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ABEM Recert Exam 2015 > ABEM Recert Exam pt. 6 > Flashcards

ABEM Recert Exam pt. 6 Flashcards

1
Q

What nerve injury can a perilunate dislocation cause?

A

Median nerve compression

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2
Q

Tick paralysis: si/sx

A

Ascending paralysis like GBS

First step in rx is to remove tick

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3
Q

Tick paralysis: rx

A

Remove tick

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4
Q

When should emergency contraception be initiated?

A

Within 72h

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5
Q

Central retinal artery occlusion: rx

A

Digital massage of orbit

Acetazolamide

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6
Q

Maximal dose for lidocaine without epi

A

7 mg/kg

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7
Q

Maximal dose with lidocaine with epi

A

5 mg/kg

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8
Q

Source of bleeding in anterior epistaxis

A

Kiesselbach’s plexus

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9
Q

Toxic Shock Syndrome: What are most cases associated with?

A

Menstruation (but don’t have to leave tampon in for longer than normal)

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10
Q

Toxic Shock Syndrome: Skin findings

A

Blanching macular rash

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11
Q

Toxic Shock Syndrome: Bacteria causing

A

Staph aureus

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12
Q

Most specific test for pediatric UTIs

A

Nitrite on urine dip test strips

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13
Q

Bacerial tracheitis: MCC

A

Staph aureus

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14
Q

Central retinal artery occlusion: Fundoscopic finidngs

A

Cherry red spots

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15
Q

Central retinal vein occlusion: Fundoscopic findings

A

Blood and thunder

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16
Q

Central retinal vein occlusion: rx

A

ASA & ophtho consult

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17
Q

Pertussis: Best lab dx test for

A

PCR

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18
Q

Meckel’s diverticulum: What’s the best test to use to dx?

A

Technetium-99 RBC scan (tagged RBC bleeding scan)

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19
Q

Resuscitation dose of epi in kids

A

0.01 mg/kg

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20
Q

Pediatric cardioversion energy dose

A

0.5 - 1 J/kg

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21
Q

How to position patient with pulmonary contusion and hypoventilation/hypoxygenation?

A

Good lung down

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22
Q

Where are most clavicle fractures?

A

Lateral 1/3

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23
Q

Cause of most clavicle fractures?

A

Direct force to lateral shoulder

Causes fx to lateral 1/3 of clavicle, which is most common area of clavicle fractures

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24
Q

Parkland formula for fluids in burn resuscitation

A

4 mL/kg per % BSA total in 24 hours

Give initial 50% in 1st 8h, then rest over next 16h

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25
Q

Pediatric adenosine dose

A

1st dose: 0.1 mg/kg IV/IO

2nd dose: 0.2 mg/kg IV/IO

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26
Q

Pediatric atropine dose

A

0.02 mg/kg IV/IO (minimum dose 0.1 mg)

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27
Q

Pediatric amiodarone dose

A

5 mg/kg IV/IO

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28
Q

Pediatric calcium chloride dose

A

20 mg/kg IV/IO

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29
Q

Pediatric epinephrine dose

A

0.01 mg/kg (1:10,000) or 0.1 mg/kg (1:1,000)

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30
Q

Pediatric glucose dose

A

1-2 mL/kg D50
2-4 mL/kg D25 (children)
5-10 mL/kg D10 (neonates)

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31
Q

Pediatric lidocaine dose

A

1 mg/kg

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32
Q

Pediatric magnesium sulfate dose

A

25-50 mg/kg bolus (max dose 2 gm)

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33
Q

Pediatric sodium bicarb dose

A

1 mEq/kg

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34
Q

Entamoeba histolytica infection: si/sx

A

fever
RUQ pain
Possible liver abscess

Rx is metronidazole

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35
Q

Most common primary headache

A

Tension

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36
Q

Endocarditis prophylaxis: When is it required

A

Previous endocarditis
Prosthetic heart valves
Unrepaired congenital cyanotic heart disease (but don’t have to if repaired)

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37
Q

Endocarditis prophylaxis: What to use

A

Amoxicillin 2gm (kids 50 mg/kg) PO 1h before

If can’t use amoxicillin:
Clindamycin, Azithomycin or Clarithromycin

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38
Q

Endophthalmitis: definition

A

Infection of deep structures of eye

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39
Q

Endophthalmitis: si/sx

A

Chemosis
Decreased visual acquity
Hazy opaque appearance of anterior and posterior chambers on slit lamp exam

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40
Q

ACA stroke: si/sx

A

Affects frontal lobe function

C/L sensorimotor deficits, leg > arm

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41
Q

MCA stroke: si/sx

A

C/L sensorimotor deficits, arm & face > leg
Aphasias
Gaze preference towards affected hemisphere

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42
Q

Posterior circulation stroke: si/sx

A 
Crossed deficits (motor on one side, sensory on the other)
Cerebellar deficits
CN deficits
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43
Q

Central cord syndrome: si/sx

A

Upper extremity weakness > lower extremity weakness

44
Q

Anterior cord syndrome: si/sx

A

Loss of pinprick and temperature below level of lesion

45
Q

Brown-Sequard syndrome: si/sx

A

I/L motor & 2pv loss with C/L pinprick and temperature sensation

46
Q

CNS Toxoplasmosis: rx

A

Pyrimethamine & sulfadiazine

47
Q

What is first si/sx of flexor tenosynovitis?

A

Pain on passive extension of finger

48
Q

Monoarticular septic arthritis: most common pathogen

A

S aureus

49
Q

Felon: Rx

A

Single lateral incision on ulnar aspect of digits 2-4, radial aspect of digits 1, 5

50
Q

Most common extraarticular manifestation of anklylosing spondylitis

A

Uveitis

51
Q

Dacrocystitis: Definition

A

Inflammation of nasolacrimal duct

Causes swollen & teary eyes

52
Q

Formula to calculate how much factor to administer in hemophilia

A

wt(kg) x 0.5 x desired percentage change in factor
Assume starting at 0 activity
Need to get to 30-50% for hemarthrosis
Need to get to 100% for CNS & GI issues

53
Q

How to phlebotomize for polycythemia?

A

Slowly, 1-1.5L over 24h

Also rx with ASA 81 mg daily

54
Q

What are platelets like in vWd?

A

Normal levels of, but they don’t work as well

55
Q

What are the 2 most serious opportunistic infections in HIV & when do they occur?

A

CMV retinitis; MAC

Don’t occur until CD4

56
Q

What is most common clinical manifestation of rheumatic fever?

A

Migratory polyarthritis

57
Q

Kawasaki’s dz: What is definitive rx and what are other rxs

A

IVIG is definitive (can cause hypotension)

High-dose ASA also used

58
Q

What does HBsAg mean?

A

Surface antigen (caused by virus envelope)

59
Q

What does anti-HBs mean?

A

Antibody that develops against HBsAg

60
Q

What does HBcAg mean?

A

Core of Hepatitis B virus

61
Q

What does HBeAg mean?

A

Indicates active Hep B infection; thought to be the degredation of HBcAg

62
Q

What Hep B serology do you see in someone who’s been vaccinated but not exposed?

A

anti-HBs but no HBcAg (patient has developed anti-HBs to the vaccine envelope but has never actually been exposed to core of virus

63
Q

Histoplasmosis: Where is it seen? What does it cause?

A

Fungal infection seen in Ohio & Mississippi river valleys
Causes erythema nodosum

64
Q

What findings do you see with malaria?

A

Inc LFTs, hepatomegally, anemia

65
Q

What must BP be below to use tPa?

A

185/110

66
Q

Myoclonic atonic sz: What do you see?

A

Sudden jerk forward, often loss of postural tone and fall forward
Usually in children

67
Q

What is the first u/s sign of pregnancy?

A

Gestational sac

68
Q

At what point in gestation do you no longer need to give steroids or tocolytics for preterm labor

A

After 34 weeks

69
Q

Naltrexone: Use and mechanism

A

mu-receptor antagonist

Used to reduce alcohol cravings and decreases alcohol-induced euphoria

70
Q

What is goal UOP in rhbdomyolysis?

A

3 ml/kg/hr

71
Q

What is initial rx for post-strep glomerulonephritis?

A

HCTZ

72
Q

What lab values are seen with HUS?

A

Anemia, Increased creatinine (renal failure), thrombocytopenia

73
Q

How to tell if pleural effusion is exudate or transudate?

A

exudate = pleural fluid protein / serum protein > 0.5

74
Q

How to rx post viral pneumonia with abscess?

A

CAP coverage (most are s auerus) and Vanco

75
Q

gamma-hydroxybutyric acid (GHB) OD: si/sx

A

Agitation, then coma, then full return to consciousness

76
Q

Bleach ingestion: disposition

A

d/c home without observation (it’s benign)

77
Q

When to surgically repair patella fx?

A

If extensor mechanism is disrupted (e.g. can’t fully extend knee)

78
Q

Radial head fx: Rx

A

Splinting or arm sling followed by early ROM

79
Q

Most common skull bone fractured in kids

A

Parietal

80
Q

Rx for adult and pediatric tooth avulsions

A

Reimplant permanent adult, don’t reimplant kids primary

81
Q

Cause of foot puncture wound osteomyelitis

A

pseudomonas

82
Q

Can you trephinate subungual hematoma over an underlying fx?

A

Yes

Blood remains fluid/liquid for up to 36h

83
Q

Nerve injury often seen with Motegia fx

A

Radial nerve injury

84
Q

Erysipelas: Definition & cause

A

Rapidly advancing superficial skin infection from GASen
Usually, but not always, seen on LE
Also has burning sensation and is bright red & shinny

85
Q

Erysipelas: How to diff from regular cellulitis?

A

Erysipelas has elevated advancing margin of infection

86
Q

What is first rx is hypercalcemia?

A

NS (patients are usually volume depleted)

87
Q

What is most specific lab test for alcoholic ketoacidosis?

A

Increased beta-hydroybutyrate

88
Q

What does Vit A OD cause?

A

intracranial HTN, hepatotoxicity, hypercalcemia

89
Q

What does Vit A deficiency cause?

A

Night blindness

90
Q

What does B1 (thiamine) deficiency cause?

A

Wernicke-Korsakoff syndrome

91
Q

What does B3 (niacin) deficiency cause?

A

Pellagra (Diarrhea, Dementia, Dermatitis)

92
Q

What does B3 (niacin) excess cause?

A

Flushing

93
Q

What does B6 (pyridoxine) excess cause?

A

Peripheral neuropathies

94
Q

What dose Vit C deficiency cause?

A

Scurvy (bleeding gums, poor wound healing)

95
Q

What does Vit D excess cause?

A

Hypercalcemia

96
Q

What electrolyte abnormality can cause adynamic small bowel ileus?

A

Hypokalemia

97
Q

What are phases of acute radiation syndrome?

A
  1. Prodromal phase: self-limiting autonomic stuff like n/v
  2. Latent phase: period of no smptoms
  3. Manifest illness: depends on severity of exposure
  4. Recovery or death
98
Q

What happens during manifest illness phase of acute radiation syndrome?

A

1st: Hematopoietic: decrease in lymphocytes, then pancytopenia. Absolute lymphocyte count at 48h is best progrostic indicator
2nd: GI: N/V/D
3rd: CNS

Extent of progression depends of amount of radiation exposed to. Never had CNS without hematopoietic and GI first

99
Q

What happens in cold water immersion syndrome?

A

Cardiac dysrhytmias upon sudden contact with water much colder than core temperature

100
Q

Pathophysiology of decompression sickness

A

Formation of nitrogen gas bubbles during ascent

101
Q

Decompression sickness type I

A

More common

Skin, lymphatic and musculoskeletal system involvement

102
Q

Decompression sickness type II

A

Less common

CNS, inner ear and lungs

103
Q

What do you see with arterial gas embolism?

A

Diver who surface unconscious or looses consciouness within 10 minutes of sufracing

104
Q

Chalazion: Def & Rx

A

Tender red nodule under eyelid
Due to blockage of Meibomian gland
Rx with warm compresses

105
Q

Sty (hordeolum): Def & Rx

A

Pustule secondary to S aureus
Seen on outside of eyelid
Rx with warm compresses, but often also requires topical abs

ABEM Recert Exam 2015 (7 decks)

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