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4/10 Flashcards

1
Q

sternal clicking followed by CABG

A

sternal dehiscence - requires surgical fixation

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2
Q

TB treatment causing anemia

A

isoniazid interferes with RBC production - should give B6 (pyridoxine)

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3
Q

treatment of alcoholic seizures

A

lorazepam - intermediate acting benzo

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4
Q

pseudoachalasia

A

narrowing in the esophagus that looks like achalasia but is caused by malignancy

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5
Q

monochorionic twins are at risk for….

A

twin-twin transfusion syndrome

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6
Q

chronic hypertension in pregnancy

A

before 20 weeks, two measurements taken 4 hours apart

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7
Q

risk with hypertension in pregnancy

A

placental dysfunction from thickened vessels that can cause preterm labor

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8
Q

factors favoring albuminuria in diabetic patient not cause by diabetic nephropathy

A

onset of proteinuria less than 5 years after onset, urine sediment, 30% reduction of GFR after starting ACEi

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9
Q

initial evaluation of mixed urinary incontinece

A

voiding diary - to classify dominant type and determine treatment

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10
Q

risk of infection with atopic dermatitis

A

can have superimposed infection due to underlying inflammation

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11
Q

painful vesicles with an erythematous base

A

HSV

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12
Q

dehydrated patient with high urine sodium and orthostatic hypotension

A

diuretic abuse

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13
Q

respiratory features of CF

A

chronic sinus infections, nasal polyps, bronchiectasis, digital clubbing

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14
Q

oxygen lab values in methemoglobin

A

o2 sat shows 85% because it absorbs light differently, PaO2 shows normal because it only measures unbound 02
- does not improve with supplemental oxygen

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15
Q

treatment of methomaglobin

A

methylene blue

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16
Q

most common cause of aortic dissection

A

systemic hypertension

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17
Q

EKG finding in pericardial effusion

A

electrical alterans

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18
Q

actinic keratosis can lead to…

A

squamous cell carcinoma

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19
Q

treatment of pulmonary hypertension due to LV failure

A

ACEi and diuretic

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20
Q

signs of congenital syphilis

A

copious nasal discharge, maculopapular rash on feet and buttocks that desquamates, abnormal long bone xrays

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21
Q

binge eating followed by compensatory behavior

A

bullemia

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22
Q

treatment for ITP in kids

A

usually self resolves - advance to treatment if there is mucosal bleeding

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23
Q

screening for AAA

A

65-75 ultrasound with smoking history

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24
Q

migraine prevention meds

A

beta blockers, tricyclics, divalproex, topirimate

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25
Q

colonoscopy in IBD

A

10 years after diagnosis then every 1-3 years

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26
Q

seizure in COPD patient

A

caused by CO2 retention

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27
Q

febrile illness after syphilis treatment

A

JH reaction caused by release of spirochetes

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28
Q

cause of HIV dementia

A

macrophage induced neuronal damage

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29
Q

Lambert Eaton

A

autoantibodies against presynaptic calcium channels

- proximal muscle weakness, reduced tendon reflexes and autonomic dysfunction

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30
Q

recommendation to reduce calcium stones

A

decreased sodium intake (sodium increases calcium excretion causing stones

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31
Q

timing of Rh administration

A

in a negative mother at 28-32 weeks, after abortion or after birth if baby is positive

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32
Q

infection timing after transplant

A
  • less than one month = bacterial from operation
  • 1-6 months = opportunistic pathogens (CMV)
  • more than 6 months = same as general pop
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33
Q

hypotension after epidural

A

caused by venous pooling and vasodilation

34
Q

medications that exacerbate anaphylaxsis

A

NSAIDS or beta blockers (mast cell activation or alpha activation)

35
Q

definition of second stage arrest

A
  • 3-4 hours of pushing in primip

- 2 hours of pushing in multip

36
Q

cause of endometrial hyperplasia

A

unopposed estrogen exposure

37
Q

first step in evaluation of precocious puberty

A

bone age (if it correlates - it is likely benign)

38
Q

sunburst pattern and codman triangle

A

osteosarcoma

39
Q

periosteal reaction with onion skinning

A

ewing sarcoma

40
Q

congenital infant hypothyroid

A

apathy, weakness, abdominal distension, large tongue, sluggish movement and hernia

41
Q

treatment for urge incontinence

A

antimuscarinics (oxybutynin)

42
Q

most common symptom of sickle trait

A

hematuria

43
Q

treatment of alcoholic with altered mental status

A

glucose and thiamine

44
Q

causes of acute erosive gastropathy

A
  • aspirin - decreases prostaglandin
  • cocaine - vasoconstriction
  • alcohol - direct injury
45
Q

treatment of moderate to severe rhinitis

A

antihistamine and inhaled steroid

46
Q

how does a pharm stress test work

A

give adenosine to maximally dilated all vessels - affected vessels can dilate any further

47
Q

features of Felty syndrome

A
  • Rheumatoid arthritis
  • neutropenia
  • splenomegaly
48
Q

presbycusis

A

age related hearing loss - can also have tinnitus

49
Q

features of Menieres disease

A

fullness, vertigo, tinnitus, hearing loss

- cause = accumulation of endolymph

50
Q

type of gout associated with hypercalcium

A

pseudogout

51
Q

test for vesicovaginal fistula

A

bladder dye

52
Q

tenderness to gentle percussion over back in IV drug user

A

osteomyelitis

53
Q

most common heart defect in Edwards syndrome

A

VSD

54
Q

cause of cutaneous flushing after giving niacin

A

prostaglandin related reaction

55
Q

green drainage after chest tube placement in MVA

A

esophageal rupture (gastric contents)

56
Q

seizures in GI illness in children

A

Shigella

57
Q

schizotypal vs schizoid

A 
typal = like schizophrenics
oid = loner types
58
Q

drug of choice in PBC

A

ursodeoxycholic acid - should be started right away

- most will eventually need a liver transplant

59
Q

CSF in GBS

A

elevated protein, all else normal

60
Q

when to PCI

A

within 12 hours of symptom onset, with 90 minutes of medical contact

61
Q

DIC and seizures in patient after birth

A

may be amniotic embolus -

62
Q

most common cause of pneumonia in CF

A

s aureus in young - followed by pseudomonas in old

63
Q

disease causing common VDRL false positive

A

antiphospholipid antibody

64
Q

medication to reduce pregnancy risk in APS

A

LMWH

65
Q

medications causing hemolysis in G6PD

A

dapsone, primaquine, bactrim

66
Q

jaundice, light stools and dark urine in 2-3 week old infant

A

biliary atresia

67
Q

most common cause of stroke

A

hypertension

68
Q

confirmatory test for preeclampsia

A

urine protein to creatinine ratio

69
Q

only contraindications to giving vaccines

A

anaphylaxis, unstable neurological disorders, and encephalopathy (not seizures)

70
Q

cause of vertigo after head illness

A

vestibular neuritis

71
Q

electrolyte change after treating COPD

A

beta agonist causes potassium shift into cells leading to hypokalemia

72
Q

bladder problems, neurological changes and no reflexes after aortic dissection

A

anterior spinal artery infarction

73
Q

calciphylaxis

A

usually in end stage renal disease

  • nodules that can become necrotic
  • high PTH and hyperphosphatemia
  • calcium can be normal
74
Q

fever after antipsychotic

A

NMS - dose independent reaction

75
Q

treatment for cancer pain

A

short acting opioid - can use longer if ineffective

76
Q

treatment of septic arthritis in addition to vancomycin

A

need to cover gram negative - ceftriaxone

77
Q

cause of pityriasis versicolor

A

malassezia globosa - budding yeast - spaghetti and meatballs

78
Q

preferred first line in treatment of fibromyalgia

A

tricyclic antidepressants

79
Q

vesicular rash in auditory canal

A

herpes zoster

80
Q

no urinating after giving birth

A

pudendal nerve damage or bladder atony after epidural

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