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MCCQE1 > Medicine (Acute Care/Preventive) > Flashcards

Medicine (Acute Care/Preventive) Flashcards

1
Q

causative agent of chancroid, painful papule or pustule with irregular, deep, and demarcated borders

A

Haemophilus ducreyi

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2
Q

Syphilis is caused by

A

Treponema pallidum (spirochete)

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3
Q

presents with painless ulcer called chancre

A

Syphilis

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4
Q

maculopapular rash + condylomata lata + low grade fever + malaise + headache + generalized lymphadenopathy

A

Syphilis - Secondary stage (4-8 wks after chancre)

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5
Q

presents with multiple painful vesicles accompanied by vulvar pain and pruritus

A

Herpes simplex

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6
Q

most common bacterial STD

A

Chlamydia trachomatis

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7
Q

STD often asymptomatic, but may present with urethritis, mucopurulent cervicitis, or PID

A

Chlamydia trachomatis

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8
Q

causes granuloma inguinale (donovanosis)

A

Klebsiella granulomatis

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9
Q

lesion characterized by beefy red ulcer with a rolled edge of granulation tissue

A

granuloma inguinale / donovanosis

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10
Q

seizure treatment or prophylaxis for head trauma px at ER

A

phenytoin or levetiracetam

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11
Q

signs of increased ICP

A

deteriorating LOC
deteriorating resp pattern
cushing reflex
lateralizing CNS signs (cranial nerve palsies, hemiparesis)
seizures
papilledema (occurs late)
n/v and h/a

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12
Q

response to increased ICP presenting as high BP, low HR and irregular respirations

A

Cushing reflex

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13
Q

signs of basal skull fracture

A

raccoon’s eyes
hemotympanum
battle’s sign
csf rhinorrhea or otorrhea

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14
Q

meds to administer at least 2 mins prior to RSI in suspected raised ICP

A

fentanyl or lidocaine

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15
Q

goals for head trauma cases in ED

A

avoid secondary injuries:
ischemia
dec CPP
hypoxia
seizures

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16
Q

vitamin K-dependent clotting factors

A

factors 279,10
receptor proteins C&S

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17
Q

When may gastric lavage be useful?

A

Gastric lavage may occasionally be useful in the first hour of ingestion.

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18
Q

In what situations is gastric lavage dangerous?

A

Gastric lavage is dangerous in:
1. Caustic ingestion
2. Altered mental status

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19
Q

Why is gastric lavage dangerous in caustic ingestion?

A

It causes burning of the esophagus and oropharynx.

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20
Q

Why is gastric lavage dangerous in altered mental status?

A

It may cause aspiration.

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21
Q

What are the most common causes of death by overdose?

A

Acetaminophen and Aspirin

They are, by far, the most common cause of death by overdose.

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22
Q

benign and should be given to anyone with a pill overdose; superior to lavage and ipecac

A

Activated charcoal (SDAC / MDAC)

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23
Q

acetaminophen ingestion causes toxicity at how many grams (and # of 500mg tabs)?

A

> 8g or > 16 tabs

24
Q

acetaminophen ingestion causes fatality at how many grams (and # of 500mg tabs)?

A

> 12 g or > 24 tabs

25
Q

aspirin overdose treatment

A

urinary alkalinization with sodium bicarbonate

26
Q

What condition is characterized by crushing, substernal chest pain with ST elevations in V1, V2, V3, short breath, crackles, and LE edema?

A

STEMI

27
Q

What condition is indicated by an unrestrained passenger in a motor vehicle accident presenting with unilateral diminished breath sounds and dullness to percussion?

A

Hemothorax

28
Q

What condition is seen in a young person with unilateral upper extremity swelling, pain, and erythema following vigorous exercise?

A

Deep venous thrombosis

29
Q

What condition is presented by an older man with a recent history of abdominal surgery, severe abdominal pain, constipation, and an irreducible mass in the left lower quadrant?

A

Incarcerated inguinal hernia

30
Q

What condition occurs immediately after completing a marathon when a runner collapses without loss of consciousness and has minimally elevated temperature?

A

Exercise-associated postural hypotension

31
Q

What condition is indicated by a young patient with moderate chest pain worsened by palpation?

A

Costochondritis

32
Q

Miner present with Ataxia, irritability, gingival inflammation, and excess salivation

A

Mercury poisoning

33
Q

What condition is suggested by a sudden-onset, severe headache in an elderly patient?

A

Subarachnoid hemorrhage

34
Q

What type of headache is characterized by sudden-onset, severe, unilateral, periorbital headache with tearing and conjunctival injection?

A

Cluster headache

35
Q

What condition is indicated by an elderly patient with an extensive smoking history presenting with fatigue, malaise, bilateral upper extremity edema, and headache worse with supine positioning?

A

SVC syndrome (Pancoast tumor)

36
Q

What injury is indicated by a fall onto an outstretched hand with arm in adduction and internal rotation, showing widening of the glenohumeral joint space?

A

Posterior shoulder dislocation

37
Q

What condition is characterized by repeated bilateral lower extremity pain and swelling after strenuous exercise with spontaneous resolution?

A

Chronic exertional compartment syndrome

38
Q

What condition presents in a young patient with no past medical history, showing encephalopathy, anion gap metabolic acidosis, and hyperglycemia?

A

Diabetic ketoacidosis

39
Q

What injury is indicated by a fall from a roof with spinal tenderness and spinal X-ray showing decreased vertebral body height at T8?

A

Vertebral compression fracture

40
Q

What injury is associated with a recent bar fight and severe tenderness of the medial hand at the 5th metacarpal?

A

Boxer’s fracture

41
Q

associated injury in head-on collision

A

head/facial, thoracic (aortic), lower extremity

42
Q

associated injuries in lateral/T-bone collision

A

head, c-spine, thoracic, abdominal, pelvic, and LE

43
Q

associated injuries in rear-end collision

A

hyperextension of C-spine (whiplash injury)

44
Q

head trauma with a gcs score of 8 or less, + cushing’s response

A

A: intubate
B: hyperventilate (100% O2)
C: maintain adequate bp (sBP >90)
administer fentanyl or lidocaine (2mins prior to RSI)
sedate
elevate head to 20 °
seizure prophylaxis
mannitol 1g/kg rapidly infused or 3% saline 3ml/kg
remove cervical collar if possible

45
Q

treatment of TCA overdose

A

sodium bicarbonate

46
Q

most accurate test for carbon monoxide poisoning

A

level of carboxyhemoglobin

47
Q

very high carbon monoxide will lead to ph?, pCO2?, HCO3?

A

low ph
low pCO2
low HCO3

48
Q

decreases the half life of methemoglobin

A

methylene blue

49
Q

shortens half life of carboxyhemoglobin

A

hyperbaric oxygen

50
Q

first step in managing organophosphate poisoning / nerve gas at ER

A

administer Atropine

51
Q

dangerous mechanisms requiring c-spine radiography (Canadian C-Spine Rule)

A

Fall from 1m or more / 5 stairs
axial load to head (e.g. diving)
MVC high speed (>100km/hr), rollover, ejection
motorized recreational vehicles
bicycle collision

52
Q

GCS15, alert and stable trauma patients requiring c-spine radiograph

A

age 65 or older, OR
dangerous mechanism
paresthesias in extremities

53
Q

next step after confirming there is no high-risk factor that mandates c-spine radiography for gcs15, alert and stable patient? (Canadian C-Spine Rule)

A

assess any low-risk factor that allows safe assessment of ROM
- Simple rear-end MCV , OR
- Sitting position in ED, OR
- Ambulatory at anytime, OR
- Delayed (not immediate) onset of neck pain, OR
- absence of midline C-spine tenderness

54
Q

mechanisms excluded in simple rear-end MVC

A

hit by truck/bus
hit by high-speed vehicle
rollover
pushed into oncoming traffic

55
Q

mgmt for patient with SCI and in shock

A

IVF
vasopressors
maintain normothermia
maintain euglycemia

56
Q

High urine pH increases the risk of developing this stone

A

struvite stones (magnesium ammonium phosphate)

MCCQE1 (7 decks)

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