mar 7 Flashcards
how to investigate for urethral trauma?
retrograde urethrography
how does retrograde urethrography work
xray of the urethral tract following injection with radioopaque contract. Extravasation of contrast indicates urethral injury
should you catheterize a potential urethral trauma?
no - not until retrograde urethrography is performed to make sure theres not an injury (catheter can worsen injury)
biphasic stridor that improves with neck extension =
vascular ring
worsening biphasic stridor with skin hemangiomas =
airway hemangioma
empiric antibiotics for osteomyelitis in a healthy child?
Staph aureus coverage needed so either:
- nafcillin or oxacillin (low chance of MRSA)
- clindamycin or vancomycin (high change or MRSA)
empiric antibiotics for osteomyelitis in a child with sickle cell?
Add third gen cephalosporin to cover salmonella
what is radiculopathy?
irritation of a nerve as it leaves the spinal canal
manifestations of cervical radiculopathy?
- pain in the neck and upper extremity
- sensory and motor deficits and diminished reflexes
which exam finding is diagnositc for cervical radiculopathy?
improvement of symptoms when the hand is placed on top of the head (shoulder abudction reduces tension on the impinged nerve root)
how does raising the arm effect symptoms in thoracic outlet syndrome?
worsens them
how can you treat a disabling strawberry hemangioma?
beta blockers
what is selegiline?
MOA-B inhibitor
prevention of gonorrheal conjunctivits in a neonate?
topical erythromycin
treatment of gonorrheal conjunctivitis in a neonate?
single IM dose of 3rd gen cephalosporin
how does low albumin affect calcium levels?
low albumin = low total calcium (but not active calcium levels)
can you give a live attenuated vaccine to a patient with SCID?
No - can cause severe disease
Symptoms of theophyline toxicity?
CNS stimulation (headaches, insomnia, seizures) GI disturbance (nausea, vomiting) Cardiac toxicity (arythmia)
theophyline has a ____ therapeutic index
narrow
Why are cystic fibrosis patients predisopsed to higher rates of heat exhaustion?
greater losses of sodium and chloride in sweat
what should be done in a patient with recurrent tinea infection?
thorough skin inspection for other sites of infection that werent treated -> reexposure
A soft S2 is characteristic of…
aortic stenosis
vestibular neuritis often follows…
a viral syndrome
episodes of benign paroxysmal positional vertigo are triggered by…
head movements
Facial characteristics in fetal alcohol syndrome?
small palpebral fissues
smooth philtrum
thin vermillion border
is trigeminal neuralgia usually unilateral or bilateral?
unilateral
if a patient presents with bilateral trigeminal neuralgia, this may be the initial presentation of…
MS
How can you protect the sexual partner of a patient who has just been diagnosed with hep A?
Postexposure prophylaxis with the Hep A vaccine or hep A immunoglobulin
For prophylaxis after contact, which patients should receive the hep A vaccine?
those <40
For prophylaxis after contact, which patients should receive the hep A immunoglobulin?
those >40
is there muscle pain in polymyalgia rheumatica?
yes
treatment of polymyalgia rheumatica?
rapid response to glucocorticoids
does glucocorticoid induced myopathy cause muscle pain?
NO - just weakness
ESR in glucocorticoid induced myopathy ?
normal
ESR in polymyalgia rheumatica?
elevated
in heart failure, hyponatremia is a sign of…
severity/poor prognosis
how can a severe asthma attack/COPD exacerbation lead to pulsus paradoxicus
- during these exacerbations, the drop in intrathoracic pressure increases greatly with inspiration, and causes pooling of blood in the pulmonary vascular -> decreased left ventricular preload
- also the marked expansion of the lungs can impinge on the contraction of the heart
