facts

[Anonymous]

USMLE FACTS
Zidovudine causes macrocytic anemia and bluish discoloration of nails
ACE levels are increased in Sarcoidosis and HIV and Tb. Almost all granulomatous diseases have increased levels
Lead poisoning causes motor mononeuritis multiplex
Fathers of patients with Cystic fibrosis are unlikely to have the disease themselves as the disease makes patients infertile because of absent vasdeferens
Meningococcemia is best detected in the Buffy coat of blood and is predisposed to by terminal compliment deficiency
Popcorn lesions on CXRs are most likely to be Hamartomas
BUN/Creatinine ratio is raised by dehydration, GI bleed, Steroids, High protein diet and Partial urinary obstruction
Dyspnea in erect position (but not in lying) is called platypnea and is a feature of liver failure and Osler -Rendu-Weber
Gauchers is confirmed by checking WBC Glucocerebrosidase levels
The most common areas of cerebral hemorrhage are Internal capsule (putamen), Thalamus, Pons & cerebellum
Legionella became famous after an outbreak affecting a doctor's conference in a philadelphia hotel
The most common scenario for disseminated Gonococcus is during menses
Cough suppressants are ineffective in pertussis

Identify adverse affects of various commonly used medications:
ACE-inhibitors - cough (also unsafe in pregnancy) and angio-edema
Dihydropyridine CCB’s (such as Nifedipine) - peripheral edema
Verapamil - constipation
Quinidine - diarrhea, thrombocytopenia
Hydralazine - drug induced Lupus (rash, serositis, positive ANA, anti-histone antibody)
Thiazide diuretics - hypercalcemia , may precipitate gout, hypokalemia
Trazodone - priapism (This appears on a lot of tests)
Niacin - flushing (abnormal LFT’s at high doses of slow-release preparations)
HMG CoA Reductase inhibitors (statins) - Myositis, elevated transaminases
Mitomycin - Hemolytic Uremic syndrome
Cisplatin - Deficiencies of Magnesium, Potassium, and Calcium
Cyclophosphamide - Hemorrhagic cystitis and urothelial cancer
Vincristine: Sensory neuropathy
Imipenem - seizures
Cephalosporins and IV Clindamycin - Clostridium dificile colitis
Hydroxychloroquine (Plaquenil) - Corneal opacities, macular edema
Erythropoietin - Hypertension
Metformin - Lactic acidosis (also anorexia and weight loss)
Acarbose - flatulence
Sulfonylureas - prolonged hypoglycemia
Methimazole (Tapazole) - agranulocytosis, aplastic anemia
Iron and Bismuth compounds - blackening of stools which is heme (guaiac) negative.
Rifampicin - red-orange discoloration of secretions (tears and urine), flu like illness
Salicylates - ototoxicity and respiratory alkalosis/metabolic acidosis
NSAIDS - gastric mucosa injury, nephrotoxicity, elevated BP
Heparin - thrombocytopenia =(HIT) heparin induced thrombocytopenia (the only low molecular weight heparin-LMWH that can be used in such patients is Danaparoid.

Known Risks of Breast Implants
Signing a consent form is now part of the procedure for all women undergoing breast implant surgery. They must also be given information about the devices' known and possible risks.

Silicone gel-filled breast implants

Implant Risks
· capsular contracture (hardening of the breast due to scar tissue)
· leak or rupture--silicone implants may leak or rupture slowly, releasing silicone gel into surrounding tissue; saline implants may rupture suddenly and deflate, usually requiring immediate removal or replacement
· temporary or permanent change or loss of sensation in the nipple or breast tissue
· formation of calcium deposits in surrounding tissue, possibly causing pain and hardening
· shifting from the original placement, giving the breast an unnatural look
· interference with mammography readings, possibly delaying breast cancer detection by "hiding" a suspicious lesion. Also, it may be difficult to distinguish calcium deposits formed in the scar tissue from a tumor when interpreting the mammogram. When making an appointment for a mammogram, the woman should tell the scheduler she has implants to make sure qualified personnel are on-site. At the time of the mammogram she should also remind the technician she has implants before the procedure is done, so the technician can use special techniques to obtain the best mammogram and to avoid rupturing the implant.
Possible Risks of Breast Implants
· Autoimmune-like disorders--signs include joint pain and swelling; skin tightness, redness or swelling; swelling of hands and feet; rash; swollen glands or lymph nodes; unusual fatigue; general aching; greater chance of getting colds, viruses and flu; unusual hair loss; memory problems; headaches; muscle weakness or burning; nausea or vomiting; and irritable bowel syndrome. Recent studies have shown, however, that there is not a large increased risk of traditional autoimmune, or connective tissue disease, from silicone gel implants.
· Fibrositis/fibromyalgia-like disorders (pain, tenderness and stiffness of muscles, tendons and ligaments).
Some women who had silicone gel-filled breast implants were invited to undergo a magnetic resonance imaging (MRI) examination of their breasts to determine whether their implants had ruptured. MRI allows the radiologist to see the breast implant while it is still inside the breast.
FDA conducted this study because of concerns about the frequency and results of rupture. Rupture is a concern because:
· Rupture of silicone gel-filled implants may allow silicone to migrate through the tissues. The relationship of free silicone to development or progression of disease is unknown.
· Rupture is a device failure – the implant is no longer performing as intended.
MRI examination in this cohort of patients demonstrated that the majority of women had at least one ruptured implant.

BT prolonged: vWD, TTP, ITP.
PT: vitamin k defi. liver disease, drug (coumadin), (extrinsic c.factor defi.).
PTT: hemophilia A & B (intrinsic coagulation factor).