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Step 2 CK > May 1st > Flashcards

May 1st Flashcards

1
Q

What is the presentation of staphylococcal toxic shock syndrome?

A

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

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2
Q

What is the treatment for staph toxic shock syndrome?

A

Fluids, removal of foreign body, antibiotics (eg clindamycin plus vanco)

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3
Q

What is seen on electron microscopy in minimal change disease?

A

Effacement of foot processes of podocytes

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4
Q

What is the treatment for MCD?

A

Corticosteroids

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5
Q

In a posterior shoulder dislocation, how is the shoulder usually positioned?

A

Held in adduction and internal rotation; see visible flattening of anterior shoulder

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6
Q

When do you see posterior shoulder dislocations clinically?

A

Seizures of electrocution injury

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7
Q

What is the MOA of tamoxifen?

A

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)

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8
Q

What are the risk factors for placenta accreta?

A

Prior C section, h/o dilation and curettage, maternal age >35

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9
Q

What are the two types of etiology in stress incontinence?

A

Decreased urethral sphincter tone, urethral hypermobility

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10
Q

What is the first line treatment for stress incontinence?

A

Kegel exercises

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11
Q

Infant with small-for-gestational age with cataracts and PDA (continuous machine like murmur)

A

Think congenital rubella syndrome; can also see sensorineural hearing loss

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12
Q

What is the treatment for measles?

A

Supportive and vitamin A for hospitalized patients

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13
Q

Child with macrocytic anemia, low retic count, and congenital anomalies (webbed neck, cleft lip, shielded chest, and triphalangeal thumbs)

A

Diamond Blackfan anemia

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14
Q

What is seen on Hgb electrophoresis in Diamond Blackfan anemia?

A

Increased fetal Hgb

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15
Q

What is the treatment for social anxiety disorder?

A

CBT + SSRI (propranolol for performance only social anxiety disorder)

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16
Q

Guillain Barre effects what portion of the neuromuscular pathway?

A

Peripheral nerves

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17
Q

Why is erythromycin contraindicated in neonates?

A

Can lead to pyloric stenosis

18
Q

What is post-exposure prophylaxis for pertussis?

A

Macrolide ( eg azithromycin)

19
Q

Normal anion gap acidosis and FTT with alkalotic urine

A

Think RTA type 1 (distal)

20
Q

Fanconi syndrome is associated with what type of RTA?

A

Type 2

21
Q

What is a normal Hgb electrophoresis pattern?

A

99% Hgb A, 0 % Hgb S and <1 % Hgb F

22
Q

What is seen on Hgb electrophoresis in Sickle cell disease?

A

0% Hgb A, 85-90% Hgb S and 5-15% Hgb F

23
Q

What is seen on Hgb electrophoresis in sickle cell trait?

A

50-60% Hgb A, 35-45% Hgb S, <2% Hgb F

24
Q

What is seen on Hgb electrophoresis in a patient with Sickle cell disease and is on hydroxyurea?

A

Hydroxyurea increased Hgb F, resulting in Hgb F % >15 on electrophoresis

25
Q

Hydroxyurea causes what kind of blood dyscrasis?

A

Can result in macrocytic anemia, and myelosuppression (neutropenia)

26
Q

APGAR score of what requires intervention?

A

Less than 7

27
Q

How does gonococcal conjunctivitis present in a neonate?

A

Usually persents at age 2-5 days with eyelid swelling and mucopurulent discharge and chemosis

28
Q

What is the gold standard for diagnosing gonococcal conjunctivitis?

A

Culture on thayer-martin agar

29
Q

What is treatment for gonococcal conjunctivitis?

A

Single dose IM 3rd gen cephalosporin

30
Q

Why is topical erythromycin ointment administered to neonates?

A

Prophylaxis for gonococcal conjunctivitis

31
Q

What is the preentation of chlamydial conjunctivitis in neonates?

A

Presents 5-14 days, mild eyelid swelling with watery serosang discharge

32
Q

What is the treatment for chlamydial conjunctivitis?

A

PO macrolide

33
Q

What are teh adverse effects of MTX?

A

Nausea, stomatitis, rash, hepatotoxicity, ILD, alopecia, fever, MACROCYTIC ANEMIA, and severe: pancytopenia

34
Q

What is the MOA of MTX?

A

Inhibits dihydrofolate reductase

35
Q

What is seen on liver biopsy in Reye syndrome?

A

Microvesicular fatty infiltration

36
Q

What is the empiric treatment for suspected bacterial meningitis?

A

3rd gen cephalosporin (ceftriaxone) and vancomycin

37
Q

Patient presents with pulmonary abscess and recurrent cutaneous abscesses with organism-filled neutrophils

A

Chronic granulomatous disease

38
Q

What is chronic granulomatous disease?

A

Immunodeficiency caused by mutation that prevents phagocytic oxidative burst - impairs intracellular killing

39
Q

Patients with chronic granulomatous disease are particularly susceptible to what types of organisms?

A

Catalase-positive

40
Q

How is chronic granulomatous disease diagnosed?

A

Test neutrophil function - eg dihydrorhodamine 123 or nitroblue tetrazolium test

41
Q

In breastfeeding failure jaundice, hyperbilirubinemia is due to what?

A

Increased enterohepatic circulation of bilirubin, resulting in increased unconjugated bilirubin

42
Q

What is the threshold for phototherapy in a full-term healthy 4-day old infant with elevated bilirubin?

A

Total bil >/= 20

Step 2 CK (19 decks)

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