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World week 1 > 5/10 > Flashcards

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
Acute intermittent porphyria symptos
Abdominal pain, neuralgic and psychiatric abnormalities
26
Anemia on methotrexate
Macrocytic
27
Antimitochondrial Ab for
Primary biliary cholangitis
28
What must be done if a patient on warfarin needs emergent surgery
Reversal with FFP
29
What causes itchy butt worms? tx?
Enterobius vermicularis | Tx is Albenazole
30
Most common neuro symptoms of HHS
1. Decreased consciousness (MCC) | 2. Blurred vision
31
What is positive in UC
p-ANCA (also see it w/ AS)
32
What causes symptoms in cardiac tamponade
Exaggerated shift of inter ventricular septum toward left ventricular cavity, which reduces left ventricular pre-load, SV, and cardiac output
33
Leukemoid reaction vs CML
1. High LAP score 2. Greater proportion of late neutrophil pre-cursors 3. Lack of absolute basophilia
34
Tx for complicated diverticulitis w/ abscess formation
CT-Guided percutaneous drainage
35
Who gets nasopharyngeal carcinoma? ass w/?
Mediterranean and far est | Ass w/ EBV infection
36
Nasopharyngeal carcinoma presentatoin
Recurrent otitis media (from eustachian tube obstruction by tumor) Recurrent epistaxis Nasal obstruction
37
Lichen sclerosis exam
Porcelain-white atrophy and "cigarette paper" skin | *punch biopsy these*
38
Hyatic cyst buzzword
Cystic hepatic lesion with eggshell calcification
39
Hyatid cyst tx
Surgical resection under the cover of albenazole
40
How does dipyridamole cause coronary steal
Redistributes blood flow to non-disease segments (diseased segments already maximally dilated)
41
Suspect leprosy in who? how do you dx
Asian patient with an insensate, hypo pigmented patch of skin Dx by acid fast bacilli on skin biopsy
42
Randomization used to control what in a study
Confounders
43
First line tx of atopic dermatitis
Topical emoilments
44
How can SS cause folate def
Increased red blood cell turnover and increased consumption of folate in bone marrow
45
What should be suspected in a cyanotic infant w/ LAD
Tricuspid valve atresia
46
Goodpastures dx by
Renal biopsy showing linear IgG antibodies along the glomerula basement membrane
47
Laryngomalacia features
- Inspiratory stridor what worsens in the supine position and w/ crying - Peaks at 4-8 months - Dx w/ flexible laryngoscopy
48
NNT formula
1/ARR
49
ARR formula
Incidence without treatment - incidence with treatment
50
Underlying pathology of lacunar strokes
Microantheroma and lipohyalinosis
51
Most common site for a lacunar infarct w/ features
Internal capsule --> pure motor stroke (w face, arm and leg equally)
52
Exam of open angle glaucoma
Cupping of the optic disk w/ loss of peripheral vision
53
Open angle glaucoma first line
Timolol eye drops
54
Tina capitis treatment
Oral griseofulvin
55
2 mCC of epilgottitis in adults
H influenza | Streptocus progenies
56
MC complication seen post thyroidectomy
Hypocalcemia
57
MC presenting symptoms of whipples disease
Chronic malabsorptive diarrhea, weight loss, migratory arthritis, lymphadenopathy, and low grade fever
58
Anti-neutrophil cytoplasmic antibodies ass w/
Wegener's (granulomatosis w/ polyangitis)
59
Ab ass w/ systemic sclerosis
Anti-nuclear | Anti-topoisomerase-1
60
First line for osteoarthritis pain
Acetaminophen
61
Fatigue and dyspnea w/ splenomegaly and reticulocytosis
Autoimmune hemolytic anemia
62
Liver abscess + Mexican + recent bloody diarrhea
Amebiasis w/ Entamoeba histolytic | Tx Metronidazole
63
What has decreased passive and active range of motion int he shoulder
Adhesive capsulitis
64
Classic presentation with a clavicle fracture kid walks in
Supporter w/ contralateral hand
65
Thiazide diuretics metabolic AE**
Hyperglycemia | Increased LDL cholesterol and plasma triglycerides
66
Thiazide electrolyte abnormalities
Hyponatremia Hypokalemia Hypercalcemia
67
Postpartum endometritis tx
Iv Clindamycin and gentamicin
68
Why is GERD more common in kids
1. Shorter esophagus 2. Incomplete closure of LES 3. Grat time spent in the supine position
69
A puncture wound in an adult resulting in osteomyelitis most likely due to
Pseudomonas aeruginosa
70
Acute liver failure most often due to
1. Acute viral hepatitis 2. Acetaminophen toxicity 3. ischemic hepatopathy (shock liver)
71
When did blood start getting tested for Hep C
1992
72
UA w/ normal appearing RBCs
Papillary necrosis
73
Classic extra pulmonary manifestation of mycoplasma pneumonia
Erythema multiforme
74
Drug that inhibits ventricular remodeling after MI
ACE inhibitors
75
Lung contusion CXR
Patchy, irregular alveolar infiltrates
76
Bite from family dog w/ unknown rabies exposure
Observe animal for 10 days | Don't start PEP yet
77
Wide complex tachycardia drug
Amioderone or lidocaine
78
Narrow complex (SVT) drug
Adenosine or vagal manuevers | *Can unmask "hidden" P waves in pt's with a-flutter or atrial tachycardia*
79
Cryptococcal meningitis
Amphoteric B + flucytosine
80
CT scan and colonoscopy of ischemic colitis
CT: Thickening of the bowel wall Colonoscopy: Cyanotic mucosa and hemorrhage ulcerations

World week 1 (17 decks)

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