5/10 Flashcards
Who is ECT best for
Depressed geriatric patients who are not eating, drinking, psychotic, or actively suicidal
3 systems TCA overdose involved
- CNS (seizures, coma)
- Anticholinergic
- Cardiac
TCA effect on myocardium
Inhibits fast Na channels in the His-Purkinje system and myocardium
Cardioprotection for TCA overdose
Sodium bicarb (when QRS inc. pH and extracellular sodium, deceasing drug avidity for Na channels
Pneuomo vaccine for high risk pt’s (not very high risk)
PPSV23 alone at 19-64
then normal schedule at 65
All pt’s w/ bilateral Carpal tunnel should be screened for
Hypothyroidism
Two common complications w/ SS trait
- Hematuria from sickling in the renal medulla
2. Isosthenuria (impaired concentrating ability)
What kind of Anemia does B6 def cause
Sideroblastic (microcytic but elevated total serum iron and dec TIBC)
2 Tet murmurs
- Harsh systolic ejection murmur at left upper sternal border
- Single S2 (from pulmonary stenosis)
Tx for any pt post stent placement
Dual anti platelet (aspirin and P2y12 receptor blocker)
Big B and T cell markers
B = CD19
T=CD3
What causes B-cell dysfunction in SCID
Absent T cells
What kids should get a renal US w/ UTI
- All under 24 months (when febrile)
- Recurrent in any age
- Fam hx or poor response to Ab
Typical x-ray of supracondylar fracture of the humerus
Triangular anterior fat pad and posterior fat pad (lucent on X-ray)
Two late findings of compartment syndrome
Pulselessnes and paralysis
Red flags for orbital cellulitis vs preseptal
- Decreased visual acuity
- Diplopia
- Ophthalmoplegia
- Proptosis
Hyperandrogenism during pregnancy usually from
Ovarian masses (Luteoma - bilateral and solid)
Bilateral theca lutein cyst ass w/
Molar pregnancy and multiple gestation
First step for suspected VAP, then what?
- CXR
2. Lower respiratory tract sampling and empiric antibiotics
What is Enthesitis
Inflammation and pain at sites of tendon and ligament attachment to bone
Commonly found in AS
Metastatic bone pain features
Constant progressive pain that wakes the patient up at night
Common clinical features of Vasa previa
- Painless vaginal bleeding that occurs with rupture of membranes
- Fetal deterioation (sinusoidal tracing or brady)
- Maternal vital signs unchanged as bleeding comes from fetus
Retinal harmartoma typical of
Tuberous sclerosis
What is primidone? what can it cause?
Anticonvulsant that converts phenylethylmalonamide and phenobarbital
Can cause acute intermittent porphyria
Acute intermittent porphyria symptos
Abdominal pain, neuralgic and psychiatric abnormalities
Anemia on methotrexate
Macrocytic
Antimitochondrial Ab for
Primary biliary cholangitis
What must be done if a patient on warfarin needs emergent surgery
Reversal with FFP
What causes itchy butt worms? tx?
Enterobius vermicularis
Tx is Albenazole
Most common neuro symptoms of HHS
- Decreased consciousness (MCC)
2. Blurred vision
What is positive in UC
p-ANCA (also see it w/ AS)
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