Term
| which is the encapsulated yeast? |
|
Definition
|
|
Term
| treatment of cryptococcus |
|
Definition
| amphotericin plus flucytosine then if there is a + response do oral fluconazole |
|
|
Term
| itraconazole is used for? |
|
Definition
moderate blastomyces in healthy individuals
maintenance therapy for histoplasma meningtits after initial tx with amphotericin |
|
|
Term
| what is sulfadiazine pyrimethamine used for |
|
Definition
|
|
Term
| most common cause of acute back pain |
|
Definition
|
|
Term
| tx of flash pulmonary edema |
|
Definition
|
|
Term
| what do you NOT use to treat MI if there is flash pulmonary edema? |
|
Definition
|
|
Term
test for mononucleosis
limitations of this test |
|
Definition
heterophile antibody test
may be negative in the first week |
|
|
Term
|
Definition
| high fever, lymphadenopathy and pharyngitis |
|
|
Term
| what lymph nodes are mostly effected in mono |
|
Definition
| posterior cervical chain > anterior cervical chain |
|
|
Term
| treat neuroleptic malignant syndrome |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
| often ppl on steroids long term or some other form of immunocomp |
|
|
Term
what do leafy greens do to the effects of warfarin?
acetominophen? |
|
Definition
decrease
increases (increased bleeding risk) |
|
|
Term
| what else increases the effects of warfarin? |
|
Definition
other NSAIDS
thryoid hormone
PPI
amiodarone
antibiotics |
|
|
Term
| what besides vit K decreases the effects of warfarin |
|
Definition
rifampin
carbamazepine
OCP
st johns wort |
|
|
Term
| which is used for smoking cessation buproprion or buspirone |
|
Definition
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|
Term
| after a pt gets a blood transfusion, if they have some adverse reaction, based on the timeline you can narrow your differential. How? |
|
Definition
rxn in seconds or minutes = anaphylaxis
within 1 hour: acute hemolytic
1-6 hours: febrile nonhemolytic, TRALI
over 2 days: delayed hemolytic |
|
|
Term
| why would you irradiate RBCs before giving them to a patient |
|
Definition
-if donated by 1st or 2nd degree relatives
-in BM transplant patients
-in acquired or cellular immunodeficiency |
|
|
Term
| Why would you luekoreduce RBCs before a transfusion |
|
Definition
-if they are CMV seronegative and immunocompromised
-if they are chronically transfused patients
-if they are potential transplant recipients
-if they had a previous febrile nonhemolytic rxn |
|
|
Term
| when do you wash RBCs before a transfusion |
|
Definition
-IgA def
-complement dependant autoimmune hemolytic anemia
-continued allergice rxn (hives) with transfusion even when you give antihistamine |
|
|
Term
| what exactly is a nonhemolyltic transfusion reaction? |
|
Definition
-occurs in 1-6 hrs after transfusion
-from cytokines that still remain in the blood after plasma is removed
-causes fever, chills, malaise and NO HEMOLYSIS |
|
|
Term
| how do you manage nonhemolytic transfusion reaction |
|
Definition
-stop transfusion
-give antipyretic
-use leukoreduced blood products next time |
|
|
Term
|
Definition
| transfusion related acute lung injury |
|
|
Term
|
Definition
looks just like ARDS
-sudden development of dyspnea, hypoxemia and fever
-hypotension or hypertension |
|
|
Term
|
Definition
give O2 and aggresive respiratory support
give fluids or vasopressors if hypotensive
steroids |
|
|
Term
|
Definition
| transfusion assocaited circulatory overload |
|
|
Term
|
Definition
dyspnea
orthopnea
peripheral edema
rapid increaes in bp |
|
|
Term
|
Definition
|
|
Term
| what causes acute hemolytic transfusion reaction |
|
Definition
| usually ABO incompatability |
|
|
Term
| What are the major microcytic anemias? |
|
Definition
IDA
Thalassemia
Anemia of Chronic Disease |
|
|
Term
| MCV, Fe, TIBC, % Sat and ferritin levels in IDA |
|
Definition
MCV lo
Fe lo
TIBC hi
% sat low
ferritin low |
|
|
Term
| MCV, Fe, TIBC, % Sat and ferritin levels in Thalassemia |
|
Definition
MCV lo
Fe hi
TIBC lo
% sat hi
ferritin hi |
|
|
Term
| MCV, Fe, TIBC, % Sat and ferritin levels in anemia of chronic disease |
|
Definition
MCV normal or lo
Fe lo
TIBC low
% sat normal or lo
ferritin normal or lo |
|
|
Term
| how do OCPs cause hypertension |
|
Definition
| estrogen may ingrease the synthesis of antiogensinogen in the liver and effect the RAAS system |
|
|
Term
| pneumonia culture that grows mucoid colonies that are capsulated |
|
Definition
|
|
Term
| what kind of kidney problem do elderly ppl in nursing homes have (hint they have poor oral intake). what is the pathogenesis of this problem? |
|
Definition
prerenal azotemia
initial volume depletion results in vasoconstriction of efferent arterioles and vasodilatition of afferent. however further depletion results in big GFR decrease and decline in renal functino (hi Cr, hi BUN) |
|
|
Term
| BUN/Cr in prerenal vs renal azotemia |
|
Definition
|
|
Term
|
Definition
| if ATN is the result of hypoperfusion then initally there will be an elevated BUN/Cr. However once the ATN sets in and tubes are damaged they cant reabs urea so BUN/Cr drops |
|
|
Term
| emperic treatment of iv drug related endocarditis |
|
Definition
|
|
Term
| Ca, P, K, and uric acid in tumor lysis syndrome |
|
Definition
|
|
Term
| in a pt with tumor lysis syndrome you are owrried about the uric acid damaging kidneys, how do you prevent this? |
|
Definition
|
|
Term
| what types of cancer are at a higher risk of tumor lysis |
|
Definition
| poorly differentiated lymphomas and leukemias |
|
|
Term
| what metal is most likely to cause allergic rxn |
|
Definition
|
|
Term
| what is the algorithm for working up hypercalcemia? |
|
Definition
1. measure PTH
2. Hi normal or Hi PTH =
primary/tertiary hyperparathyroidism, familial hypercalcemic hypocalciuria, lithium
3. If PTH is lo then measure PTHrP, and vit D. That should help elicit the cause..... |
|
|
Term
| What are the two most common causes of hypercalcemia |
|
Definition
hypercalcemia of malignancy
primary hyperparathyroidism |
|
|
Term
| how does malignancy cause hypercalcemia |
|
Definition
1. bone mets
2. secretion of PTHrP
3. increased vitD? |
|
|
Term
|
Definition
CKD causes 2ndary hyperparathyroidism
INITIALLY
hi PTH
low/normal Ca
hi P
low 1,25 vitD
LATER
the patient may get parathyroid hyperplasia leading two tertiary hyperparthyroidism and so much PTH that Ca becomes elevated |
|
|
Term
|
Definition
| serum protein binds free hemoglobin and promotes its exretion by RES |
|
|
Term
| what are haptoglobin levels in hemolytic anemia? |
|
Definition
low
all the haptoglobin is being used to bind up free hemeglobin from the hemolysis |
|
|
Term
| treatment of flu pneumonia |
|
Definition
|
|
Term
| what do steroids do the WBC count |
|
Definition
increases neutrophil count
"mobilizes the marginated netrophil pool" and pushes wbcs out of bone marrow |
|
|
Term
| splinter hemorrhages under nail beds are seen in _____________ |
|
Definition
|
|
Term
| fever + chills + LUQ pain + splenic fluid collection = |
|
Definition
|
|
Term
| what is a splenic abscess associated with in a non immmunocomp patient |
|
Definition
| endocarditis, IV drug abuse, trauma, hemoglobinopathies |
|
|
Term
| dome shaped lesions with central umbilication? |
|
Definition
| molluscum contagiosum cuased by poxvirus |
|
|
Term
| in a MI, what is the major factor that deterimines prognosis during the acute event? |
|
Definition
| how long it takes to restore coronary blood flow |
|
|
Term
|
Definition
|
|
Term
|
Definition
pinpoint pupils
lethargy
dec bowel sounds
DECREASED resipratory rate |
|
|
Term
| how do you manage a pt with DVT and elevated homocysteine |
|
Definition
|
|
Term
| major features of tinea corporis |
|
Definition
ring shaped scaly pathces with central clearing and distinct borders
very itche
KOH yields hyphae |
|
|
Term
| treatment of tinea corporis |
|
Definition
lotion like terbinafine
if super severe: griseofulvin |
|
|
Term
| tx of severe alcoholic cirrhosis with edema, ascites and esophageal varicies (non bleeding) |
|
Definition
|
|
Term
| clinical features of glucagonoma |
|
Definition
necrolytic migratory erythema (erythematous papules/plaques on face perineum and extremities that enlarge and coalexce with centreal clearing and peripheral crusting)
DM
GI: diarrhea, anorexia, abdo pain |
|
|
Term
|
Definition
hyperglycemia
glucagon > 500 |
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|
