I like chicken, I like gravy

Question 1

Euthyroid sick syndrome

Answer 1

levels of T3 and/or T4 are at unusual levels, but the thyroid gland does not appear to be dysfunctional

seen in critically ill

Question 2

C1 esterase inhibitor deficiency

Answer 2

Causes angioedema

swellings of the intestinal mucous membrane may lead to vomiting and painful, colic-like intestinal spasms that may mimic intestinal obstruction

Question 3

Palpable purpura on buttocks/legs, joint pain, abdominal pain
(child), hematuria

Answer 3

Henoch-Schönlein purpura (IgA vasculitis affecting skin and

kidneys)

Question 4

Thrombotic
thrombocytopenic
purpura pathogenesis

Answer 4

Inhibition or deficiency of ADAMTS 13

↓ degradation of vWF multimers–> plt aggregation –> thrombosis

Question 5

Thrombotic
thrombocytopenic
purpura s/s

Answer 5

pentad of neurologic and renal symptoms, fever, thrombocytopenia,
and microangiopathic hemolytic anemia.

Labs: schistocytes, ↑ LDH.

Question 6

Thrombotic
thrombocytopenic
purpura rx

Answer 6

Treatment: plasmapheresis, steroids.

Question 7

Immune

thrombocytopenia purpura

Answer 7

Anti-GpIIb/IIIa antibodies–> splenic macrophage consumption of
platelet‑antibody complex.

Commonly due to viral illness.

Question 8

Immune

thrombocytopenia s/s and rx

Answer 8

Labs: ↑ megakaryocytes on bone marrow biopsy.

Treatment: steroids, IVIG, splenectomy (for refractory ITP).

Question 9

Purpura fulminans

Answer 9

many causes, but ultimately is due to defects in the protein C anticoagulant pathway.

DIC, purpura, hemorrhagic skin necrosis –> often fatal

Question 10

Lymphangiosarcoma

Answer 10

malignant tumor which occurs in long-standing lymphedema.

progresses from bruise appearance to ulcer

Question 11

E histolytica causes?

Answer 11

Protozoan; amebic dysentery (bloody poo) and liver abscess

Question 12

Croup Rx for airway inflammation

Answer 12

nebulized racemic epinephrine and steroids

Question 13

Necrotizing surgical infection s/s and rx

Answer 13

• intense pain
• decreased sensitivity
• cloudy grey discharge
• +/- crepitus

rx: abx and debridement

Question 14

Akathisia rx

Answer 14

↓ anti-psych dose
B-Blocker
Benzodiazepine
Benztropine

Question 15

HELLP

Answer 15

Hemolysis
Elevated Lfts
Low Platelet

Question 16

HELLP rx

Answer 16

delivery 
-- if >34 weeks
-- or deteriorating mom/ baby 
Mag- sz
Anti-HTN

Question 17

Most common brain tumor in kids

Answer 17

1- Astrocytoma

2- Medulloblastoma (posterior fossa)

Question 18

Ependymoma

Answer 18

glial cell tumor of ventricles (often 4th) –> hydrocephalus

Question 19

Lone A-Fib

Answer 19

1 episode of AF that spontaneously converted to NSR

CHADVASc= ~ 0

Low embli risk, no rx

Question 20

Exercise induced asthma rx

Answer 20

albuterol 10 min before workout (if not using daily)

If working out daily, inhaled steroids

Question 21

When does a 1st degree heart block need further work up

Answer 21

if QRS is also wide

may indicate bundle block

Question 22

Femoral nerve region of sensory

Answer 22

Medial side of entire leg

Also does motor for anterior thigh compartment

Question 23

Use dependance widening of QRS may be due to?

Answer 23

Class 1 antiarrhythmics (1C the most)

Question 24

2nd trimester quad screen

What is special in downs syndrome?

Answer 24

↑ HCG and inhibin

Question 25

Mild hypercalcemia in context of bony mets. Rx?

Answer 25

Bisphosphonates

inhibits osteoclasts, stabilizes destructive bone tumors, prevents fxs

Question 26

2nd trimester quad screen

What is special in Trisomy 18

Answer 26

Normal Inhibin

↓ HCG

Question 27

Hepatic biopsy findings in CHF

Answer 27

sinusoidal congestion, hemorrhagic necrosis

Question 28

Test of choice to ddx chronic lymphocytic leukemia

Answer 28

flow cytometry to look for monoclonal b cells

Question 29

Bugs that cause UTI w/ urinary catheters

Answer 29

E Coli
Klebsiella
Proteus Mirabilis

Question 30

Factious hyponatremia

Answer 30

inappropriate diuretic use