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Rosh > Last Go Round > Flashcards

Last Go Round Flashcards

1
Q

Outside Hx with redness and pustule and pain in localized area

A

think bee sting or ant bite

  • Local=ice/Nsaids
  • think anaphyalxis
  • if 1 week out from it= serum sickness!
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2
Q

anterior cord syndrome?

A

Motor and pain/temp

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3
Q

Lymes ppx

A

1x dose of Doxy 200

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4
Q

10 year old with abnormal vitals and SVT firs tTx? Adenosine fluids or shock?

A

Shock (adenosine if stable)

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5
Q

Sudden hadache, visual stuff, Hyperdensity in sella?

A

Pituitary apoplexy - sudden hemorrhag or inafractin of th epituitary gland likely in the setting of a mass

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6
Q

Can TTP be acquired? What are the cuases?

A 
Yes
Preggos
Drugs (tacro, anti-immunes)
Auto immune disorders
Bacterial illness
AIDS
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7
Q

What is TTP Pentad

A 
Fever
Anemia
Thrombocytopenia
Renal 
AMS
needs staroids, big line for PLEX
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8
Q

Order of Thyroid meds?

A

Propanolol, PTU
Iodine
Steroids

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9
Q

Neg FAST, GSW to abdomen/flank - next step

A

Ex lap

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10
Q

Kid IV access= No IOs in the lower extremities due to fractures. hem shock so no EJ an dno IV in the arms - next place for resuscitation…

A

Femoral Vein

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11
Q

ph 7.3 but CO2 10 — gotta think

A

Slaicylate posioning - CO2 should be 30 so now we have a resp alk on top of it

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12
Q

What is brpnchiloitis oliterans?

A

submucosal lymphocytic inflammation can disrupt the epithelium of the small airways followed by an ingrowth of fibromyxoid granulation tissue into the airway lumen, which can lead to obliteration of the airway lumen

Usually chornic lung transplant rejection

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13
Q

Always chack what is preg VB? What and hwo much do you give?

A

Mom is Rh Neg = 300 mcg rhogam if under 20 weeks

if > 20 weeks need the KB test to see how much rhgam to give

remember if she is Rh(-), there is a risk for Ab to be formed to the ag and risk for subsequent pregnancies

Rh(-) mom, rh + dad and then a Rh + baby later= Ab cros splaenta and attack and fetal hemolysis

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14
Q

Difference in CCB vs BB overdose?

clonidine?

A

HypoG is BB

pinpoint pupils is clonidine (the other is big pupils)

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15
Q

infant with bilious emesis - KUB or gi series , VS nomral

A

GI sereis for malroation

VS abnromal = X ray

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16
Q

outpatient fight bite meds- PCN allergy

A

doxy clinda

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17
Q

kidney stne 2 mm, UTI, VS normal- can you DC?

A

ROsh says yes. Urology follow up, abx, flomax. If there is obstruction (significant), fever than inpatient admission

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18
Q

figure 3 sign chest x ray

A

aortic coaractaion

look for rib notching

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19
Q

labrythinitis tx

A

steroids

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20
Q

severe sepsis out of favor

A

now septic shock

sepsis is used for SOFA scoring

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21
Q

+ romberg test means

A

Vestibular system is out

  1. msk proprioception
  2. Vestibular
  3. vision
  4. PNS + 5. CNS sytheszing the info
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22
Q

rapid ascent diving SOB

A

PTX

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23
Q

cold and feet
Damp, non freezing- red and burning
wet, non freezing
freezing

A

pernio or chilblains
trenchfoot
frostbite

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24
Q

ingown toenail tx

A

partial nail removal near the edge with digital block

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25
Q

PLacental abrption is painful or not

A

painful. +/- bleeding depdning on where tje placenta is

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26
Q

Salicylate txicity

ABG, tx

A

met acid, resp alk - low bicarb, hyprevent and low co2. alinlize the serum. lactic acidosis too

Low Co2, low bicarb!

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27
Q

acute chest tx

A

fludis, abx, transfusion therpay

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28
Q

high risk laryngospasm for ketamine

A

<3 months

URI in a kid

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29
Q

ear hematoma tx

A

ID at bottom of it, compressive dressing
ID after 48 hours or big >2 cm
Needle apsiration if <48 <2 cm

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30
Q

Nasal bone fx, packing, abx decision

A

Pack it, no abx (controversial) take packing out in 3 days and follow up ENt 1 week

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31
Q

preggo, hypotensive, LUQ pain

A

Splenic artery aneyrusm rupture (MC in preggos)

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32
Q

Ketosis w.out acidosis

A

Isopropyl
Elevated osmol gap
no role for fomepizole- supportive

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33
Q

Tx for eye chlamydia infant

A

Or erythromycin

Not topical

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34
Q

Refractory htn, alkalosis, hypok

A

Renal artery stenosis

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35
Q

Soilled teacup

A

Lunate

If upright it is capitate

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36
Q

Nms tx

A

Benzo

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37
Q

ascending paralysis, hyporeflexia, intact sensation…

A

tick paralysis

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38
Q

what suture should you do on the volar aspact of the hand?

A

Horizontal (straight line) mattress - reduces skin necrosis

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39
Q

what bite or sting? oral secretions + nystagmus

A

scorpion

40
Q

How to treat CAP -

A

no more HCAP

go off of risk factors

41
Q

give tamiflu to old lady hospitlaized after 3 days of symptoms?

A

yes

42
Q

Where do you put abx for periotneal dialysis infection

A

intraperiotneal

43
Q

diving

A

Ascent:
Air embolus- 100% oxygen
decomrpession sickness- bends- hours

Descent:
nitrgne narocsis 100 ft
barotisis 30 ft

44
Q

Recent C section with foul semlling and pain= Tx

Cervicitis tx

A

Clinda gent endometritis

Azithr CFTX

45
Q

hyperoxia test, symptoms improve with ___ problems

A

Lung

if not, its heart and give PGE1

46
Q

oral or topical acycolivr for herpes eye?

A

Oral + topical steroids

47
Q

ischemic stokre < 3 months ago tp a conteaidicitaion?

A

yes

48
Q

flail chest tx

A

basically jus tpain control

49
Q

stipid heme

A 
PV= phleboomty
PLasmaphereisis= MM and proteins
leukaphroeis= AML
50
Q

conreal ulcer vs abrasion looks

A

sharply demarcated with grey ring around it

51
Q

All ICDs are also..

A

Ventricular pacemakers

MAgnet = Pacing mode and defbrillator off

52
Q

atrial myxoma associated with what disease?

A

raynauds

53
Q

what is hellp and how do you treat

A

Form of severe Pre-E- Abd pain/SOB/blurry vision +
PLts/LFts/Anemia
Mg + Labetalol + Delivery

54
Q

obvious urethral injury - suprapubic cath or Uroloy consult for repair

A

suprapbuic cath - they repair these weeks after injury

55
Q

rash around dickhole without getting better on abx and now spreading?

A

think SJS!

56
Q

BIpap in COPD

A

Remember fio2 and pep is oxygen

so put the diriving pressure up and go 12/4 and allows less PEEP (the 4) and more time to exhale

57
Q

CT head or give factor first in a truama?

A

Give factor, you would do that in head trauma and a neg ct anyway

58
Q

osler weber syndrome?

A

AVMs, epistaxis, Telangiesctaisa on the mouth

59
Q

Minimal VB in first trimester pregnant bleeding- give rohgam

A

controversial but Guidleines say yes
the Ab portion of the test actually looks at Anti duffy Ab

Give if Rh negative

60
Q

lidocaine dosing in a code?

A

1.5 mg/kg - then half

61
Q

What is rhematic fever

what is scaret fever

A

JONES after strep

Big rash during strep

62
Q

If stable on trauma go to CT scanner first

A
63
Q

peds svt dsing adenosine

electricity

A

.1 mg/kg > .2 mg/kg

0.5J/kg then 2x it

64
Q

what physical exam do you do for costochondritis

A

hands behind head and posterior retractionog elbows

65
Q

bells palsy tx

A

Steroids

+/- anitvirals

66
Q

predicotrs for head bleed

A

loss of consciousness, seizure prior to the injury, advanced age (age greater than 60 years), amnesia after the event, intoxication, or a coagulopathy.

67
Q

SSS vs NMS

A

SSS is quickly after a change (hyper/clonus)

NMS is after a long time on psych meds (rigidity, autonomic instabiltiy, fever)

68
Q

Tx for a hearald patchand then rash

A

Pit rose

no tx

69
Q

Lunate dislocation next step

A

transfer for ortho hand reduciton
Lunate is spilled
mEDIAN NERVE PALSY!

70
Q

lata vs accuminata difference

A

lata is flat and pale (secondary syhp and)painless

Accumiante is pink and much more beefy - warts HPV

71
Q

erythemas!

A 
Nodosum= SLE, sarcoid, malignancy
Multiforme: EM from drugs or infections
Infectioisum: Pervo
Migrans: lymes
Marginatum: Rheamtic fever (JONES)
72
Q

HSV eye tx

A

Trifluridine
or acyclovir
topcial

73
Q

scarelt fever

A

is associated WITH phayrhngitis (still jsut abx not other tx)
Rhemuatic fever- AFTER infection

74
Q

light bulub sign (there is rotatio nwhere you dont see greater tuberoisty)

A

posterio shoulder dislocation

75
Q

elli0s 2/3

A

clina or augmention + calcium or znic sealant

76
Q

tx brugada

A

ICD

77
Q

afib wpw tx

A

procain

NOT BB- it uses accessory pathway

78
Q

MVC with a horizontal SPine fx- associated injury?

A

Bowel injury

unstable fx- spine Chance fx

79
Q

tx kawasaki

A

high dose aspirin
IVIG
admit

80
Q

shock

A 
Class 1- Pulse pressure 15
class 2- tachycardia 30
class 330-40 BP
class 4-40
81
Q

pterygium tx

A

nothing unless covers pupil

optho

82
Q

osms

A

NA x2
Glucose / 2
BUN/ 2.8

218 218

83
Q

Jones and stuff

A

Jones (worse and more distal and bigger)
psuedojoens is avulsin fx and walking boot
Lisfranc- WB, 2nd metatarsal

84
Q

triads

A

cushings

85
Q

alveolar osteotis (dry socket)

A

Clove oil-Eugenol

86
Q

digoxin stuff

A

Dig effect- scooped st depressin (not toxic)

Toxicity is VT, arrythmia, PVC stuuff

87
Q

Jesserson
hangman
clay shoverelver

A

Jeff- axial load c 1 (you would see dens to see c1)
hanfman- bilateral c2 fx
clay shovel- stabel c7 SP fx

88
Q

Neck zones

A

1- bottom up to cric (trach one finer in)
2- cric to madible (cric someone)
3- mandible and up (bag someone with three fingers)

89
Q

airway peds

A

get it in OR not ED

90
Q

saline soaked gauze for a tooth and transfer them

A

toth avulsion

91
Q

Ccb and bb OD tx

A 
Calcium 
Glucagon (imaptied gluconeogenesis and pressorh in heart adenylate cyclase myocarial, bypasses BB recepotr and works in minutes- first line)
High dose insulin (positivr inotrope)
Fluids
Pressors
Lipid emulsion
92
Q

Spironolactone can cause…

A

HyperK

93
Q

LP spot for infants??

A

L45

Lower for yiung infants

94
Q

First thiing that shows in 3 weeker with meningitis?

A

Pradoxical irritability

Cries when you pick it up

95
Q

Ehat does extenral validlity also mean

A

Is the study geneaizable

96
Q

Hyoothermia tezt iok answer- sklwiing warming in eztenral- nezt sept

A

Intebtla re wamring.

Rosh (14 decks)

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