Question Notes

Id
high output failure occurs in p's ds due to av malformations in the rapidly remdelling
1451
bone.
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2662 jkvhvjhvjjkvhhjkv
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1558 i concluded from a house md episode knowledge database!
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2044 tabulate the diffeternt zones of perfusion
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2406 yum
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Remember, honey has clostridium botulinium living inside it, while mis-shapen canned
354 food has botulinium toxin pre-formed in it - the baby didnt eat canned food, granny fed
him honey
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Increased BUN/creat ratio is seen in pre-renal failure G I bleed (secondary to
2240
reabsorption of blood from the GI tract) Steroid use
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337 What is cyclical vomiting?
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Tetanus immunization: tetanus Immune globulin is given only in: High risk dirty
woulds, when past h/o tetanus imminization is unknown, or less that three doses - i.e. in
1249 complete Give TT if: 1. incomplete / unknown tt immunization if tt immunization is
complete, 2. low risk wounds if tt more that 10 yrs ago. 3 high risk wounds if tt more
taht 5 yrs ago
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Phobia vs panic??? panic disorder has episodes of panic attacks, phobia is related to
1931 specific precipitating factors- one factor - simple phobia, usually the specific phobias
more factors - complex, ot general phobia
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2318 Pronator drift is a sensitive and specific sign od UMN lesion!!!!
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Avascular necrosis of femoral head is seen with: chronic corticosteroid use alcoholism
1983
hemoglobinopathies
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 In immunocompromised patients, both tb and nocardiosis can present the same way, but
microscopy will differentiate: tb: non gram staining, and acid fast rods, while nocardia
2354
is gram positive, partially acid fast "BRANCHING" rod. Important to differentiate as
tretment is different: INH/Rif/Ethm fpr tb, vs trimethoprim/sulfa for nocardiosis
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Colon cancer screening: can use any of these - 1 FOBT 2 Flexible sigmoidoscopy 3
2441 FOBT + Flex Sig 4 Colonoscopy - MOST SPECIFIC AND SENSITIVE BUT MOST
COSTLY AND EXPERTISE DEPENDANT 5 Double contrast barium enema
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Elbow # in kids are common, but you dont see a broken bone on xray - you see
2810
radiolucency anterior and posterior to the elbow joint and taht is diagnostic
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1933 Rheumatoid arthritis predisposes to amyloidosis!!!!
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RALOXIFENE s a selective estrogen receptor MODULATOR it increases bone mineral
287
density Increases risk of DVT
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Kissing Disease/ Infectious Mononeucleosis Diagnosis is by a MONOSPOT test - which
1544
is a heterophile antibody test
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PPD: Induration> 5 mm is considered +ve in: *HINV positive * induviduals with
2407 recent TB contact *Positive TB on X ray * post trans plant, or other immunosupressed
pts > 10 mm in *
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1257 Review Diabetic and Hypertensive retinopthy differences
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WOW!!! Remembered Conrad Fischer's lectures: In America, mom makes the decision
1684
for her unborn fetus!!!
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Osgood schlatter disease ( patellar apophysitis) has point tenderness over tibial tubercle,
2786
but in patellar tendonitis, tenderness is over inferior pole of patella
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trachoma of the eye presents with NEOVASCULARIZATION of the cornea i.e. pannus
761
formation
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Hemochromatosis = excess iron in serum = predisposes to infection with listeria
1077
monocytogenes, yersinia enterocolitica vibrio vulnificus all are iron loving bacteria
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 prospective cohort: two groups are made: exposed and non exposed, then they are
followed over time to see if disease developes or not retrospective cohort: sample
population is chosen, past records are reviewed, to see exposed or not exposed, then
1585
followed into future to see if disease developes or not cross sectional: population taken
at random, one point in time, and stratified for exposure/non exposure and disease / no
disease - it can show assosiation, but not causatio
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Infantile spasms - symmetrical contractions of neck, trunk and limbs, in infants,
associated with hypopigmented ash leaf spots, cortical tubers on ct, and
1613
HYPSARRYTHMIA on eeg. treatment - ACTH, as the ideal drug vigabatrin is not
apprved in USA.
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Pseudo dimentia vs alzheimers dementia: pseudo dementia pts are often overly
concerned with their memory loss, and seek help, alz dem pts are often indifferent ato
1855 memory loss and are brought in by families also, diagnosis of alzheimers requires
presence of more symptoms such as apraxia agnosia aphasia, disturbance in executive
functioning
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720 Read up on metab alkalosis and how to differentiate between all
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875 remember: TRANSudate is TRANSparent EXudate in infEXious
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PKU is associaed with an eczematous rash, and can have hypopigmentation, fait hair
1037
and blue eyes (like albino) due to low tyrosine.
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Pelvic abcess: tender mass in rectovesical pouch/rectovaginal pouch anorectal abcess:
1097
fluctuant mass in perinium!!
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In emergency, life threatening situation, a jehovah's wittness can refuse treatment with
1550 blood etc, and the physician must comply, but an unconscious patient's spouse can not
refuse for the patient if the patient has a written will etc, then that will be followed
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what causes rash in axillae? Kawasaki disease and scarlet fever can look alike clinically,
as both have: Fever, LNP, strawberry tougue, rash, but points of difference are: For
kawasaki, at least one of these additional criteria must be present such as - conjunctival
1905
injection, peripheral rash - hands, and periungual also, in scarlet fever, there is
circumoral pallor if doubt, treat with penicilline/erythromycin, and a rapid response
would confirm scarlet fever
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 alpha 1 anti trypsin defficiency causes lung damage esp n smokers - typical course early
emphysema/copd, and cirrhosis kartageners syndrome: abnormal cilliary function
1952 causing recurrent sinusitis, otitis, and lung infections cystic fibroosis - chloride chanel
transport defect, causing abnormal, thickened secretions - reproductive defects,
pancreatic filure, uris, sinusitis, ....
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Shy dagger syndrome = Parkinsonism + autonomic symptoms such as impotence,
orthostatic hypotension, + widespread neurological signs such as cerebella, pyramidal,
2066
lower motor neurons.... Reiley dey syndrome = autosomal recessive familial autonomis
dysfunction, in ashkenazi jews
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is this restless leg syndrome? you treat it with pain blockers? NO!!!! treat it with
2624 Dopamine agonists as the pathology involves abnormal dopamine transmission -
pramipexole, ropinerole
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2746 can mgso4 cause uterine atony? after all it is an anti arrythmic....
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121 what do you do for a CVA in a 12 yr old sickle cell patient
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2553 a s/e of heparin is hypercoagulability
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Primary amenorrhoea - no menarche till 16 years of age. Investigate: 1 . FSH if
increased, peripheral cause, if decreased, central cause 2. if FSH is decreased, do Gn
267
RH to see if defect is in hypothalamus or in pitutary 3 if FSH is increased, do a
karyotype 4 if FSH is normal, it menas there is ovarian agenesis or dysgenesis.
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Antihypertensive drugs acceptable in pregnancy: 1 Labetelol 2 Methyldopa Note in a
woman who has essential hypertension, and gets pregnant, treat hypertension only if BP
279 is > 120/80 for values lower or equal, consider stopping therapy For pregnant women
who develop hypertension for the first time during pregnancy, treat hypertension only
if BP> 150/95
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378 Cry du chet= deletion of 5p
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771 where the hell do you see auer rods?
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Sudden increase n TLC with left shift represents a serious infection with or without
792 underlying leukemia LAP score is decreased in leukemia but imcreased in leukemoid
reaction.
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 Even in presence of occupational risk factors, the occurence of bronchogenic carcinoma
928 is higher that mesothelioma so, even though mesothelioma can occur only in exposed
people, risk of brochogenic ca is higher.
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sporotrichosis looks like a papule which later ulcerates and occurs in gardeners
1610 Cutaneuos larva migrans looks like multiple pruritic papules - usually after handling
soil or sand contaminated with dog or cat feces
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she has ischemic nephropathy = Acute Tubular Necrosis ATN hallmarks= muddy
1891
brown granular casts containing renl tubular epithelial cells
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2439 Bladder cancer: NO SCREENING, even in patients who are at high risk
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Treatment of hepatic encaphelopathy Lactulose Neomycin Rifaximin(non absorbable
2562
intertinal antibacterial - also used for travellers diarrhoea) Laxatives
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2798 remember, joint bleed = deep tissue bleed = hemophilia
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Acute onset bloody diarrhoea in a young person, in abscence of an infection usually
associated with tenesmus = Ulcerative Colitis Extracolonic manifestations=Erythema
1236
nodosum, puoderma gangrenosum, Ankylosing spondylitis like arthritis, colangitis,
episcleritis
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Tourettes is associated with the folowing, in decresing frequency: 60% ADHD 30%
1696
OCD conduct disorder oppositional defiant disorder antisocial personality disorder
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Self mutilation = Lysch Nyhan Syndrome x linked recessive, hence boys only Purine
metabolism defect-defficiency in HPRT(hypoxanthine guanine phosphoribosyl
1753 transferase) features: gout and tofi mental retardation, choreoathetosis, spasticity and
dystonia if you see gout in a young boy, suspect lesch Ny synd treatment: fluids,
allopurinol, diazepam
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temporal arteritis can cause......? Temporal arteritis is a giant cell arteritis, and vcan
2397
involve the major branches of aorta - and can cause aneurysms.
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Treatment of asymptomatic bacteriuria: must treat in pregnancy, esp 12-16 weeks.
2409
recommended abs: amoxycilline nitrofuramtoin oral cephalosporins
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2484 Hepatitis B vaccination Indication: patients who are already infected with Hep C
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TOF: pulmonary outflow obstruction overriding aorta-with biventricular connection
VSD Right ventricular hypertrophy Tet spells are due to low oxygen sully upon
2779 exertion - such as feeding: Any manouvre that increases pulmonary flow relieves the tet
spells- usually, knee-chest position, which causes increased systemic resistance and
directs flow from systemic to pulmonary bed.
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856 This is primary billiary cirrhosis, and just like primary sclerosing cholangitis,
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Dont know why, but i remember from nephro posting taht transplant patients were
always on azithromycin Got it wrong: Azithromycin is used for mycobacterium avium
1017 cpmplex prophylaxis in hiv if cd50 to prevent oppertunistic infections in post transplant
immunosupressed patients, tmp-smx is used for PCP gancyclovir for CMV vaccines for
influenza, pneumococcus, hepatitis b
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Pseudotumor cerebri - treatment options are 1 medical - acetazolamoide 2
1571 corticosteroids 3 repeated lumbar punctures if these fail. surgery: optic nerve sheath
decompression or lumbo-peritomneal shunting
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Diabetes is the most imp risk factor for coronary disease but hypertension os for
1815
cerebrovascular disease
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2111 the sequence of newborn care immediately after birth
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What is the best step for hemoptysis in different situations? 1 Massive hemoptysis due
to trauma: immediate thoracotomy 2 massive hemoptysis due to vascular malformation
2486 - pulmonary angiography and embolization 3 massive hemoptysis due to a disease
eroding underlying vessels, like tb - bronchoscopy, esp rigid, as it gives both diagnostic
AND therapeutic use
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In metabolic alkalosis due to surreptious vomiting, therapy is saline infusion, clue -
2803
urine chloride 20
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biopsy looks like scarred liver hence transplant but note, this patient had normal liver
function! so decide therapy for HCV infection based on: 1 natural history 2 stage of ds
3 liver biopsy findings 4 liver enzyme levels 5 presence of HCV RNA 6. efficacy and
866
adverse effects of drugs in pts. All patients with increased ALT, detectable DNA, and
evidence of chronic hepatitis need treatment with INTERFERON and RIBAVARIN
(note INTERFERON and LAMIVUDINE are for Hep B)
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973 heriditary spherocytosis is autosomal DOMINANT
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Gout- uric acid - needle shaped crystals Pseudogout - calcium pyrophosphate -
1067
Rhomboid positively birefringent srystals Chronic UTI - Struvite - coffin lid shape
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In premature ovarian failure, the type of in vitro fertilization applied is where there is
1296
an oocyte donor and a surrogate mother.
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1369 Hemolytic Uremic Syndrome - ecoli???
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what are the cyanotic diseases of the newborn? 1 TOF 2 VSD Note, in congenital
cyanotic heart disease, the disease may be dependant on blood flow through the ductus
2598
arteriosus, eg TOF, therefore, attempts must be made to keep it open, till further
evaluation is done and a diagnosis is made.
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Note, in differentiating between gestational trophoblastic disease and hyperemesis
2726 gravidarum. both quantitative HCG and USG are important, but usg is less reliable, and
QTV HCG is more reliable.
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Cluster headache: Severe, acute, retro-orbital pain tearing, stuffy/runny nose, horners
2190
syndrome treatment: verapamil lithium and ergot.
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Mycoplasma pneumonia is the commonest atypical pneumonia, and is associated with
166
erythema multiforme.
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hydroxychloroquin is used in treatment of SLE s/e retinppathy - therefore, 6 monthly
1090
eye exam to be done.
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Fetal growth restriction: most sensitive/useful/reliable measurement is the one which
1199 will be affected in all types of growth restriction - symmetric/asymmetric.... so it is the
abdominal circumference, not head circumference which is spared in asymmetric..
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what is the cause of death in meningococcemia? Waterhouse frederichsen syndrome -
1374
i.e. adrenal hemorrhage leading to a rash and sudden vasomotor collapse
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Even today, treat suspected nephrotic syndrome in kids, with steroids right away - no
1954
documentation required - clinical diagnosis.
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 SLE = autoimmune disease, hence, it causes autoimmune anemia: WARM Ig G
2353
antibodies to RBCs positive direct coombs extravascular hemolysis Spherocytosis
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For diagnosis of major depressive dosorder, you need the symptoms for 2 weeks, not 6
2818
weeks.
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In abruptio placenta, at term, if mom and baby are stable, go for rapid vaginal delivery,
419 as this is the best way to remove retroplacental hemorrhage, and to prevent DIC
indications for C SEC: 1 obstetric indications 2. rapid deterioration of mom or baby
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in hepatocellular ca, ascitic tapis a low yeild test - go for tumour marker and ct/mri
808
afterward note - not rad onco opd
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Hyperextension traumatic injury to the neck causes trauma to the CENTRAL portion of
983 anterior sp cord causing: central cord syndrome - weakness more in upper than lower
limbs - selective loss of pain and temp in arms
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Note, this patient has ANTERIOR UVEITIS not RETINITIS therefore, it is sarcoid,
1093
not histoplasmosis
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FIBROMYALGIA non inflammatory disease treatment: amytryptaline: also increases
1125
stage 4 restorative sleep
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Gram positive branching bacteria= ACTINOMYCES treatmenyt: high dose IV
1494
penicillin for 6-12 weeks
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I chose salmonella just because of fever with chills..... correction: fever with chills =
1574
pneumonia too plus, osteomyelitis ruled out when there is NO BONE PAIN!
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hyposthenuria: excretion of LOW specific gravity urine seen in sickle cell disease or
2373
trait cause: sickling of rbcs in vasa recta impairs free water resorption
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2487 2487 - too difficult - revise revise
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Bupropion: An SSRInwhich also improves the impaired concentration and lack of
energy experienced by depressed patients, and particularly, does NOT cause sexual
2683
dysfunction. BUT!!!! Can cause seizures - so avoid in pts with seizure disorder, ot pts
at high risk of seizures - like electrolyte abnormalities, brain disease etc....
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 Metatarsus adductus: type 1 - overcorrects actively and passively - no treatment
1620 required type 2 - corrects to neytral position - treated with orthotic shoes/plaster casts
type 3 - rigid feet - serial casts
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UPDATE on DISK HERNIATION!!!!! acute pain in low back, s/o herniation, with
1936
positive leg raise test, but NO neuro deficit, NSAIDS and mobilize no role of bed rest!
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lumbar pain which worsens on extension and is relieved on flexion of spine = lumbar
2306
spine stenosis disc herniation pain is worsened by flexion!
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Fuck! it is torticollis! I'm so dated right now!! Torticollis = dystonia of SCM causes:
2336 congenital idiopathic post traumatic drugs - metoclopramide, antipsychotics,
prochlorperazine inflammation
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2731 Diabetic mom's baby will be plethoric and big
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1183 Could be e coli, but if urine is alkaline, ie ph>7 cosider proteus
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1603 posterior vermis syndrome: trunk dystaxia: seen in medulloblastoma
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surgery - to prevent complications later - it seems like a small VSD got it wrong - if
1926
pulm vas markings are minima - go for observation
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2343 Haptoglobin eats hemoglobin spilled in blood!
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Thalasemia: major - pts are severly symptomatic and transfusion dependant minor -
2377 asymptomatic, may have impressive microcytosis, but only mild anemia - hence no
treatment required
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2540 Think - occult bleed will never cause hypotension
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2823 Not haloperidol - it will be worse not dantrolene - it is for NMS
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Umbilical cord compression: variable decelerations uretero placental insufficiency:
2855 LATE decel Fetal hypoxia: late decel fetal acidosis: late decel Early decelerations are
normal, and occur due to fetal head compression
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 Tick borne paralysis: RAPID ascending paralysis Normal CSF studies No systemic
159
signs h/o colorado etc
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remember - huntington's chorea is problem in the basal ganglia: caudate nucleus and
1565
globus pallidus
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back pain+constipation+anemia+elevated ESR = multiple myeloma aymptoms are due
1949
to hypercalcemia
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pseudomonas aeruginosa treatment: hallmark of therapy is: use two agents against
pseudomonas: because it is often resistant/develops resistance duriing the course of
1966
therapy 1st line: ceftazidime/penicilline derivative such as ticarcillin + gentamycin 2nd
line: imipenem/cilastin
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Intracranial hemorrhage tip: Subarachnoid: usually due to Aneurysms AV malformation
2061
Sub dural/Epidural: Trauma
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Cold Hard Facts about PERNICIOUS ANEMIA: 1. auto immune disorder 2 causes B
12 dficiency in two ways: - causes atrophic gastritis, which leads to decreased
2293 production of B 12 - causes destruction of INTRINSIC FACTOR, hence, less of
already scant B 12 is available 3 gastric atrophy leads to higherchance of intestinal type
gastric cancer!
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increased bp systolic > 140, diastolic > 90 in pregnancy, BEFORE 20 weeks = chronic
2714
htn or H mole
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259 note, when you see the word screening, remember about osteoporosis
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329 NIEMANN PICK DISEASE cherry red macula sphyngomyelinase deficiency
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HYDATID CYST: infection with causative agent: Echinococcus Granulosus is acquired
876 by close contact with dogs egg shell calcification DO NOT ASPIRATE: can cause
anaphylactic shock treat with surgery under the cover of albendazole
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1098 ileo-psoal abcess?
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1376 which infection gives a rash with penicillin? when pt is not hypersensitive to penicillin?
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1486 RSV infection may predispose to asthma later in life
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Patients who undergo partial gastrectomy for an ulcer, often experience "dumping
syndrome" =rapid emptying of hypertonic gastric contents into duodenum / small
1998
intestine =osmosis/absorption of fluid in gut = VIP secretion = stimulation of
autonomic reflexes
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2118 yes it was a renal cyst, but SIMPLE - do nothing1
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491 Multiple Myeloma: IgG or Ig A heavy chain ds: IgA waldenstroms: IgM
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1795 testing for PE: spiral CT V/Q scan pulmonary angiogram
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primary amenorrhoea with ANOSMIA = Kallmann's pts have a normal female
1848
karyotype, and have low fsh/lh-just like GnRH deficiency
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in status epilepticus, if pt does not respond to BZPs, do Endotracheal intubation before
2025
giving second line anti epileptic: phenytoin
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Note FAST is not negative - but inconclusive in this patient - in this case do DPL
2435
before laprotomy
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187 RA: Polymyalgia rheumatica: Giant cell Arteritis Psoriatic Arthritis: nail pitting
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pagets disease of the breast is due to an underlying ADENOCARCINOMA of the
501
breast!!! not squamous!!!!
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Diphenhydramine: an OTC anti allergic: benadryl -has a cholinergic action -anti allergy
- antihistaminic -powerful hypnotic -antiemitic -mild anxiolytic overdose treated by
557
cholinesterase inhibitor - physostigmine. also use to treat side effects of some
cholinergic drugs
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EARLY SYPHILIS TREATMENT: IM BENZATHINE PENICILLIN IF
1177 ALLERGIC: 1. SINGLE DOSE OF ORAL AZITHROMYCIN 2. TWO WEEK
COURSE OF ORAL DOXYCYCLIN
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1388 NOte:venous stasis ulcers forst occur above the medial malleolus
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 Neonatal chlamydial infection: 25-50% chance of cinjunctivitis 5-20 % chance of
1596
pneumonia treatment: ORAL erythromycin
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1866 Alcohol abuse is the most common cause of nutritional deficiency of FOLATE in usa.
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olanzapina is like clozapine - antipsychotic s/e most frequent: weight gain most
1982
dreaded, but less frequent: metabolic syndrome
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2132 grandiosity: the chosen one? "SPECIAL POWER"
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GLATI.RAMER: A random mixture of polypeptides with those aminoacids, that are
found in myelin basic protein. MOA: it stimulates supressor T cells that downregulate
2578
the "T cell mediated immune response to myelin antigens. ARGRA.TROBAN: drug
used to treat heparin induced thrombocytopenia
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PREMATURE rupture of membranes, if assocoated with intraamniotic infection,
2735
mandates immediate delivery!
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Turcots syndrome: brain tumour+Familial adenomatous polyposis or heriditary non
477
polyposis colorectal cancer
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704 tinnitus: aspirin toxicity
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Hyperthyroidism and menopause can have similar symptoms, so check TSH and FSH
2072
always!
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Staph epidermidis: infects prosthetic valves staph aureus: infects normal tissue in IV
2325
drug abusers strept viridans: SABE in previously damaged heart valves
------------ -------------------------------------------------------
if pt has s/o dehydration, always giveNS fo resusitation even in setting of
2361 hypernatremia note MILD hypernatremia with mild hypovolemia may be treayed with
D5 and .45saline
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meniscal injury: distinct recollection of trauma popping next day swelling (contrast
2491
with ligament tear where there is popping, but IMMIDIATE swelling!)
------------ -------------------------------------------------------
2502 avascular necrosis causes: sickle cell disease chronic steroid use
------------ -------------------------------------------------------
 Major depression, unlike some psychiatric disorders, requires symptoms for 2 weeks
only. any 5 of the following: 1. Depressed mood 2. Sleep disorder 3. Interest disorder
(anhedonia) 4. Guilt (feeling hopeless, worthless, regret) 5. Energy deficit 6.
228
Concentration deficit 7. Appetite disorder 8. Psychomotor (retardation/agitation) 9.
Suicidallity mnemonic: SIGECAPS mistake: sertraline is NOT serotena - t is an SSRI -
escilatrpram other SSRIs: fluo.xetine dapo.xetine paro.xet
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one of the few storage diseases that may present beyond childhood: Lysosomal storage
disease: Gaucher's disease. -manifests in adolescence -anemia and fatigue
384 -thrombocytopenia and easy bruisability -pathological fractures and bone pain
confirmation by: Erlenmyer flask deformity of distal femur gaucher cells in bone
marrow - wrinkled papre appearance.
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387 Panic disorder: treat acute attack with benzos then maintain with SSRIs
------------ -------------------------------------------------------
LAP score is low in: CML PNH hypophosphatemia LAP is high in: Leukemoid
791 reaction Auer rods in AML absence of measurable erythropoietin in urine -
polycythemia vera Tartrate resistant acid phosphate - hairy cell leukemia
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A newly diagnosed pt with cirrhosis, 1. do a screenng endoscopy 2. if varices are found
827
and not bleeding - give beta blockers as a prophylactic therapy
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Marijuana: -most commonly used illicit drug in US -involved in 10-50% of accidents
-cheapest to obtain, hence use by teens/poor causes: 1. slowed reaction time 2. impaired
1043
short term memory 3. increased appetite 4. conjunctival injection 5. dry mouth 6.
hypertension 7. tachycardia
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A bipolar presents with mania, first rule out cocaine/amohetamine use by urine tox
1105
screen second check blood lithium levels
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in children, severe cough can cause air leak and emphysema - always look for
1390
pneumothorax in sucha a child, as the often coexist.
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1470 in intracranial hemorrhage, stop all anticoagulants treat with FFP and vitamin K
------------ -------------------------------------------------------
1516 looks like a lymphoma
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Recommended treatment of LYME's: 1. Doxycycline for adults 2. Amoxicilline for
1570 kids under 9 3. Erythromycin for pregnant women 4. Ceftriaxone if adult or child is
sensitive Disseminated Lyme's: 1. Ceftriaxone 2. Pen G
------------ -------------------------------------------------------
in chronic tophaceous gout, urate crystals can be deposited in the skin resulting in the
1714
formation of tumours with chalky white appearances.
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2119 matching is an efficient method to control confounding
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also, no aortic rupture as mediastinum is normal.not widened cardiac tamponade X ray
2493 will show normal cardiac image - the change in shape is INSIDE the heart - therefore,
the shillouette is normal, even though the ventricles may be thoroughly compressed
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community acquired pneumonia is usu due to strept pneumoniae staph aureus can cause
2804
pneumonia in community - after a recent influenza in fection
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76 52 - smoker thrombus 2 wks ago - treated now has ruddy arm normal hematocrit
------------ -------------------------------------------------------
346 confirmatory test for hypertrophic pyeloric stenosis: usg or contrast radiography??
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Note: in pt with apnea and h/o head injuries: 1. orotracheal intubation first 2. surgical
1147 cricothyroidotomy intubation over a fibroptic scope is best, but not as fast - good as
prophylactic measure, but not fast enought for an apneic patient
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2349 this is porphyria??
------------ -------------------------------------------------------
923 Note: birds can cause infection as well as Hypersensitivity Pneumonitis
------------ -------------------------------------------------------
tb like ilness that is not tb: blastomycosis in the missisipi area ( but has skin
945
manifestations histoplasmosis
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Choice of test for diagnosing pulmonary embolism 1. if renal function normal, and no
1434
allergy to contrast: Spiral/helical CT 2. if renal failure/ reaction to contrast: V/Q scan
------------ -------------------------------------------------------
As opposed to pneumonia, PE is typically wedge shaped on X ray wedge shaped
2627
opacity on ct is virtually pathognomic of PE
------------ -------------------------------------------------------
in a patient with severe COPD exacerbation, there may be CO2 retention - DO NOT
2655 use SEDATIVE HYPNOTICS i such patients for anxiety as they can further propagate
respiratory depression
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 the glucose in a pleural effusion: normal > 50 30 - 50 : something in the pleural fluid is
eating up the glucose - something small - eg, malignant cells, TB, lupus wbcs,
2690
esophageal rupture 30: something very hungry - eating all the glucose: HOT!
EMPYEMA, too many busy hard working neutrophils, or rheumatic
------------ -------------------------------------------------------
dead space ventilation occurs when there is normal ventilation, but no blood flow, or no
gas exchange - eg, pulmonary embolism, ards increased R to L shunting occurs in the
2707
opposite scenario: there is zero ventilation, but normal blood flow through the area: eg
consolidation, collapse etc
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types of arrest of labor : 1. arrest of dialation: > 2 hours no dialation of cervix 2. arrest
1030 of descent: > 1 hour and no descent in head causes: hypotonic contractions excessive
sedation cephalo - pelvic disproportion malpresentation conduction anaesthesia
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very important to do a serum level 4 hrs after poisoning because THERE IS NO
1052
CORRELATION BETWEEN INGESTED DOSE AND SERUM LEVELS!
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femur fracture can vause fat embolism, not tibial fracture - also, may be the baby is lost
during all this... so amniotic fluid embolism more possible got it wrong - femur and
1226 proximal humurous, as well as ribs/ vertebrae etc are sites of erythropoiesis, while tibil/
fibula/ radius etc are not but ALL MARROW IS FAT!!! NO MATTER WHERE _
EVEN ERYTHROPOIETIC MARROW HAS SOME FAT!!!!
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carpal tunnel syndrome: cause: 1. estrogen mediated DEPOLYMERIZATION of
ground substance, which causes edema in hands and feet 2. repetitive flexion and
2573 extension of wrist exacerbate the symptoms treatment: 1. NSAIDS (contraindicated in
pregnancy) 2. wrist splinting (first line of treatment in pregnancy) 3. local steroid
injection 4. open or endoscopic surgery
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2751 rabies is seen in dogs bats raccoons skunks foxes
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defficiency: selenium - cardiomyopathy B12 - macrocytic anemia, and neuropathy A -
1726 blindness, dry skin, impaired immunity zinc - alopecia, abnormal taste, skin lesions,
impaired wound healing
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2077 Buspirone is the first line agent for treatment of Generalized Anxiety Disorder
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2552 Forgetting misleading!
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