Day 6 Review - Pulm1, Pulm2, Pulm3

Question 1

Tx cluster HA

Answer 1

100% oxygen; Triptans, ergotamines

Question 2

Class of antiHTN contraindicated in pts: COPD

Answer 2

Nonselective Beta-blockers

Question 3

Class of antiHTN contraindicated in pts: b/l Renal artery stenosis

Answer 3

ACEi/ARBs

Question 4

Class of antiHTN contraindicated in pts: Pregnancy

Answer 4

ACEi/ARBs

Question 5

Class of antiHTN contraindicated in pts: Advanced renal failure

Answer 5

If Hyperkalemia, no ACEi/ARBs; No potassium-sparing diuretics

Question 6

Class of antiHTN contraindicated in pts: Gout

Answer 6

Diuretics (Thiazides)

Question 7

Heart sounds considered benign when no evidence of disease

Answer 7

(1) Split S2 on inspiration (2) Split S1 (3) S3 (asx) (4) Early quiet systolic murmur (all Diastolic murmurs should be evaluated); Any sx, evaluate

Question 8

Associated heart defects: chromosome 22q11 deletion

Answer 8

CATCH 22: DiGeorge syndrome; Truncus arteriosus & ToF

Question 9

Associated heart defects: Down syndrome

Answer 9

Endocardial cushion defects (ASD, VSD, abnormal connection bn all 4 chambers, AV connection, etc.)

Question 10

Associated heart defects: Congenital rubella

Answer 10

PDA; Pulmonary artery stenosis

Question 11

Associated heart defects: Turner syndrome

Answer 11

Coarctation

Question 12

Associated heart defects: Marfan syndrome

Answer 12

Aortic insufficiency (e.g., AR)

Question 13

Next step once brain tumor identified on CT/MRI head

Answer 13

Most common cause of brain tumor is metastasis, so look for source: full body CT, bone scan

Question 14

W’s of postop fever

Answer 14

Wind (atelectasis), Wound (infx, after POD5), Water (UTI), Walking (DVT), Wonder drugs (incl. antibx), Wayne (for vein, thrombophlebitis), sinusitis especially if NGT

Question 15

Tx Tb meningitis

Answer 15

Isoniazid, ethambutol, pyrizinamide, rifampin (same med combo as pulmonary Tb)

Question 16

Pericarditis p/w s/sx

Answer 16

Pleuritic chest pain (worse supine, relieved leaning forward), dyspnea, fever, cough; Pericardial friction rub, JVD, pulsus paradoxus, diffuse ST elevations

Question 17

Antidotes: Acetaminophen

Answer 17

N-acetylcysteine

Question 18

Antidotes: Lead

Answer 18

Penicillamine, EDTA, Dimercaprol, Succimer

Question 19

Antidotes: Cyanide

Answer 19

Sodium thiosulfate, Hydroxycobalamin, Amyl or sodium nitrate

Question 20

Antidotes: Methemoglobin

Answer 20

Methylene blue, Vitamin C

Question 21

Antidotes: Opioids

Answer 21

Naloxone, Naltrexone

Question 22

Indications for surgical parathyroidectomy

Answer 22

Parathyroid adenoma - (1) Sx (2) Serum Ca > 1 above upper limit of normal (3) 24 Urine Ca > 400 mg (4) Cr clearance reduced by 30% (5) Bone mineral density t score