HWK SB2 (-6)

Question 1

what is separation anxiety?

Answer 1

= marked fear of being separated

-often younger kids, but it’s possible to see this at any age

Question 2

how to tx appendiceal abscess?

Answer 2

IVF, ABX, NPO, appendectomy

Question 3

until what age do you automatically test sexually active young adults for G/C @ every visit?

Answer 3

age < 24 yo

Question 4

what exercises aren’t allowed during nL pregnancy?

Answer 4

• contact sports
• high risk of falling (eg. gymnastics, skiing, etc)
• hot yoga
• scuba diving

Question 5

which factors are decr by warfarin?

Answer 5

• factors 2, 7, 9, 10

- proteins C & S

Question 6

how does exertional heat stroke present?

Answer 6

T > 104F (>40C) + AMS

Question 7

What are the components of the glasgow coma scale?

Answer 7

1. eye opening
2. verbal response
3. motor response

Question 8

what does the CSF look like in guillain-barre?

Answer 8

• incr protein
• nL WBC and glucose
• no blood

Question 9

how can Asherman synd present?

Answer 9

• abn uterine bleeding
• amenorrhea
• infertility
• cyclic pelvic pain
• h/o repeated miscarriages

Question 10

what class of meds do you avoid in bipolar pts b/c they can incr mania?

Answer 10

SSRIs

Question 11

what is the 1st line tx for acute bipolar depression?

Answer 11

1. quetiapine (2nd gen antipsychotic)

2. lurasidone (2nd gen antipsychotic)

Question 12

why must you give adequate pain control for pts w/ rib fracture?

Answer 12

adequate pain control –> decr hypoventilation –> decr risk of developing atalectasis and pneumonia

Question 13

what is the timeline for EtOH withdrawal?

Answer 13

12-24 hr = s/s hangover
12-48 hr = hallucinations and/or siezures
48-96 hr = DTs

Question 14

Expected Fe study results in Fe def anemia vs thalassemias?

Answer 14

MCV FE TIBC Ferritin Sat
Fe –> decr decr incr decr decr
T –> DECR incr decr incr INCR

Question 15

why is Fe nL/incr in thalassemias?

Answer 15

incr RBC turnover

Question 16

other than incr Fe what other lab will be elevated in thalassemias?

Answer 16

• reticulocyte count

- total bilirubin

Question 17

if Fe is decr what will TIBC be incr/decr?

Answer 17

incr (b/c more available binding sites)

Question 18

what is the nL range for Fe?

Answer 18

50-170

Question 19

how does acute mesenteric ischemia present?

Answer 19

acute abdoment + rectal bleeding

Question 20

how does chronic mesenteric ischemia present?

Answer 20

• crampy abd pain after meals
• wt loss
• pt will avoid eating

Question 21

what does SOAPBRAIN MD stand for?

Answer 21

Serositis
Oral ulcers
Arthritis
Photosensitivity
Blood abn (CBC abn)
Renal 
ANA
Immunologic (anti-dsDNA, anti-smith antibodies)
Neuro (AMS, seizures)
Malar rash
Discoid rash

Question 22

what is the difference btwn cirrhosis and adrenal insufficiency affects on sexual f(x)?

Answer 22

cirrhosis –> gynecomastia, testicular atrophy

adrenal insufficiency –> ED

Question 23

how does vertebral osteomyelitis present?

Answer 23

• FEVER
• back pain
• FOCAL SPINAL TENDERNESS

Question 24

Ddx focal tenderness over spine

Answer 24

• vertebral osteomyelitis
• vertebral cancer (prostate or breast ca mets)
• multiple myeloma
• vertebral compression fracture

Question 25

what specific muscle group can you strengthen to limit knee OA progression?

Answer 25

quads

Question 26

how do you distinguish between premature adrenarche, premature thelarche, and precocious puberty from one another?

Answer 26

Premature adrenarche = nL bone, early breast Premature thelarche = nL bone, early breast Precocious puberty = bone maturity, incr FSH/LH, adv developement

Question 27

how will a lacunar stroke present?

Answer 27

FND that does not generally develope incr ICP (no n/v/HA/AMS)

Question 28

how will an intracranial hemorrhage typically present?

Answer 28

1. FND --> 2. incr ICP (n/v, HA, AMS)

Question 29

how will pleural effusion 2/2 pneumonia present?

Answer 29

- small/mod volume that is stable in size - on POD 1 or 2 - NO respiratory s/s

Question 30

how can most pleural effusions 2/2 CABG be managed?

Answer 30

watchful waiting. will generally self-resolve

Question 31

what is laryngomalacia?

Answer 31

- supraglottic tissue collapse | - presents as stridor when supine (babies)

Question 32

what is the timeline for larygomalacia presentation?

Answer 32

- stridor peaks at 4-8 mos old | - self-resolves by 18 mos old

Question 33

how does black widow spider bite present?

Answer 33

local + systemic presentation (injected toxin)

Question 34

what local s/s does black widow spider bite present w/?

Answer 34

- painless lesion | - does not form deep ulcer

Question 35

what systemic s/s are seen w/ black widow spider bite?

Answer 35

-n/v -muscle pain -abd rigidity muscle cramps

Question 36

how does a brown recluse spider bite present?

Answer 36

- local s/s only! | - lesion = painful, deep, expanding ulcer --> eschar

Question 37

what is the drug of choice for infective endocarditis in IVDU?

Answer 37

vancomycin

Question 38

when do you start supplementing Fe (to prevent anemia) in infants?

Answer 38

pre-term = day 1 | full term = age > 4mos

Question 39

what is the 1st line tx for migraine in kids age < 12 yo?

Answer 39

- acetominophen - NSAIDS - supportive tx (triptans = 2nd line)

Question 40

what mimics sarcoidosis and should be r/o prior to starting steroids?

Answer 40

fungal infections (histoplasmosis, blastomycosis, coccidiomycosis)

Question 41

what is the MCC spontaneous lobar hemorrhage in elderly pts?

Answer 41

cerebral amyloid angiopathy | assoc. w/ alzheimer's dz

Question 42

how do cardioembolic strokes present?

Answer 42

1. stuttering course --> 2. FND

Question 43

imaging findings on cardioembolic stroke = ?

Answer 43

multiple ischemic intensities @ grey-white matter junction

Question 44

what does trichophyton rubrum cause?

Answer 44

- ringworm - tinea pedis - tinea manuum

Question 45

what is herpetic whitlow?

Answer 45

HSV infec of hand s/p genital ulcer contact

Question 46

how to decr kidney stone recurrence?

Answer 46

- incr IVF - decr Na intake - thiazide diuretics - KCitrate (incr pH of urine) - HCO3-salt (incr pH of urine)