Deck 3 Flashcards
which side MI do you fluid restrict and which do you give fluids
left no fluids (inferior leads) because this can cause flash pulmonary edema // right give fluids bc you want to maintain preload
signs if CNIII palsy
right ptosis, opthalmoplegia, pupillary dilation
what type of bias is attrition bias
selection bias
congenital melanocytic nevus signs
has extra hair, can be large, this is what maya has
loss of fetal station during delivery what does that mean
uterine rupture, fetus retracts up into the uterus
cholestasis of pregnancy vs. HELLP syndrome
cholestasis wont have HTN or significantly lower platelets, HELLP will be more acute with HTN and low platelets
child with minimal care for comfort and little desire for connection
reactive attachment disorder
rib fracture with hemothorax cause
injury to the intercostals which are right below the rib
signs of ecstacy overdose
hypertension, hyperthermia, euphoria, serotonin syndrome, hyponatremia
what do you see in smear of a patient with sickle cell in the RBCs
howell jolly bodies (remnants of RBCs the spleen typcally removes)
can immunocomp poeple get live vax
NOPE
treatment of pain crisis IV or PO pain meds
IV
what is salmeterol
it is a beta agonist
do you treat partners of pt dx with trichomonis
yace with metronidizole
what type of renal injury does MM cause
parenchymal disease
what does heroin do to the kidneys
causes focal segmental glomerulosclerosos via nephrotic syndrome
treatment of body dysmorphic disorder
SSRI
delusions about body image dx
this is body dysmorphic disorder NOT delusional disorder
treatment of tourettes
antidopaminergic meds like tetrabenazine or antipsychotics
management of suspected VP shunt complication
CT head
infants with PJP b or t cell deficiency
t cells!
signs of hypermagnesemia
absent reflexes, weakness, paralysis, bradycardia, hypotension, lethargy, somnolence
management of hemorrhagic stroke
blood pressure control, reversal of any anticoagulation, ICP regulation with mannitol etc.
mangement of snake bite
antivenom IF unstable
what is likelihood ratio
how likely a person with a given test result is to have the disease depending on their pretest probability
equation for positive likelihood ratio
TP rate/FP rate (1-specificity)
signs of polycythemia in the newborn
high HCT, ruddy appearance, hypoglycemia, jitteriness
VACTERL association
vertebral, Anal, cardiac, TEF, renal, limb
signs of riboflavin deficiency
stomatitis, glossitis, anemia, dermatitis
biceps innervation
musculocutaneous nerve, C5/C6
what nerve does wrist extension
radial
what nerve does wrist flexion
medial
signs of scleroderma renal crisis
severe hypertension with acute renal failure
treatment of scleroderma renal crisis
ACE inhibitors
what does no bleeding on progesterone challenge test mean
NO to minimal estrogen!
signs of biliary leakage post lap chole
persistent RUQ pain, fever, leukocytosis, elevated livery enzymes
lyme facial uni or bilateral
can be either
firm mass in testicle of younger male likely dx
testicular cancer, typically noticed after injury or sex
what type of branching does candida have
pseudohyphae budding yeast
treatment of sunburn in child
NSAIDs
what type of incontinence is it if you have frequent need to use the bathroom
urge incontinence caused by involuntary detrusor contractility
brain herniation signs depending on type
uncal: CNIII palsy // subfalcine: Anterior cerebral artery (legs) // foramen magnum: impaired consciousness, decerebrate posturing, apnea
distal limb ischemia and gangrene in a young person with no atherosclerosis risk
thromboangiitis obliterans
when do you give penicillin for unknown GBS status
<35wks, previous baby with sepsis, prolonged rupture of membrane
most common reason for medication nonadherance
chronic silent illnesses in which patients dont have immediate perceived benefit
signs of colonic pseudo obstruction on xray
colonic dilation wtihout obstruction, no loss of haustra
consequences of consistently elevated phosphorus
soft tissue calcification, cataracts, nephrocalcinosis
basophilic stipling, neuro deficits, GI sx likely dx
lead poisoning
what does chemo do to the heart
fibrous replacement causing cardiomyopathy
signs of olecrenon bursitis
pain free range of motion, minimal pain
hepatic lesion with central stellate scar management
this is focal nodular hyperplasia and you dont need to do anything
female sexual interest disorder signs
lack of interest and lack of response to sexual cues or attemps to initiate activity
what do you see in the optic disc of a pt. with glaucoma
optic disc cupping
most common cause of amaurosis fugax (artery)
atherosclerotic emboli originating from the carotid artery
chorio mets in vagina appearance
friable vascular nodule
which PSC or PBC has intrahepatic fibrosis
PSC
adverse effects of lithium
thyroid, diabetes insip
neutrophil changes in myelodysplastic syndromes
decreased segmentation and decreased granulation
what causes testicular torsion
failure of fixation of the tunica vaginalis to testes
causes of uric acid kidney stones
chronic diarrhea (from acidic urine), gout, DM, increased urine concentration
where in the lung are squamous, small cell and adeno
squamous is mostly central and causes cavitary // small cell : central hilar mass // adeno: periphery
signs of acute cerebellar ataxia
gait disturbances, symmetric involvement of all extremities, nystagmus
what are kids with ADHD without treatment at risk of
substance use disorder
what medication do you use for after TIA
aspirin or plavix
what do you use for testing in a patient iwthout a pituitary gland to see if they’re treated adequately
Free T4
what meds are used for alcohol use disorder
acomprosate, disulfiram, gabapentin, naltrexone
do you have to tell police about poeples drug use
NO
what other drugs can cause serotonin syndrome
lithium, triptans, odansetron
drug to avoid in WPW
beta blockers
causes of potter sequence
abscense of urinary tract parts,
consequences of potter sequence
pulmonary hypoplasia
treatment of pitiriasis versicolor
topical steroid for sx but generally reassurance
what is hyperplastic dystrophy
this is chronic inflammatory changes to the vulva like lichen sclerosis, dermatitis etc
duration of action of hydromorphone
2-3 hours
infections seen in hyper IgM
severe pyogenic infections and oppurtunistic infections too
treatment of lumbar spinal stenosis
NSAIDs, physical therapy, surgery for refractory cases
treatment of de quarvain thyroiditis
beta blockers for thyrotoxif phase, NSAIDs for pain and to decrease inflammation
gram stain of neisseria
gram negative dipIococcus
most common cause of meningitis in 1mo-2yo
strep pneumo
signs of poor prognosis in COPD
progressive dyspnea despite adequate medical therapy
management of exposure to parvo in pregnancy
measure IgG and IgM to see if pregnant person infected
treatment of viral conjunctivitis
supportive!
signs of zinc deficiency
dermatitis, alopecia, taste disturbance, delayed wound healing
signs of vertebrobasilar infarct
vertigo, lightheadedness, ataxia, nystagmus
signs of carotid artery dissection
ipsilateral headache/face pain, partial horner syndrome, cranial nerve neuropathies
what tumor causes facial flushing and what does it secrete
carcinoid tumor, secretes serotonin, histamine, etc
common signs of zenkers
cough!, dysphagia, regurg of undigested food
treatment of androgen insensitivity
gonadectomy and then hormone replacement
what vessel is affected in anterior MI
LAD (give dobutamine)
signs of DVT in the arm
superficial collateral veins dilation on the upper arm and chest
what is tracheitis
this is a serious respiratory infection that presents similar to epiglottitis but the trache is what gets infected
signs of chronic transplant nephropathy
onset of sx after a long asymptomatic period, fatigue, swelling, decreased appetite
for patients with hydronephrosis what is best next step to prevent failure of kidneys
insert nephrostomy tube
when can gestational htn be diagnosed
after the 20th week
what type of hyperparathyroidism do CKD patients get
tertiary hyperparathy from parathyroid hyperplasia
what to administer next in the case of shock not repsonding to pressors
hydrocortisone or some sort of steroid
first imaging for back pain
xray!
two biggest complications of scaphoid fracture
avascular necrosis and nonunion
can you do a sleep study in children
yace
treatment of epithelioid sarcoma
amputation
can oral candida always be scraped off
doesnt have to be able to be scraped
drugs that help in frontotemporal dementia
SSRIs, atypical antipsychotics
dx testing for insulinoma
72hr fast followed by measurement of insulin and glucose
when do you give ABX prophylaxis for sickle cell
0-5yrs of age
WHAT DOES VALSALVA DO TO HOCM
IT MAKES IT LOUDER!!!!
ferritin in anemia of pregnancy
it is low! just like normal iron deficiency
management of warfarin induced skin necrosis
stop warfarin, administer vitK, heparin and protein C
management of chronic gout
first is lifestyle mods like low purine diet and reduced alcohol use, then allopurinol
what will a UA of a patient with MM show
4+ protein, fat bodies, bence jones
management of confirmed peripheral vascular disease
statin and antiplatelet therapy (aspirin or plavix)
treatment of symptomatic PVD
cilostazol or pentoxifylline
when do you discuss contraception with children
before they become sexually active so like 13-15yo
complications of bronchiolitis in neonates
apnea and respiratory failure
signs of LV aneurysm on ECG
persistent ST elevation, deep Q waves
presentation of LV aneurysm post MI
typically heart failure or angina
what causes erysipelas
GAS
do you intubate or needle thoracostomy first in tension pneumo
needle thoracostomy
lactation failure jaundice vs. breast milk jaundice
LF: age <1wk, signs of dehydration // breast milk jaundice: peaks at 2wks, due to increased beta glucuronidase
evaluation of strabismus
dilated funduscopic examination
cause of trigeminal neuralgia
compression of the trigeminal nerve by vasculature
variability effect on power
greater variability decreases power and vice versa
difference between ecthyma and pyoderma gangrenosum
ecthyma is caused by pseudomonas and you have systemic sx, pyoderma is typically due to a related systemic disorder (Cancer, IBD, etc)
signs of vascular ring in baby
biphasic stridor that improves with neck extension
sickle cell disease electrophereisi vs. sickle cell trait
HbF, HbS, NO HbA // trait: decreased HbA, HbS
sleep changes in depression
decreased REM latency, increased REM, decreased slow wave sleep
treatment of binge eating disorder
SSRI
do you need to biopsy suspected lichen sclerosis
yes to make sure its not cancer
antihistone ab
drug induced lupus
what abs are seen in lupus
antinuclear, anti Ds DNA
where is pes anserinus bursitis located
anteriomedial knee
msk complications of turners
osteoporosis
henoch shonlein purpura clinical signs
purpura, petichiae, abdominal pain, arthralgias
HUS signs
hemolytic anemia, thrombocytopenia, mucosal bleeding, hematuria, hx ecoli
what deficiency does phenytoin cause
folic acid
when is disruptive mood dysregulation disorder dx
before age 10
which SNRI causes HTN
venlafaxine
describe the types of decels
early- start with contractions (mirror them) // variable: sharp V’s that are not associated with contractions // late: peaked W’s that are after the contraction
PEP for hepA
vaccine or immune globulin
when do you do GTT in pregnancy
24-28 wks
pulse ox level in acrocyanosis of the newborn
normal!
CMV vs toxo calcifications
CMV is periventricular // toxo is diffuse
timecourse of transient synovitis
typically occur within a couple weeks of infection and then resolves in a couple weeks
