First Flashcards

(162 cards)

1
Q

What are the medications for acute angle closure glaucoma?

A

Apraclonidine
Timolol
Mannitol or acetazolamide)
Pilocarpine

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2
Q

How often should you check response to the medications for acute angle closure glaucoma?

A

q60 minutes

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3
Q

What level of iron is systemically toxic?

A

500-1000 mcg/dL

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4
Q

What is the treatment for an acute ingestion of Fe?

A

Whole bowel irrigation with NGT placement
Deferoxamine

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5
Q

What is the role of TIBC with acute iron overdoses?

A

Little to no value

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6
Q

What is the pediatric dose of bicarb?

A

1 Meq/kg

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7
Q

What is the pediatric dose of calcium gluconate?

A

60 mg/kg

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8
Q

What is the pediatric dose of calcium chloride?

A

20 mg/kg

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9
Q

FAT RN

A

Fever
Anemia
Thrombocytopenia
Renal failure
Neurologic deficits/confusion

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10
Q

What is the reversal agent for lovenox and heparin?

A

Protamine

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11
Q

What is the treatment for HUS? TTP? ITP?

A

HUS: supportive or plasmapheresis
TTP: Plasmapheresis
ITP: Steroids, IVIG

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12
Q

At what level are platelets indicated for everyone without bleeding? Anticoagulated?

A

Everyone gets platelets under 10,000
If AC, 50,000

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13
Q

What are the lab findings indicative of cyanide poisoning?

A

Refractory Lactic acidosis
large AG

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14
Q

What are the dimensions of an esophageal FB that require removal?

A

5 cm x 2 cm

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15
Q

What is the treatment for a cecal volvulus? Sigmoid?

A

Cecal = surgery
Sigmoid + NG tube and rectal tube

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16
Q

What are the s/sx of a black widow envenomation? Treament?

A

Abdominal pain
Myalgias
Diaphoresis

Benzos, GSC

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17
Q

What is the typical mechanism of a boutonniere deformity of the finger? Treatment?

A

Jammed finger causes rupture of the central slip of the extensor tendon
Splint PIP in extension

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18
Q

What is the typical mechanism of a mallet deformity of the finger? Treatment?

A

Forced flexion of the DIP (direct blow to finger)
Extensor tendon rupture
Splint distal tip in extension

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19
Q

What is the typical mechanism of a jersey deformity of the finger? Treatment?

A

Avulsion of the FDP at the DIP joint ( can’t fully flex the distal tip
Splint with flexion

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20
Q

What is the splint for a gamekeeper’s thumb?

A

Thumb spica

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21
Q

What type of heart block occurs with an anterior MI? Inferior?

A

Anterior = Mobitz II or complete
Inferior = First degree

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22
Q

Chest pain + new onset pulmonary edema + murmur + inferior MI on EKG =?

A

Papillary muscle rupture

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23
Q

What are the only absolute contraindications to cooling post rosc?

A

Bleeding/coagulopathy
Pregnancy
Severe sepsis

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24
Q

How do you treat a patient in v tach/fib when they have an LVAD?

A

Shock as you normally would

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25
How will a clot present in a patient with an LVAD?
Low flow warning, increased energy demand
26
What are the indications for treatment with digibind?
K over 5 MeQ/L Ingestion over 10 mg (5 mg for children)
27
What is eczema herpeticum?
Eczema that get secondarily infected with herpes
28
Erythematous plaques with silver scales and nail pitting = ?
Psoriasis
29
Where on the body is psoriasis usually seen?
Extensor surfaces
30
What rash has the characteristic Christmas tree pattern, and how is it treated?
Pityriasis Rosea Antihistamines
31
What lab will be low in cases of acute angioedema?
C4 levels
32
What is the specific drug used to treat angioedema?
Icatibant (FFP can also be used)
33
How does giving FFP treat angioedema?
has a kinase that degrades excess bradykinin
34
What is the treatment for erysipelas?
Dicloxacillin or erythromicin
35
Erythematous nodules on the shin = ?
Erythema nodosum
36
Inflammatory pustule that progresses to a painful ulcer = ? What type of diseases is this associated with?
Pyoderma gangrenosum Chronic inflammatory conditions (IBDs)
37
Small area of edema progressing to painless nodular lesions with central hemorrhage and necrosis = ?
Ecthyma gangrenosum
38
What is the difference between erythema multiforme minor vs major?
Major = mucosal involvement
39
How long after giving amoxicillin to a pt with mono can the rash present?
day to a week
40
Besides admitting to a burn unit, what consultant should be involved with SJS/TEN patients?
Ophthalmology
41
Which has a positive Nikolsky sign: bullous pemphigoid or pemphigus vulgaris?
Pemphigus vulgaris
42
What type of tinea must be treated with oral antifungals?
Tinea capitis
43
What is the treatment for tinea versicolor?
Selenium sulfide shampoo
44
What is the classic rash of gonococcemia?
Pinpoint petechial macules that progress to vesicles or bullae
45
What is the treatment for sporotrichosis?
KI
46
What is the treatment for RMSF in pregnant women and children?
Doxycycline
47
What is the difference in the timing of the rash in chicken pox vs smallpox?
Chicken pox = different stages of healing Small pox = all in the same stage.
48
What is the specific "antidote" for sulfonylurea overdoses?
Octreotide
49
What are the ages for the rule of 50?
1-8
50
What is the pediatric dose of glucagon?
0.03 mg/kg
51
Why does alcoholic ketoacidosis have an AG, but usually normal-ish pH?
Compensation and/or concomitant vomiting
52
What is the equation for osmolality?
2Na + glucose/18 + BUN/2.8 + Etoh/3.7
53
When in pregnancy does thyrotoxicosis of pregnancy typically resolve?
20 weeks
54
Why should you not give ASA to patients with thyroid storm?
Precipitates conversion of T4 to T3
55
What is the order for medications to treat thyroid storm?
Propranolol PTU Iodine Steroids
56
What is the treatment for myxedema coma?
Levothyroxine
57
What is the steroid of choice for adrenal issues?
Hydrocortisone
58
What is the treatment for hyponatremic seizures?
100 cc of 3% given over *10 minutes
59
What is the formula for correcting [Ca] for albumin levels?
[Ca] + 0.8(4-[albumin])
60
What is the treatment for hypermagnesmia?
Calcium
61
What are the components of the MUDPILERS mnemonic?
Methanol Uremia DKA Paraldehyde INH/Iron Lactic acidosis Ethylene glycol Rhabdomyolysis Salicylates
62
Metabolic acidosis + hypokalemia = ?
Diarrhea
63
Metabolic acidosis + hyperkalemia = ?
Renal failure
64
Metabolic alkalosis + hypokalemia = ?
Vomiting
65
Hematomas can generally be aspirated/drained within how many hours?
48
66
What is the difference between vestibular neuritis vs labyrinthitis?
Labyrinthitis has hearing loss, while vestibular neuritis does not
67
Diabetic patient with think, black mucoid sinus discharge = what disease?
Mucormycosis
68
What defines le fort fractures I - III?
I = hard palate II = Extends to orbital floor III - Zygoma
69
What is the predominant fatal rhythm found in drowning victims?
Asystole
70
True or false: significant electrolyte imbalances generally do not occur with drowning
True
71
What is the primary factor in determining survival with drowning?
Time of immersion
72
Diver losing consciousness when surfacing = ?
Air embolism
73
What is the goal temperature of cooling a patient with hyperthermia? What is the temperature of water you should use to warm a hypothermic patient?
39 C
74
What is the parkland formula?
4(kg)*(%BSA).
75
What is the goal urine output for a burn patient?
0.5 cc/kg/hr
76
48 hour lymphocyte count above (___) after radiation is a good prognosis sign? Bad?
Good = 1200 less than 300 is bad
77
True or false: you should immobilize a snake bitten body part
True, it reduces the movement of the venom, but do NOT put a tourniquet around it
78
What are the s/sx of a scorpion bite?
Pancreatitis Neuroexcitation
79
What is the treatment for a sea urchin sting, or a jellyfish envenomation?
Hot water and vinegar
80
A platelet count of less than what is an indication for platelet transfusion with ITP? What if they're bleeding?
less than 30,000 less than 50,000
81
What type of casts are seen with RPGN? What is the treatment?
RBC casts Steroids
82
What type of casts are seen with Acute interstitial nephritis? What is the treatment?
WBC casts, eosinophiluria Remove offending agent
83
What type of casts are seen with ATN? What is the treatment?
Muddy brown granular and epithelial cell casts IVFs, correct underlying pathology
84
Hyaline casts generally indicate prerenal, renal, or postrenal pathology?
Pre or postrenal
85
What are the components of the I-STUMBLED mnemonic for ingestions that can be dialyzed off?
Iron/INH Salicylates Theophylline Uremia Methanol Barbiturates Lithium Ethylene glycol Depakote
86
What bedside test can be performed to assess if a new AV fistula is causing high-output HF?
Occluding the fistula will cause bradycardia
87
What should not be seen on UA in a patient with prostatitis?
RBCs
88
True or false: patients with tertiary syphilis are not longer infectious
True
89
STD with painless, herpes like ulcer and inguinal LAD = ?
LGV
90
STD presenting with tender papule progressing to a painful ulcer = ?
Chancroid
91
What are the abx of choice for the treatment of neonatal meningitis?
Gentamicin + ampicillin
92
What abx is used for PEP for Neisseria meningitidis?
Single dose of oral cipro Single dose of ceftriaxone Two doses of rifampin
93
What are the three classic symptoms of optic neuritis?
Painful EOM Vision loss Red color blindness
94
What is the treatment for Guillain-Barre syndrome?
IVIG
95
What are the 3 components of treatment for a myasthenic crisis?
IVIG Plasmapheresis Steroids
96
What is the classic triad of symptoms for Wernicke's encephalopathy?
Ophthalmoplegia Ataxia Encephalopathy
97
True or false: there is usually sensory loss in patients with ALS
False, sensation is usually spared
98
What are the classic s/sx of syringomyelia?
Progressive loss of pain/temp in hands Loss of sensation in cape-like distribution
99
Where is the lesion with Wallenberg syndrome, and what are the general s/sx?
Blockage in the PICA or vertebral artery Ipsilateral CN deficits, with contralateral pain/temp loss
100
What is the target BP for a hemorrhagic stroke?
Less than 140 mmHg
101
What is the order of US findings for a pregnancy?
Gestational sac Yolk sac Fetal pole
102
Any patient with vaginal bleeding after what gestational age should have an US done prior to pelvic exam to r/o placenta previa
24 weeks
103
What are the findings of Acute fatty live of pregnancy?
Hypoglycemia High NH3 Coag abnormalities
104
All pregnant trauma patients over how many weeks gestation need fetal monitoring
23 weeks
105
Where anatomically is an episiotomy performed?
Oblique, not midline
106
What is blepharitis, and what is the treatment?
Chronic infection of the eyelid margin Warm compresses and topical abx
107
What are the three components of Horner's syndrome?
Ptosis Miosis Anhydrosis
108
How can you confirm a lacrimal system injury?
Fluorescein staining
109
What is dacrocystitis and what is the treatment?
Infection of the draining sac. Warm compresses and oral abx
110
What is a chalazion? Treatment?
Chronic, painless inflammation of the meibomian gland Warm compresses, no abx
111
What is the treatment for a stye (hordeolum)?
Warm compresses and topical abx
112
What is the usual etiology of neonatal conjunctivitis at: -24-48 hours postpartum -3-5 days postpartum -5-14 days postpartum
-24-48 hours = chemical -3-5 days = gonorrhea -5-14 days = chlamydia
113
What is the difference between episcleritis and scleritis
Episcleritis is superficial vessels only sudden, mild eye pain and redness Scleritis with severe pain, photophobia, blurry vision. NEEDS OPHTHO
114
What are the components of the STAMP mnemonic for the treatment of acute angle closure glaucoma?
Supine position Timolol Acetazolamide Mannitol Pilocarpine
115
Neonatal jaundice within how many hours of birth or after how may weeks is ALWAYS pathologic?
Less than 24 hours or persists longer than 2 weeks
116
When does physiologic neonatal jaundice tyically develop?
After the first 24 hours of birth, but within the first week
117
When does physiologic neonatal jaundice tyically develop?
After the first 24 hours of birth, but within the first week
118
What is the most common cause of neonatal jaundice?
Liver immaturity
119
When does malrotation with volvulus usually present?
age 3-7 days
120
Pyloric stenosis is rarely present after what age?
3 months
121
What are the metabolic derangements that are typically seens with pyloric stenosis?
Hypochloremic hypokalemic, metabolic alkalosis
122
What is the risk of untreated Hirschprung's disease?
Toxic megacolon
123
What is the test to perform on neonatal stool to tell the difference between blood from mother vs necrotizing enterocolitis fetal blood?
APt test
124
Painless rectal bleeding in an otherwise well appearing infant = ?
Meckel's diverticulum
125
Whare are the s/sx of Rey'es syndrome?
Rash Vomiting Encephalopathy cirrhosis
126
What is the treatment for mild omphalitis?
IV abx and admission, discuss with peds surgery
127
Which type of hallucinations are more associated with a medical cause of psychosis, rather than an organic one: visual vs auditory?
Visual = medical cause
128
What is somatiation disorder?
Patient has physical complaints as a result of an underlying psychological condition
129
What is the "antidote" for serotonin syndrome?
Cyproheptadine
130
What is the "antidote" to NMS?
Dantrolene
131
What are the components of the DOPE mnemonic for troubleshooting a vent?
Dislodgement Obstruction PTX Equipment failure
132
True or false: legionella is not spread person to person
True
133
Pneumonia with GI s/sx =?
Legionnaire's disease
134
Is anthrax contagious?
Only the cutaneous form
135
What are the CXR findings associated with Anthrax?
Widened mediastinum
136
What are the components of the INH mnemonic for the side effects of INH?
Injures Neurons and Hepatocytes
137
What three labs findings are commonly found with sarcoidosis?
Anemia Elevated ACE Hypercalcemia
138
What is the equation for the A-a gradient?
[150 -(1.25 x pCO2)] - pO2
139
In an acute respiratory acidosis, every 10 mmHg change in CO2 leads to a pH change of what?
0.8
140
What is the antidote for: barbiturates
Alkaline diuresis, dialysis
141
What is the antidote for: Benzos
Flumazenil
142
What is the antidote for: CYanide
Hydroxycobalamin + sodium thiosulfate
143
What is the antidote for: ethylene glycol
Fomipizole
144
What is the antidote for: Pb
Succimer
145
What is the antidote for: Hg
DMSA
146
What is the antidote for: methanol
fomipizole
147
What is the antidote for: organophosphates
Atropine 2PAM
148
What is the treatment for a wide QRS complex caused by anticolinergics?
Sodium bicarb
149
What is the end point of titrating atropine for organophosphate poisonings?
Drying of secretions
150
What is the alcohol found in antifreeze?
Ethylene glycol
151
Which causes hypoglycemia BB or CCB?
BB
152
What is the treatment for hydrogen sulfide toxicity?
Amyl nitrate
153
Over what serum Fe level is deferoxamine indicated?
500
154
When is dialysis indicated for Li overdoses?
AMS, seizures Level over 5 (4 if CKD)
155
Vomiting early in (___) ingestion is a good sign, but bad in a (___) ingestion
Early is good for mushrooms, bad for Fe
156
What is the dose of bicarb for ASA ingestions?
3 amps in D5 running at 2-3 mlkg/hr bolus of 1-2 mEq/kg
157
Overdose of what medication causes hyperammoniemia with normal LFTs?
Valproic acid
158
Chest tubes should be placed how many levels high in a pregnant patient?
1-2 levels
159
What is the most sensitive test for detecting placental abruption after trauma?
Continuous fetal monitoring
160
How much blood in the chest is needed for a hemothorax to appear on a CXR?
300 mL
161
What are the indications for a surgical thoracotomy in a hemothorax?
More than 1500 cc out, or 200 cc/hr
162
What is the treatment for chest wall rigidity from fentanyl?
Naloxone