JB can have my HEART
If you suspect a patient has valvular disease, what is the next best step in management?
Echocardiogram
OH no i ate cheese and drank wine, now my BP is 200000/100000
MAO-I
isocarboxazid, phenelzine, tranylcypromine
Top risk factor for developing ESRD in US
DM
High fever, seizure for <15 min, no recurrence, generalized tonic clonic seizure. diagnosis and tx?
Typical febrile seizure
Tx: antipyretics
Increased risk of recurrence
No imaging, send them home
MC brain tumor in kids?
What marker is elevated?
Pilocytic Astrocytoma
GFAP (glial cell marker)
Histology: Rosenthal fibers
What is the most common complication of Mitral Stenosis?
Atrial Fibrillation
(LA contracts against increased resistance d/t stenotic mitral valve → dilation of LA → disrupts electrical conduction pathways of LA)
Upper GI complication? Dysphagia (mitral stenosis causes dilation of LA, which compresses esophagus)
This medication can cause:
Hyper/Hypothyroid + skin discoloration + pulmonary fibrosis
Amiodarone
Reverse menses through fallopian tubes
Child with trisomy 21 will is coming to you because they want to participate in sports this upcoming season. What should you do before you clear them in addition to other typical physical exam stuff?
Before starting sports, lateral neck x-ray
Brain tumor that causes loss of “vertical gaze”
pinealoma (causes Parinaud’s syndrome)
Compression of superior colliculus, which is the vertical conjugate gaze center
A patient is found to have a BP of 145/60. What is this and what does it likely indicate in an adult? in a child?
Adults - Aortic Regurg
Children - PDA
Avoid this class of drugs if you're trying to put patient on antidepressant therapy but they have HTN
SNRI (venlafaxine, duloxetine)
Mechanism behind insulin resistance during pregnancy?
Human placental lactogen
6 month old kid, losing motor milestones, dies before age of 2, autosomal recessive disease
Spinal muscular atrophy (Werdnig-Hoffman)
Chr 5 (SMN1 gene)
Hypotonic infant with fasciculations
Brain tumor that produces EPO?
Associated Syndrome?
Hemangioblastoma
VHL syndrome
Patient with aortic regurgitation can develop this type of HF
HFrEF 2/2 eccentric hypertrophy of LV
What if they had Aortic Stenosis?
This anti-epileptic can cause agranulocytosis
Carbamazepine
Most likely infection following blood transfusion
CMV
NOT HEP C
Clustered seizures in child, contraction of neck and arms, EEG shows hypsarrhythmia, hypopigmented macules on skin
Tuberous sclerosis, the seizures are West syndrome (infantile spasms)
West syndrome tx = ACTH, also vigabatrin (GABAergic agent)
Intellectual disability, nodules in ventricular system (subependymal nodule), subependymal giant cell astrocytoma, cardiac rhabdomyoma, renal angiomyolipoma
Anesthesia over medial thigh + weak thigh adduction
Obturator nerve injury (L2-L4)
Propranolol - Type B
Do not give use hydralazine b/c it causes reflex tachycardia (causes vasodilation → results in reflex baroreceptor activation)
Must avoid increased heart rate b/c ↑HR = ↑shear stress on aortic valve = ↑risk of worsening aortic dissection
Red man syndrome, nephrotoxic, ototoxic
Vancomycin
Most common cause of pneumothorax in HIV patient
PCP infection
Kid w/ many kinds of seizures, bad cognitive dysfunction, EEG shows generalized spikes and slow waves
Lennox Gastaut syndrome
7 yo kid with ataxia + hypertrophic cardiomyopathy + LE hyporeflexia
What trinucleotide repeat?
Freidrich's ataxia
GAA repeat
LOF mutation in frataxin gene (iron binding protein) → iron overload causes oxidative damage
Destruction of dorsal columns of spinal cord → hyporeflexia
Cerebellar destruction → ataxia
Inheritance? AR
Unlike other trinucleotide repeat disorders, which are AD
MC cause of death? CHF 2/2 hypertrophic cardiomyopathy