EOR questions

Question 1

How do you treat WPW and what is associated with it?

Answer 1

Delta wave, wide QRS, short PR

Meds: Procainamide*, amiodarone, flecainide, ibutilide

Def Man: radiofrequency ablation

Question 2

How do you dx a pericardial effusion?

Answer 2

EKG (low voltage QRS, electric alternans)

Echo shows increased fluid

CXR shows cardiomegaly

Question 3

Got questions about dx CAD wrong- don’t understand this

Answer 3

pg 23 PANCE

Question 4

Herpes simplex causes what skin problem MC?

Answer 4

erythema multiforme

Type IV hypersensitivity rxn

Question 5

“dusty-violet red, dull, purpuric macules/vesicles or bullae in the center with a pale edematous rim and a peripheral red halo

Answer 5

erythema multiforme

Question 6

Pt has widespread blisters on trunk/face, erythematous/pruritic macules involving >1 mucous membrane with epidermal detachment. What is a common cause?

Answer 6

SJS

sulfa and anticonvulsant meds

Question 7

What is the difference between vestibular neuritis and labyrinthitis?

Answer 7

Vestibular = continuous vertigo, dizziness, N/V, gait with no hearing loss

Labyrinthitis = hearing loss

Question 8

What is the difference between a pterygium and a pinguecula?

Answer 8

pterygium = fleshy, growing triangular shape fibrovascular mass in on nasal side of eye

pinguecula = elevated yellow nodule, does not grow

Question 9

What factors is vit K a part of?

Answer 9

7, 9, 10

Question 10

what kind of diarrhea does shigella have?

Answer 10

water, explosive that leads to mucoid and bloody

Question 11

What has pea soup diarrhea?

Answer 11

typhoid fever

Question 12

How do you dx active TB?

Answer 12

acid fast smear and sputum cultures

AFB cultures is the gold standard

(so I think if TB is suspected you do cultures, if not suspected to CXR to confirm)

Question 13

When do you use cxr in active TB?

Answer 13

to exclude active TB

also used as yearly screening in pts with + PPD to rule out active

Question 14

How do you tx an immunocompromised pneumonia?

Answer 14

like a hospital infection
cover PCP (pneumocystis jirovecii), fungi, nocardia, atypical mycobacterium, viruses HSV and CMV

so...
anti-pseudomonal b lactam: 
- zosyn (pip/tazo)
- cefipime
- imipenem
-meropenem
- ceftazidine

+

anti-pseudomonal AG or FQ:

• levofloxacin
• moxiflocacin
• amikacin
• gentamicin
• tobramycin

Add bactrim if PCP is suspected
add vanco if MRSA is suspected
add levo/azithro if legionella is suspected

Question 15

Tx of bursitis? non-infected

Answer 15

rest
NSAIDs
steroid injections

Question 16

Clinical intervention for biceps tendonitis?

Answer 16

?

NSAIDs

Question 17

First clinical sign of compartment syndrome?

Answer 17

1 pain with passive stretching

tense extremities, wooden feeling, paresthesias

pulselessness and paresis are late findings (capillary refill is usually preserved)

Question 18

Difference between Mallory-Weiss and Boerhaave?

Answer 18

Mallory-wise: longitudinal muscle tears, hematemasis after forceful retching (EtOh binge)

Boerhaave: full thickness rupture, persistent forceful retching, iatrogenic or bulimia

Question 19

Tx of ischemic priapism:

Answer 19

phenylephrine injection (increases venous outflow)
terbutaline
needle aspiration