General

Question 1

Decompression sickness can cause?

Answer 1

Pathophysiology (in diving)
The pressure increases as the diver dives deeper → more oxygen and nitrogen are dissolved in the blood.
During normal ascent → pressure decreases and the tension of gas in the blood exceeds the surrounding pressure → dissolved nitrogen changes back into its gaseous form → the gas is exchanged with the lungs and breathed out.
In rapid ascent → formation of nitrogen gas bubbles within the blood vessels → insufficient time for the gas to be released via the lungs → gas bubbles remain in circulation and obstruct proper blood flow → air embolism
Clinical features
Prodromal stage: malaise, fatigue, anorexia, headaches
Later stages
Muscle and joint pain
Pruritus
Cutis marmorata (a mottling, reticular skin rash)
Neurological defects
Chest pain and dyspnea
Can be lethal
Treatment
Hyperbaric, 100% oxygen
Hydration
Positioning maneuvers (left lateral decubitus and lowering the head zone of the bed)
Prevention
Avoid situations with rapid decline of barometric pressure
Follow diving safety guidelines

Question 2

Hypervolemic or Euvolemic Hypotonic Hyponatremic Treatment

Answer 2

Fluid restriction and diuretics

Question 3

Pt gets supplemental O2, midazolam and paracervical lidocaine block for D&C. She reports numbness of lips and twitching of hands with pulse ox of 99%. What med is causing this?

Answer 3

Lidocaine

Question 4

CYP Inhibitors. Who are they and what would they do to warfarin?

Answer 4

CYP Inhibitors include: 
Tylenol + NSAIDS
Antibiotics & Antifungals
Amiodarone
Cemetidine
Omeprazole
Cranberry + Ginko + Vitamin E
SSRIs
Thyroid Hormone
Increase Warfarin's effect (Increased bleeding risk)

Question 5

CYP Inducers. Who are they and what would they do to warfarin?

Answer 5

CYP Inducers:
-Carbamazepine, Phenytoin, and Phenobarb
-Ginseng, St. Johns Wort
-OCPs
-Rifampin
Decrease effect of warfarin
InDucers=D=decrease effect.

Question 6

Vitamin A Deficiency causes?

Answer 6

Night blindness and dry skin

Question 7

Vitamin B1 deficiency

Answer 7

Thiamine.
Beriberi: peripheral neuropathy + heart failure (dialated cardiomyopathy, high output CHF)
Wernicke-Korsakoff syndrome

Question 8

Vitamin B2 deficiency

Answer 8

Riboflavin (flava-flav!)
Angular stomatitis, cheliosis, corneal vascularization
Normocytic anemia
Sebhorric dermatitis

Question 9

Vitamin B3 deficiency

Answer 9

Niacin (pelican Pellagra)

3D’s: Diarrhea, Dementia, Dermatitis + glossitis

Question 10

Vitamin B5 deficiency

Answer 10

Pantothenate. Dermatitis, enteritis, alopecia, adrenal insufficiency

Question 11

Vitamin B6 deficiency. Required co-admin with what med?

Answer 11

Pyridoxine.
Cheliosis, stimatitis, irritability, confusion, depression, convulsions.
Give with INH

Question 12

Vitamin B9 deficiency

Answer 12

Folate. megaloblastic anemia

Question 13

Vitamin B12 deficiency

Answer 13

Cobalamin. Megaloblastic anemia. Neurologic deficits: confusion, paresthesias, ataxia

Question 14

Vitamin D deficiency in kids causes?

Answer 14

Rickets. (bending bones, hypocalcemic tetany

Question 15

________ is a destructive and expanding growth consisting of keratinizing squamous epithelium in the middle ear and/or mastoid process. Ccan result in the destruction of the bones of the middle ear (ossicles), as well as growth through the base of the skull into the brain. They often become infected and can result in chronically draining ears. Treatment almost always consists of surgical removal.

Answer 15

Cholesteatoma

Question 16

What is DRESS, what drugs are associated?

Answer 16

DRESS syndrome (Drug-induced hypersensitivity syndrome, Drug rash with eosinophilia and systemic symptoms)
(Abbreviations: DRESS, DIHS)
A severe hypersensitivity reaction that occurs 2–8 weeks after exposure to drugs such as antiepileptic agents (e.g., phenobarbital, carbamazepine), allopurinol, or sulfonamides. Characterized by fever, lymphadenopathy, a diffuse rash, facial edema, and eosinophilia. Can also lead to multiple organ failure.