Mixed Subject Flashcards
Odd Ratio =
ad/bc (“X”)
The risk of Dz second to exposure
Asterixis is …
Flapping Tremor
Fetor Hepaticus is …
“breath of the dead”a sweet musty fecal order of the breath associated w/ Liver Dz.
Trendeleburg sign is associated w/ damage to this nerve
Superior Gluteal
Dactylitis is …
inflammation of the digits associated w/ SCD, Athropathy and TB
Dx a cardiac tamponade w/ …
Transthoracic Echocardiogram
Pt w/ no risk factors and Alpha-1-Antitrypsin Deficiency concurrent w/ Liver Dz or COPD will have this abnormal lab.
Decreased Albumin
Pt w/ elevated Serum CK and Pulmonary Edema indicates this condition.
Acute and Chronic Renal Failure
Pt w/ Dyspnea and elevated BNP will have this condition.
Cardiac Failure, MI, Etc…
Pt w/ Dyspnea, Systolic Ejection Murmur, normal Pulmonary exam. Next lab to check…
CBC for Anemia
Febrile Pt w/ consolidations on CXR and Dyspnea will have this abnormal lab.
Elevated WBC
Straight Leg Test indicates …
Sciatic Nerve/Disc Herniation
Seated Flexion Test and ASIS Compression indicates …
Sacroilliac Dysfxn
Standing Flexion Test indicates …
Illiocsacral Dysfxn
Asthma Pulmonary Fxn tests will indicate ..
Decreased FEV, FEV/FVC
Increased DLCO
“Morning After Pill” contains … and is effective if taken w/n …
Progestin Only
72 hrs of sex
Tx for Benzo OD
Flumazenil
Tx for APAP OD
N-acetylcysteine
Tx for Heparin OD
Protime
Tx for Lead Toxicity
Dimercaprol
Succimer
Edetate Calcium Disodium
Tx for Mercury or Lead Toxicity
Dimercaprol
Pt Chest pain that radiates to jaw and had MI w/n last ten days, to r/o reinfarct use…
EKG
Pt w/ abd pain out of proportion to physical. Barium Enema indicates thickened mucosal fold. Hx of Malignancy, Infection, Pancreatitis, OCP, Portal HTN.
Dx…
Tx…
Acute Mesenteric Ischemia second to Venous Thrombosis
Heparin
Pt w/ abd pain out of proportion to physical. Hx of Heart/Arterial Pathology/Procedure.
Dx…
Tx…
Acute Mesenteric Ischemia second to Arterial Thrombosis
IV Strepokinase, Papaverineif during Angiography
Pt has resistant MDD, next step in pharm
Lithium
Atypical Antipsychotics, Non-SSRI Antidepressant
Pt has Post-Partum Hemorrhage. Amenorrhea, anorexia and inability to breast feed occur d/t …
Dx…
Decreased TSH (all Ant. Pit hormones decreased)
Sheehan Syn.
ST elevation in II, III, AVF. Infarct at …
Inferior
ST elevation in I, AVL, v5, v6. Infarct at …
Anteriolateral
ST depression in v1, v2, v3. Infarct at …
Posterior (suspected, confirm w/ posterior EKG and elevations at v7, v8, v9)
ST elevation in v1, v2, v3, v4, v5, v6. Infarct at …
Anterior
Lead and heart position
I - Lateral II - Inferior III - Inferior AVR - NONE AVL - Lateral AVF - Inferior v1 - Septal v2 - Septal v3 - Anterior v4 - Anterior v5 - Lateral v6 - Lateral
Alcoholic Pt has Ataxia, Confusion, and Eye dysfxn. Smear shows target cellsMost likely Dx is …
Wernicke Encephalopathy
Difference b/t Wernicke and Korsakoff is
Korsakoff is chronic dementia w/ confabulations
Pt w/ urinary frequency and painless hematuria. Dx w/
Cytoscopy and Bx
Pt is prev vaca w/ rabies and is bite by a bat, Tx …
Irrigate wound + 2x Rabies vacc
Pt is bite by a bat, Tx …
Irrigate wound + 4x Rabies vacc + Rabies Ig
Baby cant feed, use OMM to Tx …
Occipital Condyles
Cardiac tamponade is a form of this type of shock
Cardiogenic
TTP Tx
FFP + Urgent Plasma Exchange
Pt w/ elevated LDH, decreased haptoglobin, bloody diarrhea.
HUS
Ask Infant presents w/ bright red blood in stool, most likely Dx.
Meckel Diverticulum
Dx w/ Nuc Tec-99 Scan.
Pt presents w/ multi Cancers and has Fam Hx w/ Mult Cancers, suspect…
Lynch Syn (HNCC)
4 things done by angiotensin II
CNS»_space; Thirst
Posterior Pituitary»_space; ADH»_space; Reabsorb Water and Urea
Alpha-1»_space; Vasoconstriction of renal afferent and efferent
Zona Glomerular»_space; Release ALD»_space; Pull Water in»_space; Increase Preload»_space; Atria release ANP»_space; Blocks cGMP»_space; Dialates renal afferent»_space; Increase GFR, drops two waters
Other ways to describe ‘Dehydration’
Gaisbock Syn
Stress Polycythemia
Spurious
Plasma Volume Loss
The main difference between Polycythemia Vera and Essential Polycythemia.
Essential Polycythemia PLTs >600,000
Retroperitoneal Organs
SAD PUCKER S = Suprarenal (adrenal) glands. A = Aorta/Inferior Vena Cava. D = Duodenum (second and third segments) P = Pancreas. U = Ureters. C = Colon (ascending and descending only) K = Kidneys. E = Esophagus. R = Rectum.
When to use CT or MRI
Squishy = MRI ( EXCEPT if retroperitoneal, then CT) Hard = CT
ACTH activates …
Cortisol
Beta-Lipotropin»_space; MSH/Endophins
What lab determines liver failure?
PT-INR + Albumin < 3
Sertoli cells are activated by … and produce …
FSH/Testosterone
Inhibin B
Sperm
MIF
Leydig Cells are activated by … and produce …
LH
Testosterone
This is a stalker of water
Urea
ADH causes …
water to be reabsorbed
Traits of a Lipid Drug
Taken 1-2/day
High VOD
High Toxicity
Proccessed by the liver
Sx examples of ‘Chronic’ Dz.
What Dx Test(s)?
Weakness/Dyspnea or Tachy/Dyspnea
Get a UA and CXR
Rapid cells regenerate ….
every 5-7 days
Second messenger of anabolism
Tyrosine Kinase
1 Cz of death
Heart Failure
EPO Induced by: Blocked by: Target: MOA: Messenger:
Induced by: Hypoxia Blocked by: Oxygen Target: Bone Marrow MOA: RBC Production Messenger: TK
You have Hgb, but need Hct
Hgbx3=Hct
Ferrous Iron symbol
Fe+2
Pt has Hct >55%, Dx…
Next Step…
Polycythemia
Check EPO
Pt Labs: EPO Inc, RBC Inc, WBC Inc, PLTs Inc
Polycythemia Vera or Essential Thrombocythemia
look at PLTS, >600K = ET
Tx for Essential Thrombocythemia
NS, ASA, Ane
Common Cz of Polycythemia
Wilms Tumor
RCC
Hypoxia
Effects of aldosterone
Increase basolateral Na/K exchange
Zones/Hormones of Adrenal gland
Glomerulus»_space; Ang II»_space; ALD
Fasiculata»_space; ACTH»_space; Cortisol
Reticulanis»_space; ACTH»_space; Androgen
Medulla»_space; Catecholomines
Most common Renal mass
Cyst
Most common primary renal tumor in adults/children
Adults: RCC (adenoma)
Children: Wilms
ALD Induced by: Blocked by: Target: MOA: Messenger:
Induced by: Low BP/HypoNa/HypoVol/HyperK Blocked by: HyperVol Target: Kidney >> DCT/CD MOA: Stimulate basolateral Na/K Messenger: None
Conn Syn Path
Too much ALD
- HypoK
- HyperNa
- HyperVol (HTN)
- Met Alkalosis
1 Cz of Adrenal insufficency in world/US
TB/Steroids
How to tell the differece b/t adrenal insuff d/t TB or steroids
Steroids will still allow other adrenal Fxn»_space; will NOT bronze
Adrenal Steroid path
Cholesterol»_space; Pregnolone»_space; Progesterone»_space;Zone Dependant Hormone
Deficiency of:
11 Hydroxylase …
17 Hydroxylase …
21 Hydroxylase …
HTN/SEX
11 – HTN (High ALD-like, low Renin)/Virilization/HypoK
17 – HTN (High ALD)/No Virilization/HypoK
21 – HypoTN/Virilization/HyperK
Cortisol Induced by: Blocked by: Target: MOA: Messenger:
Induced by: Low Sugar Blocked by: High Sugar Target: Anywhere it wants MOA: Upregulates ALL receptors Messenger: none
Addison’s Path
Too little Cortisol
Cushing’s Syndrome Path
Too Much Cortisol (M+M)
- Moonface
- Truncal obesity
- Purple striae
- Buffalo hump
Pt w/ HTN, HypoK.
Labs show Low Renin + Low ALD
DDx…
2nd HyperALD
- Diuretic Use
- Renin Tumor
- Malig HTN
- Renovascular HTN
Pt w/ HTN, HypoK.
Labs show Low Renin + High ALD
DDx…
Primary Hyper ALD
- ALD Tumor
- Deoxycorticosterone Tumor
- b/l Adrenal hyperplasia
Pt w/ HTN, HypoK.
Labs show High Renin + High ALD
DDx…
Non-ALD Cz
- CAH
- Cushing Syn
- Exogenous Mineralocorticoids
Major adverse effect of PTU/Methimazole
Agranulocytosis
Antithyroid med, 1st trimester
Side effects include …
PTU
Hepatic Failure, ANCA Vasculitis
Pt is a smoker w/ high Ca and low Phos
Dx and Abnl lab …
Lung SCC
Increased PTH-like protein
Decreased PTH
Increased Calcitonin occurs in this cancer
Medullary Thyroid
MEN Syn
1»_space; Pituitary/Pancreas/Parathyroid
2a»_space; Medullary/Pheo/Parathyroid
2b»_space; Medullary/Pheo/Mucosal Neuroma Marfan
Labs of Ca, Phosphate, PTH in aPt w/ CKD
Ca – Low
Phos – High
PTH – High
Pt develops esophagitis following Hyperthyroid Tx
Dx/Tx
Agranulocytosis
Stop the Drug, CBC w/ Diff
Pt w/ hypoglycemia + c-peptide >0.5
Beta-Cell Tumor (Insulinoma)
Pt w/ hypoglycemia + c-peptide 0.2-0.5
Sulfonylurea Use
Pt w/ HTN, HypoK
Dx Test
Renin + ALD
Carcinoid Syndrome
Diarrhea
Wheezing
Flushing
Pt w/ recent stressful event develops Tach, HTN, Arrhythmia, AMS, Lid Lag, Seizure, Fever
Dx/Tx
Thyroid Storm
Thyroid panel + propranolol
High CK indicates
Damage to heart, kidney or muscle
Primary Adrenal Insufficiency labs
ACTH High
ALD/Cortisol Low
Secondary Adrenal Insufficiency labs
ACTH/Cortisol Low
ALD nl
Correct Calcium Equation
Ca + 0.8 x (4-Albumin)
Dx of HyperCa Path
Retest Ca, Correct Ca»_space; PTH Low?
PTH Low (Independent)»_space; Measure PTHrP/25-Vit D/1-25 Vit D»_space; DDx = Malignancy, Immobilization, Vit D Toxic, Granulomatous Dz, Thyrotoxicosis, Vit A Toxic
PTH nl/High (Dependent)»_space; Cz is Primary/Tertiary HyperThyroid, Li, or Fam Hypo/HyperCa
RAIU >40%, DDx
Graves – Symmetrical
Toxic Goiter – Asymmetric
Toxic Node
Antithyroid Peroxidase Ab indicate
Hashimoto’s
Pt presents w/ Watery Diarrhea, Flushing, Pancreatic Tumor. Dx
VIPoma
Monitor DKA w/ this lab
Anion Gap
Pt has proximal muscle weakness and HyperThyrois Sx
Chronic HyperThyroid Myopathy
Neuroimaging shows cortical volume loss and enlarged ventricles. Pt most likely has this behavior disorder
Schizophrenia
Pt has a traumatic experience but is not ready to talk. Next step is to …
educate Pt on the range of reactions to trauma
This type of psychotherapy is indicated for depression and difficulty w/ relationships.
Interpersonal
This type of psychotherapy is indicated for pain disorders or physical Sx
Biofeedback
This type of psychotherapy is indicated for substance abuse or bad habits
Motivational
This type of psychotherapy is indicated for high fxn pt w/ personality disorder, Tx the subconcious
Psychodynamic
This type of psychotherapy is indicated for Borderline Personality Disorder.
Dialectical
This type of psychotherapy is indicated for lower fxn pt w/ psychosis or crisis
Supportive
This type of psychotherapy is indicated for Depression
Cog/Behavioral
This type of psychotherapy is indicated for GAD
Cog/Behavioral
This type of psychotherapy is indicated for Eating Disorder
Cog/Behavioral
This type of psychotherapy is indicated for PTSD
Cog/Behavioral
This type of psychotherapy is indicated for Panic Disorder
Cog/Behavioral
This type of psychotherapy is indicated for OCD
Cog/Behavioral
This type of psychotherapy is indicated for Negative Thought Pattern
Cog/Behavioral
Liver levels to suggest alcoholic liver disease
AST/ALT 2:1
Risk for C. Diff
> 65 yo
Abx use
Gastric Acid Suppression
Elevated Alk Phos indicates
extrahepatic, biliary tree
New IDA in elderly pt, next step is
Colonoscopy and endoscopy
Pulmonary nodular infiltrate with vegetation, IV drug user. Most likely Dx is
Infectious endocarditis d/t Staph Aureus
Tx for pasturella
PCN
Holosystolic murmurs
VSD, TR, MR
Chlamydia Conjunctivitis presents … after birth. Tx w/ ….
1-2 weeks
Oral Erythromycin
Pt presents w/ impaired taste, rash, impaired healing, and alopecia. Dx…
Zinc Deficient
Who gets PPSV23
<65yo w/ chronic condition or current smokers
Taenia Solium is transmitted by
contaminated food, water, undercooked pork
Pt presents w/ tach, dyspnea, Resp Alk, Hypoxia
Resp failure
Pt has rest failure, fever, dry cough and is immune competent. CXR shows b/l infiltrates. LDH increased.
PCP Pneumonia
Anti-mitachondrial Antibody
Primary Biliary Cirrhosis
Ursodeoxycholic Txs
Gallstones, Primary Biliary Cirrhosis, Primary sclerosis Cholangitis
Common bugs travelers diarrhea
Giardia
ETEC
Crypto Parvum
Cyclospora
Pt has Neuro, GI, Pulmonary Sx with HypoNa
Dx…
Legionella
Pt with alcohol abuse and macrocytic anemia. MMA nl, Homocysteine elevated. Pt is deficient in…
Folate
What do atypical antipsychotics, metoclopramide, droperidol, domperidone have in common
Anti Dopoamine – risk of EPS
Pt w/ recent travel hads RUQ pain, Fever, Cyst in right Liver Lobe
E. Histo – Protozoan infection
Restrictive Lung characteristics
Dry Cough O2 Low CO2 Low Ph High Ground Glass on XR
Obstructive Lung characteristics
Wet Cough
PO2 Low (early nl)
CO2 High
Ph Low
Kussmaul Breathing
Short rapid breathing seen in DKA
Cheyne-Stokes Breathing
Near Death Breathing – consistency pattern of apnea
Biots Breathing
Irregular breathing w/ random apnea
Hyponatremia + High Serum Osmo
Dx…
Renal Failure
Hyperglycemic
Hyponatremia + Urine Osmo <100
Dx…
Primary Polydipsia
Malnutrition (Drinker Potomania)
Most common cause of HyperNa is …
HyperVOL
Mild Tx w/ 5% Dextrose, 0.5 NS
Severe Tx w/ NS
Pt w/ DM has Renal damage. First abnormality is …
First quantified damage is …
Glomerular Hyperfiltration
Glm BM Thickening
Dx imaging for Kidney stones
Non-Contrast CT or U/S
Persistant activation of Complement
BM deposits on EM
IF +C3
MPGN
Most common HIV related kidney Damage
Focal Segmental
Nephritic Syndromes
PIG ARM
Post Strep IgA Goodpasture RPGN MPGN
Nephrotic Syndromes
MGN Focal Segmental Min Change SLE Amyloidosis Diabetic Nephropathy
AA, Hispanic, Heroin, HIV, Obesity
Nephrotic Syndrome association…
FSGN
HSV, Lipodystrophy
MPGN
Lymphoma, NSAIDs
Min Change
URTI
IgA Nephropathy
Lupus, Hep B, NSAIDS, Adenocarcinoma
MGN
Best screen for nephropathy
UA microalbuminuria
Pt is prescribed a new drug and is also taking digoxin. You reduce the dose of digoxin by 25-50%, what drug was given to the patient
Amiodarone
Verapamil
Quindine
Propafenone
Pt has a heart condition controlled by medication. Another drug is added and two weeks later the patient develops Neuro and GI Sx. What is the Dx?
Digoxin Toxicity
Free floating bowel in utero
elevated AFP
thickened bowel lining
Gastroschisis – defect lateral to bowel wall
Causes for elevated MS-AFP
Neural Tube Defect
Ventral Wall Defect
Mult Gestation
Low AFP High hCG High Inhibin A Low Estriol Dx...
Turner’s
Down Tri 21
“Turn it Down + say HI!”
Low AFP
High hCG
Low Inhibin A
High Estriol
Edward’s Tri 18
“HE is Edward”
High AFP
Normal hCG
Normal Inhibin A
Normal Estriol
Patau’s 13
Aww… F Patau!”
Pt is in active labor and is given an epidural. Pt becomes lightheaded and BP drops d/t …
vasodilation and venous pooling from sympathetic blockade.
Thorencelntesis shows... pH >7.4 PF/Serum Protein <50% PF/Serum LDH <60% LDH <60% of upper limit (<200) Dx...
Transudate Pleural Effusion
Best way to prevent post-op pneumonia
Incentive Spirometry
Pt has CP and collapses. No pulse is felt. Next best action to allow best chance at survivability is…
Rhythm analysis and shock if necessary
Pt has abdominal pain and orthostatic hypotension. Has N, V, and diffuse pain. Last BM was 3 days ago.
Dx…
SBO
Most common location of ectopic foci that cause atrial fibrillation.
Pulmonary veins
Tx for catonia
ECT or Benzo
Neuromuscular agitation
AML
Autonomic Instability
Dx/Tx
Seretonin Syndrome, Tx w/ cyproheptadine
Benztropine is used to Tx
EPS
Pt presents w/ fever, leukocytosis and LUQ pain
Splenic Abcess
Neonate w/ Triple Bubble, gasless colon, abdominal distention, bilious vomiting. Mom has Hx of cocaine abuse.
Dx…
Jejunum atresia
Anti-Arrhythmic drugs that prolong the QRS complex at higher heart ratehigher
CLASS IC
Flecainide
Propafenone
Moricizine
Meningitis cause by age
<3 mo …
3mo-10yo…
10yr +
BEL, HSV
N. Men, S. Pneumo
N. Men
Pt >50yo w/ mult sites of pain along w/ elevated ESR
Dx…
Tx…
Poly Rheumatica
Low dose steroids
Measurement bias
poor data collection
Selection bias
Subjects are specifically selected for a group d/t a certain feature
Observer bias
Observer has prior knowledge that influences the results
Lead time bias
Earlier Dx w/o affecting outcome
Recall bias
Subjects asked to remember previous exposures and outcomes
Deletion of paternal chromosome 15q11, Dx…
Prader Willi
When to cardiovert
SVT, A-fib, A-flutter, V-tach w/ pulse
When to use defibrillation
V-tach w/o pulse, V-fib, Torsades
Biolateral loss of sensory and pain reception, areflexia, weakness. Vibratory is intact.
Dx…
Arnold-Chiari 1 – Syringomyelia – Fluid filled cavity on spinal cord
Spasms, cant open mouth, muscle stiffness and pain
C. Tetani
Px predictor in CHF pts
sodium
Tx of torsades
Stable: Mg Sulfate
Unstable: Shock
drug indicated for PSVT
Adenosine
Drug indicated for hyperkalemia
Ca Gluconate
Tx for torsades + Quinidine use
Sodium Bicarb
Abortive Migraine Tx
NSAID APAP Triptan Ergots Anti-emetic
Preventive Migraine Tx
Topiramate
TCA
Beta-Block
Divalproex
holosystolic murmur at apex
MR
papillary muscle rupture post MI occurs w/n …
2-7 days
What is femitus
Vibration
Fluid = Increase
Air = Decreased
Proportional to Breath Sounds
Inhalation of burning rubber or plastic may lead to this intoxication
CN
Pt presents w/ Sx of CO poisoning but their membranes and skin are blue
Methemoglobinbinemia
acute back pain and midline tenderness
vertebral fracture
Med to Tx prolactinoma prior to surgery
Bromocriptine
Cabergoline
Free of the disease if the test is negative
NPV (will vary depending on pretest probability)
Have the disease if the test is positive
PPV
b/l motor spasm paresis distal to injury,
Ant. Cord Syn
b/l loss of sensory and vibration, common in MS and vascular injury.
Post Cord Syn
Ipsilateral weakness, loss of vibration and proprioception
contralateral loss of pain and temp
Brown Sequard
Pt has cirrhosis, portal HTN and fluid passage through diaphragmatic defects
Hepatic Hydrothorax
Inflammation of the lacrimal sac
Dacryocystitis
Dressler Syn
Fever
Pleuritic pain
Pleuritic Effusion
Pericarditis
Osteomyelitis after punter through shoe
Pseudomonas
3 causes of chronic dry cough
Nasal Drip
Asthma
GERD
Generalizability
External Validity
Can it be applied to other cohorts
Internal validity
applied to others of same group
Mutated Filagrin
dry rough rash w/ no erythema or exudate
Ichthyosis vulgaris
Mutated Filagrin
dry rough rash w/ no erythema or exudate
Ichthyosis vulgaris
GI malformation
Short Thumb
Macules
Short stature
Fanconi Anemia
Nephrotic syndrome associated w/ HBV
Membranous
Nephrotic syndrome associate w/ minorities
MPGN
Blisters, bull, scars, hypo/hyperpigmentation on sun exposed skin
Hx of HVC, Smoking, Etoh, Estrogen
Pophyria Cutanea Tarda
Tx w/ Phleb or hydroxychloroquine
Sensory Pain and Temp
Ascend two levels then crosses»_space; Thalamus»_space; Parietal Lobe
Spinothalamic Tract
Sensory Proprioception and Depth
Crosses Twice»_space; Thalamus»_space; Cerebellum
Spinocerebellar Tract
Motor Inhibitory
Frontal Gyrus»_space; Internal Capsule Genu»_space; Cross at pyramids»_space; Muscle
Corticospinal Tract
Sensory 2pt, proprioception, vibration and position
Ascend»_space; Cross at pyramids Thalamus»_space; Parietal Lobe
Dorsal Columns
Lateral Pontine Syndrome
Ipsilateral fascial paralysis
Hearing loss
Occlusion at …
AICA – CN 7 + 8
Lateral Medullary Syndrome Ipsilateral limb ataxia Ipsilateral Horners Dysphagia Occlusion at ...
PICA (Wallenburg)– Cerebellar Peduncles, Descend Hypothalamic, Nucleus Ambigus
Medial Medullary Syndrome
Contralateral spastic hemiparesis
Tongue deviates to side
Occlusion at …
Vertebral Artery – CN 12, Pyramids
Median Midbrain Syndrome
Contralateral Spastic Hemiparesis of Arm
Lower Face paralysis
Occlusion at …
PCA (Weber) – CST, Corticobulbar
FTT, Hypoglycemia, Hepatomegaly, Ketosis
G6P Dysfxn
Von Gierke
Type I
<2yo, Cardiopulmonary Failure
Lysosomal Alpha-1,4-Glucosidase Dysfxn
Pompei
Type II
FTT, Hypoglycemia, Hepatomegaly, Ketosis
Amyl-1,6-Glucosidase Dysfxn
Cori
Type III
<2yo Liver Cirrhosis and failure
Branching 1,4»1,6 Enzymme Dysfxn
Anderson
Type IV
Cant exercise, Muscle cramps
Phosphorylase Dysfxn
McArdle
Type V
NNT Equation
1/ARR
NNH Equation
1/AR
Relative Risk Equation
PPV/VPN
Relative Risk Reduction Equation
1-RR
Attributive RiskEquation
PPV-VPN
Absolute Risk Reduction Equation
VPN-PPV
Likelihood Ratio Equation +
Sen/1-Spec = TP/FP = a/b
Likelihood Ratio Equation -
1-Sen/Spec = TN/FN = d/c
Pt complains of tense and tender limb post burn. Eschar from a 3rd degree burn present
Dx…
Vascular compromise d/t Acute Compartment Syndrome
Pt presents w/ HA, Nausea, Eye Pain, Eye is red and mid-diaated. Not reactive to light.
Test and Dx…
Tonometry
Acute Angle Glaucoma
Pts with mono should abstain from contact sports for …
min 3 wks
Tx hoarding disorder w/ …
CBT
Forms of Anabolic Steroids
Testosterone Boldenone Trenbolone Stanozolol Nandrolone
Following heparin therapy, PLTs drop by 50% or a thrombus occurs w/n 10 days
HIT
Role of Beta hcG is…
Maintenance of the corpus luteum
Tx for chorioamnionitis
Abx and Expedited Delivery
Foley catheter produces frank blood post MVA
Pelvic fracture w/ extraperitoneal bladder damage
Post cold knife conization, the best way to determine preterm risk is …
Vag U/S
Short cervix defined as …
Hx of preterm labor: <2.5 cm
No Hx of preterm labor: <2.0 cm
Tx for short cervix …
Hx of Preterm: Progesterone then Cerclage
No Hx of Preterm: Vag Progesterone
HIV Pt presents w/ dull TM that is hypomobile. No exudate, fever, chills, HA.
Dx…
Non-Infection Serous Otitis Media
Baby is tachypneic and cyanotic at rest. Worse w/ feeding, improves w/ crying. Dx…
Choanal Atresia
Neonate presents w/ hoarse cry, jaundice, large tongue , decreased activity. Tone is normal. TSH Increased, T4 decreased. Dx…
Congenital hypothyroid d/t Thyroid Dysgenesis.
Neonate premie presents w/ hydrocephalus sx. MCC is …
Intraventricular Hemorrhage
Major complications of mumps
Aseptic Meningitis and Orchitis
Hernia inferior to Inguinal ligament and medial to the femoral artery
Femoral
Hernia medial to inf epigastric vessels
Direct
Hernia lateral to inf epigastric vessels
Indirect
Pt can’t lift arms after acute asthma attack and Tx. Immediately check …
Electriolyte panal for hypokalemia
Pt w/ acute appy Sx. Next step…
Lap surgery
Pt is an athlete and has a popping in the knee w/ rapid edema. Joint aspiration is bloody. Dx…
ACL tear
Tx for Essential Tremor
Beta-Blocker»_space; Primidone/Topiramate»_space; Benzo
Allergic Rhinitis Tx
Intranasal Corticosteroid
Pt presents w/ 2nd Amenorrhea, Beta HCG is negative. Next test …
Prolactin, TSH, Testosterone, FSH
Pt has syncope, chest pain, neck pain, pericardial effusion, and widened mediastinum. Next step …
CT Angiography to r/o aortic dissection
Menopausal pt w/ ovarian cyst, next step …
U/S and Ca-125
Trisomy 18 heart defects
VSD, ASD, PDA
Infant sinus/pulmonary infections, eczema, thrombocytopenia
Wiskott-Aldrich
X-linked Agammagloblinemia
All Ig is low
MCC of urinary tract obstruction that leads to Potter Sequence
Post Urethral Valves
Tx for NMS
Dantrolene
Bromocriptine
Tx for NMS
Dantrolene
Bromocriptine
Biphasic stridor in infant that improves w/ neck extension
Vascular Ring/Sling
Pt with precocious puberty, first test …
Bone Age
Tay-Sach Sx
Red macula
Diminished motor milestones
Hyperreflexia
Beta-Hexosaminadase A Deficient
Niemann Pick Sx
Red Macula Loss of motor milestone Areflexia Hepatosplenomegaly Sphingomyelinase Deficient
Lysosomal Hydrolase Deficient Course face Hernia Cataracts Hepatosplenomegaly
Hurler
Gaucher Sx
Glucocerebrosidase Deficient
Anemia
Thrombocytopenia
Hepatosplenomegaly
Krabbe Sx
Galactocerebrosidase Deficient
Hypotonia
Loss of milestone
Areflexia
Increased risk of placenta abruption increases the risk of this bleeding pathology
DIC
Meaning of neonate intrauterine acceleration, deceleration
VEAL CHOP
Variable = Cord compression Early = Head compression Acceleration = Okay! Late = Placental Insuff.
Abdominal pain w/ Hip Extension
Psoas Sign
Pt w/ Ptosis. Ice pack test may help Dx …
MG
Rx to facilitate passage of a stone
Tamsulosin
ALS Rx…
Riluzole
MG pt cant swallow, mcc …
thyoma
First line considerations in acute incontinence in the elderly
DIAPPERS
Delirium Infection Atrophy Pharm Psychologic Excessive urine Restricted mobility Stool Impaction
Rheumatoid arthritis involves the … joints
Morning stiffness lasts …
MCP
>1hr
Osteoarthritis involves the … joints of the hands
Morning stiffness lasts …
DIPS and PIPS
<1hr
Pt arrives during July in AZ and presents w/ Syncope, Sweating, Nausea, Vomiting, Cramps, Weak pulse
Heat Exhaustion
Cool Pt
Pt arrives during July in AZ and presents w/ HA, Fever >104, Dry skin, Nausea, Vomiting, Strong pulse, loses consciousness
Heat Stroke
Seek immediate attention
Calcium affect on body systems
High = Slows Down Low = Speeds UP
Bugs that cause osteomyelitis in children
S. Aures
Salmonella
Pt in active labor. When is “arrested labor”
No change in dilation/station w/n 4 hrs w/ regular contractions. W/n 6 hr w/ irregular contractions.
Acute psychosis in children. Consider …
Substance abuse
Wilsons Dz
Thyroid nodule is found. Next step?
TSH, U/S
Pt Tx w/ Chemo/Rad for Hodgkin Lymphoma years prior. Now presents w/ various Sx … Dx
2nd malignancy of Lung, Bone, Breast, Thyroid, GI
Upper motor dysfxn sx
Hyperreflexia, Hypertonicity, Babinski +, Spastic
Lower motor dysfxn sx
Wasting, Weakness, Fasciculations, Areflexia
Tx for acute alcohol w/d
Benzo
CP improves w/ nitro. Spontaneous pain to hot and cold foot. Food regurge. Dx Test…
Esophageal motility study for esophageal spasm
Pt w/ HTN and DM has sudden onset double vision, Ptosis w/ no other findings. MCC …
Nerve ischemia
First line HTN med for preggo
Beta Blocker
CCB
Hydralazine
Methyldopa
Emergency contraception pill
Ulipristal > Levonogestrel
Systolic Murmur w/ wide S2 split
Pulm Stenosis
