ACNP--Rosh review
Von Willebrand Disease - bleeding disorder caused by a deficiency of von Willebrand factor, a
"sticky" protein that lines blood vessels and reacts with platelets to form a plug that leads to clot
formation (most common genetic coagulopathy); Treated with nasal DDAVP.
Depression Symptoms - SIG E CAPS (sleep, interest, guilt, energy, cognition, appetite,
psychomotor (restless), suicide)
Alpha Adrenergic Blockers - helps small blood vessels remain open. Doxazosin (Cardura), Prazosin
(Minipress), Terazosin.
Ankle-brachial index (ABI) -
Anticholinergics - atropine, belladonna, Cogentin, Enablex, Toviaz
Any bleeding noted in the airway or around stoma more than 48 hours after trach is concerning for -
tracheoinnominate artery fistula; initial management is to increase cuff pressure, then intubate.
Benzodiazepines - Xanax, Librium, Klonopin, Tranxene, Valium, Ativan
Brudzinskis Sign - Severe neck stiffness causes a patient's hips and knees to flex when the neck is
flexed. Can point to meningeal irritation
Cardiogenic Shock--hemodynamics - Increased PCWP, Decreased CO, Increased SVR
Central Herniation (transtentorial-descending bilateral) - Downward displacement of the cerebral
hemispheres and basal nuclei compressing and displacing the diencephalon and midbrain rostrocaudally
throught the tentorial notch. Causes Medium-sized fixed pupils, early coma, decorticate posturing,
Cheyne-Stokes RR, DI
, Charcot's triad - RUQ pain, jaundice, and fever/chills in the setting of ascending cholangitis
Cullen's sign - ecchymosis around the umbilicus associated with retroperitoneal bleeding.
(associated with ruptured ectopic pregnancy and hemorrhagic pancreatitis.)
Dantrolene is used to treat - Malignant hypertehermia
Decreased ADH levels are seen in - Central Diabetes Insipidus
Decreased TSH levels seen in - hyperthyroidism
Ace inhibitors contraindicated in patients with - hyperkalemia, abnormal renal function, aortic
stenosis (can cause severe hypotension), pregnancy
Distributive shock--hemodynamics - Decreased PCWP or no change, Increased CO early,
Decreased CO late, Decreased SVR
DKA causes and treatment - hypovolemia, hyperglycemia, acidemia, and hyperkalemia (but with
total overall potassium deficit); Treatment includes fluid repletion, insulin, and treatment of electrolyte
imbalances; with BG <200, dextrose is added to fluid.
Exclusion criteria for tPA - after 4.5 hrs or, age >80, NIH >25, DM with previous infarct, SBP>185 or
DBP >110, plt <100, INR>1.7, anticoagulant use, BG <50
First line treatment for venous thromboembolism in pregnancy - Heparin or Lovenox
Hemophilia A is - X-linked recessive, decreased synthesis of Fctor VIII, treatment with recombinant
FActor VIII
Hemophilia B is - genetically inherited deficiency in factor IX associated with prolonged aPTT. PT
may be normal. Treatment with Factor IX concentrate.
