Day 2 Flashcards
1
Q
what eye finding is associated with MS?
A
internuclear opthalmoplegia
2
Q
what is internuclear opthalmoplgeia?
A
conugate horizontal gaze
3
Q
what is issue in internuclear opthalmoplegia?
A
medial longitudinal fasciculus
4
Q
what are features of PNH?
A
dark urine, hemolysis, hepatic vein thrombosis, fatigue
5
Q
what is rx of PNH?
A
eculizumab
6
Q
pregnant patient has significant hemorrhage, what position should they be in?
A
left lateral decubitus
7
Q
what are drug options for mild to moderate dementia?
A
rivastigmine, donepezil and galantamine
8
Q
what is drug option for severe dementia?
A
memantine
9
Q
women with migraines with aura should stop what medication? why?
A
OCP, at increased risk of stroke
10
Q
what is cause of infertility in klinefelter?
A
semineferous tubule dysgenesis
11
Q
what is karyotype of klinefelter?
A
47XXy
12
Q
what are findings in klinefelter?
A
tall stature, small balls, infertility, gynecomastia
13
Q
what is fetal hydantoin syndrome?
A
in utero exposure to phenytoin, valproate or carbamazapine
14
Q
what are findings of fetal hydantoin syndrome?
A
cleft lip/palate, wide anterior fontanelle, cardiac isses, distal phalange hypoplasia
15
Q
what are classic findings of interstitial nephritis?
A
rash, fever, eosinophilia, WBCs in urine
16
Q
vertigo can be presenting symptom of what type of stroke?
A
posterior circulation (vertebral artery)
17
Q
hyper IgE syndrome is associated with what blood finding?
A
eosinophilia
18
Q
hyper IgE leads to what type of infections?
A
lots of eczema and reccurent abscesses and sinopulmonary infections
19
Q
what is unique about development in hyper IgE syndrome?
A
retained primary teeth
20
Q
what is treatment of hyper IgE syndrome?
A
supportive skin care
21
Q
what are some topical treatment options for acute angle closure glaucoma?
A
timolol, pilocarpine and apraclonidine
22
Q
what are risk factors for vaginal hematoma?
A
forceps delivery, big baby, prolonged 2nd stage of labor
23
Q
what is clinical sign of vaginal hematoma?
A
patient getting shocky and has a vaginal mass
24
Q
what is treatment of vaginal hematoma?
A
if not expanding, observe. if expanding surgery
25
what is formula for Number needed to harm?
1/absolute risk increase....to calculate absolute risk increase it is rate of AE with intervention minus rate of AE without intervention
26
two options for endometrial hyperplasia management?
give progestins or hysterectomy
27
what are lab findings in MM?
normocytic anemia,
renal insufficiency,
hypercalcemia
M spike
28
what is radiology finding in MM?
osteolytic lesions of bones
29
what are some common signs/sx of MM?
bone pain, constipation, weight loss, fatigue and recurrent infections
30
what Ig is elevated in MM?
IgG or IgA
31
IgM spike is daignostic of what?
waldentstroms macroglobulinemai
32
what age should baby begin to respond to name?
6 months
33
what are emergency contraception options?
single pill of ulirpristal, oral levanorgestrol, IUDs
34
in secondary adrenal insufficiency, what are levels of ACTH, cortisol and aldosterone?
ACTH and cortisol low, aldosterone normal
35
in primary adrenal insufficiency, what are levels of ACTH, cortisol and aldosterone?
cortisol and aldosterone are low and ACTH is high
36
which of primary or secondary adrenal insufficiency has skin changes?
primary gets skin hyperpigmentation
37
what are three main findings in cauda equina syndrome?
saddle anesthesia, severe unilateral radicular pain, bowel/bladder issues
38
what is rx of cauda equina syndrome?
surgical decompression
39
what heme findings can occur in HELLP syndrome?
MAHA and thrombocytopenia
40
what can happen to lungs in HELLP/preeclampsia?
pulmonary edema
41
what med should sickle cell pregnant patients be taking?
aspirin
42
what are obstetric complications that patients with sickle cell are at increased risk for?
abruption, preeclampsia, spontaneous abortion
43
what acid base disturbance is normal in pregnancy?
respiratory alkalosis
44
what happens to HR and CO in pregnancy?
both go up
45
when do patients get peripatum cardiomyopathy?
within a month of delivery or 5 months after
46
what are common symptoms of opioid/heroin withdrawal?
abdominal pain, N/V/D, muscle aches
47
what are PE signs of heroin withdrawal?
dilated pupils, yawning, hyperactive bowel sounds
48
how does nasal mucosa appear in allergic rhinitis?
pale edematous
49
what are characteristic features of trisomy eighteen?
micrognathia, low set ears, clenched hands and overlapping fingers, heart defects, rocker bottom feet
50
what is most common heart defect in trisomy 18?
VSD
51
what is CXR finding in neonat respiratory distress syndrome?
diffuse reticulogranular pattern with air bronchograms
52
symmetric fetal growth restriction likely onset when? what are most likely causes?
first trimester...cause likely genetics of infection
53
asymmetric fetal growth restriction likley onset when? what are causes?
2/3rd trimester...uteroplacental insufficiency and maternal malnutrition
54
what are two meds used to treat organophosphate poisoning?
atropine first then pralidoxime
55
what are muscarinic toxicities noted in organophosphate poisoning?
```
Diarrhea
Urination
Mmiosis
Bronchospasms
Emesis
Lacrimation
Salivation
```
56
what are some things that put pregnant patient at high risk of preeclampsia?
multiple gestations, DM, prior preeclampsia, chronic HTN
57
patients at high risk of preeclampsia should be on what?
low dose aspirin
58
what is treatment of submucosal fibroids in patient who wants future kids?
hysteroscopic myomectomy
59
what is triad of wernickes?
ataxia, encephalopathy and occulomotor dysfunction
60
whatis korsakoff syndrome?
retrograde and antegrade amnesia in alcoholic
61
what is rx of wernickes?
thiamine
62
three indications for statin as primary prevention?
LDL over 190
DM and 40+ years old
ASCVD greater than 7.5
63
what are the two phases of the first phase of labor?
latent and active
64
what is latent phase of first stage of labor?
0-6cm dilation...no specific rate
65
what is active phase of first stage of labor?
6-10 cm dilation, must be more than 1cm/2hours
66
when is active phase of first stage of labor considered arrested?
no cervical change for 4 hours with adequate contractions or 6 hours with inadequate contractions
67
watery diarrhea and maculopapular rash in post transplant patient should make you think about what?
GVHD
68
what cells mediate GVHD?
CD8
69
what is mainstay of rx for GVHD?
steroids
70
giant cell bone tumor occurs where? what appearance?
epiphysis...soap bubble
71
MC pediatric primary brain tumor?
astrocytoma
72
medulloblastoma is common in kids or adults? where does it occur? what symptom is common?
kids...cerebellum...ataxia
73
what is cause of lactation failure jaundice?
baby dehydrated, leads to decrease in elimination of bilirubin through pee
74
when does lactation failur jaundice onset?
within 1 week of life
75
what causes breastmilk juandice?
bilirubin gets deconjugated by glucorinidase in breast milk
76
when does breast milk jaundice onset?
1 week and beyond
77
what is rx of lactation failure jaundice?
if milk is in increase feeding and follow up closely, if milk not in formula
78
two long QT syndromes, which has sensorineural hearing loss
romano ward and Jervell lange nielsen (SNHL)
79
what med should patient with long QT syndrome be taking?
propanolol
80
what is protein, glucose and WBC count for viral CSF?
normal glucose, mild protein elevation, mild leukocytosis
81
what abx can cause hyperkalemia?
bactrim
82
what is mnemonic for manic episode
```
Distractability
Impulsivity
Grandiosity
Flight of idease
Activity increase
Sleep decrease
Talkative
```
83
what is rx of lithium toxicity?
dialysis
84
what is cutoff for amniotic fluid index for polyhydramnios?
greater than 8cm
85
when does hcg peak?
end of first trimester
86
what is hcg level in hydatiform mole?
100k or more
87
what is a missed abortion?
no bleeding, closed cervix, no cardiac activity or empty sac
88
what is a threatened abortion?
vaginal bleeding with closed cervix and still has cardiac activity
89
what is an incomplete abortion?
vaginal bleeding, dilated cervix, some products remain
90
what is an inevitable abortion?
vaginal bleeding, dilated cervix and products of conception seen at or above level of cervix
91
what are two main meds given in COPD exacerbation?
inhaled bronchodilators and systemic roids
92
weber test (one you put on top of head) lateralizes to unaffected or affected in sensorineural?
unaffected
93
weber test (one you put on top of head) lateralizes to unaffected or affected in condctive?
affected
94
1st line rx for primary dysmenorrhea?
NSAIDs
95
what are findings in GPA?
sinusitis, pulmonary nodules, glomerulonephritis,
96
which Ab in GPA?
c-anca
97
what is rx of GPA?
steroids and methotrexate or cyclophosphamide
98
what are symptoms of central retinal artery occlusion?
severe vision loss with temporal sparing
99
what is PE finding in central retinal artery occlusion?
pale fundus with cherry red spot
100
what is symptom of central retinal vein occlusion?
blurred vision to severe vision loss
101
what is PE finding of central retinal vein occlusion?
fundus with retinal hemorrhage and optic disc edema
102
what is rx of central retinal vein occlusion?
observation
103
what are symptoms of retinal detachment?
floaters, flashing lights and progressive visual field defect
104
what are PE findings of retinal detachment ?
fundus with vitreous hemorrhage and marked elevation of retina
105
what is rx of retinal detachment?
surgery
106
what are sx of vitreous hemorrhafe?
floaters and hazy vision
107
what are PE findings of vitreous hemorrhage?
decreased red reflex, RBCs/floating debris in vetrous, obscured view of fundus
108
what is rx for vitreous hemorrhage?
bed rest and head of bed elevation
109
is FRC increased or decreased in COPD?
increased
110
is vital capacity increased or decreased in COPD?
decreased
111
what is management of laryngomalacia?
should resolve on own
112
is LA enlarged in athlete heart or hypertrophic cardiomyopathy?
enlarged in hypertrophic cardiomyopathy not in athletes heart
