One Liners part 4

Question 1

What 2 things do if 1 day old infant now satting at 80%

Answer 1

1. ) Give 100% oxygen

2. ) If not improve, give prostaglandin E1

Question 2

Why give PGE1 for R-L shunt in newborn?

Answer 2

Prostaglandin E1 is a vasodilator can prevent PDA from closing

Question 3

Why remove gonads in 46 X,Y appearing female after puberty?

Answer 3

Cryptorchid gonads 1-5% risk dysgerminoma or gonadoblastoma after puberty
So keep in to get benefits of puberty
Complete androgen insensitivity

Question 4

Recurrent intrusive thoughts about wanting to stab a loved one, need to perform ritual to get past, 3-5x / day. Tx?

Answer 4

Obsessive Compulsive Disorder

- SSRI - Fluoxetine + CBT

Question 5

Why give Epi for anaphylaxis?

Answer 5

b2 agonist - bronchial SM relaxation

a1 agonist - vasoconstrictor to raise BP

Question 6

What happens in nursemaid’s elbow?

Answer 6

Radial head sublaxation

• kids 1-5 - lifted/pulled by hand/arm
• radial head slips through the annular ligament
• kid keeps it pronated

Question 7

Hemiphyerplasia?

Answer 7

Overgrowth of one side of the body

• assoc w/ Beckwith-Wiedemann syndrome
• also macroglossia, omphalocele
• hyperinsulinism due to pancreatic hyperplasia

Question 8

How treat GDM LGA clavicular fracture in newborn?

Answer 8

If non-displaced – heal spontaneously w/ no long-term sequelae so reassurance + gentle care

Question 9

What surges w/ refeeding in refeeding syndrome?

Answer 9

Insulin

• get Na/H2O retention
• which decreases K, P, Mg (cellular uptake)

Question 10

Clinical manifestation of Refeeding-Syndrome?

Answer 10

Arrhythmia (low K & Mg)
Wernicke encephalopathy (low thiamine)
Seizures
CHF + pulmonary edema + peripheral edema

Question 11

Test for Addison’s ?

Answer 11

ACTH stimulation test:

• compare baseline cortisol level to 1 hour after ACTH injection
• normally cortisol level doubles

Question 12

How treat adrenal crisis?

- think Addison’s, Waterhouse-Friderichsen

Answer 12

IV fluids w/ D5 (normal saline)

• need the sugar to prevent hypoglycemia
• need the NS to prevent hyponatremia

Question 13

Test for glucocorticoid excess?

- think cushing, iatrogenic

Answer 13

Dexamethasone suppression test

• give this in the evening and it should suppress the morning physiologic rise in cortisol
• we will NOT see this suppression in GE

Question 14

How Dx T1DM?

Answer 14

Random blood sugar draw > 200 with…

• weeks of polyuria
• weeks of polydipsia
• weeks of nocturia

Question 15

What is Somogyi phenomenon?

Answer 15

Some mornings…too high evening Insulin =
- hypoglycemia in early morning
- get epi & glucagon released to counter
- so high blood glucose + ketones in AM
Tx: lower evening dose of insulin!

Question 16

Ketonuria + bicarb < 15 mmol/L . . . also x2?

Answer 16

pH < 7.3 and hyperglycemia > 300 mg/dL
(anion gap metabolic acidosis)

Diabetic Ketoacidosis

Question 17

Rapid and deep (kussmaul) respirations?

Answer 17

DKA:

• insulin deficiency means low cellular glucose (despite high serum)
• cells need energy so convert FFA’s into ketones