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.RoshReview > Feb '22 > Flashcards

Feb '22 Flashcards

1
Q

treatment of TTP

A

plasma exchange

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2
Q

stable pneumomediastinum, whats next?

A

observe, probs discharge

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3
Q

giving calcium in hyperK can potentiate what drug toxicity?

A

digitalis toxicity

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4
Q

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

A

infancy, recurrent episodes of failure to thrive and dehydration

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5
Q

what steroids should be avoided in patients with muscular dystrophy?

A

dexamethasone and triamcinolone can induce worsening myopathy

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6
Q

differentiate ventricular aneurysm and acute stent thrombosis on ekg

A

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

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7
Q

osler-weber-syndrome is aka

A

hereditary hemorrhagic telangiectasias

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8
Q

hereditary hemorrhagic telangiectasias presents with

A

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

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9
Q

respiratory indices noting likely impending respiratory failure

A

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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10
Q

CSF findings in GBS

A

albuminocytologic dissociation - elevated protein and normal white count

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11
Q

ventricular dysrhythmia from inhaling hydrocarbons, treatment?

A

esmolol

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12
Q

inhalation/huffing hydrocrabons does what?

A

over sensitizes myocardium to catecholamines

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13
Q

besides tamponade, what can cause pulsus paradoxus?

A

asthma, COPD, constrictive pericarditis, PE

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14
Q

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

A

vanc to cover for MRSA

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15
Q

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

A

PE

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16
Q

FB in ear is removed… next step?

A

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

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17
Q

inferior or superior crus cut in lateral canthotomy?

A

inferior crus of lateral canthal tendon

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18
Q

features of nephrotic syndrome

A

proteinuria, edema, hypoalbuminemia, hyperlipidemia, hyponatremia

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19
Q

treatment of choice for minimal change in nephrotic syndrome?

A

prednisone

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20
Q

neonatal conjunctivitis 5-14 days, dx and tx

A

chlamydia trachomatis, tx with PO erythromycin

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21
Q

tx of gonorrheal conjunctivitis

A

IV cefotaxime

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22
Q

herpes zoster tx

A

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

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23
Q

what lies behind a peritonsillar abscess?

A

internal carotid artery, internal jugular vein, CN

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24
Q

epiglottitis kid on brief exam and hx, next step

A

mobilize difficult airway team

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25
Q

H. influ is resistant to what IV abx?

A

ampicillin

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26
Q

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

A

azithro, clarithro, or clindamycin

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27
Q

prostatitis tx

A

bactrim, cipro or levo

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28
Q

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

A

malaria

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29
Q

hallmark finding of isopropanol toxicity

A

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

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30
Q

TXA in head bleed

A

no significant improvement

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31
Q

surgery is indicated in hyphema when

A

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

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32
Q

trigeminal nerve originates where

A

lateral pons

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33
Q

what CN are responsible for afferent and efferent corneal reflex

A

trigeminal and facial respectively

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34
Q

specific finding for post-streptococcal glomerulonephritis?

A

decreased serum C3

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35
Q

maltese cross sign is pathognmonic for

A

nephrotic syndrome

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36
Q

tx of hypercalcemia associated with malignancy

A

IV hydration and bisphosphonates

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37
Q

what makes a complex febrile seizure

A

> 15 minutes
seizure has focal component
1 in 24 hours

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38
Q

Fe containing fb in the eye, tx?

A

rust ring, see ophtho in 24 hours

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39
Q

acutely thrombosed external hemorrhoid

A

excision otherwise will ulcerate

40
Q

severe neutropenia defined

A

ANC <500

WBC 4000 with <10% neutrophils

41
Q

calculate ANC

A

WBC x %neutrophils

42
Q

MC pathogen in neutropenic fever

A

Staph epidermidis

43
Q

baby formula ratio

A

one scoop per 2 oz water

44
Q

CSF finding with GBS

A

elevated CSF protein

45
Q

tests that help determine need for intubation with GBS

A

vital capacity or negative inspiratory flow

46
Q

pinworms/enterobius tx

A

albendazole

47
Q

bacterial parotitis tx

A

IV ampicillin sulbactam

48
Q

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

A

eastern coral snake, elapidae family

49
Q

what is the risk of recurrent febrile seizure?

A

30%

50
Q

magical thinking is seen in

A

schizotypal

51
Q

macrocytic anemias

A

Pernicious/B12 and folate

52
Q

Fe deficiency anemia is

A

microcytic

53
Q

lightening strike triage

A

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

54
Q

amyl nitrite causes

A

methhemoglonemia

55
Q

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

A

Zika virus

56
Q

homonymous quadrantanopia is due to

A

optic radiations lesions

57
Q

swallowed foreign bodies in peds most often obstruct where

A

cricopharyngeus muscle

58
Q

high risk wound with uncertain tetanus vaccine status

A

dT and TIG

59
Q

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

A

acute reheumatic fever

60
Q

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

A

3.3- 5.2 K

61
Q

sensation and finding in most lower leg compartment syndrome

A

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

62
Q

thrombocytopenia with petechiae in kid following viral illness

A

ITP - tx with corticosteroids

63
Q

normal PaO2

A

70-100

64
Q

bee sting with wheezing

A

epi

65
Q

COPDer basic vent settings

A

volume control, rate 10, allows for appropriate exhale time

66
Q

iron toxicity late complication

A

pyloric stenosis

67
Q

infantile spasms

A

occur in clusters, crescendo decrescendo, west syndrome

68
Q

anticholinergic toxidrome

A

hot as a hare, mad as a hatter, etc

antihistamines and benadryl

69
Q

insectisides overdose could cause

A

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

70
Q

goal of treatment for cholinergic (crop duster) toxicity

A

drying of secretions with atropine tx

71
Q

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

A

skin exam - tick paralysis

72
Q

MC presentation of nontuberculous mycobacterium in young children

A

lymphadenitis

73
Q

leading cause of poisoning morbidity and mortality in the US

A

CO poisoning

74
Q

differentiate serotonin syndrome v NMS

A

clonus is defining feature of SS

75
Q

splenic vein thrombosis, what causes varices?

A

short gastric veins create varices in distal esophagus

76
Q

early presentation of salicylate tox

A

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

77
Q

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

A

mitral regurg

78
Q

tx influenza in these pts

A

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

79
Q

TCA overdose with EKG changes, next step

A

sodium bicarb

80
Q

necrotizing otitis externa on exam - next step

A

pip tazo

81
Q

perfed TM from blast injury, next step?

A

chest XR

82
Q

magnet on ICD will cause

A

default to pace maker mode

83
Q

tx of nail plate avulsion

A

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

84
Q

fever associated with systemic juvenile idiopathic arthritis?

A

intermittent high fever, spikes about once a day

85
Q

ASIS avulsion fracture tx

A

d/c with crutches and symptomatic treatment

86
Q

contraindications to mtx for ectopic -

A

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

87
Q

patient with refractory septic shock -

A

consider hydrocortisone and levothyroxine when indicated

88
Q

acid base disturbance caused by pyloric stenosis?

A

hypochloremic metabolic alkalosis

89
Q

electrolyte change with digoxin tox? tx?

A

hyperK

give digoxin antibodies

90
Q

allergy to lidocaine, what should be used as anesthetic?

A

procaine, or tetracaine for ocular, topical, and epidural

91
Q

mouth injury with dental step off

A

mandibular fracture

92
Q

tx of acute lithium overdose

A

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

93
Q

rapid fluid resus should be through

A

16 gauge or larger AC

94
Q

hyperviscosity syndrome labs

A

elevated serum protein, or leukocytosis

95
Q

indications for hyperbaric oxygen therapy in setting of CO poisoning?

A

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

96
Q

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

A

scleritis

.RoshReview (11 decks)

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