Best prognostic sign in patients with primary CNS lymphoma with HIV?
Improvement of CD4 counts
Complications of bicuspid aortic valve (in 30% of turner syndrome), best screening test for pt and family members?
- echo
- infective endocarditis
- severe regurg/ stenosis
- aortic root/ ascending aortic dilation
- dissection
Loud S1, diastolic rumble, opening snap
mitral stenosis
most common cause of mitral stenosis
rheumatic heart disease
clinical features of mitral stenosis
- dyspnea
- hemoptysis
- afib
- thromboembolism
- voice hoarseness from recurrent laryngeal compression from LAE
How do you diagnosis mitral stenosis
CXR: flattened left heart border, LAE, dilated pulmonary arteries
EKG: broad and notched p waves/ P mitrale
TTE
How do you diagnose disseminated gonococcal infection?
culture joint fluid, mucosal surfaces (urethral, rectal, oral, cervical)
Clinical features of gonococcal infection
joint pain
tenosynovitis (painful tendons around ankle and toe)
transient pustular skin rash
Gold standard diagnostic test for Hirschsprung’s disease, and difference with meconium ileus on imaging
- rectal suction biopsy will show absence of ganglion cells
- diff: meconium ileus shows narrow underused microcolon, related to CF. HD has “transition zone”
Endoscopy showing red velvety colored squamous epithelium with pale and glossy appearance with intestinal metaplasia. Ddx and management?
Barrett’s esophagus
- no dysplasia: regular endoscopic surveillance
- low dysplasia: surveillance or endoscopic eradication
- high dysplasia: endoscopic eradication/surgery
clinical features of 21 hydroxylase enzyme deficiency (most common cause of congenital adrenal hyperplasia)
- hypotensive shock
- ambiguous genitalia in 46 XX individuals
- hyponatremia
- hyperkalemia
- hypoglycemia
- vomiting, dehydration
clinical features of 17 alpha hydroxylase enzyme deficiency
- phenotypically looks female
- fluid, salt retention
- hypertension
Treatment of CAH
- glucocorticoids and mineralocorticoids
- high salt diet
- genital reconstruction for girls
best choice med for preventing cluster headache
- verapamil!
- prednisone and lithium are alternatives
Treatment of cataplexy (sudden loss of muscle tone) in narcolepsy
- SNRI (venlafaxine), SSRI, TCA or sodium oxybate
Treatment of PE stepwise
small amount of hemoptysis is normal in PE
- low molecular weight heparin or unfractionated heparin
- early initiation of warfarin
- fibrinolytic therapy with hypotension (no antiplatelet therapy!)
- Last if all fails– IVC filter
treatment of raynaud’s syndrome
calcium channel blockers such as nifedipine or amlodipine
what test is good to look for osteoblastic lesions in prostate cancer?
radioisotope bone scans
Cocaine induced MI treatment regimen
- nitrates/CCB, benzo, aspirin
- if no improvement, coronary angiography due to risk of coronary thrombus
Which drugs can induce acute pancreatitis?
- diuretics
- Inflammatory bowel disease meds: sulfasalazine, 5-asa
- immunosuppressive agents
- bipolar/seizure meds: valproic acid
- AIDS patient: didanosine, pentamidine
- abx: metronidazole, tetracycline
Which areas of the brain is affected by Wernicke’s-Korsakoff’s syndrome?
diencephalon: mamillary bodies, thalamus– abnormal enhancement in MRI
Management of asthma exacerbation
- mild to moderate (40-69%): SABA, PO steroids
- moderate to severe (<40%): SABA and ipratropium, PO/IV steroids
- impending respiratory arrest: SABA and ipratropium, IV steroids and magnesium sulfate, SQ terbutaline or epinephrine, intubation (last resort)
Signs of early cardiac tamponade in echo
- right atrial and ventricular collapse during diastole
- exaggerated respiratory variation of cardiac and venous flow
- IVC plethora (dilation and <50% decrease in IVC size during inspiration)
chronic diarrhea, weight loss, iron deficiency anemia, eosinophilia, and pt is from developing countries. Likely ddx?
intestinal parasitosis/helminth infection
