Day 12 Flashcards
what is first line med for angina episodes? How does it work?
beta blockers..decrease contractility
what are two inhaled substances that can be in a fire?
cyanide and carbon monoxide
what are signs of cyanide poisoning?
headache, vertigo, dizziness, tachycardia, hyperventilation, N/V
what is preferred treatment of cyanide poisoning?
hydroxycobalamin
define CHARGE syndrome
Coloboma Heart defects Atresia choana Retardation Genitourinary Ear abnormalities
how does cryptococcal meningitis presemt?
progressive headache, N/V fever and malaise….over two week period usually
what is Cd4 count to put at risk of cryptococcal meningitis?
100 or less
what is imaging finding in JC virus PML?
patchy areas of white matter consistent with demyelination
what is imaging finding of toxoplasmosis in HIV patient/
ring enhancing lesion
when do you start aspirin for preeclampsia prevention?
12 weeks gestation
what is MOA of tardive dyskinesia?
dopamine receptor supersensitivity
whatshould be used to treat CKD induced 2ndary hyper PTH?
phosphate restriction and phosphate binders
what is CAVSD? who gets it?
complete atrial ventricular septal defect…kids with T21
what are murmurs of CAVSD?
fixed split S2 and systolic ejection murmur
generalizability is the same as what?
external validity
what are some risk factors for vulvovaginal candidiasis?
DM
abx use
OCPs
immunosuppression
lab findings in babies from moms with DM
hypoglycemia
hypocalcemia
hypomagnesemia
hyperbilirubinemia
signs of hypocalcemia in newborn?
will be really jittery
what happens to heart rate before vasovagal syncope usually? why?
bradycardia…parasympathetic overload usually
which of central or nephrogenic DI usually has abnormal Na levels? what is it?
central will have hypernatremia
two MSK findings in cushing syndrome?
bone loss and myopathy
perianal pruritis at night should make you think of what?
enterobius (pinworm) infection
what is rx ofenterobius (pinworm) infection?
pyrantel pamoate or albendazole
what will urine sodium be in chronic vomiting?
will be low
what is the main difference between preseptal cellulitis and orbital sellulitis?
will have eye pain, proptosis and opthalmoplegia with orbital cellulitis
what is a bug that causes sepsis and skin ulcers?
pseudomonas
what is brain finding with status epilepticus?
cortical necrosis
what is management of ABO incompatability transfusion reaction?
stop it…support and fluids
what is rx of localized non bullous iimpetigo?
topical mupirocin or other topical Abx
what is rx of diffuse non bullous impetigo?
oral cephalexin or dicloxacillin
papules and pustules that develop goldne crusting is what?
impetigo
patients without high risk of STI get screening when in pregncny?
just 1st trimester
patients with high risk of STIs get screening when in pregnancy?
1st and 3rd trimester
what are symptoms of sertoli leydig tumor in female?
oligomenorrhea, rapid onset virilization, clitoromegaly, muscle mass increase
what are levels of testosterone and DHEA in sertoli leydig tumor?
testosterone high and DHEA low
explain what causes aromatase deficiency issues
aromatase is not converting DHEA into estradiol so get virilization…
what are testosterone and DHEA levels in aromatase deficiency?
testosterone nromal DHEA is high
liver mass with central scar
focal nodular hyperplasia
can patietns with focal nodular hyperplasia keep using OCP?
yes
can patient with hepatic adenoma keep using OCP?
NO
what happens to joint space in OA versus avascular necrosis?
is preseverd in avascular necrosis but lost in OA
will patient with GBS have reflexes?
no they will be lost
what is rx of GBS?
IVIG or plasmapheresis
normal heoglobin A is made of what?
alpha and beta
fetal hemoglobin is made of what
alpha and gamma
hgb A2 is made of what?
alpha and delta
what hemoglobin globulin is issue in sickle cell
beta
what is shape of cystine kidney stones?
hexagonal
what happens to calcium, magnesium and potassium levels with HCTZ?
ALLL LOW
femoral neck fracture leads to what position change in leg?
shortened and externally rotated
ages for meningococcal vaccine?
11 and 16
name the live vaccines
intranasal flu
MMRV
yellow fever
what is rx for methanol/ethanol poisoning?
fomepizole
what are two treatment options first line for alcohol cravings?
naloxone, and acamprosate
when should you choose acamprosate for alcohol cravings over naloxone?
if patient has liver disease or using other opioids
two bugs that if found infected with, patient should get colonoscopy
strep bovis and clostridium septicum
three abx options in pregnancy UTI
macrobid, augmentin and cephalexin
in young girl, if she has vaginal foreign body what should be done to remove it?
irrigate with warm water and local anesthetic
what are some risk factors for restless leg syndrome?
diabetes, iron deficiency, pregnancy
what is rx of RLS?
gabapentin
what is moA of gabapentin?
alph 2 delta calcium channel
3 meds that can induce methemoglobinemia
dapsone
benzocaine
nitrates
what are findings in chronic supporotiva otitis media
chronic purulent otorrhea
hearing loss
what bugs cause chronic supooritivea otitis media?
staph and pseudo
what is difference between aplastic crisis and aplastic anemia?
anemia is pancytopenia, crisis is just bad anemia
in acute panic attack, what should be given?
benzo
does zika virus cause macrocephaly or microcephaly?
microcephaly
what are findings of congenital toxoplasmosis?
chorioretinitis
diffuse intracranial calcifications
seizures
micro or macrocephaly
how is toxoplasmosis transmitted to mom?
undercooked meat or cat shit
treatment of nummular eczema?
steroids topically
who gets nummular eczema?
middle aged men
what causes lichen simplex chronicus?
recurrent itching of same skin
what is chronic pelvic pain syndrome?
pain in pelvis or genitalia, pain with ejaculation, irritative voiding sx
how does prostate feel in chronic pelvic pain syndrome?
normal
parkinsons from antipsychotic use is treated how?
if psychotic working then continue and add benztropine
treatment of TCA overdose?
sodium bicarb for cardiac issues
charcoal if within 2 hours of ingestion
fluids and oxygen
what are some causes of minimal variability in fetal HR tracing?
opioids, fetal sleep, hypoxia
define minimal variability of fetal HR
<5bpm variation
describe body dysmorphic disorder
patient very focused on specific flaws in appearance and leads to compulsions and actions to “fix” these
what is rx of body dysmorphic disorder?
SSRIs
what is somatic symptom disorder?
preoccupation with physical sx like abdominal pain or
what are clinical features of PKU?
severe ID
seizures
musty body odor
blue eyes and fair skin
what is rx of PKU?
restrict dietary phenylalanine
how to diagnose PKU?
amino acid quantification
nocardia rx is what?
bactrim
actinomyces rx is what?
penicillin
which toxic alcohol causes calcium oxalate stones?
ethylene glycol
what two bugs are most common in acute cervical lymphadenitis in a kid?
strep pyo and staph aureus
what abx fo acute cervical lymphadenitis in a kid?
augmentin or clindamycin
