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Family Medicine Flashcards

1
Q

ABCD of Melanoma

A

a - asymmetry (symm vs asymm)
b - border (defined vs ragged)
c - color (uniform vs variegated)
d - diameter (less vs greater than 6 cm)

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2
Q

tx for benign melanoma

A

monitor

educate patient

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3
Q

tx for suspicious melanoma

A

excise with 2-3 mm margin

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4
Q

how do you excise malignant melanomas

A

5 mm margin

if on face, refer to plastic surgeon

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5
Q

what is follow-up after excising a melanoma

A

annual follow-up

observe for new/changing lesions

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6
Q

most important prognostic indicator for melanoma

A

thickness of tumor
(aka breslow measurement)

less than 1mm thick has low rate of metastasis

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7
Q

how to prevent melanomas

A

reduce exposure to UV radiation
clothe properly
sun-screen

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8
Q

describe basal cell carcinomas

A

pearly papules
central ulceration
multiple telangiectasias
bleeds or itches

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9
Q

tx for bcc

A

excision

rarely metastasizes

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10
Q

which metastasizes more: scc or bcc

A

scc

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11
Q

describe scc

A

irregularly shaped plaques or nodules with raised borders
scaly
ulcerated
bleed easily

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12
Q

tx for scc

A

excision

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13
Q

how do you image the upper urinary tract

A

IV Pyelo

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14
Q

how do you image the lower urinary tract

A

cystoscopy

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15
Q

define microscopic hematuria

A

> 3 RBC per HPF
from 2-3 Ua tests

freshly voided
morning
clean catch
midstream urine

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16
Q

eos in the urine

A

interstitial nephritis

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17
Q

how long does exercise-induced hematuria last

A

less than 72 hours

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18
Q

pt with hematuria, has repeat Ua showing hematuria again, what do you do next

A

full work-up

Ua
microsopy of urinary sediment
Ucx to r/o UTI
BMP to get Cr –> focus on renal cause if elevated (May need renal bx)

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19
Q

what exactly is an IVP

A

x-ray of urinary tract after administration of contrast

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20
Q

CT with or without contrast to look for calculi

A

non-con

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21
Q

complication of CT with con or IVP

risk factor for it

how do you prevent it

A

nephropathy

renal insufficiency

premedicate with N-acetylcysteine

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22
Q

if patient has renal insuff, whats another way to evaluate for upper urinary tract

A

retrograde pyelography with renal ultrasound

place catheter in the bladder and inject contrast up ureter to kidneys

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23
Q

how do you examine for transitional cell carcinoma

A

cystoscopy

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24
Q

patient with hematuria, but with a thorough negative work-up

what do you do now?

A

do BP measurements
Ua
voided urine ctyologic studies

all done at 6, 12, 24 and 36 months

basically you`re looking for any underlying lesions, after this if they are still asymptomatic, then no further tests required

however, if they still have sx (i.e. hematuria, dysuria, develops HTN, proteinuria, casts), refer to urologist

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25
Q

is radioactive iodine therapy safe in pregnant woman

A

no

radioactive isotope can cross placenta and cause fetal thyroid ablation

alternative: surgical removal of thyroid

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26
Q

meds for graves

A

antithyroid drugs (PTU and methimazole)

beta-blockers to counter peripheral effects

these are only temporary

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27
Q

definitive tx for graves

A

radioactive iodine

destroys thyroid gland

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28
Q

signs and sx

thyroid storm

A

fever
confusion
restlessness
psychotic-like behavior

tachycardia
elevated BP
dysrhythmias
dyspena on exertion
peripheral vasoconstriction
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29
Q

Signs and sx of hyperthyroidism

A 
nervous
palpitations
wt loss
fine resting tremor
dyspnea on exertion
difficulty with concentration
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30
Q

50% of graves has this finding

A

exophthalmos

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31
Q

how do you diagnose hyperthyroidism

A

low TSH

high Free T4

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32
Q

you suspect graves dz

whats your next step

A

imaging with technetium-99

its a radionucleotide scan

tells you active/inactive areas
usually DIFFUSE uptake

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33
Q

radionucleotide scan in thyroiditis vs graves

A

graves - diffuse uptake

thyroiditis - patchy uptake

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34
Q

how does PTU and methimazole work?

A

inhibits organification of iodine

PTU also prevents peripheral conversion of T4 to T3

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35
Q

side effect of PTU and methimazole

A

agranulocytosis

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36
Q

Are PTU and methimazole safe during pregnancy?

A

YES

PTU is preferred however

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37
Q

for graves, when is surgery indicated

A

pregnant women
cannot tolerate side effects of PTU
large goiter compressing nearby structures

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38
Q

signs and sx of hypothyroidism

A 
lethargy
weight gain
hair loss
dry skin
slow mentation/forgetfulness
constipation
intolerance to cold
depression
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39
Q

in elderly, differential dx for dementia

A

alzheimers

hypothyroidism

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40
Q

side effect of PTU and methimazole

A

agranulocytosis

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41
Q

is PTU and methimazole safe during pregnancy

A

YES

PTU is preferred however

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42
Q

for graves, when is surgery indicated

A

pregnant women
cannot tolerate side effects of PTU
large goiter compressing nearby structures

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43
Q

signs and sx of hypothyroidism

A 
lethargy
weight gain
hair loss
dry skin
slow mentation/forgetfulness
constipation
intolerance to cold
depression
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44
Q

in elderly, differential dx for dementia

A

alzheimers

hypothyroidism

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45
Q

in women, differential dx for depression

A

depression

hypothyroidism

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46
Q

physical findings of hypothyroidism

A 
low BP
bradycardia
nonpitting edema
hair thinning or loss
dry skin
diminished relaxation of reflexes
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47
Q

Most common cause of hypothyroidism

A

Hashimoto thyroiditis

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48
Q

what are secondary causes of hypothyroidism

A

hypothalamic or pituitary dysfxn

pts received intracranial irradiation or surgical removal of a pituitary adenoma

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49
Q

dx of primary and secondary hypothyroidism

A

primary:
high TSH
low Free T4

secondary:
low tsh and free T4

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50
Q

how would you distinguish between hypothalamic vs pituitary hypothyroidism

A

inject TRH

if TSH increases, its a hypothalamus problem

if TSH remains low, its a pituitary propblem

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51
Q

as you age, you may need to decrease levothyroxine dosage

why?

A

thyroid binding to albumin decreases b/c albumin also decreases with age

monitor TSH annually in elderly

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52
Q

you find thyroid nodules on PE
what do you do next?
why?

A

evaluate thyroid fxn (tsh/t4)

functional adenomas with hyperthyroidism are rarely malignant

to rule out malignancy in solitary nodules

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53
Q

risk factors for thyroid malignancy

A

history of head/neck irradiation
family hx of thyroid cx
cervical LA
recent development of hoarseness of voice

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54
Q

tx for hyperfunctioning thyroid nodules

A

surgery

radioactive ablation

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55
Q

nonfunctioning thyroid nodules

what do you do next?

A

assuming you found this nodule by ultrasound or physical exam

FNA biopsy

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56
Q

FNA of thyroid nodule is INDETERMINATE

whats the next step

A

you need a definitive dx by surgery only

this is b/c indeterminate means that you cannot distinguish between follicular cell malignancy from its benign equivalent

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57
Q

tx for thyroid malignancy

A

thyroidectomy

followed by radioactive ablation

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58
Q

pregnant woman with thyroid nodule

next step?

A

FNA to find out what it is
thyroidectomy is SAFE
radioisotope scan is CONTRAINDICATED

or just wait til postpartum period b/c thyroid cancer is relatively indolent

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59
Q

tx for GBS during pregnancy

A

penicillin

others: ampicillin, cephalothin, erythromycin, clinda

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60
Q

how to confirm rupture of membranes

A

see amniotic fluid leaking from cervix

polling of amniotic fluid in vaginal fornix

Nitrazine paper - pH >6.5 in vaginal fluid

ferning on dried slide

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61
Q

prolonged rupture of membranes predisposes to what

A

infection

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62
Q

define first stage of labor

A

contractions until complete cervical dilation

latent phase

active phase - starts at 4cm

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63
Q

rate of dilatation

epidural vs nonepidural

A

NO EPIDURAL

  1. 2cm / hr (nulliparous)
  2. 5cm / hr (parous)
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64
Q

define second stage of labor

A

delivery of fetus

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65
Q

normal duration of 2nd stage of labor

A 
2 hours (nulliparous)
1 hour (parous)

epidural can prolong these times by 1 hour

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66
Q

Normal duration of 3rd stage of labor

A

30 min

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67
Q

labor depends on 3Ps

A

power (strength of contractions)

passenger (size, lie, position)

pelvis (shape and size)

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68
Q

what can cause of false-positive nitrazine test

A

semen
blood
bacterial vaginosis

all can elevate pH

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69
Q

how do you assess fetal well being when mother is admitted to Labor and Delivery

A

fetal heart rate monitoring

with a doppler ultrasound

or fetal scalp electrode
(requires membranes to be ruptured)

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70
Q

what 3 things do you look at in fetal heart rate tracings

A

baseline heart rate
variability
heart rate changes

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71
Q

normal baseline heart rate of fetus

A

110-160

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72
Q

normal variability of fetus

A

3-5 cycles per minute

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73
Q

comomn causes of decreased fetal heart rate variability

A

fetus sleeping
cns depressants (narcotic analgesics)
prematurity
fetal acidemia 2nd to hypoxemia

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74
Q

define fetal heart rate accel

A

15 beats/min

15 sec

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75
Q

what causes early decels

A

compression of fetal head

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76
Q

what causes late decel

A

uteroplacental insufficiency

causes:
maternal hypotension (given epidural or oxytocin)
maternal HTN, DM, placental abruptio

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77
Q

what causes variable decel

A

umbilical cord compression during contractions

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78
Q

what do you use to monitor uterine contractions and its strength

A

external toco

strength: IUPC (need ruptured membranres)

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79
Q

giving too much oxytocin during labor can result in what consequence

A

uterine hyperstimulation

late decels

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80
Q

Cardinal movements during labor

A

refers to movement of fetal head

flexion
internal rotation (occiput to move anteriorly - symphysis)
extension
external rotation

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81
Q

maneuvers for shoulder dystocia

A

McRoberts Maneuver (hyperflexion of maternal legs)
suprapublic pressure
episiotomy

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82
Q

most calcium is found where in the body?

A

bones - 98% of total

bound to albumin - 1%
watch out for low albumin, causing low calcium (correct for this)

free - 1% (active)

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83
Q

formula for corrected serum calcium

A

corrected calcium =

[normal albumin - serum albumin] X 0.8(serum calcium)

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84
Q

what hormone decreases serum calcium and how?

A

calcitonin

causes increased renal excretion

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85
Q

what hormone increases serum calcium and how?

A

PTH

increases bone resorption by activating osteoclast

promotes kidney resorption

promotes GI absorption through calcitriol

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86
Q

most common cause of hypercalcemia

A

hyperparathyroidism

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87
Q

signs and sx

hypercalcemia

A

kidney stones
bone pain (arthritis, etc)
psychic (poor concentration, weakness, fatigue)
abdominal (pain, constipation, NV, pancreatitis)

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88
Q

first thing you look at when a pt has hypercalcemia

A

look at meds they`re taking

stop the suspected med

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89
Q

if a pt has hypercalcemia, what is the next step

A

order PTH

if PTH is low, feedback loop is working fine

if PTH is high or normal, feedback is not fine
(primary hyperparathyroidism)

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90
Q

how do you distinguish between primary hyperparathyroidism vs familial hypocalciuric hypercalcemia (FHH)

A

FHH is a genetic disorder

measure 24-hour urinary calcium
FHH: low calcium level
hyperparathyroidism: normal or elevated urinary calcium

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91
Q

if hypercalcemia, if PTH is low and Ca2+ is high, what lab test do you order next?

A

PTH-rP
parathyroid hormone related peptide

this is produced by cancers
lung, SCC of head and neck, kidney cx

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92
Q

how does PTH-rP work

A

osteoclast bone resorption
increases calcitriol (uptake in gut)
inc kidney resorption

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93
Q

tx for primary hyperparathyroidism

A

surgical removal of the adenoma

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94
Q

activities of daily living

A 
bath
dress
eat
toilet
continence
transfer from bed to chair
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95
Q

instrumental activities of daily living

A 
transportation
shop
cook
telephone
manage money
take meds
housecleaning
laundry
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96
Q

leading cause of blindness in elderly

A

age-related macular degeneration

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97
Q

what is macular degeneration

A

atrophy of cells in central macular region

leading to central vision loss

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98
Q

what is glaucoma

what is responsible for the disease

A

increased intraocular pressure

optic neuropathy

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99
Q

most common cause of blindness worldwide

A

cataracts

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100
Q

leading cause of blindness in working age adults in US

A

diabetic retinopathy

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101
Q

what is presbycusis

how does it present

A

age-related hearing loss

sensorineural hearing loss results in:
high-frequency loss
difficulty with speech discrimination

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102
Q

what is otosclerosis

A

autosomal dominant disorder of inner ear bones

loss of conduction

presents in 20-40s
speech discrimination is preserved

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103
Q

what is CAPD and contrast it with presbycusis

A

central auditory processing disorder
(CNS dysfxn)

has difficulty understanding spoken language
but hears sound well

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104
Q

quick cognitive screening test for dementia

A

clock draw

three-item recall

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105
Q

immunizations for ppl over 65

A

annual influenza
pneumococcal once
DPT booster

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106
Q

acute bronchitis

which antibiotic

A

none

antibiotics has not been shown to benefit

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107
Q

orgs in bacterial sinusitis (adults)

A

pneumococcus

h influenzae

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108
Q

orgs in bacterial sinusitis (children)

A

pneumococcus
h influenzae
moraxella catarrhalis

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109
Q

tx for acute sinusitis

A

first line
amoxicillin and bactrim

if fail, then 2nd line
amoxicillin-clavulanic acid
2nd/3rd gen cephalo
quinolones
macrolides (azithro)
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110
Q

common causes of pharyngitis in teens/young adults

A

group A strep
mycoplasma pneumoniae
chlamydia pneumonia
arcanobacterium haemolyticus

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111
Q

group A strep findings

A 
ABRUPT onset of sore throat/fever
tonsillar/palatal petchiae
tender cevical adenopathy
NO COUGH
sandpaperlike rash (scarlatiniform)
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112
Q

signs of

infectious mono

A

cervical and generalized adenopathy
HSM
atypical lymphocytes on smear

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113
Q

complication of infectious mono

A

splenic rupture to trauma

restrict sports

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114
Q

signs and sx
epiglottitis

cause?

A

stridor
drooling
toxic appearance
leaning forward (tripod position)

H influ

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115
Q

differential dx of tonsillar exudates

A 
GAS
EBV
mycoplasma
chlamydia
adenoviruses

note: having tonsillar exudates does not automatically mean its bacteria vs virus

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116
Q

signs and sx

peritonsillar abscess

A

tonsil is pushed toward midline

uvula deviation

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117
Q

tx of peritonsillar abscess

A

surgical drainage

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118
Q

causes of peritonsillar abscess

A

strep

GAS

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119
Q

complications of GAS

A 
rheumatic fever
glomerulonephritis
toxic shock syndrome
peritonsillar abscess
meningitis
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120
Q

does tx prevent poststreptococcal glomeruloneprhitis

A

NO

you can get it either way

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121
Q

tx for GAS

A

10-day course of oral penicillin

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122
Q

what is swimmer`s ear and what causes it

A

otitis externa

pseudomonas aeruginosa

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123
Q

Common causes of otitis media

A

s pneumo, h influe, m catarrhalis

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124
Q

tx for otitis media

A

aomxicillin

alternative
amox/clavu
bactrim
2nd/3rd gen cephalosporins

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125
Q

immediate tx for chest pain

A

MONA

morphine
oxygen
nitro
aspirin

beta blocker

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126
Q

how does cocaine induce angina?

A

coronary artery spasm

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127
Q

patient is on clopidogrel needs bypass surgery, what do you do next?

A

withhold clopidogrel for 5-7 days before surgery

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128
Q

what is unstable angina

what is the immediate treatment

A

angina at rest

give platelet inhibitors gIIb/IIIa

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129
Q

how are beta blockers helpful in MIs

A

reduces infarct size

decreases mortality

reduces risk of another one

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130
Q

how are ace-i helpful in MIs

A

reduces shor-tterm mortality if started within 24 hours of MI

prevents LV remodeling

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131
Q

hypomagnesemia increases risk of what

A

torsades de pointes

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132
Q

what is benefit of CCB in MIs

which CCB is contraindicated in MIs

A

none

nifedipine - increases mortality

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133
Q

diet for MI patients

A

low saturated fat and cholesterol

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134
Q

risk factors for CAD

A 
DM
HLD
age
HTN
smoking
family hx of CAD
Male
postmenopausal
LVH
homocystinemia
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135
Q

why give statins right after having ACS

A

decreases incidence of major adverse cardiovascular events

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136
Q

what is goal LDL if using statins after MI

A
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137
Q

minimum duration of exercise

A

30 min

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138
Q

minimum weight reduction to get benefits

A

5% minimum

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139
Q

Levine Sign

A

Holding fist to chest, sign of MI

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140
Q

unequal upper extremity pulses is a sign of what

A

aortic dissection

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141
Q

tx for elevated potassium

A

kayexalate
insulin
retention enemas

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142
Q

causes of chronic renal failure

A

DM
HTN
glomerulonephritis

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143
Q

drugs that affect kidney fxn

A

nsaids
aminoglycosides
contrast

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144
Q

in chronic renal failure, what is the first step in management

A 
remove anything that reduces renal perfusion:
hypovolemia (give IV fluids)
hypotension
infection --> sepsis
drugs that lower GFR like nsaids
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145
Q

Goal of BP tx in chronic renal failure

A

Less than 130/80

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146
Q

what med do u treat BP with in chronic renal failure

A

ace-i

add diuretic if BP still not controlled

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147
Q

microscopic exam of trichomonas vaginalis

A

motile
flagellated
many wbcs

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148
Q

tx for trichomonas vaginalis

A

flagyl 2g one dose

and for partner as well

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149
Q

signs and sx

trichomonas vaginalis

A

green frothy discharge

strawberry cervix

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150
Q

vaginitis with recent abx use

what org is it

A

candida

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151
Q

vaginitis in a DM pt

what org is it

A

candida

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152
Q

describe candidal vaginitis

A

white discharge
no odor
VERY itchy

involves vulvar and vaginal areas (outside and inside)

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153
Q

tx for candidal vaginitis

A

single dose fluconazole
or
creams/vaginal suppositories

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154
Q

should you treat sexual partners of women with candidal vaginitis?

A

no, unless symptomatic

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155
Q

signs / sx
of gardnerella vaginalis

A

pH > 4.5
,positive KOH whiff test (fishy odor after adding KOH), clue cells on wet mount

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156
Q

tx for gardnerella vaginalis

A

metronidazole or clindamycin

oral or vaginal preparations

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157
Q

should sexual partners of gardnerella vaginosis be treated?

A

not necessary

as it does not reduce risk of recurrent infection

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158
Q

tx for gonorrhea

A

CTX

or Cipro

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159
Q

tx for chlamydia

A

doxycycline x 7 days
or azithromycin ONCE

and treat partners

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160
Q

PID

A

Pelvic Inflammatory Disease

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161
Q

signs and sx

NPH

A

urinary incontinence
gait disturbance
dementia

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162
Q

Contrast Lewy body dementia with Alzheimers dementia

A

Lwy body - hallucinations early on

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163
Q

tx for obesity

A

diet AND exercise….one alone is not good enough

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164
Q

Diagnostic components of metabolic syndrome (5)

A

waist > 40 in (men) or 35 in (women)
triglycerides >150
HDL 130/85
fasting glucose > 110

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165
Q

signs and sx

migraines

A 
pulsating HA
unilateral
photophobia
phonophobia
worsens with activity
multiple attacks lasting hours to days
NV
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166
Q

diagnosis?

headache with fundoscopic showing papilledema

A

increased intracranial pressure

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167
Q

When should u image a pt with migraines

A

if he/she has red flags. Trauma, Sudden onset, Incr severity or freq, Old than 50, AIDS, neck stiff, Focal neuro

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168
Q

tx for migraines

A

triptans
ergotamine
NSAIDs

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169
Q

signs and sx

tension HA

A

bilateral bandlike distribution

no aggravation with activity
no NV
no photophobia / phonophobia

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170
Q

tx for tension HA`s

avoid what

A

caffeine and ergotamine drugs

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171
Q

signs and sx

cluster HA

A

unilateral
orbital / supraorbital / temporal

PACES AROUND - unable to find a comfortable position

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172
Q

contrast cluster vs migraines

A

migraines - wants to stay in one place

cluster - PACES AROUND

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173
Q

what are screening recs for lipids?

A

starting at 20yo

then ever 5 yrs after that

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174
Q

how do u screen for cholesterol?

A

fasting lipid panel (total, LDL, HDL, trig)

or

nonfasting total and HDL with subsequent fasting lipid panel if total is > 200 or HDL

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175
Q

Which class of drugs are best to lower LDL

A

Statins

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176
Q

which class of drugs are best to lower Triglycerides

which have no effect on triglycerides

A 
nicotinic acids (niacin)
fibrates (gemfibrozil)

bile acids

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177
Q

side effects

niacin

A

facial flushing

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178
Q

side effects

statins

A

muscle pain

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179
Q

side effects

bile acids

A

constipation

decreased absorption of other drugs

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180
Q

contraindications

niacin

A

gout

DM

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181
Q

contraindications

fibrates

A

severe kidney or liver disease

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182
Q

bucket-handle fracture of long bones in children

A

abuse

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183
Q

circumferential hematoma of anus of child

A

abuse

184
Q

retinal hemorrhages in child

A

shaken baby syndrome

abuse

185
Q

Describe slipped capital femoral epiphysis

A

Seen in overweight pts. Pain with internal rotation of hip,

external rotation during passive flexion

186
Q

how pts with septic hip joint position their legs

A

flex at hip
abducted
externally rotated

187
Q

definitive dx of septic joint

A

joint aspiration

188
Q

most common cause of septic joint

A
189
Q

what is toddler`s fracture

how do you diagnose it

A

spiral fracture of tibia when twisting while foot is planted

x-ray

190
Q

congenital dysplasia of hips

pain or no pain

A

painless limp

191
Q

joint complication of viral illness

A

transient synovitis

192
Q

lab findings on transient synovitis

A

normal WBC

normal ESR

193
Q

tx for slipped capital femoral epiphysis

A

surgical pinning of femoral head

194
Q

causes of postop fever

A 
5Ws
water - uti
wind - pna
wound - incisional infxn
walk - dvt
wonder drugs
195
Q

which drugs cause wonder drugs

A

beta lactams
sulfas
heparin
amphoterrible

196
Q

causes of immediate postop fever

A

malignant hyperthermia
(b/c of anesthetics halothane and succinylcholine)

bacteremia

197
Q

CXR findings on postop atelectasis

A

Elevated hemidiaphragm, discoid infiltrate

198
Q

what kind of pain in DVT pts

what maneuver can u use

A

calf pain

homan`s sign
pain in calf on foot dorsiflexion

199
Q

most common cause of wheezing in children

A

bronchiolitis

RSV

200
Q

signs and sx

bronchiolitis

A

at first, rhinorrhea/wheezing
then fever

then gets worst
coughing starts

201
Q

define

croup

A

inflammation of subglottic region

202
Q

signs and sx

croup

A

barking cough

hoarse voice

203
Q

cause of croup

A

viral

parainflu, adeno, RSV, rhino

204
Q

x-ray of croup

A

steeple sign

narrowing of subglottic region

205
Q

tx for croup

A

supportive b/c its viral

cool-mist therapy
corticosteroids

206
Q

hot potato voice

A

epiglottitis

h. influ

207
Q

x-ray of epiglottitis

A

thumb sign

208
Q

signs and sx

IBS

A

constipatio
diarrhea
ALTERNATING

with periods of normal bowel habits

209
Q

how to diagnose

IBS

A

Rome criteria
cumulative total of 12 weeks of this:

abdominal pain/discomfort, PLUS
relieved with BM
change in freq BMs (more or less)
change in stool appearance

210
Q

IBS

alarm features

A 
fever
anemia
wt loss > 10 lb
hematochezia (BRBPR)
melena
refractory/bloody diarrhea
fam hx of colon cx or Inflamm Bowel Dis
211
Q

IBS

no alarm features, whats the workup then

A

CBC
stool hemoccult

colo if > 50yo

212
Q

tx for IBS

A

antaispasmodics - dicyclomine / hyoscyamine
TCA`s / SSRIs
tegaserod (5HT serotonin) - constipation

213
Q

CAGE questions

A

cut drinking
annoyed
guilty
eye opener

214
Q

at-risk drinking

A

men 65 and ALL women
more than 3 drinks per day
more than 7 in a week

215
Q

how effective are antidepressants in alcoholics?

A

if depression came at same time as alcoholism, then antidepressants have NO EFFECT

216
Q

signs and sx

alcohol withdrawal

A 
shake/jitters
insomnia
anxiety
depressed mood
heart palpitations

severe sx:
seizures
hallucinations
DTs (agitation/tremors)

217
Q

tx for alcohol withdrawal

A

benzodiazpines

218
Q

complications of long QT syndrome

A

ventricular arrhythmias
sudden cardiac death
(more in females)

219
Q

how long should long QT syndrome be

A

470 msec

if over 500 msec, major problemos

220
Q

features

Marfans

A 
scoliosis
pectus excavatum
arachnodactyly
high arched palate
arm span greater than height
mitral valve prolapse
aortic aneurysm rupture
221
Q

tx for SVTs

A

carotid sinus massage
valsalva maneuver
cold applications to face

adenosine

222
Q

tx for local reactions of insect stings

A

supportive
ice
antihistamine for itching
tetanus prophylaxis if not vaccinated

223
Q

tx for delayed reaction to bee sting

A

oral steroids

tetanus prophylaxis

224
Q

tx for anaphylaxis of bee sting

A

sq or IM epi ASAP
antihistamine
bronchodilators

225
Q

tx for animal bites

A

irrigate and debride it

abx for 3-5 days (amox-clav)
if celllulitis - abx for 7-14 days
hospitalization for more severe

226
Q

thrombolytic therapy should be started within how many hours after onset of stroke

A

3 hours

227
Q

waht sign tells you a stroke has affected the dominant hemisphere

A

aphasia

middle cerebral artery

228
Q

what tests to order in a stroke pt

A

head CT noncon

EKG (MI may cause stroke)

229
Q

goal BP for stroke

A
230
Q

how to prevent another stroke

A

stop smoking
drinks less

treat HLD
antiplatelets (aspirin)

231
Q

signs and sx following initial exposure to HIV

6-8 weeks following exposure

A

low-grade fever
fatigue
myalgias

232
Q

why do you get the symptoms of HIV?

A

seroconversion

development of antibodies to virus

233
Q

lab definition of AIDS

A

CD4

234
Q

prophylaxis for what when CD4 dips below 200

A

pneumocystis

bactrim

235
Q

prophylaxis for what when CD4 dips below 50

A

MAI

azithromycin

236
Q

in hyperbilirubinemia, what urinarlysis results do you get

A

elevated bilirubin in CONJUGATED because it gets excreted in urine

unconjugated is not excreted

237
Q

what is gilbert syndrome

A

unconjugated hyperbilirubinemia

238
Q

Marker for hepatitis contagiousness

A

Surface antigen

239
Q

markers for acute viral hepatitis

A

IgM to core antigen

surface antigen

240
Q

definition of chronic viral hepatitis

A

surface antigen

but no IgM to core antigen

241
Q

lab findings in alcohol abuse

A

AST&raquo_space;» ALT

200 : 1

242
Q

how do you test for h pylori

A

urea breath test
stool antigen test
serum antibodies

243
Q

In a patient with new onset dyspepsia, when should you do an upper gi endoscopy

A 
wt loss
progressive dysphagia
recurrent vomiting
GI bleed
FAMILY HX OF CANCER
244
Q

risk factors for PUD

A

h pylori
NSAID
smoking
personal/family hx of PUD

245
Q

in a pt over than 50 who has PUD or melena, what else should you do besides upper endoscopy

A

colonoscopy

r/o cancer

246
Q

signs and sx

roseola

A

fever comes then goes

then rash: trunk –> arms

247
Q

waht causes roseola

A

HHV6

248
Q

tx for roseola

A

nothing

limited

249
Q

dewdrops on a petal

A

chickenpox

250
Q

diagnosis for chickenpox

A

tzanck smear

251
Q

tx for chickenpox

A

acyclovir

valacyclovir

252
Q

complication of parvovirus B19 in pregnancy

A

fetal hydrops

abortion

253
Q

describe skin findings of neisseria meningitis

A

erythematous maculopapular
then becomes petechiae

254
Q

describe skin findings on rocky mountain spotted fever

A

maculopapular rash starts on WRISTS and ANKLES

255
Q

What is Strabismus?

A

ocular misalignment

256
Q

Define failure to thrive.

A
  1. weight below 3rd or 5th percentile, or

2. decelerations of growth that have crossed 2 major growth percentiles, in a short period

257
Q

Most common cause of amblyopia.

A

Strabismus

258
Q

Name 2 required newborn screening tests.

A

PKU and congenital hypothyroidism

259
Q

Name some common newborn screening tests

A

Hemoglobinopathies (sickle), galactosemia

260
Q

How do you evaluate for iron deficiency in children?

A

get hemoglobin or hematocrit bt 6-12 months of age

261
Q

what is the meaning of a red reflex in an ophthalmoscopic exam of a newborn

A

no cataracts or retinoblastoma

262
Q

how do you test for strabismus

what do you do if the child tests positive

A

asymmetric light reflex, or

cover-uncover test
child focuses on object with both eyes, then cover one eye, if the uncovered eye deviates then it is a sign of strabisumus

refer to ophthalmologist asap to prevent amblyopia

263
Q

leading cause of death in children under 1yo

A

SIDS

264
Q

what is the car safety law for children

A

rear-facing car seat until 1yo and weighs 20 lbs

front-facing seat btw 20-40 lbs

booster seat when >40lbs, with shoulder belt

265
Q

leading cause of death of children older than 1 yo

A

accidents and injuries

266
Q

contraindications to vaccines

A

hx of anaphylactic reaction to vaccine or its component (regardless if having fever or not)

267
Q

sx: nasal itching, sneezing, rhinorrhea

A

allegic rhinitis

268
Q

signs: nasal turbinates swollen (boggy), pale/bluish color

A

allergic rhinitis

269
Q

tx for allergic rhinitis

A

antihistamines, decongestants or intranasal steroids

270
Q

complications of tx for allergic rhinitis

A

excess use of decongestants can cause rebound congestion

rhinitis medicamentosa

271
Q

name sx of allergic rhinitis

A 
sneezing
itching (nose/eyes/ears)
rhinorrhea - thin/watery
postnasal drip
congestion
anosmia
HA
earache
tearing/red eyes
drowsiness
272
Q

contrast the mucous secretion of rhinitis vs sinusitis

A

rhinitis - thin/watery

sinusitis - thick/purulent

273
Q

how do you test for nasal polyps

A

spray a topical decongestant, the polyp does not shrink, but the surrounding nasal mucosa does

274
Q

name some 1st gen antihistamines

A

diphenhydramine
chlorpheniramine
hydroxyzine

275
Q

name some 2nd gen antihistamines

A

loratadine
fexofenadine
cetirizine

276
Q

why do 2nd gen antihistamines have less sedative effects than 1st gen

A

less penetration into cns

277
Q

name a decongestant and its mech of action

A

pseudoephredine

alpha agonst

278
Q

why avoid oral decongestants

A

may cause tachycardia, tremors, insominia

279
Q

side effects of corticosteroid nasal sprays

A

nosebleeds, pharyngitis, URI

280
Q

describe urticaria

A

large, irregularly shaped
pruritic
erythematous wheals

281
Q

describe angioedema

A

painless
deep
subcu swelling

involves:
periorbital
circumoral

282
Q

describe anaphylaxis

A 
systemic rxn:
skin findings
dyspnea
visceral edema
hypotension
283
Q

Immediate tx for anaphylaxis

A

Epi SQ or IM

284
Q

what is asthma

A

msucle spasms

285
Q

signs/sx

asthma

A 
wheezing
SOB
cough
increase airway sections
increased expiratory phase
286
Q

What 2 major triggers of asthma

A

Viral infections and Allergens

287
Q

acute relief of asthma

A

beta2 agonist

albuterol

288
Q

tx for persistent asthma

A

long acting b2 agonist (salmeterol)

inhaled corticosteroids

289
Q

bacterial conjunctivitis

name them

A 
staph
strep
hemophilus
moraxella
pseudomonas
290
Q

cause of pink eye

A

adenovirus

291
Q

how is conjunctivitis spread

A

by direct contact

292
Q

smoking cessation interventions

A

meds: buproprion

nicotine replacement:
gum, patch, inhaler, nasal spray

293
Q

5As a physician should use to assist in smoking cessation

A 
ask about tobacco use
advise to quit (talk about risks/benefits)
assess willingness to quit
assist to quit
arrange follow-up/support
294
Q

buproprion contraindicated in what kinds of pts

A

seizures
eating disorders
MAO-I

295
Q

can pregnant women use the nicotine or buproprion to stop smoking

A

yes

296
Q

are physicians required to report STIs?

A

YES!

297
Q

what is emancipation

A

legal process to declare a person under 18 a legal adult: housing, education, healthcare, conduct

but u still cannot drink EtOH, smoke or vote

298
Q

besides emancipation, what is another way a child may consent to receive medical care w/o parents

A

Mature Minor Doctor, court may deem the child to be mature

299
Q

what are the moral principles of ethics

A

autonomy - patient choice
beneficence - do right for patient
nonmaleficence - do no harm
justice - be fair and nonbiased

300
Q

reliable sign of anemia in elderly

A

conjunctival pallor

301
Q

General signs of anemia

A

fatigue
weaknesss
dyspnea

302
Q

general signs of vit b12 def

A 
glossitis
decreased vibratory/positional senses
ataxia
paresthesia
confusion
dementia
pearly gray hair
303
Q

Initial workup of anemia

A

CBC
Peripheral blood smear
Retic count

304
Q

iron panel results for iron def anemia

A

low iron
low ferritin
high TIBC

305
Q

how do u confirm vit b12 def

A

elevated methylmalonic acid

306
Q

other diseases or conditions causing vit 12 def

A

pernicious anemia
history of gastrectomy

is associated w/ malabsorption (bacterial infxn, crohn dis, celiac)

307
Q

folate def is assoc with what condition

A

alcoholism

308
Q

causes of acute diarrhea

A

virus

bacteria (e coli, campylobacter, shigella, salmonella, giardia)

309
Q

causes of chronic diarrhea

A 
crohns
UC
gluten intolerance
IBS
parasites
310
Q

bacterial causes of bloody diarrhea

A

e coli
yersinia
shigella
e histolytica

311
Q

stool leukocytes is indicative of what orgs

A 
salmonella
shigella
yersinia
e coli
c dif
campylobacter
e histolytica
312
Q

travelers diarrhea

A

enterotoxigenc e coli

313
Q

campers diarrhea

A

giardia

314
Q

daycare diarrhea

A

shigella
giardia
rotavirus

315
Q

diarrhea from nursing homes or recent hospitalization

A

c dif colitis from antibiotic use

316
Q

how do u check for c dif colitis

A

stool c dif toxin

317
Q

first step in tx of diarrhea

A

fluid resuscitation and electrolytes

318
Q

best way to prevent viral diarrhea

A

handwashing

319
Q

tx for traveler`s diarrhea

A

quinolone (cipro 500mg bid)
for 1-2 days

or azithromycin

bactrim is more resistant now so avoid it

320
Q

bugs in each diarrhea time course:
within 6 hours
8-12 hours
12-14 hours

A

s aureus
c perfringens
e coli

321
Q

How to reduce risk of developing osteoporosis

A

Daily Ca2+ and Vit D, Weight-bearing exercise

322
Q

how often do u do mammograms

A

start at 40

every 1-2 yrs after that

323
Q

screening for HTN in adults

A

starts at 18

measure blood pressure

324
Q

lipid screening guidelines

A

lipid screen starting at 45yo for women

325
Q

how long should HRT be used

A

lowest dose

as short as possible

326
Q

when to start screening for cervical cancer

A

21

or within 3 yrs of having sex

327
Q

How is screening for osteoporosis done

A

dexa scan (bone density)

328
Q

which joint is most likely to be affected in osteoporosis

A

hip

329
Q

osteoporosis is present if dexa results should a t-score is below what value

A
  • 2.5

2. 5 SD below a young woman`s

330
Q

how do u dx osteopenia

A

dexa scan

T value = -1 to -2.5

331
Q

mech of injury of an ankle sprain

A

inversion of ankle while plantar flexed

332
Q

most commonly injured ligament in ankle sprain

A

lateral ankle more injured than medial ankle

anterior talofibular ligament

333
Q

what is a grade 1 ankle sprain

A

stretching of the ATFL
(anterior talofibular ligament)

pain and swelling
no mechanical instability or loss of fxn

334
Q

what is a grade 2 ankle sprain

A

partial tear of ATFL
stretching of CFL (calcaneofibular lig)

severe pain, swelling, bruising
mild-to-moderate joint instability, pain with weight bearing, loss of ROM

335
Q

what is a grade 3 ankle sprain

A

complete tear of ATFL and CFL
partial tear of PTFL (posterior talofibular ligament)

signifcant joint instability
loss of fxn
inability to bear weight

336
Q

ottawa rules

when do u perform a foot x-ray

A

bony tenderness over:
navicular bone (medial midfoot)
base of 5th metatarsal (lateral midfoot)
unable to bear weight (immed or during exam)
posterior edge or tip of medial/lateral malleolus

337
Q

management of ankle sprain

A 
PRICE
protection (splint/cast)
rest
ice (minimize swelling/pain)
compression (reduce swelling)
elevation (reducing swelling)

NSAIDs / acetaminophen

338
Q

how do you test for supraspinatus injury/tear

A

Empty Can Test

with arm abducted, elbow extended, thumb point down

patient elevates arm against resistance

339
Q

how do you test for infraspinatus or teres minor injury/tear

A

External Rotation

with elbows at side and flexed at 90 degrees

patient externally rotates against resistance

340
Q

how do you test for subscapularis tear

A

Lift-Off Test

patient places dorsum of hand on lumbar back and attempts to lift hand off of back

341
Q

how do you test for ATFL injury or tear

Anterior Talofibular Ligament

A

Anterior Drawer

pull forward on pts heel while stabilizing lower leg

excess translation of joint suggests ATFL tear

342
Q

how do you test for CFL injury or tear

Calcaneofibular Ligament

A

Inversion Stress Test

invert ankle with one hand while stabilizing lower leg with other

excessive translation or palpable clunk of talus on tibia suggests ligament tear

343
Q

how do you test for syndesmosis injury

A

Squeeze Test

examiner compresses tibia/fibula at midcalf

pain at anterior ankle joint (where you`re squeezing) suggests syndesmotic injury

344
Q

how do you test for ACL injury/tear

A

Lachman Test or Anterior Drawer

put knee in 20 degree flexion
pull forward on upper tibia

345
Q

howd you test for MCL injury/tear

A

Valgus Stress

in full extension and at 30 degree flexion, medial-directed force on knee, lateral directed on ankle

look for excess translation

346
Q

how do you test for LCL injury/tear

Lateral Collateral Ligament

A

Varus Stress

in full extension and at 30 degree flexion, lateral-directed force on knee and medial-directed force on ankle

347
Q

according to ottawa knee rules, perform knee x-ray when….

5 things

A 
age 55 orolder
isolated patella tenderness
fibular head tenderness
can`t flex knee to 90
can`t bear weight for 4 steps 
(then or now, regardless of limp)
348
Q

if x-ray of joint is normal, but symptoms persist, whats the next test

A

MRI

349
Q

most common cause of persistent stiff or painful joints following sprains

A

inadequate rehab

350
Q

Single most important risk factor for development of skin cancer

A

Exposure to UV radiation (sun)

351
Q

Risk factors for skin cancer

A 
prior history of skin cancer
family hx of skin cancer
fair skin
red/blonde hair
burn easily
exposure to chemicals (arsenic, radium)
suppressed immune system

exposure to UV radiation

352
Q

most common type of melanoma

A

superficial spreading melanoma

radial growth phase is slower than vertical phase (grows into dermis and can metastasize)

353
Q

most common type of melanoma in the elderly and hawaii

A

lentigo maligna

found on chronic sun-damaged skin (face, ears, arms and upper trunk)

(however this is the least of the 4 in total)

354
Q

most common type of melanoma in african-american and asians

A

acral lentiginous melanoma

found under nails
soles of feet
palms of hands

355
Q

most aggressive type of melanoma

invasive at time of dx

A

nodular melanoma

356
Q

signs and sx

PID

A 
inflammation of any of the reproductive organs
ovaries
fallopian tubes
uterus
cervix
vagina

all you need for dx:
cervical motion tenderness
adnexal tenderness

357
Q

tx for PID in prego woman or HIV

A

admit

parenteral abx

358
Q

complications of PID

A 
recurrence
tuboovarian abscess
chronic abdominal pain
infertility
ectopic pregnancy
359
Q

diagnostic test for lower GIB

A

colonoscopy

360
Q

what are hemorrhoids

A

dilated veins in the hemorrhoidal plexus of the anus

361
Q

risk factors for hemorrhoids

A

chronic constipation
straining for BMs
pregnancy
prolonged sitting (truck drivers)

362
Q

where do diverticula mostly occur

A

where blood vessels penetrate thru muscles of the colon

363
Q

signs and sx

diverticulosis

A

painless bleeding

364
Q

management of asymptomatic diverticulosis

A

dietary modification

high-fiber diet

365
Q

management of hemorrhoids

A

high-fiver diet

stool softeners

366
Q

contrast diverticulitis and diverticulosis

A

itis - painful inflammation

osis - not painful

367
Q

usual location of diverticulitis

A

lower left quadrant

368
Q

complication of diveritculitis

A

perforation resulting in:

peritonitis
intraabdominal abscess

369
Q

tx for diverticulitis

A

bowel rest
abx (quinolone and metro)

if perforated –> surgery

370
Q

major risk factor for IBD

A

family hx

371
Q

IBD

besides GI, what are other common manifestations

A

arthritis

372
Q

tx for IBD

A

symptomatic therapy
antidiarrheal
aminosalicylates
corticosteroids

373
Q

precancerous polyps

name the 3

A

in order of increasing risk
tubular adenomas
tubulovillous adenomas
VILLOUS ADENOMAS

374
Q

most common causes of CAP

A

pneumococcus

others
h influ
moraxella catarrhalis

common in very young and old

375
Q

cause of pneumonia in COPD patients

A

h influ

376
Q

atypical pneumonia

A

mycoplasma pneumonia
chlamydia pneumoniae
legionalla pneumphila

common in adolescent or young adults

377
Q

risk factors for hospital acquired pna

A

intubation
NG tube
preexisting lung disease
multisystem failure

378
Q

orgs in hospital acquired pna

A

aerobic GM-
pseudomonas
klebsiella
acinetobacter

GM+ cocci
staph aureus

379
Q

ways to reduce intubation associated pna

A

use oropharyngeal vs naso
elevate head during feeds
infection control (wash hands, alcohol based disinfectants)

380
Q

pneumonia with diarrhea

what bug

A

legionella

381
Q

pneumonia after influenza

A

staph aureus

382
Q

abrupt onset of pna

A

pneumococcus

383
Q

sign of focal lung consolidation

A

egophony (E to A change)

384
Q

sign of pleural effusion

A

dullness to percussion

385
Q

cxr

ground glass infiltrates

A

pneumocystis carinii

AIDS patients

386
Q

GI aspiration usually affects what lobe

A

right lower lobe

due to branching of bronchial tree

387
Q

how to diagnose legionella

A

urine antigen testing

388
Q

tx for pneumococcus pneumonia

A

beta lactam (ctx) or macrolide (azithromycin)

389
Q

complications of pna

A

bacteremia

pleural effusion

390
Q

tx for pleural effusion

A

if lots of fluid, do a thoracentesis with gram stain/cx

if empyema fluid, place chest tube for drainage

391
Q

differential dx

depression

A

hypothyroidism
anemia
substance abuse

392
Q

tx duration for depression

A

at least 6-9 months

if recurrent depression, treat for longer

393
Q

Side effects of SSRIs

A 
sexual dysfxn
weight gain
GI disturbance
fatigue
agitation
394
Q

side effects

TCA

A 
sedation
dry mouth and eyes
urinary retention
wt gain
sexual dysfxn
HIGHLY TOXIC / FATAL IN OD
395
Q

side effects

MAO-I

A

drug-drug interactions

SSRI and meperidine (Demerol)

396
Q

Most concerning side effect of buproprion

A

Seizure. Contraindicated in pts with seizure disorders

397
Q

side effect

trazodone

A

priapism (persistent erection)

sedation (used for insomnia)

398
Q

comorbidity of panic disorders

A

depression

399
Q

bereavement vs depression

A

bereavement

400
Q

rule out what in depressed patients

A

bipolar

ask about mania

401
Q

benefits of breast feeding

A

faster return of uterine tone (reduced bleeding)
quicker return to prepregnant wt
reduced incidence ov ovarian/breast cx
lower cost

402
Q

what hormonal contraception is recommended in breast-feeding women

A

progestin-only mini-pill, avoid combined pills b/c it interferes with milk supply

403
Q

how long does uterus take to return to prepregnant size after labor

A

6 weeks

404
Q

White/yellow discharge in weeks following labor

A

Lochia (normal)

405
Q

When does ovulation and menstruation return after pregnancy

A

For non breast feeding mothers, 3 months. Longer if you are breast feeding

406
Q

common causes of postpartum hemorrhage

A

4Ts

uterine atony
trauma (lacerations)
retained Tissue (placenta)
thrombin (coagulopathies)

407
Q

Most common cause of postpartum hemorrhage

A

uterine atony

408
Q

tx for uterine atony

A

oxytocin and bimanual uterine massage

if fails, give methylergonovine
contraindicated in pts

409
Q

Signs and sx of endometritis after labor

A

postpartum fever
uterine tenderdness
smelly lochia

410
Q

how do u reduce risk of endometritis

A

abx prophylaxis during delivery

cover vaginal and GI flora

411
Q

duration of maternity blues

A

gone by 10 days after labor

412
Q

tx of depression in breast-feeding mothers

A

SSRIs

413
Q

how soon should women be allowed to breast feed after labor

A

asap

414
Q

what is in colostrum

A

antibodies!

415
Q

what is mastitis?

should she stop breast feeding?

A

obstruction of milk glands then becomes infected

no, keep pumping away

416
Q

how long after labor to start OCPs

A

6 weeks

3 if not breast feeding

417
Q

is depo provera ok in breast feeding women

A

yes

418
Q

how long after labor can she resume IUD or diaphragms

A

6 weeks

get re-fitted

419
Q

what is diastolic vs systolic chf

A

systolic - dilated LV and impaired contractility

diastolic - normal LV but impaired relaxation

420
Q

sensitive and specific marker for CHF

A

BNP

> 500

421
Q

cxr finding in CHF

A

cephalization of pulmonary vasculature

422
Q

initial management of CHF

A

ABCs
then O2

if pulmonary edema, start diuretic

423
Q

first line tx of CHF

A

ACE-I

424
Q

CHF

what benefits do beta blockers offer

A

reduce sympathetic tone

reduce cardiac muscle remodeling

425
Q

3 meds in CHF

A

ACE-I
beta blockers
diuretics

426
Q

use ccb in systolic CHF?

A

NO they are contraindicated

427
Q

when would you use ccb in CHF

A

in DIASTOLIC CHF

promotes increased cardiac output by lowering HR
allows for more ventricular filling time

428
Q

benefits of combination OCPs

A

protects against ovarian/endometrial cx
protects against iron-def anemia
PID
fibrocystic disease

429
Q

how do combo OCPs work

4 things

A

suppresses ovulation
thickens cervical mucus
retards sperm entry
discourages implanation

430
Q

side effects of OCPs

A 
Nausea
HA
breast swelling
fluid retention
weight gain
irregular bleeding
depression
431
Q

what to do if OCP pill is missed

A

take it asap

take next dose as usual

432
Q

if two pills are missed in OCP

A

take 2 pills together 2 days in a row

and use alternative contraception for 7 days

433
Q

how long does depo-provera last

A

14 weeks

so inject every 3 months

434
Q

Failure rate of spermicides? When combined with condoms?

A

20-30 percent. Down to that of OCPs

435
Q

emergency contraception

works when taken within how many hours

A

72

436
Q

in adolescents, screen them for sports participation

what are you looking for?
what are signs/sx?

A

hypertrophic cardiomyopathy
murmur left sternal border
accentuates with activities that decrease cardiac preload and EDV of LV
(i.e standing or straining with valsalva maneuver would increase murmur; while squatting would decrease murmur)

437
Q

nonpharm tx of HTN

A

DASH
Dietary Approaches to Stop HTN

high K+ and Ca2+
effective as a single agent antihypertensive therapy

438
Q

Goal BP for regularly HTN and hypertensive DM pts respectively

A

Less than 140/90 less than 130/80

439
Q

How do you diagnose HTN?

A

Two PROPER measurements on two occasions

440
Q

signs and sx

intussusception

A

abdominal pain
crying (infants)
periods of pain-free / no crying

SAUSAGE SHAPED MASS
currant jelly stool (red mucousy)

441
Q

x-ray of intussusception

A

coiled spring

442
Q

diagnostic test for intussusception

A

barium enema

its also therapeutic

443
Q

X-ray shows perforation in intussusception. What is the next step?

A

Surgery

444
Q

how does vomiting present in intussusception

A

vomiting gradually becomes bilious as obstruction sets in

445
Q

where do most intussusception occur

A

right lower quadrant

ileocecal jxn

446
Q

signs and sx

malrotation in a child

A

bilious vomiting and abdominal pain

447
Q

complication of malrotation

A

twisted bowel will become necrotic

causing fluid loss and sepsis

448
Q

imaging findings on malrotation

A

misplaced duodenum or obstruction

beaklike appearance caused by volvulus

449
Q

tx for malrotation

A

surgery

450
Q

which objects require immediate intervention in a foreign body complication

A

batteries

if both poles touch the esophageal wall, it will conduct electricity and PERFORATE

451
Q

what is aphasia

A

cannot understand words

452
Q

what is apraxia

A

lost of muscle coordination

cannot perform complex tasks involving muscles

453
Q

what is agnosia

A

cannot recognize common objects

454
Q

what is pseudodementia

A

depression in the elderly which appears as alzheimers

455
Q

tx for alzheimers

A

cholinesterase inhibitors

donepezil
rivastigmine
tacrine
memantine

456
Q

what is vascular dementia

A

memory loss from STROKES

457
Q

compare vascular with alzheimers dementia

A

alzheimers - GRADUAL

vascular - SUDDEN ONSET, STEPWISE FASHION loss as subsequent infracts occur

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