Day 11 Review - Ms1, Ms2, Ms3

Question 1

Lab changes: HUS/TTP

Answer 1

Platelet count low, Bleeding time increased, PT/PTT Normal

Question 2

Lab changes: Hemophilia

Answer 2

Platelet count & Bleeding time normal, PT Normal, PTT increased

Question 3

Lab changes: vWD

Answer 3

Platelet count normal, Bleeding time increased, PT normal, PTT elevated (Factor VIII)

Question 4

Lab changes: DIC

Answer 4

Platelet count low, Bleeding time increased, PT/PTT elevated

Question 5

Lab changes: Warfarin use

Answer 5

Platelet count & bleeding time normal, PT & PTT elevated

Question 6

Lab changes: End-stage liver disease

Answer 6

Platelet count low or normal, bleeding time high or normal, PT & PTT elevated

Question 7

Lab changes: ASA use

Answer 7

Platelet count normal, Bleeding time high, PT & PTT normal

Question 8

Iron studies: iron deficiency anemia v. anemia of chronic disease

Answer 8

Serum iron low in both; Ferritin low in iron def v. high (non-specific) in ACD; Transferrin high v. low; Serum Iron/TIBC 18%

Question 9

Meds necessary in ESRD

Answer 9

Vit D; Phosphate binders; Baby ASA; EPO (if low Hb fort this cause - goal: 11-12); Statins (especially helpful on dailysis); BP/Glucose control; ACEi (unless causing hyperkalemia)

Question 10

Tx hyperkalemia

Answer 10

If evidence of heart damage, calcium gluconate (stabilize myocardium); Rapid lowering: amp D50 w/ insulin, sodium bicarb, & albuterol neb; Kayexlate or Lasix for long-term

Question 11

4 potassium-sparing diuretics

Answer 11

Spironolactone (only one w/ anti-androgenic effects), Eplerenone; Triamterene, Amiloride

Question 12

Deep palpation in RUQ, inspiration arrest due to pain

Answer 12

Murphy’s sign - Cholecystitis

Question 13

Charcot’s triad v. Reynold’s pentad

Answer 13

Fever, RUQ pain, Jaundice +/- AMS, Hypotension = Cholangitis

Question 14

RLQ pain on passive extension of hip

Answer 14

Psoas sign - Appendicitis

Question 15

RLQ pain on passive internal rotation of flexed hip

Answer 15

Obturator sign - Appendicits

Question 16

LUQ pain & referred shoulder pain

Answer 16

Kehr sign - Splenic rupture

Question 17

Ecchymosis of skin overlying flank

Answer 17

Gray-Turner’s sign - Pancreatitis

Question 18

Ecchymosis of skin overlying periumbilicus

Answer 18

Cullen sign - Pancreatitis

Question 19

X-ray finding indicative of croup

Answer 19

Steeple sign

Question 20

X-ray finding indicative of epiglotittis

Answer 20

Thumbprint sign

Question 21

Tx RSV bronchiolitis

Answer 21

Albuterol or Racemic epi (use whichever works; if not work, don’t use either); Oxygen may be necessary; NO steroids; Ribavirin only as last resort (given side effects)

Question 22

Beck’s triad

Answer 22

JVD, hypotension, muffled heart sounds = Cardiac tamponade

Question 23

Typical initial postop fever w/u

Answer 23

CBC w/ diff, U/A, blood cultx, CXR