Day 4 Review - CV1, CV2, Trauma

Question 1

Tx hyperparathyroidism 2/2 parathyroid hyperplasia

Answer 1

Remove 3.5 glands & mark remaining 0.5 gland with clip; If high risk (e.g., MEN I), may autotransplant from neck to forearm

Question 2

Name antipsychotics in each category: (1) High potency (2) Low potency (3) Moderate potency (4) Atypical

Answer 2

(1) High potency antipsychotics: more extrapyramidal side effects, less cholinergic; Haloperidol, Fluphenazine, Thiothixene, Droperidol (2) Low potency: more anticholinergic side effects, less EPS (not give to elderly) - Chlorpromazine, Thioridazine (3) Malidone, Loxapine, Trifluoperazine (4) Olanzipine, Risperidone, Arpiprazole, Quetiapine, Clozapine, Paliperidone

Question 3

Mineralocorticoid used in tx of aldosterone deficiency (e.g., adrenal insufficiency, 21-hydroxylase deficiency)

Answer 3

Fludrocortisone

Question 4

Lesion of brain: (1) Contralateral hemiballismus (2) Hemispatial neglect (3) Coma (4) Poor repetition (5) Poor comprehension (6) Poor vocal expression (7) Resting tremor (8) Intention tremor (9) Hyperorality, hypersexuality, disinhibited behavior (10) Change in personality (11) Dysarthria (12) Agraphia, acalculia, finger agnosia

Answer 4

(1) STN (2) Right parietal lobe (3) RAS (4) Arcuate fasciculus (5) Wernicke’s area (6) Broca’s area (7) Basal ganglia (8) Cerebellum (9) Bilateral amygdala (Kluver-Bucy syndrome) (10) Frontal lobe (11) Cerebellar vermis (12) Left parietal lobe

Question 5

Age start dose dexamethasone before or with antibiotics in cases of suspected bacterial meningitis

Answer 5

After 6 mo. of age

Question 6

Drugs used in renal disease to bind phosphate to prevent hyperphosphatemia

Answer 6

Calcium carbonate, Calcium acetate; NOT Calcium citrate (would increase Al absorption)

Question 7

ASA overdose p/w

Answer 7

(1) Tinnitus (2) Respiratory alkalosis from hyperventilation, becomes mixed respiratory alkalosis and metabolic acidosis with anion gap; Also - AMS, n/v, dehydration

Question 8

Tx overdose: (1) Salicylates (i.e., ASA) (2) Beta blockers or Verapamil (3) Digoxin (4) Iron (5) Copper (6) tPA/Streptokinase

Answer 8

(1) Charcoal; Sodium bicarbonate; Dialysis if severe (2) Glucagon, Calcium, Atropine (treat bradycardia), Insulin + Glucose (3) Charcoal (w/i first 24 h, binds Dig), NOT give Calcium (although can also cause bradycardia), Dig Fab fragment if severe (4) Deferoxamine (5) Penicillamine (6) Aminocaproic Acid