ACOFP site review questions Flashcards
ecg finding with hypokalemia
prominent U waves, flattened or inverted T waves, ST segment depression, and conduction disturbances.
ecg finding with hyperkalemia
peaked t waves
kawasaki’s findings
fever, conjunctivitis, dry/cracked lips, cervical L.A., swollen red hands/feet with peeling,skin
sarcoidosis blood test
ACE level (angiotensin-converting enzyme )
HTN, hypokalemia, weakness, muscle cramps, polydipsia/polyuria - are signs of what disease? what tests should you do?
Primary Hyperaldosteronism (Conn’s Syndrome), check AM levels: aldosterone level will be high while renin will be low or undetectable. The potassium level may be low or normal, CT for adrenal adenoma
SIADH is hyponatremia with ______ urine osmolality and _____ serum osmolality
HIGH urine osmolality (concentrated urine) despite LOW serum osmolality (in fluid overload, less than 280 mOsm/kg) , Urine sodium typically above 20 mEq/L
Baseline variability on a fetal heart rate monitor predominantly reflects
integrity of the autonomic nervous system. (moderate variability is considered normal)
loss of heart rate variability on a fetal heart rate monitor predominantly reflects
hypoxemia
variable decelerations on a fetal heart rate monitor predominantly reflects
cord compression
early decelerations in fetal heart rate predominantly reflects
Head compression
in Type 2 diabetes, insulin levels will be ______
elevated (ie HYPERinsulinemia )
Acute anterior shoulder dislocation with neurovascular compromise (you are the team doctor at the game)- treatment is….
IMMEDIATE attempt at reduction to minimize risk of permanent sequelae
Malaria treatment
1) Uncomplicated (Central America/Caribbean)
2) uncomplicated Chloroquine- resistant (South America, south Asia, Africa, or unknown)
3) complicated (inpatient therapy)
4) Drug of choice for pregnancy prophylaxis or treatment
1) chloroquine or hydroxychloroquine
2) atovaquone-proguanil(Malarone) OR
Quinine+doxy or tetracycline or clinda
3) IV artesunate (preferred)
4) chloroquine
High-pitched decrescendo Blowing diastolic murmur left sternal border
Aortic regurgitation
Large anterior fontanelle Macrocephaly, large forehead Trident deformity of the hands Low nasal bridge Shortened extremities
Achondroplasia
(Most common cause of dwarfism)
Diagnosed by genetic testing
“Trident deformity” = Short stubby fingers with separation between middle and ring finger (think “Spock” live long and prosper!)
Treatment for viral pericarditis
ibuprofen 300-800 mg PO q8h x2wks plus colchicine 0.6 mg PO BID x 3 mo
BP medication you should not use in heart failure
Diltiazem due negative inotropic effects
ACEIs) are______________ in patients with bilateral renal artery stenosis
contraindicated
Starting an ACE inhibitor in a patient with bilateral renal artery stenosis will cause the creatinine to increase dramatically since angiotensin II usually constricts the efferent arteriole and blocking it will cause the efferent arteriole to dilation and thus less filtration.
EKG:
Delta waves are __________
Delta waves are most commonly associated with_______
Slurring of upstroke of QRS w shortened PR interval (< 120ms)
pre-excitation syndrome such as WPW
1) SVT treatment in unstable/hypotensive patient
2) acute mgmt of symptomatic SVT in stable pt - 1st choice med if vagal maneuvers don’t work
3) 2nd and 3rd choice for acute SVT
4) long term choices for SVT
1) cardioversion with sedation
2) IV adenosine
3) IV CCB or BB
4) CCB. BB. DIG. Amiodarone
radio frequency catheter ablation
•Mobitz type I (Wenkebach) second degree AV block is _________
progressive PR prolongation before the dropped beat. There is only one non-conducted P wave
Mobitz type II second degree AV block is _____________
usually indicative of underlying disease of the His-Purkinje conduction system and is characterized by episodic and unpredictable failure of the node to conduct the impulse (or more than one impulse) from the atria to the ventricles. The PR interval does not change prior to or after the dropped beats. There may be more than one non-conducted P wave.
Third degree or complete AV block is __________
The P waves are completely dissociated from the QRS complexes.
The P waves (atrial activity) are said to “march through” the QRS complexes at their regular, faster rate. The QRS complexes (ventricular activity) also occur at a regular, but slower rate. There are two independent rhythms occurring simultaneously.
What are Dihydropyridine calcium channel blockers
nifedipine, isradipine, felodipine, nicardipine, amlodipine
…. “ DihydropyridINES end in ‘PINE!!”
What are nondihydropyridine calcium channel blocker
Diltiazem and verapamil
“NON dihydropyridines do NOT end in “pine”
Blue toe syndrome is
characterised by tissue ischaemia secondary to cholesterol crystal or atherothrombotic embolisation. It leads to the occlusion of small vessels. Cyanosis of the digits may have several etiologies ranging from trauma to connective tissue disease
specificity being the ability of a screening test to detect a
true negative, being based on the true negative rate, correctly identifying people who do not have a condition
sensitivity being the ability of a screening test to detect
a true positive, being based on the true positive rate, reflecting a test’s ability to correctly identify all people who have a condition
CHF
Potassium goal
Magnesium goal
K>4.0
Mg >2.0
Veltassa (patiromer) is used for
Hyperkalemia
Bupropion is contraindicated in which disorder
eating disorder/ bulimia or anorexia
warfarin and life threatening bleeding
Start a 4-factor Prothrombin Complex Concentrate (PCC, this is better than FFP) + Vitamin K 10mg IV (not IM)
1st 3 steps in BLS?
ratio compressions/breaths in adult?
rate of compressions/minute?
first check a pulse, if no pulse -> CAB (Compressions first, followed by clearing of the Airway and rescue Breaths)
30 compressions at a rate of 100 compressions per minute to 2 breaths
Which anemias could falsely elevate A1c
Iron deficiency anemia, b12/folate def (associated with decreased red cell turnover exposes the cell to glucose for a longer period of time,)
Slipped capital femoral epiphysis SCFE (“scifee”)
Most common in…..
Fat teenage boys!
Overweight males 12-16 yrs old
Legg calve Perthes disease
Most common in….
Boys 4-10yrs
Avascular necrosis of proximal femoral epiphysis
Rheumatic heart disease affects which valve most commonly
Mitral STENOSIS
“Slapped cheek” rash
Erythema infectiosum
(Fifth disease). caused by Parvovirus B19
Diaper rash
A) skin fold are spared
B) skin fold are affected
A) Diaper (irritant)dermatitis
B) candidal dermatitis
Classic triad of
NEPHRITIC syndrome
HTN
HEMATURIA
DEPENDENT EDEMA
Most common cause of NEPHROTIC syndrome
FSGC
Focal segmental GlomeruloSclerosis
This is most common glomerular disease leading to ESRD
Most common cause of drug induced lupus - list top 3
Procainamide (IV anti-arrhythmic)
Hydralazine
Minocycline
What is Takotsubo cardiomyopathy
is a temporary heart condition that develops in response to an intense emotional or physical experience. It’s also known as stress cardiomyopathy or broken heart syndrome.
The rapid-acting insulin analogs (insulin lispro, lispro-aabc, aspart, faster aspart, and glulisine) have __________onset and __________ duration of action than regular insulin for pre-meal coverage
faster
shorter
they are better than regular insulin for postprandial coverage
(Rarely use regular insulin anymore)
