic is painLESS
thyroiditis uptake scan resultsdecreased uptake
dx- head truama -> loc -> lucid interval -> progressive neuro declineepidural hematoma (middle meningial a)
dx- head truama (accel/decel) -> loc -> amssubdural (bridging veins)
ct epidural hematomadoes NOT cross suture lines, biconvex
ct subdural hematomaDOES cross suture lines, crescent shape
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Question Answer
plan b pill is E or PP (levonorgestrel, 72 hr)
1st line rx RLSDA agonist (pramipexole, levo/carbi, bromocriptine), Fe suppl
dx- PP pain, wt loss, h/o vascular dz, abd bruitintentestinal ischemia
dx test and mgmt- mesenteric ischemiaangio, surg
staph w/ oxacillin MIC >4 meansMRSA
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mgmt- perf ulcer <70 y/o, stable, no s/s peritonitis : IV abx, NGT, IVF -> surg
Question Answer
mgmt- perf ulcer w/ peritonitisemergent surg
moa- shoulder stuck in IR and ADD, flat ant shoulderposterior dislcoation (SZ)
mgmt- prolactinomabromocriptine -> cabergoline -> surg if rx fails
mgmt- rhabdo (i.e., 2/2 statin)IVF, ecg
dx- target lesions on extremities <10% BSA w/o mucosalerythema multiforme minor
dx- target lesions on extremities <10% BSA with mucosalerythema multiforme major
dx- widespread bllisters w/ face/trunk <10% BSASJS
dx- widespread blisters >30% BSATEN
ab type- <20wk GA, bleed, open osinevitable ab
dx- purple, polygonal, pruritic, papules, flexural surfacelichen planus
rx- reduce morbidity/mortality in measles (cough, coryza, conjuctivitis, koplik spots)vit A
measles is contagious for _________ days after rash4
mc meningitis adultss pneumo
mc meningitis neonatesGBS
mc meningitis s/p surg or cathstaph
mc meningitis immuncomp or elderlylisteria
mc meningitis AIDS CD4<100cryptococcus
mc meningitis young adult w/ petechial rashneisseria
rx and ppx meningitis young adultsvanc, ceftriaxone, steroids; ppx rifampin or cipro
rx for meningitis elderlyvanc, ceftriaxone, steroids, ampicillin (listeria)
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Question Answer
dx test- esoph perfcontrast esophogram (endoscopy makes worse)
dx test- esoph perf if esophgram - or surg plannedendoscopy
dx test- esoph malignancyupper endoscope > barium swallow
dx test- dysphagia with s/s stricturebarium swallow
mgmt- breastfeeding mother w/ VZVnothing if >2d old and no breast lesions, IVIG and isolation if <2d old
dx test- PUD perf with peritonitisabd XR -> CT scan if neg
ethics term- doc removes new rx from pt shown to worsen dznon-maleficence (do no harm)
mgmt- TSSIVF, nafcillin, aminoglycoside
dx- fears social situations d/t fear of rejection, but wants friendsavoidant personality d/o
dx- few friends, but content with itshizoid personality d/o
dx- closed femur fxr, dyspnea, cough, hypoxia, ams, petechial rashfat embolus
dx- arm exercise, bp L>R, syncope, vertigo, dysarthriasubclavian steal synd
dx test and mgmt- subclavian steel styndangio, stent or bypass
3 terms for bug causing cough, coryza, conjunctivitismeasles, rubeola, paramyxovirus
3 terms for bug causing suboccipital postauricular LAD, rash face, arthralgiagerman measles, togavirus, rubella
rx c diffpo metro > po vanc
sacral axis- resp and cranial motionsuperior transverse
sacral axis- dynamic motionr and l oblique
sacral axis- postural motionmiddle transverse
sacral axis- innominate motioninferior transverse
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Question Answer
dx- fht with sinosoidal patternfetal anemia (rh isoimmunization)
dx- fht with fetal bradycong heart block
mortality rate eq#deaths/# at risk per 100k
hr rx that can cause sle and pericarditisprocainamide
mgmt- bleeding diverticulosisIVF (fiber for prevention)
autonomic hyperreflexia @ leves _________ and aboveT6
2 most specific abs for sleanti smith, anti ds dna
memorize
tx lead poisoning >45 level and < 45 level : >45 -> chelate, <45 -> find source
Question Answer
pre-renal- bun/cr, fena, una>20, <1%, <20
post-renal- bun/cr, fena, una<20, >2%, >20
acute hiv s/s evalELISA and viral load
screen hiv w/o s/sELISA -> western blot if +
exudative effusion rulespleural/serum protein >0.5, pleural/serum LDH >0.6, pleural LDH >2.3 ULN (60)
exudative effusion ddxca, tb, pna, trauma, asbestosis
rx touretteantipsychotics (risperidone, fluphenazine, haldol)
tourette a/w what other psych dzsadhd, ocd, learning d/o, conduct d/o
CAP rxazithromax, moxifloxacin. doxy
HAP rxvanc, zosyn
HBV a/w what vasculitispolyarteritis nodosum
hep b rxIFN, lamivudine, telbivudine, teofovir
hep c rxribavirin, IFN
CMV rxganciclovir, foscarnet
mc transfusion rxn with mild fever, chills, sobnon hemolytic febrile rxn
ppx- non hemolytic febrile rxn of transfusion and TRALIleukocyte washed rbc
dx- hyperBG at 3am d/t GHdawn phenomenon
dx- hoBG at 3am d/t over NPH txsomogyi phenomenon
mgmt- dawn phenomenonincrease evening basal
mgmt somogyidecrease evening nph
memorize