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HIGH YIELD > HIGH YIELD > Flashcards

HIGH YIELD Flashcards

1
Q

What post-MI complication presents ~1 week out with a “step-up” in oxygenation from RA to RV? Which with an equalization of pressures (PCWP=RA=RVEDP=LVEDP)

A

VSD –> step-up

tamponade –> equalization

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2
Q

Contrast/compare cluster HA vs paroxysmal hemicrania vs SUNCT in terms of:

  • how long last
  • how many times occur/day
  • tx
A

bCLUSTER: lasts hours, 1-8x/day, O2, verapamil
p. HEMICRANIA: lasts ins, 1-40x/day, indomethacin
SUNCT: lasts secs,1-200x/day, lamotrigine

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3
Q

what is SE of topiramate?

A

kidney stones

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4
Q

compare the dix-hallpike for central and peripheral nystagmus with regards to direction, latency, duration and fatigable

A

CENTRAL: horiz/tors/VERTICAL, no latency, lasts >1 min, not fatiguable
PERIPHERAL: horiz/tors, up to 15 s latency, lasts

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5
Q

If someone has conductive hearing loss on the left, describe their weber and rinne.

A

affected ear on the left, Weber localizes left, BC>AC on Rinne

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6
Q

describe weber and rinner for SNL on the left.

A

weber localizes R, AC>BC on Rinne

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7
Q

give formula for NNT.

A

NNT = 1/ (ARcontr. - ARexp.)

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8
Q

compare/contrast physical exam for impingement vs AC joint degeneration

A

impingement: pain c. 60-120 abduction, + Neer, + Hawkins
degenerations: pain c 120+abduction, anterior pain, ?palpable osteophytes

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9
Q

what maneuver differentiates MVP from HOCM? How?

A

isometric handgrip increases afterload, improves outflow obstruction so makes HOCM better; worsens prolpase so makes MVP quierer

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10
Q

Give CI for TPA for

A

185/110, bleeding, s/sx of SAH

  • labs: plts 1/3 of brain, AVM/aneurysm/mass
  • histo: any h/o ICH, or ANY CVA w/in 90 days

3-4.5 above+:
age >80, any anticoag use, NIHSS >25, h/o DM + iCVA

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11
Q

give BP goals after stroke for:

  • before TPA
  • after TPA
  • if TPA is CI
A

-before TPA:

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12
Q

compare/contrast presentation of MCA and ACA stroke

A

MCA: aphasia, homnymous hemianposia, ARM > LEG

ACA: LEG>ARM, tactile agnosia

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13
Q

CVA of which major vessel (ACA, MCA or PCA) involves no motor sx/

A

PCA - just sensory loss

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14
Q

compare/contrast presentation of primary and secondary adrenal insufficiency

A

both have hypotension,fatigue, nausea; PRIMARY only should have hyperpigmentation and salt-craving/orthstasis

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15
Q

What is the CD4:CD8 ratio on BAL for sarcoid? for hypersensitivity penumonitis?

A

sarcoid: >3.5
HP:

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16
Q

Nonsmoking worker (farmer, bird fancier, cheese factory worker) p/w flu-like sx, nl IgE, no eos and intersitiaonl lung pattern on CXR.

A

hypersensitivity pneumonitis

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17
Q

vesicles on the ear drum and PNA – what type PNA?

A

mycoplasma PNA

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18
Q

PNA with hemolytic anemia – what type PNA?

A

mycoplasma

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19
Q

PNA with widened mediastinum and hemoptysis – what type PNA? tx?

A

anthrax, tx with cipro

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20
Q

give CURB 65 score and admission critieria

A 
Confusion
Uremia >19
RR >30
BP 25
2+ -- > admit
21
Q

give lights criteria.

A

LDH >2/3 ULN
Pl LDH: s LDH .0.6
Pl p: S p 0.5

22
Q

name 3 things that cause v. low glucose in pleural effusion

A

RA – 0ish

Tb

23
Q

when do you do pleurodesis for PTX?

A

1st episode of secondary PTX (eg bullous disease in COPDer)

24
Q

give PFTs for obstructive and restrictive dz

A

obstructive: FEV1/FVC 80

25
Q

draw the loops for fixed obstruction, extra-thoracic, intra-thoracic.

A

if O centered on X-axis –> fixed (goiter, stricture, tumor)
if O above X-axis –> extra (cord paralysis)
if O below X-axis–> intra tracheomalcia

26
Q

what is tx for asthma wiht ASA use and nasal polyps

A

leukotriene modifiers (montelukast)

27
Q

whioch ICS is good in pregnancy?

A

budesonide

28
Q

give medication options for intermittent, mild persistant, mod persistant and severe persistant asthma.

A

intermittent: SABA
mild persist: LICS
mod persist: LICS + LABA or MICS or MICS + LABA
severe persist: HICS+LABA

29
Q

at what FEV1 should pts e on a LABA or LAMA? on LABA+LAMA+ICS?

A
30
Q

True/false: pulmonary rehabilitation confers a mortality benefit in COPD patients.

A

False — improves Q of Life and exercise tolerance

31
Q

True/false: smoking cessation confers a mortality benefit in COPD patients.

A

true duh

32
Q

True/false: flu vaccination confers a mortality benefit in COPD patients.

A

true

33
Q

panniculitis + lung dz

A

alpha 1 antitrypsin

34
Q

what part of the lung is affected by alpha 1 antitrypsin

A

lower

35
Q

t/f. alpha 1 antitrypsin does not affect fertility.

A

true

36
Q

what PaO2 qualifies for home O2?

A

55 or less or 59 or less with cor pulmonale (may give you elevated hct)

37
Q

describe the fleishner criteria.

A

low-risk pateint:
none for 8

high-risk pt:
12 mos for 8

38
Q

how is DLCO changed in pulm HTN?

A

low

39
Q

what presents as a mass-like infiltrate with broad-based budding yeast?

A

blastomycoces

40
Q

what are tx options for histo?

A

itraconazole

ampho

41
Q

how do you calculate rapid shallow breathing index? what is ratio?

A

RR/TV

42
Q

what is the significance and normal value of a peak pressure? plateau pressure? what does it signify if both are elevated? if the peak increases while the plateau doesn’t?

A

peak = airway resistance
plateau (nl 30) = lung/chest wall compliance

both elevated: ptx, r mainstem
peak only: mucus plugging, inadequate sedation

43
Q

what is goal PaO2 on vent?

A

55-80

44
Q

60 yo M on MV: RR 12 TV 6 mL/KG, FiO2 45%, PEEP 5, plateau 18. ABG 7.23/58/50

A

increase TV until plateau 30

increase FiO2

45
Q

60 yo M on MV: RR 12 TV 6 ml/KG, FiO2 100%, PEEP 8, plateau 22. ABG 7.38/43/50

A

increase PEEP

46
Q

60 yo M on MV: RR 14, TV 10 ml/KG, FiO2 55%, PEEP 5, plateau 38. ABG 7.38/43/65

A

decrease TV

47
Q

what is tx for stenotrophomonas?

A

bactrim

48
Q

what is tx duraiton for VAP?

A

8 days

49
Q

give tx for serotonin syndrome, malignant hyperthermia and NLMS.

A

SS: cyprohetadine
MHT: dantrolene
NLMS: bromocriptine

HIGH YIELD (1 decks)

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