HY Associations

Question 1

Reversal agent in severe respiratory depression on opioids for pain control

Answer 1

Naloxone

Question 2

DOC in the treatment of an oncology patient with copious vomiting

Answer 2

ondansetron

Question 3

Plt count is 50k 6 days after surgery, it was 140k initially. Dx & tx?

Answer 3

HIT

Tx: d/c heparin/LMWH
switch to argatroban (Thrombin IIa inhibitor)

Question 4

Treatment of postop CVA tenderness, fever, and pyuria?

Answer 4

Ciprofloxacin –Fq
(pyelonephritis)

Ceftriaxone if resistant to E.Coli

Question 5

Treatment combination for most GI infections?

Answer 5

Ciprofloxacin + Metronidazole

Question 6

Baby with abdominal distension, extensive drooling, & maternal polyhydramnios. Dx?

Answer 6

Esophageal Atresia with TEF

Question 7

Infertility, bag of worms sensation on palpation of the testicles

Answer 7

Varicocele

Question 8

Double bubble sign on XR, newborn with Down’s syndrome. Dx?

Answer 8

Duodenal atresia (poor recanalization)

same sign seen in midgut volvulus btw

Question 9

GI organs extruding through the umbilicus, sealed with peritoneum ____

Extruded GI organs to the right of midline, not sealed with peritoneum _____

Answer 9

omphalocele

gastroschisis

Question 10

Bilious emesis in a newborn, abdomen not distended, double bubble on X-ray

Answer 10

Malrotation

Question 11

3 yo with bright red blood per rectum & lower abdominal tenderness? dx?

Answer 11

Meckel’s diverticulum
(vitelline duct persists, gastric mucosa)

Tm-99-Pertechtinate scan

Question 12

Infant with scaphoid abdomen & severe respiratory issues at birth

Answer 12

Congenital diaphragmatic hernia

Prenatally CDH: antenatal glucocorticoids

Postnatally: IVFs/’lytes→ fix hypoxia (intubation) + surfactant <34w→ NGT→ surgical repair (thoracotomy or laparotomy)

Question 13

10d old infant w/ exposure to erythromycin, has non-bilious vomiting & olive mass. dx & tx?

Answer 13

Pyloric stenosis

Pyloromyotomy (or ballon dilation)

Question 14

DOC in the treatment of red eye and fever in a contact lens wearer?

Answer 14

topical FQ (anti-pseudomonal)

Question 15

NBSIM of severe eye pain, slit lamp exam shows dendritic ulcers-

Answer 15

Acyclovir (HSV Keratitis)

Question 16

Cherry red spot on fundoscopic exam, decreased retinal blood vessel size, painless monocular vision
loss. Dx & Tx?

Answer 16

Central retinal artery occlusion

ocular massage, hyperbaric oxygen, thrombolytics

Question 17

Funduscopic exam reveals hemorrhage, increased retinal blood vessel size, painless monocular vision loss, “blood and thunder appearance”, edema, cotton wool spots. Dx & Tx?

Answer 17

Central retinal vein occlusion (photocoagulation)

Question 18

35 yo F, with multiple neuro deficits separated in space and time presenting with severe eye pain/sudden loss of vision. Dx & Tx?

Answer 18

optic neuritis (MS)

High-dose glucocorticoids

Question 19

35 yo M punched in the eye, restricted upward gaze, loss of sensation in the “inferior eyelid” Dx & next step in management?

Answer 19

Orbital floor fracture

(get a coronal CT)

Question 20

35 yo F has a “foreign body” sensation in the eye, recent makeup use. Dx & Tx?

Answer 20

Corneal abrasion

NSAIDs, abx

Question 21

MVA, patient’s leg is shortened, internally rotated, and adducted. Dx?

Answer 21

Posterior hip dislocation

Question 22

Pt  w/ fever, drooling, submandibular tenderness,
“raised floor of the mouth” 
dysphagia, trismus,
stiff neck,
Airway obstruction may occur! 
Dx & Tx?

Answer 22

Ludwig’s angina

penicillin- peptidoglycan cross-linking of cell wall inhibitor

Question 23

Pt w/ respiratory distress, uvula deviation, muffled voice, dysphagia, unilateral cervical lymphadenopathy. Dx, imaging & Tx?

Answer 23

Peritonsillar abscess (secure airway if compromised)
Contrast CT
ABxs +/- FNA or I &D

Question 24

Pt w/ fever, pneumatic otoscopy reveals a bulging, erythematous tympanic membrane. Dx?

Answer 24

otitis media

Question 25

Conductive hearing loss, pneumatic otoscopy reveals middle ear fluid, NO fever.

Answer 25

otitis media w/effusion

Question 26

Seen in congenital rubella, continuous machine like murmur, treated with indomethacin (NSAID)

Answer 26

Patent ductus arteriosus