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Guidelines > 11 June > Flashcards

11 June Flashcards

1
Q

What to look for when thinking MDD

A

Look for psychotic features, treatment is different as you need to add anti psychotics

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2
Q

What are the 2 primary complications of symptom onset of aortic dissection and how to differentiate between them

A

Aortic insufficiency and pericardial effusion, in pericardial effusion there is JVD symptoms and symptoms of right sided failure whereas aortic insufficiency there is predominantly pulmonary edema

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3
Q

Next step in single metastatic tumor at the gray white junction in the brain?

A

Surgical resection

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4
Q

Complicated pyelo in a pediatric patient next step

A

Abx and renal and bladder US

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5
Q

Varicella post exposure prophylaxis

A

Varicella vaccine if immunocompetent, if not varicella Ig

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6
Q

What blood lead levels warrant chelation therapy

A

> 44

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7
Q

NEXT step when suspected nephrolithiasis

A

Abdominal and pelvis US or NON CONTRAST spiral CT

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8
Q

Abnormal uterine bleeding in a 14 year old most probable cause

A

Hypothalamic pituitary axis immaturity, in the question the patient had heavy bleeding

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9
Q

Major toxicity of mycophenolate

A

bone Marrow suppression (myco for marrow, m for m)

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10
Q

Major toxicity of azathiopurine

A

Diarrhea, leukopenia and hepatotoxicity

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11
Q

Major toxicity of cyclosporine

A

Neurotoxicity, nephrotoxicity, hyperkalemia, bone marrow supression, gym hypertrophy, HTN, tremor, hirsutism

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12
Q

Major toxicity of tacrolimus

A

Same as cyclosporine except for hirsutism and gum hypertrophy

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13
Q

Ambiguous genitila in CAH

A

Only ambiguous in girls

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14
Q

Another name of supraventricular tachycardia and what is its tx in stable and unstable patients?

A

Narrow complex tachycardia, stable patients vagal maneuvers or adenosine, unstable pts -> synchronized cardioversion

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15
Q

Most common childhood leukemia and what is the presentation

A

ALL: lymphadenopathy, hepatosplenomegaly, fever, anemia, leukocytosis/leukopenia, bone pain, night sweats, chills, weight loss, thrombocytopenia leading to bruising

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16
Q

How to differentiate aplastic anemia from ALL

A

Aplastic anemia does not cause fever or pain

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17
Q

What disease do we see Auer rods in?

A

AML, presents more acutely than CML

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18
Q

Tests to confirm Hep C

A

Serology and PCR

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19
Q

Transposition of great vessels associated with?

A

DiGeorge

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20
Q

Tetralogy of Fallot associated with?

A

Down syndrome or DiGeorge

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21
Q

What is the name of the pulseless disease and what are its symptoms

A

Takayasu arteritis, differences in BP between both arms

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22
Q

Most important risk factor for abdominal aortic aneurysm expansion

A

Size more than 5.5 cm, rapid expansion and active smoking

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23
Q

Nephrotic syndrome puts the patient at risk for what

A

Thromboembolism and atherosclerosis

24
Q

Untreated giardia infection complication?

A

Lactose intolerance

25
Q

Tx for metastatsis of the cancer to the bone

A

Usually results in hypercalcemia for which the tx is bisphosphonates, for prostate cancer it is radiation

26
Q

Whats the difference between Waldenstorm macroglobulinemia, MM and monoclonal gamoopathy of undetermined significance

A

Waldenstorm has a single Ig spike usually of IgM, MM has spikes of all Igs, monoclonal usually has a spike in only one other than IgM (like IgG or IgE etc) but it does not cause hyperviscosity syndrome and stuff like Waldenstorm causes

27
Q

Symptoms of Waldenstorm macroglbulinemia

A

Hepatosplenomegaly, lymphadenopathy, hyper viscosity syndrome, neuropathy, bleeding, Roleoux formation

28
Q

Ideal respiratory settings for intubation

A
  1. Low tidal volume ventilation - 6 ml/kg
  2. SpO2 more than 88%,
  3. FiO2 of less than 0.6
29
Q

Most common complication of sickle cell trait

A

Hypothenuria and hematuria

30
Q

Whats different about vascular dementia

A

It presents with sudden change in executive function and mild memory loss, like within an year

31
Q

2 tests to check for CGD

A

Dihydrorhodamine test and nitroblue tetrazoleum test

32
Q

2 tests to check for CGD

A

Dihydrorhodamine test and nitroblue tetrazoleum test

33
Q

Most common cause of acute cervical lymphadenitis in children?

A

Staph aureus

34
Q

What changes are seen in methemoglobulinemia

A

Cyanosis, oxidized iron binds to O2 more tightly, normal PaO2 since that is the O2 in plasma, the O2 bound to Hb is tightly held causing cyanosis, pulse oximetry shows reduced reading since the oxidised Fe3+ changes hemoglobin structure and the light absorbed by it.

PaCO2 actually decreases because patients hyperventialte in cyanosis

35
Q

Difference between complicated pleural effusion and empyema

A

Both have pH less than 7.2, empyema has positive bacterial culture

36
Q

Precoccious puberty evaluation in a pediatric patient

A
  1. Measure bone age
  2. If bone age is normal, then its premature therlarche or adrenarche
  3. If bone age is advanced measure LH
  4. If LH is low, do GnRH stimulation test to see if there is an increase in LH
  5. If LH increases with GnRH or is high by itself, then it is central precocious puberty - patient require an MRI although most of the cases are idiopathic and treated with GnRH analog to make them tall
  6. If LH remains low then it is peripherap precocious puberty and a more thorough medical eval is required
37
Q

Most common cause of mastoiditis and the best next step when mastoiditis is suspected

A

Head MRI, Strep pneumo

38
Q

Explain the cardinal features of serum sickness

A

Starts 1-2 weeks after medication exposure, fever, hives (maculopapular rash) and joint pain

39
Q

Treatment of varicella zoster infection - whether its chicken pox or shingles

A

Valcyclovir

40
Q

What causes increased BP in thyrotoxicosis

A

Increased HR and inotropy, I said increased vascular resistance

41
Q

What is PSC associated with in term of antibody

A

pANCA

42
Q

Beads on a string appearence

A

PSC

43
Q 
Muddy brown cast
RBC cast
WBC cast
Fatty cast
Broad and waxy cast
Hyaline cast
A 
Muddy - ATN
RBC - Glomerulonephritis
WBC - Interstitial nephritis or pyelo
Fatty cast - nephrotic syndrome
Broad and waxy cast - chronic renal failure
Hyaline cast - normal
44
Q

Urine Na and FENA when there is ATN

A

Urine Na > 20 and FENA is >2%

45
Q

What is the buzzword for fibrocystic changes of breast on physical exam

A

Diffusely nodular breast, nodular breast etc

46
Q

Myotonic dystrophy features

A

Unable to release hand after shaking, autosomal dominant, inverted V shaped cheeks, temporal wasting, cardiac conduction abnormalities and arrythmias, testicular atrophy, insulin

47
Q

Increased DLCO

A

Asthma

48
Q

How can you differentiate between SCID and CVID

A

Depending on what lab values they give you it can be hard to distingusih, just know SCID presents in infancy, like wayyy early than CVID

49
Q

Management of CVID

A

IVIG

50
Q

Tx of reactive arthritis

A

NSAIDs

51
Q

Does asbestosis cause restrictive lung disease by itself?`

A

No, it is the collective pulmonary fibrosis due to multiple etiologies that can cause ILD, pleural calcifications on their own do not cause lung disease

52
Q

Symptoms of scarlet fever and tx

A

Pharyngeal erythema with exudate, strawberry tongue, sandpaper rash, tender lymphadenopathy, penicillin

53
Q

What is choanal atresia associated with

A

CHARGE syndrome

54
Q

Next best step when lupus is suspected

A

ANA titers

55
Q

Most common thrombophilias

A

Factor V Leiden deficiency and 2nd most common is prothrombin mutation

Guidelines (8 decks)

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