IM Bits Pieces 3-11-16

ruhland1's version from 2016-03-11 15:10

Section 1

Question Answer
Neck Pain PXEXROM, Strength, Reflexes, Spurling
C5 Strengthdeltoid
C6 Strengthbiceps
C7 StrengthTriceps
C8 T1 Strengthfinger abduction/adduction
cervical degenerative disk diseaseparkinsonian cogwheel, + babinski
Secenda= VictozaLiraglutide GLP-1
Creatinine 1.3NSAID contra
Ankolysisning Spnodylitis Bamboo SpineHLA-B27
Interstitial Cystitissx of cystitis w/o pyuria/bacuria
Interstitial Cystitis sxdyspareunia, pelvic pain
Interstitial Cystitis cytoscopypetechiae, ulcer
Interstitial Cystitis txsupportive, Elmiron (coats bladder like pepto bismol)

Section 2

Question Answer
Interstitial Lung dzinflx space between alveoli, capillaries, airways
Interstitial Lung dz ddxARDS, Sarcoid, Goodpasture, fibrosing alveolitis, RA, SLE, Extrinsic Allergic Alveolitis, Cyrptogenic Fibrosing Alveolitis, Asbe
Interstitial Lung dz earlysob, clubbing
Interstitial Lung dz latetachypnea, RHF, cyanosis, pulm htn, cor pulmonale
Interstitial Lung dz Auscultationend inspiratory crepitation
Lumbar PXEXF, Nightchills, M Spasm, radioulopathy, straight leg raise
La SaiguesStraight Leg Raise
Straight Leg RaiseMCC= L5 herniated disk, lift both legs reproduces sciatic nerve pain
EBV MonoSplenomeg
Mumpsunilateral partoid enlargement, unlateral testi enlargement
Pancreatitis ETIOGallstone, ETOH
PANCREATITIS etio mnemonicPosterior perf peptic ulcer, Alcohol, Neoplasm, Cholelith, Renal dz, Ercp, Anorexia, Trauma, Infection, Toxins, Incineration, Stings, Hypertg
Hypertgup risk pancreatitis
increased LDHthink increased cell turnover
Livercoags, LFT, protein, bili
pancreatitis reliefleaning forward
panc sxepig pain rad to back, NVD, week, low F, Shock
panc pxexabd tender without guarding, rebound
panc GIdn bowel sounds, up ileus
panc signsgrey turner flank, cullen periumb
panc amylaseelevated during fir
more specific for liverALT > AST
panc lipaseelevated, non specific
high FerritinAcute Phase Reactanct
Panc AXRsentieniel loop

Section 3

Question Answer
Senteniel Loopisolated loop of bowel seen in inflx
panc CXRexudative pleural effusion
panc CT/USperipancreatic fluid, panc calcifications
panc txIVF, bowel rest, NG decomp, ABX (contreversial), surgical debride if peripanc fluid
AB LAWRANSON mnemonic on admission (Age, Blood glc, Ldh, Ast, Wbc)
RANSON W>16000
RANSON 48hr HCTdrop 10%
RANSON 48hr BUNup BUN 5 after resusc
RANSON 48hr Ca<8
RANSON 48hr fluid def>6 L
RANSON 48hr base def>4
RANSON 48hr Amylase Lipasenot prognostic
Panc findingpsuedocyst
Panc bloodsplenic vein thrombosis

Section 4

Question Answer
CKD metabin urine, dn Nitrogen excrete
CKD pHdn ability to buffer
CKD dn 1-alpha-hydroxylasedn synth 1,25 vit D
CKD rbcdn EPO
Uremiaanorexia, N, V, mental, bleeding, epig pain
Why bleed uremiadown platelet function (why they use hydroxyurea to treat essential thrombocythemia)
why epig pain in uremiaup fibrinous pericarditis
H2O retentionCHF, hypertn, pulm edema
why frx and bone pain in CKDdn Vit D, up PTH (up osteitis fibrosa cystica)
CKD osteomalaciadn Vit D
CKD oseoporosisdue to metab acidosis
CKD labdn pH, up K, dn Ca, anemia, up TG
biomarker of kidney func ( is filtered but not secreted)Cystatin C
excreted vs secretedexcreted is leaves body, secreted means is filtered but returned back to circ
CKD uAwaxy casts, fixed specific gravity (can no longer concentrate urine)
waxy caststhink ESRF
ATNmuddy brown
ATN granular casts
PyelonephWBC casts
Glomnephritis pathognomonicRBC casts
Nephrotic Synddouble refractile fat bodies
Atheroembolic diseaseurinary eosinophils
Allergic Nephritisurinary eosinophils
CKD imagerenal osteopor and metastatic calcification
meta calcificationdue to hyper PO4 in CKD driving calcium into tissue (calciphylaxis)
sevelamerphosphate chelator
CKD txdn protein/salt intake, diuresis, BB, vasodilatorm, vit D, Ca, sevelamer, dialysis
NorvascAmoldipine indic in Stable Angina, Prinzmetal angina