Adol Med, Poisoning, Pharma and Environmental hazards

Question 1

first visible sign of maturity in males

Answer 1

testicular enlargement
- hallmark of SMR 2

Question 2

in females, this is the first visible sign of puberty

Answer 2

appearance of breast buds (thelarche)

Question 3

menses in females begins within __ yr of thelarche

Answer 3

three years

Question 4

this hormone normally stimulates gynecomastia that occurs in many newborn males

Answer 4

Maternal estrogen

Question 5

incidence of pubertal gynecomastia in males peaks at what tanner stage

Answer 5

Tanner Stage 3-4

Question 6

normal cycle length

Answer 6

21-35 days (can be 21-45 days during the 1st 3 yr after menarche)

Question 7

Menarche usually occurs during what SMR stage

Answer 7

4

Question 8

most common cause of secondary dysmenorrhea

Answer 8

endometriosis

Question 9

brief severe pain with ovulation which occurs at mid-cycle

Answer 9

Mittelschmerz

Question 10

role of prostaglandin in dysmenorrhea

Answer 10

stimulates local vasoconstriction, uterine ischemia and pain, smooth muscle contraction

Question 11

mainstay of treatment of primary dysmenorrhea

Answer 11

NSAIDs
-beginning at or preferably the day before menstruation

Question 12

most prevalent viral STI

Answer 12

Herpes simplex virus type 2

Question 13

most commonly identified pathogens in urethritis

Answer 13

Chlamydia trachomatis
Neisseria gonorrhoeae

Question 14

these 2 symptoms suggest the presence of STI unless proven otherwise in the typical sexually active adolescent male

Answer 14

Dysuria
Uretheral discharge

Question 15

most common organisms associated with genital ulcer syndromes

Answer 15

HSV
Treponema pallidum (syphilis)

Question 16

HPV types that can cause cervical cancer

Answer 16

HPV Type 16 and 18

Question 17

treatment of chlamydia trachomatis STI

Answer 17

Azithromycin 1 g OD or Doxycyline 100 mg PO 2x a day for 7 days

Question 18

treatment of N. gonorrhea

Answer 18

Ceftriaxone 250 mg IM + Azithromycin 1 g PO 1 dose

Question 19

Treatment of Trichomonas vaginalis STI

Answer 19

Metronidazole 2 g orally x 1 dose

Question 20

treatment of HSV STI

Answer 20

Treat for 7-10 days with Acyclovir/Valacyclovir/Famciclovir

Question 21

4 principles of management of poisoned patients

Answer 21

1 Decontamination
2 Enhance elimination
3 Antidotes
4 Supportive care

Question 22

GI decontamination strategies are most likely effective in how many hours after an acute ingestion?

Answer 22

1 or 2 hours

Question 23

Even rapid institution of GI decontamination with activated charcoal will at best bind only approximately how many percentage of the ingested substance?

Answer 23

30%

Question 24

Antidote of Acetaminophen

Answer 24

N-acetylcysteine

Question 25

Antidote of beta blockers

Answer 25

Glucagon

Question 26

Antidote of Calcium channel blockers

Answer 26

Insulin

Question 27

Antidote of Isoniazid (INH)

Answer 27

Pyridoxine

Question 28

Antidote of Opioids

Answer 28

Naloxone

Question 29

what are the substances poorly adsorbed by activated charcoal?

Answer 29

alcohols
caustics such as alkalis and acids
cyanide
heavy metals such as lead
hydrocarbons
Iron
Lithium

Question 30

single acute toxic dose of Acetaminophen

Answer 30

> 200 mg/kg in children
7.5 - 10 g in adolescents and children

Question 31

if a toxic ingestion is suspected, a serum acetaminophen level should be measured __ hour after the reported time of ingestion

Answer 31

4 hour

Question 32

golden period of institution of NAC in patients with acetaminophen poisoning

Answer 32

no later than 8 hours from the time of ingestion

Question 33

Antidote of Salicylates

Answer 33

Sodium bicarbonate

Question 34

antidotes of organophosphates and carbamates

Answer 34

Atropine and Pralidoxime

Question 35

most common complication of bite injuries regardless of the species of biting animal

Answer 35

Infection

Question 36

All ___ wounds are at high risk for infection from animal bites

Answer 36

Hand

Question 37

Bites from these animals carry a high risk of rabies and PEP is indicated

Answer 37

Bats
Foxes
Skuinks
Raccoons