13 June Flashcards
Hemodynamically stable and wide complex and narrow complex tachycardia
Look for fusion beats, if there are fusion beats, its Vtach, treat with IV amiodarone, if there are no fusion beats its SVT, do carotid message, vagal maneuvers and if it fails do IV adenosine
Know the difference between polymyositis and polymyalgia rheumatica
Creatinine kinase and other muscle enzymes are elevated in polymyositis as well as ESR, muscles enzymes are normal in polymyalgia rheumatica
What is the cause of transient tachypnea of the newborn
Delayed reabsorption and clearance of lung fluid
According to UWorld who should get a VCUG for pediatric patients
Recurrent febrile UTIs or a febrile UTI by an organism other than E. Coli
How to avoid uric acid kidney stones
Urine alkalinization by potassium citrate
Describe the gait of Parkisonsons disease
Shuffling, hypokinetic gait
Does Touretty syndrome movements stop when patients focus like when they play a musical instrument?
Yes!
Describe a breath holding spell and what are they associated with
Episode of cyanosis, loss of conciousness, patients is awake after a few seconds, acts normally then.
Associated with normal development
What is so special about lung consolidation
Literally the only lung pathology that has increased breath sounds, and it has increased tactile fremitus, nothing else has an increase in either of these properties
What are the different pH of pulmonary effusion
Normal pleural pH is 7.60
Transudative have 7.40 to 7.55
Exudative have 7.30 to 7.45
What test can confirm venous valve insufficiency
Duplex US
Most common cause of sudden cardiac arrest in patients who just had an MI
Re entrant ventricular arrhythmia
In primary amenorrhea eval, what do you do next when FSH is low?
Check prolactin and serum TSH
What if TSH and prolactin are normal?
It is then functional hypothalamic amenorrhea
What is basophilic stippling associated with
Alcoholism (megaloblastic anemia), lead toxicity, thalassemia
First step when IUFD is suspected
Abdominal US to determine fetal heart rate
What is retroperitoneal lymphadenopathy a potential symptom of?
Testicular cancer
Most common bugs that cause acute bacterial rhinosinusitis
Most common is hemophilus non typeable, next 2 is a tie between Group A Strep and Moraxalla
Findings of euthyroid sick sinus syndrome
Only significant findings is low T3, hence its other name is low T3 syndrome
Unique adverse effect of OCPs
Cervical cancer
Explain aromatase deficiency and its classic presentation
Adolescent girl with delayed puberty, has high testosterone levels represented by increased hair distribution, osteoporosis and clitoromegaly, ovaries on US are polycystic due to high concentration of gonadotrophins.
At birth they can have ambiguous genitilia and their mothers during birth can experience virilization
What fetal syndrome classically associated with virilization in mother during pregnancy
Placental aromatase deficiency
Treatment of PID
Thurd gen cephalosporin + Azithro or doxy
What is supravavlular aortic stenosis associated with?
Williams syndrome
First step to do when there is spiked T waves in setting of hyperkalemia?
Give calcium gluconate
6 month old girl with a to and fro murmur and persistent infection, what is the diagnosis?
She has PDA, persistent infections cause prostaglandins release leading to a murmur
52 year old assymptomatic man wanting to start exercising, what is the best next step?
Exercise stress test
How do you know when an antipsychotic is in the long acting form?
Has decanoate in its name, like Haldol Decanoate
What does NF1 include and what is it inheritance pattern?
Autosomal dominant:
- Cafe au lait
- Cutaneous neurofibromas
- Optic glioma
- Lisch nodules
- Pheochromocytoma
Unqiue drug used for hypertensive encephalopathy
Nitroprusside
Most common cause of post partum fever
Endometritis
Most common bacteria causing endometritis
Poly microbial, aerobic and anaerobic
How long does post partum blues last for?
2 weeks only
Bruning and peeling aroela with bright red nipples for a breast feeding mother, what is the dx and what is the next best step
Candida infection, examine the baby’s mouth
A young female recently had a D&C done for termination of a pregnancy and comes to the clinic after 4 days with fever, spotting with scant blood in the vagina and abdominal discomfort. US shows 8 mm endometrial strip. What is the diagnosis?
Classic case of uterine perforation. Retained products of conception would not be the answer since that would cause a lot of bleeding and septic abortion
Systemic diseases that increase the risk of spontaneous abortion
Diabetes, chronic renal disease and lupus
Screening guidelines 2 points for pregnant women
- Universal screening between 24 and 28 weeks gestation
2. Women with risk factors should be screened on their first visit
What do we need to know about mitral valve prolapse and its treatment?
Most women are asymptomatic, but those that develop chest pain, palpitations and other symptoms either before or during pregnancy can be treated with beta blockers
What do the following lab findings show:
Hg 9.1, MCV: 72, serum ferritin: normal, HB electrophoresis normal
Alpha thalessemia trait
Most common pregnancy complication for a morbidly obese woman?
HTN and pre eclampsia
There is a fine line in expectant management of pre eclampsia and delivery in case it occurs very early in pregnancy. What are the indications for immediate delivery?
Inability to control BP, oligouria, LFTs x2 normal limit, eclampsia, persistent CNS symptoms, non reassuring fetal surveillance AND thrombocytopenia < 100,000
Most significant chronic disease that increases the likelihood of pre eclampsia?
Chronic renal disease
Best test to check for fetal anemia?
Middle cerebral artery peak systolic velocity
Explain the phenomenon and pathogenesis of fetal hydrops fetalis
What are the 2 disease caused by Rh sensitization
Hydrops fetalis is characterized by fluid in the organs of the fetus due to decreased protein production by the liver, can consist of pericardial effusion, pleural effusion, ascites, can easily be seen in US.
2 disease caused by Rh sensitization are hydrops fetalis and fetal erythroblastosis in which there is destruction of the fetal RBCs by Anti D IgG. In that case amniotic fluid has increased levels of bilirubin
Most common cause of fetal demise in a 30 week gestation woman?
Undiagnosed poorly controlled diabetes
What do you use to induce labor?
Misoprostol
What are the different stages of labor and what are they marked by
- First stage, onset of contractions to 10 cm dilation
- Second, Fetal expulsion
- Third, placental expulsion
First is characterized by active and latent phase, the cut off for them is 6 cm, that’s when active phase begins
Duration of active and latent phase
Latent phase is prolonged if more than 20 hours in nulliparous and 14 hours in multiparous, active phase is usually around 3 or 2 hours for multiparous and nulliparous
What is the best next step when there is secondary arrest of dilation
Amniotomy
Strongest association of umbilical cord prolapse
Fetal positioning, especially a backup transverse lie
Cut off for PPROM management
34 weeks
