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ABEM Recert Exam 2015 > ABEM Recert Exam pt. 4 > Flashcards

ABEM Recert Exam pt. 4 Flashcards

1
Q

Macule: Definition

A

<1 cm, non-palpable

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2
Q

Papule: Definition

A

<1cm, palpable

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3
Q

Patch: Definition

A

> 1cm, non-palpable

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4
Q

Plaque: Definition

A

> 1cm, palpable

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5
Q

Vesicle: Definition

A

<1cm papule with clear fluid

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6
Q

Bullae: Definition

A

> 1cm plaque filled with clear fluid

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7
Q

What conditions is Nikolski’s sign seen with?

A

SSSS, TEN/SJS, Pemphigus Vulgaris

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8
Q

Bullous pemphigoid vs Pemphigus vulgaris: How to diff?

A

Bullous pemphigoid doesn’t have Nikolski’s sign

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9
Q

HUS-TTP: Rx

A

Exchange transfusion

NO PLATELETS, since it’s a consumptive process

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10
Q

Bullous pemphigoid and Pemphigus vulgaris: Appearance

A

Large, flat bullae

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11
Q

Leptosporosis: How is it transmitted?

A

Through contact with urine in a contaminated water source (e.g. exposure as a cattle rancher or through recreation in water)

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12
Q

Babesiosis: si/sx

A

Similar to malaria

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13
Q

Babesiosis: Geographic distribution

A

Found in New England

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14
Q

Babesiosis: Pathophysiology

A

Intracellular parasite which infects RBCs

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15
Q

Yersinia pestis (plague): Appearance

A

Patients have a bubo (infected, tender, swollen lymph node)

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16
Q

Tularemia: Geographic distribution

A

Found world-wide, but often in California on board questions

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17
Q

Tularemia: Reservoir, vector and how it’s spread

A

Reservoir = Rabbits
Vector = Fleas / ticks
Can’t be spread human to human

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18
Q

Tinea: Rx

A

Must use oral antifungal if involves hair or nails, otherwise can use topical

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19
Q

SJS/TEN vs SSSS: How to diff?

A

SSSS usually doesn’t have mucous membrane involvement

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20
Q

SJS/TEN: Typical cause

A

Medications (often sulfa or antiepileptic)

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21
Q

Hemophilia A: Cause

A

Factor 8 deficiency

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22
Q

Hemophilia B: Cause

A

Factor 9 deficiency (Christmas disease)

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23
Q

Will PT, PTT, or both be abnormal in hemophilia?

A

Only PTT is abnormal

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24
Q

von Willebrand’s disease: Rx

A

DDAVP for mild disease

Factor 8 for severe disease

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25
Q

ITP: Rx

A

Steroids

NO platelets

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26
Q

TTP: si/sx

A 
FAT-RN
Fever
Anemia
Thrombocytopenia
Renal involvement
Neurologic changes
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27
Q

TTP: Rx

A

Plasma exchange transfusion
Steroids
NO platelets

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28
Q

Microcytic anemia: Causes

A

Lead
Iron deficiency
Sideroblastic
Thalassemia

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29
Q

Normocytic anemia: Causes

A

Decreased production of normal RBCs (anemia of chronic disease, aplastic anemia)
Destruction of normal RBCs (hemolysis, blood loss)
Uncompensated increase in plasma volume (pregnancy, fluid overload)

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30
Q

Macrocytic anemia: Causes

A

Alcohol
B12/Folate deficiency
COPD
G6PD

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31
Q

AML vs CLL: How to diff

A

AML usually dosen’t have lymphadenopathy, CLL usually does

CLL always has increased WBCs, AML may have low, normal, or high WBCs

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32
Q

Optic neuritis: si/sx

A

Eye pain
Blurred vision
APD

Is unilateral, never bilateral

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33
Q

Normal ESR: How to calculate

A

(age + 10) / 2

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34
Q

Encephalitis: Definition

A

Fever
Headache
Neurologic changes

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35
Q

Encephalitis: MRI findings

A

Edema and/or hemorrhage in temporal lobe

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36
Q

Epidural abscess: Causative agent

A

Most are Staph aureus

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37
Q

Encephalitis: CSF findings

A

Increased protein

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38
Q

Guillane Barre syndrome: Most common preceding infection

A

Camplobacter jejuni

39
Q

Myasthenia gravis: Pathophysiology

A

Antibodies form against postsynaptic ACh receptors

40
Q

Myasthenia gravis vs organophosphate poisoning: How to diff

A

MG gets better with edrophonium (Tension)

Organophosphate gets worse

41
Q

Organophosphate poisoning: Pathophysiology

A

Excess cholinesterase inhibitor which causes functional decrease in ACh

42
Q

Pseudotumor cerebreri: What is typical opening pressure?

A

> 25 cm H2O

43
Q

Febrile seizures: Ages affected

A

6 mo - 6 yo (but usually 12-18 months)

44
Q

Primary CNS tumors: What type are most?

A

50% are gliomas

45
Q

Tumors which met to brain

A

Lung > Breast > Melanoma

46
Q

Hiccups: Rx

A

Thorazine

47
Q

Boerhaave’s sydrome: Pathophysiology

A

Full-thickness esophageal tear

48
Q

Narrowest part of esophagus

A 
Kids = C6 criccopharyngis muscle
Adults = T11 GE junction
49
Q

How to tell if a coin is in esophagus or trachea?

A

Flat in AP projection = esophagus
Thin line in AP projection = trachea
Flat in sagital / cross section view = trachea

50
Q

Hepatic encephalopathy: precipitants / causes

A 
LIVER
Librium
Infection
Volume loss
Electrolyte disorders
RBCs in gut (GI bleed)
51
Q

What does IgM indicate?

A

Acute infection

52
Q

What does Anti HBS indicate?

A

Patient is not infectious

53
Q

What does HBS antigen indicate?

A

Patient is infectious

54
Q

What does Anti HBc indicate?

A

Patient has low levels of infectivity

55
Q

What does HBAg indicate?

A

Patient has high levels of infectivity

56
Q

What does HBCAb (Hep B core Ab) indicate?

A

Previous Hep B infection

57
Q

Ascending cholangitis: si/sx

A

Charcot’s triad

  1. Fever
  2. RUQ abd pain
  3. Jaundice

Reynold’s pentad adds

  1. Hypotension
  2. Altered MS
58
Q

Pancreatitis: xray findings

A

Colon cut off sign (abrupt cut off of colon near left side of abdomen on KUB)

Sentinal loop (air fluid levels near pancreas on KUB)

59
Q

Ranson’s criteria

A 
GA-LAW
Glucose > 200
AST > 250
LDH > 350
Age > 55
WBC > 16,000
<3 = mild disease
3+ = severe disease
60
Q

Malrotation with midgut volvus: si/sx

A

bilious emesis

Usually affects age

61
Q

Most common protozoal diarrhea in US

A

Giardia

62
Q

Salmonella: Rx

A

TMP-SMX or quinolone

63
Q

Shigella: Rx

A

TMP-SMX or quinolone

64
Q

Most common bacterial diarrhea

A

Camplobacter

65
Q

Camplobacter diarrea: Rx

A

Quinolone or erythromycin

66
Q

Vibrio cholera: Rx

A

Doxycycline, TMP-SMX, or Cipro

67
Q

Indications for thoracotomy after chest tube placement

A

> 1500 ml blood out initially

>200 ml/h blood out for 4 hours

68
Q

Traumatic pericardial tamponade: Rx

A

Thoracotomy

Pericardiocentesis not effect

69
Q

Aortic dissection: Width on PA CXR

A

8 cm

70
Q

At what level on chest can you have penetrating trauma cause intrathoracic and/or intraabdominal contents?

A

Nipple line

71
Q

Blunt diaphragmatic injury usually affects the (LEFT / RIGHT) side. Why?

A

Left side, because liver protects on right

72
Q

Duodenal hematoma: Usual mechanism and si/sx

A

Handle bar hit kids in abdomen while riding bike
Causes abdominal pain and vomiting
Will see on CT

73
Q

Pelvic fractures: Types

A
  1. AP compression - highest rate of GU injuries
  2. Lateral compression - most common
  3. Vertical sheer - fall from height; highest rate of hemorrhage
74
Q

Which type of pelvic fracture is most common?

A

Lateral compression

75
Q

Which type of pelvic fracture has the highest rate of GU injuries?

A

AP compression

76
Q

Which type of pelvic fracture has the highest rate of hemorrhage?

A

Vertical sheer

77
Q

Retroperitoneal hemorrhage in trauma: When to suspect

A

Patient with normal CXR and FAST who remains hypotensive despite fluid resuscitation
NOT seen on FAST

78
Q

Hematuria in children after trauma: When to work up?

A

> 50 RBC/hpf

79
Q

DPL: Definition of (+)

A

> 10 mL blood on initial aspirate

>100,000 RBC/mL after instilling 1L fluid

80
Q

FAST: What are 4 components

A
  1. RUQ view (Morrison’s pouch/hepatorenal recess)
  2. LUQ view (area around spleen and diaphragm)
  3. Subcostal view (fluid around heart)
  4. Pelvic view (pelvic free fluid)
81
Q

Where does traumatic TM perforation usually occur?

A

Pars tensa

82
Q

Traumatic TM perforation: Disposition

A

If in posterior superior quadrant or from penetrating trauma, needs ENT f/u within 24h

83
Q

Raynaud’s disease: Color progression

A

Red -> Blue -> White

84
Q

Reiter’s syndrome: New name

A

Reactive arthritis

85
Q

SLE triad

A

Fever
Rash
Joint pain

86
Q

Drug-induced lupus: What marker do you see

A

Anti-histone Ab

87
Q

Drug-induced lupus: Common drugs causing

A 
HIPPS
Hydralazine
INH
Phenytoin
Procainamide
Sulfonamides
88
Q

Bechet’s disease: Pathophysiology

A

Medium and large vessel vasculitis

89
Q

Bechet’s disease: Si/sx

A

Chronic recurrent oral and genital ulcers

May also have uveitis and optic neuritis (if does = admission)

90
Q

Bechet’s disease: Rx

A

High dose steroids

91
Q

Thromboangitis obliterans: Pathophysiology

A

Medium and small vessel vasculitis

92
Q

Thromboangitis obliterans: Typical patient affected

A

Young male smoker

93
Q

Thromboangitis obliterans: Si/sx

A

Superficial thrombophlebitis and necrosis of distal digits

94
Q

Thromboangitis obliterans: Rx

A

Smoking cessation

ABEM Recert Exam 2015 (7 decks)

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