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1
Q

causes of stridor > 6 month

A

croup, epiglottitis, RPA, FB, tracheitis

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2
Q

bugs in epiglottiits

A

mc in unvaccinated kids, h flu spneumo s aureus

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3
Q

treatments for CRAO

A

oribtal massage, anterio chamber paracentesis, mannitol acetazolamide, IA trhomblytic

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4
Q

cotton wool spots, blood and thunder

A

CRVO

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5
Q

disc hyperemia, painfull, inflammation on fundus

A

optic neuritis

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6
Q

infant with poor feeding, tachypnea, irritaiblity, what is tx

A

PSVT, adenosine, procainamide, amio b block- if unstble can sync CV .5-1j/kg

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7
Q

causes of erythema multiforme- SOAPS

A

hsv, m pneumo, sulfa oralhypogly antivconv pcn nsaids

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8
Q

bug in lyme

A

borrelia burdorferi- E mygrains, tx doxy

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9
Q

what casuses scarlet fever

A

GABHS- exudative pharyngitis, stawberry tongue, sandppaer rash- tx PCN

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10
Q

HIV meningitis bug

A

crypotoccous- ELEVATED OP, leukocytosis, low glucose, CD4< 100 cram stain negative

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11
Q

how to look for cryptococcus on HIV CSF

A

CrAg or INDIA innk- round encapsulated - tx IV AMPH B flucosytosine

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12
Q

ring enhancing lesions on brain CT

A

toxoplasmosis

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13
Q

encephalitis in HIV pt

A

CMV

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14
Q

how to get a BP in LVAD

A

doppler probe over brachial artery -g ives a single BP reading

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15
Q

blast trauma- what is primary, seconary, 3, 4th

A

TM rupture and barotrauma, 2nd is fling objects and lacerations, 3rd is victim getting launched, crushed - 4th is burns, radiation explosure, inhalation

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16
Q

eye inflmamation after blunt trauma- injection, pain with constriciton/photphobia, cells and flare

A

traumatic iritis (iridocyclitis) iris and ciliary body inflamaed- tx CYCLOPLEGIC like homatropine, iritis also assn with HLAB27 ank spondy

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17
Q

risk factors for ectopic

A

prior ectopic, tubal, PID, IUD, mc fallopian

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18
Q

where does LOWER GI bleed start anatmically

A

distal to ligament of treitz

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19
Q

cause of post colonocsopy bleed

A

eschar sloughing from procedure

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20
Q

contraindciatioons for MTX for ectopic

A

fetal heart tones, >4 cm, unstable patient, if theres a rupture

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21
Q

corkscrew hairs, anermia, assn iron deficiency, muscle pains, anemia

A

vit c deficiency

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22
Q

watery diarhrea, dementia, dermatiits - hyperpigmented and hyperkeratitic skin, mouth inflamation, cheliosis

A

niacin deficincy - pellagra

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23
Q

anorexia, weight loss, peripheral neuropathy, ataxia, confusion, opthalmoplegia

A

thamine deficiency- berber1- B1

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24
Q

skeletal bowing, bone pain, m weakness

A

vit d deficiency

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25
Q

mandatory reporting

A

elder and child abuse, deadly weapon

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26
Q

mechanism of black widow spider bite

A

ACH and NE release- cramping in abd wal back and legs- systemic CNS and peripheral hyepractivity- tx opiods and benzos

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27
Q

nausea vomiting gastritis, tachycardia, tachypnea, tinnitus, AMS, cerebral edema

A

aspirin toxicity - mixed anion gap meta acidosis and resp alkalosis - low NA from renal and bicarb due to respo alkalossi

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28
Q

chem7 changes in ASA tox

A

low Na, low bicarb, neuroglycopenic

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29
Q

treatment of ASA tox

A

urine alkalinzation with bicarb, glucose, 1-2meq/kg and d5w w bicard and Kcl- urine Ph 7.5-9 and blood ph 7.45 for AMS

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30
Q

SLUDGE mneumonic and tx

A

organophosphate, slaivation, lacrimation, urination, diarrhea, Gi distress, tx pralidoxime or atropine

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31
Q

gout crystlas and refringence

A

monosodium urate, neg

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32
Q

psuedogout and refringe

A

cal pyrophosphate, pos

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33
Q

sickle cell patient with acute drop in Hb and retic

A

splenic sequestration and hemolytic crisis- kids

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34
Q

which antidepressant avoid in eating disorder

A

bupropion- lower sz threshold

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35
Q

recurrent fever lsating 1-4 days with pleuritic chest pain

A

familar meditrerranean fever

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36
Q

pruritis, burning, red discoloration of hands and feet

A

PCV - give hydroxyurea for elevated uric acid- Jak2 mutation- splenomegaly

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37
Q

PCV what cell linsare increased

A

erythrocte, granuolcte, plateletes

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38
Q

transplant infections - immediate, 1-6 mo, chronic

A

1 - mrsa, pseudo (nosocomial) -1-6 opportunistic - CMV EBV PCP aspergillisu >6 chronic viral – cmv ebv hsv hep b c cap vzv

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39
Q

high fever for 3-4 days then rash, child 6mo - 3yrs - runny nose, cough, malaise

A

roseola - measels- blanching rash on trunk neck then extremimtieis - HSV6

40
Q

c spine mneumonic

A

jefferson bit off a hangmans thumb J (c1 burst) Bilateral Facet, Odontoid II, III, any dislocation, Hangmans - Teardrop

41
Q

artery injured to cause epidural hematoma

A

middle meningeal

42
Q

rules for nexus

A

no focal neuro, no intox, normal alertness, no disctracting, no midline c spine pain

43
Q

dental fracture ellis types

A

elliis 1- enamel II dentin and enamel- hot and cold sensitivity - yellow - cover the exposed with CaOH paste - III refer- enamel dentin and pulm- oral surgery and pen VK

44
Q

cause of abducens palsy

A

dm, ischemia- SAH, intercavernous anerurysm, GCA

45
Q

motor of CN IV

A

superior oblique- inward and downward movement of eye

46
Q

complications of meases

A

PNA, SSPE,

47
Q

ipsilateral dilated pupul, contralateral hemiparesis, decerbrate posturine

A

transtentorial herniation- uncal, medial temporal lobe

48
Q

tonsillar hernation-

A

foramen magnum- conpresses medulla and cord- HTN BRADY arrest

49
Q

eyes moving in opposite direction of head turning is ….

A

intact brainsttem oculocephalic

50
Q

irrigation of saline into ear and no eye mvmt =

A

brainstem injury - oculovestibular

51
Q

decorticate vs decerebrate

A

decorticate is upper flexion and lowe extension

52
Q

tx cholinergic toxicity

A

atropine, pralidoxime

53
Q

treatment anticholinergic tox

A

physostigmine

54
Q

when to use active invasive core rewardming

A

severe hypotenrmia with unstable vitals - J waves on EKG osborne , possible VF and asystole

55
Q

CSF with elevated Wbc, protein, low glucose

A

menigitis, gram +

56
Q

what febrile sz can you d/c

A

6mo to 5 years, tonic clonic, less than 15 mins, no neuro deficits, no recurrence 24 hours

57
Q

what do you do if complex febrile

A

work up for meningitis, ICH , mass

58
Q

kid with tender erythroderma, crusting around lips, bullae, nikoslsky +, desqumation 3-4 days after rash

A

SSSS - exotoxin realse from staph- tx dicoxaclillin - b lactamase

59
Q

MCC EM

A

HSV1-2, M pneumo

60
Q

where is FB likely tog et stuck in adults and kds

A

t11, GE jxn, kids c6- cricopharyngeus- t4, aortic arch, t6 trachel birufcation

61
Q

causes of icreased unconjugated bilirubin

A

hemolysis, giberts, noenalatal jaundice, sepsis

62
Q

causes of increased conjugated direct bili

A

obstruction, HC hepatitis cirrhosis sepsis, osbstruciton, stone CHF

63
Q

hep thats fecal oral, ppx vaccine, tx IG within 2 weeks of exposure

A

hep a

64
Q

hep from perc sexual, incubatio 1-6 months, 10% carrier

A

hep B

65
Q

HBSAG

A

active

66
Q

HBSAB

A

positive after clearance, marker for immunity

67
Q

HBEAG

A

high infectivity

68
Q

HBCAB

A

at some point infected- hx HBV infxn

69
Q

heathcare worker stuck with crhonic hep bw hat do you do

A

draw titers – if adequate no tx, otherise give Hb IG and restart 0 -1 6 mo vaccins

70
Q

hep from blood xfusions, 50% chronic, IVDA

A

hep c - 2% seroconversion after perc exposure

71
Q

hep can only get if Hep B - HBSAG needed for coinfection

A

hep d- IVDA homos

72
Q

hep fecal oral

A

hep e

73
Q

bugs in SBP

A

e coli, enterococcus- due to portal htn and bowel demea leaking bugs- postiive paracentiss PMN > 250 acute, >100 chronic or PD

74
Q

mcc ALF

A

tylenol, also HAV HEV

75
Q

mcc death in ALF

A

intracraniel HTN, cerebral eedema due to ammonia leve- tx mannitol, indomethacin HTN saline

76
Q

mcc suriga abdominal pain elderly, what bugs

A

chole, E coli, klebsiella

77
Q

what is galstone ileus

A

stone goes into small bowel, blocks iloecael valve

78
Q

air iin RUQ

A

emphesematous chole or mesenteric ischemia

79
Q

jaundice, feve,r rUQ pain

A

ascending hcolangitis

80
Q

drugs that can cause pancreatitis

A

thaizide, salicylate, acetaminhen, abx, estrogens- also viral infxm bacteral like salmonella, strep

81
Q

sentinal loop on XR

A

bowel gas in middle of xray over pancreaus - ileus near pancreas

82
Q

compoennts of ransons criteria

A

age 55, glucose >200, WC >16000, AST >250, LDH >350 - 3 positive is severe

83
Q

diffuse infection of eyelid margin - what and what tx

A

blephartis, staph optical

84
Q

inflammation of lacrimal duct

A

DACRO LACRO - staph- topical abx compres

85
Q

infection of eyelid- localized

A

hordeolum - staph, abscess- compress abx

86
Q

chronic internal sterile granulomatous rxn of eyelid

A

chalazion- meobmian gland - nontender non inflam upper lid margin - optho i/d

87
Q

complications of orbital cellulits

A

meningits, cavernous sinus thrombisis and CN deficits

88
Q

severe conjunctiivits

A

epidemic keratoconjunctivitys- adenovirus

89
Q

neontal conjucntiivits

A

chlamydia

90
Q

tx uveitis

A

uvea- iris, ciliary body, choroid- inflammation causes cell and flare, photopbia, ache, red eye- tx cycloplegics, steroids

91
Q

atropine, cyclopentolate, homatropine, scopolamine and tropicamide

A

muscarinic, cyloplegics

92
Q

inflammation of cornea, perilimbic flush

A

keratitis - fro infxn, sjogrens, drug tox- get PERILIMBIC flush - can also be from dry eyes or bacteria

93
Q

viral kertaitis bug

A

HSV- neonates- dendritic branching- tx acyclovir, also VZV keratitis- zoster- hutinchinsons sign- may have irits- needs steroids

94
Q

treatent for glaucoma- sequence

A

timolol, acetazolaminde, apraclonidine- dec aq humor produ -mannotil- osmotic decompresison- then pilocarpine- drainage of Aq humor after production lowered (IOP >40 bad)

95
Q

bitemporal hemoanposia-

A

pituitary optic chiasm

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