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Clerkship > Assorted > Flashcards

Assorted Flashcards

1
Q

Prophylaxis for meningitis exposure is generally

A

Rifampicin or ceftriaxone

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2
Q

Tx for acute gout

A

Corticosteroids, colchicine, or NSAIDS

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3
Q

Common tx for chronic gout

A

Allopurinol

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4
Q

Pharmacological tx for meningitis

A

Ceftriaxone + vancomycin + dex (admin before/with abx)
(+ampicillin if risk of Listeria - elderly, immunocompromised, newborns, pregnancy)

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5
Q

Initial meds for status epilepticus (2 meds with doses)

A

Midazolam 10mg IV/IM
Lorazepam 4mg IV/PR

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6
Q

Indications to do a CT before LP

A

FAILS
Focal neuro deficit
AMS
ICP elevated, Immunocompromise
Lesions in brain
Seizures (not in young children)

**do NOT delay empiric tx for meningitis bc of this

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7
Q

THe main pathophys of ILD can be summed up as

A

Pulmonary inflammation –> fibrosis

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8
Q

Findings of ILD on imaging

A

Reticular opacities (fibrosis)
Ground-glass opacities (increased density but can still see bronchial structures/vessels)
Honeycombing (air-filled cysts w/ fibrotic walls)

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9
Q

3 drugs for Afib rate control

A

Beta blocker
ND-CCB
Digoxin

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10
Q

Gram-positive cocci in clusters

A

Staph aureus

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11
Q

Gram-positive cocci in chains

A

Streptococcus

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12
Q

What blood product contains Vit-K dependent factors? Uses?

A

PCC
Can reverse warfarin (+vit K), DOACs if no other antidote (idarucizumab) available

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13
Q

What blood product Is prepared from plasma and contains fibrinogen, factor VIII, von Willebrand factor, factor XIII and fibronectin

A

Cryoprecipitate

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14
Q

Most patients with afib should be on what type of med? What do you add and when?

A

DOAC
CAD/PAD –> antiplatelet therapy

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15
Q

When can you cardiovert Afibwithout 3 weeks of OAC or TEE?

A

1) Hemodynamically unstable acute AF
2) NVAF <12 hrs (no recent stroke)
3) NVAF 12-48 hrs and CHADS 0-1

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16
Q

Gonorrhea Tx

A

Ceftriaxone 500mg IM (or cefixine PO) + azithro (co-tx for chlamid)

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17
Q

Chlamydia treatment

A

Azithro (1g PO x 1)
OR
Doxycycline 100mg PO BID x 7 days

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18
Q

Location of STEMI with changes in leads II, III, aVF

A

Inferior

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19
Q

Location of STEMI with changes in leads I, aVL, V5, V6

A

Anterolateral

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20
Q

Location of STEMI with changes in leads V3/V4

A

anteroapical

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21
Q

Location of STEMI with changes in leads V1/V2

A

Anteroseptal

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22
Q

U wave shows up in what condition?

A

Hypokalemia

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23
Q

Mnemonic for determining reciprocal changes

A

PAILS
e.g. Posterior STEMI causes depression in Anterior leads
*lateral can have reciprocal in inferior/septal

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24
Q

Normal PR interval

A

3-5 small boxes = 0.12-0.2

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25
Q

1 large box on ECG = ? seconds

A

0.2 (so 1 small = 0.04)

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26
Q

Normal QRS complex

A

0.1 sec (<2.5 small boxes)

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27
Q

Normal QTc
Shortcut?

A

<0.44
Shortcut if normal HR (60-100): if QT <50% interval b/w QRS complexes, then it’s ok

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28
Q

Contraindications to thrombolysis

A

Prior ICH
Non structural cerebral vascular lesion or intracranial malignancy
Ischemic stroke within 3 months
Suspected aortic dissection
Active bleeding or bleeding diathesis (excluding menses)
Significant facial/closed head trauma within 3 months

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29
Q

Enoxaparin, Dalteparin, and Tinzaparin are all examples of…

A

Low molecular weight heparin

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30
Q

Mechanism/treatment of ITP

A

Autoimmunity, often follows viral infection in children
Usually no tx, but steroids/IVIG if severe

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31
Q

An indirect inguinal hernia protrudes through the…

A

Deep inguinal ring (LATERAL to inferior epigastric vessels)

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32
Q

Congenital hydrocele treatment

A

Usually resolves spontaneously by 6 months
Consider Sx if present @ 1 yr

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33
Q

Colon cancer screening for no FMHx of colon cancer

A

Age 50-74
FIT q2 years

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34
Q

Colon cancer screening for FMHx colon cancer (parents, sibilng, child)

A

Colonoscopy q5 years if family member had it before age 60, q10 if after
starts 10 years before their diagnosis (age 50 latest)

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35
Q

Freq of pap tests

A

q3 years

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36
Q

When can you stop paps

A

After age 70 if 3+ normal in past 10 yrs

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37
Q

Lung cancer screening

A

Age 55-74 years old
Smoke 20 year hx (non-consecutive)
Low-dose CT

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38
Q

Breast cancer screening guidelines

A

Age 50-74 mammogram q2 yrs

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39
Q

A1C for prediabetes

A

6.0-6.4

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40
Q

Who gets screened for diabetes and how often

A

> 40 years or high-risk –> q3 yrs
Very high risk –> q6mo-1yr

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41
Q

Diabetes pt >40 or >30 with diabetes 15+ yrs should be on a

A

Statin

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42
Q

Pt with diabetes >55yo with CV risk factors OR microvascular disease should be on…

A

Stain + ACEi/ARB

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43
Q

Pt with diabetes and CV disease should be on…

A

Statin + ACEi/ARB + ASA (add GLP-1 agonist or flozin)

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44
Q

Outpt abx for febrile ndutropenia

A

Fluroquinolone (cipro or levofloxacin)
+ Amox-clav

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45
Q

Inpt abx for febrile neutropenia

A

Pip-tazo OR cefepime OR merepenem
Add vanco if indication (MRSA coverage)

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46
Q

Abx in otitis media

A

Amoxicillin
(try amox clav if that doesn’t work for H influenzae coverage)

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47
Q

Abx for strep throat (GAS)

A

Amoxicillin (UNIVERSALLY SUSCEPTIBLE TO BETA LACTAM - do not need amox-clav)

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48
Q

Attributes of hypercalcemia

A

Bones (fractures)
Stones (kidney stones, polyuria, dehydration)
Groans (headache, abdo pain, nausea, ileus, constipation)
Psychiatric overtones (lethargy, stupor depression, psychosis, cognitive dysfunction)

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49
Q

For every 10 decrease in albumin how do you change Ca level?

A

+0.2 Ca (more unbound)

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50
Q

Cornerstones of hypercalcemia of malignancy management?

A

IV saline & bisphosphonates
(also replete phosphate if low)

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51
Q

What do you suspect in a pt with JIA or Still disease who has a high, unremitting fever, leukopenia/anemia/thrombocytopenia, elevated liver enzymes/feritin…

A

Macrophage Activation Syndrome

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52
Q

Major risk in children with oligoarticular JIA that should be proactively prevented

A

Anterior uveitis (can be asymptomatic, early detection/tx useful due to chance of glaucoma, cataracts, optic nerve damage)
- Slit lamp exams, q3 months if ANA positive

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53
Q

Prognosis of JIA

A

95% resolve by puberty
(worse prognosis if early onset with growth issues/deformities), polyarticular/symmetrical, auto-antibodies

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54
Q

Transient salmon-pink rash, intermittent fever, leukocytosis hepatosplenomegaly, serositis, and arthritis are features of…

A

Systemic JIA (Still disease)

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55
Q

Most common type of JIA

A

Oligoarticular (good prognosis)

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56
Q

Mismatch between the rapid growth of the femoral epiphyses and the slower development of adequate blood supply to the area –> juvenile hip pain

A

Legg-Calve-Perthes disease

[idiopathic, avascular necrosis of the femoral head]

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57
Q

superior and anterolateral displacement of the femoral neck due to weakening of the proximal femoral epiphyseal growth plate –> peds hip pain

A

Slipped capital femoral epiphesis

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58
Q

Name 5 differentials for peds hip pain

A

Transient synovitis (usually resolves in <1 week with rest/NSAIDS)
Septic arthritis
SCFE
Legg-Calve-Perthes disease
Developmental dysplasia of hip

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59
Q

traction apophysitis that occurs where the patellar tendon attaches to the tibial tuberosity –> anterior knee pain = ? disease
Who usually gets this

A

Osgood Schlatter
Children 9-14 in athletics

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60
Q

Tx for Osgood-Schlatter

A

Relative rest, NSAIDS, ice; brace if persistent
NOT steroid injections (can weaken tendon)
90% resolve once full bone maturity reached

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61
Q

Main pathogen causing croup

A

Parainfluenza virus 1

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62
Q

Flashes/floaters/curtain in PERIPHERAL vision is a sign of

A

Retinal detachment

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63
Q

Sudden vision loss/double vision in pt >60, always think…

A

GCA! If CRP elevated –> high-dose steroids

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64
Q

Sudden vision changes with RAPD in young person (30F), think….

A

Optic neuritis

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65
Q

Young person, wears contact lenses (sleeping/swimming) –> think

A

Bacterial infectious keratitis –> corneal ulcer (white spots on cornea)

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66
Q

Pt with sudden acute severe eye pain, blurry vision, temporal headache…

A

Acute angle closure glaucoma

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67
Q

Hx of being in the dark –> blurry vision, headache, nausea/vomitting

A

Acute angle closure glaucoma

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68
Q

Definitive tx for Acute angle closure glaucoma

A

Laser iridotomy (make hole in iris)

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69
Q

Non-surgical management of AAC glaucoma

A

Pilocarpine (muscarinic, constrict pupil)
Acetazolamide, dorzolamide (decrease aqueous humor prod)
Hyperosmotic agents (glycerol, mannitol)
Timolol (also decrease prod)

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70
Q

Charcot’s triad of acute ascending cholangitis

A

Fever + RUQ pain + jaundice

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71
Q

Reynold’s pentad for acute suppurative cholangitis

A

Fever + RUQ pain + jaundice + AMS + hypotension

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72
Q

Gilbert syndrome and Crigler-Najjar syndrome are disorders of…

A

Bilirubin conjugation

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73
Q

Most common type of neonatal jaundice? Natural history?

A

Physiologic jaundice
Usually resolves within ~1 week of life

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74
Q

2 types of non-pathological unconjugated hyperbili in infants?

A

1) Breastfeeding (not enough! –> increased enterohepatic circulation reabsorbs bilirubin)
2) Breast milk (B-glucuronidase in breast milk –> deconj/reabsorb bili)

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75
Q

Jaundice at what time period is always pathologic in a baby?

A

<24 hours old if term

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76
Q

Limited internal hip rotation in a child with thigh pain should make you think…

A

Slipped capital femoral epiphysis (SCFE)

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77
Q

Adjustment disorder time period

A

Starts within 3 months of stressor
Sx last <6 months following stressor resolution

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78
Q

First-line lab test for celiac disease

A

tTG IgA (sensitivy/specificity >95%)

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79
Q

Alternative lab tests for celiac disease

A

Total IgA –> if deficient, perform IgG-based testing
HLA testing (NPV ~100% if neg for HLA-DQ2 & DQ8)
Anti-endomysial antibody (higher specifity but expensive)

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80
Q

Calculate specificity

A

Specificity = True negative/True negative + false positive

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81
Q

5 cyanotic heart lesions

A

Truncus arteriosus (aorta/pulmonary artery join to make 1)
Transposition of the great vessels
Tricuspid atresia
Tetralogy of fallot
Total anomalous pulmonary vascular return

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82
Q

4 defects in tetralogy of fallot

A

RV hypertrophy
Overriding aorta
Subvalvular pulmonic stenosis
VSD

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83
Q

what is Eisenmenger syndrome

A

Shunt reversal due to chronic L>R shunting through congenital defect –> increased pulmonary flow –> severe pulmonary vascular obstruction –> shut reversal (R->L; cyanotic)

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84
Q

Explain Wolff-Chaikoff effect

A

Excess iodine –> transient inhibition of TH production (to avoid hyperthyroidism, but eventually gland “escapes” unless there is a disorder)

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85
Q

Explain Jod Basedow effect

A

In pts with multinodular goiters/Graves, excess iodine –> hyperthyroid (no Wolff-Chaikoff)

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86
Q

What is the one “opposite” effect of hyperthyroidism?

A

Lowers DIASTOLIC pressure by decreasing PVR

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87
Q

In thyroid storm why must iodine load be given AFTER a thioamide?

A

To prevent Jod basedow!

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88
Q

Hashimoto’s autoimmune thyroiditis cases ____ TH

A

Low

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89
Q

Thioamides include

A

PTU (given in thyroid storm bc inhibits production & peripheral conversion, safe in T1 pregnancy)
Methimazole (generally 1st line, inhibits production)

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90
Q

Scoop on a PFT is an indicator of

A

Emphysema

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91
Q

Bottom of Flow-volume loop is ___, top is ____

A

Bottom = Inspiration
Top = expiration

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92
Q

Indicator of obstruction on PFT

A

FEV1/FVC ratio (actual value) <0.7 or <LLN if given

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93
Q

How to grade severity of obstruction on PFT

A

by FEV1 PERCENT PREDICTED
Mild >70%

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94
Q

FCV low with normal FEV1/FVC ratio indicates

A

Restriction

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95
Q

Ectopic pregnancy should be suspected if no IU gestational sac and beta higher than…

A

1500

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96
Q

Rhogam should be given when?

A

28-32 weeks (if RH neg)
WIthin 72 hr of delivery if infant Rh+

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97
Q

What does mono-di mean for twins
What is the risk?

A

Monochorionic diamniotic
*must be monozygotic to be monochorionic
RIsk of twin-twin transfusion syndrome

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98
Q

What is normal baseline variabilit in intrapartum fetal surveillance?

A

6-25 bpm

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99
Q

What is the maternal mortality rate

A

Maternal deaths per 100,000 live births (while pregnant or within 42d postpartum)

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100
Q

Define fetal mortiality

A

Stillbirths/1000 total births

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101
Q

Define infant mortality rate

A

Infant deaths within first year of life/1000 live births

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102
Q

Kawasaki disease mnemonic

A

CRASH and BURN
Conjunctivitis (painless/bilateral)
Rash (polymorphous, originating on trunk)
Adenopathy (cervical, mostly unilateral)
Strawberry tongue
Hands and feet (erythema/edema)

BURN = Fever 5+ days

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103
Q

Treatment of kawasaki

A

IVIG (reduces risk of coronary artery aneurysms)
High-dose oral aspirin (exception to rule re Reye syndrome)

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104
Q

Kawasaki is an acute necrotizing ___ and its most concerning complication is _____

A

Vasculitis
Coronary artery aneurism

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105
Q

5 Ws of postpop fever

A

Wind (atelectasis/lungs)
Water (UTI/catheter)
Wound (superficial or deep)
Walking (DVT)
Wonder drugs (or blood products)

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106
Q

____ do NOT reduce bleeding secondary to leiomyomas. Try what instead?

A

NSAIDS do NOT
Try OCP/GnRH agonist/depo

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107
Q

2 alternative surgeries apart from hysterectomy for fibroids

A

Myomectomy (risk of recurrence, req C/S in future preg)
Uterine artery embolization

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108
Q

Stages of labour

A

1st latent: ends at 6cm dilation, mild/irregular contractions
1st active: 6-10cm, increased contractions/dilation
2nd: complete dilation - birth
3rd: birth - placenta delivery
4th: 1-2 hr postpartum

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109
Q

Clinical features of amniotic fluid embolism

A

ARDS
DIC
Shock/cardiac arrest

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110
Q

What is the most frequent cause of medication-induced hyperprolactinemia –> secondary amenorrhea

A

Antipsychotics

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111
Q

Abnormal uterine bleeding mnemonic

A

PALM-COEIN (structural-nonstructural)
Polyps
Adenomyosis
Leiomyomas
Malignancy
Coagulopathy
Ovulatory dysfunction
Endometrial (local hemostasis dysreg)
Iatrogenic
NYS

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112
Q

Name a few absolute contraindications to COCP

A
  • current pregnancy or <6wks postpartum if breastfeeding
  • Undiagnosed vaginal bleeding
  • Smoker >35 years old (>15 cigs/day)
  • HTN (sBP>160 or dBP>100)
  • Current or past VTE
  • PMHx of ischemic heart disease, CVA, complicated valvular heart disease
  • Migraine with focal neuro Sx (aura = relative contraindications)
  • Current breast cancer
  • Diabetes with end-organ involvement
  • Severe cirrhosis or liver tumour
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113
Q

Preconception folic acid dosing

A

400mcg
4g if high-risk (prev NTD, epilepsy, diabetes)

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114
Q

Abx for GBS

A

Pen G
allergic –> erythromycin or clindamycin

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115
Q

When is GBS swab done

A

35-37 wks

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116
Q

Antihypertensives for preeclampsia

A

Hypertensive Moms Need Love
Hydralazine Methyldopa Nifedipine Labetalol

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117
Q

Green/yellow foul-smelling purulent discharge & strawberry cervix likely indicates

A

Trichomonas

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118
Q

Treatment for trich

A

Metronidazole (2g) + treat partner

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119
Q

Diffuse thin/grey discharge with fish small likely is

A

Bacterial vaginosis

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120
Q

Tx for bacterial vaginosis if symptomatic

A

Metronidazole 500mg BID x 7d (don’t need to tx partner)

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121
Q

Micro testing for BV includes

A

Looking for clue cells, “whiff test” with KOH

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122
Q

First line & 2nd line tx of lichen sclerosis

A

Clobetasol (superpotent topical steroid)
Topical calcineurien inhibitor (tacrolimus)

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123
Q

Bleeding, cramps, but cervix closed = ___ abortion

A

Inevitable

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124
Q

Heavy bleeding + cramps + passage of tissue with cervix open = ___ abortion

A

nIcomplete

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125
Q

No bleeding, cervix closed, fetal death = ___ abortion
Tx?

A

Missed
Watch/wait, mifepristone + miso, or D&C

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126
Q

How to confirm success of medical abortion

A

Reduction in beta HCG (50% after 2 days or 80% after 1 week)

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127
Q

Until what time can medical abortion be used?

A

9 weeks from LMP (evidence supports up to 10 wks)

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128
Q

Reactive (normal) NST entails?

A

2+ FHR accelerations of at least 15 bpm above baseline and 15+ seconds

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129
Q

Biophysical profile has what 4-5 key components?

A

Fetal movement
Fetal tone
Fetal breathing
Amniotic fluid level
[+/- Nonstress test]
evaluated with 2 points each

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130
Q

Normal amniotic fluid index

A

5-25cm

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131
Q

What is the routine prenatal genetic screening and when are they done

A

eFTS (1st trimester) - week 11-14
if too late, MSS (no NT in this)

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132
Q

When can NIPT be done

A

10 weeks to end of pregnancy

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133
Q

Amnio vs CVS timeline

A

CVS 11-14 wks
Amnio >15 wks

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134
Q

Name the TORCH infections

A

Toxoplasmosis
Other (syphilis, varicella, Parvovirus B19, Listeriosis, Zika)
Rubella
CMV
HSV

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135
Q

Anticoagulant to use during pregnancy

A

Heparin

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136
Q

What is erythema infectiosum (fifth disease) cased by? Main clinical Sx?

A

Human parvovirus B19
Fever –> “slapped cheek” rash/maculopacular examthum
Can cause arthralgias in adults
Can also cause transient anemia, and more severe hematological effects in people with predisposion (sickle cells, immunocompromise)

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137
Q

Primary hereditary hemochromatosis involves what mechanism?

A

No functional HFE protein –> NO HEPCIDIN –> unregulated ferroportin –> FE oerload
(HEPCIDIN DOWNREGULATES FE ABROPTION)

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138
Q

How to tell the difference between anticholinergic OD and serotonin syndrome?

A

Anticholinergic = dry as a bone
SS = hot and wet! w/ nausea/vomiting

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139
Q

NMS vs SS key differences?

A

Onset (SS faster onset & resolution)
NMS more “sluggish” neuro, serotonin neuro hyperactivity
NMS more mute/staring, SS more hyperkinetic/agitated

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140
Q

Management of serotonin syndrome

A

STOP agent(s)
Supportive care, IV hydration
Meds: benzos, antihypertensives, anticonvulsants, PRN
Cyproheptatine (serotonin antagonist) and Dantrolene (muscle relaxant)

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141
Q

Serotonin syndrome typically resolves within ___ of meds being stopped

A

24 hours (vs ~9d for NMS)

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142
Q

Management of NMS

A

STOP causal agents
Supportive care, IV hydration
Meds: Benzos, ECT, Dantrolene (muscle relaxant)

143
Q

Prolonged ROM is considered

A

> 18 hrs between rupture –> delivery

144
Q

Diagnosis of ROM

A

Nitrazine paper turns blue (pH>6)
Ferning pattern on glass slide

145
Q

What are tocolytics used for? examples?

A

To DELAY labour so corticosteroids can be given!
Indomethacin (NSAID, 24-32 wks)
Nifedipine (CCB, 32-34 wks)
IV MgSO4 for neuro protection until 24 weeks

146
Q

When are corticosteroids given during labor

A

Between 24-34 weeks in all case of PPROM and in PTL if delivery expected within 7 days
A single rescue course if >14 days since admin and delivery again expected
From 34-36 weeks if PPROM or PTL occurs and no prior steroids –> 1 dose betamethasone (ALPS)

147
Q

MgSO4 given for preterm labour up to how many weeks

A

24-32 wks

148
Q

Preferred approach to GDM testing

A

50g GCT –> if abnormal. 75g OGTT
(alternative is one-step 75g)

149
Q

All pregnant women not known to have pre-existing DM should be screened when?

A

24-28 wks

150
Q

Most common site of ectopic pregnancy

A

Ampulla

151
Q

Methotrexate can be used for ectopic if…

A

<3.5 cm unruptured ectopic, beta <5000, no FHR
Also must be assured of compliance/FU

152
Q

Most common pathogens in asplenic sepsis

A

Encapsulated bacteria
Think: “Has No Spleen”
H infuenzae, N meningitidis, S pneumonia

(note that pts with sickle cell can have functional asplenia)

153
Q

Common meds used chronically in sickle cell

A

Daily prophylactic penicillin & hydroxyurea in children, some adults
(hydroxyurea increases HbF –> fewer vasoocclusive episodes)

154
Q

Pneumonia + sickle cell crisis should be managed as

A

Acute chest syndrome

155
Q

Howell-Jolly bodies indicate…

A

Asplenia (e.g. in sickle cell)

156
Q

2 types of alpha-thalassema that cause significant symmptoms

A

Hemoglobin H disease (3 defective alleles –> HbH)
Hemoglobin Bart’s (4 defective –> Hb Bart –> hydrops fetalis)

157
Q

Alpha and Beta thalassemia are common in what populations

A

Alpha: Asian/African (think “A”)
Beta: Mediterranean

158
Q

Why does thalassemia B not appear until ~6 months old vs A has immediate clinical features?

A

Because Hb F = 2 alpha + 2 gamma and so compensates in B-thal

159
Q

Treatment for thalassemia major/intermedia

A

Transfusion therapy
Chelating if iron overload

160
Q

Target cells, teardrop cells (extramedullary hematopoiesis), and anisopoikilocytosis (varying RBC shape/size) on PBS indicate

A

Likely thalassemia

161
Q

___ should be strongly suspected if HbA2 (2 alpha + 2 delta) is elevated

A

Beta-thalassemia

162
Q

HbH =

A

bet-globin tetramer

163
Q

HbF =

A

a2y2

164
Q

Microcytosis cutoff

A

MCV <80

165
Q

Thalasemmia presents with ___ anemia

A

Microcytic

166
Q

GSC components

A

Eyes
Verbal
Motor

167
Q

GCS Eyes most to least

A

Spontaneously open
Open to voice
Open to pain
Closed

168
Q

GCS Verbal highest to lowest

A

Oriented
Confused
Inappropriate words
Sounds
None

169
Q

GCS Motor

A

Follows commands
Localizes pain
Withdraws to pain
Decorticate
Decerebrate
None

170
Q

CF causes what type of alkalosis

A

Contraction (loss of fluid w/ NaCl though sweat) = chloride-responsive!
RAAS activation –> H+/K+ loss (hypokalemia)

171
Q

Best first test for CF when suspected (+NBS, sibling with it, Sx)

A

Quantitative pilocarpine iontophoresis (sweat test)
if moderate (30-60) –> need genetic analysis

172
Q

What are the most common pathogens in CF

A

Staph aureas & Pseudomonas aeruginosa (for PA may need chronic azithromycin)

173
Q

Meds for CF

A

High-dose ibuprofen (can slow lung disease)
Bronchodilators (SABA)
Mucolytics: hypertonic saline neb, aerosolized Dornas alfa
Pancreatic enzymes
supplement NaCl/fat-soluble vits

CFTR modulators are new, target underlying protein defect in pts with specific mutations!!

174
Q

What is both diagnostic & therapeutic for meconium ileus?

A

Gastrografin enema

175
Q

Double bubble xray in newborn indicates

A

Duodenal atreisa

176
Q

In CF, residual lung volume is…

A

Increased (obstructive disease w/ air trappin)

177
Q

Why do CF patients have elevated PT?

A

Vit K deficiency (fat soluble, exocrine pancreatic insufficiency)

178
Q

Bell palsy is often precipitated by what infection?

A

EBV
HZ
Borreliosis (lyme)
HSV

179
Q

A “good baby” who doesn’t cry much and has a large anterior fontanel, umbilical hernia, and macroglossia likely has…

A

Congenital hypothyroidism

180
Q

Is normal CO2 during an acute asthmatic episode a good sign or bad sign

A

BAD because it should be low due to hyperventilation –> impending resp failure!!

181
Q

The only thing youshould NOT do in COPDis _____ as monotherapy.
The only thing youshould NOT do in asthma is ______ monotherapy.

A

ICS
LABA

182
Q

Indications for intubation (5 not including GCS <8)

A

1) Airway obstruction
2) Can’t oxygenate
3) Can’t ventilate
4) Can’t protect airway
5) Anticipated clinical deterioration to the above

183
Q

5 sources of hemorrhage where blood may be lost

A

Thorax
Abdomen
Retroperitoneum (pelvic fractures)
Long bone fractures (femur)
“The street”

184
Q

Cushing’s triad for ICP

A

Hypertension
Bradycardia
Irregular respirations

185
Q

Management for circumferential chest burns impeding resp

A

Escharotomy

186
Q

Tx for CO poisoning from burning environment

A

100% O2, hyperbaric if available

187
Q

Second degree burn penetrates the

A

Dermis

188
Q

If tactility is impaired the burn is likely what degree?

A

3rd (full thickness) or 4th (deep structures, e.g. muscles)

189
Q

Surgery is always mandated in what degree(s) of burns

A

3rd/4th, but commonly deep 2nd as well

190
Q

Rule for peds fluid maintenance

A

4,2,1 (mg/kg/hr)

191
Q

What is a greenstick fracture

A

Discontinuity of cortex.periosteum on convex side, just bending on concave side
usually in kids

192
Q

Open fracture AKA

A

Compound fracture

193
Q

When should pt be given tetanus toxoid immunization if they have an open fracture

A

No booster in 5 yrs
If >10 yrs or immnocompromised, give both toxoid & human tetanus immune globin

194
Q

What is a salter-harris fracture?

A

Fracture of physis (growth plate)

195
Q

Name the 5 types of salter-harris fractures

A

SALTER
Straight across physis
Above
Below
Through everything
cRush

196
Q

6 Ps of compartment syndrome

A

Pain
Pallor
Pulselessness
Paresthesia
Paralysis
Poikilothermia (temp dysreg)

197
Q

Management of compartment syndrome

A

Fasciotomy

198
Q

Anion gap calculation

A

Na - (HCO3 + Cl)

199
Q

How to adjust normal AG in hypoalbuminemia

A

For every 10 g/L decrease, reduce “normal” by 2.5 (albumin = major unmeasured anion)

200
Q

Formula to check for additional metabolic disorders in AG metabolic acidosis

A

(AG-12) + HCO3
<23 –> primary non-AG met acidosis
>30 –> primary met alkalosis

201
Q

Expected PCO2 compensation in non-mixed metabolic acidosis

A

PCO2 = 1.5(HCO3) + 8 +/-2

202
Q

Expected metabolic compensation for increase in PaCO2 of 10 (acute & chronic)

A

1, 4

(increased)

203
Q

Expected metabolic compensation for decrease in PaCO2 of 10 (acute & chronic)

A

2, 5

(decrease)

204
Q

Causes of AG-metabolic acidosis

A

MUDPILES
Methanol
Uremia
DKA
Propylene glycol
Iron tablets / Isoniazid
Lactic acidosis
Ethylene glycol
Salicylates

205
Q

Causes of non-AG metabolic acidosis

A

HARD-ASS
Hyperalimentation
Addison disease
Renal Tubular Acidosis
Diarrhea
Acetazolamide
Spironolactone
Saline infusion

206
Q

What is Beck triad?

A

Hypotension + muffled heart sounds + distended neck veins
Seen in CARDIAC TAMPONADE

207
Q

Diffuse ST elevation in all leads except aVR & V1 is an indicator of…

A

Pericarditis

208
Q

Electrical alternans is a sign of

A

Large pericardial effusion

209
Q

Infants who may have esophageal atresia should not be ______ under any circumstances!

A

Fed orally (likely fistula to trachea –> aspiration!!)

210
Q

Esophageal atresia often presents with what finding during pregnancy?

A

Polyhydramnios (fetal can’t swallow fluid)

211
Q

What is Kussmaul sign

A

Distention of jugular veins during inspiration
Sign of constrictive pericarditis

212
Q

What is Dressler syndrome?

A

Pericarditis occuring weeks after MI (usually happens acutely)

213
Q

How to treat post-MI pericarditis?

A

Rest & aspirin

214
Q

Treatment of minimal change disease

A

Prednisone

215
Q

3 characteristics of nephrotic syndrome

A

Nephrotic-range proteinuria (>3.5 g/day)
Low albumin
Edema/anasarca
(+/- hyperlipidemia, thromboses)

216
Q

Which nephrotic syndrome causes immune complex deposition between basement membrane and podocytes with a “spike & dome” appearance

A

Membranous nephropathy/glomerulonephritis
(Membranoproliferative glomerulonephritis can also cause immune complex deposition but involves thickened glomerular BM, and typically nephritic syndrome)

217
Q

Nephritic syndrome is characterized by

A

Glomerular capillary damage –> hematuria (RBC casts), pyuria, hypertension (also edema)

218
Q

How does nephrotic syndrome impact coagulability?

A

Hypercoag due to loss of antithrombin III, protein C/S

219
Q

Red cell casts =

A

Glomerulonephritis
Vasculitis

220
Q

White cell casts =

A

Acute interstitial nephritisF

221
Q

Fatty casts =

A

Nephrotic syndrome, minimal change disease

222
Q

Muddy brown casts =

A

Acute tubular necrosis

223
Q

Mainstays of tx for nephrotic syndrome

A

Treat underlying cause (if primary –> immunosuppression)
Edema: loop diuretics
Proteinuria: ACEi
*no role for anticoagulation prophylaxis

224
Q

ATN most commonly cause by what 2 main categories?

A

Ischemic (typically damages LoH)
Toxic (PCT)

225
Q

Indications for RRT

A

AEIOU
Metabolic acidosis <7.1
Electrolytes: hyperkalemia/hypercalcemia
Toxic Infection/Intoxication (poisoning)
Fluid overload
Uremia

226
Q

5 Ps of drugs causing AIN

A

Penicillin
PPIs
Pee (diuretics)
rifamPin
Pain (NSAIDS)

227
Q

Symptoms of AIN

A

Painless hematuria (no RBC casts!)
Sterile pyuria
Diffuse maculopaular rash, peripheral eosinophilia
Fever
Arthralgias

228
Q

Main treatment for drug-induced AIN

A

D/C causative agent & fluids

229
Q

3 main causes of rapidly progressive (crescent) glomerulonephritis

A

Anti-glomerular BM Abs (goodpasture - affects lungs as well)
Lupus nephritis
Vasculitis-associated glomerulonephritis

230
Q

4 main causes of intra-renal AKI

A

Vascular (vasculitis, emboli)
Acute glomerulonephritis (post-infectious, RPGN)
Acute interstitial nephritis (“kidney allergy”)
Acute Tubular Necrosis (ischemic/nephrotoxic)

231
Q

1st line medical treatment for portal hypertension

A

Beta blockers (leads to unopposed alpha action on splanchnic circulation –> splanchnic vasoconstriction –> reduced portal/collateral blood flow)

232
Q

Drug for acute esophagial variceal hemorrhage

A

Octreotide (+IV abx prophylaxis)

233
Q

Ideal surgery for esophageal bleed

A

Endoscopic band ligation

234
Q

1st line tx for hepatic encephalopathy

A

Lactulose (leads to NH3 protonation –> excretion/not absorbed in bowel)
Rifaximin = 2nd line (reduced NH3-producing intestinal bacteria)

235
Q

ALT/AST in 1000s (suuuuper high) probably

A

acute viral hepatitis

236
Q

Alpha-1 antitrypsin defieicny manifests with

A

Panacinar emphysema
Hepatic fibrosis, sometimes HCC

237
Q

Budd Chiari involves

A

Obstructino of hepatic vein

238
Q

Procedure for portal hypertension/complications

A

TIPS (transjugular intrahepatic portosystemic shunt)

239
Q

In women with uncomplicated pre-existing diabetes, induction should be considered between

A

38-39 weeks (reduces risk of stillbirth)

240
Q

Naegel’s rule

A

-3 months + 1 week

241
Q

What nephropathy commonly occurs immediately after (or potentially during) URTI or GI infection

A

IgA nephropathy

242
Q

Main difference between IgA nephropathy and Post-Strep GN?

A

IgA onset faster

PSGN occurs after a latent period of approximately 10 days following group A strep pharyngitis. Generally, PSGN occurs up to 3 weeks following group A strep skin infections.

243
Q

What is Henoch-Schonlein purpura

A

Iga Vasculitis
Like IgA nephropathy onset preceded by URTI/GI infx
Manigests in palpable purpura, arthritis/arthralgia, abdo pain, usually in children (nephro usually more in adults)

244
Q

What is HUS typically caused by? Who is usually affected

A

Bacterial toxins (e.g. Shiga-like toxin of enterhemorrhagic E coli) –> platelet microthrombi –> hemolytic anemia, thrombocytopenia, AKI
Young children

245
Q

Main differentiator of TTP and HUS

A

TTP more in adults (median 40 yrs)
TTP is ADAMTS13 deficiency (usually acquired/autoantibodies related to systemic disease, drugs, pregnancy); HUS triggered by bacterial toxins

246
Q

Child who comes un with pain/limited ROM of arm, held in flexed/pronated position likely has

A

Radial head subluxation (caused by traction, e.g. adult grabbing child’s arm to prevent fall)

247
Q

Most common cause of traveler’s diarrhea

A

Enterotoxicenic E Coli

248
Q

What Abx in EHEC?

A

NONE!!! Contraindicated bc lead to toxin release

249
Q

Prefererd Abx for bite wound

A

Amox/clav

250
Q

Strong family history of facial/laryngeal edema with abdo symptoms and possibly extremity edema likely indicates what condition? Inheritance?

A

Hereditary angioedema (Autosomal Dom)
(Inherited C1 inhibitor deficiency)

251
Q

3 autoimmune-type liver disorders

A

Primary sclerosing cholangitis
Primary biliary cholangitis
Autoimmune hepatitis

252
Q

Children under 9 years of age who have never had an influenza vaccine need…

A

2 doses, 4 weeks apart

253
Q

Older pt describes “curtain coming down” in front of eye (unilateral) intermittently, episodes last up to 30 min. Likely diagnosis/initial tx?

A

Amaurosis fugax (retinal ischemia following transient occlusion of retinal artery by microemboli)
Harbinger of stroke!! –> start aspirin
**can be part of GCA –> steroids

254
Q

Difference between selective IUGR vs twin-twin transfusion syndrome in monochorionic diamniotic?

A

TTTS will have amniotic fluid abnormalities

255
Q

Unhappy triad involves what ligaments of the knee?

A

ACL (most commonly injured)
MCL
Medial meniscus

256
Q

When are Abx indicated in acute otitis media?

A

<2 years old
Severe Sx
Otorrhea

257
Q

What are Koplik spots?

A

Grains-of-sand-like spots in buccal mucosa
PATHOGNOMONIC for measels!!

258
Q

What populations should be treated with asymptomatic bacteruria

A

Pregnant women, or undergoing endourological procedure
NOT older adults/diabetes/catheters/SC injuries

259
Q

Benzos ___ risk of opioid overdose

A

Increase!

260
Q

Incidental finding of large abdominal mass in child 2-5yo with hematuria, think…

A

Nephroblastoma (Wilms tumor)

261
Q

Next step for incidental solitary pulmonary nodule <3cm on CXR

A

If prev imaging shows stability >2 years, no further testing
Otherwise obtain CT and assess risk via lesion/personal characteristics.
If intermediate risk, serial CT for 2-3 yrs; if high risk, surgical excision

262
Q

3 important vaccines 2 weeks after splenectomy

A

Pneumococcal
Hib
Meningococcal

263
Q

Post-splenectomy Abx

A

Daily proph of pen or amox in children to 5 years, everyone 1 yr after surg, and lifelong if IC or hx sepsis
Early empiric amox-clav if any signs of infx

264
Q

2 meds for urge incontinence

A

Muscarinic antagonist = oxybutynin
Sympathomimetic - mirabegron

265
Q

Most common cause of pancreatitis

A

Biliary (alcochol 2nd)

266
Q

Most important therapeutic measure in pancreatitis

A

Fluid replacement!!
Note: ECRP can be necessary if gallstone is cause, but also can make pancreatitis worse :( - in these cases likely will need cholecystecomy

267
Q

Test to determine exocrine pancreas function

A

Fecal elastase-1 in stool (low = insufficiency)
*Test this in chronic pancreatitis

268
Q

After fine needle aspirate, what breast cysts need core needle biopsy to evaluate for breast cancer?

A

Bloody fluid or if doesn’t resolve after draining

269
Q

ND-CCBs are contraindicated in heart failure with..

A

Reduced EF
Systolic dysfunction
(so in these pts with AFib use digoxin - BB also not ideal in this population due to need for slow titration)

270
Q

Acute asthma exacerbation drugs

A

Supplemental O2
SABA + SAMA
IV corticosteroids (key)
IV MgSO4

271
Q

4 key pharmacological pillars in pts with HFrEF

A

●Renin-angiotensin-aldosterone system antagonist, with a preference for an angiotensin receptor-neprilysin inhibitor (ARNI; ie, sacubitril-valsartan)
●Beta blocker.
●Mineralocorticoid receptor antagonist (MRA) = aldosterone antagonists (spironolactone, eplerenone)
●Sodium-glucose co-transporter 2 (SGLT2) inhibitor.

+ loop diuretics as needed for volume overload

272
Q

Pharmacotherapy for HFpEF

A

sodium-glucose co-transporter 2 (SGLT2) inhibitor
AND
mineralocorticoid receptor antagonist (MRA)
+loop diuretics as needed for volume overload

273
Q

When are inotropes (dobutamine, milrinone) given in Heart Failure?

A

Severe acute decompensated HF (not if preserved systolic fn i.e. HFpEF)

274
Q

When are Abx indicated in COPD exac?

A

Cardinal Sx: increased dyspnea, sputum volume, sputum purulence

At least 2/3 and must include increased purulence

275
Q

Fever during a transfusion could indicate what 3 conditions

A

Bacterial sepsis/contamination (rare)
Acute hemolytic transfusion reaction
Febrile non-hemolytic transfusion reaction

276
Q

Acute hemolytic transfusion reaction typically caused by what?

A

ABO incompatibility (often human/clerical error)

277
Q

How to manage Febrile Non-Hemolytic Transfusion Rxn

A

Acetaminophen
(pre-medication doesn’t seem helpful)

278
Q

Dyspnea during transfusion likely indicates what 3 dx

A

TRALI
TACO
Anaphylaxis

279
Q

TRALI management

A

Typically mechanical ventilation

280
Q

Pharmacotherapy for tourettes

A

Alpha-adrenergic agonists: clonidine, guanfacine
Dopamine-blocking agents: antipsychotics

281
Q

Is ODD or conduct disorder more likely to involve legal infractions, aggression toward people/animals, deceit

A

Conduct disorder

282
Q

Current first-line therapy for H pylori eradication

A

Non-bismuth quadruple therapy (regimen with bismuth is rescue therapy, more effective but +++tablets)
PPI BID
Amoxicillin
Clarithromycin
Metronidazole

283
Q

Recommended testing for H pylori eradication (AFTER pt has used abx)

A

NOT serology (false positives, not specific to active infx)
Urea breath test or stool antigen test test (or scope)

284
Q

Bismuth quadruple therapy for H pylori

A

Bismuth
Metronidazole
PPI
Tetracycline

285
Q

Most common site if diverticulosis

A

Sigmoid colon

286
Q

Workup if borderline B12/folate

A

Increased homocysteine & methylmalonic acid –> B12 deficiency confirmed (folate possible)
Increased homocysteine only –> folate deficiency confirmed

287
Q

VITAMIN CDE mnemonic for ddx

A

Vascular
Inflammatory/Infectious
Traumatic
Autoimmune
Metabolic
Iatrogenic/Idiopathic
Neoplastic

Congenital
Drugs
Endocrine

288
Q

Diagnosis of diverticolosis vs diverticulitis

A

Diverticulosis –> Colonoscopy
Diverticulitis –> Do not scope (perf risk)! CT abdo with contrast

289
Q

Management of diverticulitis

A

Uncomplicated –> clear fluids, supportive care; empiric Abx in specific cases
Complicated (perf, abscess, peritonitis, obstruction, fistula) –> Broad-spectrum IV abx, admission, urgent or later elective colectomy, abscess drainage PRN

290
Q

Eosinophilic esophagitis diagnosis & tx

A

Histopathological dx
PPIs; +/- topical steroids, dietary eliminiation of allergens

291
Q

Define achalasia

A

Failure of LES to relax (degeneration of inhibitory neurons in esophageal wall)

292
Q

Tx of achalasia

A

Pneumatic dilation, myotomy, botox
CCBs (nifedpine) if refractory

293
Q

Diagnosis of Achalasia

A

Upper endoscopy
Barium swallow
Esophageal manometry = confirmatory (looks at peristaylsis, LES perssure)

294
Q

What is pseudoachalasia

A

A dilation of the esophagus in an achalasia-like pattern due to distal esophageal narrowing from causes other than primary achalasia. Causes of pseudoachalasia include malignancy (most common), Chagas disease, amyloidosis, and sarcoidosis.

295
Q

How to differentiate alcohol-induced psychotic disorder (alcoholic hallucinosis) vs alcohol withdrawal delirium (delirium tremes)

A

Hallucinosis onset within 12-14 hrs of heavy drinking, vitas often normal
Delirium tremens starts 3-4 days after stopping

296
Q

Triad of Wernicke encephalopathy

A

1) Confusion
2) Oculomotor dysfunction (diplopia, nystagmus, etc.)
3) Gait ataxia (small wide-based steps)

297
Q

Wernicke/Korsakoff are caused by a deficiency of…

A

Thiamine (B1)

298
Q

Meniere triad

A

1) Peripheral vertigo
2) Tinnitus
3) Asymmetric fluctuating SNHL

299
Q

Synthetic cathinones AKA ____. How to differentiate from PCP?

A

PCP intoxication of shorter duration, usually tested on urine tox. Can also cause nystagmus.
Synthetic Cathiones can last up to a week

300
Q

What is the most common type of RTA

A

Type 4 (hyperkalemic)
E.g. hypoaldosteronism (addison), K-sparing drugs
Hyperkalemia impairs ammonium excretion

301
Q

Early-onset ___ is common in T21

A

Alzheimers

302
Q

Tx for syphilis

A

Pen G

303
Q

Very early cervical cancer –>
Any kind of advancement –>

A

LEEP
Chemo + rad

304
Q

Most common type of uterine cancer

A

Adenocarcinoma

305
Q

In terms of EPS, dystonia and parkinsonism are managed by ___. Akathisia managed by ____

A

a) Benztropine
b) Beta blockers/benzos

306
Q

Tx for Wernickes

A

Give IV thiamine THEN glucose (glucose can cause toxicity if thiamine low!!)

307
Q

Do alcohol withdrawal seizures or delirium tremens come first

A

Seizures first

308
Q

First line pharmaceuticals for AUD

A

Naltrexone
Acamprosate (modulates glutamate receptors)

309
Q

2 main classes of stimulants for ADHD

A

Methylpheidate and amphetamine anologues

310
Q

In ADHD use behavioural interventions only for children of what age

A

<6 years old

311
Q

Characteristics of FASD

A

Microcephaly
Epicanthal folds
Smooth philtrum
Downslanting/short palpebral fissures
Thin upper lip

312
Q

Indications for admitting an adolescent with anorexia nervosa

A

Weight <75% of ideal body weight
Tempt < 35.5
HR < 45
SBP <80 or orthostatic hypotensions

313
Q

What psychotropic drug can cause myocarditis

A

Clozapine

314
Q

Treatment for myasthenia gravis

A

Cholinesterase inhibitors (pyridostigmine)
Supplemental immunosuppressants if refractory
Thymectomy can help

315
Q

Treatment for myasthenic crisis

A

IVIG, plasmapheresis, intubation, steroids

316
Q

Differentiate myasthenic crisis vs cholinergic crisis (caused by too much of the anticholinesterase meds)

A

Cholinergic –> muscle fasciulations, lacrimation, salivation, tachycardia, diarrhea (SLUDGE syndrome)
Can be hard to tell if mild

317
Q

Inheritence of DMD

A

X-linked recessive

318
Q

Atrophy = reduction in __ of muscle fibres
Dystrophy = reduction in ____

A

Size
Number

319
Q

What serum markers are elevated in DMD

A

CK
Aldolase

320
Q

Typically proximal weakness = ___ issue
Distal weakness = ___ issue

A

Proximal = muscle
Distal = nerve
(in general not always)

321
Q

What is Pellagra? Characteristics?

A

Vitamin B3 deficiency (Niacin)
4 Ds: Diarrhea, dermatitis, dementia, [death]
+Glossitis

322
Q

MS is the most common cause of what visual disorder? Clinical features?

A

Optic neuritis
Subacute vision loss, visual field defects, reduced acuity/colour perception
Retrobulbar PAIN, worse w/ eye movements
**typically monocular

323
Q

Gram negative diplococci with vaginal discharge –>

A

Gonorrhea

324
Q

Black box warning for haldol

A

Increased risk of death (usually cardiac or infx) in elderly pts with dementia-related psychosis

325
Q

Key component of physical exam in someone with suspected SBO

A

Palpate inguinal area (hernia)

326
Q

Top 3 causes of SBO

A
  • A = adhesion
  • B = bulge (hernia)
  • C = cancer, crohn’s (gallstone ileus, radiation, FB)
327
Q

Top 3 causes of LBO

A
  • Colorectal cancer (65%)
  • Diverticular disease (20%)
  • Volvulus (sig > cecum)
  • (hernia, adhesions, ovarian Ca, endometriosis)
328
Q

4 main types of hernias

A

inguinal (direct/indirect), femoral, umbilical, incisional

329
Q

Upper GI bleed most important med

A

IV PPI! Even more important than octreotide

330
Q

_____ are a common cause of massive LGIB. Treatment?

A

Diverticular bleed
Usually conservative tx, usually resolve

331
Q

Name a few diagnoses to rule out when someone presents with apparent panic disorder

A

Hyperthyroidism (or other endocrine)
Substance use/withdrawal
Cardiac/resp

332
Q

Tx for nec fasc

A

Immediate surgery
Immediate IV Abx (pen, clindamycin, IVIG)

333
Q

Most common cause of acute diarrhea in Canada is attributed to ____ but rapid onset is more likely ____

A

Campylobacter jejuni (onset at least 12-48 hr later)
Staph aureus toxin is preformed so onset in 1-4 hrs

334
Q

Shortcut for mean SBP in kiddos

A

90mmHg + 2(age)

335
Q

Normal infant resp rate

A

~40

336
Q

Fluid deficit for mild, mod, severe clinically assessed dehydration by % of body weight

A

<2 yrs old: 5%, 10%, 15%
>2 yrs: 3%, 6%, 9%

337
Q

Management of severe peds dehydration

A

NS boluses (10-20mL/kg) PRN
Fluid replacement over 24-48 hrs using 1.5-2x maintenance

338
Q

General best peds fluid if pt is voiding

A

D5NS + KCl (20mEq/L)

339
Q

Most common cause of traveler’s diarrhea

A

Enterotoxigenic E coli

340
Q

Ethosuximide is 1st line tx for what? What is 2nd line?

A

Childhood absence seizures
Valproate 2nd line

341
Q

Rabies post-exposure prophylaxis consists of…

A

Rabies immunoglobulin into the site of wound (passive immunization to tie them over until they can make own antibiodies)
PLUS inactivated rabies vaccine on days 0, 3, 7, 14

342
Q

Who should you send for BMD

A

Age >50 with prev fracture or 2+ RFs
>65 with 1 RF
Age >70
(note - if prev hip/spine fracture or 2+ fractures, just treat)

343
Q

Hyp__thyroidism –> hyponatremia

A

Hypothyroid

344
Q

Catch-up immunization is necessary for any adult who has not received what MMR schedule?

A

2 MMR doses after 12 months at least 1 month apart

345
Q

PEP for measels

A

Active immunization (MMR vaccine) for immunocompetent individuals after direct exposure, passive for immunocompromised
*indicated if negative or indeterminate serology

346
Q

2 central principles of the Canada Health Act

A

Universality
Accessibility

347
Q

Pts with hypertension and adrenal incidentaloma should be tested for ___ via _____

A

Primary aldosteronism
Plasma aldosterone to renin ratio

348
Q

Urine osmolality and urine sodium in SIADH

A

Osmolality high (>100)
Na high (>30) - because aldosterone isn’t kicking in bc pt isn’t actually IV depleted

349
Q

Most common inherited thrombophilia

A

Factor V Leiden mutation heterozygote (resistant to cleavage by activated Protein C)

350
Q

Post-menopausal woman with abdo distention and solid mass on pelvic exam, think…

A

Epithelial ovarian cancer

351
Q

All pregnant women should be offered U/S at ___ wks to confirm viability/GA. And then at __ weeks for anatomy (incld NT)

A

7+ weeks
11-14 wks

352
Q

Organic nitrates can lead to ___ and therefore should be co-administered with ___

A

Reflex tachy
BBs

353
Q

PCI if available within what time period?

A

90 min in centre, 120 if transferring

354
Q

ACS tx concurrent to PCI (or general conservative strategy)

A

Anti-ischemic: BB, nitrates, +/- CCB
Anti-platelets x2
Anticoagulants x1
Statin + ACEi

Clerkship (6 decks)

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