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Exam Master Didactic Yr > EM No. 1 > Flashcards

EM No. 1 Flashcards

1
Q

what is the dx: pt has swollen red and tender right calf. dorsiflexion of the right foot induces pain in calf. venous ultrasonography reveals failure of venous compression with passive dilatation.

A

DVT

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2
Q

sign associated with passive dorsiflexion of the foot inducing pain in the calf - also, what is the dx once the sign is positive?

A

homan sign; dvt

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3
Q

once dvt is dx what is the immediate treatment regimen?

A

anticoagulant - heparin for the first 5-7 days followed by oral anticoagulants with interlacing in the 3 or 5th days

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4
Q

during pregnancy when treating a DVT, what is the preferred anticoagulant?

A

heparin b/c warfarin is associated with congenital anomalies

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5
Q

with pleural effusion, the trachea is displaced to the which side?

A

the side opposite the fluid

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6
Q

what is the dx - increasing dyspnea, mild temp elevation; dull percussion note of posterior chest, distant bronchovesicular breath sounds, increased whispered voice sounds, and diminished voice sounds below 6th ITS.

A

pleural effusion - dullness in area of effusion; distant sounds due to fluid presence; whispers increase in area of fluid, and spoken are diminished in areas of fluid.

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7
Q

what is the formula for the anion gap? what is the normal range?

A

sodium minus chloride plus bicarb; 3 to 12

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8
Q

in cardiac arrest involving ventricular fibrillation, what is the highest priority in terms of next step management?

A

DEFIBRILLATION - immediately - DO NOT do anything else before you DEFIB!

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9
Q

what is the first line treatment of management of asystole and PEA?

A

DO NOT DEFIB!! continue CPR and give epinephrine.

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10
Q

what are the 4 rhythms that can produce pulse cardiac arrest?

A

vfib, pea, rapid vtach, asystole

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11
Q

an increase in stroke volume leads to what type of pulse pressure and eventual systolic pressure?

A

increase in pulse pressure and increase in systolic pressure

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12
Q

what eventually happens to stroke volume with chronic aortic regurgitation?

A

increases

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13
Q

what is the definitive treatment of AR?

A

valve replacement

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14
Q

what is the MCC of CHF? and the 2nd MCC?

A

CAD; dilated cardiomyopathy

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15
Q

pts with protein c and s deficiencies are more prone to a hyper-coagulable state which predisposes them to what condition?

A

DVT and PE

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16
Q

what is known as enlargement of the right ventricle of the heart as a response to increased resistance or high blood pressure in the lungs (pulmonary hypertension).

A

cor pulmonale

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17
Q

which heart sound is associated with pulmonary embolism that has progressed to acute cor pulmonale?

A

s3 gallop

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18
Q

as the RV suffers from acute pressure overload it will increase RV wall tension , dilatation and failure. RV dilatation shifts the ITV septum towards the LV reducing its capacity and increasing resistance of LV - what is the phenomenon called?

A

ventricular interdependence

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19
Q

what are the two signs you are looking for on the echo to dx PE?

A

right ventricular dilatation and asynergy except in the apex (McConnell’s sign) *Remember that pts with RV abnormalities are at higher risk than those without

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20
Q

what are the two ways you can differentiate a right ventricular infarction from a PE?

A

on the EKG look for signs of inferior infarction and also look for ST elevations

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21
Q

what are the two ways you can differentiate PE from pneumonia?

A

in pneumonia the cough is typically productive and also the dyspnea is typically NOT of sudden onset

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22
Q

in terms of the primary treatment for PE what are your top 3?

A

oxygen, NSAID, and dobutamine (positive inotropic and pulmonary vasodilator)

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23
Q

why is it IV fluids is NOT advised in PE?

A

b/c ventricular interdependence may lead to left sided heart failure

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24
Q

what is the major cause for concern with thrombolytic therapy?

A

intracranial bleeding (1% risk)

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25
Q

pt with peptic ulcer disease presents with PE and is need of therapy - what line of treatment is an absolute contraindication?

A

thrombolytics due to pts active peptic ulcer disease

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26
Q

an atypical antipsychotic medication used in the treatment of schizophrenia, and is also sometimes used off-label for the treatment of bipolar disorder. this drug also has a very high risk of aggranulocytosis

A

clozapine

27
Q

what are the 4 components of tetralogy of fallot?

A

pulmonary stenosis, RVH, overriding aorta, ventricular septal defect.

28
Q

i say “boot shaped hear” you say …

A

TOF - associated with right atrial enlargement and decreased pulmonary vasculature

29
Q

pt presents with hearing loss in the R ear - what are the expected test results if the pt has conductive hearing loss? (Weber and Rinne)

A

lateralization to the R ear (affected) and BC > AC in the R (affected) ear.

30
Q

pt presents with hearing loss in the R ear - what are the expected test results if the pt has sensorineural hearing loss? (Weber and Rinne)

A

Weber would lateralize to the GOOD ear (left unaffected ear) and AC > BC in BOTH ears.

31
Q

what are the pressure drop requirements for orthostatic hypotension?

A

drop in standing systolic of at least 20mmHg and 10 mmHg diastolic

32
Q

what is the cornerstone treatment of HCM?

A

beta blockers - they reduce the amount of obstruction by decreasing the HR and therefore also increase LV filling.

33
Q

what is a common occurrence after CABG?

A

pericardial effusions –> remember that an effusion can become tamponade

34
Q

i say child pt with fever that subsides followed by a rash - you say?

A

roseola (HHV6)

35
Q

childhood rash - begins in the face, spreading to the entire body and disappearing by 4th day - what is it?

A

rubella

36
Q

childhood rash - spreads down from the face and hairline to the TRUNK over 3 days - other signs of the illness include fever, cough, conjunctivitis and coryza.

A

rubeola (aka measles)

37
Q

i say erythema infectiosum you say …

A

slapped cheek

38
Q

i say Erythema migrans you say ?

A

rash often (though not always) seen in the early stage of Lyme disease

39
Q

i say Erythema marginatum you say ?

A

RF

40
Q

i say verrucous endocarditis, you say?

A

Libman Sacks endocarditis - associated with SLE patients

41
Q

what are the three types of cardiomyopathies?

A

dilated; obstructive and restrictive

42
Q

MCC of mitral stenosis

A

rheumatic heart disease

43
Q

what is the relationship between MVP and MR?

A

MVP can lead to/because/cause MR

44
Q

diastolic rumbling murmur heard best at the apex in the LL position?

A

MS

45
Q

diastolic rumbling murmur heard best along the left sternal border accompanied by a thrill?

A

TS

46
Q

soft early diastolic murmur, high pitched and heard best when sitting and leaning forward?

A

AR

47
Q

i say opiod overdose - you say? (for treatment)

A

naloxone NOT naltrexone (don’t be tricked! trix are for kids silly rabbit!)

48
Q

DOC of acetaminophen OD?

A

N-acetylcysteine

49
Q

T or F: beta blockers are contraindicated in patients who suffer from hyperkalemia.

A

true

50
Q

which htn medication is contraindicate in patients with gout?

A

loop diuretics due to causation of hyperuricemia

51
Q

T or F: secondary HTN is more common in children than in adults.

A

TRUE

52
Q

what is the relationship between feeling of satiety/appetite suppression and serotonin

A

serotonin levels (high) will cause feeling of satiety - appetite suppressing drugs will raise serotonin levels!

53
Q

HTN is what case is associated with BP difference btwn arms and legs?

A

coarctation of the aorta

54
Q

HTN is what condition is associated with central obesity ,hirsutism, pigmented striae, buffalo hump and moon face?

A

Cushing’s syndrome

55
Q

HTN associated with what will be likely to present with palpitation, anxiety, moodiness, weight loss, and heat intolerance?

A

hyperthyroidism

56
Q

HTN associated with decreased K+ levels indicates what?

A

primary aldosteronism

57
Q

T or F: pain of MI is unrelieved with nitroglycerin

A

TRUE

58
Q

i say pericardial friction rub (is heard on auscultation) you say ?

A

pericarditis

59
Q

i say steamy cornea, you say?

A

acute angle closure glaucoma

60
Q

i say systolic ejection CLICK! you say ?

A

Aortic Stenosis (AS)

61
Q

tall, peaked T waves say what about serum potassium levels?

A

increased

62
Q

inverted t wave on EKG indicates what about potassium serum levels?

A

low!

63
Q

what is the most common chronic arrhythmia is pts with hyperthyroidism?

A

AFIB

64
Q

the initial step in the management of atrial fibrillation is to control what rate?

A

ventricular response

Exam Master Didactic Yr (9 decks)

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