Buzz Words Flashcards
Bence Jones Proteins
Multiple Myeloma
AML
Auer Rods
Reed-Sternberg Cells
Hodgkins Lymphoma
Philadelphia Chromosome
CML
Chronic Myelogenous Leukemia
Howell-Jolly Bodies
asplenism
D/t sickle cell anemia
Basophilic stippling
Beta thalassemia, sideroblastic anemia, lead poisoning
Ringed Sideroblasts
Melodysplasia (MDS), alcoholism, lead poisoning
Smudge cells
CLL
Tear drop RBC
Myelofibrosis
“Helmet cells” - schistocytes
HUS, TTP
Christmas disease
Hemophilia B
X linked recessive disease, affects men
Hypersegmented neutrophils
B12 or folate deficiency
Prussian blue staining for ringed sideroblasts
Sideroblastic anemia
Target cells
Liver disease, hemoglobinopathy or post splenectomy
How do you reverse heparin?
Protamine sulfate
Rouleaux formation (RBCs stacked like coins)
Multiple myeloma
Myelodysplastic syndrome
Trilineage dysplasia and pancytopenia and cytogenic abnormality 5q,20q, monosomy 7
Kayser-Fleischer rings
Wilson’s disease
Horner’s Syndrome
Unilateral small pupil, mild ptosis with normal response to light and accommodation
Adie pupil
Unilateral dilated pupil sluggish to direct light stimuli
Argyll Robertson pupils
Bilateral irregularly shaped pupil, poorly reactive to light
Marcus Gunn pupil
Constricts slower to direct light than consensual light
Blue sclera
Osteogenesis imperfecta (OI)
Bamboo sign on radiograph
Ankylosing spondylitis
Finkelsteins sign
De Quervans Tenosynovitis
Sickle cell patient with osteomyelitis…what bug?
Salmonella
Osteoporosis
Demineralization of the spine and pelvis
Apprehension test
Patellofemoral syndrome
How to test for a meniscus tear?
McMurry/Appley test
How to test for ACL tear?
Lachman’s test
How to test Achilles injury?
Thompsons test
Polymyositis
Proximal muscle weakness of insidious onset
Bouchards and Heberdens nodules
Osteoarthritis
Use frog leg imaging for…
Slipped capital femoral epiphysis
Reactive arthritis
“Can’t see, can’t pee, can’t climb a tree”
Conjunctivitis, urethritis, arthritis
Caused by chlamydia
Mallory bodies
Alcoholic liver disease
Newborns who don’t pas meconium > first 48 hours of life or at all, ribbon-like stool
Hirschsprung disease
“Currant jelly stool”
Intussusception
“Olive sign”
Pyloric stenosis
“String sign” on upper GI series
Pyloric stenosis
“Double bubble sign” on CXR in pedis
Duodenal atresia
Pancreatic carcinoma triad
Weight loss, jaundice, midepigastric pain
“Courvoiser’s sign”
Palpable, non-tender gallbladder
Seen in pancreatic cancer
Sister Joseph node
Umbilical nodule
Seen in advanced gastric adenoma
Pt went/is camping, possibly mentions drinking water or something to do with lake
Ends up with diarrhea
Think probable giardia and treat with flagyl
“Birds beak” on barium swallow study
Achalsia
“High-pitched” bowel sounds
Small bowel obstruction
“Apple-core” lesion
Colon cancer (seen on barium enema results)
Charcot’s Triad
Ascending cholangitis
RUQ pain, jaundice, fever
Pain out of proportion to exam
Mesenteric ischemia
Increased indirect (unconjugated) bilirubin
Consider Gilbert’s syndrome
Peutz-Jeghers syndrome
Single or multiple hemartomas in GI tract with pigmented spots on lips, oral mucosa, face, and palms
(Associated risk for cancers of stomach, breast, lung, ovary, cervix)
Carcinoid tumor
Most frequent location is the appendix
Sxs: flushing, diarrhea, cramps, bronchospasm and valvular lesion of the right side of heart
More common in young patient
Treatment for migraines
-triptans! (Sumatriptan)
Ergotamine
Thunder clap and/or meningeal signs
Subarachnoid hemorrhage
Guillain-Barré syndrome
Weakness in legs ascending upwards
“Dural tail”
Meningioma
Multiple Sclerosis common findings
Recurrent sensory abnormalities, blurred vision, weakness with or without spasticity
Myerson sign
Sustained eye blinking in response to repetitive tapping just above the nasal bridge
Seen in Parkinson’s disease
“Stuck on” hyperpigmented lesions in elderly
Seborrheic Keratosis
Psoriasis dermatology findings
Silvery, scaly plaques, not itchy
Impetigo findings and treatment
Weeping, crusting, oozing and draining of skin
Tx: mupirocin
“Exclamation point hair”
Alopecia Areata
Yellowish scale-forming plaques
Think seborrheic dermatitis
Tense bullae on flexor surfaces
Bullous pemphigoid
Painful, erythematous, indurated nodules
Erythema Nodosum
Pearly papule with central ulceration and telangiectasis
Basal cell carcinoma
Oil spots, nail pitting, onycholysis, arthritis
Psoriasis
“Itch that rashes”
Atopic dermatitis
“Spaghetti and Meatballs”
Tinea versicolor
What uric acid level helps to confirm a diagnosis of gout?
> 7.5
A pathology report comes back with positive
birefringent crystals. What is the most likely
diagnosis?
Pseudogout
A positive Neer’s test indicates what diagnosis?
Rotator cuff impingement
Anatomically where are 80% of clavicle fractures located?
Middle third
What ligament is most commonly injured in an ankle sprain?
Anterior talofibular ligament (ATF)
There is a sunburst appearance on x-ray. What is the most likely diagnosis?
Osteosarcoma
Necrotic lesion w/ blue halo around puncture site
Brown recluse spider bite
Velvety, hyperpigmented, papillomatous lesions of neck, axilla, and groin
Ancanthosis nigricans
Vascular, sessile, dome shaped lesion that bleeds easily
Pyogenic granuloma
Herald Patch
Pityriasis Rosea
Remember - starts with herald patch, then disseminates
“Slapped cheek appearance”
Fifth dz or erythema infectiosum (Parvovirus B19)
Strawberry tongue
Strep
Lab uses chocolate agar for diagnosis
Gonorrhea
India Ink Prep (dark field)
Syphillis
Tzanck Smear
Herpes Simplex Virus
Trypanosoma cruzi
Chagas disease
Gray, frothy, malodorous vaginal discharge
Bacterial vaginosis
Clue Cells
Bacterial vaginosis
Whipple dz (Tropheryma whippelii)
fever, arthritis, malabsorption
Grey pseudomembranes of tonsils
corynebacterium diphtheriae
rash starts on the trunk and spreads, fever for 3 days followed by the rash after the fever disappears
Roseola
“Hot potato” voice, drooling in tripod position
Epiglottitis
Thumbprint sign
Epiglottitis
Pink Puffer (pursed lips)
Emphysema
Steeple sign
Croup
First line tx for sarcoidosis
Corticosteroids
Young AA woman w/ erythema nodosum & lymphadenopathy
Sarcoid!
Tx of TB
RIPE (Rifampin, Isoniazid, Pyrazinamide, Ethambutol)
Tx for bronchiolitis
humidified oxygen
Chemo agents associated with…?
pleural effusion
Atrial Flutter most common in…
COPD patients
Purulent, ‘foul-smelling’ sputum w/ digital clubbing
Bronchiectasis
Lace-like/reticular-nodular pattern on imaging
Interstitial Pulmonary Fibrosis
PCP treatment:
Metronidazole
Pertussis tx
Macrolide
Small cell lung carcinoma
central mass lesion, NON-CAVITARY, more common mets to brain (aka: oat cell)
Squamous cell lung carcinoma
central CAVITARY lesion
Non-caseating lung granuloma
Sarcoidosis
Eggshell calcification of hilar or mediastinal LN (on x-ray)
Chronic silicosis
URI followed by unconsciousness w/ elevated LFTs (no jaundice)
Reye’s syndrome
Pellagra
(4 D’s - diarrhea, dermatitis, dementia, death), niacin [vitamin b3] deficiency
Echymoses, bleeding gums, petechiae, curly q hair
Vitamin C deficiency, scurvy
Diffuse vasculitis that SPARES THE LUNGS
Polyarteritis nodosa
Big CABG Indication
Ostial Left Main lesion
Mechanical Valve INR goal
2.5-3.5
Blowing holosystolic murmur LLSB
Tricuspid regurg
Roth spots, janeway lesions, osler’s nodes
Endocarditis
Peripheral Artery Disease dx
Ankle brachial index < 1.0
“Knock” on auscultation
constrictive pericarditis
Boot Shaped Heart
TOF
Cobblestoning
Crohn’s Dz
“Punched out” ulcers on a necrotic base
d/t chronic ARTERIAL insufficiency
edema, induration, pigmentation, and ulceration
d/t chronic VENOUS insufficiency
Egg on a string heart on x-ray
transposition of the great arteries (need PDA open)
Machinery like murmur
PDA (esp under the left clavicle)
Rib notching and 3 sign on x-ray
Coarc of aorta
Aortic Dissection
Widened mediastinum, difference in BP on arms, pain btwn scapula, “Ripping/tearing sensation”
“Pencil in a cup” deformity on xray of joint
Psoriatic arthritis
Reiter’s Syndrome
CHLAMYDIA
- Oligoarthritis
- Conjunctivitis
- Urethritis
- Mucocutaneous Lesions
HLA-B27
Reactive arthritis
Clean surgical procedure prophylaxis
Cefazolin, Vanc if cephalosporin allergic
Episodic headache + tachy + diaphoresis
Pheochromocytoma (elevated urine metanephrines too)
Insulin sensitizers
thiazolidinediones
Insulin secretagogues
sulfonylureas and meglitinides
Decrease hepatic output
biguanides
delay glucose absorption
glucosidase
always give this during thyroid issues to anyone who is pregnant!
PTU
“Steeple Sign”
Viral croup - pediatrics
“Egg on a string”
Transposition of Great Arteries
“Bulging fontanelle”
Meningeal sign in peds
most common cause of postpartum hemorrhage, unable to contract and control bleeding
Uterine Atony
Endometriosis dx
Laparoscopy
Pitocin
given during incomplete abortion (or to get labor to progress/induction)
Recurrent Miscarriage
give progesterone, metformin
Gestational Diabetes
Insulin is always the drug of choice b/c it does not cross the placenta
pre-term labor
Cervical dilation >3 cm + 80% effacement + before 37 weeks
OCD Treatment
Clomiparine (Anafranil) or Sertraline (Zoloft)
Interstitial Cystitis tx
Amytriptyline 1st line therapy
Renal Cell Carcinoma
flank pain, abdominal mass, hematuria
PAD: 5 P’s
pain, pallor, pulselessness, paresthesia, poikilothermia, paralysis
Most common cause of pancreatitis
Alcohol or gallstones
Most common cause of arthritis
Osteoarthritis (>75% of cases)
1 highest mortality rate cancer for males? females?
Males: Lung
Females: Lung
1 highest incidence cancer for males? females?
Males: Prostate
Females: Breast
Sequelae of lung cancer
- Hemoptysis
- Horner syndrome
- superior vena cava syndrome
- phrenic nerve involvement
- hoarseness from laryngeal nerve involvement
- paraneoplastic syndromes (Cushing, SIADH, hyperca++, Eaton-Lambert syndrome)
Most sensitive test for MS
MRI
What do you find in an LP for MS?
Elevated IgG oligoclonal bands and myelin basic protein levels, mild elevation in lymphocytes and protein
Unconscious of delirious patient in ED with no hx or signs of trauma…what do you give them empirically?
Assume they are hypoglycemic, an alcoholic or they overdosed on opioids!
Give glucose, naloxone and thiamine
Polycystic ovarian syndrome
women who are “heavy, hirsute and amenorrheic”
most common cause of dysfunctional uterine bleeding
because of unopposed estrogen, higher risk of endometrial cancer
Fetal or neonatal macrosomia
MATERNAL DIABETES (unless proven otherwise)
Tx: diet and insulin (not oral agents)
Low maternal serum alpha-fetoprotein
Down syndrome, inaccurate dates (most common!!!), fetal demise
High maternal serum alpha-fetoprotein
Neural tube defects (did they take their folic acid???), ventral wall defects (e.g., omphalocele, gastroschisis), inaccurate dates (most common) and multiple gestation
usually measured between 16-20 weeks gestation
Maternofetal monitoring: EARLY decelerations means…
probably normal and due to head compression
Maternofetal monitoring: VARIABLE decelerations means…
common and usually due to cord compression
tx: turn mother on her side, give O2 and fluids, stop oxytocin
Maternofetal monitoring: LATE decelerations means…
uteroplacental insufficiency, WORRISOME
tx: turn mother on her side, give O2 and IV fluids, stop oxytocin, measure fetal O2 sat or scalp PH and prepare for c-section stat
Third-trimester bleeding
ULTRASOUND!!!!!
in case placenta previa is present
and what is placenta previa…? (refer to other flash card)
Neonatal conjunctivitis
First 12-24 hours: think chemical reaction to prophylaxis drops
2-5 days after birth: think gonorrhea, usually prevented by prophylactic drops
5-14 days after birth: think chlamydia, usually NOT prevented by prophylactic drops
Uveitis
Signs and sxs: Photophobia, blurry vision, eye pain
Marker for systemic conditions such as:
- Juvenile rheumatoid arthritis
- sarcoidosis
- IBD
- AS
- Reiter syndrome
- MS
- Psoriasis
- Lupus
“Claw hand”
Elbow dislocation, affects ulnar nerve, trouble with finger abduction
Legg-Calve-Perthes Dz
4-10 y/o
Short male with delayed bone age
Signs and sxs: Knee, thigh, groin pain, limp
Tx: orthoses
Congenital hip dysplasia
At birth!
Epidemiology: Female, first-borns, breech delivery
Signs and sxs: Barlow and Ortolani signs
Tx: Harness
Barlow and Ortolani signs
congenital hip dysplasia
Slipped capital femoral epiphysis
9-13 y/o
Overweight male, adolescent
Signs and sxs: Knee, thigh, groin pain and limp
Tx: Surgical pinning
When do you avoid lumbar puncture?
Patient with head trauma or signs of increased ICP
Perform CT scan without contrast instead
Pulsatile abdominal mass plus hypotension
Ruptured AAA until proven otherwise
IMMEDIATE LAPAROTOMY
90% mortality rate
Cryptorchidism
Main identifiable risk factor for testicular cancer
Can cause INFERTILITY
Tx: surgical retrieval and orchiopexy (or removal)
10/10 on Apgar score findings (maximum score)
And when do you perform?
- HR >100 bpm = 2 pts
- Good, strong cry = 2 pts (good resp effort)
- Active motion = 2 pts (good mm tone)
- Grimace and strong cry, cough, and sneeze = 2 pts (reflex irritability tested by touching sole of foot or putting catheter in nose)
- Body pink, extremities blue = 2 pts
Perform at 1 and 5 min after birth
Complications of thiazide diuretics
- Calcium retention
- Hyperglycemia
- Hyperuricemia
- Hyperlipidemia
- Hyponatremia
- Hypokalemic metabolic alkalosis
- Hypovolemia
Note any sulfa allergies!
Complications of loop diuretics
Hypokalemic metabolic alkalosis, hypovolemia
3 C’s - cough, coryza, conjunctivitis w/ Koplik spot, starting on the head and moving down; palms/soles spared
Rubeola or measles
“Slapped cheek appearance”
Fifth dz or erythema infectiosum (Parvovirus B19)
Strawberry tongue
Strep
Lab uses chocolate agar for diagnosis
Gonorrhea
India Ink Prep (dark field)
Syphillis
Tzanck Smear
Herpes Simplex Virus
Trypanosoma cruzi
Chagas disease
Gray, frothy, malodorous vaginal discharge
Bacterial vaginosis
Clue Cells
Bacterial vaginosis
Whipple dz (Tropheryma whippelii)
fever, arthritis, malabsorption
Grey pseudomembranes of tonsils
corynebacterium diphtheriae
rash starts on the trunk and spreads, fever for 3 days followed by the rash after the fever disappears
Roseola
“Hot potato” voice, drooling in tripod position
Epiglottitis
Thumbprint sign
Epiglottitis
Pink Puffer (pursed lips)
Emphysema
Steeple sign
Croup
First line tx for sarcoidosis
Corticosteroids
Young AA woman w/ erythema nodosum & lymphadenopathy
Sarcoid!
Tx of TB
RIPE (Rifampin, Isoniazid, Pyrazinamide, Ethambutol)
Tx for bronchiolitis
humidified oxygen
Chemo agents associated with…?
pleural effusion
Atrial Flutter most common in…
COPD patients
Purulent, ‘foul-smelling’ sputum w/ digital clubbing
Bronchiectasis
Lace-like/reticular-nodular pattern on imaging
Interstitial Pulmonary Fibrosis
PCP treatment:
Metronidazole
Pertussis tx
Macrolide
Small cell lung carcinoma
central mass lesion, NON-CAVITARY, more common mets to brain (aka: oat cell)
Squamous cell lung carcinoma
central CAVITARY lesion
Non-caseating lung granuloma
Sarcoidosis
Eggshell calcification of hilar or mediastinal LN (on x-ray)
Chronic silicosis
URI followed by unconsciousness w/ elevated LFTs (no jaundice)
Reye’s syndrome
Pellagra
(4 D’s - diarrhea, dermatitis, dementia, death), niacin [vitamin b3] deficiency
Echymoses, bleeding gums, petechiae, curly q hair
Vitamin C deficiency, scurvy
Diffuse vasculitis that SPARES THE LUNGS
Polyarteritis nodosa
Big CABG Indication
Ostial Left Main lesion
Mechanical Valve INR goal
2.5-3.5
Blowing holosystolic murmur LLSB
Tricuspid regurg
Roth spots, janeway lesions, osler’s nodes
Endocarditis
Peripheral Artery Disease dx
Ankle brachial index < 1.0
“Knock” on auscultation
constrictive pericarditis
Boot Shaped Heart
TOF
Cobblestoning
Crohn’s Dz
“Punched out” ulcers on a necrotic base
d/t chronic ARTERIAL insufficiency
edema, induration, pigmentation, and ulceration
d/t chronic VENOUS insufficiency
Egg on a string heart on x-ray
transposition of the great arteries (need PDA open)
Machinery like murmur
PDA (esp under the left clavicle)
Rib notching and 3 sign on x-ray
Coarc of aorta
Aortic Dissection
Widened mediastinum, difference in BP on arms, pain btwn scapula, “Ripping/tearing sensation”
“Pencil in a cup” deformity on xray of joint
Psoriatic arthritis
Reiter’s Syndrome
CHLAMYDIA
- Oligoarthritis
- Conjunctivitis
- Urethritis
- Mucocutaneous Lesions
HLA-B27
Reactive arthritis
Clean surgical procedure prophylaxis
Cefazolin, Vanc if cephalosporin allergic
Episodic headache + tachy + diaphoresis
Pheochromocytoma (elevated urine metanephrines too)
Insulin sensitizers
thiazolidinediones
Insulin secretagogues
sulfonylureas and meglitinides
Decrease hepatic output
biguanides
delay glucose absorption
glucosidase
always give this during thyroid issues to anyone who is pregnant!
PTU
“Steeple Sign”
Viral croup - pediatrics
“Egg on a string”
Transposition of Great Arteries
“Bulging fontanelle”
Meningeal sign in peds
most common cause of postpartum hemorrhage, unable to contract and control bleeding
Uterine Atony
dystocia
abnomal progression of labor due to “power, passage, or passenger”
trophoblastic disease
Preeclampsia before 20 weeks
threatened abortion
Vagnial bleeding before 20 weeks
Goddell’s sign
softening of cervix beginning of 2nd month of pregnancy
Chadwick’s Sign
congestion of pelvic vasculatures causing bluish/purplish discoloration of vagina/cervix
Hegar’s sign
Widening of the softened area of the isthmus/compressability of isthmus on bimanual exam
McDonald’s Sign
Uterine body/cervix can be easily flexed against one another
Placenta Previa
PAINLESS 3rd trimester vaginal bleeding; digital examination CONTRAINDICATED, get a transvaginal U/S
Placenta Abrupto
PAINFUL 3rd trimester bleeding, premature partial or complete separation of the placenta from its normal implantation
Preeclampsia
TRIAD: HTN, proteinuria, edema—> if they have all of these + seizures, its ECLAMPSIA (definitive tx is delivery)
Placenta accreta
directly adheres to the myometrium without an intervening decidual layer
Endometriosis dx
Laparoscopy
Pitocin
given during incomplete abortion (or to get labor to progress/induction)
Recurrent Miscarriage
give progesterone, metformin
Gestational Diabetes
Insulin is always the drug of choice b/c it does not cross the placenta
pre-term labor
Cervical dilation >3 cm + 80% effacement + before 37 weeks
OCD Treatment
Clomiparine (Anafranil) or Sertraline (Zoloft)
Interstitial Cystitis tx
Amytriptyline 1st line therapy
Renal Cell Carcinoma
flank pain, abdominal mass, hematuria
PAD: 5 P’s
pain, pallor, pulselessness, paresthesia, poikilothermia, paralysis
Most common cause of pancreatitis
Alcohol or gallstones
Most common cause of arthritis
Osteoarthritis (>75% of cases)
1 highest mortality rate cancer for males? females?
Males: Lung
Females: Lung
1 highest incidence cancer for males? females?
Males: Prostate
Females: Breast
Sequelae of lung cancer
- Hemoptysis
- Horner syndrome
- superior vena cava syndrome
- phrenic nerve involvement
- hoarseness from laryngeal nerve involvement
- paraneoplastic syndromes (Cushing, SIADH, hyperca++, Eaton-Lambert syndrome)
Most sensitive test for MS
MRI
What do you find in an LP for MS?
Elevated IgG oligoclonal bands and myelin basic protein levels, mild elevation in lymphocytes and protein
Unconscious of delirious patient in ED with no hx or signs of trauma…what do you give them empirically?
Assume they are hypoglycemic, an alcoholic or they overdosed on opioids!
Give glucose, naloxone and thiamine
Polycystic ovarian syndrome
women who are “heavy, hirsute and amenorrheic”
most common cause of dysfunctional uterine bleeding
because of unopposed estrogen, higher risk of endometrial cancer
Fetal or neonatal macrosomia
MATERNAL DIABETES (unless proven otherwise)
Tx: diet and insulin (not oral agents)
Low maternal serum alpha-fetoprotein
Down syndrome, inaccurate dates (most common!!!), fetal demise
High maternal serum alpha-fetoprotein
Neural tube defects (did they take their folic acid???), ventral wall defects (e.g., omphalocele, gastroschisis), inaccurate dates (most common) and multiple gestation
usually measured between 16-20 weeks gestation
Maternofetal monitoring: EARLY decelerations means…
probably normal and due to head compression
Maternofetal monitoring: VARIABLE decelerations means…
common and usually due to cord compression
tx: turn mother on her side, give O2 and fluids, stop oxytocin
Maternofetal monitoring: LATE decelerations means…
uteroplacental insufficiency, WORRISOME
tx: turn mother on her side, give O2 and IV fluids, stop oxytocin, measure fetal O2 sat or scalp PH and prepare for c-section stat
Third-trimester bleeding
ULTRASOUND!!!!!
in case placenta previa is present
and what is placenta previa…? (refer to other flash card)
Neonatal conjunctivitis
First 12-24 hours: think chemical reaction to prophylaxis drops
2-5 days after birth: think gonorrhea, usually prevented by prophylactic drops
5-14 days after birth: think chlamydia, usually NOT prevented by prophylactic drops
Uveitis
Signs and sxs: Photophobia, blurry vision, eye pain
Marker for systemic conditions such as:
- Juvenile rheumatoid arthritis
- sarcoidosis
- IBD
- AS
- Reiter syndrome
- MS
- Psoriasis
- Lupus
“Claw hand”
Elbow dislocation, affects ulnar nerve, trouble with finger abduction
Legg-Calve-Perthes Dz
4-10 y/o
Short male with delayed bone age
Signs and sxs: Knee, thigh, groin pain, limp
Tx: orthoses
Congenital hip dysplasia
At birth!
Epidemiology: Female, first-borns, breech delivery
Signs and sxs: Barlow and Ortolani signs
Tx: Harness
Barlow and Ortolani signs
congenital hip dysplasia
Slipped capital femoral epiphysis
9-13 y/o
Overweight male, adolescent
Signs and sxs: Knee, thigh, groin pain and limp
Tx: Surgical pinning
When do you avoid lumbar puncture?
Patient with head trauma or signs of increased ICP
Perform CT scan without contrast instead
Pulsatile abdominal mass plus hypotension
Ruptured AAA until proven otherwise
IMMEDIATE LAPAROTOMY
90% mortality rate
Cryptorchidism
Main identifiable risk factor for testicular cancer
Can cause INFERTILITY
Tx: surgical retrieval and orchiopexy (or removal)
10/10 on Apgar score findings (maximum score)
And when do you perform?
- HR >100 bpm = 2 pts
- Good, strong cry = 2 pts (good resp effort)
- Active motion = 2 pts (good mm tone)
- Grimace and strong cry, cough, and sneeze = 2 pts (reflex irritability tested by touching sole of foot or putting catheter in nose)
- Body pink, extremities blue = 2 pts
Perform at 1 and 5 min after birth
Complications of thiazide diuretics
- Calcium retention
- Hyperglycemia
- Hyperuricemia
- Hyperlipidemia
- Hyponatremia
- Hypokalemic metabolic alkalosis
- Hypovolemia
Note any sulfa allergies!
Complications of loop diuretics
Hypokalemic metabolic alkalosis, hypovolemia, ototoxicity, calcium excretion
Carbonic anhydrase inhibitor complications
metabolic acidosis
Postassium-sparing diuretic complications
hyperkalemia
Antidote for acetaminophen?
Acetylcycsteine
Antidote for cholinesterase inhibitors?
Atropine, pralidoxime
Antidote for digoxin?
Normalize K+ and other electrolytes; digoxin antiboties
Antidote for benzos?
Flumazenil
Antidote for beta blockers?
Glucagon
Antidote for opioids?
Naloxone
Antidote for muscarinic blockers?
Physostigmine
Central pontine myelinolysis
Brainstem damage and possibly death
-may result from overly rapid correction of hyponatremia
Bitot spots
think vitamin A deficiency
Meconium ileus
think cystic fibrosis
Rectal prolapse
think cystic fibrosis
Malar rash on the face
think SLE
Cherry-red spot on macula, no hepatosplenomegaly
Tay-Sachs Dz
deadly…ashkenazi jews
Clue cells
bacterial vaginosis (gardnerella vaginalis infection)
Cafe-au-lait spots with mental retardation
McCune-Albright syndrome or tuberous sclerosis
Children who torture animals
Conduct disorder
Anaphylaxis from immunoglobulin therapy
IgA deficiency
Postpartum fever unresponsive to broad-spectrum abx
Septic pelvic thrombophelbitis
Sudden death in young athlete
think HOCM
Koilocytosis
HPV or cytomegalovirus
Facial port wine stains and seizures
Sturge-Weber syndrome
Charcot triad
- fever/chills
- jaundice
- RUQ pain
+ for Cholangitis
Chvostek sign
Tapping on the facial nerve elicits tetany
+ for Hypocalcemia
Cullen sign
Bluish discoloration of flank
+ for pancreatitits with retroperitoneal hemorrhage
Homan sign
Calf pain on forced dorsiflexion of the foot
+ for DVT
McBurney sign
Tenderness at McBurney point
+ for appendicitis
Rovsing sign
Pushing on LLQ then releasing hand produces pain at McBurney point
+ for appendicitis
Prehn sign
Elevation of a painful testicle relieves pain
+ for epididymitis
rules out testicular torsion
Virchow triad
- Stasis
- Endothelial damage
- Hypercoagulability
Risk factors for DVT
Leriche syndrome
Claudication and atrophy of the buttocks with impotence
+ for aortoiliac occlusive disease
Tinel sign
Tapping on the volar surface of the wrist elicits paresthesias
Carpal tunnel syndrome
Cushing reflex
Hypertension, bradycardia and irregular respirations
High intracranial pressure
Common causes of respiratory acidosis
COPD, asthma, drugs (opioids, benzos,barbiturates, ETOH and other resp depressants), sleep apnea, chest wall problems (paralysis/pain)
Common causes of metabolic acidosis
ETOH, diabetic ketoacidosis, uremia, lactic acidosis (e.g., sepsis, shock, bowel ischemia), methanol/ethylene glycol, aspirin/salicylate overdose, diarrhea and carbonic anhydrase inhibitors
Common causes of respiratory alkalosis
anxiety/hyperventilation, aspirin/salicylate overdose
Common causes of metabolic alkalosis
diuretics (except carbonic anhydrase inhibitors), vomiting, volume contraction, antacid abuse/milk-alkali syndrome and hyperaldosteronism
Signs and sxs of hyponatremia?
- lethargy
- seizures
- mental status changes/confusion
- cramps
- anorexia
- coma
What med do you use to treat SIADH if water restriction fails?
Demeclocycline
-induces nephrogenic diabetes insipidus
What is the classic cause ofh yponatremia in pregnant patients about to deliver?
Oxytocin
-antidiuretic hormone-like effect
Hemophilia A
Prolonged aPTT
Treat with cryoprecipitate or factor 8
Hemophilia B
Factor 9 deficiency
HIV + patient with ring lesions on MRI and constitutional sxs
Toxoplasmosis
Tx with pyrimethamine and sulfadiazine
Prophylactically treat with bactrim
What will a newborn weigh in 1 year?
Triple birth weight
Hordeolum
Stye
Staph infection abscess of upper or lower eyelid
Chalazion
Granulomatous inflammation involving the meibomian gland
Dacrocystitis
Infection of the lacrimal gland 2/2 obstruction
Lateral spinothalamic tract
Pain and temp sensation
Ventral spinothalamic tract
Pressure and touch
Posterior column
Proprioception and vibration
