Cardiology
Name the 4 drugs which reduce mortality in CHF with a reduced Ejection fraction
ACEi/ARBi
Beta-blocker (metoprolol, carviealol, bisoprolol)
SGLT2 inhibitors
Spironolactone
Name three extra intestinal manifestations of IBD?
Arthralgia's
uveitis, iritis
eryhtema nodosum , pyoderma gangrenosum
Sclerosing cholangitis
What crystals are observed in gout and pseudogout?
GOUT: Monosodium-urate (NEEDLE-LIKE NEGATIVE BIREFRINGENCE)
PSEUDOGOUT: Calcium pyrophosphate (RHOMBOID, POSITIVE BIREFRINGENCE)
What type of casts are seen in UA in dehydration?
Hyaline cast
Other casts:
Red cell cast in nephritic
Eosinophilic cast in ALLERGIC nephritis
Broad waxy in chronic renal disease
Muddy brown granular in ATN
What are the indications of CABG in CAD?
- Tripple Vessel disease
- Double Vessel disease with Diabetes
- Left Main vessel (LAD)
Name common antibodies associated with Crohn's AND UC?
CROHN DISEASE :ASCA( ANTISACCHAROMYCES CEREVISIAE ANTIBODY)
UC: ANCA
What is the best initial test for ankylosing spondylitis?
XRAY for sacroiliac joint
Mechanism of action of Bumetanide?
Inhibits Na+-K+2CL in the thick ascending loop of Henle.
Metolazone acts through the inhibition NaCl reabsorption in DCT
Which patients would need prophylaxis for Infectious endocarditis?
- Prosthetic heart valve
- Implanted durable mechanical circulatory support device (ventricular assist device or artificial heart).
- Previous IE.
- Congenital Heart Diseases
- Cardiac transplant recipients who develop cardiac valvulopathy.
What gene is mutated in hemochromatosis and Wilson's disease?
C282y in hemochromatosis
ATP7B in Wilson's disease
What is felty and Caplan syndrome?
Felty syndrome:RA, SPLENOMEGALY, NEUTOPENIS
Caplan syndrome:RA, Pneumocoiosis,lung nodule
What are the clinical features of ALPORT SYNDROME?
-Nephritic syndrome, sensorineural hearing loss and visual disturbance.
-It is a congenital defect that is caused by type IV collagen formation.
What medication can be used in HFrEF to reduce mortality if the patient has hyperkalemia?
Hydralazine+ nitrates
What lab values are required to calculate MELD score and what is it used for?
Serum Bilirubin, INR, Creatinine and serum sodium
The Model for End-stage Liver Disease (MELD) score is a prospectively developed and validated cirrhosis severity scoring system that uses a patient's laboratory values for serum bilirubin, serum creatinine, the international normalized ratio (INR) and serum sodium to predict three-month survival. In patients with cirrhosis, an increasing MELD score is associated with increasing severity of hepatic dysfunction and increasing three-month mortality risk
What antibodies are associated with scleroderma?
ANTI SCL 70( ANTI TOPOISOMERASE ANTIBODIES)
What are the shapes of Calcium oxalate, Magnesium ammonium phosphate, Uric acid and cystine stones?
- Calcium- Enveloped shaped
-Mg AMP- Coffin lid/ rectangular
-Uric acid- Rhomboid
-Cystine stone- Hexagonal
Indications of Cardiac resynchronization therapy?
- CRT is recommended for symptomatic patients with heart failure (HF) in sinus rhythm with LV ejection fraction (LVEF) ≤35%, QRS duration ≥150 ms, and LBBB QRS morphology.
- CRT should be considered for symptomatic patients with HF in sinus rhythm with LVEF ≤35%, QRS duration 130-149 ms, and LBBB QRS morphology.
- CRT should be considered for patients with HF in sinus rhythm with LVEF ≤35%, QRS duration ≥150 ms, and non-LBBB QRS morphology
What is cutoff value for MADDREY SCORE for steroid use?
Scores above 32 typically suggest poor prognosis and that these patients may be helped by steroid administration.
When a patient with alcoholic cirrhosis is ill, the Maddrey Score is used to determine if they would benefit from the use of steroids as part of their medication regimen
What is the most accurate test for Sjogren Disease?
Anti Ro (Anti SSA)
Anti la (Anti SSB)
Name three lab findings related atheroemboli?
- Eosinophilia
- low complement
- eosinophiluria
- elevated ESR
-Elevated BUN and Cr