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EM R PGY2 > 1 > Flashcards

1 Flashcards

1
Q

What improves mortality hepatorenal syndrome?

A

Albumin

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2
Q

Skin ulcer lesion, joint pain and diarrhea, what dz

A

Ulcerative colitis

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3
Q

Child sickle who stroked tx ?

A

Exchange transfusion

No fibrinolytics

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4
Q

Kid with clinical picture of appy symptoms improved with abx and US unable to visualize, next step to rule out?

A

CT or MRI

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5
Q

Sinusitis indication for antibiotics

A

Worsening symptoms after initial improvement

More or equal to 10 days

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6
Q

How long for Molluscum contagion to improve

A

Months to years

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7
Q

Mallory weis vs Boerhaave presentation

A

Both tears after vomiting

Boerhavve present sick

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8
Q

Septic Pt with plum HTN what to be careful with?

A

Fluids, will increase right sided pressure and worsen right sided failure

Nitric oxides is a treatment, decrease pulm resistance and improve right failure

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9
Q

Acute myeloid leukemia with stroke symptoms what lab abnormality

A

Leukocytsis causing viscosisty

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10
Q

Conductive hearing loss causes

A

Otitis media

Wax

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11
Q

Low sodium
Neuro sx
Tx?

A

Hypertonic saline

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12
Q

Persistently hypothermic after warm blankets tx

A

Warm fluids (internal rewarming)

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13
Q

Measles rash is

A

Diffuse rash with white spots on bucks mucosa

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14
Q

Most common complaint of scuba drivers

A

Middle ear barotrauma

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15
Q

Max amount of intrathoracic blood that can be missed on CXR

A

1L

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16
Q

Acute lithium overdose management

A

Whole bowel irrigation

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17
Q

Isopropyl alcohol ingestion lab finding

A

Osmolar gap

No anion gap

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18
Q

Bronchilitis sign of impending failure

A

Increase retractions
Decrease breath sounds
Decrease responsiveness

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19
Q

Herberden nodes associated with which arthritis

A

Osteo

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20
Q

CO vs cyanide poisoning

A

Cyanide extremely high lactate

CO carboxyhemoglobin > 10% to be toxic

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21
Q

Homeless
Metabolic acidosis
Optic neuropathy
Toxin? And metabolite

A

Methanol

Formic acid

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22
Q

Snake bite with systemic signs type

A

Coral snake

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23
Q

Pneumomediastinum management

A

If isolated issue

Supportive care

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24
Q

HF exacerbation related to aortic stenosis best tx

A

Bipap

Lasix and nitro drop preload

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25
Q

Repeat dvt presentation test

A

Repeat duplex

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26
Q

Paronychia tx

A

I&d and cephalexin if immuncomp/steroids

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27
Q

Hypothyroidism associated lab abnl

A

Hyponatremia

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28
Q

Migrating arthritis
Fever
Skin lesions
Dx

A

Disseminated gonorrhea

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29
Q

Crohns exam findings

A

Full thickness bowel lesions

Abscess

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30
Q

How many does post chemo does neutropenia happen

A

7-14 days

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31
Q

Universal donor for FFP

A

AB

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32
Q

Cyanide treatment

A

Hydroxocobalamine

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33
Q

Schizoid characteristics

A

Avoids relationships

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34
Q

Routine care for sexual assault

A 
Empiric abx for sti
Hep B vaccine if not
HIV exposure meds
HPV vaccine
Emergency contraceptive
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35
Q

Contraindication methotrexate for ectopic

A

Unstable
Ruptured
Sac > 4cm
Fetal heart activity

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36
Q

Febrile infant between 30-60 days old eval

A

Urine and blood cultures to start, don’t need LP

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37
Q

Most common bugs causing food borne disease

A

Salmonella

Campy

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38
Q

Post strep glom lab finding, not antibody test

A

Decreased C3

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39
Q

Knee aspiration method

A

Anterolateral towards femur

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40
Q

Febrile kiddo for 5 days management

A

UA and PO challenge

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41
Q

Intusseception in adult tx

A

Exploratory lap

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42
Q

Kiddo with vesicles and ulcers in posterior pharynx dx and cause

A

Herpangina

Cocksakie

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43
Q

Serve malaria drug tx

A

Artesunate

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44
Q

When to medicate SVT

A

5cm from the deep system

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45
Q

Myocardial contusion post complication most likely

A

Pericardial effusion

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46
Q

Contraindication to LP

A

Vertebral trauma, overlying infection, CNS mass, spinal mass, plt 20, cogulopathy

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47
Q

Intracranial bleed BP goal

A

Systolic 140-180

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48
Q

Best test for ACL

A

Lachman better than anterior draw

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49
Q

Isolated pleural effusion with no other findings consider

A

PE

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50
Q

Bowel obstruction kid dx and tx

A

Volvulus/malrotarion

Surgery

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51
Q

Lithium toxicity due to meds

A

Hydroclorothiazide, ACEi or ARBs, NSAID

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52
Q

Viral labyrinthitis tx

A

Steroids

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53
Q

Inj ass with posterior hip dislocation

A

Acetabular frx

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54
Q

Necrotizing entercolitis tx

A

NG tube

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55
Q

G6PD def lab finding

A

Heinz bodies peripheral smear

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56
Q

New murmur, multiple joint pain, fever dx

A

Rheumatic fever

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57
Q

Ketamine dose for agitation and procedural sedation

A

1-2mg/kg IV

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58
Q

Scleroderma renal crisis UA

A

Normal

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59
Q

Highest sensitivity and specificity for gonorrhea and chlamydia

A

Vaginal or cervical PCR

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60
Q

Lab test indicative of cirrhosis

A

Thrombocytopenia

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61
Q

Type 1 hypersentiviry is

A

Anaphylaxis, hives

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62
Q

Pneumomediastinum healthy young person next step

A

Dx home

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63
Q

ST elevation in aVR and/or V1 where is MI

A

Left main

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64
Q

Rust ring tx

A

Optho follow up 24 hours

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65
Q

COPD exacerbation with prior pseudomonas infections abx choice

A

Cipro

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66
Q

Fail Romberg with eyes closed cause

A

Vestibular, need eyes

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67
Q

Recent dental extraction, severe pain dx

A

Dry socket

Acute alveolar osteitis

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68
Q

Azithromycin in HIV Pt is for

A

When CD4 count is below 50 for MAC risk

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69
Q

Most likely complication of endometriosis

A

Infertility

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70
Q

Nigerian with info def most likely cause

A

Beta thalassemia

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71
Q

Septal hematoma tx

A

I&D

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72
Q

Watery Diarrhea most likely bug

A

Rotavirus

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73
Q

Peritoneal dialysis Pt with peritonitis tx

A

Intraperitoneal abx

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74
Q

Alcoholic pneumonia abx choice

A

Azithromycin and ceftriaxone

Do not do anaerobic coverage unless abscess or empyema

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75
Q

Probable abdominal injury persistently hypotensive with negative FAST tx

A

Ex lap

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76
Q

Most combine bug for

Osteo

A

Staph

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77
Q

Loud diastolic murmur with wide pulse pressure

A

Aortic regurgitation

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78
Q

Hydrogen sulfide tx

A

Sodium nitrite

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79
Q

Serotonin syndrome antidote

A

Cyproheptadine

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80
Q

Hepatorenal syndrome histo of kidneys

A

Normal

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81
Q

HTN before 24 weeks of pregnancy dx

A

Molar pregnancy

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82
Q

Ehrlichiosis tx in child

A

Doxycycline

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83
Q

Cyanotic baby likelt cardiac defect, egg on string, but is not better with squatting dx and tx

A

Transposition of arteries

Prostaglandin E

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84
Q

Enlarged ltmph node in neck in old chacetic is and ass with

A

Virchow node

Gastric cancer

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85
Q

Ranson score ast and glucose leveks

A

250

200

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86
Q

Munchausen is also called

A

Factitious disorder

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87
Q

First symypoms aortic stenosis

A

Shortness of breath

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88
Q

Overdose diltiazem persotent hypotentsive bradycarida adter fluids, calcium and atropine tx

A

Insulin and glucose (pacing might not work)

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89
Q

Painful squishy bullae dx

A

Pemphigus vulgaris

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90
Q

Dc anaphylaxais rx beside epi

A

No others recommended

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91
Q

Post exposure pertusis adult tx

A

Azithro 500 then 250 from 2-5 days

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92
Q

Maintenance fluids kids calc

A

100 cc/kg for first 10 kg + 50 cc/kg for next 10 + 20 cc/kg for rest

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93
Q

Refractory anaphylaixs to epi on beta blocker tx

A

Glucagon, beta blocking epi

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94
Q

Sickle cell and blood in anyerior chamber avoid

A

Acetazolamide causes sickling and increase pressure

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95
Q

Leg swelling and pin no clot risk factors testing

A

D-dimer and if neg dc

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96
Q

Tx syphilis

A

Onde dose IM pencillin

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97
Q

Red and itchy tip of oenis dx and tx

A

Balantitis

Clotrimazole cream

98
Q

Most common cause chorea no genetic

A

Stroke

99
Q

Spiral frx in what age is ok

A

9 month to 3 years

100
Q

Septic with hernia nwxt step

A

Surg consult

Dont reduce will make sepsis worse

101
Q

Young adult constipated with volvulos on xray dx

A

Cecal volvulos (sigmoid is old pt)

102
Q

Radiation exposure signs of sig exposure

A

Decrease lymphocyte

Vomiting

103
Q

Mycotic aneursym cause

A

By septic emboli usualy endocarditis

104
Q

Torsade no pulse tx

A

Defib regardless of energy

105
Q

Cardiac complication f hyperthyroid

A

Cardiomyopthy > high output failure from tachy

106
Q

Fat embolism syndrome is and presents as

A

Embolism everywhere

Resp distress, altered, petechial rash

107
Q

When to give HIV pt witu PCP steroids

A

Hypoxia

PaO2 less than 70 or a-a gradient more than 35

108
Q

Neceotizing enterocolitis presents in age pts

A

First three weeks

109
Q

DVT distal when to tx

A

If symptomatic

110
Q

Fast high rate, weight loss, heat intolerance on amio dx

A

Hyperthyroid

111
Q

When to tx lobar pna with vanc and zosyn

A

Recent antibiotics or prior clx wirh staph or pseudomonas

112
Q

Ethylene glycol poisoing need supplement what

A

Thiamin and B6 (used up in metabolism)

113
Q

MS flare tx

A

Steroids (interferon is maintenance)

114
Q

Hypotensive pelvic trauma OR or IR

A

OR and pack

115
Q

Distal finger fracture what splint

A

DIP extension only

116
Q

The forst acidnbase abnl in asa od

A

Respirstory alkalosis, asa makes you breath fast

Then metabolic acidosis

117
Q

Most common hernia innwomen

A

Inguinal

118
Q

Erythema nodosum ass with

A

Strep infxn

119
Q

Side effect of prostaglandin

A

Apnea, hypotension, hyperthermia

120
Q

Febrile seizures stop at age

A

5

121
Q

Corneal ulcer abx coverage in contact wearer

A

Tobramycin

Cipro

122
Q

Elevated calcium in sarcoidosis is from

A

Macrophage production of calcitriol

123
Q

Test for severity of bleeding in placentsl abruption

A

Fibrinogen

124
Q

Most commin oresentstion of hypertrophic cardiomyopathy

A

Shortness of breath

125
Q

Young pt gum bleed and noseblleds woth petechial rash and low plt tx

A

Steroids for ITP

126
Q

Reed sternberg cells ass with what dx

A

Hodgkin lymphoma

127
Q

Minor mvc pregnant no sx next step

A

Give rhogam

128
Q

Painful red knee, with mild white count in knee, neg gram stain and neg crytsals what is it

A

Lyme or reactive arthritis

129
Q

Ct finding for cebreal venous thrombosis

A

Delta sign

130
Q

Preseptal vs orbital cellulitis

A

Not painful with movement

131
Q

Facial frx le fort numbers mean

A

1 maxilla
2 max and nose
3 max, nose and cheeks

132
Q

Glyburide is what kind of drug

A

Sulfonyurea

133
Q

Direct vs indirect ingunial hernia

A

Indirect down into scrotum

Direct into abdominal wall

134
Q

Flexion tesrdrop fracture is what

A

Unstable

135
Q

Blotchy rahs that coalesced and heat worsens it dx

A

Rheumatic fever

136
Q

10 day old, cyanosis what congentical defect

A

Transposition of great vessels

137
Q

Most common comprtment in lower leg for compartment syndrome and ass lack of function

A

Anterior

Dorsiflexion

138
Q

Viral meningitis lp

A

Some wbc, but not that high
Normal protein (bacteria is high)
Glucose is low in everything

139
Q

Esophagitis in hiv pt
CD4 is 90
Dx

A

Candida

CMV is CD4 50 or less and tend to have fever and burning pain

140
Q

Thyroid storm med order

A

Propanalol (control sympathetic hyperactivit)
PTU (or meth to prevent thryoid hormon and before iodid whoch can increase)
iodide, steroids

141
Q

DKA when to given insulin and potasium

A

K 3.5 to 5.5

142
Q

Cd4 vs cd8 organ rejection

A

4 is chrinic and 8 is acute

143
Q

Enterococcus uti abx

A

Amoxicillin, resists others

144
Q

Dissection cusijg neuro sx on what side

A

Opposite side of vessel

145
Q

Testiculr torsion tx

A

Medial to later more than 360 degrees

146
Q

Cholrine gas exposure is from im industrial setting from what

A

Chloramine (ammonia and blech mixed)

147
Q

Amox/sulbactam is what abx

A

Unysyn

148
Q

Oral infxn woth fever abx choice

A

Unasyn over augmentin

149
Q

Endometritis abx

A

Clinda and gent

150
Q

S/p FB from ear tx

A

Cipro drops and close follow up

151
Q

Concern for ludwigs next step

A

Early intubation

152
Q

Refeesing sundrome most common electrolyte abnl

A

Low phos, also loe K and Mg

153
Q

When give trtanus imminuglobin

A

If they never got their childhood series

154
Q

URI sx followed by toxic, increase work of breathing, stridor dx and cause

A

Bacterial tracheoitis

Staph

155
Q

Iron toxicity causes

A

GI sx, metabolic acidosis, liver failure

156
Q

Felon define

A

Fingertip abcess

157
Q

Left main EKG findings

A

St elevation in aVR, with depressions in inferior leads

158
Q

Tx acute dystonic rxn from new osych med

A

Benadryl or beztropine

159
Q

Thyroid storm meds mechanism

A

Steroid and propanalol peripheral conversion
PTU and meth synthesis
Iodine stored hormone

160
Q

Endometrosis tx

A

Augmentin

Or clinda and gent

161
Q

Appy size on US

A

6-7mm or greater

162
Q

Imaging for hirschprung

A

Barium enema

163
Q

Young female hearing loss dx

A

Otosclerosis

164
Q

Define presbycusis

A

Age related hearing loss

165
Q

Proststis tx length

A

4-6 weeks

166
Q

Persistent st elevations after mi and treated dx

A

Ventricular aneurysm

167
Q

Uri them comes back toxic with stridor dx

A

Bacterial tracheitis

168
Q

Prevent lyme disese after dinding tick tx

A

One dose

Doxy

169
Q

Blowout ocular frx with entrapment can wait 48hrs to see opth outpt

A
170
Q

Contraindicated in frostbite

A

Massaging

171
Q

Leg affected in stroke what artery

A

Anterior, coveres top and middle cleft of brain

Arm is middle

172
Q

Large gums side in seizure pt from

A

Phenytoin

173
Q

Neuroleptic malignant syndrome tx

A

Benzos

174
Q

Perforated eardrum tx

A

Discharge and follow up

If obvious signs of infection oral amox

175
Q

Postpartum vaginal bleeding tx

A

Conjuagted esteogen

176
Q

Food Bug causes preterm labor

A

Listeria

177
Q

Kid with lower extrmitiy paralysis nl CSF DDX

A

Tick paralysis

178
Q

Foodboarne bacteria cause illness via preformed toxin

A

Bacillus

179
Q

G tube fell out less than 4 weeks new tx

A

Admit for abx and monitor for peritonitis

180
Q

Labs ass with heat stroke

A

Elevated LFTs

181
Q

Peds code epi dose

A

0.1 mg/kg

182
Q

What ekg finding supprst VT

A

Fusion beats

183
Q

Dilated and fixed pupil where is the bleed

A

Putamen

184
Q

Rocky mountain fever describe rash

A

Centripetal

185
Q

Kid fall on bike handle comes in with vomiting dx

A

Doudenal hematoma

186
Q

St depressions in V1 and V2 with cp dx and tx

A

STEMI posterior

Cath

187
Q

Transplant rejections options

A

Hyperacute, acute, chronic

188
Q

Delta for comprtment syndrome

A

30 or lower

189
Q

Sudden shortness of breath after diving woth rapid ascent dx

A

Pneumo more common than embolis

190
Q

HIV lobar penoumnia bug

A

Strep pneumo

191
Q

Post flu pneumonia bug most likely

A

Strep pneumo

192
Q

Most common macrocytic anemi

A

Pernicous/ b12 and folate def

193
Q

Bacterial meminigits glucose and protein

A

Glucose low

Protein high

194
Q

Viral infection in kid, then HF sx what test and dx

A

Echo

Myocarditis

195
Q

Colorado tock fever vs ehrlichiosis

A

Colorado biphasic fever

Erhlichosis abnl labs

196
Q

Femur frx concerning for elserly abuse

A

Midshaft

197
Q

Most common cause of vertigo

A

BBPV

198
Q

Pericarditis s/p MI dx

A

Dressler syndrome if one to sveral months out

199
Q

Pyloric stenosis lab abnl

A

Hypochloremic hypokalemia alkalosis

200
Q

Back pain, blood in urine but UA positive for blood but no RBCs dx and mech

A

Rhabdo

Increase calcium in cells

201
Q

Acute mountain sickness elevation onset

A

6500 ft

202
Q

Smallpox rash first sign

A

Intraorao enanthem

Forehead rash starts after as macules

203
Q

HIV prophylaxis best if ststted when

A

2hrs post

204
Q

Elevated magnesium tx

A

Fluids for vasodilation
Lasix to help excretion
Calcium for arythmias

205
Q

Broken nose dows not need abx

A
206
Q

Mono test is called a

A

Heterophile test

207
Q

Hypithermia tx

A

Warm the core

208
Q

Bleeding fistula not responding to compression tx

A

Suture

209
Q

Gasoline exposire managmenet

A

Obs and cxr

210
Q

AML presenting with fluid overload from white cells tx

A

Chemo

211
Q

Afrin is

A

Oxymetazoline

212
Q

Stridor not is resp ditress next step

A

Xray to dx

213
Q

Febrile but bormal heart rate can be cause by what bug

A

Samanella typhi

214
Q

Uganda bloddy diarrhea bug

A

Ebola

215
Q

Scorpion clincal signs

A

Hyerpsalivate

Got the jits

216
Q

Gold standard for malrotaion testing

A

Upper GI

217
Q

Meneire vs labrynthitis dx

A

Meneire multiple episodes

Labrynth only one

218
Q

Post LP headsche risk factors

A

Large bore (20 guage), multiple attemots, cutting needle

219
Q

Isolated peripheral nerve issue testing

A

Electromyelogrpahy

220
Q

Old guy with prostatist tx

A

Cipro (not cef amd doxy not sexually)

221
Q

MI most likely need transvenoys pacing

A

Anterior do to more like unstable

222
Q

SBP bug causes

A

E coli

Kleb, prtoteus, entercoccus, strep pneumo, pseudomonas

223
Q

Bullseye rash isolated rahs name

A

Erythema migrans

Multiforme is multiple rashes

224
Q

Leading tox morbidity and mortalitiy

A

CO

225
Q

Deprecompression sickness can happen when

A

Minutes to hours

226
Q

Type 1 vs 2 depcomoresions sickness

A

1 - joints and skin

2 - lung and brain

227
Q

Lithium causes thyroid issue

A

Hypothyroid

228
Q

Premie comes back woth poor feeding, tachy, fever

A

Air in intestines/ necrotizing

229
Q

Tx helps COPD mortslity

A

Oxygen

230
Q

Cerebellar stroke test that would find cause

A

Echo show heart and aortic arch

Carotids dont feed posterior brain

231
Q

Velvety vaginal warts is dx

A

Syphilus

232
Q

Cancer pleural effusion same profile as infectious

A
233
Q

Hr and BP goal for aortic dissection

A

HR<60

BP 100-120

234
Q

Untavle pepvic frx with neg fast next step

A

IR

235
Q

Most common sx aortic dissection

A

CP

236
Q

Indications for hyperbaric for CO

A

Neuro sx inculding syncope

237
Q

Hydrocarbon huffing caridact arrest tx

A

Esmolol

238
Q

Steve johnson vs TEN

A

TEN is worse

239
Q

Tx for MAC infxn

A

Azithromycin or clarithromycin

And rifabutin and ethambutol

240
Q

TTP vs ITP

A

TTP effects everything and tx woth olasma exchange

ITP plts abd IVIG

241
Q

Glaucoma eye drops

A

Timolol

Apraclonidine

EM R PGY2 (1 decks)

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