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ABEM Recert Exam 2015 > ABEM Recert Exam pt. 2 > Flashcards

ABEM Recert Exam pt. 2 Flashcards

1
Q

Scarlet fever: Cause

A

Group A Beta-hemolytic strep

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2
Q

Scarlet fever: si/sx

A

Sore throat, then rash 12h later

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3
Q

Scarlet fever: Rx

A

PCN

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4
Q

Staph Scalded Skin Syndrome (SSSS): Age involved

A

<5 yo

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5
Q

Staph Scalded Skin Syndrome: Rx

A

Fluids, just like a burn patient with excess fluid loss from skin

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6
Q

Staph Scalded Skin Syndrome: Skin involved

A

Almost everywhere but no mucous membrane involvement

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7
Q

Erythema Multiforme: Appearance

A

Target lesions, symmetric on extensor surfaces, elbows and knees
DOES have mucous membrane involvement

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8
Q

Steven Johnson syndrome vs TEN: How to diff

A

SJS has >30% BSA involvement, TEN has less

Almost all TEN is from drugs, SJS is mostly drugs too but can also be from infection, or graft versus host

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9
Q

Measles: Incubation period

A

1-2 weeks

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10
Q

Measles: si/sx

A

3 Cs
Cough
Conjunctivitis
Corzya (irritation of nasal mucous membrane, runny nose)
Fever
Morbiliform rash starts on face then spreads

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11
Q

Measles: Rx

A

IVIG

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12
Q

Henoch-Schonlein Purpura (HSP): si/sx

A 
ARENA
Abdominal pain
Rash
Edema (hands & feet)
Nephritis
Arthritis/arthralgias
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13
Q

Henoch-Schonlein Purpura: What complication is at increased risk with

A

HSP has increased risk of intussecption

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14
Q

Do petechiae and purpura blanch? Why?

A

DO NOT blanch. Is a vasculitis, so vessels are leaky and blood that you see is outside vessel, so when you press on it, it doesn’t go back in

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15
Q

Erythema Infectiousum: AKA

A

Fifth disease (slapped cheek disease)

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16
Q

Erythema Infectiousum: Complications

A

Aplastic anemia in patient’s with sickle cell dz

Fetal demise in pregnant patients

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17
Q

Roseolla: si/sx

A

3-5 days of fever, which then resolves

As fever resolves, blotchy, macular rash appears

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18
Q

Roseolla: Rx

A

None

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19
Q

Impetigo: Causes

A

GAS

Staph aureus

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20
Q

Characteristics of life-threatening rashes

A 
Mucous membrane involvement (but not always, i.e. Hand ,Foot, Mouth disease)
Pain out of proportion to exam
Skin sloughing
Petechiae / purpura
Altered LOC
Persistent fever
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21
Q

Myocarditis: When to think about it

A

When an ill-appearing child gets worse after a fluid bolus, not better

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22
Q

Classes of congenital heart disease

A 
Blue baby (right to left shunt)
Gray/mottled baby (cardiac outflow obstruction)
Pink baby (left to right shunt)
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23
Q

HOCM murmur: What changes the murmur?

A

Gets worse with standing or Valsalva

Better with squatting, isometric hand grips or lying down

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24
Q

Intussecption: Radiographic findings

A

Target sign on ultrasound

Decreased bowel gas in RLQ on KUB

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25
Q

Meckles rule of 2s

A

2% of population affected
Most are 2’ from ileocecal valve
Most are 2” in length
Most present before age 2

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26
Q

Most common disorder requiring surgery in infants

A

Pyloric stenosis

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27
Q

Pyloric stenosis: Ages affected

A

2 weeks - 2 months

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28
Q

Pyloric stenosis: si/sx

A

Projectile non-bilious emesis

Hypochloremic hypokalemic metabolic acidosis secondary to vomiting

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29
Q

What to be concerned about in newborn who hasn’t passed a meconium stool?

A

Hirschprung’s disease

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30
Q

Most common GI emergency in neonates

A

Necrotizing enterocolitis (NEC)

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31
Q

Necrotizing enterocolitis: Ages affected

A

2-3 weeks old

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32
Q

Necrotizing enterocolitis: si/sx

A

Classic triad is abdominal distention, bloody stools, pneuomotosis intestinalis on xray

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33
Q

Necrotizing enterocolitis: Rx

A

Abx, NGT, surgery consult

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34
Q

Disc or button battery injestion: Rx

A

Immediate removal if in esophagus

If passed lower esophageal sphincter, can observe and repeat xray to ensure passing

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35
Q

Lowest normal SBP in kids

A

70 + age/2

36
Q

How to correct sodium in hyperglycemia

A

Add 1.6 for every 100 glucose is over 100

37
Q

Congenital adrenal hypoplasia: Si/sx

A

Low Na, High K, low glucose

Sometimes see ambigious genitalia

38
Q

Primary syphilis: si/sx

A

Painless chancre

1-3 month incubation

39
Q

Secondary syphilis: si/sx

A

Maculopapular rash, involves palms & soles

Resolves spontaneously in 1-2 months without therapy

40
Q

Tertiary syphilis: When does it occur?

A

Anytime 2+ years after initial infection

41
Q

Lymphogranuloma venerium (LGV): cause

A

Chlymadia trachomonas

42
Q

Lymphogranuloma venerium (LGV): rx

A

Doxy, azithromycin, erythromycin

43
Q

Uterine fibroid: other name of

A

Uterine leiomyoma

44
Q

Most common uterine cancer

A

Endometrial cancer

45
Q

Vulvovaginitis: MCC

A

Bacterial vaginosis

46
Q

Bacterial vaginosis: Rx in pregnany

A

Oral metronidazole

47
Q

Bacterial vaginosis: Rx in non-pregnant

A

Oral metronidazole or intravaginal clindamycin

48
Q

Ward catheter: How long to leave in

A

6-8 weeks

49
Q

Herpes vaginalis: Appearance

A

Vessicles on an erythematous base (dew drops on a rose petal)

50
Q

Beta HCG: How does it change in pregnancy

A

Doubles every 48h for first 8 weeks, then starts to level off

51
Q

Maximum safe total radiation exposure in pregnancy

A

5-10 rads

Less than this causes no greater increase in birth defects

52
Q

Is barbituate withdrawal life threatening?

A

Yes

53
Q

Botulism: Pathophysiology

A

Toxin irreversibly binds to presynaptic ACh release mechanisms, which prevents release of ACh

54
Q

Types of botulism

A

Infant (most common, 75% of cases)
Food borne
Wound

55
Q

Botulism: si/sx

A

Descending weakness
Cranial nerve deficits
Usually have double/blurred vision
NO sensory deficits

56
Q

Botulism: Rx

A

Antitoxin

57
Q

Tetanus: Causative agent

A

Clostridium tetani

58
Q

Anthrax: Types

A

Dermatologic (most common, 90% of cases)
GI (rare)
Pulmonary (hilar adenopathy and effusions)

59
Q

Anthrax: Rx

A

Quinolones or doxy

60
Q

Is anthrax contageous from one patient to another?

A

No

61
Q

Most common ricketsial infection in US

A

RMSF

62
Q

RMSF: Time of year it is typically seen

A

Spring & early summer

63
Q

RMSF: Cause

A

Ricketsial ricketsia

64
Q

RMSF: si/sx

A

Rash (starts on periphery and moves to trunk)
Fever, HA, malaise
Sometimes leukopenia, thrombocytopenia and inc LFTs

65
Q

RMSF: Rx

A

Doxycycline or chloramphenacol

66
Q

Pertussis: Causative agent

A

Bordatella pertussis

67
Q

Pertussis: How is it spread?

A

Droplet transmission

68
Q

Ehrlichiosis: si/sx

A 
Spotless RMSF (but sometimes will have slight rash)
Fever, HA, malaise
69
Q

Ehrlichiosis: Rx

A

Doxycycline

70
Q

Pertussis: Phases

A

1st: Catarrhal phase (1-2 weeks, URI, cough, anorexia)
2nd: Paroxsymal phase: whooping cough
3rd: Convalescent phase

71
Q

Pertussis: Rx

A

Macrolides

72
Q

Plague: Causative agent

A

Yersinia Pestis

73
Q

Plague: Vector

A

Fleas

74
Q

Plague: Resevoir

A

Rats

75
Q

Plague: Rx

A

Aminoglycosides

76
Q

Most common vector borne disease in US

A

Lyme disease

77
Q

Lung abscesses: Causative agent

A

Most are anaerobes (from aspiration of oropharyngeal flora)

78
Q

Lung abscesses: Rx

A

Clindamycin or ampicillin-sulbactam

Add gram negative coverage for immunocompromized patients

79
Q

Beta HCG: When does it start rising?

A

At implantation (6-7 days after conception)

80
Q

Preeclampsia: Rx

A

Magnesium sulfate 4-6 gm IV bolus then drip at 2-4 gm/h

81
Q

Placental abruption: Dx

A

Clinical

Can’t r/o with ultrasound, but you may see evidence of

82
Q

How does vaginal bleeding work up differ between trimesters?

A

No blind speculum/digital exam in 2nd/3rd trimester until ultrasound to r/o placenta previa

83
Q

Post partum fever: Causes

A

Endometritis (rx with IV abx & hospitalization)

Mastitis

84
Q

Mastitis: Rx

A

If no abscess, abx and can continue breastfeeding

If abscess, no breastfeeding and will need I&D in OR

85
Q

DVT/PE: Rx in pregnancy

A

Heparin / LMWH

NO warfarin

ABEM Recert Exam 2015 (7 decks)

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