High Yield Flashcards
Fever / anemia / thrombocytopenia / AKI / AMS
TTP / tx is plasmapheresis with iv corticosteroids
Clonus / hyperreflexia / mydriasis / diaphoresis
Serotonin syndrome / tx with benzos, hydration/cooling, cyproheptadine
Ototoxic drugs
Aminoglycosides
Loop diuretics
Platinum chemo
Conjunctivitis in first 5 days of life
Gonococcal / tx with ceftriaxone (or cefotaxime if hyperbili)
Simple febrile seizure
6mo to 5yrs
1 in 24 hours
Duration <15 min
Generalized
Severe malaria subtype
P falciparum
Tx with IV quinine / doxy
Tx for malaria (ovale / vivax)
Primaquine
Tx for RMSF
Doxy
Babesiosis tx
Atovaquone + azithro
Ring enhancing lesions on head CT / MRI
Toxo - dx with IgM (early) IgG (late)
Tx with Pyrimethamine, sulfadiazine
Viral meningitis findings
High protein
Lymphocytes
Gram stain negative
Tx for patient with fluke (river blindness)
Ivermectin
Painless genital ulcer
Syphilis
Vdrl first
Fta second
Frothy green dc / punctuate lesions on cervix
Trichomonas
Hyponatremia
Hyperkalemia
Hypoglycemia
Adrenal crisis / addisons
Hyper / hypocalcemia
Hypercalcemia causes
Hyperparathyroidism
Malignancy
Granulomatous disease
Thiazide diuretics
Lithium
Hypocalcemia
Hypoparathyroidism
Vitamin D deficiency
Sepsis
Renal failure
Pancreatitis (causes saponification of pancreas)
Rhabdomyolysis (complexes with phosphate)
Thyroid storm meds order
Block peripheral thyroid hormone effect: Propranolol 1-2 mg IV q10min as needed
Block thyroid hormone production: Propylthiouracil (PTU) (600-100 mg orally)
Inhibit thyroid hormone release: Iodine (wait 1 h after PTU)
Inhibit conversion of T4 to T3: Dexamethasone (2 mg IV q6h)
Joint fluid wbc count
Inflammatory
Septic
Inflammatory: wbc 200-50k
Septic: >50k
Rheumatic fever major criteria
J<3NES (need 2 major)
Joints
Carditis
Nodules
Erythema marginatum
Sydenham chorea
Abdominal signs
Grey Turner
Kehr
Cullens
Grey turner: flank discoloration - hemorrhagic pancreatitis or retroperitoneal hematoma
Kehrs: L shoulder pain from spleen
Cullens: periumbilical ecchymosis
Absolute contraindications to TPA
Active bleeding
CVA within 6 mo
Hemorrhagic CVA ever
Head/spine surgery in past 2 mo
Brain tumor, aneurysm, AV malformation
Suspected aortic dissection
Antidote for arsenic, lead, mercury poisoning
BAL, DMS
Aspirin, barbiturate OD antidote
Alkaline diuresis, HD
Tx for HACE
O2, dex, descent
1+ somatic sxs that cause distress / psychosocial impairment
Xs thoughts about the sxs
>6 mo
Somatic symptom disorder
Loss of motor or sensory function often triggered by an acute stressor
Functional neurological symptom disorder (prev conversion disorder)
Minimal somatic sxs but significant distress about having or acquiring a serious illness
Illness anxiety disorder (prev hypochondriasis)
Tx for Tylenol OD 8-24 hrs after ingestion
NAC while awaiting Tylenol level, can stop after if low
Acid base disturbance pyloric stenosis
Hypochloremic metabolic alkalosis (fluid losses from stomach aka HCl)
Post transplant infections:
1st month
Months 2-6
>6 mo
1st: nosocomial (staph, strep, pseudomonas)
2-6: cmv, ebv, listeria, pneumocystis, fungi
>6: chronic cmv, ebv, hsv, hep, vzv, toxo
Cyclosporine toxicity
Hyperkalemia, nephrotoxicity
Rash, hyperbili, diarrhea post transplant
GVHD
Hemodialysis for OD
Alcohols, salicylates, lithium, theophyline
Currant jelly sputum
Klebsiella
Lobar, copd, alcoholics, diabetics
Staccato cough
Chlamydia pneumonia
Conjunctivitis in neonates
Fungi locations
Southwest
MS river valley
Southeast
Southwest = coccidiodomycosis
MS = histo
Southeast = blasto
Light criteria
Protein
pleural:serum protein
LDH
Transudate: (inc hydrostatic / dec oncotic pressure)
-protein <3
-pleural:serum protein <0.5
-LDH: <200
Exudate:
-protein >3
-pleural:serum protein >.5
-LDH >200
TOF
VSD, overriding aorta, pulmonary stenosis, RVH
Peds ACLS:
defib dose
cardioversion dose
ETT size
defib: 2J/kg
cardioversion: 0.5J/kg
ETT: (16+age) / 4 (uncuffed)
Le fort fractures
Le fort I: upper dental arch is mobile (not nose)
Le fort II: upper dental arch and nose are mobile (not zygoma)
Le fort III: entire face is mobile
Salter fractures
S = slipped
A = above
L = lower
T = through
R = ram
bennets fracture
rolando fracture
bennets: axial load with hand closed
-base of thumb at MCP joint, intra-articular w/ dislocation/subluxation of CMC joint
rolando: intra-articular metacarpal fx, no dislocation of CMC joint
*both need thumb spica and emergent ortho referral
colles fracture
most common fx in adults >50
-distal radius fx at the metaphysis, dorsal displacement
perilunate vs lunate dislocation
lunate = spilled teacup sign
lunate: lunate displaced volarly
perilunate: capitate displaced dorsally
Monteggia / Galeazzi
MUGR
Monteggia = ulnar fx
Galeazzi = radial fx
Dancer’s / Jones fractures
base of 5th metatarsal
-dancers: avulsion fx, doesn’t involve joint - ortho shoe
-jones: prox diaphysis - needs ORIF/cast
Common bugs, bone/joint infections
Neonates
IVDA
sickle cell
foot puncture
cat bites
fresh water
diabetic foot
human bite
reptile bite
Neonates: GBS
IVDA: pseudomonas
sickle cell: GNR, salmonella
foot puncture: pseudomonas
cat bites: pasteurella
fresh water: aeromonas
diabetic foot: polymicrobial
human bites: eikenella, staph/strep, anaerobes
reptile: salmonella
Nerve roots in arm; reflex, sensory, motor
C5: biceps reflex, deltoid, deltoid/biceps
C6: biceps/brachioradialis reflex, thumb/index, biceps/wrist extensors
C7: triceps reflex, long finger, triceps
C8: little finger, finger adduction
T1: medial arm, finger abduction
Nerve roots in leg: reflex, sensory, motor
L4: knee jerk reflex, medial leg, knee extension
L5: dorsum foot / big toe, foot dorsiflexion
S1: ankle jerk, lateral foot/sole, foot plantarflexion
unstable c-spine fractures
Jefferson bit off a hangman’s thumb
J: jefferson (burst fracture C1)
B: bifacet dislocation +/- fx
O: odontoid types II and III
A: any fracture/dislocation
H: hangman’s (posterior C2)
T: teardrop fx
complete motor paralysis, loss of pain/temp, vibration + proprioception preserved
anterior cord syndrome
ipsilateral weakness /loss of position/vibration + contralateral pain/temp loss
brown sequard
weakness arms >legs, some dec sensation, sacral sparing
central cord, hyperextension injury
tx for acute angle closure glaucoma
dec aqueous humor production
-topical BB (timolol)
-alpha-agonist (apraclonidine)
-acetazolamide
topical miotic
-pilocarpine (use after IOP decreased)
EOM nerves
II: optic
III: oculomotor; pupil constriction, raises eyelid, most eye motions except lateral rectus + sup oblique
IV: trochlear; sup oblique (abduction/intorsion)
VI: abducens; lateral rectus
cherry red spot on macula
CRAO; sudden painless monocular vision loss, mostly embolic
retinal hemorrhage/cotton wool spots
CRVO; more gradual onset, no acute treatment
sudden onset vision loss w/ painful eye movements + APD, unilateral optic disc edema
optic neuritis; MS until proven otherwise
brudzinskis / kernigs signs
brudzinski: flexion of hips caused by passive flexion of the neck
kernig: pain in hamstrings causes inability to straighten leg when hip is flexed to 90 deg
urine findings > renal failure type
RBC casts
WBC casts
eosinophils
granular casts
hyaline casts
RBC casts: glomerular disease > nephritis syndrome
WBC casts: interstitium > pyelo, AIN
eosinophils: interstitium > AIN
granular casts: tubule > ATN
hyaline casts: pre/post renal
HBV markers
HBsAg
HBsAb
HBeAg
HBcAb
HBsAg: active infection
HBsAb: pos after clearance of HbsAg
HBeAg: high infectivity
HBcAb: hx of HBV infection
Diving
Ascent
Descent
Ascent: air embolism, decompression illness
Descent: squeeze syndromes, nitrogen narcosis
parkland formula
4ml x kg x % BSA > 1/2 volume over first 8 hours
radiation exposure 48 hr ALC
> 1200 (v good)
300-1200 (possibly lethal)
<300 (lethal)
non-gap metabolic acidosis
HARD UP
Hypoaldosteronism
Acetazolamide
RTA
Diarrhea
Ureterosigmoidostomy
Pancreatic fistula
reed sternberg cells
hodgkin lymphoma (better survival than non-hodgkin)
