Missed Q's Flashcards
1
Q
What complication is MC associated w/Bell’s palsy?
A
Corneal exposure keratitis
2
Q
Pt w/suspected Bell’s Palsy that is able to wrinkle forehead on affected side indicates what?
If it does NOT spare the forehead, then what?
A
Central lesion
Bell’s Palsy
3
Q
B/L facial nerve paralysis ddx?
A
Lyme
Infectious mono
HIV
Botulism
4
Q
Rhabdo UA shows what?
Goal of therapy is what?
E- abnormalities?
A
3+ blood, no rbcs
Urine output of 3 mL/kg/hr
Hyper K and PO4, low Ca
5
Q
What test in pts w/GBS correlates w/need for intubation?
A
Dec FVC
6
Q
What characterizes a Galeazzi fracture?
A
Fracture of distal 1/3 of radial shaft
Disruption of distal radioulnar joint (DRUJJ)
7
Q
Pt w/exquisite sensitivity to percussion or chewing w/acute pain, swelling and mild tooth elevation has what?
Common predisposing condition?
A
Periapical abscess
Cavities
8
Q
What is alveolar osteitis?
A
Dry socket
9
Q
ABD pain, bleeding, tenesmus in setting of active radiation therapy indicate what?
A
Acute radiation proctocolitis
10
Q
MC cause of SVC syndrome?
MC presenting symptom?
A
Malignancy
Dyspnea from mediastinal compression
11
Q
Liver Cirrhosis causes asterisks how?
A
Inc metabolism of ammonia leads to inc Glutamine in CNS
12
Q
Cocaine OD is aka what?
Treat how?
Avoid?
A
Sympathomimetic toxidrome
Benzos
BBlockers
13
Q
What cofactors need to be given with ethylene glycol poisoning?
A
B1, B6
Thiamine and pyridoxine
14
Q
Pt w/eye exam showing superficial punctate epithelial surface irregularities which cover the entire cornea has what? Often seen in b/l eyes
Treatment?
A
UV keratitis
Topical NSAIDs +/- abx or cycloplegics
15
Q
Treat klebsiella PNA how?
A
3rd gen cephalosporin + aminoglycoside
16
Q
Pt w/organophosphate poisoning, how long do you keep giving atropine?
Why?
Dose and route?
A
Until respiratory secretions decrease
Mortality linked to ventilatory failure from severe secretions and bronchoconstriction
2-4 mg IM
17
Q
Pt w/ankle pain needs xray when?
A
Tenderness to posterior edge of LATERAL Malleolus
18
Q
A spiral fracture of the proximal 1/3 of the fibula assoc w/tear of the distal tibiofibular syndesmosis and the interosseous membrane is what?
A
Maisonneuve fracture
19
Q
Treatment of acute sinusitis?
After 7-10 days treat how?
A
NSAID
Abx
20
Q
Volar wrist refers to what?
A
Palmar aspect
21
Q
Thyroid storm, what is the initial treatment? What does it do?
A
1) BB - blocks peripheral effects of hormone
2) dexamethasone - blocks peripheral conversion of T4 to T3 (steroids also help with any AI)
22
Q
What layer of skin edema defines urticaria?
A
Dermis - via transvascular fluid extravasated
23
Q
STEMI is differentiated from pericarditis how?
A
STEMI has reciprocal ST depression
If inferior MI, look for ST depression in leads aVL, V1, V2
24
Q
What are the correct positions (2) for electrode pad placement for cardioversion?
A
Left Ant chest and left upper back
OR
Right upper chest and left midaxillary line
25
What causes barotitis (middle ear barotrauma)?
Descent barotrauma
26
Which lab studies are unreliable when drawn from an IO?
Which med takes longer to take effect when delivered through IO?
Wbc, K, Ca, AST/ALT, blood O2
Succinylcholine
27
Cauda Equina syndrome is due to injury of what structures?
Lumbosacral nerve roots
28
What is the narrowest part of the airway in adults?
Children?
Vocal cords
Cricoid ring
29
Formula for predicting ET tube size in kids?
(Age + 16) / 4
30
What vascular structure can be injured w/proximal fibular fracture?
Anterior tibial artery
31
Pt w/high altitude cerebral edema, what is the treatment?
High-flow oxygen
Dexamethasone
Immediate descent
32
Pt that has a corneal abrasion, what is the management?
Lid eversion - looking for foreign body
Topical Abx
F/u with ophtho
33
What is Seidel’s sign?
Means what?
What is contraindicated?
Streaming of aqueous humor leaking from anterior chamber during fluorescein exam secondary to penetration of the cornea
Globe rupture
Measuring IOP
34
Jones fracture (transverse fracture in the diaphysis of the bone 1.5 cm distal to end of bone aka base of 5th metatarsal ) should be treated how?
Immobilized w/posterior splint
35
What traumatic injury to the eye will result in significantly increased IOP?
Retrobulbar hematoma
36
Treatment of otitis externa?
Mild - Acetic acid/hydrocortisone
| Mod/Severe - Cipro/hydro
37
Pt with an AICD is getting frequent shocks d/t malfunction, what can you do?
What happens?
How is ICD different from pacemaker on Xray?
Place magnet over it
Paces only, no shocks
Thicker wire in distal lead
38
Pt with palpitations after getting Holliday heart but no other symptoms, what is the treatment?
Observation 24-48 hours
39
What is the MC form of botulism?
Infantile
40
What causes a Lisfranc injury?
Pain where?
What Xray shows it? What does it show?
Severe plantar flexion of foot usually by tripping
Tarsal metatarsal joint, dorsum of foot
AP view shows lateral shift of 2nd metatarsal off middle cunieform
41
Pt with acute pulmonary edema should be treated with what immediately?
What other interventions?
Nitroglycerin
BiPAP, furosemide, nesiritide
42
What artery is responsible for blood supply to the AV node?
Occlusion can result in what?
RCA
Complete heart block
43
What are the 2 techniques to correct nursemaid’s elbow?
Hyperpronation
| Supination then elbow flexion
44
What does the inferior alveolar nerve block anesthetize?
All mandibular teeth to the midline, anterior 2/3 of tongue, floor of oral cavity
45
Intubated patients should be managed how on a ventilator?
I:E ratio of 1:3 or 1:4
Inspiratory flow rate inc > 100 L/min
46
Where does the spinal cord terminate in adults?
Infants?
What is the name of the terminal end of the spinal cord?
L1/L2
L3
Conus medullaris
47
What can happen to the eye after blunt trauma?
Treat how?
Iridocyclitis
Homatropine - dilates pupil
48
What are the 5 H’s in asystole?
```
Hypoxia
Hypovolemia
Hypo/hyperkalemia
Hypothermia
H+ - acidosis
```
49
What are the 5 T’s in asystole?
```
Thromboembolism (PE)
Thrombosis (MI)
Tension PTX
Tamponade - pericardial
Toxin
```
50
Treatment for serotonin syndrome?
Benzos
| Cyprohepatidine
51
Treatment for NMS?
Bromocriptine
52
Patient that has frostbite, how do you treat?
WET rewarming, ideally a whirlpool
53
What otc drug is associated with serotonin syndrome?
Dextromethorphan
54
How long can digits survive ischemia when they are amputated?
Limbs?
8 hours
4-6
55
Patient w/skull fracture that is linear, what is the disposition?
Who should get antibiotics?
Admission for observation
Open, depressed skull fracture
56
Jellyfish sting, what is treatment?
Salt water then hot water
57
What is the treatment for bupivacaine poisoning?
What else does this treat?
Intralipid
Local anesthetics (lidocaine), BBs, CCBs, TCAs
58
Where do you place chest tubes?
4/5th ICS at midaxillary line
59
What is the earliest US finding of cardiac tamponade?
How will the IVC appear in pericardial tamponade?
RA diastolic collapse
Plethoric (dilated and noncollapsable w/respiration)
60
What is Mallet finger?
If it gets worse can become what?
Treatment?
Forced hyperflexion of DIP, cannot extend DIP
Swan neck deformity (hyperextension of PIP and flexion of DIP)
Splinting of DIP in full extension or slight hyperextension
61
Why do bodybuilders use GHB?
Who else uses it?
PE shows what?
Elevates HGH
Nightclub goer
Agitation, bradycardia, respiratory depression
62
How to treat hydrofluoric acid burn?
Irrigation and calcium gluconate
63
What is the narrowest part of the airway in peds?
Cricoid cartilage
64
What is the main difference in epiglottis bw adults and peds?
Peds is longer, narrower, omega shaped
65
What is HHV-6?
Roseola
66
Patient that overdosed on Benzos that now has a fever, why?
Dx how?
Aspiration PNA from passing out
CXR
67
How do you treat a SALTER Harris type 1 fracture of the ankle?
Immobilize, non weight bearing
68
Why do you give BB’s in acute MI?
Dec risk of ventricular dysrhythmia if given w/in 24 hours
69
Le Fort fracture 1, 2, 3: describe
1 - speak no evil (lower face)
2 - see no evil (around the eyes)
3 - hear no evil (to the ears) —> can have rhinorrhea and cribriform plate disruption
70
UNILATERAL disc herniation bw L4/L5 compresses which root?
L4
71
Outpatient tx of PID?
Ceftriaxone 250mg IM
| Doxy 100mg PO BID x 14 days
72
When should you do a thoracotomy?
Chest tube output of > 20 mL/kg (or 1500 mL) or > 200 mL/hr
73
Where do you perform needle decompression of the chest?
2nd ICS at midclavicular line
74
What drugs in adults can be given via ET tube?
```
NAVEL
Naloxone
Atropine
Vasopressin
Epinephrine
Lidocaine
```
75
What level of carboxyhemoglobin level indicates need for hyperbaric therapy?
What else?
> 25%
Syncope, coma, seizure, FND, confusion
76
What causes bleeding into the anterior chamber of the eye secondary to blunt trauma?
Hyphema
77
What is a Clay shoveler’s fracture?
Describe it?
Avulsion to SP of C6/C7
Stable
78
Dementia patient has what kind of memory?
Good long-term recall
NO recall of immediate events
79
What is the MC visceral artery aneurysm?
Dx how?
Splenic artery
Angiogram
80
What is trephination?
Cutting a hole in the nail to release blood in subungual hematoma
81
What occurs 1st in compartment syndrome?
Next?
Sensory deficit
Loss of pulses
82
What are the Kanavel Criteria?
Tenderness along course of flexor tendon
Fusiform or symmetrical swelling of the finger
Pain w/passive extension
Flexed finger
83
GHB main complications?
Respiratory depression
| Rhabdomyolysis
84
What is the MC abnormal vital sign in pt with a PE?
Tachypnea
85
MC Primary brain tumor?
MC malignant tumor?
HA w/brain tumor worse when? Why?
Meningioma
Glioma
morning, ICP is highest
86
Infant that presents w/sudden onset abdominal distention and bilious emesis has what?
Correct how?
Malrotation w/midgut volvulus
Ladd’s procedure
87
What is the standard energy level for cardioversion?
Peds?
100 joules
.5-1 J/kg
88
What is the San Fran criteria for syncope high risk?
```
CHESS
CHF
Hct < 30%
ECG abnormal
SOB
Systolic BP < 90
```
89
What classifies to moderate persistent asthma?
Night awakenings > 1x/wk, aka 5 or more a month
90
What drugs can cause asthma exacerbation?
ASA
| BBlocker
91
MC complication of basilar skull fracture?
CN entrapment: CN 7 - facial droop
92
McRoberts maneuver uses what type of pressure?
Suprapubic
93
What is the MC cause of dysentery in the US?
Shigella sonnei
94
When is proper irrigation of chemical burn achieved?
PH between 7.0-7.2
95
What nerve is MC injured in perilunate dislocation?
Median nerve
96
Earliest neuro finding of heat stroke?
Ataxia
97
How to treat Croup?
Dexamethasone and racemic Epi
98
Treatment for isolate pubic ramus fracture (nondisplaced)?
Conservative treatment w/PT and weight bearing exercises
99
What is a hematoma above inguinal ligament called?
Indicates what?
Destot’s sign
Pubic ramus fracture
100
HIV exposure prophylaxis should be started when?
W/in 2 hours improves transmission prevention
101
How does anticholinergic poisoning present?
Antidote?
Mad as a hatter, blind as a bat, red as a beet, hot as a hare, dry as a bone
Physostigmine - AChE-i
102
What is a luxatio erecta?
Inferior GH dislocation, least common
| Assoc w/axillary artery injury
103
What causes diarrhea that was initially profuse and watery and then LATER becomes bloody?
Yersinia
104
Clinical signs of epididymitis?
Increasing, dull, UNILATERAL scrotal pain
Erythematous, painful, swollen scrotum
Relief w/testicular elevation (Prehn’s sign)
105
What is an Amp of D50?
25 grams of dextrose = 100 calories
Aka 25 grams / 50 mL
106
50% dextrose means what?
50 grams / 100 mL
107
ACLS epinephrine dose?
1mg (10 mL of 1:10,000)
108
Anterior STEMI will have what reciprocal changes?
ST depression in III and aVF
109
Acute ST elevation in lead aVR can indicate what?
Left main coronary artery
110
What formula do you use for the DEPTH of an ET tube in pediatric pt?
(Age in yrs/2) + 12 OR 3x tube size
In centimeters
111
What artery is indicated in a TIA that causes hemiplegia/quadriplegia, sensory changes, blindness, vertigo, difficulty speaking, etc?
Vertebrobasilar artery
112
What is there early respiratory alkalosis in ASA poisoning?
ASA directly stimulates the respiratory center of the brain to cause hyperventilation
113
Axial load falls directly on pt head, at risk for what fracture?
Jefferson Burst fracture of C1
114
What causes vesicular rash around the ear canal, facial paralysis, and hearing loss?
Ramsay hunt syndrome caused by zoster
115
Hypotensive patient with VTach what is the treatment?
Synchronized cardioversion
116
What are the 5 treatments for HPV warts?
```
Podofilox
Imiquimod
Cryotherapy
Trichloroacetic acid
Surgical removal
```
117
Old pt that is constipated w/lots of comorbitidites and CT shows no obstruction has what?
Treat how?
Ogilvie syndrome
Neostigmine (SE: Bradycardia, asystole)
118
MC fracture involving the elbow in children under 8 years old?
What nerve is injured?
Supracondylar fracture
Anterior interosseous - branch of median n.
Check w/“ok” sign
119
Primary blast injury causes what injury?
Secondary?
Tertiary?
Quart?
TM rupture, pulmonary contusion
Injury via flying object
Victim flying through air and hit stuff
Burns, radiation, other injures
120
Burns from military white PO4 munitions produces what lab abnormalities?
HypoCalcemia
| HyperPO4
121
What vessel is located at the commissure of the lip?
Labial artery
122
How to manage acute COPD exacerbation?
Duoneb
PO Prednisone (60mg)
BiPAP
Abx
123
Def in what vitamin causes anemia and peripheral neuropathy?
Vit B12
124
Person going through opiate withdrawal what med to give for symptomatic relief?
Clonidine
125
IT CRIES mneumonic?
```
Infection
Trauma, tourniquet
Cardiac disease
Reflux, rxn to meds, rectal fissure
Intussusception
Eye (corneal abrasion)
Strangulation, hernia
```
126
Treatment for epididymitis in pts < 35?
> 35?
Ceftriaxone + Doxycycline
Bactrim or Levo/ciprofloxacin
127
What is Hutchinson sign?
Means what?
Blistering at tip of nose
Shingles - herpes zoster
128
Forced hyperextension causes what kind of injuries?
Called what?
Prognosis?
Sensory and motor, deficit UE > LE
Central cord
Average
129
EKG changes d/t hyperkalemia other than peaked T waves?
Bradycardia, wide QRS, dropped/absent P waves
130
GHB is used to treat what medical condition?
Narcolepsy
131
What is AV-Nodal Reentrant Tachycardia?
Treat how?
MC cause of paroxysmal SVT
Adenosine if stable
132
What is a classic symptom of PUD?
Pain that wakes pt up in the middle of the night bc acid production peaks at 2am
133
What crown-rump length is a heartbeat expected on US?
5mm
134
What is the inability to reduce the foreskin back to an atomic position called?
Paraphimosis
135
What is phimosis?
Inability to retract the foreskin
136
What can happen if septal hematoma left untreated?
What is the consequence of a septal hematoma?
How to determine if it is a septal hematoma?
Necrosis and septal perforation
Abscess, saddle nose deformity
Size will NOT change with administration of oxymetazoline
137
What classes are local anesthetics divided into?
Esters - procaine (Aka Novocain)
Amides - lido, bupivacaine
All the amides have 2 “I’s” in their name, the esters only have 1!!!
138
Pt that comes from the Caribbean and has severe, diffuse myalgia and arthralgia has what?
Dengue fever
139
Old pt with abdominal pain and distention with nausea but NO vomiting often has what?
Treat how?
Sigmoid volvulus
Sigmoidoscopy
140
What is splenic sequestration crisis?
Causes what?
Rapid splenic sequestration of RBCs
SM, severe anemia
141
Acute chest syndrome has what CF?
CXR shows what?
Fever, CP
Pulmonary infiltrate
142
What radiographic finding of a COPD pt suggest inc risk of a PTX?
Bullae
143
What is normal compartment pressure?
What P is assoc w/ischemic necrosis?
What else to look for?
0-10 mmHg
30-40 mmHg
HoTN
