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Guidelines > 13 June > Flashcards

13 June Flashcards

1
Q

Hemodynamically stable and wide complex and narrow complex tachycardia

A

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

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2
Q

Know the difference between polymyositis and polymyalgia rheumatica

A

Creatinine kinase and other muscle enzymes are elevated in polymyositis as well as ESR, muscles enzymes are normal in polymyalgia rheumatica

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3
Q

What is the cause of transient tachypnea of the newborn

A

Delayed reabsorption and clearance of lung fluid

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4
Q

According to UWorld who should get a VCUG for pediatric patients

A

Recurrent febrile UTIs or a febrile UTI by an organism other than E. Coli

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5
Q

How to avoid uric acid kidney stones

A

Urine alkalinization by potassium citrate

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6
Q

Describe the gait of Parkisonsons disease

A

Shuffling, hypokinetic gait

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7
Q

Does Touretty syndrome movements stop when patients focus like when they play a musical instrument?

A

Yes!

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8
Q

Describe a breath holding spell and what are they associated with

A

Episode of cyanosis, loss of conciousness, patients is awake after a few seconds, acts normally then.

Associated with normal development

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9
Q

What is so special about lung consolidation

A

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

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10
Q

What are the different pH of pulmonary effusion

A

Normal pleural pH is 7.60
Transudative have 7.40 to 7.55
Exudative have 7.30 to 7.45

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11
Q

What test can confirm venous valve insufficiency

A

Duplex US

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12
Q

Most common cause of sudden cardiac arrest in patients who just had an MI

A

Re entrant ventricular arrhythmia

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13
Q

In primary amenorrhea eval, what do you do next when FSH is low?

A

Check prolactin and serum TSH

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14
Q

What if TSH and prolactin are normal?

A

It is then functional hypothalamic amenorrhea

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15
Q

What is basophilic stippling associated with

A

Alcoholism (megaloblastic anemia), lead toxicity, thalassemia

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16
Q

First step when IUFD is suspected

A

Abdominal US to determine fetal heart rate

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17
Q

What is retroperitoneal lymphadenopathy a potential symptom of?

A

Testicular cancer

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18
Q

Most common bugs that cause acute bacterial rhinosinusitis

A

Most common is hemophilus non typeable, next 2 is a tie between Group A Strep and Moraxalla

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19
Q

Findings of euthyroid sick sinus syndrome

A

Only significant findings is low T3, hence its other name is low T3 syndrome

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20
Q

Unique adverse effect of OCPs

A

Cervical cancer

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21
Q

Explain aromatase deficiency and its classic presentation

A

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

22
Q

What fetal syndrome classically associated with virilization in mother during pregnancy

A

Placental aromatase deficiency

23
Q

Treatment of PID

A

Thurd gen cephalosporin + Azithro or doxy

24
Q

What is supravavlular aortic stenosis associated with?

A

Williams syndrome

25
Q

First step to do when there is spiked T waves in setting of hyperkalemia?

A

Give calcium gluconate

26
Q

6 month old girl with a to and fro murmur and persistent infection, what is the diagnosis?

A

She has PDA, persistent infections cause prostaglandins release leading to a murmur

27
Q

52 year old assymptomatic man wanting to start exercising, what is the best next step?

A

Exercise stress test

28
Q

How do you know when an antipsychotic is in the long acting form?

A

Has decanoate in its name, like Haldol Decanoate

29
Q

What does NF1 include and what is it inheritance pattern?

A

Autosomal dominant:

  1. Cafe au lait
  2. Cutaneous neurofibromas
  3. Optic glioma
  4. Lisch nodules
  5. Pheochromocytoma
30
Q

Unqiue drug used for hypertensive encephalopathy

A

Nitroprusside

31
Q

Most common cause of post partum fever

A

Endometritis

32
Q

Most common bacteria causing endometritis

A

Poly microbial, aerobic and anaerobic

33
Q

How long does post partum blues last for?

A

2 weeks only

34
Q

Bruning and peeling aroela with bright red nipples for a breast feeding mother, what is the dx and what is the next best step

A

Candida infection, examine the baby’s mouth

35
Q

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?

A

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

36
Q

Systemic diseases that increase the risk of spontaneous abortion

A

Diabetes, chronic renal disease and lupus

37
Q

Screening guidelines 2 points for pregnant women

A
  1. Universal screening between 24 and 28 weeks gestation

2. Women with risk factors should be screened on their first visit

38
Q

What do we need to know about mitral valve prolapse and its treatment?

A

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

39
Q

What do the following lab findings show:

Hg 9.1, MCV: 72, serum ferritin: normal, HB electrophoresis normal

A

Alpha thalessemia trait

40
Q

Most common pregnancy complication for a morbidly obese woman?

A

HTN and pre eclampsia

41
Q

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?

A

Inability to control BP, oligouria, LFTs x2 normal limit, eclampsia, persistent CNS symptoms, non reassuring fetal surveillance AND thrombocytopenia < 100,000

42
Q

Most significant chronic disease that increases the likelihood of pre eclampsia?

A

Chronic renal disease

43
Q

Best test to check for fetal anemia?

A

Middle cerebral artery peak systolic velocity

44
Q

Explain the phenomenon and pathogenesis of fetal hydrops fetalis

What are the 2 disease caused by Rh sensitization

A

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

45
Q

Most common cause of fetal demise in a 30 week gestation woman?

A

Undiagnosed poorly controlled diabetes

46
Q

What do you use to induce labor?

A

Misoprostol

47
Q

What are the different stages of labor and what are they marked by

A
  1. First stage, onset of contractions to 10 cm dilation
  2. Second, Fetal expulsion
  3. 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

48
Q

Duration of active and latent phase

A

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

49
Q

What is the best next step when there is secondary arrest of dilation

A

Amniotomy

50
Q

Strongest association of umbilical cord prolapse

A

Fetal positioning, especially a backup transverse lie

51
Q

Cut off for PPROM management

A

34 weeks

Guidelines (8 decks)

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