Pearls 4 IM Boards

Essential Facts for Internal Medicine Board Certification and Recertification ~ Tweets by Dedicated Physicians.

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Bradykinin-mediated angioedema

NO urticaria

CAUSES
Ace inhibitor
C1 inhibitor deficiency
→Hereditary
→Acquired: Lymphoma|MGUS|SLE

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Repair Indication Type B Aortic Dissection

Occlusion major vessel/end organ ischemia
Severe HTN/pain
Dissection/aneurysm progression

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Patients with only 1-2 small (<1cm) tubular adenomas with only low-grade dysplasia should have their next follow-up colonoscopy in 5-10 yr

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Drug-induced edema

Dihydropyridines
Pioglitazone
NSAIDS
Estrogen/testosterone
Pramipexole
Gabapentin/pregabalin
Omeprazole

#ABIM #meded

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Patients who have >10 adenomas at one examination should be examined again in <3 years

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Meneire Disease

Classic triad
Vertigo
Unilateral hearing loss
Tinnitus

#abim #usmle #MedEd

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Baseline colonoscopy s/p polypectomy requires 3-yr follow-up:

3-10 adenomas
Any adenoma >1cm
Any w villous features or high-grade dysplasia

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Hot flash & Tamoxifen

Avoid-CYP2D6 inhibitor
Fluoxetine
Paroxetine
Bupropion

May use venlafaxine, citalopram, gabapentin for vasomotor Sx

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Botulism

TRIAD
Descending flaccid paralysis w prominent bulbar palsies: diplopia, dysarthria, dysphonia, dysphagia
Afebrile
Clear sensorium

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Mucormycosis treatment

Amphotericin B and aggressive surgical debridement

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Rhinocerebral mucormycosis

Rapid fatal infection
Finding Black necrotic tissue on nose/palate is pathognomonic

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Syncope
Head CT, Carotid U/S, EEG, and cardiac enzymes should not be performed in the absence of symptoms pointing to specific etiologies.

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Oral hairy leukoplakia

EBV

White corrugated painless plaques affects lateral portions of the tongue among pts w HIV

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Differentiate smallpox from chickenpox

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Streptococci and staphylococci account for 80% of cases of infective endocarditis

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Most common infectious causes of fever of unknown origin are

TB
Infective endocarditis
Abdominal/pelvic abscess

#ABIM #meded

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Avoid corticosteroids in treating toxic shock syndrome

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HT @edgarvlermamd
Comparison of Alcohol Poisoning (Dr Rosner/ASN BRCU 2012)

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Hungry bone syndrome

Severe/prolonged hypocalcemia after parathyroidectomy ≫thyroidectomy

Tetany
Seizures
Arrhythmias
Laryngeal spasm

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HT @nephondemand
Massive ingestions→HD instability despite aggressive fluid resuscitation/vasopressor should consider hemodialysis