Question | Answer |
You can't fibrillate a patient with what rhythms? | Asystole or PEA (Pulse-less Electrical Activity) |
This antibiotic is never the correct answer on the boards for staph infection | PCN |
Treatment for chlamydia or gonorrhea | Azithromycin (macrolide) + ceftriaxone |
The electrocardiogram (ECG) demonstrates a short PR interval | <12 sec |
The presence of a short PR interval, frequently with a delta wave | preexcitation syndrome |
A short PR interval, <0.12 sec, with a narrow complex QRS and palpitations | Lown-Ganong-Levine (LGL) syndrome |
an accessory pathway, the Kent bundle, which directly links the atria to the ventricles, bypassing the atrioventricular (AV) node | Wolff-Parkinson-White (WPW) pattern |
slurred and broad upstroke of the QRS complex | delta wave |
The rotator cuff is a group of four muscles that support the shoulder joint. What are the four muscles? | Supraspinatus, infraspanatus, teres minor and subscapularis |
What is the standard oral antibiotic regimen for prevention of endocarditis in adults with high risk cardiac lesions? | Amoxicillin 2g PO 30-60 min prior to procedure (for patients not allergic to penicillin) |
What is the standard oral antibiotic regimen for prevention of endocarditis in adults with high risk cardiac lesions who are allergic to PCN? | Cephalexin 2g or Clindamycin 600mg or Azithromycin 500mg |
A Churg-Strauss Syndrome patient's anti-neutrophil cytoplasmic antibody (ANCA) blood test test comes back positive. What other conditions might he have? | glomerulonephritis, alveolar hemorrhage, purpura or mononeuritis complex. |
Cough in gi may suggest - suggests a | malignant trachea-esophageal fistula. |
Hoarseness - may be invasion into the left recurrent laryngeal. | |
esophagram - demonstrate an “apple core” or obstructive mass lesion with | esophageal cancer. |
Chemicals irritation to esophagus | squamous cell cancer. |
alcohol binge drinking and vomiting, over a chronic period of time, | adenocarcinoma. |
“apple core” type of appearance. | esophageal cancer |
Progressive dysphagia. | Esophageal cancer. Surgery is the only curative option. |
A Schatzki ring, this ring in the esophagus would be | distal. |
non-progressive dysphagia | Schatzki Ring |
An esophageal web will be more so in the upper portion. true or false | True |
the nails and it looks like they’re depressed, spooning of the nails.and the tongue looks beefy, beefy red. | iron deficiency. |
koilonychia - spooning of the fingernails, spooning, there’s esophageal webs, iron deficiency anemia | Plummer-Vinson Syndrome |
spooning of the fingernails, | koilonychia |
the esophageal web is made up of squamous cell, with persistent irritation may go on to develop dysplasia and | squamous cell cancer of the esophagus. |
Plummer-Vinson Syndrome treatment | dilatation of esophageal webs |
The fundus of the stomach herniating into the thoracic cavity? | Hiatal hernia. |
what % of your patients with GERD could have an associated hiatal hernia | 40% |
GERD associated in immunocompromised patients | Infectious |
GERD associated with - Herpes, Cytomegalovirus, HIV | Viral GERD |
The squamous cells of the esophagus may then turn into or undergo metaplasia into columnar cells. | Barrett’s esophagus. |
Barrett’s esophagus, which is not a cancer, but its metaplasia, is at risk for dysplasia and adenocarcinoma. True or False | True |
in GERD, there’s decreased relaxation of he esophagus. T or F | False : in GERD, there’s excessive relaxation. |
What kind of cancer would this be most likely with GERD? | Adenocarcinoma..You go from Barrett’s esophagus to metaplasia, into dysplasia and into your adenocarcinoma, most likely located in your lower esophagus. |
the perfusion of esophagus with acid to induce the symptoms of GERD | The Bernstein test |
Gerd use The histamine blockers H2 blocker | ranitidine, cimetidine. |
PPIs would be even better for gerd - Proton Pump Inhibitor | Prevacid, Prilosec, Nexium (the purple pill). |
Treatment if your patient is still exhibiting symptoms of GERD, after H2 blockers and PPIs | surgery. |
Barrett’s esophagus would be the beginning stages or confirmation that metaplasia is taking place. But this is not cancer, is it? So this is reversible? | correct. |
as the Barrett’s esophagus persists _________into columnar, associated with long term acid exposure.
, | metaplasia |
What kind of dysphagia would this be in Barrett's Esophagus ? | progressive solids first, then liquids |
potassium compounds, NSAIDs , quinidine, iron, , alendronate due to osteoporosis, tetracycline, vitamin C; all this could cause | pill-induced esophagitis. |
Infectious Esophagitis diagnosis | Endoscopy is the test of choice, |
painful swallowing | painful swallowing - odynophagia |
Cytomegalovirus esophagitis, you’d find this ulcer to be | circumscribed |
Cytomegalovirus esophagitis, - biopsy shows | viral inclusions |
Cytomegalovirus esophagitis, treatment | Foscarnet may be necessary for resistance., but also
Acyclovir, Gancyclovir, Foscarnet - drugs that you want to keep in mind in the family of Herpes. |
Cytomegalovirus esophagitis, Management, | Management, it would be IV ganciclovir followed by something like Valgancyclovir and Foscarnet |
Most frequent cause of esophagitis in immunocompromised patients. | Candida Esophagitis |
Candida Esophagitis findings | the pseudo hyphae and the yeast. |
Candida Esophagitis Management | fluconazole, oral |
obstruction of your lower esophageal sphincter. | achalasia |
Some peptides that you know of that are responsible for normal relaxation physiologically of the LES. | VIP - Vasoactive Intestinal Peptide, and nitric oxide. |
Failure of the relaxation of LES | Found in achalasia. |
Necessary to rule out achalasia | Esophagogastroduodenoscopy necessary to rule out… EGD |
Chagas disease for you, and I keep repeating this, will be responsible for 3 major sites for pathology.
04:11 One would be the esophagus with achalasia, dilation of the proximal esophagus. | |
Chagas with amastigotes in the heart destroying the myocardium, resulting in dilated cardiomyopathy. | |
Chagas disease down in the intestine.
04:31 Trypanosoma Cruzi resulting in toxic megacolon. | |
So what is the confirmatory test for achalasia? It is not endoscopy. | do an Esophageal motility test |