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Management of a tension pneumothorax that is diagnosed clinically?
prophylaxis with rabies iv should be given to patients who were bitten by what kind of animals?
carnivores like bats, skunks, foxes
rx for minimal change disease?
horseshoe kidneys are seen in what 2 conditions?
hypermobility, blue sclera, dentinogenesis imperfecta are all a part of what syndrome?
first step after placement of a central venous catherer guided by ultrasound?
most common presentation of renal papillary necrosis?
management of a solitary metastatic nodule from a lung cancer tot he brain?
multiple metastatic nodules?
resection and whole brain irradiation
multiple--palliative care with whole head radiation
rx for an abcess in the pleura of the lungs--( empyema)
surgery and drainage
3 indications for oxygen therapy in copd?
- pulmonary htn and PaO2--60
- signs of cor pulmonale
- pao2 60 and sao2 90 if nocturnal hypoxia
cause of lymphedema in turners?
dysgenesis of lymphatic networks
what two conditions have non pitting edema?
- hypothyrodism--increased glycosaminoglycans
congenital causes of high unconjugated bilirubin?
- conjugated--dubin and rotor
- both have normal alp
best initial rx for acute and chronic anal fissures?
rx for refractory cases?
stool softener, diet modification and local anesthetic
3 complications of nephrotic syndrome?
- loss of anti tthrombin 3 leading to hypercoagubility
- increased infections
- high lipids--atherosclerosis
fluid in abdomen and hemodynamically unstable, next step?
most common presenation of sickle cell patient?
- painless hematuria
- inability to concentrate urine
side effect of carbamezapine?
1st line rx for hcm?
- or ccb like diltiazem or verapamil
inheritance of hcm?
dm most commonly produces what kind of neuropathy/.
distal symmetrical polyneuropathy
best initial rx for stye caused by s. auresu?
warm compress if doesnt resolve after 48 hours, I and D
rx for chalazion?
incision and curettage
cause of cholesterol emboli syndrome?
disruption of an atherosclerotic plaque leading to livedo reticularis and acute renal failure
lab finidings in cholesterol emboli syndrome?
- low complement levels
most common cause of idiopathic cirrhosis?
- alcohol abuse
- chronic infection iwth hep b
duration of rx for bipolar after 1 episode?
duration of rx for bipolar after 3 relapses?
1 year and taper
best diagnostic test for fat embolism?
- fat droplets in urine
- fat deposits in the arterioles on fundoscopy exam
chest pain, abdominal pain thats worse with palpation?
managment of refractory cases of myesthenia gravis?
- >60--- prednisone
components of metabolic syndrome?
- insulin resistance
- high tg
- low hdl
- increased waist size
what causes metabolic syndrome---
dry silvery plaques in the eye, what vitamin def?
poor adaptation to darkness, dry cornea, dry conjunctiva, silvery plaques in the eyes?
vitamin a deficiency
rx for bipolar with impaired kidney function?
rx for patients with scfe?
what in jelewery causes contact dermatitis?
dheas is specific to what organ?
what drugs causes hyperkalemia?
- aceI, ARB
- K sparing
- tmp smx
diagnostic criteria for kawasaki?
- fever of 5 days +
- mucous changes
- limb changes
- scantiliform rash
best initial test for as?
difference in presenation between alzeheimers and normal pressure hydrocephalus?
alzheimers--memory problems then incontinence
normal pressure hydrocephalus--incontinence and gait problems first and then memory
Riley Day syndrome(familial Dysautonomia) vs shy-drager syndrome (Mutliple System atrophy)
- Shy drager-occurs with parkinsons
- riley day occurs in jews
causes of hypoparathyroidism?
- digeorge syndrome
- apecd syndrome
difference between preseptal or periorbital and septal or orbital cellulitis?
orbital cellulitis has opthalmoplegia including double vision and tenderness with eye movement
difference for periorbital cellutlitis vs orbital cellulitis?
- periorbital--oral antibiotics
- orbtial--iv antibiotics
what happens to the levels of thyroxine with ocp?
icp decrease levels of thyroxine by increased TBG
what happens to the height of an infant as he reaches 1 year?
- increased by 50%
- doubled by 4
- tripled by 13
cause of varcocele?
- dilated pampiform plexus
- patent tunica vaginalis
- dilated epidydimal duct
cause of dilated small and large bowel?
rx for paralytic ileus?
rest supportive care
2 causes for paralytic ileus?
- retroperitoneal hemorrhage
- post surgery
electric alternans is specific for what?
midcycle pain or mittelshmertz, what is the cause of it?
how does it present?
- 2 weeks after last menstruation, no other symptoms such as tach, fever, pain radiating anywhere
what is the quadruaple screen pattern for down syndrmoe?
- beta hcg is high
- Inhibin is high
- msafp is low
- estriol is low
rx for neuroleptic malignant syndrome?
obesity associated hypoventilation or pickwickian syndrome vs obstructive sleep apnea?
- in pickwickian--fat prevents movement of the chest wall and abdomen leading to low SaO2
- vs in osa where SaO2 is normal
rx for active genital hsv infection?
most common primary brain tumor in kids?
second most common?
Rx for enterobius vermicularis?
aport syndrome vs thin basement membrane dz?
- both lead to hematuria and proteinuria
- thin basement membrane--in adults
recurrent pneumonia in the right lower lung with foul smelling sputum/.?
3 reasons to replace aortic valve?
- symptomatic--syncope, angina, dyspnea
- pt is undergoing gabg
- low ejection fraction<55% or LVH
3 p's of maccune albright syndrome?
- precocious puberty
- polyostic fibrous dysplasia
Mccune albright syndrome usually occurs with what other syndrome?
in any patient that is somnolent or near loss of consciesness, consider?
intubation so as to prevent aspiration
ekg findings with pericarditis?
- diffuse st elevation
- pr elevation
what does uremia cause?
indications for hemodialysis?
- electrolyte disorders like high K
- Intoxication with methanol
- Overload or p. edema refractory to diuretics
- Uremia--pericarditis, encephalopathy, coagulopathy
1st line rx for primary biliary cirhosis?
definitive rx for primary biliary cirhosis?
- ursedeoxycholic acid
- liver transplant
3 occasionas when ursodeoxycholic acid is used?
- primary biliary cirhosis
- symptomatic cholelithiasis
- pregnancy induced cholestasis
when do u transplant in pbc?
if cirhosis sets in
best initial test for allerghic rhinitis?
nasal cytology for eosinophils
contraindication to sumatriptans?
- uncontrolled htn
- ischmic stroke
- basilar migraine
- hemiplegic migraine
dx of melanoma?
basal cell carcinoma?
- full thickness biopsy
- punch biopsy
- shave biopsy
best initial analgesic rx for oa?
- capsacin cream
- intraarticular steroids
- joint replacements
rx for human and dog/cat biutes?
most common side effects of ssri?
- decreased libido
- impaired ejaculation
management of a fetus with major congenital disorder that renders it icompatible with life?
best initial rx for spinal cord compression with neurological deficits?
rx for angioedema?
management of terminal malignancy pain?
- short term opiods
- long term opiods
what kinds of vessels supply the internal capsule?
small vessels--ie. lacunar infarcts
what causes hypocalcemia and hypomagnesemia post transfusion?
the chelating agent citrate in the packed RBC
when do you treat pid as inpatient vs outpatient?
inpatient--nausea and vomiting- cant take anything by oral
outpatient--cant take oral antibiotics
hiv pt with esophagitis symptoms, next step?
- trial of fluconazole
- if fails to improve
progressing stroke symp[toms usually imply what kind of pathology?
intracerebral hemorrhage leading to increased ICP
after treatment for cin 2 and 3 what is the screening recommendation?
- pap smear with or without colposcopy untill 3 negative tests are obtained
- then regular screening
genotype xx and no uterus, cause?
genotype xy and no uterus?
- androgen insensitivity
- alpha 5 reductase deficiency
hydantoin syndrome caused by?
phenytoin and carbamezapine
presentation of hydantoin syndrome?
- facial hypoplasia
- digital hypoplasia
- lip and palate hypoplasia--cleft lip and palate
difference between fetal alcohol syndrome and hydantoin syndrome?
fas--no cleft palate and no digit hypoplasia
hydantoin syndrome--has cleft palate and digit hypoplasia
best initial test when suspecting pad?
abi if unequivical
do pre exercise, exercise and post excercise abi
new onset hirsuitism or virilization with pregnancy?
- if unilateral solid--laparotomy to r/o malignancy
- if bilateral solid-reassurance pregnancy luteoma
- if bilateral cystic-- theca lutein cyst r/o w/ bhcg
presentation of a meniscal tear?
popping and locking of knee on extension and flexion
what causes the following pathology of the liver?
panlobular mononuclear infiltration and portal necrosis with bridging fibrosis
inflammatory desterction of small intrahepatic biliary tracts?
- hepatitis virus
- primary biliary cirhosis
- rye--aspirin induced
ear pain worse with chewing and a history of grinding teeth in sleep?
ramsay hunt syndrome?
shingles affecting the ear
best initial rx for tmj dysfunction?
most specific sign for opiod intoxication?
decreased respiratory effort
2 conditions that have hyperextensible joints?
marfans and ehlers danlos
how early do the symptoms of extrapyramidal patter began with antipsychotic therapy?
- 4 hours--dystonia
- 4 days-akinesia
- 4weeks- akathesia
- 4 months-- tardive dyskinesia
how can respiratory failure be followed in gbs?
unequivical sweat chloride test, next step?
most common cause of erysepalas?
most common drug cause iron deficiency anemia?
1st line rx for pseudotumor cerebri?
most common cause of primary adrenal insufficiency in developing countries?
what causes adrenoleukodystrophy?
deposition of very long chain fatty acids
normal contractions in pregnancy occur how often?
1 every 5 minutes
when the fetus is how many weeks are steroids given?
between 24 and 34 weeks
which of the causes of conjugated hyperbilirubeniemia has dark pigments in the hepatocytes?
best initial rx for dubin johnson?
- high conjugated bilirubin with normal lfts
- urinary corproporphyrin I
difference on physical exam between empyema and consolidation?
- empyema--no bronchial breath sounds
- consolidation--bronchial breath sounds
perinauds or pinelaoma presents how?
precocioius puberty and opthalmoplegia
dacrocystitis is ?
inflammation of the lacrimal glands in the medial canthal fold
which of the infection sof the eye causes purulent discharge?
presentation of fetal alcohol syndrome?
- long filtrum
- thin upper lip
most common complication of meningitis?
what complications arise from meningtis?
most common is hearing loss
- all compliations occur--cognitive dysfunction
inverted champainge glasses look of the legs is seen in ?
charcot marie tooth disease
when does candida cause pneumonia?