MALT lymphoma is associated with
H. pylori infection
Celiac disease dx with
IgA anti-endomysial antibodies
Celiac disease assoc with
dermatitis herpetiformis
Pt with ascitis develops sudden onset fevers, chills, and generalized
abd pain Paracentesis to r/o spontaneous
bacterial peritonitis
Pts with late compliment deficiencies are prone to
Gonococcal infections.
Herpes simplex virus CNS infection will see
Temporal lobe lesions with mass effect/edema.
Start acyclovir ASAP
m/c inherited bleeding disorder, associated with bleeding symptoms
from nose or gingival. Factor V Leiden
65 yo male with headache and fever, spinal tap with decreased
glucose, increased protein, lymphocytosis and gram positive
bacilli best treated with Ampicillin plus Gentamycin.
Loop diuretics act on
the Na+-K+-2Cl- symporter (cotransporter) in the thick ascending
limb of the loop of Henle to inhibit sodium and chloride reabsorption
What is associated with severe phosphatemia (<1.0)?
Vitamin D deficiency
65 yo male with h/o recurrent calcium urolithiasis has anion gap 13
with bicarb of 15 and urine pH 6, potassium 3.2.
Type I RTA
45 yo female with nl BUN/Cr, sodium 120 with urine sodium 40
and urine osm 240
Psychogenic Polydypsia
Dirty brown casts are characteristic of
acute tubular necrosis
44 yo male with psych history found comatose with anion gap and calcium oxalate crystals in UA,
diagnosis is
Ethylene glycol intoxication.
16 yo male with asymptomatic hematuria, nl blood pressure, no edema, UA with 60-80 RBCs/HPF
and C3 nl, m/l dx is:
IgA Nephropathy
What drug may cause hyperkalemia by decreased renal tubular secretion
of potassium?
Bactrim (I don’t think this is right)
30 yo male with acute nephroureterolithiasis, calcium 9.8,
phos 3.6, creatinine 0.8, urine calcium 320/24h, urine uric acid
500/24h, urine pH 6.8, the m/l dx is:
Idiopathic hypercalciuria
55 yo with painless hematuria with UA has RBCs but no proteinuria, no red cell dysmorphia or no RBC casts;
what should next test be:
Cystoscopy
28 yo WM with hematuria, proteinuria, nephritic syndrome, b/l
cataracts, high frequency hearing loss =
Alport’s Syndrome
48 yo alcoholic has sodium 105 what is initial tx:
10 gram Regular Diet
32 yo male construction worker treated for heat stroke has renal
insufficiency m/l secondary to: with BUN 35 and Cr 3.5 and UA with
protein and 2-3 RBCs:
ATN secondary to hypovolemia or myoglobulinuria
42 yo female with adult polycystic kidney disease with flank pain and
fever with infected cyst in right kidney, should be treated
empirically with:
LEVAQUIN Gram negative bacteria are most common
36 yo male with creatinine of 3.0 has a GFR of ~24, STAGE?
Stage 4 CKD.
64 yo black female with HTN and DM2 has increased BUN/Cr, K 5.2; what is the cause for her increased
K:
RTA 4
60 yo with h/o CHF, systolic dysfunction and CKD presents with
heart palpitations, K 6.5, Dig 3.5; what is relatively contraindicated:
CALCIUM GLUCONATE - The injection of calcium preparations is strictly
contraindicated in digitalized patients.
What can cause decreased anion gap
HypoalbuminemiaIncreased immunoglobulins (MYELOMA, gammopathies)
Increased unmeasured cations (hyperkalemia, hypercalcemia, hypermagnesemia)
Lithium therapy
40 yo WF with ARF, sinus infection, pulmonary infiltrate, conjunctivitis, hemoptysis, positive c-ANCA; most
likely dx:
Wegener’s
What factor places patient at greatest risk to develop
osteoporosis:
Long-term corticosteroids
Patient presenting with headache, nausea, vomiting, hypotension,
blurred vision, diplopia, impaired consciousness; most likely has:
Pituitary apoplexy – know diagnosis/treatment
Schmidt’s syndrome :
consists of Adrenal insufficiency, gonadal failure, hypoparathyroidism, lymphocytic
thyroiditis and Diabetes
Solitary thyroid nodule most likely malignant if:
Serum thyroglobulin (papillary or follicular) or calcitonin (medullary) elevated
What diagnostic test would prove self-induced hyperthyroidism?
Thyroglobulin level low
46 yo hypertensive male with acute nephrolithiasis and h/o PUD and
constipation; nephrolithiasis most likely d/t:
HYPERPARATHYROIDISM
Goal of LDL-C in patients with CKD stage IV is
< 100.
18-hydroxysteroid measurements and postural stimulation used to
differentiate
Aldosterone deficiencies
Subacute granulomatous (DeQuerveins) thyroiditis is
characterized by:
DECREASED UPTAKE OF IODINE
What causes low total T4PREGNANCY OR INCREASED THYROGLOBULIN
Craniopharyngioma Empty sella syndrome
Metastases to the pituitary Pituitary irradiation
Pituitary tumor Post cranial irradiation
Post surgery Sheehan's syndrome
48 yo asymptomatic female with elevated AST and ALT with
ultrasound showing fatty infiltration; what would predispose her to abnl LFTs with nl alk phos and albumin
DIABETES MELLITUS
MEN IIa:
Pheochromocytoma, medullary thyroid carcinoma, and parathyroid hyperplasia
Patient with easily palpable 1.5 cm thyroid nodule; what is best next
approach?
Fine needle aspiration
36 yo nurse with repeated bouts of palpitations, sweating, anxiety,
hunger, dizziness and blurred vision; glucose in ER 20; confirm dx by
checking:
C-Peptide level will be low
34 yo WM with hypercalcemia on routine physical exam, calcium 11, urinary calcium <200/24h; patient
most likely has:
Familial Hypocalciuric Hypercalcemia
76 yo female obtunded with glucose 1200 and sodium 126:
She is in hyperosmolar coma requiring aggressive fluid rehydration with
normal saline
30 yo obese female with hirsutism, irregular menses, LH/FSH 2:1,
TSH/Prolactin nl; what else would be expected:
ACANTHOSIS NIGRICANS – know other PCOS criteria
58 yo female diagnosed with osteoporosis by DEXA with t-score -
3 SD with increased PTH and nl serum calcium, 24h urine calcium 200; she should be treated with:
vitamin D plus calcium supplements for osteomalacia
Complication of RA:
Splenomegaly
Patient with pain/redness of both ears, arthritis of hands and knees,
b/l conjunctivitis, and diastolic decrescendo murmur has:
Relapsing Polychondritis
49 yo female with Raynaud’s and pains in both hands/wrists,
dysphagia, sclerodactyly, ANA 1:160, anticentromere antibodies, neg
rheumatoid factor, negative antiribosomal antibodies; most
likely has:
Scleroderma
Lymphoma + stocking glove purpura + arthralgias + Raynaud’s +
glomerulonephritis; most likely has:
MCTD – what lab is diagnostic ANTI-RNP
#1 cause of death in SLE is
INFECTION
negative birefringent crystals
GOUT
36 yo male from upper Midwest presents with rash + Bell’s palsy +
photophobia + headache and 4 months later heart block:
Lyme disease
Recommended