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 Hypoalbuminemia Increased 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
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 A ldosterone deficiencies
Subacute granulomatous (DeQuerveins) thyroiditis is characterized by: DECREASED UPTAKE OF IODINE
What causes low total T4 PREGNANCY 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
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