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Pulm
Cardiology
GI
Endocrine
Critical Care
100
What are the 2 things proven to improve survival in COPD
Smoking Cessation Home O2; minimum of 15hrs a day
100
what causes S3 and S4? when do they occur?
3- rapid passive filling; early diastole 4- Stiff ventricle; late diastole
100
Patient with intermittent pain with solids and liquids (esp. cold). Name Dx.
Diffuse esophageal spasm. Best evidence for treatment is CCB.
100
name the homones synthesized in the Posterior pituitary
None- they are made in hypothalamus ADH Oxytocin
100
Vasopressor without Beta activity?
Phenylepherine (alpha 1 agaonist)
200
This dz is caused by dysfunction of Na and Cl channels. Name dz and chromosome.
Cystic Fibrosis Chrom 7; CFTR; MC mutation F508
200
What is kussmal sign? what are two possible causes?
JVD with inspiration constrictive pericarditis (not tampanod) RH MI
200
Name 3 factors that cause/ increase risk for GERD?
Transient LES relaxation Hiatial hernia Increased BMI Delayed gastric emptying GERD is MCC of esophageal stricture 20vs40mg omeprazole are equivocal
200
Name the hormones synthesized in the Anterior Pituitary
GH LH/FSH ACTH TSH Prolactin
200
Indications for intubation (name 3)?
Failure to maintain airway tone/protection Decreased LOC Failure to Ventilate or oxygenate Anticipated deterioration of clinical status
300
What is definition of pulmonary hypertension
PA pressure of >25 at rest or >30 with exercise
300
LVEF for ICD placement?
<35% EF
300
No peristalsis and Increased lower esophageal sphincter pressure. Name disease and what is wrong pathologically?
Achalasia
300
types and causes of Diabetes insipidus
DI= dilute polyuria, Hypernatremia, hypokalemia, high serum osmolality Central- trauma, surgery, idiopathic, sarcoidosis Nephrogenic- lithium, hypercalcemia **Water deprivation test should increase plama osmolality if it doesn't or plateaus (in 300-400 range) then give DDAVP.. if serum osm increases by 50% then it is due to central; if no increase in osmolality then its nephrogenic
300
Dx of ARDS and classification.
INCLUSION CRITERIA: Acute onset of: 1. PaO2/FiO2 ≤ 300 (corrected for altitude) 2. Bilateral (patchy, diffuse, or homogeneous) infiltrates consistent with pulmonary edema 3. No clinical evidence of left atrial hypertension P:F ratio mild ARDS: 201 - 300 mmHg (≤ 39.9 kPa) moderate ARDS: 101 - 200 mmHg (≤ 26.6 kPa) severe ARDS: ≤ 100 mmHg
400
What is the trans pulmonary gradient? How does it help you?
mPAP - PCWP In the setting of mPAP >25 PCWP <15 = pulmonary artery hypertension PCWP 15-25 with TPG >12 PH out of proportion to HF <12PH in proportion to HF PCWP >25 in proportion to HF
400
Pt with lateral STEMI suddenly develops shock and murmur. what is the murmur?
Mitral Regurgitation
400
75yo female pt with sedentary lifestyle and BMI of 17. severe chest and back pain when swallowing solids, liquids and saliva. DX? cause?
Pill esophagitis; bisphosphonate
400
Pt has menorrhagia, fatigue, constipation, weight gain and muscle cramps. What clinical diagnosis? What are the two typical labs and their results?
Hypothyroidism low Free T4 and High TSH
400
Treatment for Thyroid storm
PTU (blocks T4 synthesis) and glucocorticoids (block T4-T3 conversion. 1hr after PTU give iodine (non-radioactive) load to stop release of already made T4
500
What are the 5 types/classes of pulmonary hypertension?
1- primary pulmonary artery HTN 2- 2/2 Left side failure 3- 2/2 lung disease 4- CTEPH 5- Misc
500
Pt with CVD and stable angina, intolerant of Beta blockers due to bronchospasm, nitro 2/2 sildenafil for pulm-HTN. alternative treatment for angina?
Ranolazine
500
Prognosis for hyperplastic polyp? Name 3 factors that increase the risk for a polyp to me cancerous?
Totally Benign >2cm, sessile base, Villous, multiple polyps (remove all polyps >2mm)
500
AMS, decreased respiration, hypothermia, hyponatremia and elevated TSH. What clinical diagnosis/ treatment? what is another lab that you should always check in this type of patient?
Myxedema Coma- IV levothyroxine +/- IV glucocorticoids Don't give IV T3 Check Cortisol- rule out adrenal insufficiency
500
How do you set up a ventilator?
http://www.ardsnet.org/files/ventilator_protocol_2008-07.pdf