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Dressler's syndrome: fever, pericarditis, ↑ ESR
Autoimmune complication occurring 2-4 weeks post-MI.
Treat existing heart failure and replace the tricuspid valve
IV drug use with JVD and holosystolic murmur at the left sternal border. Treatment?
Echocardiogram (showing thickened left ventricular wall and outflow obstruction)
Diagnostic test for hypertrophic cardiomyopathy.
Renal artery stenosis, coarctation of the aorta, pheochromocytoma, Conn's syndrome, Cushing's syndrome, unilateral renal parenchymal disease, hyperthyroidism, hyperparathyroidism
Eight surgically correctable causes of hypertension.
> 5.5 cm, rapidly enlarging, symptomatic, or ruptured
Indications for surgical repair of abdominal aortic aneurysm.
Morphine, O2, sublingual nitroglycerin, ASA, IV β-blockers, heparin
Treatment for acute coronary syndrome.
Abdominal obesity, high triglycerides, low HDL, hypertension, insulin resistance, prothrombotic or proinflammatory states
What is the metabolic syndrome?
Exercise stress treadmill with ECG
Appropriate diagnostic test? ■ A 50-year-old male with angina can exercise to 85% of maximum predicted heart rate.
Pharmacologic stress test (e.g., dobutamine echo)
Appropriate diagnostic test? ■ A 65-year-old woman with left bundle branch block and severe osteoarthritis has unstable angina.
ST-segment elevation (depression means ischemia), flattened T waves, and Q waves
ECG findings suggesting MI.
A young patient has angina at rest with ST-segment elevation. Cardiac enzymes are normal.
A young patient with a family history of sudden death collapses and dies while exercising.
Oral surgery—amoxicillin; GI or GU procedures—ampicillin and gentamicin before and amoxicillin after
Endocarditis prophylaxis regimens.
Pain, pallor, pulselessness, paralysis, paresthesia, poikilothermia
The 6 P's of ischemia due to peripheral vascular disease.
Basal cell carcinoma
The most common type of skin cancer; the lesion is a pearly-colored papule with a translucent surface and telangiectasias.
A febrile patient with a history of diabetes presents with a red, swollen, painful lower extremity.
Acanthosis nigricans. Check fasting blood sugar to rule out diabetes
A 55-year-old obese patient presents with dirty, velvety patches on the back of the neck.
A lesion characteristically occurring in a linear pattern in areas where skin comes into contact with clothing or jewelry.
Alopecia areata (autoimmune process)
A 16-year-old presents with an annular patch of alopecia with broken-off, stubby hairs.
Pinkish, scaling, flat lesions on the chest and back. KOH prep has a "spaghetti-and-meatballs" appearance.
Asymmetry, border irregularity, color variation, large diameter
Four characteristics of a nevus suggestive of melanoma.
Inflammation and epithelial thinning of the anogenital area, predominantly in postmenopausal women.
Squamous cell carcinoma
Exophytic nodules on the skin with varying degrees of scaling or ulceration; the second most common type of skin cancer.
Iatrogenic steroid administration. The second most common cause is Cushing's disease
The most common cause of Cushing's syndrome.
1° hyperaldosteronism (due to Conn's syndrome or bilateral adrenal hyperplasia)
A patient complains of headache, weakness, and polyuria; exam reveals hypertension and tetany. Labs reveals hypernatremia, hypokalemia, and metabolic alkalosis.
A patient presents with tachycardia, wild swings in BP, headache, diaphoresis, altered mental status, and a sense of panic.
α-antagonists (phentolamine and phenoxybenzamine)
Should α- or β-antagonists be used first in treating pheochromocytoma?
Nephrogenic diabetes insipidus (DI)
A patient with a history of lithium use presents with copious amounts of dilute urine.
SIADH due to stress
A postoperative patient with significant pain presents with hyponatremia and normal volume status.
1° adrenal insufficiency (Addison's disease). Treat with replacement glucocorticoids, mineralocorticoids, and IV fluids
A patient presents with weakness, nausea, vomiting, weight loss, and new skin pigmentation. Labs show hyponatremia and hyperkalemia. Treatment?
Bias introduced into a study when a clinician is aware of the patient's treatment type.
Bias introduced when screening detects a disease earlier and thus lengthens the time from diagnosis to death.
If you want to know if race affects infant mortality rate but most of the variation in infant mortality is predicted by socioeconomic status, then socioeconomic status is a _____.
The number of true positives divided by the number of patients with the disease is _____.
Highly sensitive for TB
PPD reactivity is used as a screening test because most people with TB (except those who are anergic) will have a +PPD. Highly sensitive or specific?
High reliability, low validity
Describe a test that consistently gives identical results, but the results are wrong.
Cohort studies can be used to calculate relative risk (RR), incidence, and/or odds ratio (OR). Case-control studies can be used to calculate an OR
Difference between a cohort and a case-control study.
The incidence rate (IR) of a disease in exposed − the IR of a disease in unexposed
The IR of a disease in a population exposed to a particular factor ÷ the IR of those not exposed
The likelihood of a disease among individuals exposed to a risk factor compared to those who have not been exposed
Patients with IBD; those with familial adenomatous polyposis (FAP)/hereditary nonpolyposis colorectal cancer (HNPCC); and those who have first-degree relatives with adenomatous polyps (< 60 years of age) or colorectal cancer
In which patients do you initiate colorectal cancer screening early?
Prostate cancer is the most common cancer in men, but lung cancer causes more deaths
The most common cancer in men and the most common cause of death from cancer in men.
Number of deaths from birth to one year of age per 1000 live births (neonatal + postnatal mortality)
Number of deaths from 20 weeks' gestation to one month of life per 1000 total births
False. Patients may change their minds at any time. Exceptions to the requirement of informed consent include emergency situations and patients without decision-making capacity
True or false: Once patients sign a statement giving consent, they must continue treatment.
No. Parental consent is not necessary for the medical treatment of pregnant minors
A 15-year-old pregnant girl requires hospitalization for preeclampsia. Should her parents be informed?
The patient is a danger to self, a danger to others, or gravely disabled (unable to provide for basic needs)
Involuntary psychiatric hospitalization can be undertaken for which three reasons?
False. Withdrawing and withholding life are the same from an ethical standpoint
True or false: Withdrawing life-sustaining care is ethically distinct from withholding sustaining care.
When there is no rationale for treatment, maximal intervention is failing, a given intervention has already failed, and treatment will not achieve the goals of care
When can a physician refuse to continue treating a patient on the grounds of futility?
Treat immediately. Consent is implied in emergency situations
An eight-year-old child is in a serious accident. She requires emergent transfusion, but her parents are not present.
Real threat of harm to third parties; suicidal intentions; certain contagious diseases; elder and child abuse
Conditions in which confidentiality must be overridden.
When treatment noncompliance represents a serious danger to public health (e.g., active TB)
Involuntary commitment or isolation for medical treatment may be undertaken for what reason?
Treat because the disease represents an immediate threat to the child's life. Then seek a court order
A 10-year-old child presents in status epilepticus, but her parents refuse treatment on religious grounds.
A patient's family cannot require that a doctor withhold information from the patient
A son asks that his mother not be told about her recently discovered cancer.
Emergent laparotomy to repair perforated viscus, likely stomach
Patient presents with sudden onset of severe, diffuse abdominal pain. Exam reveals peritoneal signs and AXR reveals free air under the diaphragm. Management?
Isospora, Cryptosporidium, Mycobacterium avium complex (MAC)
Identify key organisms causing diarrhea: ■ AIDS
A 25-year-old Jewish male presents with pain and watery diarrhea after meals. Exam shows fistulas between the bowel and skin and nodular lesions on his tibias.
Uveitis, ankylosing spondylitis, pyoderma gangrenosum, erythema nodosum, 1° sclerosing cholangitis
Extraintestinal manifestations of IBD.
5-aminosalicylic acid +/− sulfasalazine and steroids during acute exacerbations
Medical treatment for IBD.
Mallory-Weiss—superficial tear in the esophageal mucosa Boerhaave—full-thickness esophageal rupture
Difference between Mallory-Weiss and Boerhaave tears.
Charcot's triad plus shock and mental status changes, with suppurative ascending cholangitis
Hemolytic-uremic syndrome (HUS) due to E. coli O157:H7
A four-year-old child presents with oliguria, petechiae, and jaundice following an illness with bloody diarrhea. Most likely diagnosis and cause?
TB medications (INH, rifampin, pyrazinamide), acetaminophen, and tetracycline
Classic causes of drug-induced hepatitis.
Biliary tract obstruction
A 40-year-old obese female with elevated alkaline phosphatase, elevated bilirubin, pruritus, dark urine, and clay-colored stools.
Confirm the diagnosis of acute pancreatitis with elevated amylase and lipase. Make patient NPO and give IV fluids, O2, analgesia, and "tincture of time"
A 50-year-old man with a history of alcohol abuse presents with boring epigastric pain that radiates to the back and is relieved by sitting forward. Management?
TICS—Thalassemia, Iron deficiency, anemia of Chronic disease, and Sideroblastic anemia
Four causes of microcytic anemia.
Fecal occult blood test and sigmoidoscopy; suspect colorectal cancer
An elderly male with hypochromic, microcytic anemia is asymptomatic. Diagnostic tests?
Sulfonamides, antimalarial drugs, fava beans
Precipitants of hemolytic crisis in patients with G6PD deficiency.
Anemia associated with absent radii and thumbs, diffuse hyperpigmentation, café-au-lait spots, microcephaly, and pancytopenia.
Chloramphenicol, sulfonamides, radiation, HIV, chemotherapeutic agents, hepatitis, parvovirus B19, EBV
Medications and viruses that → aplastic anemia.
Both have ↑ hematocrit and RBC mass, but polycythemia vera should have normal O2 saturation and low erythropoietin levels
How to distinguish polycythemia vera from 2° polycythemia.
Pentad of TTP—"FAT RN": Fever, Anemia, Thrombocytopenia, Renal dysfunction, Neurologic abnormalities
Thrombotic thrombocytopenic purpura (TTP) pentad?
Usually resolves spontaneously; may require IVIG and/or corticosteroids
Treatment for idiopathic thrombocytopenic purpura (ITP) in children.
Fibrin split products and D-dimer are elevated; platelets, fibrinogen, and hematocrit are ↓.
Which of the following are ↑ in DIC: fibrin split products, D-dimer, fibrinogen, platelets, and hematocrit.
Hemophilia A or B; consider desmopressin (for hemophilia A) or factor VIII or IX supplements
An eight-year-old boy presents with hemarthrosis and ↑ PTT with normal PT and bleeding time. Diagnosis? Treatment?
von Willebrand's disease; treat with desmopressin, FFP, or cryoprecipitate
A 14-year-old girl presents with prolonged bleeding after dental surgery and with menses, normal PT, normal or ↑ PTT, and ↑ bleeding time. Diagnosis? Treatment?
Monoclonal gammopathy, Bence Jones proteinuria, "punched-out" lesions on x-ray of the skull and long bones
A 60-year-old African-American male presents with bone pain. Workup for multiple myeloma might reveal?
A 10-year-old boy presents with fever, weight loss, and night sweats. Examination shows anterior mediastinal mass. Suspected diagnosis?
Anemia of chronic disease
Microcytic anemia with ↓ serum iron, ↓ total iron-binding capacity (TIBC), and normal or ↑ ferritin.
Chronic lymphocytic leukemia (CLL)
An 80-year-old man presents with fatigue, lymphadenopathy, splenomegaly, and isolated lymphocytosis. Suspected diagnosis?
Blast crisis (fever, bone pain, splenomegaly, pancytopenia)
A late, life-threatening complication of chronic myelogenous leukemia (CML).
A 50-year-old male presents with early satiety, splenomegaly, and bleeding. Cytogenetics show t(9,22). Diagnosis?
An autosomal-recessive disorder with a defect in the GPIIbIIIa platelet receptor and ↓ platelet aggregation.
O2, analgesia, hydration, and, if severe, transfusion
A 25-year-old African-American male with sickle cell anemia has sudden onset of bone pain. Management of pain crisis?
Iron overload; use deferoxamine
A significant cause of morbidity in thalassemia patients. Treatment?
Infection, cancer, and autoimmune disease
The three most common causes of fever of unknown origin (FUO).
Fever, pharyngeal erythema, tonsillar exudate, lack of cough
Four signs and symptoms of streptococcal pharyngitis.
A nonsuppurative complication of streptococcal infection that is not altered by treatment of 1° infection.
Encapsulated organisms--pneumococcus, meningococcus, Haemophilus influenzae, Klebsiella
Asplenic patients are particularly susceptible to these organisms.
Pregnant women. Treat this group aggressively because of potential complications
Which healthy population is susceptible to UTIs?
Coccidioidomycosis. Amphotericin B
A patient from California or Arizona presents with fever, malaise, cough, and night sweats. Diagnosis? Treatment?
Group B strep, E. coli, Listeria. Treat with gentamicin and ampicillin
Meningitis in neonates. Causes? Treatment?
Pneumococcus, meningococcus, H. influenzae. Treat with cefotaxime and vancomycin
Meningitis in infants. Causes? Treatment?
Cutaneous anthrax. Treat with penicillin G or ciprofloxacin
Initially presents with a pruritic papule with regional lymphadenopathy and evolves into a black eschar after 7-10 days. Treatment?
Tabes dorsalis, general paresis, gummas, Argyll Robertson pupil, aortitis, aortic root aneurysms
Findings in 3° syphilis.
Arthralgias, migratory polyarthropathies, Bell's palsy, myocarditis
Characteristics of 2° Lyme disease.
Candidal thrush. Workup should include an HIV test. Treat with nystatin oral suspension
A 24-year-old male presents with soft white plaques on his tongue and the back of his throat. Diagnosis? Workup? Treatment?
≤ 200 for PCP (with TMP); ≤ 50-100 for MAI (with clarithromycin/azithromycin)
Begin Pneumocystis carinii pneumonia (PCP) prophylaxis in an HIV-positive patient at what CD4 count? Mycobacterium avium-intracellulare (MAI) prophylaxis?
Pregnancy, vesicoureteral reflux, anatomic anomalies, indwelling catheters, kidney stones
Risk factors for pyelonephritis.
Fever, heart murmur, Osler's nodes, splinter hemorrhages, Janeway lesions, Roth's spots
Classic physical findings for endocarditis.
A 55-year-old man who is a smoker and a heavy drinker presents with a new cough and flulike symptoms. Gram stain shows no organisms; silver stain of sputum shows gram-negative rods. What is the diagnosis?
Lyme disease, Ixodes tick, doxycycline
A middle-aged man presents with acute-onset monoarticular joint pain and bilateral Bell's palsy. What is the likely diagnosis, and how did he get it? Treatment?
S. aureus or S. epidermidis.
A patient develops endocarditis three weeks after receiving a prosthetic heart valve. What organism is suspected?
All-compartment fasciotomy for suspected compartment syndrome
A patient presents with pain on passive movement, pallor, poikilothermia, paresthesias, paralysis, and pulselessness. Treatment?
Back pain that is exacerbated by standing and walking and relieved with sitting and hyperflexion of the hips.
Joint pain and stiffness that worsen over the course of the day and are relieved by rest.
Genetic disorder associated with multiple fractures and commonly mistaken for child abuse.
Suspect ankylosing spondylitis. Check HLA-B27
Hip and back pain along with stiffness that improves with activity over the course of the day and worsens at rest. Diagnostic test?
Reactive (Reiter's) arthritis. Associated with Campylobacter, Shigella, Salmonella, Chlamydia, and Ureaplasma
Arthritis, conjunctivitis, and urethritis in young men. Associated organisms?
Gout. Needle-shaped, negatively birefringent crystals are seen on joint fluid aspirate. Chronic treatment with allopurinol or probenecid
A 55-year-old man has sudden, excruciating first MTP joint pain after a night of drinking red wine. Diagnosis, workup, and chronic treatment?
An elderly female presents with pain and stiffness of the shoulders and hips; she cannot lift her arms above her head. Labs show anemia and ↑ ESR.
Duchenne muscular dystrophy
A young child presents with proximal muscle weakness, waddling gait, and pronounced calf muscles.
Developmental dysplasia of the hip. If severe, consider a Pavlik harness to maintain abduction
A first-born female who was born in breech position is found to have asymmetric skin folds on her newborn exam. Diagnosis? Treatment?
Slipped capital femoral epiphyses. AP and frog-leg lateral view
An 11-year-old obese, African-American boy presents with sudden onset of limp. Diagnosis? Workup?
Broca's aphasia. Frontal lobe, left MCA distribution
A 55-year-old patient presents with acute "broken speech." What type of aphasia? What lobe and vascular distribution?
Subdural hematoma—bridging veins torn
A crescent-shaped hyperdensity on CT that does not cross the midline.
Epidural hematoma. Middle meningeal artery. Neurosurgical evacuation
A history significant for initial altered mental status with an intervening lucid interval. Diagnosis? Most likely etiology? Treatment?
Guillain-Barré (↑ protein in CSF with only a modest ↑ in cell count)
Cold water is flushed into a patient's ear, and the fast phase of the nystagmus is toward the opposite side. Normal or pathological?
Lung, breast, skin (melanoma), kidney, GI tract
The most common 1° sources of metastases to the brain.
May be seen in children who are accused of inattention in class and confused with ADHD.
Infection, febrile seizures, trauma, idiopathic
The most common cause of seizures in children (2-10 years).
Trauma, alcohol withdrawal, brain tumor
The most common cause of seizures in young adults (18-35 years).
Wernicke's encephalopathy due to a deficiency of thiamine
Confusion, confabulation, ophthalmoplegia, ataxia.
Seventy percent if the stenosis is symptomatic
What % lesion is an indication for carotid endarterectomy?
Rigidity and stiffness that progress to choreiform movements, accompanied by moodiness and altered behavior.
Sturge-Weber syndrome. Treat symptomatically. Possible focal cerebral resection of affected lobe
A six-year-old girl presents with a port-wine stain in the V2 distribution as well as with mental retardation, seizures, and leptomeningeal angioma.
Snowstorm on ultrasound. "Cluster-of-grapes" appearance on gross examination
Classic ultrasound and gross appearance of complete hydatidiform mole.
Obstetric conjugate: between the sacral promontory and the midpoint of the symphysis pubis
Shortest AP diameter of the pelvis.
Sheehan's syndrome (postpartum pituitary necrosis)
A patient fails to lactate after an emergency C-section with marked blood loss.
Uterine bleeding at 18 weeks' gestation; no products expelled; membranes ruptured; cervical os open.
Uterine bleeding at 18 weeks' gestation; no products expelled; cervical os closed.
β-hCG; the most common cause of amenorrhea is pregnancy
The first test to perform when a woman presents with amenorrhea.
Cause of amenorrhea with normal prolactin, no response to estrogen-progesterone challenge, and a history of D&C.
Diagnostic step required in a postmenopausal woman who presents with vaginal bleeding.
Stable, unruptured ectopic pregnancy of < 3.5 cm at < 6 weeks' gestation
Indications for medical treatment of ectopic pregnancy.
A patient has ↑ vaginal discharge and petechial patches in the upper vagina and cervix.
Endometrial or estrogen receptor- breast cancer
Unopposed estrogen is contraindicated in which cancers?
CA-125 and transvaginal ultrasound
Annual screening for women with a strong family history of ovarian cancer.
Kegel exercises, estrogen, pessaries for stress incontinence
A 50-year-old woman leaks urine when laughing or coughing. Nonsurgical options?
Anticholinergics (oxybutynin) or β-adrenergics (metaproterenol) for urge incontinence.
A 30-year-old woman has unpredictable urine loss. Examination is normal. Medical options?
Colposcopy and endocervical curettage
Two consecutive findings of atypical squamous cells of undetermined significance (ASCUS) on Pap smear. Follow-up evaluation?
Lobular carcinoma in situ
Breast cancer type that ↑ the future risk of invasive carcinoma in both breasts.
Esophageal atresia with distal TEF (85%). Unable to pass NG tube
The most common type of tracheoesophageal fistula (TEF). Diagnosis?
Mild illness and/or low-grade fever, current antibiotic therapy, and prematurity
Not contraindications to vaccination.
Correct metabolic abnormalities. Then correct pyloric stenosis with pyloromyotomy
A two-month-old presents with nonbilious projectile emesis. What are the appropriate steps in management?
Febrile seizures (roseola infantum)
An infant has a high fever and onset of rash as fever breaks. What is he at risk for?
High-dose aspirin for inflammation and fever; IVIG to prevent coronary artery aneurysms
Acute-phase treatment for Kawasaki disease.
Phototherapy (mild) or exchange transfusion (severe)
Treatment for mild and severe unconjugated hyperbilirubinemia.
Sudden onset of mental status changes, emesis, and liver dysfunction after taking aspirin.
Chronic granulomatous disease
What is the immunodeficiency? ■ A boy has chronic respiratory infections. Nitroblue tetrazolium test is +.
What is the immunodeficiency? ■ A child has eczema, thrombocytopenia, and high levels of IgA.
Bruton's X-linked agammaglobulinemia
What is the immunodeficiency? ■ A four-month-old boy has life-threatening Pseudomonas infection.
Kwashiorkor (protein malnutrition)
A homeless child is small for his age and has peeling skin and a swollen belly.
Lesch-Nyhan syndrome (purine salvage problem with
Defect in an X-linked syndrome with mental retardation,
A 17-year-old female has left arm paralysis after her boyfriend dies in a car crash. No medical cause is found.
A 35-year-old male has recurrent episodes of palpitations, diaphoresis, and fear of going crazy.
Schizophreniform disorder (diagnosis of schizophrenia requires ≥ 6 months of symptoms)
A 21-year-old male has three months of social withdrawal, worsening grades, flattened affect, and concrete thinking.
Acute dystonia (oculogyric crisis). Treat with benztropine or diphenhydramine
A young weight lifter receives IV haloperidol and complains that his eyes are deviated sideways. Diagnosis? Treatment?
A 13-year-old male has a history of theft, vandalism, and violence toward family pets.
A five-month-old girl has ↓ head growth, truncal dyscoordination, and ↓ social interaction.
Acute mania. Start a mood stabilizer (e.g., lithium)
A patient hasn't slept for days, lost $20,000 gambling, is agitated, and has pressured speech. Diagnosis? Treatment?
After a minor fender bender, a man wears a neck brace and requests permanent disability.
Factitious disorder (Munchausen syndrome)
A nurse presents with severe hypoglycemia; blood analysis reveals no elevation in C peptide.
A patient continues to use cocaine after being in jail, losing his job, and not paying child support.
Phencyclidine hydrochloride (PCP) intoxication
A violent patient has vertical and horizontal nystagmus.
A woman who was abused as a child frequently feels outside of or detached from her body.
Frotteurism (a paraphilia)
A man has repeated, intense urges to rub his body against unsuspecting passengers on a bus.
Tardive dyskinesia. ↓ or discontinue haloperidol and consider another antipsychotic (e.g., risperidone, clozapine)
A schizophrenic patient takes haloperidol for one year and develops uncontrollable tongue movements. Diagnosis? Treatment?
A man unexpectedly flies across the country, takes a new name, and has no memory of his prior life.
Think of leaky capillaries. Malignancy, TB, bacterial or viral infection, pulmonary embolism with infarct, and pancreatitis
Causes of exudative effusion.
Think of intact capillaries. CHF, liver or kidney disease, and protein-losing enteropathy
Causes of transudative effusion.
Fatigue and impending respiratory failure
Normalizing PCO2 in a patient having an asthma exacerbation may indicate?
Dyspnea, lateral hilar lymphodenopathy on CXR, noncaseating granulomas, increased ACE, and hypercalcemia.
Diffuse interstitial pulmonary fibrosis. Supportive care. Steroids may help
Honeycomb pattern on CXR. Diagnosis? Treatment?
Spontaneous pneumothorax. Spontaneous regression. Supplemental O2 may be helpful
A tall white male presents with acute shortness of breath. Diagnosis? Treatment?
Age > 45-50 years; lesions new or larger in comparison to old films; absence of calcification or irregular calcification; size > 2 cm; irregular margins
Characteristics favoring carcinoma in an isolated pulmonary nodule.
Right-to-left shunt, hypoventilation, low inspired O2 tension, diffusion defect, V/Q mismatch
Causes of hypoxemia.
Cardiomegaly, prominent pulmonary vessels, Kerley B lines, "bat's-wing" appearance of hilar shadows, and perivascular and peribronchial cuffing
Classic CXR findings for pulmonary edema.
Type I (distal) RTA
Renal tubular acidosis (RTA) associated with abnormal H+ secretion and nephrolithiasis.
Cerebral berry aneurysms (AD PCKD)
A 20-year-old man presents with a palpable flank mass and hematuria. Ultrasound shows bilateral enlarged kidneys with cysts. Associated brain anomaly?
Uremic syndrome seen in patients with renal failure
Drowsiness, asterixis, nausea, and a pericardial friction rub.
Wait, surgical resection, radiation and/or androgen suppression
A 55-year-old man is diagnosed with prostate cancer. Treatment options?
Anion gap acidosis and 1° respiratory alkalosis due to central respiratory stimulation
Salicylate ingestion → in what type of acid-base disorder?
RCC or other erythropoietin-producing tumor; evaluate with CT scan
Elevated erythropoietin level, elevated hematocrit, and normal O2 saturation suggest?
Likely BPH. Options include no treatment, terazosin, finasteride, or surgical intervention (TURP)
A 55-year-old man presents with irritative and obstructive urinary symptoms. Treatment options?
Antipsychotics (neuroleptic malignant syndrome)
Class of drugs that may cause syndrome of muscle rigidity, hyperthermia, autonomic instability, and extrapyramidal symptoms.
Acute mania, immunosuppression, thin skin, osteoporosis, easy bruising, myopathies
Side effects of corticosteroids.
Rate control with carotid massasge or other vagal stimulation
Treatment of supraventricular tachycardia (SVT).
Treat CO poisoning with 100% O2 or with hyperbaric O2 if severe poisoning or pregnant
A burn patient presents with cherry-red flushed skin and coma. SaO2 is normal, but carboxyhemoglobin is elevated. Treatment?
Widened mediastinum (> 8 cm), loss of aortic knob, pleural cap, tracheal deviation to the right, depression of left main stem bronchus
Radiographic evidence of aortic disruption or dissection.
Free air under the diaphragm, extravasation of contrast, severe bowl distention, space-occupying lesion (CT), mesenteric occlusion (angiography)
Radiographic indications for surgery in patients with acute abdomen.
↓ CO, ↓ pulmonary capillary wedge pressure (PCWP), ↑ peripheral vascular resistance (PVR).
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