hammer21 Flashcards
What is the presentation, pathophysiology of Reye syndrome?
Hyperammonemia, transaminitis, coagulopathy, vomiting and mental status change. Microvesicular fatty infiltration and hepatic mitochondrial dysfunction. Elevated transaminases, PT, INR, PTT and ammonia
What is the presentation of carbon monoxide poisoning?
Headache, nausea, abdominal discomfort, pinkish red hue on examination confirmed by carboxyhemoglobin level.
What causes rapidly developing hyperandrogenism? What is the next step in evaluation and what do results mean?
Androgen secreting neoplasm of the ovary or adrenal glands. Measure serum testosterone and DHEAS. Elevated testosterone with normal DHEAS suggests an ovarian source, whereas elevated DHEAS suggests an adrenal source.
What is the presentation of Kallman syndrome, chromosome number?
Delayed/absent puberty and anosmia. 46 XX. Low FSH and LH 2/2 gonadotropin releasing hormone deficiency.
Where does medulloblastoma occur? What symptoms?
Posterior fossa tumor, typically arises from the cerebellar vermis, resulting in truncal and gait ataxia. Due to proximity to the fourth ventricle, obstructive hydrocephalus and signs of increased ICP.
Where is the level of Block for Mobitz type I? Response to Atropine/exercise? Vagal maneuvers (carotid sinus massage), risk of complete heart heart block?
AV node. Narrow QRS. Atropine improves it. Vagal maneuver worsens type I AV block.Low risk of heart block
Where is the level of Block for Mobitz type II? Response to Atropine/exercise? Vagal maneuvers (carotid sinus massage), risk of complete heart heart block?
Below the level of AV node. Atropine worsens type II AV block. Vagal maneuvers improve type II AV block. High risk of heart block, required pace maker.
What is the cause of NPH?
Decreased CSF absorption
What is a sensitive marker for SLE?
antinuclear antibody
How long does a cough have to happen to be considered chronic? What is a suspected etiology in nocturnal cough and test do yo do?
> 8 weeks. Asthma so do spirometry
What is the treatment for Wolf-Parkinson-White patients with afib?
If hemodynamically unstable, electrocardioversion. If stable, rhythm control with anti-arrhythmic drugs like procainamide, ibutilide
What is the management in a patient who has hyperthyroidism but low RAIU uptake?
Measure serum thryoglobulin. If high, thyroiditis, iodine exposure, release of preformed hormone. If low, exogenous hormone.
What is the first step after identifying a VSD in a child?
Echocardiography to determine the location and size of defect
What is the presentation of jejunal atresia? What are risk factors?
Biolious vomiting and abdominal distension. Triple bubble sign and gaseless colon. Risk factors - prenatal exposure to cocaine and other vasoconstrictive drugs
What is the most common cause of lower GI bleeding in adults? What are associated symptoms?
Diverticulosis. Painless bleeding with lightheadedness and hemodynamic instability
What two values are lowered in cardiogenic shock?
Cardiac index and mixed venous oxygen saturation
What two values are elevated in septic shock?
Cardiac index and mixed venous oxygen saturation
What is the presentation of embolic strokes? Which patients do they occur in?
Maximal onset of symptoms at the beginning. In patients with a history of structural cardiac disease. Patients with afib PLUS existing structural cardiac heart disease have an increased risk of cardioembolic stroke.
What do acute appendicitis pateints with a classic presentation immediately have?
Immediate appendectomy
What is the most common cause of cardiac arrest in the immediate post MI period?
Reentrant ventricular arrhythmias like vfib
What is the management of dumping syndrome?
Small frequent meals, replace simple sugars with compex carbohydrates, incorporate high fiber-protein rich foods
What is the management of Group A strep in children?
Confirm with rapid strep antigen test before antibiotic initiation. Penicillin and amoxicillin for treatment
Which portion of brain is affected in Huntington’s chorea?
Caudate nucleus
What nerve controls corneal sensation?
V1 ophthalmic branch of trigeminal nerve