Day 15 Review - Ob4, Peds1, Peds2

Question 1

Why thiamine given in glucose infusion to alcoholics w/ hypoglycemia?

Answer 1

Glucose in absence of thiamine can worsen Wernicke encephalopathy (mamillary bodies)

Question 2

Sx of Lacunar stroke

Answer 2

5 syndromes: (1) Pure motor hemiparesis (2) Pure sensory (3) Ataxic hemiparesis (4 Sensory-motor (5) Dysarthria clumsy hand

Question 3

Meds/Interventions in tx of CP to alleviate contractures & improve function

Answer 3

Pharm: Dantrolene, Baclofen; Benzos, Botox; NonPharm: PT, Bracing (risk of ulcers), Surgery

Question 4

2 most common primary brain tumors in adults

Answer 4

Gliobastoma, Meningioma; Recall: Brain tumor mnemonic in order of decreasing incidence - MGM Studios = Metastasis, Glioblastoma, Meningioma, Schwannoma

Question 5

3 most common primary brain tumors in children

Answer 5

Astrocytoma, Medulloblastoma, Ependymoma

Question 6

ACLS tx V fib

Answer 6

Immediate CPR; 360 J; Epi or Vasopressin as 1st dose; Subsequent doses Epi; Continue CPR & repeat Epi q 3-5 min, repeat defibrillator

Question 7

Vasopressor: theoretically causes renal vasodilation

Answer 7

Dopamine (does not do this so much)

Question 8

Vasopressor: High dose optimizes alpha1 vasoconstriction

Answer 8

Epinephrine

Question 9

Vasopressor: ADH analog

Answer 9

Vasopressin

Question 10

Vasopressor: Best choice for anaphylactic shock

Answer 10

Epinephrine

Question 11

Vasopressor: Best choice for septic shock

Answer 11

Norepinephrine (causes vasoconstriction)

Question 12

Vasopressor: Best choice for cardiogenic shock

Answer 12

Dobutamine

Question 13

Vasopressor: Causes vasoconstriction but w/ bradycardia

Answer 13

Phenylephrine

Question 14

Next step eval penetrating injuries to different zones of neck

Answer 14

Zones follow arterial blood flow 1-3; Zone 1 (clavicle to cricoid cartilage): 4 vessel arteriogram or CT angiogram; Zone 2 (cricoid cartilage to angle of mandible): easy to access in surgery, surgical exploration; Zone 3 (above angle of mandible): also 4 vessel arteriogram or CT angiogram, triple endoscopy - esophagus, larynx, bronchi

Question 15

How to prevent flushing reaction of niacin

Answer 15

ASA; Also taking it at night or using it long-term helps

Question 16

EKG finding seen in WPW & Cause

Answer 16

Delta wave prior to QRS; Reentry thru accessory conduction pathway

Question 17

Tx SVT 2/2 WPV v. SVT due to other etiologies

Answer 17

Tx WPW: Amiodarone or Procainamide; Tx other SVT: Adenosine

Question 18

Most sensitive & specific test for dx chronic pancreatitis

Answer 18

Low fecal elastase levels

Question 19

Supplements given to women on anticonvulsants during pregnancy

Answer 19

Folate (for phenytoin & carbamazepine, up to 4 mg daily, throughout pregnancy but extremely important in 1st trimester); Vitamin K (in last month of pregnancy to augment coagulability during delivery)

Question 20

Next step mgt AGUS pap smear

Answer 20

Colpo (especially including endocervical curettage); If 35+ or risk factors for endometrial hyperplasia, then endometrial bx