Deck 2 Flashcards
management of chorioamnionitis
ABX and immediate delivery
difference between narcissisitic PD and obsessive compulsive PD
its the motivation, narcissists are motivated by the need for praise whereas OC PD is more motivated by rules and the need for orderliness
differentiate between intussusception and malrotation presentation
intussusceptoin will have dark red currant jelly stool with attacks of pain every 15-30 mins vs. malroation will be bilious vomiting and hematochezia
treatment of decompression sickness
IV fluids ans 100% 02, hyperbaric oxygen
what situations do you use adenosine for
av node reentry tachycardia (AVNRT) or tachyarrythmias
clinical signs of amniotic fluid embolism
abrupt onset of cardio, respiratory or neurological compromise. Hypotensive, leads to DIC
how do you get trichenella
meat
aplastic anemia vs. leukemia presentation
both will have pancytopenias but leukemia will have splenomegaly and positive lymph nodes
what is power
1-beta
how long does a BCG vax cause positive ppd
it wanes within 5 years
when do you get lipid screening for men and women
men: 35 // women 45
treatment of boys with posterior urethral valves
daily abx therapy
signs of rubella
maculopapular exanthamous rash mainly confined to the neck and trunk with cervical lymphadenopathy
how do children with radial head subluxation present
with their arm flexed and pronated
what is primary eneuresis
this is when patients never develop nighttime dryness
what is osteomalacia
this is when you cant mineralize bone because you have a deficiency in vitamin D
how does obesity cause precocious puberty
obesity causes increased leptin which in turn causes increased GnRH pulsatility
how are peripheral and central precocious puberty different
peripheral is due to exogenous exposure to estrogen/progesterone without GnRH increase and central is due to increased GnRH production
where do infants get the miliaria rubra
neck, axilla, groin
first line treatment for gastroparesisi
metoclopramide
clinical course of senile purpura
spontaneous regression
what is the length of time allowed for second stage of labor in a nulliparous woman without epidural
3 hours 4 with epidural
what causes anemia of prematurity
impaired EPO production
lab findings for anemia of prematurity
normocytic normochromic anemia with normal reticulocyte count
when is eneuresis considered pathologic
> 5yrs
when do you have to give tamiflu by
within 48 hours
who specifically gets oral hairy leukoplakia
immunodeficient ppl
treatment of HCM
beta blocker or non DHP CCB
what are the two types of contact dermatitis
allergic and irritant
what patients with HIV get CMV colitis
CD4 <50
what is osteodystrophy
imparied response by the kidney to parathyroid hormone
painless jaundice and weightloss most likely dx
panc cancer
first line test in children for any imaging
do ultrasound first
management of myocardial contusion
serial ECG monitoring
when do you use atropine for heart stuff
symptomatic bradycardia
viral meningitis (aseptic meningitis) CSF
clear, mainly lymphocytes, normal glucose, normal or elevated protein, normal or slightly high opening pressure
which bloody diarrhea causes thrombocytopenia and hemolytic anemia
EHEC
signs of MAC
similar presentation to TB but with bronchiectasis, CF, etc and multiple small nodules scattered in the middle and lower lobes
when do you trach someone
if they are going to require prolonged mechanical ventilation after 10-14 days
who can be treated for CAP in the outpatient setting
young people with no comorbidities who are generally healthy
treatment for CAP in outpatient setting
oral azithromycin, doxy, or amoxicillin
what is considered a hemodynamically unstable patient
tachy or hypotensive
signs of roseola
several days of high fevers followed by blanching macular eruption on the trunk that spreads to face and extremities
what is osteochondroma
small bony spur covered by cartilage
what is chondroblastoma
benign cartilage neoplasm in epiphysis with sclerotic border
signs of ileus on xray
maintanence of haustra with colonic dilation with stool and air fluid levels
unpaired vs. paired T test
paired is means of the same group at different time points or something and unpaired is comparing means of two different groups
what is ANOVA
this is when you compare the means of three or more groups
describe categorical vs. not categorical dependent variable
categorical is when the variable can take on a limited number of values, such as yes/no vs. not categorical is a value or a response to treatment stuff like that
what do you use for non categorical dependent varaibles analyasis
t test for 2 groups ANOVA for 3+ groups
what is the calculation for sensitivity in terms of false negative rate
1-false negative rate
if someone wants to know the failure rate of a test what value is this
sensitivity (false negatives)
which polyps need more frequent follow up
adenomatous
dubin johnson vs. gilbert type of bilirubinemia
dubin is conjugated and gilbert is unconjugated
how do you get tinea capitis
its spread through fomites on combs, pillows, hats, etc
what are vegetarians often deficienct in
B12 and calcium
is asthma restrictive or obstructive
it is obstructive
what abx for pre dental procedure
amoxacillin or azithromycin/clarithromycin
when do you vaccinate mothers after birth
asap, do not have to wait for infant to be immunized
odds ratio vs. relative risk calculatin
odds ratio is X:Y vs. relative risk is X/total / y/total
metabolite changes in CKD pts
hyperphosphatemia, hyperkalemia, metabolic acidosis
estrogen levels depending on withdrawl bleeding being present or not
if withdrawal bleeding happens there is enough estrogen its just annovulatory cycles, if it does not happen with progesterone test there is a structural issue or inadequate estrogen from something else
essential tremor timing
increases with action
person with DVT that then has an arterial embolus what to check
check their heart bc they likely have a patent foramen ovale that let a clot through!!
when to start mammos and ed
40-75
tests to evaluate a pt AFTER starting infliximab
CBC
how does lowering a screening value affect PPV and NPV
lowering the screening age lowers the PPV and raises the NPV
how does cows milk intolerace present in babies
diarrhea, failure to thrive, dehydration
signs of reflux esophagitis in a baby
frequent regurgitation, pain after feeding, back aching, low weight gain, etc.
risk factors for squamous cell CA
immunosuppression (chronic), sun exposure, chronic wound
treatment of parathyroid adenoma
resection if symptomatic or if asymptomatic with evidence of renal or sekeltal involvement
management of hereditary spherocytosis
splenectomy
fever abdominal pain, peritonitis hx epigastric pain
perfed ulcer
dx of perforated viscous
chest and abdomen xray to check for air (upright)
smoking and birth contorl
no go!!
recurrent nesseria infection
terminal comp def
CML CBC
leukocytosis with thrombocytosis and elevation of many lineages
clinical signs of CML
splenomegaly, B sx etc.
cause of delayed hemolytic transfusion reaction
auto abs against minor antigens which takes longer to develop
hemolysis and recent transfusion
hemolytic transfusion reaction which is due to abs against RBCs
describe seborrheic keratoses
these are waxy stuck on lesions that are sharply demarcated and round, more common in older adults
what abx do you give for hospital acquired pneumonia
vanc and pseudomonas coverage
abx for pseudomonas
pip-tazo, ceftazidime, cefepime, fluoroquinolones, carbapenems, aminoglycocydes
sodium level in urine of a patient with ATN
high because it is not being reabsorbed
signs of candidemia
severe sepsis with skin and ophthalmologic lesions
best statistical measure for screening vs. diagnosing
sensitive: screening, captures the most people, specific is for diagnosing
what is a near miss error
this is when someone makes a mistake but someone else catches it or there is a safeguard in place to interfere with giving the med or whatever to the patient
newborn with viral bacterial and fungal infections
combined immunodeficiency
signs of opiod intoxication
low respiratory rate, 3mm pupils
what causes people to be obtunded in opioid intoxication
hypercarbia
suspected subarachnoid hemorrhage but no changes seen on CT
lumbar puncture
what is the formula for attributable risk
incidence with exposure minus incidence without exposure
NF1 vs. NF2
1: optic gliomas, many neurofibromas, cafe au lait spots pheo // 2: meningiomas, bilateral vestibular schwannoma
do you ever want to biopsy an ovarian tumor
no! it can seed the abdomen
treatment of tinea capitis
ORAL griseofulvin or terbinafine
bronchiectasis in a child likely dx
CF or primary ciliary dyskinesia
what does the sinusoidal pattern mean for fetal heart tracing
anemia or hypoxia
management of likely galactocele
ultrasound and then for symptomatic ones can do fine needle aspiration
who should get the hepA vax
MSM, people with HIV, IVDU, travel high risk settings
treatment of febrile nonhemolytic transfusion reaction
oral acetominophen
what type of incontinence does diabetes mellitus cause
overflow incontinence which is caused by impaired detrusor contractility
treatment of femoral artery aneurysm
symptomatic you need to do surgical repair right away
what type of lung disease does alpha1 antitrypsin cause
COPD/emphysema with bronchiectasis
treatment of IgA deficiency
treatment of symptomatic infections, nothing else really extra
respiratory distress with audible stridor after thyroid surgery
laryngeal nerve injury
how do you dx macular degeneration
dilated funoscopic xam
management of asymptomatic thyroid nodule
FNA
next step in neg xray that is a likely hip fracture
MRI
do you get nystagmus in NPH
nope
which tumor presents with opsoclonus myoclonus
neuroblastoma
allergic bronchopulmonary aspergillosis labs
eosinophilia, high IgE
who should get prophylaxis with ABX after splenectomy
children <5yo, aduts and children for 1 year, immunocompromise lifelong
rash that starts as one small spot that then spreads and is pruritic
pityriasis rosea
complications of preeclampsia
placental abruption, DIC
what do U waves mean on EKG
hypokalemia
common complication of cleft palate
velopharyngeal insufficiency
treatment of entameba histolytica
metro and drainiate of liver masses if no improvement with treatment
what is a case serius
study that describes the history, exposures, clincal findings and treatment of a group of patients
signs of OCD
obsessions that people then act on by doing a compulsion and bring people anxiety
ewing signs on xray
onion skin appearance in periosteum
TRALI vs. fluid overload
TRALI will have fever cyanosis, hypotension vs. fluid overload will have peripheral edema and hypoxia but no fever
complications of DM even in adolescents
early onset CAD, renal disease
which has oral/anal involvemetn UC or crohns
crohns
facial features of digeorge
hypertelorism, low set ears
which polyps need repeat in 3 years
any polyps with dysplasia tubular adenomas, or sessile polyps
treatment of firbromuscular dysplasia
antihypertensives and if those fail then angioplasty
when to intubate
hypoxia with pt. not protecting airway
further testing of hyperfunctioning thyroid nodule
thyroid scintigraphy/radioactive iodine uptake scan, ultrasound
further studies after dx pericardiitis
echo to evaluate for pericardial effusion
do you close surgical wounds with spilled bowel contents
no leave open with wound vac
management of loud breathing during death
scopolomine or glycopyrrolate
treatment of AIN
cessation of the causal medication
side effects of continued cannabis use
cannabis hyperemesis syndrome, relief with hot shower
clear mammo and FNA management of suspicisous breast mass
exisional biopsy is next step
what causes endometritis
polymicrobial but mainly ascending organisms like gardereella, staph epidermidid, GBS, ecoli
treatment of corneal abrasion
topical ABX, if contact wearers, use antipseudomonal coverage
treatment of placenta accreta dx before birth
cesarian hysterectomy
treatment of pinworm
albendazole or pyramantel pamoate
osler nodes
painful lesions from Infective endocarditis
vertebrobasilar insufficiency vs. BPPV
vertebrobasilar insuff will have syncope, tinnitis, nausea, visual changes, etc. which are not seen in BPPV, more related to head position and no syncope or other sx
natural course of osteochondroma
growth until physis closure
alcoholic cerebellar degeneration signs
slowly progressive truncal ataxia, normal proprioception and sensory
B12 deficiency early signs
paresthesias happen first and then you lose proprioception and sensation
does rotator cuff injury cause sensory loss
NO
what is observer bias
when the investigators decision is biased by the knowledge of exposure status
management of suspected lyme disease
if it is early, empiric ABX, no need to test
what is relative risk reduction
this is absolute risk reduction divided by control rate
what is telogen effluvium
this is when you have lots of acute hair loss without any inflammation, triggered by stress, positive hair pull test
treatment of menieres
low salt intake, limit caffeine and alcohol, avoid allergy triggers
diagnostic process for HCV
serology and if positive then to PCR
peribronchial cuffing on xray
bronchiolitis
who needs PEP for varricella exposure
immunocomp, pregnant/newborns who are not immune to varicella
what NT is lost in huntingtons
GABA
eval of pts with blunt chest trauma who are stable
CXR, ECG, FAST scan
management of cryptorchidism
orchiopexy before age 1
stool or serology for h pylori
stool bc past infections will make serology always positive
which side is the colon CA if there is bright red blood
left
which side is colon CA if there is occult blood
righ
stool changes colon cancer side
left (sigmoid)
what is an aplastic crisis for sickle cell
this is when you have transient arrest of erythrocytosis typically secondary to infection and reticulocytes are low
where does lithium cause diabetes insipidus
in the kidney collecting duct
what is trihexyphenidyl
anticholinergic
mitral regurg vs. mitral prolapse murmur with squatting
squatting increases MR v.s decreases MP
does TB infiltrate nerves
NO
