furosemide to spironolactone ratio

- 2/5

triad of acute interstitial nephritis

-fever

-eos

-rash

etiology- drugs, infection

angioedema and rash (urticaria)

IgE mediated

direct mast cell mediated (nsaids, contrast)

vasculitis

Pulmonary infiltrates

farmer's lung

parasitic (strongyloides, aspergillosis) - eos!

loeffler's endocarditis - eos

autoimmune churg strauss

HCV + rash = type II cryoglobulinemia (30-40%) can get palpable purpura and cidp (chronic inflammatory demyelinating polyneuropathy), type I membranoproliferative

what is the classic paraneoplastic syndrome w/dermatologic manifestations?

dermatomyositis (lung cancer)

asymptomatic eosinophilia? could be strongyloides DONT give steroids - causes devastating sepsis

give ivermectin

DRESS- drug rash w/eosinophilia and systemic symptoms

eosinophilic leukemia? very rare entity but when happens ^^^^^^eos

eosinophilia mnemonic

Neoplasm (ovarian)

Asthma

ASA/adrenal

Connective tissue disorder

Parasitic

chronic urticaria think thyroiditis

^^^B12 seen in polycythemia vera

hypereosinophilic syndrome marker - anti-PDGRFalpha/beta

aspirin allergy - nasal polyps

what estimates risk of stroke in non rheum a-fib?

CHADS2

chf

htn >140/90

age >75

dm

stroke (prior)

nares swab for influenza - 66% specific 100% sensitive

causes of A-fib mnemonic

Pulmonary (pe/copd)

Iatrogenic

Rheumatic

Atherosclerotic

Thyroid (hyper)

Endocarditis

Sick sinus

cardinal rule for history if you suspect environmental exposure - anyone else w/same sickness?

cholesterol emboli can mimic vasculitis.

wegener's patients may have a neuropathy

two cases in which you would expect a thrombocytosis?

1. anemia

2. thrombocytosis as an acute phase reactant

bacterial causes of hemoptysis

klebsiella, tb, pneumococcus, staph aureus

UGIB is 80% of all GI bleed

dx pud, avm, varices, gastritis, gave

surgeons ask for the hematocrit, physicians ask for the hemoglobin - hemoglobin is better because it is measured

shingles vaccine is a live vaccine, its more effective when you give it younger, effective even if you've already had an outbreak of shingles

heart rate best way to test for orthostasis, not bp

fecal antigen test for h. pylori ~100% sensitive

anti dsDNA levels used to monitor severity of lupus

which antibiotics cross the BBB?

azithromycin at high doses

vancomycin

zosyn does not cross bbb