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ABEM > abem > Flashcards

abem Flashcards

1
Q

hypersensitivity reactions IV

A

TB
poison IV
and 4 ppl with transplants

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2
Q

Methylene chloride (paint thinner) gives you

A

carboxyhemoglobin

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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

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4
Q

vaSA previa

A

hemorrhage with SROM or amniotomy

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5
Q

MAP calculation

A

DBP + 1/3(SBP - DBP) = MAP

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6
Q

what drugs can cause noncardiogenic pulmonary edema

A

meprobamate, opioids, naloxone, phencyclidine, and salicylates

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7
Q

cluster c

A

c for confidence avoidant, compulsive ocd, and dependent

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8
Q

serpiginous rash, subq nodules

A

rheumatic fever

get antistreptolysin o titer

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9
Q

What is the most common presenting cardiac rhythm in children found in cardiopulmonary arrest?

A

asystole

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10
Q

COCCI CLUSTERS

A

s. aureus is COAG POSITIVE

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11
Q

tx for gb

A

supportive, ivig, plasmaphoresis

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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.

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13
Q

MM IgG or IgM MORE COMMON?

A

IgG

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14
Q

bilateral posterior cervical lymphadenopathy vs unilateral?

A

bilat - mono

uni = strep

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15
Q

most sensitive for a urinary tract infection on urine dipstick testing?

A

leuk esterase

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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

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17
Q

choledocal cyst triad

A

palpable ruq mass
jaundice
abd pain

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18
Q

mid systolic click

A

mvp

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19
Q

after how many weeks do we give full dose rhogam?

A

12 weeks

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20
Q

what makes you need LESS ADENOSINE

A

carbamazepine
dypyridamole
cardiac txplant

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21
Q

pericardial knock

A

constrictive pericarditis

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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!

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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.

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24
Q

becks triad

A

muffled heart sounds
neck vein distension
hypotension

cardiac tamponade

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25
Q

code dose epi vs anaphylaxis

A

code 1:10,000

anaphylaxis: 1:1000

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26
Q

dka w k 3.3 - 5.2

A

start fluids with k supplementation

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27
Q

HIGHEST RESISTANCE TO ELECTRICITY?

A

FAT, BONE, TENDON

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28
Q

chalazion

A

meimobian gland or zeiss blocked

UPPER EYELID ABO VE eyelashes
painless

warm compress

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29
Q

small, shallow ulcer with tender lymphadenopathy

A

It is caused by Chlamydia trachomatis.

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30
Q

Which of the following is the most common manifestation of extrapulmonary tuberculosis?

A

lymphadenitis

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31
Q

urine +blood but no RBCs?

A

rhabdo
or
hemolysis

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32
Q

Hypersensitivity reactions: II

A

2 letters:
GP (goodpasture)
EF (erythroblastalis fetalis) - rho ag causes hemolytic anemia in fetus or neonatal

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33
Q

parasites in blood cells

A

babeosis

elderly or asplenic if severe infection

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34
Q

Swallowed foreign bodies in pediatrics most commonly obstruct at the level of

A

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

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35
Q

Which of the following is the most likely valvular abnormality to develop after blunt cardiac injury?

A

AR

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36
Q

labs inaccurate on IO?

A

Will be inaccurate labs, K?

WBC
Blood O2 
Ionized Ca
LFTs 
K+
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37
Q

MAC tx abx

A

Patients with HIV should be treated with azithromycin or clarithromycin in addition to ethambutol.

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38
Q

uri sx then palpable purpura in kid <20

A

IgA vasculitis (HSP)

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39
Q

tx epiglottitis abx

A

ceftriaxone

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40
Q

mngmnt intussussception in aduklts

A

intussusception in adults is managed surgically unless there has been definitive testing before to ensure a benign cause to the obstruction.

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41
Q

high flow priapism tx

A

arterial embolization

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42
Q

Which of the following is the leading cause of non-solid organ cancer-related death?

A

nhl

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43
Q

higher mortality rate

subdural or epidural?

A

subdural, bridging veins rupture

higher mortality

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44
Q

CPP formula

A

MAP - ICP

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45
Q

central cord after what type of motion

A

extension

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46
Q

What is the most frequently injured organ in blunt abdominal trauma?

A

spleen

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47
Q

Which of the following has the greatest sensitivity and specificity for diagnosing carpal tunnel syndrome?

A

flick sign

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48
Q

GPRod

A

grandpa rod loves ANTHRAX

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49
Q

cocci CHAINZ

A

STREP

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50
Q

boxcar retinal arteries

A

CRAO

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51
Q

normal compartment pressure

A

0-8mm hg

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52
Q

CN IV palsy

A

can;t look MEDIQLLY

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53
Q

erythema infectuosum

A

parvob19

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54
Q

fever, bloody diarrhea, seizure in baby

A

shigella

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55
Q

most common organism endocartitis IVDU vs native valve

A

IVDU: staph aureus

native = strep viridans

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56
Q

brown recluse venom

A

sphingomyelinase

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57
Q

T. Pallidum

  • lesion?
  • painful?
A

Syphilis

  • CHANCRE
  • PAINLESS
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58
Q

orthodromic conduction in wpw

A

normal, we don’t want ANTIDROMIC

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59
Q

cushing’s triad of ICP

A

hypertension
bradycardia
bradypnea

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60
Q

most significant risk factor for placental abruption

A

HTN/pre-ecclampsia

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61
Q

most common complication of acute sinusitis

A

orbital/preseptal cellulitis

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62
Q

WHAT DETERMINES WHETHER GIVE DIG FAB, DIG LEVEL OR POTASSIUM LEVEL?

A

POTASSIUM LEVEL

ALSO ARRHYTHMIA OR CO-INGESTION OF OTHER CARDIAC DRUGS

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63
Q

steroids in pjp pna

A

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

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64
Q

rabies bites w highest risk

A

Multiple bites to the face, such as two bites to the chin, carry an 80–100% risk of developing rabies

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65
Q

Struvite stones

A 
struvite = staghorn
PROTEUS or PSEUDAMONAS (urea splitters) 
HIGH PH (alkylotic)
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66
Q

ptu

A

blocks synthesis of thyroid hormone

also slows conversion t4 to t3

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67
Q

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?

A

ulnar styloid fx

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68
Q

He has tenderness to palpation at the inferomedial aspect of the left knee.

A

anserine bursitis

usually runners

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69
Q

where does boorhaave occur

A

distal posterolateral esophagus and more commonly occurs on the left side.

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70
Q

unhappy triad

A

acl
mcl
meniscus injury

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71
Q

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.

A

tes

72
Q

vsd murmur

A

pansystolic llsb

73
Q

cavernous sinus CN?

A

VII SIX abducens

74
Q

Question: Nebulized sodium bicarbonate serves as a useful adjunct in the treatment of patients with pulmonary injury from which inhaled gas?

A

chlorine

75
Q

Ethylene glycol / antifreeze

  • anion gap?
  • acidosis?
  • antidote
  • effects
A
  • AG metabolic acidosis
  • fomepizole
  • oxalic acid production, binds to Ca producing calox stones and hypocalcemia
76
Q

PREGNANT PT WITH RMSF TX

A

CHLORAMPHENICOL

77
Q

erhthema infectiosum

A

fifths disease

parvo 19

78
Q

ideal bodyweight calc in women

A

45.4 + 2.3kg for each inch over 5 ft

79
Q

cf baby w vomiting soon after birth

A

think meconium ileus

80
Q

Which of the following organs is most commonly injured in pediatric blunt abdominal trauma?

A

spleen

81
Q

Courvoisier sign is a physical examination finding defined as an enlarged, palpable, nontender gallbladder in the presence of painless jaundice.

A

think obstruction / malignancy

82
Q

Which of the following has been shown to decrease the frequency and severity of complications related to sickle cell disease?

A

hydroxyurea

83
Q

hypersensitivity reactions III

A

3 letters
SLE
PSGn

and SERUM SICKNESS

84
Q

ransons criteria on admission

A 
A - age 55+
B - BG 200+
C - wbC 16k+ 
D - lDH 35+
"E" - AST 350+
85
Q

blood output chest tube for or

A

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
Q

What is the most common electrocardiogram finding associated with digoxin toxicity?

A

PVCs

87
Q

contraindicated in hydrocarbon ingestion

A

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
Q

purpura fulminans

A

associated with protein C deficiency

causes DIC

89
Q

legionella

A 
GI sx
low sodium
LFTs abnormal 
no person-to-person
NO ORGANISMS ON STANDARD SMEAR
90
Q

treatment of jerix-herschimer rxn?

A

tylenol and time (obsevation)

91
Q

Goodpasture sx

A

Glomerular: AntiGBM Ab, GN

Pulmonary: DOE, cough, hemoptysis

92
Q

fishy odor and koh

A

trichamoniasis

93
Q

cluster b

A

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
Q

bullous impetigo bug?

A

staph

95
Q

complete mole

A

46xx or 46x7

partial mole has parts and either 3 or 4 chromasomes

96
Q

rf for placenta previa

A 
prior c section 
maternal age (> 40 years), grand multiparity, previous placenta previa, multiple gestations, previous multiple induced abortions, and preterm labor.
97
Q

most common sign of valproic acid toxicvity?

A

CNS depression

98
Q

kaposis sarcoma caused by

A

HHV8

99
Q

sandpaper rash, pastai lines, strawberry tongue

A

scarlet fever

strep

100
Q

Patients with a CN IV palsy adopt a particular head position

A

to avoid diplopia with head tilting to the contralateral side of injury and slightly downward.

101
Q

pars interarticularis fracturte / spondolisthesis of axis C1

A

hangman’s fx

102
Q

injured most common;y in midshaft humeral fx

A

radail nerve

103
Q

pentad of TTP

A

FAT RN

fever
anemia
thrombocytopenia
renal failure
neuro deficits
104
Q

tx of PJP PNA

A

bactrim + STEROIDS

105
Q

aka pt needs

A

glucose./dextrose w fluids

106
Q

Which of the following is the most common surgical emergency in the elderly?

A

cholecystitis

107
Q

failure to pace

A

impulse generation failure due to disruption

108
Q

west nile

A

MORE LIKE se-NILE

most ppl ASYMPTOMATIC

mild sx, but BIGGEST RISK IS ADVANCED AGE !!

109
Q

The most common bacterial pathogen causing pneumonia in influenza-positive patients is …?

A

The most common bacterial pathogen causing pneumonia in influenza-positive patients is Streptococcus pneumoniae.

110
Q

charcot triad

A

fever
RUQ pain
jaundice

ascending cholangitis

111
Q

contraindications for thrombolytics for MI

A

includes:
CVA or TBI <3 mo
brain or spine SURG <2 mo

112
Q

which drugs for DM cause hypoglycemia

A

sulfonylureas: RIDE + ZIDES

meglinitides NIDES

113
Q

loud, single heart sound with a harsh systolic murmur heard best at the left sternal border.

A

tetrology of fallot

114
Q

type 2 respiratory failure

A

Type 2 respiratory failure (D) is characterized by elevated PCO2 levels and low or normal PO2 levels.

115
Q

portuguese man o war wash with

A

saltwater

116
Q

indicatinos for digibind in digoxin tox

A

brady, block, hypotension, or K+ greater than 5.0

not given prophlactically

117
Q

epi dosage code

A

1 mg 1:10,000

118
Q

Uric acid stones

A

ACIDIC urine (it’s an acid)
gout
congenital
radiolUcent

119
Q

dermatitis herpetiformis

A

celiac

use DAPSONE

120
Q

most common cause of diarrhea in aids

A

CMV

121
Q

Cysteine stones

A 
staghorn 
YOUNG PPL
PROTEUS
inborn error of metabolism
can be BILATERAL
122
Q

delta compartment pressure < _____ is compartment syndrome

A

30

123
Q

reversal for enoxiparin

A

protamine sulfate, b/c is LMWH

124
Q

ecthyma gangrenosum

vs

pyoderma gangrtenosum

A

ecthyma = aeurginosa causes dot –> gangrene

pyoderma = pyro = inflammatory

125
Q 
methanol toxicity 
AGMA?
antidote 
produces?
CT FINDINGS?
A

yes AGMA
antidote = fomepizole
makes formic acid as toxic metabolite

can supplement FOLIC ACID or FOLINIC ACID

BILATERAL PUTAMEN HEMORRHAGES ON CT

126
Q

yellow fever

A

conjunctivitis
bradycardia
bodyaches
fever

classic relapse sx: jaundice, black eemsis, albuminuria

127
Q

anopheles mosquito

A

malaria

128
Q

normal pco2

A

40

129
Q

LP location in newborn?

A

L4-5 or L5S1
spinal cord terminates at L3
in N3onates

cord ends at L1 in adults

130
Q

Granuloma Inguinale

  • alternative name
  • lesions?
  • groin sx?
  • treatment?
A

Granuloma inguinale

  • Donovanosis
  • BEEFY RED ULCER ON GROIN + painless papule on penis
  • yes
  • Cipro, Doxy, Azithro
131
Q

cullen sign

A

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
Q

hape on cxr?

A

A chest radiograph will show patchy alveolar infiltrates, most commonly involving the right middle lobe. usually unilateral

133
Q

Risk factors for development of preeclampsia

A

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
Q

epididymitis tx 35+

A

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
Q

SNAKES IN CROTALIDS / VIPERIDAE VS SYMPTOMS

A

RATTLE - RHABDO
COTTON - COAGS
COPPER - CP
DIAMOND - DOE/SOB

136
Q

acid base in IRON toxicity

A

Metabolic acidosis with respiratory compensation

137
Q

machinery murmur

A

think AIR EMBOLUS

place in L lateral decub + trendelenburg to get air to go to FEET

138
Q

reynold’s pentad

A 
RUQ pain
fever
jaundice
shock
CNS depression

acute suppurative cholangitis

139
Q

HOMONYMOUS HEMIANOPSIA

A

OCCIPITAL LOBE LESION

140
Q

WHAT DOES PLACING MAGNET OVER PACER DO

A

TURNS OFF SENSING, SO JUST PACES AT NATIVE RATE THAT WAS SET

141
Q

<200 CD4 or aids defining illness

A

needed for stage 3 HIV - now you’er AIDS

142
Q

abo incompatability

A

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
Q

most common infectious cause myocarditis

A

parvo B19

144
Q

hand foot mouth

A

coxsackie virus

same as herpangina

145
Q

most common site of obstructin for kidney stone

A

UVJ

146
Q

Air in urine?

A

pneumobilia
STRUVITE STONES
old men

147
Q

hypersensitivity rxns ACID

A

Allergic (I)
Cytotoxic
Immune complex
Delayed

148
Q

hepatorenal syndrome

A

low uop and hypotension not responds to fluids in pt with ascites, b/c AKI

149
Q

elevated Methylmalonic acid

A

B12 deficiency

150
Q

side effect of physostigmine in patient with wide QRS?

A

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
Q

doxy doesn’t cause _____

A

qt prolongation

152
Q

Cal OX stones

A 
most common stone 
IBD (UC + CHRONS) 
Diet / DM 
young men 
envelope shaped 
hyperPTH
153
Q

tx acute chest

A

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
Q

medical negligence needs what 4

A

(1) a professional duty owed to the patient; (2) breach of such duty; (3) injury caused by the breach; and (4) resulting damages.

155
Q

failure to sense

A

fires too early or inappropriately since doesn’t sense native beat

156
Q

atopic dermatitis is also called

and where does it show up

A

atopic dermatitis = ECZEMA and it’s FLEXEMA surfaces

157
Q

posterior elbow dislocation what nerve?

A

ulnar

158
Q

Hantavirus

A

Hemorrhagic
Renal
Rats

159
Q

BITEMPORAL HEMIANOPSIA

A

OPTIC CHIASM LESION

160
Q

normal ABI

A

1.0 - 1.4

161
Q

rubeola

A

measles

162
Q

With which type of leukemia are patients most at risk for severe complications from hyperleukocytosis?

A

aml

163
Q

central pontine myelinolysis bsx

A

Symptoms of ODS include dysarthria, dysphagia, lethargy, paraparesis or quadriparesis, seizures, coma, and death.

164
Q

fever then rash

A

roseola

HHV6

165
Q

infections in erythema nodosum

A

the most common of which are Streptococcal infections. Others include: tuberculosis
sarcoidosis
coccidioidomycosis, histoplasmosis, ulcerative colitis,
enteritis,
pregnancy,
Yersinia enterocolitica, and
Chlamydia.

166
Q

DIC OCCURS DURING ____ AND NOT _____

A

PLACENTAL ABRUPTION

NOT PLACENTA PREVIA

167
Q

roseoola

A

hhv6

fever trhen rash

168
Q

Which of the following is the mechanism of action of methimazole?

A

blocks iodine oxidation

169
Q

which vaginal infection ACIDIC <4.5 ph>?

A

candidacid

170
Q

Patients with iron deficiency anemia will have increased transferrin and TIBC and decreased reticulocyte count.

A

yes

171
Q

GN intracellular

A

chlamydia

172
Q

kawasaki tx

A

asa or IVIG

173
Q

herpangina

A

coxsackie virus

174
Q

What postexposure management is indicated for close adult contacts of a patient diagnosed with pertussis?

A

Z PACK

175
Q

dialyzable drugs

A

P MELTS

phenobarb
methanol 
ethylene glycol 
lithium
theophylline 
salycilates

ABEM (1 decks)

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