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Guidelines > 22nd June > Flashcards

22nd June Flashcards

1
Q

When is NPPV contraindicated in COPD patients

A

pH < 7.1, indication is to then intubate

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2
Q

When do you give abx to COPD patients

A

2 or more of the cardinal signs: increased cough, sputum production or increased dyspnea

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3
Q

Tx of malignant hyperthermia

A

Dantrolene

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4
Q

Explain the process of management if a newborn starts emesis within 24 hours of life

A

Feeds should be discontinued, nasogastric tubes should be placed for decompression and the neonate stabilized. After that the first step to do is abdominal x ray to look for air under the diaphragm, if that is there then next step is surgery. If not then x ray shows air or no air in the bowel. If there is no air in the bowel then the differential is hirschsprung or meconium ileus, gastrogragin enema is performed as it is diagnostic and therapeutic for meconium ileus.

If NG tube is misplaced then its malrotation, if double bubble sign then dudenal atresia

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5
Q

What is duodenal atresia associated with?

A

Down syndrome

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6
Q

First step when beckewith wideman syndrome is suspected in a newborn

A

Look out for hypoglycemia

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7
Q

First step if gallstone pancreatitis is suspected? Second step?

A

First is to do RUQ US, if no glasstones are seen then do ERCP

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8
Q

What are the causes of protraction of active phase of labor

A

Passage, passenger, power, so cephalopelvic disproportion, macrosomia, inadequate strength of contraction, fetal malposition

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9
Q

Which phase of the labor is affected by epidural anesthesia usually?

A

Second stage of labor, first stage is not affected

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10
Q

Acamprosate

A

Used for alcohol cravings, second line, avoid in renal impariment

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11
Q

What is the next step in emphysematous cholecystitis

A

Emergent cholecystectomy, broad spectrum IV antibiotics

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12
Q

In utero fetal bradycardia is defined by? Tachycardia

A

HR < 110, tach is above 160

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13
Q

Basic medical workup of new onset psychosis first step

A

UDS

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14
Q

Hemodynamically stable patient with abdominal pain presents to clinic, positive urine pregnancy test but US does not show anything in the uterus, best next step?

A

Transvaginal US, have to have a diagnosis of ectopic before she can be sent for surgery

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15
Q

Interval between starting MAOI and stopping SSRI, waht does it cause?

A

2 weeks, serotonin syndrome

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16
Q

Hallmark difference between primary ciliary diskinesia and CF in pediatric patients

A

Normal growth in primary ciliary dyskinesia

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17
Q

Know the exact definition of preeclampsia

A

Systolic <140, diastolic <90, proteinuria and/or end organ damage, so proteinuria is not necessary

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18
Q

3 medication of preeclampsia HTN tx and which one is PO

A

Hydralazine, labetalol, nifedipine, with the last one being PO

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19
Q

The first step for gastric cancer is always

A

Endoscopy

20
Q

Next step if pancreas is not seen on US

A

CT scan, NEVER DO ERCP for pancreas alone, it is done for choldeocholithiasis

21
Q

Area posterior to the testis is swollen and tender, next step in management

A

Abx, acute epididmyitis

22
Q

Most common organism causing acute epididmyitis

A

Below 35, nisseria and gonorrhea, above 35, E coli and other coliform bacteria

23
Q

Cut off for renal stone management

A

10 mm, if less than that tamsulosin and medical management, if more then surgery

24
Q

Risk factors for placenta previa

A

Prior placenta previa, c section and multiple gestations, smoking

25
Q

What symptoms are common in dysuria in post menopausal woman with estrogen deficiency

A

They can have recurrent UTIs, this does not necessarily mean they have a fistula even if they have a history of surgery

26
Q

Risk factors for placental abruption

A

Smoking, cocaine use, HTN, preeclampsia, prior hx of abruption

27
Q

Most common cause of sepsis in burn patients

A

Immediately after are gram positive such as Staph and after 5 days it is gram negatives like Pseudomonas

28
Q

What is a complication of coronary catheterization and what is the best management for it

A

Retroperitoneal hematoma, non contrast CT scan of the abdomen and pelvis

29
Q

How to differentiate viral myocarditis from acute rheumatic fever

A

Viral myocarditis presents with rhinorrhea and congestion, strep throat does not causes fever and arthritis preceding the myocarditis episode

30
Q

Contraindications to dTaP vaccine

A

anaphylaxis or encephalopathy after receiving the vaccination, seizure is not a contraindication

31
Q

When is Bordetella pertussis prophylaxis indicated?

A

Within 21 days of close contacts

32
Q

What is preverteberal calcifications specific for?

A

Abdominal Aortic aneurysm

33
Q

What has to be present to diagnose Bipolar II

A

Hypomanic episode/hx of depression, bipolar 1 can still be NOT functionally impairing

34
Q

What is necessary for depression to be present in? Bipolar I or II?

A

Bipolar II, since it has to have a hypomanic episode

35
Q

Tx of pyelo in a pregnant pt?

A

Hospitalization + ceftriaxone

36
Q

Illiotibial band syndrome

A

Overuse injury, tenderness at the lateral femoral condyle during flexion and extension

37
Q

Pes anserinus pain syndrome

A

Overuse injury, pain and tenderness over the anteromedial tibia, just below the joint line

38
Q

How do we differentiate extra renal and renal sodium losses for hyponatremia

A

If urine Na is more than 20 then it is renal loss, otherwise it is extra renal loss such as from diarrhea, vomiting etc

39
Q

What murmurs prolong with Valsalva

A

MVP and HOCM

40
Q

Upper abdominal series is the best diagnostic test for?

A

Volvulus

41
Q

Feboxustat
Probenecid
Colchicine

A

Xanithinine oxidas inhibitor, same as allopurinaol, used for gout, probenecid increases uric acid secretion by blocking its reabsorption in the renal tubules, colchicine is a short term treatment for acute gout, inhibits chemotaxis

42
Q

When are alpha adrenergic antagonist used for urinary incontinence

A

When there is uretheral outflow obstruction like ib BPH, alpha adrenergic antagonist reduce uretheral sphincter tone so it can exacerbate stress and urge incontinence

43
Q

Beta blockers that improve long term mortality

A

Metoprolol, carvedilol and bisoprolol

44
Q

What are the recommendation for HTN control

A

Age less than 60, chronic kidney disease, diabetes, goal blood pressure is <140/90, for age > 60, goal blood pressure is <150/90

45
Q

OCPs reduce risk of

A

Ovarian and endometrial cancer

46
Q

What is given to shrink uteirne fibroids?

A

Leuprolide since it decreases estrogen and causes them to shrink

47
Q

Next step in hemodynamically stable patients with penetrating injuries to the neck?

A

CT angio, injuries to the trachea, larynx, esophagus and blood vessels has to be evaluated

Guidelines (8 decks)

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