Misc

Question 1

tx dog/cat bite?

Answer 1

copious irrigation, make sure tetanus is up-to-date, allow healing by 2° intention
**PPx Augmentin for Pasturella cellulitis

Question 2

human bite –> cellulitis:
organism?
tx?

Answer 2

Eikenella or other oral anaerobes

admit + debridement + IV abx, leave open to heal by secondary intention

Question 3

Black widow bite:
___toxin
s/s?
tx?

Answer 3

neurotoxin

severe abdominal cramps, acute abdomen, n/v;

Tx IV calcium gluconate + muscle relaxants

Question 4

Brown recluse bite:
___toxin
s/s?
tx?

Answer 4

necrotoxin
local skin ulceration
Tx excise ulcer + skin graft

Question 5

Tx enuresis?

Answer 5

bed-wetting alarm > desmopressin > imipramine

Question 6

Breastfeeding contraindications:

Answer 6

HIV, HSV on breast, active TB, chemotherapy, galactosemia, PKU, lithium, EtOH, iodine

Question 7

LP contraindications:

Answer 7

• elevated ICP w/o open fontanelle
• severe cardiorespiratory distress
• puncture site cellulitis
• severe coagulopathy

Question 8

Oligohydramnios =

Answer 8

↓amniotic fluid → pulmonary hypoplasia (respiratory distress) + constraint deformities (club feet)

Question 9

Polyhydramnios:

cause?

Answer 9

GI obstruction or maternal diabetes → ↑amniotic fluid

Question 10

Twin-twin transfusion syndrome (TTTS):
donor twin =
recipient twin =
Dx =

Answer 10

abnormal vascular flow between mono-di twins

donor twin = oligohydramnios/anemia

recipient twin = polyhydramnios/polycythemia

dx = hct difference >15

Question 11

BO hemolytic disease:  
↑risk of... 
Dx? 
PPx? 
Tx?

Answer 11

type-O mom w/ type-A/B baby develops anti-A/B IgG → crosses placenta and attacks fetal RBCs → causes fetal hydrops

↑risk of late-onset high output CHF
Dx Coombs test
PPx RhoGAM
Tx intrauterine blood transfusions

Question 12

Rh hemolytic disease (erythroblastosis fetalis):
Dx?
PPx?
Tx?

Answer 12

Rh- mom w/ 2nd Rh+ baby develops anti-D IgG → crosses placenta and attacks fetal RBCs → causes fetal hydrops

Dx? Coombs test
PPx? RhoGAM
Tx? intrauterine blood transfusions

Question 13

Hyponatremia + pancytopenia =

Answer 13

consider RMSF

Question 14

Refeeding syndrome in eating d/o:
↑synthesis of…
decr electrolytes?

Answer 14

incr synthesis of glycogen, fat, proteins = uses up electrolytes –> ↓K and ↓phosphate

Question 15

Cyanide:
presentation?
management?

Answer 15

headache → agitation/confusion → seizures and metabolic acidosis

Tx nitrites + hydroxocobalamin + thiosulfate

Question 16

Iron ingestion: presentation?

Answer 16

upper GI bleed, abd pain, metabolic acidosis, shock

Question 17

Tx TCA OD?

Answer 17

sodium bicarb or Fab antibody fragments

Question 18

Adolescent “HEADSSS” assessment includes…

Answer 18

Home, Education, Activities, Drugs, Sex, Suicide, Safety

Question 19

Sports contraindications:

Answer 19

• bleeding d/o (hemophilia)
• single eye
• single kidney
• unexplained syncope
• infectious mono (to prevent splenic rupture)

Question 20

Late-onset congenital adrenal hyperplasia:

Answer 20

21-hydroxylase deficiency → excess of sex steroids → precocious puberty in boys

Question 21

Tanner in Females:
1
2
3
4
5

Answer 21

1 = kid
2 = breast buds
3= breast elevation, peak growth velocity
4 = areolar mound (big nipples)
5 = adult

Question 22

Tanner in Males::
1
2
3
4
5

Answer 22

1 = kid
2 = scrotal darkening, thin long pubic hair
3 = dark curly pubic hair
4 = adult pubic hair but w/o full coverage; peak growth velocity
5 = adult

Question 23

Ataxia-telangiectasia is a/w increased incidence of…

Answer 23

non-Hodgkin’s lymphoma and gastric carcinoma

Question 24

Prune belly syndrome =

Answer 24

1. partial or complete lack of abdominal wall muscles
2. Cryptorchidism
3. urinary tract abn (VUR), UTIs
4. VSD
5. malrotation
6. club foot