5/10 Flashcards

1
Q

Who is ECT best for

A

Depressed geriatric patients who are not eating, drinking, psychotic, or actively suicidal

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2
Q

3 systems TCA overdose involved

A
  1. CNS (seizures, coma)
  2. Anticholinergic
  3. Cardiac
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3
Q

TCA effect on myocardium

A

Inhibits fast Na channels in the His-Purkinje system and myocardium

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4
Q

Cardioprotection for TCA overdose

A

Sodium bicarb (when QRS inc. pH and extracellular sodium, deceasing drug avidity for Na channels

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5
Q

Pneuomo vaccine for high risk pt’s (not very high risk)

A

PPSV23 alone at 19-64

then normal schedule at 65

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6
Q

All pt’s w/ bilateral Carpal tunnel should be screened for

A

Hypothyroidism

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7
Q

Two common complications w/ SS trait

A
  1. Hematuria from sickling in the renal medulla

2. Isosthenuria (impaired concentrating ability)

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8
Q

What kind of Anemia does B6 def cause

A

Sideroblastic (microcytic but elevated total serum iron and dec TIBC)

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9
Q

2 Tet murmurs

A
  1. Harsh systolic ejection murmur at left upper sternal border
  2. Single S2 (from pulmonary stenosis)
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10
Q

Tx for any pt post stent placement

A

Dual anti platelet (aspirin and P2y12 receptor blocker)

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11
Q

Big B and T cell markers

A

B = CD19

T=CD3

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12
Q

What causes B-cell dysfunction in SCID

A

Absent T cells

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13
Q

What kids should get a renal US w/ UTI

A
  • All under 24 months (when febrile)
  • Recurrent in any age
  • Fam hx or poor response to Ab
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14
Q

Typical x-ray of supracondylar fracture of the humerus

A

Triangular anterior fat pad and posterior fat pad (lucent on X-ray)

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15
Q

Two late findings of compartment syndrome

A

Pulselessnes and paralysis

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16
Q

Red flags for orbital cellulitis vs preseptal

A
  1. Decreased visual acuity
  2. Diplopia
  3. Ophthalmoplegia
  4. Proptosis
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17
Q

Hyperandrogenism during pregnancy usually from

A

Ovarian masses (Luteoma - bilateral and solid)

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18
Q

Bilateral theca lutein cyst ass w/

A

Molar pregnancy and multiple gestation

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19
Q

First step for suspected VAP, then what?

A
  1. CXR

2. Lower respiratory tract sampling and empiric antibiotics

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20
Q

What is Enthesitis

A

Inflammation and pain at sites of tendon and ligament attachment to bone
Commonly found in AS

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21
Q

Metastatic bone pain features

A

Constant progressive pain that wakes the patient up at night

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22
Q

Common clinical features of Vasa previa

A
  • Painless vaginal bleeding that occurs with rupture of membranes
  • Fetal deterioation (sinusoidal tracing or brady)
  • Maternal vital signs unchanged as bleeding comes from fetus
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23
Q

Retinal harmartoma typical of

A

Tuberous sclerosis

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24
Q

What is primidone? what can it cause?

A

Anticonvulsant that converts phenylethylmalonamide and phenobarbital
Can cause acute intermittent porphyria

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25
Q

Acute intermittent porphyria symptos

A

Abdominal pain, neuralgic and psychiatric abnormalities

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26
Q

Anemia on methotrexate

A

Macrocytic

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27
Q

Antimitochondrial Ab for

A

Primary biliary cholangitis

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28
Q

What must be done if a patient on warfarin needs emergent surgery

A

Reversal with FFP

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29
Q

What causes itchy butt worms? tx?

A

Enterobius vermicularis

Tx is Albenazole

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30
Q

Most common neuro symptoms of HHS

A
  1. Decreased consciousness (MCC)

2. Blurred vision

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31
Q

What is positive in UC

A

p-ANCA (also see it w/ AS)

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32
Q

What causes symptoms in cardiac tamponade

A

Exaggerated shift of inter ventricular septum toward left ventricular cavity, which reduces left ventricular pre-load, SV, and cardiac output

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33
Q

Leukemoid reaction vs CML

A
  1. High LAP score
  2. Greater proportion of late neutrophil pre-cursors
  3. Lack of absolute basophilia
34
Q

Tx for complicated diverticulitis w/ abscess formation

A

CT-Guided percutaneous drainage

35
Q

Who gets nasopharyngeal carcinoma? ass w/?

A

Mediterranean and far est

Ass w/ EBV infection

36
Q

Nasopharyngeal carcinoma presentatoin

A

Recurrent otitis media (from eustachian tube obstruction by tumor)
Recurrent epistaxis
Nasal obstruction

37
Q

Lichen sclerosis exam

A

Porcelain-white atrophy and “cigarette paper” skin

punch biopsy these

38
Q

Hyatic cyst buzzword

A

Cystic hepatic lesion with eggshell calcification

39
Q

Hyatid cyst tx

A

Surgical resection under the cover of albenazole

40
Q

How does dipyridamole cause coronary steal

A

Redistributes blood flow to non-disease segments (diseased segments already maximally dilated)

41
Q

Suspect leprosy in who? how do you dx

A

Asian patient with an insensate, hypo pigmented patch of skin
Dx by acid fast bacilli on skin biopsy

42
Q

Randomization used to control what in a study

A

Confounders

43
Q

First line tx of atopic dermatitis

A

Topical emoilments

44
Q

How can SS cause folate def

A

Increased red blood cell turnover and increased consumption of folate in bone marrow

45
Q

What should be suspected in a cyanotic infant w/ LAD

A

Tricuspid valve atresia

46
Q

Goodpastures dx by

A

Renal biopsy showing linear IgG antibodies along the glomerula basement membrane

47
Q

Laryngomalacia features

A
  • Inspiratory stridor what worsens in the supine position and w/ crying
  • Peaks at 4-8 months
  • Dx w/ flexible laryngoscopy
48
Q

NNT formula

A

1/ARR

49
Q

ARR formula

A

Incidence without treatment - incidence with treatment

50
Q

Underlying pathology of lacunar strokes

A

Microantheroma and lipohyalinosis

51
Q

Most common site for a lacunar infarct w/ features

A

Internal capsule –> pure motor stroke (w face, arm and leg equally)

52
Q

Exam of open angle glaucoma

A

Cupping of the optic disk w/ loss of peripheral vision

53
Q

Open angle glaucoma first line

A

Timolol eye drops

54
Q

Tina capitis treatment

A

Oral griseofulvin

55
Q

2 mCC of epilgottitis in adults

A

H influenza

Streptocus progenies

56
Q

MC complication seen post thyroidectomy

A

Hypocalcemia

57
Q

MC presenting symptoms of whipples disease

A

Chronic malabsorptive diarrhea, weight loss, migratory arthritis, lymphadenopathy, and low grade fever

58
Q

Anti-neutrophil cytoplasmic antibodies ass w/

A

Wegener’s (granulomatosis w/ polyangitis)

59
Q

Ab ass w/ systemic sclerosis

A

Anti-nuclear

Anti-topoisomerase-1

60
Q

First line for osteoarthritis pain

A

Acetaminophen

61
Q

Fatigue and dyspnea w/ splenomegaly and reticulocytosis

A

Autoimmune hemolytic anemia

62
Q

Liver abscess + Mexican + recent bloody diarrhea

A

Amebiasis w/ Entamoeba histolytic

Tx Metronidazole

63
Q

What has decreased passive and active range of motion int he shoulder

A

Adhesive capsulitis

64
Q

Classic presentation with a clavicle fracture kid walks in

A

Supporter w/ contralateral hand

65
Q

Thiazide diuretics metabolic AE**

A

Hyperglycemia

Increased LDL cholesterol and plasma triglycerides

66
Q

Thiazide electrolyte abnormalities

A

Hyponatremia
Hypokalemia
Hypercalcemia

67
Q

Postpartum endometritis tx

A

Iv Clindamycin and gentamicin

68
Q

Why is GERD more common in kids

A
  1. Shorter esophagus
  2. Incomplete closure of LES
  3. Grat time spent in the supine position
69
Q

A puncture wound in an adult resulting in osteomyelitis most likely due to

A

Pseudomonas aeruginosa

70
Q

Acute liver failure most often due to

A
  1. Acute viral hepatitis
  2. Acetaminophen toxicity
  3. ischemic hepatopathy (shock liver)
71
Q

When did blood start getting tested for Hep C

A

1992

72
Q

UA w/ normal appearing RBCs

A

Papillary necrosis

73
Q

Classic extra pulmonary manifestation of mycoplasma pneumonia

A

Erythema multiforme

74
Q

Drug that inhibits ventricular remodeling after MI

A

ACE inhibitors

75
Q

Lung contusion CXR

A

Patchy, irregular alveolar infiltrates

76
Q

Bite from family dog w/ unknown rabies exposure

A

Observe animal for 10 days

Don’t start PEP yet

77
Q

Wide complex tachycardia drug

A

Amioderone or lidocaine

78
Q

Narrow complex (SVT) drug

A

Adenosine or vagal manuevers

Can unmask “hidden” P waves in pt’s with a-flutter or atrial tachycardia

79
Q

Cryptococcal meningitis

A

Amphoteric B + flucytosine

80
Q

CT scan and colonoscopy of ischemic colitis

A

CT: Thickening of the bowel wall
Colonoscopy: Cyanotic mucosa and hemorrhage ulcerations