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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
Q

Hypercalcemia: EKG changes

A

Short QT

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26
Q

Hypomagnesemia: EKG changes

A

Long QT

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27
Q

TCA OD: EKG changes

A

QRS > 100ms or QTc > 430 ms

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28
Q

TCA OD: Rx for patients with EKG changes

A

Sodium bicarb

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29
Q

Adenosine: When not to use

A

WPW with wide QRS tachycardia

Also don’t use CCB

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30
Q

WPW with wide QRS tachycardia: Rx

A

Procainamide or amiodarone or cardioversion

NO adenosine

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31
Q

Aortic insufficiency murmur

A

Short diastolic murmur

Austin-Flint murmur (low pitched rumbling murmur at apex)

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32
Q

Aortic insufficiency: si/sx on physical exam

A

Nailbed pulsations with each beat (Quinke’s sign)

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33
Q

Mitral stenosis: MCC

A

Rheumatic fever

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34
Q

Mitral regurgitation: Causes

A

AMI

Endocarditis

35
Q

What does acute new onset mitral regurgitation murmur suggest?

A

Rupture of chordae tendonae or papillary muscle

36
Q

MVP: Murmur

A

midsystolic click

37
Q

Most common heart murmur

A

MVP

38
Q

Endocarditis: Frequency of valves affected

A

Mitral > Aortic > Tricuspid > Pulmonic

39
Q

Endocarditis in prosthetic valves: Causes

A

In 1st 2 months = Staph Aureus or Staph epididymitis

>2 months after surgery = Strep viridans

40
Q

R-sided endocarditis: Typical cause

A

IVDA

Usually involves tricuspid valve

41
Q

L-sided endocarditis: Typical cause

A

Congenital or acquired

42
Q

Endocarditis in IVDA: Typical pathogen

A

Staph aureus

43
Q

Most common cardiac abnormality

A

VSD

44
Q

Infant with CHF: What to suspect based on timing of onset

A 
1st day: PDA
1st week: Hypoplastic left heart
2nd week: Coarctation of the aorta
1st month: VSD
3+ months: SVT
45
Q

Torsades: Rx

A

Magnesium 1-2 gm IV then drip at 1-2 g/hr

46
Q

Do you treat reperfusion dysrhythmias after TPa?

A

No, they’re common

47
Q

Janeway lesions: What are they are what are they seen with?

A

Non-tender macules on palms and soles seen with endocarditis

48
Q

MAP: How to calculate

A

(SBP + 2DBP) / 3

49
Q

Antiarrhythmic classes

A
  1. Sodium channel
  2. Beta blocker
  3. Mixed
  4. Calcium channel
50
Q

Digibind: When to use

A

Serum digoxin > 10 or K >5.5

51
Q

Digoxin toxicity: EKG findings

A

PVCs are most common

PAT with AV block is classic

52
Q

Tetralogy of Falot: Components of

A
  1. VSD (causes R-L shunt)
  2. Pulmonic stenosis
  3. Overriding aorta
  4. RVH
53
Q

Tet spell: non-pharmacologic rx

A

Place patient in knee-chest position

54
Q

Most common cyanotic heart defect in age >1 yo

A

Tetralogy of Falot

55
Q

Which is most specific liver enzyme for liver damage?

A

ALT

Increased AST seen in mitochondrial damage and can occur outside of liver

56
Q

What does increased conjugated (direct) bilirubin mean?

A

Liver damage, liver cells aren’t working properly to remove conjugated bilirubin

57
Q

What does increased unconjugated (indirect) bilirubin mean?

A

Hemolysis or Gilbert’s syndrome

58
Q

Subacute bacterial peritonitis: Lab values for

A

WBC > 1000 or PMNs > 250 on paracentesis fluid

Cultures can be negative

59
Q

How many DKA patients are Type I diabetic?

A

2/3

60
Q

How many DKA patients are Type II diabetic?

A

1/3

Previously thought that only Type I could get DKA

61
Q

Physiology of cortisol production

A

Pituitary gland makes ACTH
ACTH stimulated adrenal cortex to make cortisol
Cortisol produces negative feedback to pituitary

Adrenal cortex also makes aldosterone

62
Q

Primary adrenal insufficiency: Pathophysiology

A

Adrenal gland failure

Si/sx due to decreased aldosterone and decreased cortisol

63
Q

Secondary adrenal insufficiency: Pathophysiology

A

Pituitary gland failure

Si/sx due to decreased cortisol only (aldosterone is normal)

64
Q

Secondary adrenal insufficiency: MCC

A

Stopping steroids

65
Q

How to diff primary vs secondary adrenal insufficiency on labs

A

Primary has hyperkalemia

Secondary has normal potassium

66
Q

Frostbite: Degrees and si/sx of each

A
  1. grey tissues
  2. clear blisters
  3. hemorrhagic blisters
  4. tissue necrosis
67
Q

Nitrogen narcosis: si/sx

A

Altered MS that occurs 70’-100’ deep under water

Resolves when patient ascends and usually asymptomatic out of water

68
Q

Amanita Phalloides: si/sx of ingestion

A

N/V after eating, then liver failure day 3+

69
Q

Amanita Phalloides: What time of year is mushroom usually found?

A

Fall

70
Q

Types of poisonous snakes

A
  1. Pit vipers (rattlesnakes, cottonmouths, copperheads)

2. Coral snakes

71
Q

Disposition for anyone treated with snake antivenom

A

Admit

72
Q

Coral snake bite: Rx

A

Antivenom

Admit all for observation since neurotoxicity can occur up to 12 hours later

73
Q

Jelly fish sting: Rx

A

Wash off neumatocysts with warm sea water, then vinegar

Fresh water will cause neumatocysts to explode

74
Q

Ciguatera toxin poisoning: Cause

A

Scombroid fish

75
Q

Cigatera toxin poisoning: si/sx

A

Presents like an allergic reaction

Reversal of hot and cold sensations is pathognomonic

76
Q

Arrhythmia that DC causes

A

VF

77
Q

Arrhythmia that AC causes

A

Asystole

78
Q

Food poisoning: 2 MCC

A
  1. non-typhoid salmonella is most common

2. Staph aureus is 2nd most common

79
Q

Yersinia: si/sx

A

Can cause terminal illeitis which looks like appendicitis

80
Q

Most common cause of anemia worldwide

A

Hookworm infection

81
Q

Hookworm: How is it transmitted?

A

People walk barefoot

82
Q

Hookworm: Causative agent

A

Necatur americanus

83
Q

Large bowel obstruction: MCC

A

Tumors

84
Q

Small bowel obstruction: MCC

A

Adhesions

ABEM Recert Exam 2015 (7 decks)

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