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50 Cards in this Set
- Front
- Back
side effects of atypical antipsychotics, like olanzapine
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weight gain, hyperglycemia, dyslipidemia, and HTN
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pt with foul smelling sputum after upper GI edoscopy must be suspected of having what?
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an anaerobic infection, treatment must have anaerobic coverage, like clindamycin
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OCPs cause what in 5% of pts?
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HTN
look to d/c OCP to correct the BP |
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treatment of a-fib
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lone AF without other risk factors treat just with aspirin
if they have any risk factors treat with warfarin, these include previous TIA/stroke, DM, HTN, HF, age >75, or valve disease |
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live vaccines generally not given in HIV pts
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BCG, anthrax, oral typhoid, intranasal influenza, and oral polio
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live vaccines that can be given to HIV pts
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MMR and varicella, as long as CD4 > 200 and no history of AIDS defining illness
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S/S of malignant otitis externa
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severe pain, otorrhea, and granulation tissue in the ear canal
MCC is Pseudomonas aeruginosa |
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what is suspect in a pt with anemia and vitiligo
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pernincious anemia
suspect this in any pt with anemia and other autoimmune disorder (vitiligo, autoimmune thyroid, MS, etc) |
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treatment of refractory hepatic hydrothorax
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transudative effusions in pts with cirrhosis and no cardiopulm disease
refratory is treated with TIPS (transjugular intrahepatic portosystemic shunt) |
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polyuria and polydipsia with dilute urine and elevated serum osm
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diabetes insipidus
usually from defective ADH production |
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polyuria and polydipsia with both plasma and urine diluted
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primary polydipsia
previously called psychogenic polydipsia |
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polyuria and polydipsia with low serum osm and inappropriately high urine osm
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SIADH
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1st step in treatment after strong alkaline ingestion (like lye)
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early upper GI endoscopy to access damage
neutralization, vomiting, or charcoal are contraindicated as they do NOT improve outcome and complicate mgmt |
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hyperosmolar hyperglycemic state
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seen in Type 2 DM
S/S are AMS, decreased consciousness, blurry vision, fatigue can be precipitated by stressors that increase cortisol and catecholamine lvls, examples are stress and infection |
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how to diff peritonsilar abscess from epiglotitis
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peritonsilar abscess can have a deviated uvula and unilateral lymphadenopathy
treatment includes aspiration, drainage, and IV antibiotics |
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diabetic neuropathy effect on urination
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diabetic neuropathy leads to denervated bladder and therefore detrusor weakness
this causes urinary retetnion and overflow incontinence |
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cauda equina syndrome (CES)
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1-23
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secondary amyloidosis
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frequently from chronic systemic inflammation seen in autoimmune disorders, chronic infections, IVDU
caused by deposition of acute phase reactants like serum amyloid A can cause nephrotic syndrome, hepatomegaly, cardiomegaly, and/or peripheral neuropathy |
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in a study, selecting pts with same age, race, or other demo is called what and reduces what problem
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it is called matching and reduces confounding
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portion of the spine most commonly affected by RA
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cervil spine
can result in C1-C2 instability subaxial subluxation |
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things that increase warfarin activity
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P450 inhibitors
EtOH, Vit E, garlic, ginko biloba, St Johns Wort |
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p450 inducers
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x
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p450 inhibitors
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x
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use of BAL (bronchoalveolar lavage)
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samples cell during bronchoscopy, used in eval of malignancy or opportunistic infection of interstitial lung disease
NOT useful in other forms of interstitial pulmonary fibrosis, sarcoid, or other connective tissue diseases |
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leukemoid rxn
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a marked increase in leukocytes due to severe infection or inflammation
looks a lot like CML blast crisis, but the luekemoid rxn will have a HIGH LAP (leukocyte alkaline phosphatase score) and it will be low in CML |
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reaction formation
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transformation of unwanted thoughts or feelings into their opposite
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best way to evaluate chronic pancreatitis
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US in pts with jaundice
CT of abdomen has a higher sensitivity in suspected pancreatic cancer |
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presentation of cavernous sinus thrombosis
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often headache, low grade fever, periorbital edema, and cranial nerve palsies
usually secondary to infection, treat with IV antibiotics then possible anticoag, glucocorticoids, or surgery |
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prophylaxis of malaria is sub-saharan Africa and India
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these areas have endemic choroquine resistant falciparum
prophylaxis is with mefloquine |
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2-18
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x
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PAP smear guidelines
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start at 21 and have one every 2 years until 30
after 30 have a PAP every 3 years as long as they are neg |
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HPV guidellines
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males and females aged 9-26, most effective if given prior to the start of sexul activity
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next step after suspected squamous cell carcinoma of head or neck
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a panendoscopy needs to be done to detect the primary tumor
panendoscopy is a triple endoscopy including esophagoscopy, bronchoscopy, and laryngoscopy |
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HSV esophagits description and treatment
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seen in HIV, HSV esophagitis has multiple, small and well circumscibed ulcers that are small and deep "volcano-like"
cells have ballooning degen and esosinophlic intranuclear inclusions treat with acyclovir |
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CMV esophagitis description and treatment
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CMV esophagitis is seen in HIV and has large, irregular, linear, shallow, superficial ulcers
cells have intranuclear and intracyto inclusions treat with ganciclovir |
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HSV vs CMV lesions in esophagous
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HSV is multiple, small, deep, well circumscribed with intranuclear inclusions
CMV is large, irregular, shallow ulcers with intranuclear and intracyto inclusions |
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1st, 2nd, and 3rd line treatment of SIADH
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1st line: fliud restriction
2nd line is hypertonic saline 3rd line is democlocycline that reduces ADH response at the collecting tube |
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treatment of symptomatic hypercalcemia
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saline hydration
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spinal cord compression
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has s/s of UMN dysfunction of weakness, hyperreflexia, and babinski
it is a medical emergency dx with spinal MRI |
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treatment of dermatitis herpetiformis
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dapsone is first line
as it is associtated with Celiac's, prevention is glutten free diet |
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pulsus paradoxus: description and causes
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diff of >12 mm Hg in SP during inspiration
caused by cardiac tamponade, tension pneumo, and severe asthma |
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1st step in eval and mgmt of ARK or AKI due to retention
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foley catheterization
post-op urinary retention is common in men > 50 and seen as oliguria (less than 250 mL in 12 hr), and increase in BUN and Cr |
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use of dihydroppyridine ca channel blockers in STEMI
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dihydropyridien ca chanel blockers are CONTRA in STEMI as they cause peripheral vasodilation and reflex tachy worsening pt. These include nifedipine and nicardipine
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organ effects in amyloidosis
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as the amyloid can deposit in various organs, you can see:
restrictive cardiomyopathy with symmetrical thickened vents proteinuria leads to edema from kidney deposits easy bleeding from decreased coag factors from liver involvement |
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S/S of cor pulmonale
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isolated right heart failure usually due to pulmonary disease
has JVD, S3, right vent heave, hepatomegaly, ascites, and dependent edema NO signs of pulmonary congestion |
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treatment of WPW
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when in a-fib with rapid vent rate, treat with cardioverion or procainamide
other AV blockers like beta blockers, ca channel blockers, digoxin, or adenosine are CONTRA because they increase the conductance through the accessory path |
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precipitating factors in PACs
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tobacco, alcohol, caffine, and stress
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treatment for uncomplicated UTI
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TMP-SMX
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treatment of hordeolum (aka: stye)
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it is a staph abscess of the eyelid and painful
treat with warm compress, if no resolution in 48 hours, then I&D |
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cause of UTI with alkaline urine
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Protues, as it makes urease which alkalizes the urine
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