CLIPP 6 Flashcards

1
Q

syncope in supine position is suggestive of

A

seizure

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2
Q

warm cyanotic or flushed skin vs pale and diaphoretic suggestive of

A

seizure

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3
Q

test indicated in any patient with syncope

A

ECG

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4
Q

Osgood-Schlatter disease

A

irritation of growth plate at tibial tuberosity that is self-limited and resolves with rest and resolves when the growth spurt ends. Ibuprofen can sometimes help. Typically no long term issues from this.
-may have swelling and tenderness below the knee

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5
Q

Has anyone in your family had an MI or stroke before age 50?

A

News that a first or second degree relative is affected should lead to further family history and further patient evaluation before approval of given to participate in sports

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6
Q

Do you have both kidneys?

A

Key to ask a) because it demonstrates the kid is not just saying no to everything and b) contact sports are not allowed if only one kidney

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7
Q

most common chest pain in adolescents

A

musculoskeletal

  • precordial catch syndrome: of unknown etiology. A benign condition, it occurs most commonly in adolescents and is characterized by sudden, sporadic onset of sharp pain, usually along the left sternal border, which is often exacerbated with deep inspiration. These pains are brief, lasting seconds to a few minutes, and resolve spontaneously. The pain can often be “broken” with a forced deep inspiration.
  • costochondritis: benign cause of chest pain but less common. The pain of costochondritis is due to inflammation and typically will last for hours or days.
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8
Q

HOCM genetics

A

AD

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9
Q

GI sources of chest pain could be caused by meds causing GI irritation, such as

A

alcohol, intoxicants, stimulants, tobacco, cocaine

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10
Q

angina vs precordial catch CP differences in onset, quality, timing, aggravating factors and associated symptoms

A

onset: typically exertional/stress vs sporadic and can occur with exertion but just as frequently with rest
quality: pressure/crushing vs sharp/well-localized
timing: 5-10 min vs brief
aggravating factors: - vs pain with deep inspiration that can be broken with forced deep inspiration
associated symptoms: syncope/palpitations vs =

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11
Q

which exam accounts for ~50% of the abnormal findings found on pre participation exam

A

msk

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12
Q

two min ortho exam

A

is part of pre participation physicals and tests symmetry in strength, muscle bulk and ROM and should NOT be done if current or prior injury. abnormalities should –> more thorough eval

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13
Q

Tdap first recommended to be given at

A

11-12 yo, used as booster dose

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14
Q

DTap

A

contains 3-5x more diphertheroid toxoid than Tdap and is pediatric dose

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15
Q

DT

A

for kids who can’t get the acellular pertussis component

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16
Q

mcv4 = meningococal conjugate vaccine4

A

11-12yo w/ booster at 16, but if you get first dose at 13-15 yo then second dose should be at 16-18 yo
-if get it after age 16, you don’t need a booster and Routine vaccination of healthy persons who are not at increased risk for exposure to N. meningitidis is not recommended after age 21 years.

17
Q

hep A

A

2 doses often done at 12 and 18 months

18
Q

hep b

A

3 doses often in early infancy

19
Q

HPV vaccine types

A
bivalent = women
quadrivelanet = for mnen 9-26
20
Q

worrisome heart murmurs in adolescents

A

diastolic, increases w/ standing, or louder than grade3-4

21
Q

Is Tanner staging a routine part of the pre-participation physical exam?

A

No

22
Q

Tanner staging of phallus development

A

1: childlike phallus, testicular vol20ml

23
Q

EMV+ limits your sports participation due to…

A

splenic rupture risk if playing contact sports

24
Q

strep throat no longer contagious after

A

24h of antimicrobials

25
Q

hypoglycemia sx

A

diaphoresis, anxiety, tremors, feeling of hunger

26
Q

congenital heart block can be caused by

A

congenital heart disease, AI disease in pregnant women, like lupus

27
Q

postural hypotension sx

A

can commonly cause dizziness and visual changes and often triggered by vol depletion and skipping meals. Typically not associated with prolonged (>5 min) LOC or CP

28
Q

prolonged QT sx

A

can lead to v fib. can be syndromic in assoc w/ sensorineural hearing loss. causes syncope in late childhood/adolescence

29
Q

VSD could cause

A

eisenmeingers

30
Q

is ECG sufficient work up in pt w/ exertion related syncope?

A

no - refer to cardiology, too!!

31
Q

when is ecg not needed

A

if not real syncopal event or cp - for example if tacky with sunken eyes and almost fainted, could be dehydrated and need fluids and VS recheck

32
Q

if pt w/ cp and recent viral URI/infecction, consider

A

pericarditis or pericardial effsuion