Deck 4 Flashcards
what infection are kids with CF at risk of vs. adults
staph a in kids, pseudomonas in adults
complement levels in IgA nephropathy vs. PSGN
normal in IgA and decreased in PSGN
sx onset of embolic stroke
worse at onset
signs of lacunar infarct
hemiparesis, sensory loss but NO cortical signs (aphasia, hemianopia)
possible compilcation of chronic middle ear disease
cholesteatoma
treatment of persistent pulmonary HTN in the newborn
inhaled NO
treatment of GBS intrapartum
penicillin, clinda, then vanc (in order of first to third line treatment)
ODD vs. conduct disorder
ODD is more mood related whereas conduct is disregard for others rights, stealing, breaking things etc.
root cause analysis findings prospective or retrospective
retro
methods to decrease intracranial pressure
hypertonic saline, hyperventilation, drain CSF, mannitol
what is the false negative ratio
1-sensitivity
what is the false positive ratio
1-specificity
which hepati lesion is linked to OCP use
hepatic adenoma
what is a spinal dysraphism
this is spina bifida aka failure of posterior vertebral arch fusion
CT scan of eclampsia
bilateral frontal lobe edema
what is herpangina and what causes it
this is gray ulcers and vesciles on the tonsils and palate due to coxsackie A
treatment of intussusception
air enema
treatment of volvulus
NPO, Ng tube, abx, surgery
FVC in restrictive lung disease
decreased
FEV1/FVC ratio in restrictive disease
typically increased or normal bc the FVC decreases more relative to the FEV1
what is best to reduce adverse drug events
pharmacist directed interventions
what should urine pH be if the patient is acidodic
it should be acidic if its not they have renal tubular acidosis
for anyone reproductive age with uterus what do you do first for abdominal pain
preg test
management of severely painful hemorrhoid (external or internal
urgent hemorrhoidectomy
when does visual screening start for kids
3+
pulmonary complication of preeclampsia
acute pulmonary edema due to increased blod pressure causing backup
signs of calcaneal apophysitis
bilateral heel pain and tenderness with squeezing the heel and on palpation of base of heel
does basal cell or SCC cause nerve infiltration
SCC
what is mittelschmerz
this is pain with ovulation and then the small amount of free fluid released from the corpus luteum irritates the peritoneum
vascular dementia vs. post stroke depression
vascular dementia is more associated iwth apathy rather than sadness that post stroke is associated with and post stroke is not so severely impaired
vitA toxicity effects on brain
IIH
treatment of NMS
stop antipsychotics, add a benzo, start bromocriptine (Dopa agonist) or dantrolene
can you undergo vaginal delivery with prior classical c section or myomectomy
NOPE
dx of IIH
ophthalmoligy then MRI, then LP
internal vs. external validity characteristics
internal is more related to causality vs. external is related to generalizability
signs of disseminated listeria
at birth the neonate has disseminated absceses or granulomas
screening after dx of popliteal aneurysm
abdominal aortic aneurysm screening
how long do you maintain SSRI after first episode
6mo
pulses in infants with coarc
diminished femoral pulses
hypoxia in the feet of a newborn only
likely a persistent PDA
treatment of thalassemia
no specific trtment
signs of acute fatty liver of pregnancy
acute liver failure (coagulopathy, leukocytosis, elevated AST and ALT etc)(
fluid collection in spleen etiology
hematogenous infection (IE), IVDU, trauma, hemoglobinopathy
dx of tinea
KOH prep
eval of continued fever in UTI of a chlid
do an U/S to eval for anotomic differences and for abcess
clinical signs of hereditary telangiectasia
frequent epistaxis, hemoptysis, hemorrhagic CVA, GI bleeds etc.
what is the dx of a patient with elevated 17-hydroxyprogesterone
congenital adrenal hyperplasia
lab findings in a child with CAH
no aldosterone or cortisol so they are going to have low sodium, high potassium, low glucose and elevated 17hydroxyprogesterone
CAH genitalia appearance
46XX are ambiguous due to excess androgens causing virulizationand 46XY are normal or virulized because they can make DHT to have external features
when do you hear vocal cord dysfunction
inspiration (stridor)
treatment of methanol poisoning
1- fomepizole or ethanol 2- sodium bicarb 3- dialysis if signs of end organ damage
signs of coronary artery dissection
same clincial picture as an MI but the patients are typically women, postpartum status, multip, connective tissue disorders
hip fracture in subtroch region
prolonged bisphos use
parathyroid and magnesioum relationship
low magnesium stimulates parathyroid hormone release
parathyroid hormone and vit D relationsihp
parathyroid hormone stimulates the kidney to convert the active form of Vit D for calcium absorbtion
complications of BPD
systemic hypertension due to increased catecholamines and pulmonary artery HTN
which twin type has increased risk of twin twin transfusion
mono di
what is fetal dysmaturity
this is when you have post term baby and they have wrinkled skin due to an aged placenta
in a box plot what do the different lines mean
these are the quartiles and distributed in evne 25% of groups
urine osmolality in diabetes insipidus
<300 because so much water
signs of ocular neurosyphilis
uveitis and optic neuritis
pharmacologic management of IBS abd pain
first line is antisposmodic therapy like bentyl but next is a TCA
alopecia skin findings
normal non erythematous skin
how to decrease risk of complications from diverticulosis
increase physical activity
which joints are affected in OA vs. RA for the hands
OA is DIPs and thumb // RA is wrist and PIPs
bilateral atrial enlargement with low voltage QRS dx
likely restrictive cardiomyopathy
most common cause of restrictive cardiomyopathy
most commonly amyloidosis
signs of monviable limb
no flow arterial or venous, absent cap refil, severe sensory/motor deficit
intervals for glucose monitoring in GDM
fasting and 1 or 2 hr postprandial
management of acetominophen toxicity
<4 hrs –> activated charcoal // >hrs NAC
sleep and steroids
they can cause insomnia
urine sediment in scleroderma renal crisis
often normal
peritoneal dialysis peritonitis signs
abdominal pain, diffuse tenderness, nausea
screening in obese children
need to screen them for HLD, T2DM, fatty liver, HTN, and sleep apnea
goal of treatment of hepatorenal syndrome
increasing mean arterial pressure to decrease RAAS activation
signs of veretebral compression fracture
spinal tenderness, acute back pain,
autoimmune conditions associated with T1DM
celiac, autoimmune thyroidiits
chronic groin pain during exercise and reproduced during valsalva
sports related groin pain due to repetitive stress on the musculotendinous portion of the lower abdomen and groin
complications of bells palsy
dry eye due to impaired eyelid closure –> trt prophylactically with eye drops and taping eye closed etc.
steps of child with likely abcess that is NOT having impending repsiratory compromose
CT scan of neck
can mono mono twins vaginally deliver
no! bc their cords can become tangled
what needs to be adminstered to a neonate to a mom with active HepB
HepB immune globulin and vaccine
signs of beckwith wiedemann syndrome
tongue, limb abnormalities, macrosomia omphalocele, umbilical hernia, screen for wilms and hepatoblastoma
cause of dysphagia in crest syndrome
fibrosis and smooth muscle atrophy in the eosphagus causing dysmotility, NOT achalasia
what cells are malignant in medullary thy ca
calcitonin secreting parafollicular C cells
accuracy equation
TP+TN/ (TP+FP+TN+FN)
reducing substances in the urine of a newborn with seizures
hereditary fructose intolerance or galactosemia
signs of malignant hyperthermia
rigidity, tachy, hyperthermia, rhabdo (blood in urine), hyperkalemia, HTN
ovarian torsion time course
can be colicky initially or if it doesnt untorse can just be constant severe pain
management of hemoptysis continued bleeding
bronchoscopy
ideal tidal volue
6ml/kg
where are thymomas
anterior mediastinum
increasing abdominal pain late in course of acute pancreatitis
likely infected pancreatic necorsis- occurs days after the initial presentation as enteric pathogens entern- CT scan
which virusues need to be on airborne precautions
TB, varicella, herpes zoster, measles
viral conjuctivitis appearance
follicular appearance of the conjunctiva
target blood glucose in GDM fasting, 1hr, and 2hr
fasting <95, 1hr <140, 2hr <120
thickness of endometrial stripe post menopause that warrants investigation
> 8mm
signs of nicotine poisoning
biphasic response first is hypertension tachy, etc // second is inhibitory phase with hypotension, brady, coma, mainly muscarinic sx with vomiting, diarrhea
what does clinda cover
anaerobes, MRSA, aspiration pneumonia, skin infections
gabapentin MOA
binds the alpha-2-delta calcium channel
causes of symmetrical IUGR
aneuploidy, congenital heart disease, early TORCH infections
causes of asymmetrical IUGR
uteroplacental insufficiency, HTN, Rh incompatibilty
cushing dx vs. PAI
cushing is 24hr free cortisol // PAI is cosyntropin stim and 8am cortisol
eval of VAP
CXR, endotracheal sample, epiric abx while awaiting culture
micro causes of brain abcsesses
nocardia, viridians strep, anaerobes
signs of language disorder in a child
difficulty pruducing language, difficulty explaining themselves, etc.
calciphylaxis causes
hypercalcemia, hyperphosphatemia
management of pancreatic cysts
ERCP for large cysts that are >3cm, involve the duct, and are irregular
management of polyhydramnios
asymptomatic: just expectant management, dont have to induce // symptomatic or if preterm: amnioreduction
what bugs need droplet precautions
bacteria and viral
contact precaution bugs
MRSA, VRE, enteric bugs, parasites, viruses
signs of dumping syndroem
sympathetic sx, tachycardia, diaphoresis, flushing, diarrhea
signs of bacterial overgrowth of small intesttine
diarrhea, flatulence, malabsorption, decreased B12 (bacteria eat it up), increased folate
treatment of atrial flutter
same as afib- unstable do synchronized cardioversion stable do rate control and do anticoag if chadvasc needs
alport pathogenesis
longitudinal splitting of the glomerular basement membrane
steroids in stroke
NO need, only for tumors use steroids before surgery
management of ICH
manage airway, permissive HTN, keep ICP stable, reverse anticoagulation, surgery for >3cm
what do you get with cave exploring
histo
signs of histo on biopsy
granulomas with yeast
what is normal amniotic fluid index
8 to 18cm >24 is poly
signs of abscess after abdominal surgery
recurrent fever, abd pain several days after the op
clinical signs of SBO
abdominal pain, nausea, vom, constipation, distention, decreased bowel sounds, not leukocytosis
management of otitis media with effusion
observation and follow up
placental aromatase deficiency signs
both mom and baby have viruIization
when do the electrolyte abnormalities show in CAH
1-2 weeks after birth
in aspirin exacerbated respiratory disease what is the main driver of pathogenesis
leukotrienes
acid base changes post seizure
pts. can have anion gap metabolic acidosis due to lactate from skeletal muscle hypoxia
HIT type 2 signs
necrotic skin lesions, decreased platelets, acute reactions after receiving heparin
what type of scan is a meckel scan
nuclear scintigraphyy
what is hypersensitivity pneumonitis
this is an immunologic response to an inhaled antigen like mold, animal hair etc
signs of hypersensitivity pneumonitis
abrupt onset fever, chills, cough, leukocytosis, cxr with scattered micronodular interstitial opacities
differentiate between Primary ovarian insuff and hypothalmic amenorrhea
in POI, you will have NO estrogen at all which means vaginal atrophy, vasomotor sx etc, and in hypothalmic amenorrhea you have a small basal estrogen amount but still no withdrawal bleeding but no vaginal changes
treatment of acute iron poisonin
deferoxamine, whole bowel irrigation
etiology of neuro complications in friedrich ataxia
degeneration of spinal tracts causing dysarthria, ataxia, loss of vibratory sense
what is the only vaginitis with normal pH
candida
is there inflammation with BV
nope
