hammer Flashcards
4 Risk factors for placental abruption
Maternal HTN, Abdominal trauma, Prior placental abruption, Cocaine use
Clinical presentation for placental abruption
sudden onset vaginal bleeding, abdominal or back pain, high frequency, low intensity contractions, hypertonic and tender uterus
2 Maternal complications of placental abruption
Hypovolemic shock and DIC
Signs and symptoms of meningogcoccal meningitis (Neisseria meningitis)
Fever, headache, AMS, petechial or purpuric rash
What does a Turner patient look like 4 characteristics?
webbed neck, horseshoe kidney, carpal and pedal edema, nail dysplasia
What causes congenital lymphedema in Turner patients?
Abnormal development of lymphatic system
What is the presentation and diagnosis of Meckel’s diverticulum?
2yo with asymptomatic painless hematochezia, intusussception, intestinal obstruction, volvulus and diagnosed with Technetium 99m pertechtnetate scan
What is the pathophysiology of Meckel’s diverticulum?
Ectopic gastric mucosa
What type of EEG pattern is seen on Absence seizures?
3 Hertz spike and wave
Where does a focal seizure originate from and is there LOC?
1 cerebral hemisphere with +/- loss of conciousness
What are the 4 types of focal seizures?
Motor - Jacksonian march, turning of eyes/head/trunk
Sensory - paresthesias, vertigo, visual phenomena
Autonomic - sweating,
Psychic - Deja vu
Which disorder is Srep gallolyticus associated with?
Colonic neoplasms
Which patients between 19 - 64 get PPSV23 alone?
Chronic heart, lung, liver disease, diabetics, curent smokers, alcoholics?
Which patients between 19 - 64 get the sequential PCV13 + PPSV23?
CSF leaks, cochlear implants, sickle cell disease, asplenics, Immunocompromised, CKD
Which age group gets the sequential PCV13 + PPSV23? and in what intervals?
Age > 65, 6-12 months apart
When is Td and Tdap vaccine given?
Tdap once as a substitute for Td booster, then Td every 10 years
Which is the most common epithelial thyroid cancer and how does it spread?
papillary > 70% via lymphatics
Which is the second most common epithelial thyroid cancer and how does it spread?
follicular, hematogenously
What is the presentation of Cushing syndrome 5 symptoms?
central obesity, facial plethora, proximal muscle weakness ,abdominal striae, ecchymosis, amenorrhea, HTN
What are the 4 sideeffects of Erythropoietin therapy?
- Worsening of HTN 2. Headaches 3. Flu like syndrome 4. Red cell aplasia
What are the clinical features of Obsessive Compulsive disorder?
Obsessions which are recurrent and intrusive, anxiety prokoking and Compulsions - which are repeated behaviors or mental acts and are time consuming
How is OCD treated
- Cognitive behavioral therapy with exposure and response prevention 2. SSRI
What two medications can be used for narcolepsy?
Modafinil and amphetamine stimulants
Which narcolpesy medication reduces cataplexy?
sodium oxybate
What are pregnancy related risks of hypertension in the mother?
postpartum hemorrhage ,gestational diabetes
What are pregnancy related risks of hypertension in the fetus?
fetal growth restriction, oligohydrammnios, perinatal mortality, preterm delivery
What are signs of HIV infection in an infant ?
Failure to thrive, lymphadenopathy, thrush
When should pregnant patients with possible HIV get tested?
in 1st and 3rd trimesters since it can take upto 3 months to develop a detectable antibody
What is the diagnostic criteria for Kawasaki?
Fever more than 5 days plus >4 of the following
- B/l nonexudative conjuctivitis,
- mucositis (strawberry tongue, injected pharynx or lips)
- cervical lymphadenopathy,
- erythematous polymorphous rash,
- extremity changes
What is the comlications for Kawasaki?
Coronary artery aneurysm, MI
What is the treatment for Kawasaki?
Aspirin plus IVIG
What are the three subtypes of cerebral palsy and what is the greatest risk factor? Comorbidities
spastic, dyskinetic, ataxic - premature birth, intellectual disability
What is the treatment for catbites?
clean and treat with amoxicillin/clavulanate and Tetanus booster as indicated
What are the symptoms of herniated disk?
acute back pain that radiates to the thighs and typically below the knee with positive leg raise test
What are the symptoms of lumbosacral strain?
local tenderness and contraction of paraspinal muscles with negative straight leg test
What is the treatment for subconjuctival hemorrhage?
Nothin
What are the levels of Ca, PTH and P in GI diseases with fat malabsorption? Why are Ca and P that way?
High PTH and low Ca and low P, because Vit D mediates their absorption from the intestine and ADEK is fat soluble
What should you give patients with ischemic stroke to improve their outcomes?
Fibrinolytic therapy
What is the treatment for antiphospholipid antibody syndrome?
LMWH plus low does aspirin
What are the features of CMV esophagitis?
Deep linear ulcers at the distal esophagus
What are the electrolyte imbalances in tumor lysis syndrome?
Decreased Cacium only, increased Phosphate, K, Uric acid
What are the characteristics of Iron deficiency anemia and what can cause it in children?
Increased RDW and increased TIBC, excess cow milk intake
What is the management of blunt abdominal trauma patients who are hemodynamically unstable?
FAST exam - if positive do laparotomy, if inconclusive do DPL, if negative and no signs of extra abdominal hemorrhage - stabilize then CT, if there are signs , stabilize
What type of lesion is pronator drift and which tract is it located on?
UMN lesion located on the pyramidal/corticospinal tract
What does raising the cutoff of a test do to sensitivity and specificity?
specificity up, sensitivity down
What is the causative organism of erysipelas and what does it look like?
group A beta hemolytic strep/ sharply demarcated, erythematous ,edematous, tender skin lesion
What is seen in tissue biopsy of sarcoidosis?
non caseating granulomas
What 3 things cause symmetric fetal growth restriction?
Genetic disorders congenital heart disease, intrauterine infections
Which nerve is damaged when anterior shoulder is dislocated?
Axillary nerve
Which nerve is damaged when humerus is fractured midshaft or crutches are used?
Radial nerve
Which nerve is damaged when medial epicondyle of humerus is fractured ?
ulnar nerve
