Nov/Dec '21 Flashcards
EKG X axis, 1mm= , so 5mm/1 big box =
40 msec
1 big box = 0.2 seconds
how many millivolts are required for the R wave in lead aVL for one of the suggested LVH criteria?
1.1 mV (11 small boxes)
normal pacemaker rates AV node and ventricle
AVN 40-60, ventricle 20-40
NSTEMI occlusion v without occlusion outcomes
acute total occlusion had higher short and long term risk of MACE and mortality
What is the mm cutoff in lead V2 for STEMI criteria for a 35 yo male
2.5 mm
EKG change in hypercalcemia, waves specifically
osborn waves (pronounced J waves)
what is arterial pulse tapping artifact?
electrical arifact caused by placing an electrode in close proximity to a large artery, can change ST segment and T wave
which lead is reciprocal to aVL?
lead III
true or false, it is normal to have negative T waves in some of the right precordial leads in the setting of RBBB
true
which leads have a formal STEMI criteria cutoff other than 1.0 mm?
V2 and V3
true or false: L posterior fascicular block can cause left axis deviation
false, LPFB causes right axis deviation while LAFB causes left axis deviation
some of the most severe LAD occlusions present with what on EKG?
acute RBBB and LAFB
what is the position, in degrees, of lead aVF in the frontal plane?
+90 degrees
AF with WPW aka preexcited Afib is characterized by
irregularly irregular, polymorphic QRS complexes, sometimes with occasional R-R intervals as short as 200msec
elements of classic triad of WPW syndrome
short PR interval, widened QRS, delta wave
target urine output to reduce the risk of rhabdo induced renal failure
200-300 cc/hr
when do you give tetanus immune globulin
ppx for high risk wound in unimmunized
MC neuro symptom from second stage lyme disease
unilateral or bilateral facial nerve palsy
neuraminadase inhibitor with bronchospasm and wheezing as side effect
zanamivir
when do koplik spots occur in relation to the rash of measles?
prior to the onset of rash
what drug can be substituted for ethambutol in the standard 4 drug regimen for pulmonary TB?
streptomycin
which metaphyseal fx are concerning for child abuse?
corner and bucket-handle fractures
what degree of angulation in greenstick fx require reduction?
greater than 10 degrees
can salter harris 1 be seen on XR
often not seen on XR
MC pediatric radial fractures and complication
torus fx, rare for complication because no true cortical disruption
tx for severe erysipelas
anti-strep like ceftriaxone or cefazolin
what is the thurstan holland sign?
triangular metaphyseal fragment in the metaphysis from salter harris II
tx and length of time for poison ivy
prednisone taper over 21 days
abx to treat lyme in pregnant patient
cefuroxime
galeazzi fracture
distal radius fx, distal radioulnar joint dislocation
tissue adhesives have the equivalent strength of
5-0 nylon sutures
what can worsen tetanus?
minor stimuli such as touch or noise
caused by the inhibition of acetylcholine release, resulting in neuromuscular blockade
botulism
complication of untreated mallet finger?
swan-neck deformity
painless, red, firm nodule that turns to vesicle and then eschar. prior to rash, vague viral syndrome. mouse droppings
rickettsial pox
tx of rickettsial pox
self limited, doxy can hasten resolution
what fx of the proximal fibula is associated with a medial ankle disruption
maisonneuve fx
T or F: SIRS and SOFA criteria typically exclude pregnant women
true
pregnant pt tx for acitve TB
ethambutol, isoniazid, rifampin
what agent used to tx sarin gas exposure has decreasing efficacy as time from sarin exposure increases?
pralidoxime
tx of sarin gas exposure
atropine for ventilation
pralidoxime for paralysis reversal
diazepam to prevent and tx seizures
T or F: posterior acoustic enhancement is seen on US of an abscess
true
CMV encephalitis v cryptococcal meningitis
low CSF glucose, probs fungal if not bacterial
appearance of cryptococcus on india ink?
round encapsulated yeast
bullos pemphigoid has what nikolsky sign
negative nikolsky
two MC infectious causes of SJS or TEN?
mycoplasma pneumoniae, or HSV
high pressure injection injury should be
evaluated by a hand surgeon emergently
alternative to sulfa drug
pentamidine
PCP pt - Steroids are indicated as adjunctive tx in pt with
PaO2< 70 or AA gradient of >35
chronic back pain with insidious onset prior to 40 yo, think
inflammatory cause
chronic back pain present at night and improvement upon standing
inflammatory, axial spondyloarthritis
MC severe complication of varicella
bacterial skin infection
abx for aspiration pneumonia
ceftriaxone and azithro, only add anaerobic coverage if lung abscess or empyema suspected
multiple target like lesions
erythema multiforme - caused by HSV or mycoplasma pneumoniae
recurrent UTI you are suspicious of it being multi drug resistant - choose to treat with
fosfomycin
anthrax treatment
cipro
difference between rubella and rubeola
rubella is mild, may go unnoticed, not associated with significant complications
tx necrotizing soft tissue infection caused by clostridium perfringens?
penicillin based abx plus clinda
tx for patient with new cellulitis and has had recent hospital admissions, other wise normal vitals and exam
amoxicillin and doxy - hospitalization is risk for MRSA
painful posterior pharyngeal lesions due to group A coxsackievirus
herpangina
acute phase mgmt of gout
NSAIDS + ice
what area of the body is the MC site of mycotic aneurysms?
intracranial
lipoma on US
hyperechoic mass without posterior acoustic enhancement
genetic condition associated with numerous epidermoid cysts on face, ears, and trunk
gardner syndrome
systemic causes of erythema nodosum
sarcoidosis, lymphoma, lupus, IBD
traumatic crush injury can cause what kidney issue
acute tubular necrosis
medial thigh and lower leg paresthesias - nerve root
L2, L3, L4
paronychia treatment
elevation of affected cuticle margin
osteosarcoma v ewing sarcoma
osteosarcoma on metaphyses, sunburst/codmans triangle; ewing on diaphyses, onion skinning
kid getting over a cold, hip pain, normal CRP, ESR, WBC,
transient synovitis
