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PEER Review Flashcards

1
Q

Erythema Nodosum

A

Red tender nodules on extensor surfaces
2/2 IBS, infx, meds
a/w HLA-B27

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2
Q

HSP

A 
pediatric vasculitis (nonblanching palpable purpura)
GI: intussusception
Renal: hematuria, protinuria
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3
Q

Pyoderma gangrenosum

A

gangrenous lesions + IBS

a/w skin trauma

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4
Q

Eyes:

  • Cherry macula
  • Blood & Thunder
  • Flame hemorrhages & papilledema
A
  • CRAO
  • CRVO
  • HTN emergency
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5
Q

Thyroid Storm tx

A 
TIC-B
Thionamide (PTU or Methimazole) - decr production
Iodine - neg feedback
Corticosteroids - stop T4 to T3
B-blockers
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6
Q

Scorpion toxicity

A

oral secretions
muscle jerking
wandering eyes (opsoclonus)

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7
Q

Black widow toxicity

A

alpha toxin (norepi) - HTN and tachy

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8
Q

Brown Recluse

A

Necrotic skin, hemolysis (DIC)

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9
Q

von Willebrand dz

A

Dysfunctional plt adhesion

Tx: factor VIII (similar to hemophilia A)

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10
Q

Infant weakness/paralysis w/ preserved deep tendon reflexes

A

Infant botulism

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11
Q

Pemphigus vulgaris

A

Elderly skin & mucosal blisters - FLACCID w/ +Nikolsky

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12
Q

Bullous pemphigoid

A

elderly skin blisters - TENSE, – Nikolsky

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13
Q

Gen. edema, protinuria, low albumin, high cholesterol

– Thrombophilic (hypercoagable)

A

Nephrotic Syndrome

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14
Q

Differentiate Anticholinergic and Sympathomimetic

A

DRY vs WET skin

(both hot, dilated, delirious

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15
Q

Anticholinergic toxidrome

A

delirium, DRY, flushed, hot, dilated

2/2: atropine, diphenhydramine, antipsych, jimson weed

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16
Q

Sympathmomimetic toxidrome

A

WET, hot, dilated

2/2: PCP, cocaine, ecstacy, meth

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17
Q

Infectious liver abscess (southwest)

A

Entamoeba histolytica (tx: IV metronidazole)

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18
Q

GI complication of HSP

A

Intussesseption

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19
Q

ABI (ankle-brachial index)

A

SBP of DP / SBP of arm
>0.9 is normal,
<0.5 severe impairment of flo

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20
Q

Tx of HTN emergency

A

Lower by 25% over 1 hour and to 160/110 over the next 6 hours

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21
Q

LBBB on EKG

A

QRS > 120
V1 & V2 - broad and deep S wave
V5 &V6 - broad and clumsy notched R wave

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22
Q

RBBB on EKG

A

QRS > 120

V1 & V2 - RSR’ (‘M’)

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23
Q

STEMI on ECG

A
  • > 1 box elevation in 2 contiguous leads
  • New LBBB
  • reciprocal changes = worse prognosis

(historically there should be 1.5 or > elevation in V2/V3)

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24
Q

Stye (hordeolum) vs Chalazion

A

Hordeolum - lashline

Chalazion - eyelid

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25
Q

Pacemaker undersensing & oversensing

A

inappropriate pacer spikes (under) not enough pacing / syncope (over)

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26
Q

Wet/Dry Beriberi

A

Thiamine (B1) Deficiency

  • Wet = CHF w/ dyspnea & pulm edema
  • Dry = Neuro w/ AMS, ataxia (Wernicke-Korsakoff)
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27
Q

High CO heart failure

A

Anemia
Thyrotoxicosis
AV Fistula
Beriberi

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28
Q

SIADH

A

Lung Cx

  • inapproprate salt wasting
  • tx: fluid restriction
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29
Q

Acute Porphyia

A

Increased heme

- psychosis and abdominal pain

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30
Q

Wilson’s Disease

A

increased copper (decr ceruloplasmin)

  • change in personality
  • tremor/ataxia
  • K-Fleischer ringxs
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31
Q

von Willebrand disease Tx

A

Factor VIII is the treatment for bleeding (25-50 U/kg)

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32
Q

Tumor Lysis Syndrome

A 
HyperK
HyperPhos
HyperUremia
HypoCa
Acute renal failure
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33
Q

Platelet transfusion level with acute bleeding

A

<50,000

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34
Q

Hemophilia A replacement

A

Factor VIII

  • 25 u/kg moderate injury
  • 50 u/kg severe injury
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35
Q

TTP pentad

A 
F - fever
A- anemia (hemolytic, schistocytes)
T- thrombocytopenia
R- renal failure
N- Neuro (AMS) 
-- Tx: plasma exchange
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36
Q

DIC labs

A

Low platelets and fibrogen

Elevated PTT, PT, INR, dimer

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37
Q

Virchow node

A

Supraclavicular lymph node in peds and adults that signifies intraabdominal cancer

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38
Q

Guillain-Barre

- Miller-Fisher varient

A

Ascending paralysis, areflexia

- MFV = ophthalmoplegia

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39
Q

Methanol
Ethylene glycol
Isopropanol

A

M - blindness, formeldhyde, folic acid
EG - CaOx crystals, fluoresent urine
Iso - Osm gap but NO AGAP (acetone)

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40
Q

“OK” sign strength tests which nerve

A

Median

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41
Q

Centripetal Rashes

A

(move centrally - extremities to trunk)

- RMSF, syphilis, dengue, Kaposi, coxsakie

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42
Q

Digoxin toxicity tx rules (2)

A
  • AVOID using calcium to treat hyperK, “stone heart”

- arrhythmia are treated with Fab NOT electricity

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43
Q

(triad) severe epigastric pain, vomiting, inability to pass NG tube

A

gastric volvulus

- stomach has duel blood supply so recovery is good

44
Q

Benztropine

A

anti-cholinergic tx of EPS sxs

45
Q

Unstable spinal fractures

A

Jefferson fracture (C1 burst)
flexion teardrop
bilateral facet d/l
Hangman (C2 fracture and dislocation)

46
Q

Juvenile arthritis (Stills dz)

A
  • F > M
  • around 2 years of age
  • large joints (hips)
  • painless morning limp that improves throughout the day
47
Q

TM perf tx (wet vs dry)

A

Dry perf - supportive care only

Wet perf - anti-pseudo abx

48
Q

Epiglottitis tx

A

Airway
Humidified oxygen
Ceftriaxone
(steroids and rac epi have no role)

49
Q

Entamoeba histolytica

A

liver abscess, fever (latino)
fecal-oral transmission
Metronidizole

50
Q

Uremic patients who are bleeding

A

Desmopression, dDAVP (increases VIII and vWF)

51
Q

bitemporal vision loss

A

pituitary tumor

52
Q

Lupus testing

A

ANA - most sensitive

Anti-Sm - most specific

53
Q

highest electrical resistance

A

fat, tendon, bone

54
Q

Primary adrenal insuff

Addisons dz

A
  • hyperpigmentation
  • hypoNA
  • HyperK
  • hypoGluc
55
Q

Secondary Adrenal Insuff

A

low ACTH levels

  • normal pigmentation
  • low NA and gluc
  • high K
56
Q

MC cause of atraumatic hip pain in children

A

Transient synovitis
(no fever, normal ESR)
- Tx: rest and NSAIDS

57
Q

Anterior Cord Syndrome

A

hyperflexion injury

  • spinothalamic tract (pain and temp loss)
  • corticospinal tract (motor loss)
58
Q

Mallet finger

A

disruption of the extensor tendon at the level of DIP

forced flexion

59
Q

Jersey finger

A

disruption of the flexor tendon at the DIP joint

forced extension

60
Q

Bennett fracture

A

intra-articular fracture of the base of the thumb

61
Q

trigger finger

A

stenosis of the flexor tendon sheath, prevents extension

62
Q

Gamekeeper thumb

A

avulsion of the ulnar collateral ligament at the thumb MCP (forced abduction and extension)

63
Q

hyperosmolar hyperglycemic syndrome (HHS) electrolyte abnormality

A

All are hypokalemic and hypovolemic

64
Q

Retrophyringial abscess measurements

A

C2 > 7 mm (adult or children)
C6 > 14 children
C6 > 22 adult

65
Q

TLS electrolytes

A

High K, Phosp, Uric acid, LDH

Low Ca

66
Q

Leptosporitia

A

Hawaii - fresh water w/ animal urine - spiralcetes

- hepititis, nephritis, DIC

67
Q

doxycycline in kids <8 yo

A

Treatment of RMSF

68
Q

Waterhouse-Friderichsen

A

meningococcemia w/ shock, petechiae, and adrenal insufficency

69
Q

RMSF that invades WBCs

A

Ehrlichiosis – diffuse rash, leukopina, DIC

70
Q

Rubeola

A

measles

- facial rash that spreads to body

71
Q

Acute Interstitial Nephritis (AIN)

A

Allergic reaction in a kidney

  • reaction to a drug (PNC, sulfa, diuretics, NSAIDs)
  • fever, rash, eosinophilia, WBC casts
72
Q

petechiae of the wrist and ankles

A

Meningococcemia

73
Q

Roseola infantum

A

Fifths disease

- fever 3-4 days, then rash

74
Q

Rash + LAN post auricular and occipital

75
Q

condyloma lata

A

secondary syphilis

76
Q

congenitally absent parathyroids

A

DiGeorge Syndrome

77
Q

Hyperviscosity syndrome

A
  • hyperleukocytosis seen in AML

- pathologic proteins in multiple myeloma

78
Q

BP management in stroke

A 
Iscemic stroke (<185/110 for tPA, otherwise do not correct unless >220/120)
Hemorrhagic (correct to 140-160)
79
Q

HTN + edema + proteinuria

A

Nephrotic syndrome

  • hypoalbuminemia
  • Thrombophilia
  • Hyperlipidemia
80
Q

Hard signs of vascular injury

no further workup -> OR

A
  • pulsless extremity
  • bruit or thrill
  • shock
  • expanding hematoma
81
Q

Cyproheptadine

A

Serotonin antagonist

- tx: serotonin syndrome

82
Q

Digitalis Ab (Fab) indicators

A
  • hyperkalemia
  • ventricular dysrhythmias
  • coingestions
83
Q

how to evaluate for pelvis instability

A

lateral compression of the iliac wings (no “opening” manuvers)

84
Q

IV BP med of choice for hypertensive crisis

A

Nitroprusside

85
Q

fever, myalgias, rash to ankles and wrist

A

RMSF

  • adults, KIDS, and TERM pregnancy get doxycycline
  • early pregnancy get Chloramphenicol
86
Q

Gray baby syndrome

A

Chloramphenicol (CAM)

87
Q

Cloudy vision with floaters

A

vitreous hemorrhage

88
Q

pupil that dilates in swinging flashlight test

A

optic neuritis

89
Q

MC organ injuried in blunt trauma (kids and adults)

90
Q

Guillain-Barre

A

Ascending paralysis

  • areflexia
  • CSF with high leukocytes
91
Q

Elderly with fever, h/a, abrupt personality change

A

HSV encephalitis

92
Q

Infections that cause Erythema Multiforme (target lesions)

A

HSV

Mycoplasma pneumoniae

93
Q

Confusion, ataxia, oulomotor dysfunction (nystagmus); normal coordination & cerebellar testing

A

Wernicke encephalopathy (etoh abuse,

94
Q

MI in LBBB

Sgarbossa

A

concordant STE >1 mm
ST depression >1mm V1-V3
discordant STE >5mm

95
Q

Strawberry cervix / froathy d/c

A

Trichamonus

96
Q

Chalazion

A

(CHRONIC, internal granulomatous swelling of the eyelid) - minimally tender, NOT an infection

97
Q

SO4, LR6, Everything else 3

A

Oculormotor:
CN4: superior oblique; downward rotation to look to nose
CN6: lateral rectus; abduction, lateral gauze
CN3: all other eom, eyelid opening, pupilary response
(CN7: eyelid closing)

98
Q

Marcus Gunn pupil

A

Swinging light test

  • afferent pupil defect (CN2)
  • no response to direct light
  • will constrict to contralateral light
  • Abnormal eye will appear DILATED
  • optic neuritis (MS)
99
Q

Defect in sympathetic pupilary input

A

Horner’s syndrome:

  • ptosis
  • miosis
  • anhydrosis
100
Q

CN3 palsy

A

-Cant open lid
-down and out dilated eye
(only SO4 & LR6 work)

101
Q

CN6 palsy

A

cant look laterally

102
Q

absent knee jerk

absent ankle jerk

103
Q

bi-temporal hemianopsia vs homonymous hemianopsia

A

pituitary tumor; optic chiasm

vs cerebellar defect; stroke

104
Q

lateral vs medial epicondylitis

A

extensor (lateral) vs flexor (medial) overuse

105
Q

Tx of HSV keritits

A

antivirals (NO steroids)

106
Q

Leptospirosis

A

fresh water exposure – conjunctivitis, jaundice, renal failure. SHIN RASH. Tx: doxy or PNC

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