-
Headache, Nausea, Vomitting, Possible seizures
Low Na, Nl to H urine osmol
- SIADH
- treat with H2O restriction
-
Glasgow coma scale
- Eyes:
- 1. Dont open
- 2. Open to pain
- 3. Open to voice
- 4. Open spontaneously
- Verbal
- 1. No sound
- 2. Incomprehensible
- 3. Inappropriate
- 4. Confused
- 5. Normal
- Muscle
- 1. No movement
- 2. Extention to pain
- 3. Flexion to pain
- 4. Withdrawal from pain
- 5. Localizes pain
- 6. Responds to commands
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Tachypnea, dyspnea, chest pain, hemoptysis, and hypotension
post sx, immobilization, etc.
What are the steps
- 1. CT c contrast (V/Q scan if no contrast)
- 2. Heparin or LMW hep
- 3. bridge to coumadin for 3-6 months
-
Signs of arterial insufficiency vs venous insufficiency
- Location: A-toes, webs, lateral maleoulus; V-proximal to medial maleoulus
- Wound: A-Deep, well defined borders; V-Shallow, irregular borders
- Pain: A-Severe pain V-Mild pain
- Temp: A-Cool to touch V-Nl skin temp
- Appearance: A-Thin shiny skin V-Brownish discoloration
-
Pupil size
- 3-9 mm
- 3-4 constricted
- 6-9 dilated
-
Type of crystals found and causes
- Needle shaped, negative birefringent: Gout
- Rhomboid shaped, + birefringent: Pseudogout (Ca oxalate)
- Coffin lid shaped: Struvite (kidney stones)
-
Causes of Carpel Tunnel Syn
- 1. Hypothyroid (waste deposits)
- 2. Amyloidosis (amyloid deposits)
- 3. RA (inflammation)
- 4. Pregnancy (fluid)
- 5. Acromegaly (tendon growth)
-
Patient treated for depression and eats cheese or meat. What is the concern
If pt is on MAOI it can cause HTN crises
-
Which ECG leads correspond to different locations on the heart (Anterior, Inferior, Lateral)
- Lateral: I, R, L, V1, V5, V6
- Inferior: II, III, F
- Anterior: V2, V3, V4
-
Obstruction of which Coronary Artery causes Anterior heart damage
LAD
-
Obstruction of which Coronary Arteries causes Lateral heart damage?
L Circumflex or Lateral branch of LAD
-
Obstruction of which Coronary Arteries causes Inferior heart damage?
RCA or L Circumflex
-
Adult pt with:
hx of URI 1-3 days ago
Oliguria, Azotemia (+ BUN and Cr), Hematuria
HTN
IgA nephropathy
-
Pt with: Liver disease
CNS disturbances (depression, tremor, paranoia, catatonia, drooling)
decreased ceruloplasmin
Kayser-Fleischer rings
Wilsons Disease
-
What are the protein, cell count, and glu levels in different CNS status changes
- Viral: p++; c+; g nl
- Bacterial: p+; c+; g-
- Herpes: p nl; c+; g nl (RBC present)
- Guilliane Barre: p+
- MS: IgG+; Bands++
-
Over 40 man with bone pain, headaches, (rarely) decreased hearing with abnormal x-ray
What is the next step? Treatment?
- Likely Pagets disease:
- Check AlkPO4(++), Ca(nl), and Phosph(nl)
- Rx: NSAIDs, Etidronate(Bisphosphonates) or Calcitonin
-
Pt with malignancy in testicle. What markers indicate which type of cancer?
- Placental AlkPO4: Seminoma
- AFP + B hCG: Embryonal
- B hCG: Choriocarcinoma
- + Testosterone and + Estrogen: Leydig cell tumor
-
When should a pt be placed for dialysis?
- 1. Refractory Fluid Overload
- 2. Refractory +K
- 3. Uremic pericarditis
- 4. Refractory Met Acidosis
- 5. Cr > 8 (>6 c DM)
-
Right Heart Cath nl values:
- R Art Pressure: 4-6
- Pul Art Pressure: 25/15
- Wedge Pressure: 6-12
-
Which organism causes basic urine and is nosocomial
Proteus
-
Requirements for Exudative Pleural Effusion
- Pleural Protein/Serum Protein > 0.5
- Pleural LDH/Serum LDH > 0.6
- Pleural LDH > 2/3 upper limit of serum LDH
-
Icterus, + indirect billi, other liver enzymes nl
Crigler-Najjar Type I
-
Severe Jaundice, Neuro impairment, ++ indirect bili, No response to phenobarbital, liver enzymes nl
Crigler-Najjar Type II
-
Malaise, fatigue, abd discomfort
Icterus after stress, illness, fasting, etc.
+ indirect billi
cell counts nl
Gilberts syndrome
-
Extraintestinal manifestations of Ulcerative Colitis
- Sclerosing Cholangitis
- Uveitis
- Erythema Nodosum
- Ankylosing Spondylitis
-
Tumor markers for : Colon, Ovarian, Testicular, Breast, Uterus, Female reproductive tract, Pheochromocytoma
- Colon: CEA
- Ovarian: Ca-125
- Testicular: AFP / HCG, +test + est, placental alk PO4
- Breast: Est or Progest receptors, HER-2 / Neu
- Uterus: Ca-125
- Female Tract: AFP / HCG
- Pheo: Milli / Vanilli
-
Pt with - Leukocyte alk PO4 and + WBC
CML
-
Pt with weakness and fatigue, with possible arrhythmias
ECG findings: tall peaked T waves, wide QRS, long PR, loss of waves, or sine wave pattern
What is the next step and steps in treatment?
- Check chemistries (++K) ECG signs are in order of increasing K
- Steps: 1. protect heart with Ca Gluconate
- 2. Insulin and Glu to push K into cells
- 3. Na HCO3 also pushes K into cells
- 4. Excrete K with Furosemide
-
Stone types and causes in nephrolithiasis
- Ca Oxalate: hypercalciuria (radiopaque, needle shaped)
- Struvite: UTI (", pyramidal crystals)
- Ca PO4: Hyperparathyroid (")
- Uric Acid: Chronic adic/concentrated urine, chemo, gout, DM (RADIOLUCENT)
- Cystine: Cystinuria, AA transport defects (radiopaque, hexagonal, +nitroprusside test)
-
Pt comes in acute cardiac failure, reports having URI a week ago. Dx?
Dilated Cardiomyopathy from acute viral endocarditis
-
PNA with high fever, N/V/D, altered mental status
No organism seen on gram stain. Next step?
- Likely Legionella use urine antigen test to confirm
- Start Rx with: Azithro or Levofloxacin
- Use Charcoal agar to grow
-
Aplastic Anemia, Thrombocytopenia, Macrocytic anemia, Congenital Abnormalities, Hypopigmented spots, Tumors
Fanconis anemia
-
WHen should D5W be used?
Hypernatremia with nl or high volume
-
When should D5 0.45 saline be used?
mild hypernatremic hypovolemia
-
What is a common complication of giant cell arteritis?
Aortic Aneurysm
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