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High Yield Flashcards

1
Q

Low risk criteria for BRUE (name 5)

A
  1. Age >60 days
  2. Born >=32 weeks gestation and CGA >=45 weeks
  3. No CPR by trained provider
  4. Duration <1 minute
  5. First event
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2
Q

PECARN Indications for CT

A

AMS
GCS <15
Palpable/Basilar skull fracture

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3
Q
  1. Name 2 Contraindications to activated charcoal (AC)
  2. Name 3 reasons cases when AC is ineffictive
A
  1. AMS, or unable to protect airway
  2. Periodic table elements, corrosive substances, rapidly absorbed liquid ingestions
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4
Q

Name the antidote:
3. Toxic alcohols (methanol, ethylene glycol)
4. Organophosphate
5. Methemogloninemia
6. Iron
7. Cyanide

A
  1. Fomepizole (ethanol)
  2. Atropine, pralidoxime
  3. Methylene blue
  4. Deferoxamine (chelation)
  5. Cyanokit
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5
Q

Indications for NAC (name 4)

A
  1. 4 hour level > cutoff
  2. Single ingestion > 150mg/kg or > 7.5g
  3. Unknown time of ingestion and level > 10mcg/mL
  4. Abnormal AST/ALT or coags
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6
Q

Shwachman-Diamond Syndrome
1. Findings (name 4)
2. Genetics

A
  1. Neutropenia (bone marrow failure), steatorrhea (pancreatic insufficiency), FTT, skeletal abnormalities (metaphyseal dysplasia)
  2. Autosomal recessive
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7
Q

Spherocytosis
1. Definitive test
2. Screening calculation
3. Inheritance

A
  1. Eosin-5-maleimide (EMA) aka epithelial membrane antigen binding
  2. MCHC/MCV ratio >0.36
    Mean corpuscular hemoglobin concentration, Mean corpuscular volume
  3. 1/3 de novo, 75% AD, 25% AR
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8
Q

Smith-Lemli-Opitz
1. Inheritance
2. Exam
3. Cause

A
  1. AR
  2. LBW, microcephalic, bitemporal narrowing, hypertelorism, ptosis, epicanthal folds, large, low set rotated ears, cleft palate, micrognathia, poly/syndactyly, underdeveloped male genitalia, retardation, FTT
  3. Cholesterol mutation, 7-de hydro cholesterol reductase
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9
Q

Fragile X
1. Findings
2. Genetics
3. Cause

A
  1. Macrocephaly, large protruding ears, prominent jaw, elongated facies, macroorchidism, joint laxity. ASD/intellect disability.
  2. X-link dominant
  3. Trinucleotide repeat expansion
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10
Q

Russell-Silver
1. Findings

A
  1. IUGR, triangular shaped facies, hemihypertrophy.
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11
Q

Trisomy 18
1. Findings

A
  1. IUGR, hypotrophy, hypotonia, microcephaly, micropthalmia, clenched hands, rocker-bottom feet, delays, FTT.
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12
Q

Name 4 types of B-cell primary immune deficiencies (PIDs)

A
  1. X-linked agammaglobulinemia
  2. Common variable immunodeficiency
  3. Selective IgA deficiency
  4. IgG subclass deficiencies
  5. Hyper IgM (reduced IgG + IgA)
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13
Q

Name 4 types of T Cell immunodeficiencies with partial defects

A
  1. DiGeorge
  2. X-linked Hyper IgM syndrome
  3. Wiskott-Aldrich
  4. Ataxia-telangiectasia
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14
Q

Name 5 neutrophil/phagocyte function disorders

A
  1. Chronic granulomatous disease
  2. Leukocyte adhesion defects
  3. Chediak-Higashi
  4. Cyclic neutropenia
  5. Schwachman-Diamond
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15
Q

Typical age of presentation of PIDs

A
  1. T Cell - 1 month (SCID) to 3
  2. Neutrophil - early infancy
  3. B Cell - late infancy (after 6mo when maternal Abs wear off), early childhood (most common type!)
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16
Q

Name the 4(+) stages of pressure ulcer

A
  1. Intact skin, nonblanching erythema
  2. Partial thickness injury, dermis exposed. Often pink, red or moist. No slouch/eschar.
  3. Full-thickness, adipose exposed, +slough/eschar. No underlying structures
  4. Exposure of fascia, muscle, tendon, ligament or bone.
    Unstageable. Stage 3 or 4 obscured by eschar
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17
Q

Name 4 types of RTA

A
  1. Distal RTA (I), can’t excrete H+, excrete K+ instead, hypokalemia
  2. Proximal RTA (II), inability to reabsorb bicarb (Seen in Fanconi syndrome)
  3. Mixed RTA (III), osteopetrosis
  4. Hyperkalemic RTA (IV), or hypoaldosteronism
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18
Q

Name 6 findings in Fanconi syndrome

A
  1. Proximal RTA (non-anion gap metabolic acidosis),
  2. Hypophosphatemia
  3. Glucosuria
  4. Proteinuria
  5. Hyperuricosuria (urine pH <5.5)
  6. Thrombocytopenia
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19
Q

Treatment of proximal RTA (name 4+)

A
  1. DC offending agent
  2. Sodium bicarb or citrate
    3 potassium salts (K citrate)
  3. K+ sparing diuretic
  4. Phosphate and Vit D (if Fanconi syndrome)
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20
Q

Name four QI measures and give an example of each

A
  1. Outcome measure - test of progress towards the project’s aim
  2. Process measure - measure of action taken
  3. Structural measure - assess capacity or infrastructure of a system
  4. Balancing measure - measure of a related outcome or process that may be affected.
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21
Q

Name the triad that characterizes McCune-Albright syndrome

A
  1. Fibrous dysplasia
  2. Cafe-au-lait spots
  3. Endocrine abnormalities (precocious puberty)
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22
Q

Define the 5 ASA Physical Status Classes

A

Class I - Healthy patient
Class II - mild systemic disease that is not limiting activity
Class III - Severe systemic disease that limits activity
Class IV - Severe systemic disease that is a constant threat to life
Class V - Substantial risk of death within 24 hours

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23
Q

What are 4 studies of correlation and when is each used?

A
  1. Linear regression - dependent variable is continuous
  2. Logistic regression - dependent variable is categorical (cannot be quantified)
  3. Pearson correlation - Analyze the linear relationship between two continuous variables
  4. Spearman correlation - evaluate relationships between ordinal variables
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24
Q

Indications for dialysis (name 5)

A

Acidosis
Electrolyte abnormalities (K, Phos)
Ingestion
Overload of fluid
Uremia

25
Q

Alport Syndrome
1. Genetics/Cause
2. Findings (2+)
3. Treatment

A
  1. X-linked most common, type IV collagen deficiency
  2. Hearing loss, hematuria=> proteinuria => ESRD
  3. ACE for renal protection
26
Q

Name 5 reasons for Renal consult in Minimal Change Disease

A
  1. > 10 yo
  2. Hypertension
  3. Gross hematuria
  4. Elevated Cr
  5. Low complement
27
Q

What is the Mentzer Index

A

MCV/RBC <13 = Thalassemia, >13 = Iron Deficiency

28
Q

What is the RDW index?

A

MCVxRDW/RBC <220 = thalassemia

29
Q

Name 6 groups at risk for Transfusion associated Graft-vs-Host Disease.

What type of pRBCs do they need, specifically.

A
  1. Congenital immunodeficiencies
  2. Neonates <4 mo
  3. Chemotherapy pts
  4. Hematopoietic stem cell transplant (past or possibly planned)
  5. Blood from a close relative
  6. Hodgkin disease

Irradiated

30
Q

What does washing pRBCs do and you when are they indicated?

A
  1. Removes plasma proteins, reducing the risk of anaphylaxis
    2 Severe allergic anaphylactic reaction to non-washed pRBCs, and pts with anti-IgA and anti-haptiglobin antibodies
31
Q

Name 4 statistical tests used for continuous variables and their proper use.

A
  1. T-test - 2 normally distributed continuous variables
  2. Anova - 3+ normally distributed continuous variables
  3. Wilcoxon Rank Sum - 2 skewed distribution continuous variables
  4. Krystal-Wallis - 3+ skewed distribution continuous variables
32
Q

CGD
1. Defect
2. Presentation
3. Tests
4. Prophylaxis

A
  1. Adenine nucleotide phosphate oxidase complex
  2. Infxns w/ Catalase+ bacteria and fungi. Also FTT, diarrhea, abnormal wound healing, hepatosplenomegaly, eczematous rash
  3. Nitroblue tetrazolium reduction, dihydrorhodamine (DHR) 123 oxidation test
  4. TMP-SMX, Itraconazole, Interferon-g
33
Q

Maple Syrup Urine Disease (MSUD)
1. Deficiency
2. Result
3. Presentation

A
  1. Branched-chain a-keto acid dehydrogenase
  2. Isoleucine, valine, leucine (branch chained AAs) build up (AG met acidosis)
  3. Maple syrup smell of urine (organic acid metabolites), hypertonicity, coma (leucine), cerumen
34
Q

Beckwith-Weidemann

A

1. Hypoglycemia hyperinsulinism
2. Macroglossia
3. Ear lobe fissures

35
Q

MAS
1. Presentation
2. Lab findings

A
  1. Acute onset fevers, cytopenias, LAD, HSM
  2. Ferritin >684 + 2 of 4 (high AST, Trigs, low plts, fibrinogen)
36
Q

Calculation for free water deficit

A

4 ml x wt in kg x (desired change in Na) ie (Na-140)

37
Q

Name 3 statistical tests of categorical variables and when to use.

A
  1. Chi-squared - compare 1 or more categorical unpaired variables (large group)
  2. Fisher Exact - same as Chi2, but with smaller sample size
  3. McNemar - comparison of paired categorical variables
38
Q

Name 4 congenital infections and the findings in each.

A
  1. CMV - microcephaly, periventricular calcifications, SN hearing loss.
  2. Toxoplasmosis - diffuse intracranial calcifications, hydrocephalus, chorioretinitis, retinopathy
  3. Parvovirus B19 - hydrops, IUGR, death
  4. Rubella - IUGR, cataracts, SN hearing loss, PDA
39
Q

Granulomatosis with polyangiitis features

A
  1. Small vessel vasculitis
  2. Sinus/lung/kidney disease
  3. Saddle-nose deformity
  4. ANCA+
40
Q

Dermatomyositis (4 characteristics)

A
  1. Heliotrope rash
  2. Gottron’s papuled on fingers
  3. Proximal muscle weakness
  4. Increased muscle enzymes (CK, aldolase)
41
Q

Sjogren’s (3 findings and 2 confirmatory tests)

A
  1. Dry eyes, dry mouth, parotitis
  2. Anti-Ro and Anti-La+
42
Q

Behcet’s (3 findings)

A

Oral ulcers, genital ulcers, eye disease

43
Q

Wiskott-Aldrich
1. Genetics
2. 2 derm findings
3. Other labs/diagnosis
4. Presentation

A
  1. X-linked
  2. Eczematous derm, petechiae
  3. Low plts, elevated IgE, IgA, low IgM
  4. Infections with encapsulated orgs (combined immunodeficiency
44
Q

Acrodermatitis eneropathica
1. Defect
2. Findings (name 3)

A
  1. Inherited defect in zinc absorption
  2. Alopecia, diarrhea, erythematous plaques on cheeks/buttocks
45
Q

Histiocytosis

A

Seborrheic rash with petechiae in diaper area/scalp

46
Q

DiGeorge syndrome (name 5 findings and 1 defect)

A
  1. Cleft Palate
  2. Abnormal facies
  3. Thymic aplasia = T-cell deficient
  4. Congenital heart defects
  5. Hypoparathyroidism = hypoCa
  6. Chromosome 22q11 deletion
47
Q

SCID
1. Deficiency
2. CXR finding
3. Treatment

A
  1. Severe B, T and NK cells
  2. Absent thymus
  3. Stem cell transplant
48
Q

Ataxia-telangiectasia
1. Defect
2. Findings (3)
3. Treatment

A
  1. DNA repair deficiency
  2. Cerebella ataxia, oculocutaneous telangiectasias
  3. Leukemia/lymphoma
49
Q

Chediak-Higashi
1. Defect
2. Pathology
3. Findings

A
  1. Neutrophil chemotaxis
  2. Giant neutrophil granules
  3. Partial albinism, recurrent pyogenic skin and lung infxns
50
Q

Cyclic neutropenia
1. History
2. Findings

A
  1. Q3week neutropenia
  2. Stomatitis, AOM, abscesses
51
Q

Leukocyte adhesion deficiency
1. Defect
2. Findings

A
  1. Failure of neutrophil migration
  2. Persistent umbilical stump, abscess without pus.
52
Q

Job Syndrome
1. Labs
2. Findings

A
  1. Markedly increased IgE and eosinophils
  2. Coarse facies, dermatitis, staph microabscesses, pneumonia
53
Q

Seizure DDx - VITAMINS

A

Vascular (stroke, HTN crisis, HUS, SLE)
Infection (meningoencephalitis, abscess)
Trauma (NAT)
AV malformation
Metabolic (hypoglycemia, hypoNa, hypoCa, hypoxia)
Ingestion (Sz meds, coke, lead, TCAs, DM meds, topical anesthetic, organophosphates
Neoplasm
Sz Disorder

54
Q

Red flags for headache

A

S - Systemic illness
N - Neurological signs (asymmetric exam, sz)
O - acute onset
O - occipital location
P - Pattern (positional, valsalva, progressive, papilledema, no fam hx)
Y - <6 years

55
Q

Status Migrainosus
1. Definition
2. Treatment

A
  1. Lasting >72 hours
  2. IVF, Mag, Valproate, Steroids, Dihydroergotamine
56
Q

Contraindications for triptans

A

Arrhythmia, CAD, stroke, Hemiplegic migraine, brainstem aura, use of ergot w/I 24 hours, risk serotonin syn with SSRI

57
Q

Treatment for hypercalcemia (4)

A
  1. IVF
  2. Loop diuretics
  3. SQ calcitonin
  4. Bisphosphonates, ie pamidronate
58
Q

Which antibodies help differentiate UC from Crohn’s?

A

UC = perinuclear antineutrophil cytoplasmic antibodies (pANCA)
CD = anti-Saccharomyces cerevisiae abs (ASCA)

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