Flashcards in General Internal Medicine Deck (442)
overall prevalence of PAD in pt iwth Age 5-69 with DM.tob/age>70
Pt with PAD risk factors and suspect PAD wtd?
Ankle brachial index
68yo M p.w intermittent claudication of legs - quit smoking 10ya - BP left arm 128/84, BPR R arm 134/82 BP RLE 128.80 - ABI =
(choose higher UE SBP) LE/UE SBP
If equivocal ABI (0.9->1)
How to manage PVD
modify risk factors (BP, gluc, chol)
Anti plt agens ASA+- palvix
Treat claudication - supervised exc program>cilostazol>pentoxyifylline
Whatd medicatio nused in PAD reduced coronary events regardly of BP effect
T/F - Pt with PAD aggressive control of hyperlipiddemia with statin drug a/w reduced overall mortality
T/F - Pt with PAD aggressive control of hyperlipiddemia with statin drug a/w reduced vascular mortaility
T/F - Pt with PAD aggressive control of hyperlipiddemia with statin drug a/w reduced cornoary events
LDL<140/80 with PAD
Pt with sudden onlset pain in foot, discoloration of oot h/o afib - petal and poterior tibila pulses not felt wtd?
arteriogram r/o embolic event from afib
Pt wit sudden onset black/blue toes, pulses felt, had cardiac cath earlier and BP elevated wtd?
Adequate BP control
Obestiy waist in males 40" (>35 asian)
35" in femael (31" asian)
Low HDL 140.85
Tx: Diet, exercise, drugs
Which antilipid medication woudl tx component of metabolic syndrome
Obesity leading cause of death in US
Obeste stage I >30
stage II >35
Morbid obesity >40
Complications of obesity
Type II DM
ele LDL, TGA dec HDL
inc'd CAD risk, SCD
(NOT OSTEOPOROSIS - protective)
45yo F gaining wight - BMI 31 FBS 105 wtd?
reduce caloric intake 500 to 1000 cal/day
Pt BMI 32 on red caloric intake 3 months later with BMI 31 - what med for long term use
Indications for bariatric surgery
BMI>35 with DM/hyperchol or HTN or CHF or OSA
BMI>40 with no other conditions
Bariatric surgery reduces mortality?
Post gastric bypass surgery - next day with horizontal nystagmus and opthalmoplegia dx?
Post bariatric surgeryc/o wk and dark colored urine, tenderness of back muscles - U dip stick + blood no RBCs dx?
Post bariatric srugery 3 days later with tachcardia nad tachypnea
Post gastic bypass 2 days later with RR 22, HR 120, tmep 100.8 dx?
Anastomatic suture /stable leak - gastrograffin study needed
Long term deficit post bariatric surgery
Vit D, B12, copper, iron
38yo F BMI 40 bariatric surgery 5ya fo rphysical - Hg 10.5, MCV 105 plt 115, retic 1%
34yo F roux en y surgery 8 monts ago - BMI dropped 40 to 28 - now BMI up to 35 - c/o heartburn
dx? Gastrogastic fistula
35yo F post bariatric surgery BMI 40-25 in 6 montsh - no ids - nauseous and bloating wtd?
Waist to hip ratio >0.9 in men >0.85 W risk factor
at any rate