Inservice Deck 5 - rapid board review 3

Question 1

pathogen and tx for neonate with sepsis?

Answer 1

GBS, listeria, gram negative

amp, gent

Question 2

pathogen and tx for infant with sepsis?

Answer 2

GBS, listeria, h influ, strep pneumo, n mening

vanc, cefotaxime/ceftriaxone

Question 3

pathogen and tx for child with sepsis?

Answer 3

h influ, strep pneumo, n mening

vanc, ceftriaxone

Question 4

pathogen and tx for adult with sepsis?

Answer 4

strep pneumo, n mening

vanc, ceftriaxone

Question 5

pathogen and tx for elderly with sepsis?

Answer 5

strep pneumo, n mening, listeria, gram neg

vanc, ceftriaxone, amp

Question 6

postmenopausal female with vaginal bleeding, what should you be concerned for?

Answer 6

endometrial carcinoma

Question 7

tx of thomboembolic disease in pregnant woman?

Answer 7

heparin

NO WARFARIN

Question 8

tx of eclampsia?

Answer 8

mg and antihypertensive

delivery is only definitive therapy

Question 9

first step for pregnant female who is critically ill

Answer 9

left lateral recumbent position, improves venous return

Question 10

what beta hcg levels are necessary for transvag ultrasound to see IUP?

Answer 10

1500/2000

Question 11

dx and tx of grey/yellow frothy malodorous discharge?

Answer 11

trich vag

metro or clinda

Question 12

dx and tx of fishy odor with clue cells?

Answer 12

gardnerella vaginalis

metro or clinda

Question 13

dx and tx of white cottage cheese discharge?

Answer 13

candida albicans

topical or oral antifungals (fluconazole)

Question 14

what does 1 unit PRBCs increase hgb and hct by?

Answer 14

1 unit hgb and 3% hct

Question 15

what factors does warfarin inhibit?

Answer 15

vit k dependent

2, 7, 9, 10

Question 16

what factor is hemophilia a a problem in? how do you treat? what do you see on labs?

Answer 16

abnl factor 8
normal PT and prolonged PTT
give factor 8, for major 50 u/kg

Question 17

what is the most common human enzyme defect?

Answer 17

G6PD deficiency

Question 18

what triggers the most common enzyme defect?

Answer 18

oxidant drugs (sulfa, phazopyridine, malarals, salicylates) or fava beans

Question 19

what are the signs of TTP?

Answer 19

FAT RN

fever
anemia
thrombocytopenia
renal insufficiency
neuro changes

Question 20

how do you treat ttp?

Answer 20

plasma exchange, FFP, steroids, antiplatelet

Question 21

what is the most common genetic bleeding disorder? what labs do you see?

Answer 21

von willebrand disease

nl platelet, prolonged bleeding time

Question 22

how do you treat the most common genetic bleeding disorder?

Answer 22

DDAVP
FFP
cryoprecipitate
factor 8

Question 23

patient who has malignancy and constipation, what diagnosis?

Answer 23

hypercalcemia

Question 24

patient who has malignancy and fever, what diagnosis?

Answer 24

neutropenia or sepsis

Question 25

patient who has malignancy and hypotension and JVD and dyspnea, what diagnosis?

Answer 25

tamponade or SVC

Question 26

patient who has malignancy and hypoglycemia, what diagnosis?

Answer 26

adrenal insufficiency

Question 27

patient who has malignancy and hyponatremia, what diagnosis?

Answer 27

adrenal insufficiency or SIADH

Question 28

patient who has maglignancy and back pain, what diagnosis?

Answer 28

cord compression

Question 29

tx of spinal cord compression in onc patient?

Answer 29

dex, radiation, surgery

Question 30

tx of upper airway compression in onc patient?

Answer 30

establish definitive airway

Question 31

tx of pericardial tamponade in onc patient?

Answer 31

pericardiocentesis

Question 32

tx of superior vena cava syndrome in onc patient?

Answer 32

diuretics, radiation, vascular stenting

Question 33

tx of SIADH in onc patient?

Answer 33

fluid restrict, diuretics, hypertonic saline

Question 34

tx of hyperviscosity in onc patient?

Answer 34

IV saline, phlebotomy

Question 35

tx of adrenocorticol insufficiency with shock in onc patient?

Answer 35

IV hydrocortisone

Question 36

dx of arthritis, conjunctivitis and urethritis (not gonorrhea)

Answer 36

reiter's syndrome

Question 37

tx of anaphylaxis?

Answer 37

epi, albuterol, diphenhydramine, H2 blocker, corticosteroids, if patient on beta blockers give glucagon

Question 38

what are signs on an EKG for TCA?

Answer 38

large S in 1 and aVL, wide QRS, sinus tach, R> 3 mm in aVR, long QT

Question 39

what are signs on EKG for dig tox?

Answer 39

paroxysmal atrial tach with variable AV block

Question 40

what are the dialyzable drugs?

Answer 40

STUMBLE ``` salicylates theophylline uremia methanol barbiturates lithium ethylene glycol ```

Question 41

what is the goal pH for TCA tox?

Answer 41

7.5

Question 42

signs of aspirin tox?

Answer 42

``` anion gap metabolic acidosis resp alk hyperthermia hypoglycemia hypokalemia ```

Question 43

signs of ethylene glycol ingestion? tx?

Answer 43

anion gap acidosis with osmolar gap | tx with ethanol or fomepizide

Question 44

signs of methanol ingestion? tx?

Answer 44

anion gap acidosis with osmolar gap visual sx tx: fomepizole, ethanol, dialysis

Question 45

triad of myxedema coma?

Answer 45

hypotension, hypothermia, and brady

Question 46

electrolyte findings in adrenal insufficiency

Answer 46

hyponatremia | hyperkalemia

Question 47

most common cause of anion gap metabolic acidosis?

Answer 47

lactic acidosis

Question 48

what should you be concerned about with hypokalemia?

Answer 48

hypomagnesemia

Question 49

how do you treat hyponatremic patient with seizures or AMS?

Answer 49

3% hypertonic saline

Question 50

what do you consider with patient with diarrhea, fever, AMS, psychosis, a fib?

Answer 50

thyroid storm

Question 51

how do you treat bony fishes, stingrays and sea urchins?

Answer 51

hot water

Question 52

how do you treat jellyfish nematocysts?

Answer 52

salt water or vinegar NOT FRESH WATER

Question 53

what is a side effect of antivenin (made from horse)

Answer 53

anaphylaxis

Question 54

how does black widow present?

Answer 54

muscular rigidity, acute abd

Question 55

how do you tx black widow?

Answer 55

benzo and antivenin