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Hospitalist boards > Quick Facts > Flashcards

Quick Facts Flashcards

1
Q

What type of seizures are characterized by brief, frequent, ‘jackknifing’ movements in infants, especially in the morning?

A

Infantile spasms

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2
Q

What does sixth cranial nerve palsy indicate?

A

Elevated ICP, if normal imaging think pseudotumor cerebri

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3
Q

infant with poor feeding and constipation?

A

Think botulism

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4
Q

erratic behavior progressing to altered mental status with CSF pleocytosis?

A

Anti-NMDA encephalitis (teen girls think ovarian teratoma)

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5
Q

newborn with bounding pulses, widened pulse pressure, and pulsatile fontanelle?

A

Arteriovenous malformation

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6
Q

What is the most accurate imaging study for stroke?

A

MRI with DWI (if can be done ASAP)

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7
Q

Pt w progressive weakness who had a diarrheal illness a month ago

A

Guillain-Barré syndrome (triggered by Campylobacter jejuni infection)

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8
Q

Evidence of a CNS infection and focal neurological findings. What imaging study is needed

A

Head CT with contrast (brain abscess)

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9
Q

What is a warm, tender neck mass in the anterior triangle indicative of?

A

Infected branchial cleft cyst

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10
Q

febrile child with a hot-potato voice and inability to extend the neck?

A

Suggestive of retropharyngeal abscess

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11
Q

cyanosis that improves with crying?

A

Choanal atresia

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12
Q

What is commonly associated with nasal polyps?

A

Cystic fibrosis

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13
Q

What is the management for nasal septal hematoma?

A

Needs urgent drainage to prevent ischemia of the septal cartilage

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14
Q

What does nontender unilateral lymphadenopathy with violaceous overlying skin suggest?

A

Possible nontuberculous mycobacterial infection

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15
Q

What is the most common cause of parotitis in an unvaccinated patient?

A

Mumps

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16
Q

neonate with fever and swollen parotid gland?

A

Acute suppurative parotitis due to Staphylococcus aureus

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17
Q

What is the most common source of orbital cellulitis?

A

Ethmoid sinusitis

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18
Q

tearing, pain, and foreign body sensation in the eye?

A

Corneal abrasion

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19
Q

What is concerning for delayed passage of a newborn’s first meconium?

A

CF

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20
Q

stridor in a neonate that resolves after intubation

A

Laryngeal web

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21
Q

What should be considered for a 2-year-old with sudden-onset wheeze that doesn’t respond to albuterol?

A

Possible foreign body aspiration

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22
Q

How should rising CO2 levels be managed in a mechanically ventilated patient?

A

Increase the respiratory rate or tidal volume

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23
Q

high fevers, drooling, and respiratory distress in an unvaccinated child? Management?

A

epiglottitis
Intubate in the OR ASAP and don’t upset the child

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24
Q

What is the most common etiology and timing of stridor?

A

Extrathoracic obstruction and inspiratory

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25
Q

What is the most common etiology and timing of wheeze?

A

Intrathoracic obstruction and expiratory

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26
Q

What is the preferred imaging to evaluate parapneumonic effusion?

A

Ultrasound

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27
Q

What condition may be indicated by unilateral pleural effusion after thoracic surgery?

A

Chylothorax

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28
Q

What does a tachypneic patient with normal PaCO2 suggest?

A

Impending respiratory failure (should have low PA CO2)

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29
Q

What is the most common organism in bacterial tracheitis?

A

S. aureus

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30
Q

Murmur worsens after standing up?

A

Hypertrophic cardiomyopathy

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31
Q

What is the most common cause of myocarditis in children?

A

Coxsackie B

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32
Q

diffuse ST segment elevations?

A

Pericarditis

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33
Q

What chest x-ray finding is described as a boot-shaped heart?

A

TOF

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34
Q

What chest x-ray finding resembles an egg-on-a-string?

A

Transposition of the great arteries

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35
Q

What chest x-ray finding is described as a snowman-shaped mediastinum?

A

Total anomalous pulmonary venous return

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36
Q

What cardiac defect is associated with Down syndrome?

A

Endocardial cushion defect (atrioventricular canal defect)

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37
Q

Name a reversible cause of cardiac arrest.

A

H’s and T’s:
hypovolemia, hypoxia, hydrogen (acidosis), hypoglycemia, hypo-/hyperkalemia, hypothermia
tension pneumothorax, tamponade (cardiac), toxins, thrombosis (pulmonary or coronary)

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38
Q

What occurs in a patient in shock that worsens after a normal saline bolus?

A

Cardiogenic shock

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39
Q

Which rhythms require an unsynchronized shock?

A

Ventricular fibrillation and pulseless ventricular tachycardia

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40
Q

What is the first-line medication for supraventricular tachycardia?

A

Adenosine

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41
Q

Patient has liver disease and low albumin but high total protein

A

Auto immune hepatitis (high protein due to elevated IGG)

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42
Q

Two month old infant has projectile vomiting and hyperbilirubinemia

A

Pyloric stenosis (icteropyloric syndrome)

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43
Q

Intussusception in a 10-year-old should prompt an evaluation for

A

A lead point (lymphoma or meckel’s)

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44
Q

Neonate with Bilious emesis: what imaging is gold standard for diagnosis?

A

Upper G.I. series (malrotation/volvulus)

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45
Q

What is the test for protein losing enteropathy?

A

Stool alpha one antitrypsin

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46
Q

Well appearing three month old with bloody stools. What is the treatment?

A

Hydrolyzed formula or elimination diet for breast-fed mom

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47
Q

Painless, bright red blood per rectum

A

Meckel’s diverticulum

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48
Q

Neonate with direct hyperbilirubinemia and high ferritin

A

Neonatal hemochromatosis

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49
Q

Fever, abdominal pain, jaundice

A

Cholangitis (charcot triad))

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50
Q

Patient with ulcerative colitis presents with pruritis

A

Primary sclerosing cholangitis

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51
Q

Diarrhea and seizures

A

Shigella

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52
Q

Signs of toxin, mediated infectious diarrhea

A

Watery, non-bloody, symptoms come on with an hour not days.
S aureus, B cereus

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53
Q

Urinalysis with blood, but no red blood cells

A

Rhabdomyolysis

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54
Q

Kidney disease with low C3 and normal C4

A

Post infectious glomerulonephritis

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55
Q

Kidney disease with low C3 and low C4

A

Lupus glomerulonephritis

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56
Q

Persistent microscopic hematuria with a family history of stones

A

Hypercalciuria.
Get a urine calcium to creatinine ratio.

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57
Q

Bilateral hydronephrosis in a male infant

A

Posterior urethral valves

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58
Q

Which stones are radio opaque

A

Anything with mineral: calcium oxalate, calcium phosphate, Mag/ammonium/phos (struvite)

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59
Q

What do white blood cell cast indicate?

A

Tubular disease like acute tubular necrosis

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60
Q

Patient with nephrotic syndrome, develops fever and abdominal tenderness

A

Spontaneous bacterial peritonitis likely caused by strep pneumonia

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61
Q

Testicular pain relieved by lifting the testicle

A

Epididymitis

62
Q

Sexually active female with pleuritic upper quadrant pain

A

Fitz Hugh Curtis syndrome from gonorrhea

63
Q

Thrombocytopenia, microangiopathic hemolytic anemia and acute kidney injury

A

Hemolytic uremic syndrome

64
Q

Patient on chronic steroids developed hip pain

A

Osteonecrosis of the femoral head

65
Q

Radiographic evidence of supracondylar fracture

A

Anterior sail sign a posterior fat pad

66
Q

Two year-old with osteomyelitis not improving on vancomycin. What organism should you consider?

A

Kingella kingae. Give a cephalosporin.

67
Q

Fever and refusal to bear weight

A

Septic joint (versus transient synovitis in which they can bear weight)

68
Q

Joint pain with daily transient fever and rash

A

JIA, treat with NSAIDs first line

69
Q

HSP develops worsening abdominal pain

A

G.I. complications like intussusception or ischemia

70
Q

Newborn presents with heart block

A

Neonatal lupus.
Check anti-ro (SS-A) and anti-la (SS-B) antibodies

71
Q

How long after high dose IVIG should you wait to give live vaccines?

A

11 months

72
Q

Most specific marker of SLE flare

A

Anti-double-stranded DNA

73
Q

Hypoglycemia, omphalocele, and hemihypertrophy

A

Beckwith Wideman syndrome

74
Q

Blood test to confirm congenital adrenal hyperplasia

A

17 hydroxyprogesterone

75
Q

Delayed Fontenelle closure

A

Congenital hypothyroidism

76
Q

Hyperammonemia with acidosis

A

Organic acidemias

77
Q

Hyperammonemia with alkalosis

A

Urea Cycle disorders

78
Q

Positive urine reducing substances

A

Galactosemia

79
Q

Hypoglycemia without ketones

A

Hyperinsulinism versus fatty acid oxidation disorder

80
Q

A patient on long-term prednisone presents with sepsis. What treatment to consider?

A

Hydrocortisone for adrenal insufficiency

81
Q

Frenulum injury

A

Think forced feeding or forced pacifier

82
Q

Other diagnosis to consider with subdural hematoma

A

Glutaric aciduria

83
Q

Other diagnosis to consider with multiple fractures

A

OI

84
Q

Fracture is more likely to be from abuse

A

Posterior rib, scapular, sternal, spinous process, metaphyseal avulsion

85
Q

Most common physical exam finding in sexual abuse

A

Normal exam

86
Q

Beard distribution of hemangiomas is concerning for

A

Internal or airway hemangioma

87
Q

Infection associated with recurrent erythema multiforme

A

HSV

88
Q

Those common cause of necrotizing fasciitis

A

Group a strep

89
Q

Rashes associated with IBD

A

Erythema nodosum, pyoderma gangrenosum

90
Q

Skin and mucosal blistering a few weeks after new medication

A

SJS/TEN

91
Q

Eczema and absent thymic shadow

A

SCID

92
Q

Eczema and thrombocytopenia

A

Wiskott Aldrich syndrome

93
Q

Common organism in osteomyelitis in sickle cell patients

A

Salmonella

94
Q

Hemolysis after cotrimoxazole

A

G6PD

95
Q

Peripheral smear with schistocytes

A

Intravascular hemolysis

96
Q

Peripheral smear with spherocyte

A

Extravascular homolysis or spherocytosis

97
Q

Peripheral smear with Howell Jolly bodies

A

Asplenia

98
Q

Peripheral smear with target cells

A

Thalassemia

99
Q

Who’s platelets should be transfused into a baby with neonatal alloimmune thrombocytopenia

A

Mother’s

100
Q

G.I. bleed at 2 to 7 days of life

A

Think classic vitamin K deficiency bleeding

101
Q

Patient with recent chemotherapy, fever, acute abdomen

A

Typhlitis

102
Q

Clotting factors in the common pathway

A

One, two, five, 10 (think small bills)

103
Q

Omphalitis, severe leukocytosis

A

Leukocyte adhesion deficiency

104
Q

Dextrocardia on chest x-ray. What infections is the patient at risk for?

A

Encapsulated organisms (heterotaxy syndrome, associated with polysplenia)

105
Q

Skin infections, deep organ abscesses, inflammatory bowel disease

A

Chronic granulomatous disease

106
Q

Fever, rash, lip, swelling, diffuse lymphadenopathy after a medication

A

DRESS syndrome, check eosinophils

107
Q

Foods most likely to cause fatal or near fatal allergic reactions

A

Peanuts, tree nuts, soy, cows milk, fish, shellfish

108
Q

Toddler with recurrent respiratory tract disease and absent lymph node/tonsils

A

X linked agammaglobulinemia

109
Q

Toddler with no response to vaccines with multiple life-threatening infections

A

SCID

110
Q

Activated charcoal is not indicated for which ingestions

A

Alcohol, caustics, heavy metals, lithium, hydrocarbons

111
Q

Which coin is the most corrosive when swallowed?

A

Penny because it has zinc in it

112
Q

Which which type of snake bite always requires anti-venom

A

Coral snakes because they release neurotoxins

113
Q

Cherry red lips, headache, headaches, malaise

A

Carbon monoxide poisoning

114
Q

Recognize, hemotympanum, cerebral spinal fluid leaking from the nose

A

Basilar Skull fracture

115
Q

Facial trauma, can’t look up, decrease sensation over cheek

A

Orbital blowout fracture

116
Q

Teenager with episodes of nausea and vomiting, relief by hot baths

A

Cannibinoid hyper emesis syndrome

117
Q

Organism associated with puncture wound in the foot

A

Pseudomonas

118
Q

Hyperthermia, agitation, clonus, in a patient with depression

A

Serotonin syndrome

119
Q

Glycol or methanol overdose

A

Give fomepizole

120
Q

Iron over dose

A

Give deferoxamine

121
Q

Anticholinergic overdose

A

Give physostigmine

122
Q

Cholinergic (organophosphate) overdose

A

Atropine, pralidoxime

123
Q

Calcium channel blocker overdose

A

Give calcium gluconate

124
Q

Tricyclic, antidepressant or salicylate overdose

A

Give sodium bicarbonate

125
Q

Benzodiazepine overdose

A

Give flumazenil

126
Q

Electrolyte abnormalities in cystic fibrosis

A

Hyponatremic hyperchloremic alkalosis

127
Q

First step and management of hyperkalemia

A

Give calcium (doesn’t lower potassium, but prevents life-threatening arrhythmias)

128
Q

Management of refractory, opioid induced constipation

A

Methyl naltrexone

129
Q

When feeding a severely malnourished patient at what electrolyte abnormalities are expected

A

Hypophosphatemia, hypokalemia, hypomagnesmia, and hypocalcemia

130
Q

Patient with lupus developed psychosis that worsens with treatment

A

Think steroid induced psychosis

131
Q

Melanosis coli

A

Laxative abuse

132
Q

Patient started on antipsychotics and develops trismus and torticollis. How to treat?

A

Benztropine or diphenhydramine for acute dystonia

133
Q

Newborn with severe thrombocytopenia

A

NAIT (maternal antibodies to newborns platelets containing paternal antigens)

134
Q

Torch, most likely to cause hearing loss

A

CMV

135
Q

Torch with cardiac defects

A

Rubella

136
Q

Opisthotonus (neck and trunk arching) and high-pitched cry

A

Severe Bilirubin encephalopathy

137
Q

How do you manage respiratory distress in a newborn with congenital diaphragmatic hernia?

A

Intubate (Do NOT bag, mask, ventilate), place NG for decompression

138
Q

Contraindications to G-tube replacement

A

First 4 to 6 weeks post placement, peritonitis

139
Q

Contraindication to ketamine for sedation

A

Increased ICP

140
Q

Contraindication to etomidate for sedation

A

Septic shock

141
Q

What’s the difference between a run chart and a control chart?

A

Control chart has upper and lower control limits

142
Q

Test with high sensitivity

A

Patient with disease will have a positive test

143
Q

Test with high specificity

A

Healthy patient will have a negative test

144
Q

The positive or negative predictive value of any test depends on this measurement

A

Prevalence of the condition in the population being tested

145
Q

Correlation coefficient interpretation

A

1=strong positive association.
0=no association.
-1=strong negative association

146
Q

When to use a T test?

A

Comparing two groups with continuous variables like an IQ score

147
Q

When to use a paired T test?

A

To compare the same patients like before, and after

148
Q

When to use a Fisher exact test or chi-squared test

A

Comparing two groups with categorical variables, like insured or uninsured

149
Q

What is a type I error in hypothesis testing

A

A false positive, P value = chance of type I error

150
Q

Type II error in hypothesis testing

A

False negative, prevented with a power calculation

151
Q

What percentage of data on a normal curve falls within two standard deviations

A

95%
68% within one standard deviation
99.7% within three standard deviation

Hospitalist boards (5 decks)

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