CCE specific Flashcards by Becca Nicole

Differential diagnosis for seizures in a nine month old

Febrile seizure, tumor, stroke, injury, meningitis, epilepsy, electrolyte imbalance, hypoglycaemia

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How long does a febrile seizure usually last

Less than 10 minutes

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Epilepsy is diagnosed when a patient has had

Two or more unprovoked seizures

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Risk factors for febrile seizures include

Previously diagnosed to neurodevelopmental abnormality, epilepsy and a first-degree relative, high fever

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Generalized and brief seizure which occurs once in does not require within 24 hours in a young child with a fever

Simple febrile seizure

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Focal and prolonged or repetitive seizure in a child with a fever

Complex febrile seizure

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Further test order in a child with hypoglycaemia on POC test

Serum glucose to confirm the diagnosis, insulin, C-Peptide, electrolytes, Uriah, creatin, AST, ALT, drug screen, BHB

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High insulin level with low C-peptide might mean

Patient has been taking exogenous insulin

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Breaking bad news mnemonic spikes stands for

Setting, perception, invitation, knowledge sharing, emotions, strategy in summary.

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Five common causes for postmenopausal bleeding

Cancer (endometrial adenocarcinoma or cervical squamous cell), endometrial atrophy due to hypo oestrogenic state, I don’t know meiosis, pull-ups, fibroids.

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Risk factors for endometrial adenocarcinoma

Postmenopausal bleeding, endometrial thickness greater than 4 mm, increased age, nulliparity, diabetes mellitus

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Common causes of viral gastroenteritis in children

Rotavirus, Norovirus, adenovirus,

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Three common causes of bacterial gastroenteritis in children

E. coli, salmonella, CDiff

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Most common cause of parasitic gastroenteritis in children

Giardia

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Treating mild to moderate dehydration and children

ORT: 90meq/L Na, 20meq/L K, 20meq/L glucose

50-100mL/kg over 2-4 hrs

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Treating moderate to severe dehydration/hypovolemic shock in child

20 mL per kilogram bolus of ringers lactate until blood pressure normalizes

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Maintenance fluids 421 rule

4 mg per kilogram for the first 10 kg, then 2 mg per kilogram for the next 10 kg, and then 1 mg per kilogram for the remaining weight

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Combined oral contraceptive pills work by mimicking which phase of the menstrual cycle

The luteal phase

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In addition to mimicking the luteal phase of the menstrual cycle and inhibiting LHFSH an ovulation combined oral contraceptives further reduce the risk of pregnancy by

Thickening the cervical mucus to burnt sperm passage and thinning the endometrium to reduce the chance of implantation

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Medical contraindications to combined hormonal birth control pills

Migraine with aura, current breast cancer, high VTE risk factors

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Some high VTE risk factors include

Atrial fibrillation, SLE positive for antiphospholipid antibodies, age 35 and smoking 15 cigarettes daily, history of stroke, history of thrombus, major surgery with prolonged mobilization

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Differential diagnosis for a necrotizing soft tissue infection

Cellulitis, pyoderma gangrenosum, gas gangrene, DVT

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Risk factors for necrotizing soft tissue infection

Anything that may depress immunity or tissue perfusion such as diabetes, intravenous drug use, alcohol abuse, obesity, chronic steroid use, liver failure or kidney failure

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Most common bugs in immuno compromised patient with necrotizing soft tissue infection

Polymicrobial

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Most common bug in an average patient with a necrotizing soft tissue infection

Group a strep, gram-positive cocci

Most common gram negative bug in necrotizing soft tissue infection

Typically a marine organism like vibrio

Asking the patient to inhaled will hook in the fingers under the liver border inspiration causing the gallbladder to send them to the fingers producing pain if the gallbladder is inflamed is called

Murphy’s sign

Location of the appendix 2/3 from the umbilicus and the ASIS

McBurney’s point

Pain in the right lower quadrant with left lower quadrant palpation

Rosvings sign

Increased abdominal pain with extension of the leg at the hip

Psoas sign

Right hypogastric pain when the right hip is flexed knee bent and internally rotated at the hip

Obturator sign

Fever right upper quadrant pain and Murphy’s sign positive

Cholecystitis

Fever right upper quadrant pain Murphy’s sign positive jaundiced an elevated labs

Choledocholithiasis

Shock, fever, jaundice, right upper quadrant pain, altered mental status

Cholangitis

Blue or gray appearance to the abdomen and the flanks

Gray Turner side

Echinosis in the Peri umbilical area around the belly button

Cullen sign

Two signs for ascites

Shifting dullness, Fluid wave test

History of diabetes, nausea and vomiting, thirsty, abdominal pain

DKA

Treat DKA with

Fluid bolus normal saline one later, DKA protocol involves IV insulin slowly with potassium

Inflammation of the pouches in the intestine is called

Diverticulitis

Left lower quadrant pain, diarrhea, maybe bloody, nausea, vomiting, older patient

Diverticulitis

Treat diverticulitis with

Metronidazole and ciprofloxacin

Three viruses that cause otitis media

RSV, para influenza, influenza

Three bacteria that causes bacterial acute otitis media

Strep pneumonia, H flu, moraxella catarrhalis

Risk factors for ear infections

Bottlefeeding, caretaker smoking, daycare attendance, pacifier use

Treatment of bacterial otitis media inpatient younger than two years, high risk, very ill appearing

High-dose amoxycillin

Treatment for severe croup

Nebulized epinephrin and steroids

Which bug causes bacterial tracheitis

Staph aureus

Which bug causes epiglottitis

H flu

Treatment for a group a strep pharyngitis

Penicillin times 10 days

Positive Monospot test or heterophile antibody

Infectious mononucleosis

First phase of whooping cough

Catarrhal phase 1 to 2 weeks of low-grade fever, cough, coryza

Second phase of pertussis

Paroxysmal phase which includes intent spasms of coughing followed by a sudden inhalation which produces a whoop sound

Risk factors for endometrial cancer

Advanced age, unopposed estrogen, tamoxiphen therapy, early menarche or late menopause more periods, nulliparity, PCOS, obesity, diabetes

Causes of postmenopausal PV bleed

Atrophy of the vagina or endometrium, cancer, I don’t know meiosis, polyps, fibroids

Two questions to ask about paranoia

Do you think that anyone is trying to harm you? Do you think that someone is following you?

Questions for thought insertion

Are your thoughts your own? Is there anyone putting thoughts into your head that you know we’re not your own

Questions for thought Broadcasting

Can anyone else hear your thoughts when you aren’t speaking

Mania questions

Have you ever felt like you haven’t needed to sleep? Have you felt like you have unlimited energy? Do you feel like you’ve accomplished a lot in a very short amount of time?

Parts of the mental status exam

Appearance, behavior, speech, mood, affect, thought content and process , perception, cognition, insight

Psychosis that lasts from one day to one month

Brief psychotic disorder

Psychosis that lasts from one month to less than six months

Schizophreniform

To diagnose schizophrenia psychosis must be present for more than

Six months

First line therapy for schizophrenia or other psychotic disorders

Second-generation antipsychotics such as Abilify, quetiapine, olanzapine

Common side effects to second-generation antipsychotics are

Metabolic, weight gain, extra Piramidal side effects

Differential diagnosis for psychosis

Schizoaffective disorder, mood disorder with psychotic features, delusional disorders

Treat bipolar type 2 with

Lithium, mood stabilizers

Cluster headache treatment

High-dose oxygen, Triptans

PR interval normal length

0.12-20

QRS interval normal length

<0.12

QTC interval normals for male and female

Male less than 460 female less than 480

m shaped P-wave can be indicative of

P-mitrale, left atrial enlargement

Peaked p-wave can be indicative of

Right atrial enlargement or p pulmonale

Septal leads

V1 and V2

Anterior wall leads

V3 and V4

Lateral wall leads

I, aVL, V5, V6

Inferior wall leads

II, III, avF

Carpopedal spasm when blood pressure cuff is inflated over arm for 2 to 3 minutes

Trousseau sign for hypocalcaemia

Facial spasm when facial nerve is tapped over the parotid

Chvosteks sign for hypocalcemia

Next best test for hypocalcaemia or hypercalcaemia

PTH

Drugs that can cause hypercalcaemia

Thiazide diuretics, lithium, vitamin D

A lipid profile includes

Total cholesterol, high density lipoprotein, low density lipoprotein, triglycerides

COPD with decreased DLCO

Emphysema

COPD with normal DLCO

Broncholitis

Restricted PFT pattern with decreased DLCO

Interstitial lung disease, congestive heart failure

Red/brown Granular casts in urine

ATN

Left anterior chest line at the level of the lower intercostal space is called

Castells point. Percuss here for splenomegaly during inspiration