Feb '22 Flashcards by Lauren Sophiea

treatment of TTP

plasma exchange

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stable pneumomediastinum, whats next?

observe, probs discharge

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giving calcium in hyperK can potentiate what drug toxicity?

digitalis toxicity

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what is the common age and presentation of nephrogenic diabetes insipidus?

infancy, recurrent episodes of failure to thrive and dehydration

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what steroids should be avoided in patients with muscular dystrophy?

dexamethasone and triamcinolone can induce worsening myopathy

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differentiate ventricular aneurysm and acute stent thrombosis on ekg

ventricular aneurysm will have ST elevation without reciprocal changes. stent rethrombosis will have reciprocal changes

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osler-weber-syndrome is aka

hereditary hemorrhagic telangiectasias

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hereditary hemorrhagic telangiectasias presents with

AV malformations in multiple organs, including brain, liver, and lung

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respiratory indices noting likely impending respiratory failure

A forced vital capacity < 20 mL/kg, maximum inspiratory pressure (negative inspiratory force) ≤ 30 cm H2O, or a maximum expiratory pressure of ≤ 40 cm H2O indicate impending failure

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CSF findings in GBS

albuminocytologic dissociation - elevated protein and normal white count

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ventricular dysrhythmia from inhaling hydrocarbons, treatment?

esmolol

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inhalation/huffing hydrocrabons does what?

over sensitizes myocardium to catecholamines

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besides tamponade, what can cause pulsus paradoxus?

asthma, COPD, constrictive pericarditis, PE

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abx added to the first line agents in immunocompromised pt with flexor tenosynovitis

vanc to cover for MRSA

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what is the most commonly overlooked condition in work up of pleural effusion?

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FB in ear is removed… next step?

amoxicillin if TM perf possible, otic drops for ppx for otitis externa

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inferior or superior crus cut in lateral canthotomy?

inferior crus of lateral canthal tendon

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features of nephrotic syndrome

proteinuria, edema, hypoalbuminemia, hyperlipidemia, hyponatremia

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treatment of choice for minimal change in nephrotic syndrome?

prednisone

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neonatal conjunctivitis 5-14 days, dx and tx

chlamydia trachomatis, tx with PO erythromycin

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tx of gonorrheal conjunctivitis

IV cefotaxime

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herpes zoster tx

acyclovir within 72 hours of onset, NSAIDs, tylenol, opiates

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what lies behind a peritonsillar abscess?

internal carotid artery, internal jugular vein, CN

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epiglottitis kid on brief exam and hx, next step

mobilize difficult airway team

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H. influ is resistant to what IV abx?

ampicillin

pt with acute rheumatic fever, has severe penicillin allergy, tx?

azithro, clarithro, or clindamycin

prostatitis tx

bactrim, cipro or levo

pt traveled out of the country, most important illness to rule out

malaria

hallmark finding of isopropanol toxicity

in setting of elevated osmolar gap, ketosis without a wide anion gap metabolic acidosis (ketosis without acidosis, acetone ingestion)

TXA in head bleed

no significant improvement

surgery is indicated in hyphema when

IOP not well controlled, >25 after 24 hours in pt with sickle cell, >50 after 6 days in other pt or Grade IV

trigeminal nerve originates where

lateral pons

what CN are responsible for afferent and efferent corneal reflex

trigeminal and facial respectively

specific finding for post-streptococcal glomerulonephritis?

decreased serum C3

maltese cross sign is pathognmonic for

nephrotic syndrome

tx of hypercalcemia associated with malignancy

IV hydration and bisphosphonates

what makes a complex febrile seizure

>15 minutes seizure has focal component >1 in 24 hours

Fe containing fb in the eye, tx?

rust ring, see ophtho in 24 hours

acutely thrombosed external hemorrhoid

excision otherwise will ulcerate

severe neutropenia defined

ANC <500 | WBC 4000 with <10% neutrophils

calculate ANC

WBC x %neutrophils

MC pathogen in neutropenic fever

Staph epidermidis

baby formula ratio

one scoop per 2 oz water

CSF finding with GBS

elevated CSF protein

tests that help determine need for intubation with GBS

vital capacity or negative inspiratory flow

pinworms/enterobius tx

albendazole

bacterial parotitis tx

IV ampicillin sulbactam

snake bite with ptosis, vertigo, paresthesias, slurred speech, drowsiness, dysphagia, restlessness, increased salivation, proximal muscle weakness

eastern coral snake, elapidae family

what is the risk of recurrent febrile seizure?

30%

magical thinking is seen in

schizotypal

macrocytic anemias

Pernicious/B12 and folate

Fe deficiency anemia is

microcytic

lightening strike triage

dead looking person may just have respiratory arrest and should be tended to

amyl nitrite causes

methhemoglonemia

travel, low grade fever, maculopapular rash, arthralgias, conjunctivitis

Zika virus

homonymous quadrantanopia is due to

optic radiations lesions

swallowed foreign bodies in peds most often obstruct where

cricopharyngeus muscle

high risk wound with uncertain tetanus vaccine status

dT and TIG

5-15 yo with migratory polyarthritis, multiple erythematous ring lesions with central clearing

acute reheumatic fever

DKA treatment, K at what level do you supplement with insulin contemporaneously

3.3- 5.2 K

sensation and finding in most lower leg compartment syndrome

decreased sensation between first and second toes, decreased dorsiflexion anterior compartment

thrombocytopenia with petechiae in kid following viral illness

ITP - tx with corticosteroids

normal PaO2

70-100

bee sting with wheezing

epi

COPDer basic vent settings

volume control, rate 10, allows for appropriate exhale time

iron toxicity late complication

pyloric stenosis

infantile spasms

occur in clusters, crescendo decrescendo, west syndrome

anticholinergic toxidrome

hot as a hare, mad as a hatter, etc | antihistamines and benadryl

insectisides overdose could cause

cholinergic symptoms - increased lacrimation, salivation, urination, and defecation

goal of treatment for cholinergic (crop duster) toxicity

drying of secretions with atropine tx

weakness over a few hours, or first noticed upon waking, tendon reflexes are lost, negative everything work up

skin exam - tick paralysis

MC presentation of nontuberculous mycobacterium in young children

lymphadenitis

leading cause of poisoning morbidity and mortality in the US

CO poisoning

differentiate serotonin syndrome v NMS

clonus is defining feature of SS

splenic vein thrombosis, what causes varices?

short gastric veins create varices in distal esophagus

early presentation of salicylate tox

hyperpnea, GI upset, tinnitus - hyperventilation causes respiratory alkalosis THEN followed by anion gap metabolic acidosis

harsh systolic murmur, best heard at apex of heart and loudest in early or mid systole?

mitral regurg

tx influenza in these pts

>65 yo, nursing home, pregnant, and up to 2 weeks postpartum, or chronic illness pt, morbid obesity, and american indian, kids <2 yo

TCA overdose with EKG changes, next step

sodium bicarb

necrotizing otitis externa on exam - next step

pip tazo

perfed TM from blast injury, next step?

chest XR

magnet on ICD will cause

default to pace maker mode

tx of nail plate avulsion

original nail plate and sterile matrix should be rinsed with saline and reattached to the nail bed to maintain patency of the nail fold

fever associated with systemic juvenile idiopathic arthritis?

intermittent high fever, spikes about once a day

ASIS avulsion fracture tx

d/c with crutches and symptomatic treatment

contraindications to mtx for ectopic -

relative with fetal heart activity, hemodynamic instability, evidence of rupture, sac >4 cm

patient with refractory septic shock -

consider hydrocortisone and levothyroxine when indicated

acid base disturbance caused by pyloric stenosis?

hypochloremic metabolic alkalosis

electrolyte change with digoxin tox? tx?

hyperK | give digoxin antibodies

allergy to lidocaine, what should be used as anesthetic?

procaine, or tetracaine for ocular, topical, and epidural

mouth injury with dental step off

mandibular fracture

tx of acute lithium overdose

whole bowel irrigation, hemodialysis if lithium level >5, or >4 plus renal insuff, and in pt with AMS, seizures or other

rapid fluid resus should be through

16 gauge or larger AC

hyperviscosity syndrome labs

elevated serum protein, or leukocytosis

indications for hyperbaric oxygen therapy in setting of CO poisoning?

signs of end organ damage, syncope, coma, seizures, confusion, focal neuro deficit, visual symptoms

eye ball with violet bluish hue with scleral edema and vascular engorgement

scleritis