march 30

Question 1

path of rhinitis medicamentosa?

Answer 1

nasal congestion - > use of nasal decongenstant -> stimulation of alpha 2 adrenergic receptors - > vasoconstriction - > relief - > prolonged use -> damage to vascular endothelium -> increasd vascular permeability and interstitial edema

Question 2

management of congenital diagphramatic hernia?

Answer 2

• chest tube placement
• gastric decomrpession
• surgical correction

Question 3

presentation of pinealoma?

Answer 3

ICP, parinaud syndrome and eyelid retraction

Question 4

what is parinaud syndrome?

Answer 4

limited upward gaze

Question 5

presentation of a medulloblastoma?

Answer 5

• cerebellar dysfunction

- obstructive hydrocephalus

Question 6

a patient with acute otitis media is treated with antibiotics now has an effusion but no signs of tympanic membrane inflammation, next steps?

Answer 6

observation (effusions after ear infection are common in children)

Question 7

Symptoms of otitis media effusion?

Answer 7

Usually asymptomatic but may cause mild discomfort (child may tug at ear)

Question 8

findings on examination of the tympanic membrane in someone with a otitis media effusion?

Answer 8

air fluid levels visible, and poor tympanic membrane mobility (but not buldging or erythematous)

Question 9

management of clubfoot (talipes equinovarus) in a neonate?

Answer 9

gentle manipulation via stretching and serial molding casts

Question 10

treatment of campylobacter?

Answer 10

supportive (unless severe)

Question 11

which campylobacter cases are considered severe enough to treat?

Answer 11

those > 7 days, blood stools or in immunocompromised or pregnant women

Question 12

what is febrile nonhemolytic transfusion reaction?

Answer 12

a benign adverse transfusion reaction

Question 13

when does febrile nonhemolytic transfusion reaction occur?

Answer 13

1-6 hours after transfusion

Question 14

pathophys behind febrile nonhemolytic transfusion reaction?

Answer 14

when in storage, the small amounts of leukocyte debris left in RBCs/plasma release cytokines which causes this reaction when given to a patient

Question 15

is a patient who had febrile nonhemolytic transfusion reaction likely to get it again with another transfusion?

Answer 15

yes

Question 16

how can you prevent febrile nonhemolytic transfusion reaction in a patient who has had it before but needs blood products?

Answer 16

give them leukoreduced blood product

Question 17

pain in carpal tunnel syndrome is often worse…

Answer 17

at night

Question 18

pain in carpal tunnel syndrome is often releived by..

Answer 18

shaking the hand around

Question 19

A patient with suspected median carpal tunnel syndrome has negative phalen and tinel tests. Next step?

Answer 19

nerve conduction studies (Phalen and tinel test not super sensitivie)

Question 20

how to diagnose primary sclerosing cholangitis?

Answer 20

magnetic resonance cholangiopancreatography

Question 21

what can you use morning cortisol levels to test for?

Answer 21

adrenal insufficiency

Question 22

can morning cortisol levels be used to test for cushings?

Answer 22

no - often overlap with normal levels in the morning

Question 23

what is streptococcal perianal dermatitis?

Answer 23

a dermatitis that occurs in young kids and presents with itching and pain of the anus

Question 24

examination findings of streptococcal perianal dermatitis?

Answer 24

bright, sharply demarcated erythma of the perianal area

Question 25

treatment of streptococcal perianal dermatitis?

Answer 25

antiobiotics