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First AId 2CK > Rapid Review > Flashcards

Rapid Review Flashcards

1
Q

Unilateral, severe periorbital headache with tearing and conjunctival erythema

A

Cluster headaches

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2
Q

Prophylactic treatment for migraine

A
  • Antihypertensives
  • Antidepressants
  • Anticonvulsants
  • Dietary changes
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3
Q

Most common pituitary tumor. Treatment?

A

Prolactinoma

-dopamine agonists (e.g. bromocriptine)

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4
Q

55 y/o patient presents with acute “broken speech”. What type of aphasia? What lobe and vascular distribution?

A

Broca’s aphasia

- frontal lobe (left MCA distribution)

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5
Q

Most common cause of subarachnoid hemorrhage

A

Trauma

- the second most common cause is berry aneurysm

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6
Q

Crescent shaped hyperdensity on CT that does not cross the midline

A

Subdural hematoma - bridging veins torn

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7
Q

Hx significant for initial AMS w/ an intervening lucid interval. Most likely source? Treatment?

A

Epidural hematoma

  • middle meningeal artery torn
  • Neurosurgical evacuation
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8
Q

CSF findings with subarachnoid hemorrhage

A
  • Elevated ICP, RBCs, xanthochromia
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9
Q

Albuminocytologic disassociation

A

Guillain-Barre syndrome

- increased protein in CSF w/o a significant increased in cell count

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10
Q

Cold water is flushed into a patient’s ear and the fast phase of the nystagmus toward the opposite side. Normal or pathologic?

A

Normal

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11
Q

Most common primary source of metastases to the brain

A 
Lung
breast
skin (melanoma)
Kidney
GI tract
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12
Q

May be seen in children who are accused of inattention in class and confused with ADHD

A

Absence seizures

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13
Q

Most frequent presentation of intracranial neoplasm

A

Headache

- primary neoplasm are much less common than brain metastases

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14
Q

Most common cause of seizures in children (2 - 10 years)

A

Infection
Febrile seizures
Trauma
Idiopathic

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15
Q

Most common cause of seizures in young adults (18 - 35 years old)

A

Trauma
Alcohol withdrawal
Brain tumor

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16
Q

First line medication for status epilepticus

A

IV benzodiazepines

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17
Q

Confusion, confabulation, ophthalmoplegia, ataxia

A

Wernicke’s encephalopathy due to deficiency of thiamine

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18
Q

What % lesion is an indication for carotid endarterectomy?

A

Seventy percent if the stenosis is symptomatic

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19
Q

The most common causes of dementia

A

Alzheimer’s and multi-infarct

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20
Q

A combined UMN and LMN disorder

A

ALS

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21
Q

Rigidity and stiffness with unilateral resting tremor and masked facies

A

Parkinson’s disease

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22
Q

Mainstay of Parkinson’s therapy

A

Levodopa/carbidopa

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23
Q

Treatment of Guillain-Barre syndrome

A

IVIG or plasmapheresis. Avoid steroids

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24
Q

Rigidity and stiffness that progress to choreiform movements, accompanied by moodiness and altered behavior.

A

Huntington’s disorder

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25
Q

A 6 year old girl presents with a port-wine stain in the V1 distribution as well as with mental retardation, seizures, and ipsilateral leptomeningeal angioma

A

Sturge-Weber syndrome

  • treat symptomatically.
  • possible focal cerebral resection of the affected lobe
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26
Q

Multiple cafe au late spots on skin

A

Neurofibromatosis type 1

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27
Q

Hyperphagia, hypersexuality, hyperorality, and hyperdocility

A

Kluver-Bucy syndrome (amygdala)

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28
Q

May be administered to a symptomatic patient to diagnose myasthenia gravis

A

Edrophonium

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29
Q

Classic ECG finding in atrial flutter

A

“Sawtooth” P waves

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30
Q

Definition of unstable angina

A

Angina that is new, is worsening, or occurs at rest

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31
Q

Antihypertensive for a diabetic patient with proteinuria

A

ACE inhibitors

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32
Q

Beck’s triad for cardiac tamponade

A

Hypotension
Distant heart sounds
JVD

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33
Q

Drugs that slow heart rate

A

B-blockers
Calcium channel blockers (CCBs)
Digoxin
Amiodorone

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34
Q

Hypercholesterolemia treatment that leads to flushing and pruritis

A

Niacin

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35
Q

Murmur - hypertrophic obstructive cardiomyopathy (HOCM)

A

Systolic ejection murmur heard along the lateral sternal border that increased with decreased preload (Valsalva maneuver)

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36
Q

Murmur - aortic insufficiency

A

Austin Flint murmur

  • diastolic, decrescendo, low-pitched, blowing murmur that is best heard sitting up
  • increased with increased afterload (handgrip maneuver)
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37
Q

Murmur - aortic stenosis

A

Systolic crescendo/descrendo murmur that radiates to the neck with increased with increased preload (squatting maneuver)

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38
Q

Murmur - mitral regurgitation

A

Holosystolic murmur that radiates to axilla

- increases with increased afterload (handgrip maneuver)

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39
Q

Murmur - mitral stenosis

A

Diastolic, mid-to late, low pitched murmur preceded by opening snap

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40
Q

Treatment for atrial fibrillation and atrial flutter

A

If unstable, cardiovert. If stable or chronic, rate control with CCBs or B-blockers

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41
Q

Treatment for ventricular fibrillation

A

Immediate cardioversion

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42
Q

Dressler’s syndrome

A

autoimmune reaction with fever, pericarditis and increased ESR occurring 2-4 weeks post MI

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43
Q

IV drug abuse with JVD and holosystolic murmur at the LSB (increases with inspiration). Treatment?

A

Tricuspid regurgitation

- treat existing heart failure and replace the tricuspid valve

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44
Q

Diagnostic test for hypertrophic cardiomyopathy

A

Echocardiogram

- showing a thickened LV wall and outflow obstruction

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45
Q

Pulsus paradoxus

A

a decrease in systolic BP > 10 mm Hg with inspiration

- seen in cardiac tamponade

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46
Q

Classic ECG findings in pericarditis

A

Low-voltage, diffuse ST segment elevation

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47
Q

Definition of hypertension

A

BP > 140/90 mm Hg on 3 separate occasions 2 weeks apart

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48
Q

Eight surgically correctable causes of hypertension

A
  • Renal artery stenosis
  • Coarctation of aorta
  • Pheochromocytoma
  • Conn’s syndrome
  • Cushing’s syndrome
  • Unilateral renal parenchymal disease
  • Hyperthyroidism
  • Hyperparathyroidism
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49
Q

Evaluation of a pulsatile abdominal mass and bruit

A

Abdominal ultrasound and CT

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50
Q

Indications for surgical repair of abdominal aortic aneurysm

A

> 5.5 cm, rapidly enlarging, symptomatic or ruptured

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51
Q

Treatment for acute coronary syndrome

A
  • ASA, heparin, clopidogrel, morphine, oxygen, sublingual nitrogen, IV B-blockers
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52
Q

Metabolic syndrome

A
  • abdominal obesity
  • high triglycerides
  • low HDL
  • hypertension
  • insulin resistance
  • prothrombotic or proinflammatory states
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53
Q

50 year old man with stable angina can exercise to 85% of maximum predicted heart rate. Appropriate diagnostic test?

A

Exercise stress treadmill with ECG

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54
Q

65 year old woman with left bundle branch block and severe osteoarthritis has unstable angina. Appropriate diagnostic test?

A

Pharmacological stress test (e.g dobutamine echo)

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55
Q

Target LDL in a patient with diabetes

A

< 70 mg/dL

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56
Q

Signs of active ischemia during stress testing

A

Angina
ST segment changes on ECG
Decreased BP

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57
Q

ECG findings suggesting MI

A

ST segment elevation (depression means ischemia)
Flattened T waves
Q waves

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58
Q

Where’s the occlusion? Anterior wall MI

A

LAD / diagonal

- ST elevations in V1 - V4

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59
Q

Where’s the occlusion? Inferior wall MI

A

PDA

- ST elevations in leads II, III, avF

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60
Q

Where’s the occlusion? Posterior wall MI

A

LCX / RCA

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61
Q

Where’s the occlusion? Septal wall MI

A

LAD / diagonal

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62
Q

Young patient with angina with rest and ST-segment elevation with normal cardiac enzymes

A

Prinzmental’s angina

- treat with CCBs (e.g. diltiazem)

63
Q

Common symptoms associated with silent MIs

A

CHF
shock
AMS

64
Q

Diagnostic test for pulmonary embolism

A

Spiral CT with contrast

65
Q

Protamine

A

reverse effects of heparin

66
Q

Prothrombin time

A

coagulation parameter affected by warfarin

67
Q

Young patient with a family hx of sudden death and collapses while exercising

A

Hypertrophic cardiomyopathy

  • decreased murmur with increased preload (squatting, Valsava maneuver)
  • increased preload
68
Q

Endocarditis prophylaxis regimens

A

Oral surgery - amoxicillin for certain situations

GI or GU procedures - not recommended

69
Q

Virchow’s triad

A

Stasis
hypercoaguability
endothelial damage

70
Q

Most common cause of hypertension in young women

A

OCPs

71
Q

Most common cause of hypertension in young men

A

Excessive EtOH

72
Q

Figure 3 sign

A

Coarctation of aorta

73
Q

Water bottle shaped heart

A

Pericardial effusion

- look for pulsus paradoxus

74
Q

Pt presents with sudden onset of severe, diffuse abdominal pain. Examination reveals peritoneal signs, and AXR reveals of free air under the diaphragm. Management?

A

Emergent laparotomy to repair perforated viscus

75
Q

Most likely cause of acute lower GI bleed > 40 years of age

A

Diverticulosis

76
Q

Diagnostic modality used when ultrasound is equivocal for cholecystitis

A

HIDA scan

77
Q

Risk factors for cholelithiasis

A

Fat
Female
Fertile
Forty

78
Q

Inspiratory arrest during palpation of RUQ

A

Murphy’s sign

- seen in acute cholecystitis

79
Q

Most common cause of small bowel obstruction SBO in patients with no history of abdominal surgery

A

Hernia

80
Q

Most common cause of SBO in patients with a hx of abdominal surgery

A

Adhesions

81
Q

Most common organism in diarrhea

A

Campylobacter

82
Q

Most common cause of diarrhea: recent antibiotic use

A

Clostridium difficile

83
Q

Most common cause of diarrhea: camping

A

Giardia

84
Q

Most common cause of diarrhea: Traveler’s diarrhea

A

ETEC

85
Q

Diarrhea organism at church picnics/mayonnaise

A

S. aureus

86
Q

Diarrhea organism causing uncooked hamburgers

A

E. coli 0157:H7

87
Q

Diarrhea organism associated with poultry/eggs

A

Salmonella

88
Q

Diarrhea organism associated with Fried Rice

A

Bacillus cereus

89
Q

Diarrhea organism associated with raw seafood

A

Vibrio, HAV

90
Q

Diarrhea organism associated with AIDS

A

Isospora
Cryptosporidium
Mycobacterium

91
Q

Diarrhea organism associated with pseudoappendicitis

A

Yersinia

92
Q

25 year old Jewish man presents with pain and watery diarrhea after meals. Examination shows fistula between the bowel and skin and nodular lesions on his tibia

A

Crohn’s disease

93
Q

Inflammatory bowel disease of colon with an increased risk of colon cancer

A

Ulcerative colitis (greater risk than Crohn’s)

94
Q

Extraintestinal manifestations of IBD

A

Uveitis
Ankylosing spondylitis
Pyoderma gangrenosum
Primary sclerosing cholangitis

95
Q

Medical treatment for IBD

A

5-ASA agents and steroids during acute exacerbations

96
Q

Difference between Mallory-Weiss and Boerhaave tears

A

Mallory Weiss: superficial tear in the esophageal mucosa

Boerhaave: full-thickness esophageal rupture

97
Q

Charcot’s triad

A

Fever
RUQ pain
Jaundice
** signs of ascending cholangitis**

98
Q

Reynold’s pentaus

A

Fever, RUQ pain, jaundice PLUS shock and mental status changes
– signs of suppurative ascending cholangitis

99
Q

Medical treatment for hepatic encephalopathy

A

Decreased protein intake
Lactulose
Rifaximin

100
Q

First step in the management of a patien with an acute GI bleed

A

Manage ABCs

101
Q

4 year old child presents with oliguria, petechiae, and jaundice following an illness with bloody diarrhea. Most likely diagnosis and cause?

A

Hemolytic-uremic syndrome (HUS) due to E.coli 0157:H7

102
Q

Post-HBV exposure treatment

A

HBV immunoglobulin

103
Q

Classic causes of drug induced hepatitis

A

TB medications (isoniazid, rifampin, pyrazinamide)
Acetaminophen
Tetracycline

104
Q

40 year old obese woman with elevated alkaline phosphotase, elevated bilirubin, pruritis, dark urine, and clay stools.

A

Biliary tract obstruction

105
Q

Hernia with highest risk of incarceration – indirect, direct or femoral?

A

Femoral hernia

106
Q

50 year old man with a history of EtOH abuse presents with boring epigastric pain that radiates to the back and is relieved sitting forward. Management?

A

Confirm diagnosis of acute pancreatitis with elevated amylase and lipase.
- Make the patient NPO and IV fluids, oxygen, analgesia, and “tincture of time”

107
Q

Four cases of microcytic anemia

A 
TICS
Thalassemia
Iron deficiency
anemia of Chronic disease
Sideroblastic anemia
108
Q

Elderly man w/ hypochromic, microcytic anemia is asymptomatic. Diagnostic tests?

A

Fecal occult blood test and sigmoidoscopy

- suspect colorectal cancer

109
Q

Precipitants of hemolytic crisis in patients with G6PD deficiency

A

Sulfonamides
Antimalarial drugs
Fava beans

110
Q

Most common inherited cause of hypercoagulability

A

Factor V Leiden mutation

111
Q

Most common inherited bleeding disorder

A

von Willebrand’s disease

112
Q

Most common inherited hemolytic anemia

A

Hereditary spherocytosis

113
Q

Diagnostic test for hereditary spherocytosis

A

Osmotic fragility test

114
Q

Pure RBC aplasia

A

Diamond-Blackfan anemia

115
Q

Anemia associated with absent radii and thumbs, diffuse hyperpigmentation, cafe au late spots, microcephaly, and pancytopenia

A

Fanconi’s anemia

116
Q

Medications and virus that lead to aplastic anemia

A 
Chloramphenicol
Sulfonamides
Radiation
HIV
Chemotherapeutic agents
Hepatitis
Parvovirus B19 
EBV
117
Q

How to distinguish polycythemia vera from secondary polycythemia

A

Both have increased hematocrit and RBC mass but polycythemia cera should have normal oxygen saturation and low erythropoietin levels

118
Q

Thrombotic thrombocytopenic purpura (TTP) pentad?

A

FAT RN:

  • Fever
  • Anemia
  • Thrombocytopenia
  • Renal dysfunction
  • Neurologic abnormalities
119
Q

HUS triad?

A

Anemia
Thrombocytopenia
Acute renal failure

120
Q

Treatment for TTP

A

Emergent large volume plasmapheresis
Corticosteroids
Antiplatelet drugs
** Platelet transfusion is contraindicated!!

121
Q

Treatment for idiopathic thrombocytopenic purpura (ITP) in children

A

Usually resolves spontaneously,

may require IVIG and/or corticosteroids

122
Q

Which of the following are increased in DIC: fibrin split products, D-dimer, fibrinogen, platelets, and hematocrit

A

Fibrin split products and D-dimer are elevated;

platelets, fibrinogen and hematocrit are decreased

123
Q

8 year old boy presents with hemarthrosis and increased PTT with normal PT and bleeding time. Diagnosis? Treatment?

A

Hemophilia A or B

- consider desmopressin (for hemophilia A) or factor VIII or factor IX supplements

124
Q

Nontender abdominal mass associated with elevated VMA and HVA

A

Neuroblastoma

125
Q

Most common type of tracheoesophageal fistula (TEF). Diagnosis?

A

Esophageal atresia with distal TEF (85%). Unable to pass NG tube

126
Q

Not contraindications to vaccination

A

Mild illness and/or low grade fever, current antibiotic therapy, and prematurity

127
Q

Tests to rule out shaken baby syndrome

A

Ophthalmologic exam, CT, and MRI

128
Q

A neonate has meconium ileus

A

Cystic fibrosis (Hirschsprung’s disease is associated with failure to pass meconium for 48 hrs)

129
Q

Bilious emesis within hours after the first feeding

A

Duodenal atresia

- associated with Down’s syndrome

130
Q

A 2 month old baby presents with nonbilious projectile emesis. Diagnosis? What are the appropriate steps in management?

A

Pyloric stenosis

- correct metabolic abnormalities; then correct pyloric stenosis with pyloromyotomy

131
Q

The most common primary immunodeficiency

A

Selective IgA deficiency

132
Q

An infant has a high fever and onset of rash as fever breaks. What is he at risk for?

A

Febrile seizures (due to roseola infantum)

133
Q

What is the immunodeficiency? A boy has chronic respiratory infections. Nitroblue tetrazolium test is negative>

A

Chronic granulomatous disease

134
Q

What is the immunodeficiency? A child has eczema, thrombocytopenia, and high levels of IgA.

A

Wiskott-Aldrich syndrome

135
Q

What is the immunodeficiency? A 4 month old boy has life threatening Pseudomonas infection.

A

Bruton’s X-linked aggamaglobulinemia

136
Q

Acute phase treatment for Kawasaki disease

A

High dose ASA for inflammation and fever

IVIG to prevent coronary artery aneurysms

137
Q

Treatment for mild and severe conjugated hyperbilirubinemia

A

Phototherapy (mild) or exchange transfusion (severe)

- Do not use phototherapy for conjugated hyperbilirubinemia

138
Q

Sudden onset of mental status changes, emesis, and liver dysfunction after ASA intake.

A

Reye’s syndrome

  • do not give aspirin to children < 15 years for viral infxns
  • bx shows microvascular steatosis in liver, brain,
139
Q

Child has loss right light reflex (white pupil). Diagnosis? The child has an increased risk of what cancer?

A

Suspect retinoblastoma

- Osteosarcoma

140
Q

Vaccinations at 6 month well child visit.

A 
HBV
DTaP
Hib
IPV
PCV
Rotavirus
141
Q

Tanner stage 3 in a 6 year old girl

A

Precocious puberty

142
Q

Injection of small airways with epidemics in winter and spring

A

RSV bronchiolitis

143
Q

Cause of neontal RDS

A

Surfactant deficiency

144
Q

A condition associated with red “currant-jelly” stools, colicky abdominal pain, bilious vomiting, and sausage-shaped mass in the RUQ

A

Intussusception

145
Q

Congenital heart disease that causes secondary hypertension. What would you find on physical examination?

A

Coarcation of the aorta

- decreased femoral pulses

146
Q

First line treatment of otitis media

A

Amoxicillin x 10 days

147
Q

Most common pathogen causing croup

A

Parainfluenza virus type I

148
Q

Homeless child is small for his age and has peeling skin and a swollen bell

A

Kwashiokor (protein malnutrition)

149
Q

Defect in a X-linked syndrome with mental retardation, gout, self-mutilation and choreoathetosis

A

Lesch-Nyhan syndrome (purine salvage problem with HGPRTase deficiency)

150
Q

Newborn girl has a continuous “machinery murmur”. What drug would you give?

A

Patent ductus arteriosus (PDA)

- indomethacin is given to close the PDA

151
Q

Newborn with a posterior neck mass and swelling of the hands.

A

Turner’s syndrome

152
Q

First line pharmacotherapy for depression

A

SSRIs

153
Q

Antidepressants associated with hypertensive crisis

A

MAO inhibitors

154
Q

Galactorrhea, impotence, menstrual dysfunction, and decreased libido

A

Dopamine antagonists

First AId 2CK (22 decks)

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