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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

Tx of Seborrheic dermatitis

Sunlight exposure

Dandruff shampoo

️Topical ketoconazole

️Topical steroids