abem Flashcards
1
Q
hypersensitivity reactions IV
A
TB
poison IV
and 4 ppl with transplants
2
Q
Methylene chloride (paint thinner) gives you
A
carboxyhemoglobin
3
Q
most common complication after pacemaker placement
A
pacemaker syndrome: present with syncope or near-syncope, heart failure, fatigue, exercise intolerance, dizziness due to LOSS OF Atrio-Ventricular synchrony…can decrease pacing rate or put in BIV pacer
4
Q
vaSA previa
A
hemorrhage with SROM or amniotomy
5
Q
MAP calculation
A
DBP + 1/3(SBP - DBP) = MAP
6
Q
what drugs can cause noncardiogenic pulmonary edema
A
meprobamate, opioids, naloxone, phencyclidine, and salicylates
7
Q
cluster c
A
c for confidence avoidant, compulsive ocd, and dependent
8
Q
serpiginous rash, subq nodules
A
rheumatic fever
get antistreptolysin o titer
9
Q
What is the most common presenting cardiac rhythm in children found in cardiopulmonary arrest?
A
asystole
10
Q
COCCI CLUSTERS
A
s. aureus is COAG POSITIVE
11
Q
tx for gb
A
supportive, ivig, plasmaphoresis
12
Q
lateral medullary syndrome
A
Lateral medullary infarction (Wallenberg syndrome) may present with a constellation of symptoms, including vertigo. Some refer to an ischemic event in this territory with clinical findings as posterior inferior cerebellar artery syndrome. The classic features of this syndrome include ipsilateral cranial nerve deficits (e.g., Horner syndrome, soft palate paralysis) and contralateral deficits in the trunk and extremities (e.g., loss of pain and temperature sensation). This crossed pattern of deficits is a hallmark of the diagnosis.
13
Q
MM IgG or IgM MORE COMMON?
A
IgG
14
Q
bilateral posterior cervical lymphadenopathy vs unilateral?
A
bilat - mono
uni = strep
15
Q
most sensitive for a urinary tract infection on urine dipstick testing?
A
leuk esterase
16
Q
G6PD deficiency
A
oxidative stress leads to hemolytic anemia
COOMBS NEG b/c not immune mediated
heinz body + bite cells
can’t produce NADPH from NAPD+
protective against malaria
17
Q
choledocal cyst triad
A
palpable ruq mass
jaundice
abd pain
18
Q
mid systolic click
A
mvp
19
Q
after how many weeks do we give full dose rhogam?
A
12 weeks
20
Q
what makes you need LESS ADENOSINE
A
carbamazepine
dypyridamole
cardiac txplant
21
Q
pericardial knock
A
constrictive pericarditis
22
Q
nephorotic syndrome
____proteinemia
____cholesterolemia
thrombo_____
A
hypoproteinemia b/c losing in urine
HYPERcholesterol b/c liver producing protein and cholesterol d/t losses
thromboPHILIA!
23
Q
rhabdo electrolytes
A
ther important metabolic disturbances include hyperkalemia, hyperuricemia, and hyperphosphatemia from the release of intracellular stores and hypocalcemia due to deposition of calcium in damaged muscle cells and decreased responsiveness to parathyroid hormone.
24
Q
becks triad
A
muffled heart sounds
neck vein distension
hypotension
cardiac tamponade
25
code dose epi vs anaphylaxis
code 1:10,000
anaphylaxis: 1:1000
26
dka w k 3.3 - 5.2
start fluids with k supplementation
27
HIGHEST RESISTANCE TO ELECTRICITY?
FAT, BONE, TENDON
28
chalazion
meimobian gland or zeiss blocked
UPPER EYELID ABO VE eyelashes
painless
warm compress
29
small, shallow ulcer with tender lymphadenopathy
It is caused by Chlamydia trachomatis.
30
Which of the following is the most common manifestation of extrapulmonary tuberculosis?
lymphadenitis
31
urine +blood but no RBCs?
rhabdo
or
hemolysis
32
Hypersensitivity reactions: II
2 letters:
GP (goodpasture)
EF (erythroblastalis fetalis) - rho ag causes hemolytic anemia in fetus or neonatal
33
parasites in blood cells
babeosis
| elderly or asplenic if severe infection
34
Swallowed foreign bodies in pediatrics most commonly obstruct at the level of
C6, the cricopharyngeus muscle, one of the four natural areas of luminal narrowing in the esophagus. The cricopharyngeus is the muscle of the upper esophageal sphincter
35
Which of the following is the most likely valvular abnormality to develop after blunt cardiac injury?
AR
36
labs inaccurate on IO?
Will be inaccurate labs, K?
```
WBC
Blood O2
Ionized Ca
LFTs
K+
```
37
MAC tx abx
Patients with HIV should be treated with azithromycin or clarithromycin in addition to ethambutol.
38
uri sx then palpable purpura in kid <20
IgA vasculitis (HSP)
39
tx epiglottitis abx
ceftriaxone
40
mngmnt intussussception in aduklts
intussusception in adults is managed surgically unless there has been definitive testing before to ensure a benign cause to the obstruction.
41
high flow priapism tx
arterial embolization
42
Which of the following is the leading cause of non-solid organ cancer-related death?
nhl
43
higher mortality rate
| subdural or epidural?
subdural, bridging veins rupture
| higher mortality
44
CPP formula
MAP - ICP
45
central cord after what type of motion
extension
46
What is the most frequently injured organ in blunt abdominal trauma?
spleen
47
Which of the following has the greatest sensitivity and specificity for diagnosing carpal tunnel syndrome?
flick sign
48
GPRod
grandpa rod loves ANTHRAX
49
cocci CHAINZ
STREP
50
boxcar retinal arteries
CRAO
51
normal compartment pressure
0-8mm hg
52
CN IV palsy
can;t look MEDIQLLY
53
erythema infectuosum
parvob19
54
fever, bloody diarrhea, seizure in baby
shigella
55
most common organism endocartitis IVDU vs native valve
IVDU: staph aureus
native = strep viridans
56
brown recluse venom
sphingomyelinase
57
T. Pallidum
- lesion?
- painful?
Syphilis
- CHANCRE
- PAINLESS
58
orthodromic conduction in wpw
normal, we don't want ANTIDROMIC
59
cushing's triad of ICP
hypertension
bradycardia
bradypnea
60
most significant risk factor for placental abruption
HTN/pre-ecclampsia
61
most common complication of acute sinusitis
orbital/preseptal cellulitis
62
WHAT DETERMINES WHETHER GIVE DIG FAB, DIG LEVEL OR POTASSIUM LEVEL?
POTASSIUM LEVEL
| ALSO ARRHYTHMIA OR CO-INGESTION OF OTHER CARDIAC DRUGS
63
steroids in pjp pna
Corticosteroids are used as adjunct therapy in HIV-positive patients with moderate to severe Pneumocystis jiroveci pneumonia, defined by a room air arterial oxygen partial pressure (PaO2) of less than 70 mm Hg (severe disease is less than 60 mm Hg) or an alveolar-arterial oxygen gradient that exceeds 35 mm Hg
64
rabies bites w highest risk
Multiple bites to the face, such as two bites to the chin, carry an 80–100% risk of developing rabies
65
Struvite stones
```
struvite = staghorn
PROTEUS or PSEUDAMONAS (urea splitters)
HIGH PH (alkylotic)
```
66
ptu
blocks synthesis of thyroid hormone
| also slows conversion t4 to t3
67
A 16-year-old boy presents to the emergency department with right arm pain after falling off of a trampoline onto his right hand. X-rays of the wrist demonstrate an acute right distal radius fracture with dorsal displacement. A fracture of which of the following is most commonly associated with this injury?
ulnar styloid fx
68
He has tenderness to palpation at the inferomedial aspect of the left knee.
anserine bursitis
usually runners
69
where does boorhaave occur
distal posterolateral esophagus and more commonly occurs on the left side.
70
unhappy triad
acl
mcl
meniscus injury
71
ABO incompatibility will frequently occur with maternal O blood types as the antibodies are predominantly IgG, can cross the placenta, and will typically cause at least some degree of hemolysis in type A or type B fetus.
tes
72
vsd murmur
pansystolic llsb
73
cavernous sinus CN?
VII SIX abducens
74
Question: Nebulized sodium bicarbonate serves as a useful adjunct in the treatment of patients with pulmonary injury from which inhaled gas?
chlorine
75
Ethylene glycol / antifreeze
- anion gap?
- acidosis?
- antidote
- effects
- AG metabolic acidosis
- fomepizole
- oxalic acid production, binds to Ca producing calox stones and hypocalcemia
76
PREGNANT PT WITH RMSF TX
CHLORAMPHENICOL
77
erhthema infectiosum
fifths disease
| parvo 19
78
ideal bodyweight calc in women
45.4 + 2.3kg for each inch over 5 ft
79
cf baby w vomiting soon after birth
think meconium ileus
80
Which of the following organs is most commonly injured in pediatric blunt abdominal trauma?
spleen
81
Courvoisier sign is a physical examination finding defined as an enlarged, palpable, nontender gallbladder in the presence of painless jaundice.
think obstruction / malignancy
82
Which of the following has been shown to decrease the frequency and severity of complications related to sickle cell disease?
hydroxyurea
83
hypersensitivity reactions III
3 letters
SLE
PSGn
and SERUM SICKNESS
84
ransons criteria on admission
```
A - age 55+
B - BG 200+
C - wbC 16k+
D - lDH 35+
"E" - AST 350+
```
85
blood output chest tube for or
Initial chest tube output of greater than 20 mL/kg
or 1,500 mL of blood,
Output of greater than 200 mL of blood
per hour for the first three hours
Persistent bleeding at a rate greater than 7 mL/kg/hr
86
What is the most common electrocardiogram finding associated with digoxin toxicity?
PVCs
87
contraindicated in hydrocarbon ingestion
Catecholamines (e.g. dopamine, norepinephrine, epinephrine), class IA (e.g procainamide), and class III (e.g. sotalol, amiodarone) antiarrhythmics should be avoided as these cause dysrhythmias and QT prolongation, respectively.
88
purpura fulminans
associated with protein C deficiency
causes DIC
89
legionella
```
GI sx
low sodium
LFTs abnormal
no person-to-person
NO ORGANISMS ON STANDARD SMEAR
```
90
treatment of jerix-herschimer rxn?
tylenol and time (obsevation)
91
Goodpasture sx
Glomerular: AntiGBM Ab, GN
Pulmonary: DOE, cough, hemoptysis
92
fishy odor and koh
trichamoniasis
93
cluster b
Cluster B disorders include borderline personality disorder, narcissistic disorder, histrionic disorder, and antisocial disorder. Patients with one of these four diagnoses present with dramatic, emotional, or erratic behaviors.
94
bullous impetigo bug?
staph
95
complete mole
46xx or 46x7
partial mole has parts and either 3 or 4 chromasomes
96
rf for placenta previa
```
prior c section
maternal age (> 40 years), grand multiparity, previous placenta previa, multiple gestations, previous multiple induced abortions, and preterm labor.
```
97
most common sign of valproic acid toxicvity?
CNS depression
98
kaposis sarcoma caused by
HHV8
99
sandpaper rash, pastai lines, strawberry tongue
scarlet fever
| strep
100
Patients with a CN IV palsy adopt a particular head position
to avoid diplopia with head tilting to the contralateral side of injury and slightly downward.
101
pars interarticularis fracturte / spondolisthesis of axis C1
hangman's fx
102
injured most common;y in midshaft humeral fx
radail nerve
103
pentad of TTP
FAT RN
```
fever
anemia
thrombocytopenia
renal failure
neuro deficits
```
104
tx of PJP PNA
bactrim + STEROIDS
105
aka pt needs
glucose./dextrose w fluids
106
Which of the following is the most common surgical emergency in the elderly?
cholecystitis
107
failure to pace
impulse generation failure due to disruption
108
west nile
MORE LIKE se-NILE
most ppl ASYMPTOMATIC
mild sx, but BIGGEST RISK IS ADVANCED AGE !!
109
The most common bacterial pathogen causing pneumonia in influenza-positive patients is ...?
The most common bacterial pathogen causing pneumonia in influenza-positive patients is Streptococcus pneumoniae.
110
charcot triad
fever
RUQ pain
jaundice
ascending cholangitis
111
contraindications for thrombolytics for MI
includes:
CVA or TBI <3 mo
brain or spine SURG <2 mo
112
which drugs for DM cause hypoglycemia
sulfonylureas: RIDE + ZIDES
meglinitides NIDES
113
loud, single heart sound with a harsh systolic murmur heard best at the left sternal border.
tetrology of fallot
114
type 2 respiratory failure
Type 2 respiratory failure (D) is characterized by elevated PCO2 levels and low or normal PO2 levels.
115
portuguese man o war wash with
saltwater
116
indicatinos for digibind in digoxin tox
brady, block, hypotension, or K+ greater than 5.0
not given prophlactically
117
epi dosage code
1 mg 1:10,000
118
Uric acid stones
ACIDIC urine (it's an acid)
gout
congenital
radiolUcent
119
dermatitis herpetiformis
celiac
| use DAPSONE
120
most common cause of diarrhea in aids
CMV
121
Cysteine stones
```
staghorn
YOUNG PPL
PROTEUS
inborn error of metabolism
can be BILATERAL
```
122
delta compartment pressure < _____ is compartment syndrome
30
123
reversal for enoxiparin
protamine sulfate, b/c is LMWH
124
ecthyma gangrenosum
vs
pyoderma gangrtenosum
ecthyma = aeurginosa causes dot --> gangrene
pyoderma = pyro = inflammatory
125
```
methanol toxicity
AGMA?
antidote
produces?
CT FINDINGS?
```
yes AGMA
antidote = fomepizole
makes formic acid as toxic metabolite
can supplement FOLIC ACID or FOLINIC ACID
BILATERAL PUTAMEN HEMORRHAGES ON CT
126
yellow fever
conjunctivitis
bradycardia
bodyaches
fever
classic relapse sx: jaundice, black eemsis, albuminuria
127
anopheles mosquito
malaria
128
normal pco2
40
129
LP location in newborn?
L4-5 or L5S1
spinal cord terminates at L3
in N3onates
cord ends at L1 in adults
130
Granuloma Inguinale
- alternative name
- lesions?
- groin sx?
- treatment?
Granuloma inguinale
- Donovanosis
- BEEFY RED ULCER ON GROIN + painless papule on penis
- yes
- Cipro, Doxy, Azithro
131
cullen sign
The image illustrates the physical exam finding called Cullen sign, which is periumbilical ecchymosis suggestive of retroperitoneal bleeding. Retroperitoneal structures are not suspended by mesentery, have mesentery only on one surface or part of one surface, or lie between the parietal peritoneum and the abdominal wall. These structures include the duodenum, kidneys, adrenal glands, ureters, ascending colon, descending colon, abdominal aorta, inferior vena cava, rectum, and pancreas.
132
hape on cxr?
A chest radiograph will show patchy alveolar infiltrates, most commonly involving the right middle lobe. usually unilateral
133
Risk factors for development of preeclampsia
nulliparity, age < 18 years or > 40 years, twin or multi-order gestations, obesity, those with a first-degree relative with pregnancy-induced hypertension, and preexisting conditions (e.g. hypertension and pregestational diabetes).
134
epididymitis tx 35+
Patients who are age 35 and older, who have risk factors for sexually transmitted diseases, should not only be treated for common sexually transmitted organisms such as gonorrhea and chlamydia but should also be treated for enteric pathogens such as Escherichia coli or Klebsiella. This is particularly true in older men who have benign prostatic hypertrophy or outlet obstruction as they are more prone to infection. Therefore, appropriate treatment in this patient includes ceftriaxone plus oral levofloxacin.
135
SNAKES IN CROTALIDS / VIPERIDAE VS SYMPTOMS
RATTLE - RHABDO
COTTON - COAGS
COPPER - CP
DIAMOND - DOE/SOB
136
acid base in IRON toxicity
Metabolic acidosis with respiratory compensation
137
machinery murmur
think AIR EMBOLUS
place in L lateral decub + trendelenburg to get air to go to FEET
138
reynold's pentad
```
RUQ pain
fever
jaundice
shock
CNS depression
```
acute suppurative cholangitis
139
HOMONYMOUS HEMIANOPSIA
OCCIPITAL LOBE LESION
140
WHAT DOES PLACING MAGNET OVER PACER DO
TURNS OFF SENSING, SO JUST PACES AT NATIVE RATE THAT WAS SET
141
<200 CD4 or aids defining illness
needed for stage 3 HIV - now you'er AIDS
142
abo incompatability
ABO incompatibility (A) causes an acute hemolytic transfusion reaction that leads to rapid destruction of donor erythrocytes by preformed recipient antibodies. This is typically the result of a clerical error. It classically presents with fever, flank pain, and hemoglobinuria.
143
most common infectious cause myocarditis
parvo B19
144
hand foot mouth
coxsackie virus
| same as herpangina
145
most common site of obstructin for kidney stone
UVJ
146
Air in urine?
pneumobilia
STRUVITE STONES
old men
147
hypersensitivity rxns ACID
Allergic (I)
Cytotoxic
Immune complex
Delayed
148
hepatorenal syndrome
low uop and hypotension not responds to fluids in pt with ascites, b/c AKI
149
elevated Methylmalonic acid
B12 deficiency
150
side effect of physostigmine in patient with wide QRS?
The antidote is physostigmine, a reversible acetylcholinesterase inhibitor. There is, however, a risk of profound bradycardia, seizures, and asystole in patients with widened QRS complexes.
151
doxy doesn't cause _____
qt prolongation
152
Cal OX stones
```
most common stone
IBD (UC + CHRONS)
Diet / DM
young men
envelope shaped
hyperPTH
```
153
tx acute chest
The mainstays of treatment include fluid resuscitation in patients with clinical evidence of dehydration, oxygen supplementation, antibiotic administration for potential infectious etiologies, which includes coverage for atypical bacteria (Chlamydia, Mycoplasma), and transfusion therapy which can involve simple transfusion to a hemoglobin of 10 g/dL to improve systemic oxygen delivery, as well as exchange transfusion or erythrocytapheresis for severe cases unresponsive to simple transfusion, severe hypoxia, or multilobar lung disease.
154
medical negligence needs what 4
(1) a professional duty owed to the patient; (2) breach of such duty; (3) injury caused by the breach; and (4) resulting damages.
155
failure to sense
fires too early or inappropriately since doesn't sense native beat
156
atopic dermatitis is also called
and where does it show up
atopic dermatitis = ECZEMA and it's FLEXEMA surfaces
157
posterior elbow dislocation what nerve?
ulnar
158
Hantavirus
Hemorrhagic
Renal
Rats
159
BITEMPORAL HEMIANOPSIA
OPTIC CHIASM LESION
160
normal ABI
1.0 - 1.4
161
rubeola
measles
162
With which type of leukemia are patients most at risk for severe complications from hyperleukocytosis?
aml
163
central pontine myelinolysis bsx
Symptoms of ODS include dysarthria, dysphagia, lethargy, paraparesis or quadriparesis, seizures, coma, and death.
164
fever then rash
roseola
| HHV6
165
infections in erythema nodosum
the most common of which are Streptococcal infections. Others include: tuberculosis
sarcoidosis
coccidioidomycosis, histoplasmosis, ulcerative colitis,
enteritis,
pregnancy,
Yersinia enterocolitica, and
Chlamydia.
166
DIC OCCURS DURING ____ AND NOT _____
PLACENTAL ABRUPTION
NOT PLACENTA PREVIA
167
roseoola
hhv6
| fever trhen rash
168
Which of the following is the mechanism of action of methimazole?
blocks iodine oxidation
169
which vaginal infection ACIDIC <4.5 ph>?
candidacid
170
Patients with iron deficiency anemia will have increased transferrin and TIBC and decreased reticulocyte count.
yes
171
GN intracellular
chlamydia
172
kawasaki tx
asa or IVIG
173
herpangina
coxsackie virus
174
What postexposure management is indicated for close adult contacts of a patient diagnosed with pertussis?
Z PACK
175
dialyzable drugs
P MELTS
```
phenobarb
methanol
ethylene glycol
lithium
theophylline
salycilates
```
