PicmonicUserXAEA-Twelve Shared "ARCHIVEDUserXAEA-12 Playlist" - 102 Picmonics
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ARCHIVEDUserXAEA-12 Playlist
Tremors
- Resting tremor
- s/s: asymmetric, 4-6 Hz, pill rolling
- dec w/voluntary mvmt; inc w/stress
- etiologies: PD, drug induced parkinsonism, PSP
- Action tremors
- Intention tremor
- s/s: cerebellar sx
- etiologies: cerebellar lesion (stroke, tumor, MS, Wilson dz, drugs)
- mgmt: PT > thalamotomy
- Essential tremor (ET)
- epi: familial, autosomal dominant, bimodal age
- s/s: 4-10 Hz flex-ext, can involve head/voice
- mgmt: propranolol, primidone
- Physiologic tremor
- Orthostatic tremor
- mgmt: clonazepam, gabapentin
Diabetic Neuropathy
- MECHANISMS
- Microvascular injury
- Demyelination
- Oxidative stress
- Glycosylation end product deposition
- POLYNEUROPATHY
- Symmetric, distal, sensorimotor
- Large fiber injury: Negative sx
- Small fiber injury: Positive sx
- Complications: Ulcers, Charcot arthropathy, Amputation
- MONONEUROPATHY
- Carpal/Tarsal tunnel syndrome, CN Palsies
- AUTONOMIC NEUROPATHY
- Gastroparesis, Orthostatic hypotension, Urinary retention/incontinence
Schizoaffective Disorder
- Diagnosis
- Psychosis >2w WITHOUT Mood Episode
- Psychosis WITH Mood episode
Cryptogenic Organizing Pneumonia (COP)
- formerly Bronchiolitis Obliterans Organizing PNA (BOOP)
- type of Idopathic Interstitial PNA
- Noninfectious bronchiole inflammation d/t Intraluminal Polyps
- Masson Bodies
- Secondary: Chronic dz (RA), Drugs (amiodarone)
- S/S: preceding Flu-like illness, mimics CAP
- Workup: No response to Abx, Ground glass opacities, Restrictive pattern
- Mgmt: Reassess (mild), PO Steroids (mod-sv), AZT, Cyclophosphamide (refractory)
Tachyarrhythmia Management
- Parosyxmal SVT (PSVT)
- HDS: Vagal maneuvers → Adenosine
- Unstable: DC Cardioversion
- Prevention: Verapamil, BBs, radiofrequency ablation
- Multifocal Atrial Tachycardia (MAT)
- Oxygen, ventilation
- Preserved LV: CCBs, Selective BBs
- Atrial Fibrillation (Afib), Atrial Flutter (AFL)
- Ventricular Tachycardia (VT, Vtach)
- Sustained
- HDS, SBP >90: IV Amio, procainamide, sotalol
- Unstable: DC Cardioversion → IV Amio
- Ventricular Fibrillation (VFib)
- IMMEDIATE Defibrillation + CPR
- Persists: Epi, intubation, continue CPR, defibrillate again
- Refractory: IV Amio
- Premature Atrial or Ventricular Contractions (PAC, PVC)
- if ASx: supportive
- if sx: BB
Atrial Fibrillation (AF) Acute Management
- All Patients: CHADS-VASc Scoring
- without Hypotension, Sv CHF
- HDS
- mgmt: rate ctl - BB, dilt, dig
- mgmt: dig > amio (if dec LVEF)
- Rhythm Ctl: Cardioversion
- Unstable
- Rhythm Ctl: Cardioversion
- >48h: TEE Algorithm
- with Hypotension, Sv CHF
- IV Digoxin (1st Line)
Pancreatic Adenocarcinoma
- KRAS GOF mutation
- activates GTPase → MAPK → cell growth
- DPC, SMAD4 LOF mutation
- CDKN2A (p16) mutation
- Tumor markers: CA 19-9 > CEA
- pancreatic Head is MC location
- RFs: Tobacco, DM, Elderly, Ashkenazi Jew, chronic pancreatitis
- Sx: epigastric pain radiates to back, weight loss, pale stools
- Courvoisier Sign: PAINLESS obstructive jaundice + NONTENDER palpable gallbladder
- Trousseau Sign: Migratory thrombophlebitis, DVT
- Workup: Abd U/S → CTAP → ERCP, PTC
- Mgmt: Whipple surg, 5-FU
NYHA Heart Failure Classification & Staging
- Staging
- A: at high risk for HF but no structural dz
- Mgmt: Lifestyle mods
- B: Structural Heart Dz
- Mgmt: ACEIs, ARBs
- C: stage B + CHF Sx
- Mgmt: stage B + Diuretics + BBs + Salt Restriction
- D: Refractory CHF
- NYHA Class
Anticoagulants
- Antiplatelet Agents
- Aspirin (ASA)
- ADPR-i: Clopidogrel, Prasugrel, Ticagrelor, Ticlopidine
- GPIIb/IIIa-i: Eptifibatide, Tirofiban, Abciximab
- PDE-i: Cilostazol, Dipyridamole
- Direct Thrombin Inhibitors (DTIs)
- Bivalirudin
- Dabigatran, Argatroban
- Indirect Thrombin Inhibitors
- UFH
- LMWH: Enoxaparin, Dalteparin, Fondaparinux
- contraindicated in AKI/CKD
- Thrombolytics
- tPA (alteplase, reteplase), streptokinase, tranexamic acid
- Factor Xa Inhibitors
- Apixaban, Rivaroxaban
- containdicated in AKI/CKD
- Vitamin K antagonists
- Warfarin
Methemoglobinemia
- Oxidation of Fe2+ to Fe3+
- Etiologies: Local anesthetics, Benzenes, Nitrites, Dapsone
- s/s: cyanosis, chocolate-colored blood
- Labs: Hb curve left shift, Pulse ox 85%, Nml PaO2
- Mgmt: Methylene Blue, Vit C, NADH
- DDx: Sulfhemoglobinemia
- Etiologies: Sulfur products e.g. Sumatriptan, SSz
- s/s: blue-green blood, mucocutaneous surfaces
Neonatal Sepsis
- S/S: non-specific, dec activity, poor feeding, irritability, lethargy, hypotonic
- Workup: CBC, BCx, UA, UCx | LP if suspect bacterial meningitis
- Mgmt: Empiric Abx
- Amp + Gent
- Cefotaxime for Gram(-)
- Acyclovir
- Vanc (bacterial meningitis)
Levetiracetam (Keppra)
- MoA: Inhibits N-type Cav Channels, Facilitate GABAergic transmission
- Indications: Myoclonic, Tonic-clonic, Partial sz
- SFx: Emotional lability (aggression), Depression, HTN, Nasopharyngitis
Pneumonia Management
- Aspiration PNA
- Aspiration PNA
- Ceftriaxone + Azithro
- MRSA: Clindamycin
- Community-acquired PNA
- Community Acquired Pneumonia (CAP)
- Healthy Outpt: azithro, doxy
- Comorbid Outpt: floxacin or [B-lac+ macro]
- Inpt: IV floxacin or [B-lac + macro]
- ICU: IV [B-lac + fluoro] or [B-lac + macro]
- PCN Allergy: floxacin + aztreonam
- Ventilator-associated PNA
- Ventilator Associated Pneumonia (VAP): 3 Drugs
- S. pneumo: ceph, PCN, carbapenem
- Pseudonomas: fluoro, aminoglycoside
- MRSA: vanc, linezolid
Meningitis Cerebrospinal Fluid (CSF) Analysis
- acute Bacterial
- Inc. WBC (PMNs), Protein, Opening pressure
- Dec. Glc
- Cx(+), Gram stain(+)
- partially treated Bacterial
- Monocytic predmoninance | Protien & Glc move towards nml
- Viral
- MCC Coxsackievirus
- Inc. WBC (Lymphocytes)
- Fungal, TB
- Inc. WBC (Lymphocytes), Protein, Opening pressure
- Dec. Glc (<10)
Drugs Contraindicated in Breastfeeding, Lactation
- ALI: Atropine, Lithium, Iodide
- CAN: Cyclosporine, Alcohol, Nicotine
- Chloramphenicol
- BB: Bromocriptine, BZDs
- RR: Rizatriptan, Radiopharmaceuticals
- EE: Ergotamine, Ethosuximide
- AA: Amiodarone, Amphetamines
- SS: Sex hormones, Stimulant laxatives
- TT: Tretinoin, Tetracycline
- Methotrexate (MTX)
Aplastic Anemia Etiologies
- Congenital: Fanconi
- Acquired
- Drugs: NSAIDs, Sulfonamides, AEDs, Chloramphenicol, EtOH, PTU, MMI
- Chemicals: Benzene, glue
- Radiation
- Viral: Parvo, EBV, CMV, HIV
- Immunue: SLE, PNH, Thymoma
Fetal Alcohol Syndrome (FAS)
- 3 pathognomonic facial dysmorphisms
- small palpebral fissures
- smooth philtrum
- thin vermilion border
- MR/DD, Social withdrawal
- Decreased growth (height, weight)
- Holoprosencephaly, Microcephaly
Diazoxide
- opens KATP channels --> Hyperpolarization
- pancreatic beta cells: decreases insulin release
- vascular SMCs: decreases b/p
- Indications: Hypertensive Emergency, Congenital Hyperinsulinism, Insulinoma
- SFx: PH, Hyperglycemia, Hypertrichosis, sodium retention, HA, reflex tachycardia
Fanconi Anemia
- epi: MCC Inherited Aplastic Anemia, Ashkenazi jews
- pathophys: auto rec NHEJ defects → BM failure
- s/s: pancytopenia
- derm sx
- MSK sx
- Head/neck sx
- Eyes, Ears, Kidney anomalies
- Comorbid Malignancies: MDS, Leukemias (AML), SQCC of Head, Neck, Vulva
- Labs: inc AFP, HbF
- Dx: Expose lymphocytes to Mitomycin C → observe Chromosomal Breakage
- Tx: Allogeneic HSCT
Collagen Types
- Type 1: MSK, Fascia, Skin, Cornea (Bowman, Stroma layers)
- Osteogenesis Imperfecta
- Type 2: Cartilage (hyaline), Vitreous Body, Nucleus Pulposus
- Relapsing Polychondritis
- Type 3 (Reticular), Blood, Uterus, Fetus, Granulation Tissue
- Type 4: Basement Membrane, Lens, Descement Membrane (Cornea)
