Forget me not Flashcards
When do we see positive Coombs?
Warm AIHA
Drugs that prolong QT?
Erythromycin Antihistamines Anticholinergics Antiarrthmics - Quinidine, Sotalol TCAs Fluroquinolones Chloroquine, Mefloquine, Haloperidol, Risperidone, Methadone, and HIV protease Inhibitors.
Indications for C section
Cephalopelvic disproportion Fetal Malpresentation Nonreassuring EFM strip Placenta previa Infxn - HIV or Active vaginal herpes Uterine scar
OCD first line TX
SSRI
When do we do Endoscopy?
Alarm sx’s: Wt loss, blood in stool, anemia
When do we hear succussion splash on abdominal auscultation?
Gas and fluid in obstructed organ Gastric Outlet syndrome Diaphragmatic Hernia Bronchopleural fistula Pyloric stenosis
What do we see in Cushing’s syndrome
Central Obesity Fat accumulation in cheeks, dorsocervical (hump behind neck), supraclavicular fat pads Purple striae Thinned skin Proximal muscle weakness HTN Glucose intolerance Skin hyperpigmentation (ACTH excess) HypoKalemia
Dx for Cushing’s?
24 hour cortisol excretion
Late evening salivary cortisol
Low dose dexamethasone suppression test
Acid base disturbance seen in Cushing syndrome?
Metabolic Alkalosis
Is osteoid osteoma benign or malignant?
Benign
Describe presentation of osteoid osteoma
Limb pain worse at night Responds to NSAIDs Unilateral pain Second decade of life Limp and point tenderness
Age for growing pains?
2-12 years
What does stridor sound like and what is pathophysiology?
Squeaky, whistlelike sound
Turbulence b/t supraglottis and trachea
Breath sounds in narrowing/congestion of bronchioles
Rales
Rhonchi
Wheezing
Causes of pediatric stridor?
Croup Foreign body aspiration Anatomic abnormalities - Laryngomalacia - Vascular ring
MCC of inspiratory stridor in kids?
Laryngomalacia
- increased laxity of supraglottic structures
Inspiratory stridor worse w supine position, crying or feeding, Improves in prone position, 4-8 months?
Laryngomalacia
Dx for laryngomalacia
flexible laryngoscopy - collapse of supraglottic structures w/inspiration and omega shaped epiglottis
When do we do CT neck in peds?
Retropharyngeal abscess
Tx for laryngomalacia?
Self resolves by 18 months
How is overexpression of HER2 assessed?
Oncogene amplification by FISH Immunohistochemical staining (IHC)
Why is HER2 assessment imp in breast cancer?
Tx with trastumab = Herceptin
- Targets HER2/neu
- Adjuvant anthracycline tx (doxarubicin, danarubicin)
JAK2 mutation ass’d with?
Polycythemia vera
How does late coarctation of aorta present?
Asymptomatic HTN
Chest pain, claudication, HA, Epistaxis, HF
Severe - Aortic dissection
EKG of late coarctation of aorta?
LVH
Increased voltage QRS
ST and T wave changes in precordial leads
Exam of late coarctation of aorta?
Brachial - femoral pulse delay
- BL arm and leg BP measurements
UE HTN and LE HypoTN
CXR of adult coarctation of aorta?
Ribbed notching 3rd - 8th ribs b/c of erosion of large intercostal arteries
“3” sign
Precordial leads?
Measure in horizontal plane
Anterior: V1-V4
Left Lateral: V5,V6
Vaccines CI in pregnant and immunocompromised?
Live attenuated VZV (VZIG for these individuals) MMR (can be given in HIV if certain criteria met) Intranasal Influenza Oral Polio Yellow Fever BCG Anthrax Oral Typhoid Small pox
When do we see situational syncope?
Micturition - straining
Coughing fits
Autonomic dysregulation
MCC peripheral solitary lung nodule?
Adenocarcinoma
Peripheral lung cancers?
Adenocarcinoma
Large cell
Lung cancer ass’d with galactorrhea and gynecomastia?
Large cell cancer
Herpetic whitlow presentation?
Women w/genital herpes, Children with gingivostomatitis, Healthcare worker
Throbbing pain in distal pulp space - swollen, tender
non purulent vesicle on volar surface
Presentation of Idiopathic Intracranial HTN
Holocranial HA
Visual Changes - blurry vision, diplopia, papilledema, pulsatile tinnitus
Young obese women
Management of IIH
Ocular exam
Neuroimagine - MRI
If empty sella -> LP
Most reliable indicator of metabolic recovery in DKA pts
Serum AG
Arterial pH
DVT TX
Heparin
Warfarin
Chronic or preexisting HTN in pregnancy
> 140/90 before 20 weeks
OR
beyond 12 weeks postpartum
MC risk factor for placenta abruptio
HTN
DX for Turner syndrome
Karyotype
Aplastic crisis in sickle cell presentation and TX
Transient arrest of erythropoiesis
Severe drop in Hgb
Virtual absence of reticulocytes on PS < 1%
TX: blood transfusion
Presentation of vasoocclusive crisis
Acute onset pain
Vasoocclusion b/c of sickling of cells
Caused by change in weather, Infxn, dehydration
Sickle cell pt - dramatic drop in hemoglobin and no change in reticulocytes
Splenic Sequestration
Presentation of splenic sequestration
Rapidly enlarging spleen
Presentation of severe pancreatitis
Fever, Tachycardia, HypoTN
Dyspnea, tachypnea, basilar crackles, abdominal tenderness/distension
Cullen sign=periumbilical
Grey Turner sign=flank
Risk factors for acute pancreatitis progressing to severe
Age > 75 Alcoholism Obesity CRP > 150 mg/dL at 48 hrs Increased BUN/Cr in first 48 hrs
Pathophys of severe pancreatitis
Local release of activated pancreatic enzymes = enter vascular system, increase vascular permeability - > fluid migrate to retroperitoneum
Widespread vasodilation, shock, capillary leak
TX for severe pancreatitis
Several liters of IVF for lost intravascular volume
How long does it take for pseudocyst to form after acute pancreatitis
3-4 weeks
