1 Flashcards
What improves mortality hepatorenal syndrome?
Albumin
Skin ulcer lesion, joint pain and diarrhea, what dz
Ulcerative colitis
Child sickle who stroked tx ?
Exchange transfusion
No fibrinolytics
Kid with clinical picture of appy symptoms improved with abx and US unable to visualize, next step to rule out?
CT or MRI
Sinusitis indication for antibiotics
Worsening symptoms after initial improvement
More or equal to 10 days
How long for Molluscum contagion to improve
Months to years
Mallory weis vs Boerhaave presentation
Both tears after vomiting
Boerhavve present sick
Septic Pt with plum HTN what to be careful with?
Fluids, will increase right sided pressure and worsen right sided failure
Nitric oxides is a treatment, decrease pulm resistance and improve right failure
Acute myeloid leukemia with stroke symptoms what lab abnormality
Leukocytsis causing viscosisty
Conductive hearing loss causes
Otitis media
Wax
Low sodium
Neuro sx
Tx?
Hypertonic saline
Persistently hypothermic after warm blankets tx
Warm fluids (internal rewarming)
Measles rash is
Diffuse rash with white spots on bucks mucosa
Most common complaint of scuba drivers
Middle ear barotrauma
Max amount of intrathoracic blood that can be missed on CXR
1L
Acute lithium overdose management
Whole bowel irrigation
Isopropyl alcohol ingestion lab finding
Osmolar gap
No anion gap
Bronchilitis sign of impending failure
Increase retractions
Decrease breath sounds
Decrease responsiveness
Herberden nodes associated with which arthritis
Osteo
CO vs cyanide poisoning
Cyanide extremely high lactate
CO carboxyhemoglobin > 10% to be toxic
Homeless
Metabolic acidosis
Optic neuropathy
Toxin? And metabolite
Methanol
Formic acid
Snake bite with systemic signs type
Coral snake
Pneumomediastinum management
If isolated issue
Supportive care
HF exacerbation related to aortic stenosis best tx
Bipap
Lasix and nitro drop preload
Repeat dvt presentation test
Repeat duplex
Paronychia tx
I&d and cephalexin if immuncomp/steroids
Hypothyroidism associated lab abnl
Hyponatremia
Migrating arthritis
Fever
Skin lesions
Dx
Disseminated gonorrhea
Crohns exam findings
Full thickness bowel lesions
Abscess
How many does post chemo does neutropenia happen
7-14 days
Universal donor for FFP
AB
Cyanide treatment
Hydroxocobalamine
Schizoid characteristics
Avoids relationships
Routine care for sexual assault
Empiric abx for sti Hep B vaccine if not HIV exposure meds HPV vaccine Emergency contraceptive
Contraindication methotrexate for ectopic
Unstable
Ruptured
Sac > 4cm
Fetal heart activity
Febrile infant between 30-60 days old eval
Urine and blood cultures to start, don’t need LP
Most common bugs causing food borne disease
Salmonella
Campy
Post strep glom lab finding, not antibody test
Decreased C3
Knee aspiration method
Anterolateral towards femur
Febrile kiddo for 5 days management
UA and PO challenge
Intusseception in adult tx
Exploratory lap
Kiddo with vesicles and ulcers in posterior pharynx dx and cause
Herpangina
Cocksakie
Serve malaria drug tx
Artesunate
When to medicate SVT
5cm from the deep system
Myocardial contusion post complication most likely
Pericardial effusion
Contraindication to LP
Vertebral trauma, overlying infection, CNS mass, spinal mass, plt 20, cogulopathy
Intracranial bleed BP goal
Systolic 140-180
Best test for ACL
Lachman better than anterior draw
Isolated pleural effusion with no other findings consider
PE
Bowel obstruction kid dx and tx
Volvulus/malrotarion
Surgery
Lithium toxicity due to meds
Hydroclorothiazide, ACEi or ARBs, NSAID
Viral labyrinthitis tx
Steroids
Inj ass with posterior hip dislocation
Acetabular frx
Necrotizing entercolitis tx
NG tube
G6PD def lab finding
Heinz bodies peripheral smear
New murmur, multiple joint pain, fever dx
Rheumatic fever
Ketamine dose for agitation and procedural sedation
1-2mg/kg IV
Scleroderma renal crisis UA
Normal
Highest sensitivity and specificity for gonorrhea and chlamydia
Vaginal or cervical PCR
Lab test indicative of cirrhosis
Thrombocytopenia
Type 1 hypersentiviry is
Anaphylaxis, hives
Pneumomediastinum healthy young person next step
Dx home
ST elevation in aVR and/or V1 where is MI
Left main
Rust ring tx
Optho follow up 24 hours
COPD exacerbation with prior pseudomonas infections abx choice
Cipro
Fail Romberg with eyes closed cause
Vestibular, need eyes
Recent dental extraction, severe pain dx
Dry socket
Acute alveolar osteitis
Azithromycin in HIV Pt is for
When CD4 count is below 50 for MAC risk
Most likely complication of endometriosis
Infertility
Nigerian with info def most likely cause
Beta thalassemia
Septal hematoma tx
I&D
Watery Diarrhea most likely bug
Rotavirus
Peritoneal dialysis Pt with peritonitis tx
Intraperitoneal abx
Alcoholic pneumonia abx choice
Azithromycin and ceftriaxone
Do not do anaerobic coverage unless abscess or empyema
Probable abdominal injury persistently hypotensive with negative FAST tx
Ex lap
Most combine bug for
Osteo
Staph
Loud diastolic murmur with wide pulse pressure
Aortic regurgitation
Hydrogen sulfide tx
Sodium nitrite
Serotonin syndrome antidote
Cyproheptadine
Hepatorenal syndrome histo of kidneys
Normal
HTN before 24 weeks of pregnancy dx
Molar pregnancy
Ehrlichiosis tx in child
Doxycycline
Cyanotic baby likelt cardiac defect, egg on string, but is not better with squatting dx and tx
Transposition of arteries
Prostaglandin E
Enlarged ltmph node in neck in old chacetic is and ass with
Virchow node
Gastric cancer
Ranson score ast and glucose leveks
250
200
Munchausen is also called
Factitious disorder
First symypoms aortic stenosis
Shortness of breath
Overdose diltiazem persotent hypotentsive bradycarida adter fluids, calcium and atropine tx
Insulin and glucose (pacing might not work)
Painful squishy bullae dx
Pemphigus vulgaris
Dc anaphylaxais rx beside epi
No others recommended
Post exposure pertusis adult tx
Azithro 500 then 250 from 2-5 days
Maintenance fluids kids calc
100 cc/kg for first 10 kg + 50 cc/kg for next 10 + 20 cc/kg for rest
Refractory anaphylaixs to epi on beta blocker tx
Glucagon, beta blocking epi
Sickle cell and blood in anyerior chamber avoid
Acetazolamide causes sickling and increase pressure
Leg swelling and pin no clot risk factors testing
D-dimer and if neg dc
Tx syphilis
Onde dose IM pencillin
Red and itchy tip of oenis dx and tx
Balantitis
Clotrimazole cream
Most common cause chorea no genetic
Stroke
Spiral frx in what age is ok
9 month to 3 years
Septic with hernia nwxt step
Surg consult
Dont reduce will make sepsis worse
Young adult constipated with volvulos on xray dx
Cecal volvulos (sigmoid is old pt)
Radiation exposure signs of sig exposure
Decrease lymphocyte
Vomiting
Mycotic aneursym cause
By septic emboli usualy endocarditis
Torsade no pulse tx
Defib regardless of energy
Cardiac complication f hyperthyroid
Cardiomyopthy > high output failure from tachy
Fat embolism syndrome is and presents as
Embolism everywhere
Resp distress, altered, petechial rash
When to give HIV pt witu PCP steroids
Hypoxia
PaO2 less than 70 or a-a gradient more than 35
Neceotizing enterocolitis presents in age pts
First three weeks
DVT distal when to tx
If symptomatic
Fast high rate, weight loss, heat intolerance on amio dx
Hyperthyroid
When to tx lobar pna with vanc and zosyn
Recent antibiotics or prior clx wirh staph or pseudomonas
Ethylene glycol poisoing need supplement what
Thiamin and B6 (used up in metabolism)
MS flare tx
Steroids (interferon is maintenance)
Hypotensive pelvic trauma OR or IR
OR and pack
Distal finger fracture what splint
DIP extension only
The forst acidnbase abnl in asa od
Respirstory alkalosis, asa makes you breath fast
Then metabolic acidosis
Most common hernia innwomen
Inguinal
Erythema nodosum ass with
Strep infxn
Side effect of prostaglandin
Apnea, hypotension, hyperthermia
Febrile seizures stop at age
5
Corneal ulcer abx coverage in contact wearer
Tobramycin
Cipro
Elevated calcium in sarcoidosis is from
Macrophage production of calcitriol
Test for severity of bleeding in placentsl abruption
Fibrinogen
Most commin oresentstion of hypertrophic cardiomyopathy
Shortness of breath
Young pt gum bleed and noseblleds woth petechial rash and low plt tx
Steroids for ITP
Reed sternberg cells ass with what dx
Hodgkin lymphoma
Minor mvc pregnant no sx next step
Give rhogam
Painful red knee, with mild white count in knee, neg gram stain and neg crytsals what is it
Lyme or reactive arthritis
Ct finding for cebreal venous thrombosis
Delta sign
Preseptal vs orbital cellulitis
Not painful with movement
Facial frx le fort numbers mean
1 maxilla
2 max and nose
3 max, nose and cheeks
Glyburide is what kind of drug
Sulfonyurea
Direct vs indirect ingunial hernia
Indirect down into scrotum
Direct into abdominal wall
Flexion tesrdrop fracture is what
Unstable
Blotchy rahs that coalesced and heat worsens it dx
Rheumatic fever
10 day old, cyanosis what congentical defect
Transposition of great vessels
Most common comprtment in lower leg for compartment syndrome and ass lack of function
Anterior
Dorsiflexion
Viral meningitis lp
Some wbc, but not that high
Normal protein (bacteria is high)
Glucose is low in everything
Esophagitis in hiv pt
CD4 is 90
Dx
Candida
CMV is CD4 50 or less and tend to have fever and burning pain
Thyroid storm med order
Propanalol (control sympathetic hyperactivit)
PTU (or meth to prevent thryoid hormon and before iodid whoch can increase)
iodide, steroids
DKA when to given insulin and potasium
K 3.5 to 5.5
Cd4 vs cd8 organ rejection
4 is chrinic and 8 is acute
Enterococcus uti abx
Amoxicillin, resists others
Dissection cusijg neuro sx on what side
Opposite side of vessel
Testiculr torsion tx
Medial to later more than 360 degrees
Cholrine gas exposure is from im industrial setting from what
Chloramine (ammonia and blech mixed)
Amox/sulbactam is what abx
Unysyn
Oral infxn woth fever abx choice
Unasyn over augmentin
Endometritis abx
Clinda and gent
S/p FB from ear tx
Cipro drops and close follow up
Concern for ludwigs next step
Early intubation
Refeesing sundrome most common electrolyte abnl
Low phos, also loe K and Mg
When give trtanus imminuglobin
If they never got their childhood series
URI sx followed by toxic, increase work of breathing, stridor dx and cause
Bacterial tracheoitis
Staph
Iron toxicity causes
GI sx, metabolic acidosis, liver failure
Felon define
Fingertip abcess
Left main EKG findings
St elevation in aVR, with depressions in inferior leads
Tx acute dystonic rxn from new osych med
Benadryl or beztropine
Thyroid storm meds mechanism
Steroid and propanalol peripheral conversion
PTU and meth synthesis
Iodine stored hormone
Endometrosis tx
Augmentin
Or clinda and gent
Appy size on US
6-7mm or greater
Imaging for hirschprung
Barium enema
Young female hearing loss dx
Otosclerosis
Define presbycusis
Age related hearing loss
Proststis tx length
4-6 weeks
Persistent st elevations after mi and treated dx
Ventricular aneurysm
Uri them comes back toxic with stridor dx
Bacterial tracheitis
Prevent lyme disese after dinding tick tx
One dose
Doxy
Blowout ocular frx with entrapment can wait 48hrs to see opth outpt
Contraindicated in frostbite
Massaging
Leg affected in stroke what artery
Anterior, coveres top and middle cleft of brain
Arm is middle
Large gums side in seizure pt from
Phenytoin
Neuroleptic malignant syndrome tx
Benzos
Perforated eardrum tx
Discharge and follow up
If obvious signs of infection oral amox
Postpartum vaginal bleeding tx
Conjuagted esteogen
Food Bug causes preterm labor
Listeria
Kid with lower extrmitiy paralysis nl CSF DDX
Tick paralysis
Foodboarne bacteria cause illness via preformed toxin
Bacillus
G tube fell out less than 4 weeks new tx
Admit for abx and monitor for peritonitis
Labs ass with heat stroke
Elevated LFTs
Peds code epi dose
0.1 mg/kg
What ekg finding supprst VT
Fusion beats
Dilated and fixed pupil where is the bleed
Putamen
Rocky mountain fever describe rash
Centripetal
Kid fall on bike handle comes in with vomiting dx
Doudenal hematoma
St depressions in V1 and V2 with cp dx and tx
STEMI posterior
Cath
Transplant rejections options
Hyperacute, acute, chronic
Delta for comprtment syndrome
30 or lower
Sudden shortness of breath after diving woth rapid ascent dx
Pneumo more common than embolis
HIV lobar penoumnia bug
Strep pneumo
Post flu pneumonia bug most likely
Strep pneumo
Most common macrocytic anemi
Pernicous/ b12 and folate def
Bacterial meminigits glucose and protein
Glucose low
Protein high
Viral infection in kid, then HF sx what test and dx
Echo
Myocarditis
Colorado tock fever vs ehrlichiosis
Colorado biphasic fever
Erhlichosis abnl labs
Femur frx concerning for elserly abuse
Midshaft
Most common cause of vertigo
BBPV
Pericarditis s/p MI dx
Dressler syndrome if one to sveral months out
Pyloric stenosis lab abnl
Hypochloremic hypokalemia alkalosis
Back pain, blood in urine but UA positive for blood but no RBCs dx and mech
Rhabdo
Increase calcium in cells
Acute mountain sickness elevation onset
6500 ft
Smallpox rash first sign
Intraorao enanthem
Forehead rash starts after as macules
HIV prophylaxis best if ststted when
2hrs post
Elevated magnesium tx
Fluids for vasodilation
Lasix to help excretion
Calcium for arythmias
Broken nose dows not need abx
Mono test is called a
Heterophile test
Hypithermia tx
Warm the core
Bleeding fistula not responding to compression tx
Suture
Gasoline exposire managmenet
Obs and cxr
AML presenting with fluid overload from white cells tx
Chemo
Afrin is
Oxymetazoline
Stridor not is resp ditress next step
Xray to dx
Febrile but bormal heart rate can be cause by what bug
Samanella typhi
Uganda bloddy diarrhea bug
Ebola
Scorpion clincal signs
Hyerpsalivate
Got the jits
Gold standard for malrotaion testing
Upper GI
Meneire vs labrynthitis dx
Meneire multiple episodes
Labrynth only one
Post LP headsche risk factors
Large bore (20 guage), multiple attemots, cutting needle
Isolated peripheral nerve issue testing
Electromyelogrpahy
Old guy with prostatist tx
Cipro (not cef amd doxy not sexually)
MI most likely need transvenoys pacing
Anterior do to more like unstable
SBP bug causes
E coli
Kleb, prtoteus, entercoccus, strep pneumo, pseudomonas
Bullseye rash isolated rahs name
Erythema migrans
Multiforme is multiple rashes
Leading tox morbidity and mortalitiy
CO
Deprecompression sickness can happen when
Minutes to hours
Type 1 vs 2 depcomoresions sickness
1 - joints and skin
2 - lung and brain
Lithium causes thyroid issue
Hypothyroid
Premie comes back woth poor feeding, tachy, fever
Air in intestines/ necrotizing
Tx helps COPD mortslity
Oxygen
Cerebellar stroke test that would find cause
Echo show heart and aortic arch
Carotids dont feed posterior brain
Velvety vaginal warts is dx
Syphilus
Cancer pleural effusion same profile as infectious
Hr and BP goal for aortic dissection
HR<60
BP 100-120
Untavle pepvic frx with neg fast next step
IR
Most common sx aortic dissection
CP
Indications for hyperbaric for CO
Neuro sx inculding syncope
Hydrocarbon huffing caridact arrest tx
Esmolol
Steve johnson vs TEN
TEN is worse
Tx for MAC infxn
Azithromycin or clarithromycin
And rifabutin and ethambutol
TTP vs ITP
TTP effects everything and tx woth olasma exchange
ITP plts abd IVIG
Glaucoma eye drops
Timolol
Apraclonidine
