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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
Meckles rule of 2s
2% of population affected Most are 2' from ileocecal valve Most are 2" in length Most present before age 2
26
Most common disorder requiring surgery in infants
Pyloric stenosis
27
Pyloric stenosis: Ages affected
2 weeks - 2 months
28
Pyloric stenosis: si/sx
Projectile non-bilious emesis | Hypochloremic hypokalemic metabolic acidosis secondary to vomiting
29
What to be concerned about in newborn who hasn't passed a meconium stool?
Hirschprung's disease
30
Most common GI emergency in neonates
Necrotizing enterocolitis (NEC)
31
Necrotizing enterocolitis: Ages affected
2-3 weeks old
32
Necrotizing enterocolitis: si/sx
Classic triad is abdominal distention, bloody stools, pneuomotosis intestinalis on xray
33
Necrotizing enterocolitis: Rx
Abx, NGT, surgery consult
34
Disc or button battery injestion: Rx
Immediate removal if in esophagus | If passed lower esophageal sphincter, can observe and repeat xray to ensure passing
35
Lowest normal SBP in kids
70 + age/2
36
How to correct sodium in hyperglycemia
Add 1.6 for every 100 glucose is over 100
37
Congenital adrenal hypoplasia: Si/sx
Low Na, High K, low glucose | Sometimes see ambigious genitalia
38
Primary syphilis: si/sx
Painless chancre | 1-3 month incubation
39
Secondary syphilis: si/sx
Maculopapular rash, involves palms & soles | Resolves spontaneously in 1-2 months without therapy
40
Tertiary syphilis: When does it occur?
Anytime 2+ years after initial infection
41
Lymphogranuloma venerium (LGV): cause
Chlymadia trachomonas
42
Lymphogranuloma venerium (LGV): rx
Doxy, azithromycin, erythromycin
43
Uterine fibroid: other name of
Uterine leiomyoma
44
Most common uterine cancer
Endometrial cancer
45
Vulvovaginitis: MCC
Bacterial vaginosis
46
Bacterial vaginosis: Rx in pregnany
Oral metronidazole
47
Bacterial vaginosis: Rx in non-pregnant
Oral metronidazole or intravaginal clindamycin
48
Ward catheter: How long to leave in
6-8 weeks
49
Herpes vaginalis: Appearance
Vessicles on an erythematous base (dew drops on a rose petal)
50
Beta HCG: How does it change in pregnancy
Doubles every 48h for first 8 weeks, then starts to level off
51
Maximum safe total radiation exposure in pregnancy
5-10 rads | Less than this causes no greater increase in birth defects
52
Is barbituate withdrawal life threatening?
Yes
53
Botulism: Pathophysiology
Toxin irreversibly binds to presynaptic ACh release mechanisms, which prevents release of ACh
54
Types of botulism
Infant (most common, 75% of cases) Food borne Wound
55
Botulism: si/sx
Descending weakness Cranial nerve deficits Usually have double/blurred vision NO sensory deficits
56
Botulism: Rx
Antitoxin
57
Tetanus: Causative agent
Clostridium tetani
58
Anthrax: Types
Dermatologic (most common, 90% of cases) GI (rare) Pulmonary (hilar adenopathy and effusions)
59
Anthrax: Rx
Quinolones or doxy
60
Is anthrax contageous from one patient to another?
No
61
Most common ricketsial infection in US
RMSF
62
RMSF: Time of year it is typically seen
Spring & early summer
63
RMSF: Cause
Ricketsial ricketsia
64
RMSF: si/sx
Rash (starts on periphery and moves to trunk) Fever, HA, malaise Sometimes leukopenia, thrombocytopenia and inc LFTs
65
RMSF: Rx
Doxycycline or chloramphenacol
66
Pertussis: Causative agent
Bordatella pertussis
67
Pertussis: How is it spread?
Droplet transmission
68
Ehrlichiosis: si/sx
``` Spotless RMSF (but sometimes will have slight rash) Fever, HA, malaise ```
69
Ehrlichiosis: Rx
Doxycycline
70
Pertussis: Phases
1st: Catarrhal phase (1-2 weeks, URI, cough, anorexia) 2nd: Paroxsymal phase: whooping cough 3rd: Convalescent phase
71
Pertussis: Rx
Macrolides
72
Plague: Causative agent
Yersinia Pestis
73
Plague: Vector
Fleas
74
Plague: Resevoir
Rats
75
Plague: Rx
Aminoglycosides
76
Most common vector borne disease in US
Lyme disease
77
Lung abscesses: Causative agent
Most are anaerobes (from aspiration of oropharyngeal flora)
78
Lung abscesses: Rx
Clindamycin or ampicillin-sulbactam | Add gram negative coverage for immunocompromized patients
79
Beta HCG: When does it start rising?
At implantation (6-7 days after conception)
80
Preeclampsia: Rx
Magnesium sulfate 4-6 gm IV bolus then drip at 2-4 gm/h
81
Placental abruption: Dx
Clinical | Can't r/o with ultrasound, but you may see evidence of
82
How does vaginal bleeding work up differ between trimesters?
No blind speculum/digital exam in 2nd/3rd trimester until ultrasound to r/o placenta previa
83
Post partum fever: Causes
Endometritis (rx with IV abx & hospitalization) | Mastitis
84
Mastitis: Rx
If no abscess, abx and can continue breastfeeding | If abscess, no breastfeeding and will need I&D in OR
85
DVT/PE: Rx in pregnancy
Heparin / LMWH | NO warfarin

ABEM Recert Exam 2015 (7 decks)

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