Tummy Aches, Pains and Hurts
What is the treatment for uncomplicated diverticulitis?
Cipro, metronidazole, analgesia, colonoscopy, surgical interventions
What are the treatments for Generalized Anxiety Disorder?
SSRIS, Buspirone, Benzos, Cognitive behavioral therapy
85 yr old man, hospitalized for community - acquired pneumonia. Treated with moxifloxacin, over a couple weeks feel as though he is slowly recovering. Hospital day 10 develops: low-grade fever, watery diarrhea and lower abdominal pain. What is most likely the diagnosis?I
Clostridium difficile (C. DIFF)
What histologic region of the liver would most be affected by Acetaminophen Toxicity/Overdose?
The centrilobular zone (zone III)
What is the classic sign associated with the acute form of Chagas Disease?
Romana Sign
What "point" during an abdominal exam, upon palpation will there be increased pain if the patient has acute appendicitis?
McBurney Point
What are signs and symptoms of Serotonin Syndrome? (Name 5)
Hyperthermia, tachycardia, diarrhea, agitation, confusion, coma, myoclonus, ataxia, shivering
36 yr old woman, recently returned from Southeast Asia presents to her physician with sudden-onset fever, severe muscle pain in her back/extremities, recent joint pain in her knees. Examination reveals erythematous macular rash that covers face and body. What's up?
Dengue Fever/"breakbone fever"
Homeless man is found collapsed, in a garage of a house with slurred speech, by a closet full of automotive supplies. Blood tests show a large anion group acidosis and markedly elevated creatine. Eye exam is normal. What is most likely the diagnosis?
Ethylene glycol poisoning
What will the CSF in bacterial meningitis show?
Bacteria on Gram stain, WBC/protein is elevated, glucose level is reduced
What anatomic structure distinguishes an upper GI bleed from a lower GI bleed?
Ligament of Treitz
What psychiatric medication can cause agranulocytosis?
Clozapine
18 yr old college freshman, delirious/less responsive, 2 days of fever, several episodes of vomiting and joint and muscle pain. Temp: 38.9 F. Physical: petechial rash on lower extremities, photophobia, Kernig and Brudzinski signs are positive. What's up?
Neisseria meningitidis meningitis
3 yr old boy, past several days noted appetite decreased, intermittingly stated tummy hurts. Mother and father experienced similar but milder symptoms. Live in rural New Mexico and make jewelry on small scale at home. What is most likely the diagnosis?
Subacute lead poisioning
What is the Virchow Triad
Endothelial injury, hyper coagulability, stasis
47 yr white man, brought in after being found wandering, incoherent. Mult. watery bowel movements on arrival. Physical examination: pigmented/scaling rash on neck/arms/hands as wel as glossitis. What is most likely the diagnosis?
Vitamin B deficiency (niacin)
What reverses a Barbiturate overdose?
No reversal agent (symptomatic management and ventilator support)
What type of microorganism is Vibrio cholerae
Gram-negative, curved, motile, polar flagellated rod
What drugs when also taken with Benzos, increases the risk of toxicity? Name at least two
Acetaminophen, Alcohol, Cimetidine, Disulfiram, Isoniazid, Valproic Acid
What is the initial diagnostic approach to dysphagia?
A Barium Swallow
3 day old white girl, is "yellow, weak, floppy, and sleeps all the time", physical examination is jaundiced infant with scleral icterus. She is arousable but lethargic with hypotonia. What is most likely diagnosis
Labs:
Total Bili: 34mg/dl. Direct Bili: Undetectable
AST: 10 U/L. ALT: 12 U/L. Coombs test: Neg
Crigler-Najjar (CN) Syndrome
MAOIs is a psychiatric medication that can cause many adverse effects such as an Hypertensive Crisis. How is an Hypertensive Crisis treated?
Phentolamine
54 yr old man, with HIV infection, ED after grand mal seizure. No known family hx of seizures. Afebrile, VSS. Funduscopic examination reveals yellow-cotton like lesions on retina. Physical examination: unremarkable. CT of head: multiple ring-enhancing lesions in the cerebral cortex. Labs: CD4+ cell: 53 cells/mm^3
What's up?
Toxoplasma gondii infection
30 yr old immigrant farmer. Severe diarrhea, SOB, sweating, abdominal pain, urinary incontinence. Patient appears confused, slurred speech. Brother saw farmer drink from an unlabeled bottle about 1 hr earlier. What is most likely the diagnosis?
Organophosphate ingestion
What are the tests/imaging tools that could be used to confirm Klinefelter Sydrome?
Elevated FSH, testosterone levels low, estradiol levels are high, karyotyping of peripheral leukocytes