May 1st Flashcards
What is the presentation of staphylococcal toxic shock syndrome?
Risks: tampon use, nasal packing, surgical/postpartum wound infection; fever >102, hypotension, DIFFUSE MACULAR RASH INVOLVING PALMS AND SOLES, desquamation 1-3 weeks after disease onset, vomiting and diarrhea, AMS
What is the treatment for staph toxic shock syndrome?
Fluids, removal of foreign body, antibiotics (eg clindamycin plus vanco)
What is seen on electron microscopy in minimal change disease?
Effacement of foot processes of podocytes
What is the treatment for MCD?
Corticosteroids
In a posterior shoulder dislocation, how is the shoulder usually positioned?
Held in adduction and internal rotation; see visible flattening of anterior shoulder
When do you see posterior shoulder dislocations clinically?
Seizures of electrocution injury
What is the MOA of tamoxifen?
Estrogen receptor antagonist at the breast, estrogen agonist in the uterus (leading to endometrial proliferation - associated with polyps in premenopausal women and hyperplasia/cancer in postmenopausal women); has some estrogen-like activity at the bone (increase bone mineral density)
What are the risk factors for placenta accreta?
Prior C section, h/o dilation and curettage, maternal age >35
What are the two types of etiology in stress incontinence?
Decreased urethral sphincter tone, urethral hypermobility
What is the first line treatment for stress incontinence?
Kegel exercises
Infant with small-for-gestational age with cataracts and PDA (continuous machine like murmur)
Think congenital rubella syndrome; can also see sensorineural hearing loss
What is the treatment for measles?
Supportive and vitamin A for hospitalized patients
Child with macrocytic anemia, low retic count, and congenital anomalies (webbed neck, cleft lip, shielded chest, and triphalangeal thumbs)
Diamond Blackfan anemia
What is seen on Hgb electrophoresis in Diamond Blackfan anemia?
Increased fetal Hgb
What is the treatment for social anxiety disorder?
CBT + SSRI (propranolol for performance only social anxiety disorder)
Guillain Barre effects what portion of the neuromuscular pathway?
Peripheral nerves
Why is erythromycin contraindicated in neonates?
Can lead to pyloric stenosis
What is post-exposure prophylaxis for pertussis?
Macrolide ( eg azithromycin)
Normal anion gap acidosis and FTT with alkalotic urine
Think RTA type 1 (distal)
Fanconi syndrome is associated with what type of RTA?
Type 2
What is a normal Hgb electrophoresis pattern?
99% Hgb A, 0 % Hgb S and <1 % Hgb F
What is seen on Hgb electrophoresis in Sickle cell disease?
0% Hgb A, 85-90% Hgb S and 5-15% Hgb F
What is seen on Hgb electrophoresis in sickle cell trait?
50-60% Hgb A, 35-45% Hgb S, <2% Hgb F
What is seen on Hgb electrophoresis in a patient with Sickle cell disease and is on hydroxyurea?
Hydroxyurea increased Hgb F, resulting in Hgb F % >15 on electrophoresis
Hydroxyurea causes what kind of blood dyscrasis?
Can result in macrocytic anemia, and myelosuppression (neutropenia)
APGAR score of what requires intervention?
Less than 7
How does gonococcal conjunctivitis present in a neonate?
Usually persents at age 2-5 days with eyelid swelling and mucopurulent discharge and chemosis
What is the gold standard for diagnosing gonococcal conjunctivitis?
Culture on thayer-martin agar
What is treatment for gonococcal conjunctivitis?
Single dose IM 3rd gen cephalosporin
Why is topical erythromycin ointment administered to neonates?
Prophylaxis for gonococcal conjunctivitis
What is the preentation of chlamydial conjunctivitis in neonates?
Presents 5-14 days, mild eyelid swelling with watery serosang discharge
What is the treatment for chlamydial conjunctivitis?
PO macrolide
What are teh adverse effects of MTX?
Nausea, stomatitis, rash, hepatotoxicity, ILD, alopecia, fever, MACROCYTIC ANEMIA, and severe: pancytopenia
What is the MOA of MTX?
Inhibits dihydrofolate reductase
What is seen on liver biopsy in Reye syndrome?
Microvesicular fatty infiltration
What is the empiric treatment for suspected bacterial meningitis?
3rd gen cephalosporin (ceftriaxone) and vancomycin
Patient presents with pulmonary abscess and recurrent cutaneous abscesses with organism-filled neutrophils
Chronic granulomatous disease
What is chronic granulomatous disease?
Immunodeficiency caused by mutation that prevents phagocytic oxidative burst - impairs intracellular killing
Patients with chronic granulomatous disease are particularly susceptible to what types of organisms?
Catalase-positive
How is chronic granulomatous disease diagnosed?
Test neutrophil function - eg dihydrorhodamine 123 or nitroblue tetrazolium test
In breastfeeding failure jaundice, hyperbilirubinemia is due to what?
Increased enterohepatic circulation of bilirubin, resulting in increased unconjugated bilirubin
What is the threshold for phototherapy in a full-term healthy 4-day old infant with elevated bilirubin?
Total bil >/= 20
