1. rhus dermatitis 2. varicella 3. HSV infection 4. staph scalded skin syndrome 5. Hand-foot-mouth dz (coxsackie) 6. lupus 7. drug mediated reaction

1. IVF 2. BB - propranolol 3. lower body temperature / cooling measures 4. methimazole 5. steroids - inhibit TH release 6. iodide - dec TH prod in 24 hrs

PEM Notes Q2 Flashcards by Magda Kazmierczak

5 findings in infantile glaucoma

Unilateral pain
Cloudy cornea
Ciliary flush
Epiphoria / photophobia
poorly reactive pupil
Enlarged eye

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causes of sudden vision loss

central retinal aa occlusion
retinal detachment
stroke
optic neuritis
glaucoma
complicated migraine

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causes of red painful eye

conjunctivitis
retained foreign body
traumatic iritis
uveitis/keratitis
globe rupture

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CF in neurogenic shock

hypotension + relative bradycardia
flaccid extremities
incontinence
loss of bulbocavernous reflex
decreased rectal tone

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ddx bullous impetigo

rhus dermatitis
varicella
HSV infection
staph scalded skin syndrome
Hand-foot-mouth dz (coxsackie)
lupus
drug mediated reaction

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ddx blistering rash s/p canoe trip

poison ivy / rhus dermatitis
cercarial dermatitis (swimmer’s itch)
dyshidrotic eczema
bullous impetigo
friction blisters
bullous cellulitis (vibrio vulnificus)

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bacteria that cause soft tissue infxn from water exposure

A- aeromonas
E - erysipelothrix
E - edwardsiella
V - vibrio vulnificus
M- mycobacterium marinum

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Electrolyte changes in CAH

hyponatremia, hypochloremia
hyperkalemia
hypoglycemia
metabolic acidosis

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RF for cerebral edema in DKA

new onset DM
age < 3 years
Elevated BUN
Decreased PCO2
tx with bicarb
failure of Na+ to rise w/ treatment
admin of insulin w/in 1st hr of fluid

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how do you differentiate between SIADH and cerebral salt wasting?

Both have LOW Na, LOW Sosm and LOW Uosm

CSW = polyuria, dec BP and volume depletion, vasopressin decreased

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5 causes of gynecomastia

hyperthyroidism (Graves disease)
primary or secondary hypogonadism
prolactin secreting tumor
drugs: THC, antipsychotics, reglan
testicular neoplasm
physiologic

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what meds can u use to tx HTN w/ pheochromocytoma

alpha blocker: phentolamine (1-5 mg)
sodium nitroprusside
- do not use BB (unopposed alpha stimulation worsens HTN)

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tx of thyroid storm

IVF
BB - propranolol
lower body temperature / cooling measures
methimazole
steroids - inhibit TH release
iodide - dec TH prod in 24 hrs

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Tx. necrotizing fasciitis

Tx. PCN (Nafcillin) + Clindamycin (Vancomycin if MRSA)
IVF
Surgical debridement

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MOA and CF of Tetanus

Neurotoxin –> uses retrograde axonal transmission to enter brain/spinal cord –> descending mm spasms that start at neck /jaw and progress to chest/abdomen

flexion/abduction of arms with extension of legs
risus sardonicus
resp failure due to mm spasm in chest wall

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Tx of tetanus

TIG - neutralizes unbound toxin
Metronidazole
Sedation w/ benzos
Paralysis - pancuronium
Baclofen

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Kocher criteria for septic arthritis

WBC > 12000
ESR > 40
Fever > 38.5 (101.3)
Non-weight bearing

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Abx for septic arthritis

< 3 mos: Amp + Cefotaxime

> 3 mos: Ancef, Clinda, Nafcillin, Vanco (either one)

Dx criteria for toxic shock syndrome

High fever
Erythroderma
Abnormal VS
Atleast 3 organ systems involved:
- NVD or increased LFTs
- myalgias or inc CPK
- elev BUN/Cr
- Plt < 100 000
- altered mental status

Tx toxic shock syndrome

Vancomycin + Ceftriaxone

mild: ancef + clinda

3 findings in exudative pleural effusion

pleural fluid: serum protein ratio > 0.5
pleural fluid: serum LDH ratio > 0.6
pleural LDH > 2/3 UNL for serum

RF for MRSA

crowded living conditions
MSM 
Prisoners
poor hygeine
cuts/abrasions
close skin/skin contact with MRSA (+) person

When do you tx with abx for abscess?

incision & drainage for all

- give abx if fever, associated cellulitis or < 3 months

Abx choices for abscess

< 1 month: vanomycin (clinda if well and < 1 cm)
1-3 mos: Bactrim until cx back, then switch to Keflex
> 3 mos and well: obs
> 3 mos + fever or cellulitis: bactrim + keflex until cx results

tx of tinea capitis with kerion

``` Griseofulvin is not available in canada Terbinafine x 4 weeks < 20 kg: 62.5 mg daily 20-40 kg: 125 mg > 40 kg: 250 mg ```

causes of acute diplopia

``` trauma (blowout fx) papilledema toxins (anticholinergics) CNS - mass, bleed myasthenia gravis refractive error head trauma ```

findings in orbital fx

restricted upward gaze numbness of I/L malar region swollen, painful eyelids diplopia

Neuro complications of Varicella (5)

1. acute cerebellar ataxia 2. meningitis 3. encephalitis 4. transverse myelitis 5. Reye syndrome

Ophtho complications of Varicella

1. conjunctivitis 2. keratitis 3. uveitis/iritis 4. acute retinal necrosis 5. corneal ulcers (dendritic)

when can you perform watchful waiting for AOM

``` > 6 months of age mild illness (fever < 39) responsible parents symptoms < 48 hours child is otherwise healthy w/ no other underlying conditions ```

3 abx choices for AOM

1. amoxicillin 90 mg/kg/day x 10 days (or 5 days if > 2) 2. Ceftriaxone 50 mg/kg IM x 3 days 3. augmentin 45-60 mg/kg/day div TID 4. cefuroxime 30 mg/kg/day div TID

3 stages of pertussis

1. catarrhal: 1-2 wk 2. paroxysmal: 2-4 wk 3. convalescent: 2-3 mos "100 d cough"

definitive criteria for PID

1. endometrial biopsy 2. imaging w/ fluid filled/thickened fallopian tubes, TOA abscess or tubal hyperemia 3. laparoscopic findings

3 stages of pertussis

1. catarrhal: 1-2 wk 2. paroxysmal: 2-4 wk 3. convalescent: 2-3 mos "100 d cough"

DDx purpuric rash

- tickborne illness - HSP - meningococcemia - DIC - endocarditis

CF of hemolytic uremic syndrome

``` Hematuria* Proteinuria* Elevated BUN/Cr* decreased plts microangiopathic anemia ```

Prophylaxis for meningitis

Contacts in last 7 days - household contacts - people sharing sleeping arrangements - direct contact with oral/nasal secretions - daycare classmates - health care workers if no PPE with close contact - traveller's seated next to index pt on flight > 8 hrs

Ddx of unilateral cervical LAD

``` atypical mycobacteria brucellosis tularemia staph aureus group A strep EBV TB ```

CANMEDS - 6

1. communicator 2. collaborator 3. manager 4. health advocate 5. scholar 6. professional

how can you tell which pupil is abnormal with anisocoria?

in LIGHT --> larger pupil is abnormal due to inappropriate pupillary constriction in DARK --> smaller pupil is abnormal due to inappropriate pupillary dilation

CANMEDS - 6

1. communicator 2. collaborator 3. manager 4. health advocate 5. scholar 6. professional

definition of menorrhagia

1. excessive uterine bleeding at regular intervals | 2. prolonged bleeding > 7 days

4 things in management of pt w/ menorrhagia and syncope

1. Obtain lab studies including CBC for anemia, iron studies 2. Obtain pelvic US 3. Consider beginning hormonal therapy such as OCP 4. If Hb < 7, consider blood transfusion 5. Consult gynecology