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ABEM Recert Exam 2015 > ABEM Recert Exam pt. 3 > Flashcards

ABEM Recert Exam pt. 3 Flashcards

1
Q

Mastoiditis: MCC

A

Strep pneumo

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2
Q

How to diff labrynthitis vs Menierre’s disease

A

Menierre’s disease has hearing loss, labrynthitis doesn’t

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3
Q

Otitis media: When is it okay to do delay antibiotic strategy

A

Age >2

Well appearing

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4
Q

Diphtheria: Rx

A

Antitoxin and PCN G

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5
Q

Diphtheria: si/sx

A

“Bull neck” deformity, F/C, sore throat, gray coating in throat

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6
Q

CENTOR criteria for pharyngitis

A
  1. Tonsilar exudates
  2. Lymphadenopathy
  3. Fever
  4. Absence of cough
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7
Q

CENTOR criteria: How to use

A

0-1: Do not test or treat
2-3: Test and treat if positive
4: Treat without testing

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8
Q

Appendicitis: Urine findings and why

A

50% can have pyuria (WBC in urine) and hematuria if appendicitis present for 3+ days because ureters run close to appendix

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9
Q

AAA: At what size don’t you have to worry about rupture

A

<4cm has essentially no chance of rupture

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10
Q

Q wave: Definition

A

1 box wide, 1/3 height of R wave in 2 contiguous leads

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11
Q

Inferior MI: Vessel involved

A

RCA occlusion

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12
Q

Anterior MI: Vessel involved

A

LAD occlusion

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13
Q

Lateral MI: EKG changes

A

I, avL, V5, V6

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14
Q

Posterior MI: EKG changes

A

ST depression in V1, V2 with upright T waves

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15
Q

Posterior MI: Vessel involved

A

Circumflex

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16
Q

Septal MI: EKG changes

A

ST elevation V2, V3

Sometimes have ST elevation in I & aVL

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17
Q

Subarachnoid hemorrhage: EKG changes

A

Sometimes can see large, broad diffuse T wave inversions

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18
Q

Pericarditis EKG changes

A
  1. Diffuse ST elevation & PR depression
  2. PR returns to baseline
  3. T wave inversions
  4. Normalization of EKG
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19
Q

CHF: 3 stages of CXR findings

A
  1. Cephalization
  2. Insterstitial edema (curly B lines)
  3. Alveolar edema (bat wing)
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20
Q

Dilated cardiomyopathy: Causes

A

Alcohol
Ischemia
Amyloidosis

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21
Q

Widened mediastinum: Definition on PA CXR

A

> 8 cm

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22
Q

AAA repair patient who presents with BRBPR: What to r/o

A

Aortoenteric fistula

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23
Q

Hyperkalemia: EKG change progression

A
  1. Peaked T
  2. Increased PR
  3. Wide QRS
  4. Bundle branch block
  5. Sine wave
  6. Asystole
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24
Q

Hypocalcemia: EKG changes

A

Long QT

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25
Hypercalcemia: EKG changes
Short QT
26
Hypomagnesemia: EKG changes
Long QT
27
TCA OD: EKG changes
QRS > 100ms or QTc > 430 ms
28
TCA OD: Rx for patients with EKG changes
Sodium bicarb
29
Adenosine: When not to use
WPW with wide QRS tachycardia | Also don't use CCB
30
WPW with wide QRS tachycardia: Rx
Procainamide or amiodarone or cardioversion | NO adenosine
31
Aortic insufficiency murmur
Short diastolic murmur | Austin-Flint murmur (low pitched rumbling murmur at apex)
32
Aortic insufficiency: si/sx on physical exam
Nailbed pulsations with each beat (Quinke's sign)
33
Mitral stenosis: MCC
Rheumatic fever
34
Mitral regurgitation: Causes
AMI | Endocarditis
35
What does acute new onset mitral regurgitation murmur suggest?
Rupture of chordae tendonae or papillary muscle
36
MVP: Murmur
midsystolic click
37
Most common heart murmur
MVP
38
Endocarditis: Frequency of valves affected
Mitral > Aortic > Tricuspid > Pulmonic
39
Endocarditis in prosthetic valves: Causes
In 1st 2 months = Staph Aureus or Staph epididymitis | >2 months after surgery = Strep viridans
40
R-sided endocarditis: Typical cause
IVDA | Usually involves tricuspid valve
41
L-sided endocarditis: Typical cause
Congenital or acquired
42
Endocarditis in IVDA: Typical pathogen
Staph aureus
43
Most common cardiac abnormality
VSD
44
Infant with CHF: What to suspect based on timing of onset
``` 1st day: PDA 1st week: Hypoplastic left heart 2nd week: Coarctation of the aorta 1st month: VSD 3+ months: SVT ```
45
Torsades: Rx
Magnesium 1-2 gm IV then drip at 1-2 g/hr
46
Do you treat reperfusion dysrhythmias after TPa?
No, they're common
47
Janeway lesions: What are they are what are they seen with?
Non-tender macules on palms and soles seen with endocarditis
48
MAP: How to calculate
(SBP + 2DBP) / 3
49
Antiarrhythmic classes
1. Sodium channel 2. Beta blocker 3. Mixed 4. Calcium channel
50
Digibind: When to use
Serum digoxin > 10 or K >5.5
51
Digoxin toxicity: EKG findings
PVCs are most common | PAT with AV block is classic
52
Tetralogy of Falot: Components of
1. VSD (causes R-L shunt) 2. Pulmonic stenosis 3. Overriding aorta 4. RVH
53
Tet spell: non-pharmacologic rx
Place patient in knee-chest position
54
Most common cyanotic heart defect in age >1 yo
Tetralogy of Falot
55
Which is most specific liver enzyme for liver damage?
ALT | Increased AST seen in mitochondrial damage and can occur outside of liver
56
What does increased conjugated (direct) bilirubin mean?
Liver damage, liver cells aren't working properly to remove conjugated bilirubin
57
What does increased unconjugated (indirect) bilirubin mean?
Hemolysis or Gilbert's syndrome
58
Subacute bacterial peritonitis: Lab values for
WBC > 1000 or PMNs > 250 on paracentesis fluid | Cultures can be negative
59
How many DKA patients are Type I diabetic?
2/3
60
How many DKA patients are Type II diabetic?
1/3 | Previously thought that only Type I could get DKA
61
Physiology of cortisol production
Pituitary gland makes ACTH ACTH stimulated adrenal cortex to make cortisol Cortisol produces negative feedback to pituitary Adrenal cortex also makes aldosterone
62
Primary adrenal insufficiency: Pathophysiology
Adrenal gland failure | Si/sx due to decreased aldosterone and decreased cortisol
63
Secondary adrenal insufficiency: Pathophysiology
Pituitary gland failure | Si/sx due to decreased cortisol only (aldosterone is normal)
64
Secondary adrenal insufficiency: MCC
Stopping steroids
65
How to diff primary vs secondary adrenal insufficiency on labs
Primary has hyperkalemia | Secondary has normal potassium
66
Frostbite: Degrees and si/sx of each
1. grey tissues 2. clear blisters 3. hemorrhagic blisters 4. tissue necrosis
67
Nitrogen narcosis: si/sx
Altered MS that occurs 70'-100' deep under water | Resolves when patient ascends and usually asymptomatic out of water
68
Amanita Phalloides: si/sx of ingestion
N/V after eating, then liver failure day 3+
69
Amanita Phalloides: What time of year is mushroom usually found?
Fall
70
Types of poisonous snakes
1. Pit vipers (rattlesnakes, cottonmouths, copperheads) | 2. Coral snakes
71
Disposition for anyone treated with snake antivenom
Admit
72
Coral snake bite: Rx
Antivenom | Admit all for observation since neurotoxicity can occur up to 12 hours later
73
Jelly fish sting: Rx
Wash off neumatocysts with warm sea water, then vinegar Fresh water will cause neumatocysts to explode
74
Ciguatera toxin poisoning: Cause
Scombroid fish
75
Cigatera toxin poisoning: si/sx
Presents like an allergic reaction | Reversal of hot and cold sensations is pathognomonic
76
Arrhythmia that DC causes
VF
77
Arrhythmia that AC causes
Asystole
78
Food poisoning: 2 MCC
1. non-typhoid salmonella is most common | 2. Staph aureus is 2nd most common
79
Yersinia: si/sx
Can cause terminal illeitis which looks like appendicitis
80
Most common cause of anemia worldwide
Hookworm infection
81
Hookworm: How is it transmitted?
People walk barefoot
82
Hookworm: Causative agent
Necatur americanus
83
Large bowel obstruction: MCC
Tumors
84
Small bowel obstruction: MCC
Adhesions

ABEM Recert Exam 2015 (7 decks)

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