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Step 2 > Deck 4 > Flashcards

Deck 4 Flashcards

1
Q

what infection are kids with CF at risk of vs. adults

A

staph a in kids, pseudomonas in adults

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2
Q

complement levels in IgA nephropathy vs. PSGN

A

normal in IgA and decreased in PSGN

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3
Q

sx onset of embolic stroke

A

worse at onset

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4
Q

signs of lacunar infarct

A

hemiparesis, sensory loss but NO cortical signs (aphasia, hemianopia)

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5
Q

possible compilcation of chronic middle ear disease

A

cholesteatoma

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6
Q

treatment of persistent pulmonary HTN in the newborn

A

inhaled NO

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7
Q

treatment of GBS intrapartum

A

penicillin, clinda, then vanc (in order of first to third line treatment)

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8
Q

ODD vs. conduct disorder

A

ODD is more mood related whereas conduct is disregard for others rights, stealing, breaking things etc.

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9
Q

root cause analysis findings prospective or retrospective

A

retro

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10
Q

methods to decrease intracranial pressure

A

hypertonic saline, hyperventilation, drain CSF, mannitol

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11
Q

what is the false negative ratio

A

1-sensitivity

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12
Q

what is the false positive ratio

A

1-specificity

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13
Q

which hepati lesion is linked to OCP use

A

hepatic adenoma

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14
Q

what is a spinal dysraphism

A

this is spina bifida aka failure of posterior vertebral arch fusion

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15
Q

CT scan of eclampsia

A

bilateral frontal lobe edema

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16
Q

what is herpangina and what causes it

A

this is gray ulcers and vesciles on the tonsils and palate due to coxsackie A

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17
Q

treatment of intussusception

A

air enema

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18
Q

treatment of volvulus

A

NPO, Ng tube, abx, surgery

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19
Q

FVC in restrictive lung disease

A

decreased

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20
Q

FEV1/FVC ratio in restrictive disease

A

typically increased or normal bc the FVC decreases more relative to the FEV1

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21
Q

what is best to reduce adverse drug events

A

pharmacist directed interventions

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22
Q

what should urine pH be if the patient is acidodic

A

it should be acidic if its not they have renal tubular acidosis

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23
Q

for anyone reproductive age with uterus what do you do first for abdominal pain

A

preg test

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24
Q

management of severely painful hemorrhoid (external or internal

A

urgent hemorrhoidectomy

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25
Q

when does visual screening start for kids

A

3+

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26
Q

pulmonary complication of preeclampsia

A

acute pulmonary edema due to increased blod pressure causing backup

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27
Q

signs of calcaneal apophysitis

A

bilateral heel pain and tenderness with squeezing the heel and on palpation of base of heel

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28
Q

does basal cell or SCC cause nerve infiltration

A

SCC

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29
Q

what is mittelschmerz

A

this is pain with ovulation and then the small amount of free fluid released from the corpus luteum irritates the peritoneum

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30
Q

vascular dementia vs. post stroke depression

A

vascular dementia is more associated iwth apathy rather than sadness that post stroke is associated with and post stroke is not so severely impaired

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31
Q

vitA toxicity effects on brain

A

IIH

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32
Q

treatment of NMS

A

stop antipsychotics, add a benzo, start bromocriptine (Dopa agonist) or dantrolene

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33
Q

can you undergo vaginal delivery with prior classical c section or myomectomy

A

NOPE

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34
Q

dx of IIH

A

ophthalmoligy then MRI, then LP

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35
Q

internal vs. external validity characteristics

A

internal is more related to causality vs. external is related to generalizability

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36
Q

signs of disseminated listeria

A

at birth the neonate has disseminated absceses or granulomas

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37
Q

screening after dx of popliteal aneurysm

A

abdominal aortic aneurysm screening

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38
Q

how long do you maintain SSRI after first episode

A

6mo

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39
Q

pulses in infants with coarc

A

diminished femoral pulses

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40
Q

hypoxia in the feet of a newborn only

A

likely a persistent PDA

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41
Q

treatment of thalassemia

A

no specific trtment

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42
Q

signs of acute fatty liver of pregnancy

A

acute liver failure (coagulopathy, leukocytosis, elevated AST and ALT etc)(

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43
Q

fluid collection in spleen etiology

A

hematogenous infection (IE), IVDU, trauma, hemoglobinopathy

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44
Q

dx of tinea

A

KOH prep

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45
Q

eval of continued fever in UTI of a chlid

A

do an U/S to eval for anotomic differences and for abcess

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46
Q

clinical signs of hereditary telangiectasia

A

frequent epistaxis, hemoptysis, hemorrhagic CVA, GI bleeds etc.

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47
Q

what is the dx of a patient with elevated 17-hydroxyprogesterone

A

congenital adrenal hyperplasia

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48
Q

lab findings in a child with CAH

A

no aldosterone or cortisol so they are going to have low sodium, high potassium, low glucose and elevated 17hydroxyprogesterone

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49
Q

CAH genitalia appearance

A

46XX are ambiguous due to excess androgens causing virulizationand 46XY are normal or virulized because they can make DHT to have external features

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50
Q

when do you hear vocal cord dysfunction

A

inspiration (stridor)

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51
Q

treatment of methanol poisoning

A

1- fomepizole or ethanol 2- sodium bicarb 3- dialysis if signs of end organ damage

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52
Q

signs of coronary artery dissection

A

same clincial picture as an MI but the patients are typically women, postpartum status, multip, connective tissue disorders

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53
Q

hip fracture in subtroch region

A

prolonged bisphos use

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54
Q

parathyroid and magnesioum relationship

A

low magnesium stimulates parathyroid hormone release

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55
Q

parathyroid hormone and vit D relationsihp

A

parathyroid hormone stimulates the kidney to convert the active form of Vit D for calcium absorbtion

56
Q

complications of BPD

A

systemic hypertension due to increased catecholamines and pulmonary artery HTN

57
Q

which twin type has increased risk of twin twin transfusion

A

mono di

58
Q

what is fetal dysmaturity

A

this is when you have post term baby and they have wrinkled skin due to an aged placenta

59
Q

in a box plot what do the different lines mean

A

these are the quartiles and distributed in evne 25% of groups

60
Q

urine osmolality in diabetes insipidus

A

<300 because so much water

61
Q

signs of ocular neurosyphilis

A

uveitis and optic neuritis

62
Q

pharmacologic management of IBS abd pain

A

first line is antisposmodic therapy like bentyl but next is a TCA

63
Q

alopecia skin findings

A

normal non erythematous skin

64
Q

how to decrease risk of complications from diverticulosis

A

increase physical activity

65
Q

which joints are affected in OA vs. RA for the hands

A

OA is DIPs and thumb // RA is wrist and PIPs

66
Q

bilateral atrial enlargement with low voltage QRS dx

A

likely restrictive cardiomyopathy

67
Q

most common cause of restrictive cardiomyopathy

A

most commonly amyloidosis

68
Q

signs of monviable limb

A

no flow arterial or venous, absent cap refil, severe sensory/motor deficit

69
Q

intervals for glucose monitoring in GDM

A

fasting and 1 or 2 hr postprandial

70
Q

management of acetominophen toxicity

A

<4 hrs –> activated charcoal // >hrs NAC

71
Q

sleep and steroids

A

they can cause insomnia

72
Q

urine sediment in scleroderma renal crisis

A

often normal

73
Q

peritoneal dialysis peritonitis signs

A

abdominal pain, diffuse tenderness, nausea

74
Q

screening in obese children

A

need to screen them for HLD, T2DM, fatty liver, HTN, and sleep apnea

75
Q

goal of treatment of hepatorenal syndrome

A

increasing mean arterial pressure to decrease RAAS activation

76
Q

signs of veretebral compression fracture

A

spinal tenderness, acute back pain,

77
Q

autoimmune conditions associated with T1DM

A

celiac, autoimmune thyroidiits

78
Q

chronic groin pain during exercise and reproduced during valsalva

A

sports related groin pain due to repetitive stress on the musculotendinous portion of the lower abdomen and groin

79
Q

complications of bells palsy

A

dry eye due to impaired eyelid closure –> trt prophylactically with eye drops and taping eye closed etc.

80
Q

steps of child with likely abcess that is NOT having impending repsiratory compromose

A

CT scan of neck

81
Q

can mono mono twins vaginally deliver

A

no! bc their cords can become tangled

82
Q

what needs to be adminstered to a neonate to a mom with active HepB

A

HepB immune globulin and vaccine

83
Q

signs of beckwith wiedemann syndrome

A

tongue, limb abnormalities, macrosomia omphalocele, umbilical hernia, screen for wilms and hepatoblastoma

84
Q

cause of dysphagia in crest syndrome

A

fibrosis and smooth muscle atrophy in the eosphagus causing dysmotility, NOT achalasia

85
Q

what cells are malignant in medullary thy ca

A

calcitonin secreting parafollicular C cells

86
Q

accuracy equation

A

TP+TN/ (TP+FP+TN+FN)

87
Q

reducing substances in the urine of a newborn with seizures

A

hereditary fructose intolerance or galactosemia

88
Q

signs of malignant hyperthermia

A

rigidity, tachy, hyperthermia, rhabdo (blood in urine), hyperkalemia, HTN

89
Q

ovarian torsion time course

A

can be colicky initially or if it doesnt untorse can just be constant severe pain

90
Q

management of hemoptysis continued bleeding

A

bronchoscopy

91
Q

ideal tidal volue

A

6ml/kg

92
Q

where are thymomas

A

anterior mediastinum

93
Q

increasing abdominal pain late in course of acute pancreatitis

A

likely infected pancreatic necorsis- occurs days after the initial presentation as enteric pathogens entern- CT scan

94
Q

which virusues need to be on airborne precautions

A

TB, varicella, herpes zoster, measles

95
Q

viral conjuctivitis appearance

A

follicular appearance of the conjunctiva

96
Q

target blood glucose in GDM fasting, 1hr, and 2hr

A

fasting <95, 1hr <140, 2hr <120

97
Q

thickness of endometrial stripe post menopause that warrants investigation

A

> 8mm

98
Q

signs of nicotine poisoning

A

biphasic response first is hypertension tachy, etc // second is inhibitory phase with hypotension, brady, coma, mainly muscarinic sx with vomiting, diarrhea

99
Q

what does clinda cover

A

anaerobes, MRSA, aspiration pneumonia, skin infections

100
Q

gabapentin MOA

A

binds the alpha-2-delta calcium channel

101
Q

causes of symmetrical IUGR

A

aneuploidy, congenital heart disease, early TORCH infections

102
Q

causes of asymmetrical IUGR

A

uteroplacental insufficiency, HTN, Rh incompatibilty

103
Q

cushing dx vs. PAI

A

cushing is 24hr free cortisol // PAI is cosyntropin stim and 8am cortisol

104
Q

eval of VAP

A

CXR, endotracheal sample, epiric abx while awaiting culture

105
Q

micro causes of brain abcsesses

A

nocardia, viridians strep, anaerobes

106
Q

signs of language disorder in a child

A

difficulty pruducing language, difficulty explaining themselves, etc.

107
Q

calciphylaxis causes

A

hypercalcemia, hyperphosphatemia

108
Q

management of pancreatic cysts

A

ERCP for large cysts that are >3cm, involve the duct, and are irregular

109
Q

management of polyhydramnios

A

asymptomatic: just expectant management, dont have to induce // symptomatic or if preterm: amnioreduction

110
Q

what bugs need droplet precautions

A

bacteria and viral

111
Q

contact precaution bugs

A

MRSA, VRE, enteric bugs, parasites, viruses

112
Q

signs of dumping syndroem

A

sympathetic sx, tachycardia, diaphoresis, flushing, diarrhea

113
Q

signs of bacterial overgrowth of small intesttine

A

diarrhea, flatulence, malabsorption, decreased B12 (bacteria eat it up), increased folate

114
Q

treatment of atrial flutter

A

same as afib- unstable do synchronized cardioversion stable do rate control and do anticoag if chadvasc needs

115
Q

alport pathogenesis

A

longitudinal splitting of the glomerular basement membrane

116
Q

steroids in stroke

A

NO need, only for tumors use steroids before surgery

117
Q

management of ICH

A

manage airway, permissive HTN, keep ICP stable, reverse anticoagulation, surgery for >3cm

118
Q

what do you get with cave exploring

A

histo

119
Q

signs of histo on biopsy

A

granulomas with yeast

120
Q

what is normal amniotic fluid index

A

8 to 18cm >24 is poly

121
Q

signs of abscess after abdominal surgery

A

recurrent fever, abd pain several days after the op

122
Q

clinical signs of SBO

A

abdominal pain, nausea, vom, constipation, distention, decreased bowel sounds, not leukocytosis

123
Q

management of otitis media with effusion

A

observation and follow up

124
Q

placental aromatase deficiency signs

A

both mom and baby have viruIization

125
Q

when do the electrolyte abnormalities show in CAH

A

1-2 weeks after birth

126
Q

in aspirin exacerbated respiratory disease what is the main driver of pathogenesis

A

leukotrienes

127
Q

acid base changes post seizure

A

pts. can have anion gap metabolic acidosis due to lactate from skeletal muscle hypoxia

128
Q

HIT type 2 signs

A

necrotic skin lesions, decreased platelets, acute reactions after receiving heparin

129
Q

what type of scan is a meckel scan

A

nuclear scintigraphyy

130
Q

what is hypersensitivity pneumonitis

A

this is an immunologic response to an inhaled antigen like mold, animal hair etc

131
Q

signs of hypersensitivity pneumonitis

A

abrupt onset fever, chills, cough, leukocytosis, cxr with scattered micronodular interstitial opacities

132
Q

differentiate between Primary ovarian insuff and hypothalmic amenorrhea

A

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

133
Q

treatment of acute iron poisonin

A

deferoxamine, whole bowel irrigation

134
Q

etiology of neuro complications in friedrich ataxia

A

degeneration of spinal tracts causing dysarthria, ataxia, loss of vibratory sense

135
Q

what is the only vaginitis with normal pH

A

candida

136
Q

is there inflammation with BV

A

nope

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