STEP 2 IM bits pieces 2-29-2016

ruhland1's version from 2016-02-29 22:16


Question Answer
7% vs 9% A1C35-70% reduction in microvascular disease in 7% but 3x risk of hypoglycemia
hypoglc and DMT2periph neuropathy may get so bad the body may not produce an SNS response .: down awareness of low glc
exelonrivastigmaine = AchE Inh
Month FocusCOPD CHF HTN Pneum DMT2 Sleep Apnea
Morgellons Diseasedelusional parsitosis, will find "unusual fibers"
pink pufferCOPD, due to compensatory hyperventilation
COPDneed CXR PFT and hx of chronic bronchitis for dx
Blood pressurehighest in the morning, a SNS surge to wake us up
OrenciaInj -mab for RA
bouchardMCP RA
heberdonPIP RA
RA DIP nodesdoes not have
fasting glc dxglc>126
MTXimmunosup for RA, contra in wounds, up lung fibrosis
cracklescan be wet or dry
Gold saltslung fibrosis
atelectasismay reinflate if inhale deep enough
ddx flea bite from scabiesflea bite is more focal, scabies has lines and surrounding erythema
subscapularis testput dorsal hand behind touching back and push away
empty cansupraspinatus
joint pain, rash muscle pain, haita"chi con gella" virus (sp.)
GenuviaDPP4 inhibitor (gliptin)
DPP4 inh.: up conc incretins
Liver funcdetoxs, makes albumin, clotting factors
AST ALTmade in Liver and muscle
DMup NASH .: up cirr
Vitamin Eliver protective cardio toxic
random glc DM>200
2 hour glc DM>200
RA fingersulnar deviation
RA organILDz, Splenomeg, Glomneph
Cauda equinaassym, incontinence, saddle parathesia ddx from conus medularris which is symm and up reflexes and up babinski
hydroceleserous fluid sac within tunica vaginalis
bumps on elbowsolecranon bursitis
Infiltrative diseasesamyloidosis, wilsons, hemachomatosis
metformin"hepatic glucose FORMation INhibitor", dn A1C 1.5%
small fiber neuropathythe "oooooohhh!" pain fiber, unmyelinated, with pathos get dysthesia and anesthesia
FMLAFamily Medical Leave Act (time off for baby/disease) not = disability
NASHup cirr
why poly phagia dipsia uria in DM-phagia because body thinks low energy state, dipsia because glc increases serum osmolality so body thinks its dehydated, uria so body can remove glucose
q-SOFAnew SIRS (need two of 3 criteria to define sepsis) 1. delta mentation 2. RR>20 3. SBP <100
PPIpossibly indicated in increase of dementia, CKD, C DIFF and lowered Mg
PPI electrolytedn Mg
look intoLight crit, ranson crit, MELD, Child Peugh
Cold txflonase, atrovent, tessalon, allergy-D med, guaifenisen
Keppraincreases agitation
how to dn K+Calcium, Insulin Gluconate, Albuterol, diuresis, dialysis, Kayexalate
Dressler Syndacute pericarditis following MI, leads II III aVF
S1Q3T3think RV strain not massive PE
Bergersvasulitis in distal extremities looks like frost bite, due to smokinh
up K+flat P wave
up K+peaked T wave
+ glutamate dehydrogenasemarker for C DIFF
EndocardEKG, blood culture,roth spot, osler node, S-meg, Murmur, Janeway, (VascInfxnTraumaAMIN mnemonic)
Endocard echoaortic regurg
endocard weird bugsHACEK
HACEKhaemoph, Actinbobacter, cardiobacterium, eiknella, kingella
when looking at creatininefind old base line to compare to
Beck TriadCardiac tamponade, up JVP, muffled hurt
electrical alternanselectric activity varies from one beat to next due to swinging within cardiac fluid of tamponade
Endocard bugBovis=colon, IVDU=tricuspid, S Viridian, S Aurem Enterococci
psoriatic arthritissausage finger, nail pitting
AKI3 causes, Prerenal (perfusion...) Intrinsic (Dz) Post renal (obstruction
most accurate test for hepatic encephCSF glutamate
OCDcingulate gyrus
paroxitine and venlafaxineup discontinuation syndrome
pretibial myxedemalook it up
duloxitinefor pain syndromes
citalopramup QT interval
PE goldCTA, old GOLD = pulm angiography
Be Dr HIPP He Have 2 Very Many Pt. I May Did Very, Hurt Many Teensimmunization mnemonic
ETOHmetabolized with acetyladehyhde dehydrogensae
polycheziamany stools
tinklinghi pitched, air moving through small pathway in bowel, seen in partial SBO
Ligament of TreitzSeparates UGI and LGI
Steroidsup glc, up BUN
AZTdn lung inflam, bronchidilation, lung ABX good stuff
CHF cxrcephalization of veins
Lasix"Last Six" T1/2=6hr lol
Sprint Trialgoal BP is 120, non diabetics is 140, better to do intensice anti-htn in all non-diabetics
A-a gradientA= 5xFiO2, a= 760 * %O2
7.36/28/90/0.28pH/PCO2/PO2/ on 28% oxygen
rule of 80s<80 metab acid, >80 metab alk, <77 metab acid w resp alk, >83 metab alk with resp acid