Flashcards in Emma Holiday Cards Deck (53):
1
Right ventricular infarct
V4-V6; may show ST segment depression
S/s: Hypotension, tachycardia, clear lungs, JVD
Tx: Fluid resuscitation to improve preload; DO NOT GIVE NITRO
2
Coronary angiography indications for CABG
Left main disease
>3 vessel disease
>70% occlusion
Pain despite maximum medical tx
Post-infarction angina
3
Work-up for unstable angina (no toponins and negative EKG after chest pain)
Exercise EKG
-Exercise echo if the pt. is on Digoxin, has baseline ST elevation, or old LBBB
-If pt. has chest pain reproduced, ST depression, or hypotension, test is positive
=>>Coronary angiography
4
Post-MI pt. who has "step up" in O2 conc. from RA to RV
IV septal rupture
5
Post-MI pt. who has persistent ST elevation and systolic MR one month later
Ventricular aneurysm
6
Canon A-waves
Pt. with bounding jugular veins
-Indicates AV dissociation in post-MI pts.; could be 3rd degree block as well
7
Pt. with canon a-waves on exam and has a regular P-P and R-R interval
EKG shows irregular PR intervals
Multifocal atrial tachycardia
8
Patient with a regular rhythm but HR between 150-220 bpm
Pt. has palpitations and dizziness
EKG shows rapid HR with barely any Repolarization time
SVT
DOC: Carotid massage THEN adenosine
9
Holosystolic murmur that radiates to the left axilla w/ LAE
Mitral regurgitation
10
Rumbling diastolic murmur with an opening snap, LAE, and possible A-fib
Mitral stenosis
11
Young pt. who has a history of viral infxn and now presents with signs of CHF
Consider myocarditis
12
CXR with "thickened peritracheal stripe and splayed carina bifurcation"
Possible mediastinal tumor
or
LAE
13
Light's Criteria
Transudative if:
LDH <200
LDH eff/LDH serum <0.6
Protein eff/Protein serum <0.5
14
Best prognostic indicator for COPD
FEV1 value
15
Goal for SpO2 in COPD
94-95
Hypercapnea keeps their respiratory drive going
16
CXR showing nodules with eggshell calcifications
Silicosis
***Pts. need yearly TB testing
17
Patchy lower lobe infiltrates with thermophilic actinomycetes
Hypersensitivity pneumonitis
"Farmer's lung"
18
Sarcoidosis findings that are sometimes thrown out there (3 things)
Increased ACE
Pts. haver hypercalcemia due to increased Vit D from pulmonary macrophages
25% have anterior uveitis =>> GET OPTHO REFERRAL
19
Lung nodule with "popcorn calcification"
Hamartoma
20
Lung nodule with eccentric calcification or spiculated calcifications
Signs of malignancy; get biopsy
21
Effusion in adenocarcinoma
High in hyaluronidase and exudative
22
Lung cancer that has a tendency for distant mets and peripheral calcification
Large cell carcinoma
23
Patient who has an AST or ALT in the 1000s after surgery or trauma
Suspect shock liver
24
Pneumonia in a farmer who has vomiting and diarrhea
Coxiella
Tx: Doxycycline
25
Pt with pneumonia who is a gardener
Don't rule out Fransicella
Tx: Gentamicin or streptomycin (AGCs from Sketchy)
26
Kid under 4 exposed to TB
Isoniazid prophylaxis for 9 months
27
#1 cause of death during endocarditis
CHF
#2 is septic emboli
28
Indications for prophylaxis for endocarditis
Prosthetic valve
Hx of EC
Uncorrected congenital lesion
29
Ziovudine ADRs
GI
Leukopenia
Macrocytic anemia
30
Pt who develops asymptomatic hyperuricemia after being treated for TB
Due to pyrazinimide
31
Abacavir ADRs
Rash, fever, muscle aches
IF HIV pt states they had this rxn after treatment, NEVER USE THIS DRUG AGAIN
32
HIV pt who has a seizure with deja-vu beforehand and CSF shows RBCs
HSV encephalitis
Give acyclovir AS SOON as you suspect
33
HIV pt. w/ hemisensory loss, visual impairment, loss of Babinski
PML
MRI shows demyelination at the gray-white jnxn
34
HIV pt. with memory and gait problems
AIDS-dementia complex
Check blood, CSF, and MRI to be sure it's nothing else tho
35
Neutropenic pt. in the ER; what should you not do?
DRE
36
Pt. with neutropenic fever and does not improve after 5 days of cefepime and Vanc but there has been no cause found
Add antifungal treatment
37
Erlichiosis tx in kids
Doxycycline!
38
Test to check if metabolic alkalosis
Urine chloride
If Cl>20 and pt. has HTN =>> Hyperaldosteronism
if nomotensive =>> Barter's or Gittelman's
If Cl <20 =>> Vomiting, diuretics, antacids
39
Type I RTA
Distal; due to the kidney being unable to excrete H+
Causes: Lithium, Ampho B, analgesics
Findings: Urine pH >5.4, hypokalemia, kidney stones
Tx: Replete K+, oral bicarb
40
Type II RTA
Proximal; due to the kidney not reabsorbing HCO3-
Causes: Fanconi's syndrome, myeloma
Findings: Hypokalemia, ostemalacia
Tx: Replete K+; replacing bicarb DOESNT HELP
41
Type IV RTA
Hyperrenin, hypoaldost
Cause: Diabetes
Findings: Hyperkalemia, hypchlorremia, high urine Na+ even with salt restriction
Tx: Fludrocortisone
42
Pt with rhabodmyolysis and kidney failure treatment
Get serum K+ and EKG to rule out cardiac probs
HCO3- to alkalinize urine to prevent precipitation
43
Kid who recently had a viral syndrome and now has arthralgia, palpable purpura (Especially on the butt), and renal failure
Henoch-Schonlein
Tx: Supportive; steroids if severe
44
Pt. with renal failure, asthma, eosinophilia, and + p-ANCA
Churg-Strauss
Tx: Cyclophosphamide
45
Cardiac pt. with renal failure, hemolytic anemia, decreased platelets, fever, AMS
TTP
Tx: Plasmapheresis
46
Polyarteritis nodosa tx
Cyclophosphamide
47
Tx for stones 5mm-2cm
Shockwave lithotripsy
48
Sideroblastic anemia lab findings
Iron: Increased
Ferritin: Increased
TIBC: Decreased
MCV: Decreased
49
Thalassemia CBC
Iron: Very low, like 60
RDW: Decreased
50
Liver disease CBC
MVC: Increased
Acanthocytes present on peripheral smear
51
Rosacea Tx
Avoid triggers
️Topical metronidazole if refractory
52
Tx of Keratocanthoma
Observation
53