Reading notes Flashcards

1
Q

Seizure causes

A

4 Ms, 4 Is

Metabolic/electrolyte/hyperthermia
Mass/hemorrhage
Missing drugs (withdrawal, noncompliance)
Miscellaneous (eclampsia, HTN cerebral edema)
Intox (cocaine, lithium, lidocaine, theoph, metal, CO)
Infection (sepsis, meningitis, abscess)
Ischemia (stroke, TIA)
Increased ICP

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2
Q

Seizure, don’t know the patient…what labs to check?

A

Na, Ca, Glc, BUN

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3
Q

Tx for severe hypovolemic hypernatremia

A

Normal saline, then switch to 1/2NS once volume status is repleted

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4
Q

Tx for mild hypovolemic hypernatremia

A

D5 0.45% saline

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5
Q

Tx for euvolemic and hypervolemic hypernatremia

A

D5W (dextrose prevents the osmotic burst of free water)

Oral free water (mild)

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6
Q

Chronic cough w/ white sputum, worse at night (adult), no other URI/LRI symptoms…suspect what?

A

Asthma

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7
Q

Coronary angiogram and stenting –> AKI, abdominal pain, mottling of LEs, elevated eosinophils on CBC

A

Cholesterol emboli syndrome

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8
Q

When to Xray vs. MRI the back

A

XRay - osteoporosis, compression fxr, malignancy, Ank Spond, MM

MRI - sensory/motor deficits, cauda equina, epidural abscess/infection

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9
Q

Biggest risk factor for cerebral palsy

A

PREMATURITY (NOT hypoxia)

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10
Q

Function of adenosine in a stress test

A

Vasodilate the coronary vessels, thus exaggerating which vessel is blocked

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11
Q

Fever, pleuritic chest pain, hemoptysis, nodules w/ surrounding ground glass opacities in upper lobe

A

Invasive aspergillosis

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12
Q

Modified Wells Criteria

A

3 points = signs of DVT, or nothing more likely
1.5 points = previous DVT/PE, recent surg/immob, HR > 100
1 point = hemoptysis or cancer

4+ = PE

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13
Q

6-week child, dyspnea and crackles w/ feeding, VSD murmur, LUSB systolic ejection murmur, loud S2

A

Complete AV septal defect - DS

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14
Q

Baby, triple or quadruple gallop, LLSB systolic murmur

A

Ebstein anomaly

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15
Q

Baby, loud systolic ejection murmur w/ click LSB, cyanosis, tachypnea, heart failure

A

Truncus arteriosus - DGS

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16
Q

Baby, cyanosis, tachypnea, murmur, relatively comfortable

A

Transposition of great vessels

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17
Q

LE pain, pale, cool temperature, loss of distal pulses, tingling/numbness, weakness

Do what first?

A

LE arterial occlusion (6 Ps - pain, pallor, poikilothermia, paresthesias, paralysis, pulseless)

Anticoagulate (heparin)

18
Q

Turner syndrome…heart anomalies?

A

Bicuspid aortic valve

Coarctation of aorta

19
Q

Abnormal ABI

Considered what?

A

Under 0.9

Occlusive PAD

20
Q

Meds that improve long term survival in LV dysfunction

A

ACEI/ARB
BB
Mineralocorticoid receptor blockers (eplerenone, Spironolactone)
Hydralazine + Nitrates (AFRICAN AMERICANS)

21
Q

Permanent pacemaker –> R heart failure…why?

A

Pacemaker wire passes through tricuspid valve to supply charge to ventricles…can accidentally obstruct tricuspid valve –> TRICUSPID REGURG

22
Q

Mid-left sternal border…murmurs?

A

AR, PR, HOCM

23
Q

LLSB…murmurs?

A

TR, TS, VSD, ASD (really increased T)

24
Q

RUSB…murmur?

A

AS

25
Q

LUSB…murmurs?

A

PS, Flow murmur, ASD (really increased P)

26
Q

L 5th intercostal (apex)…murmurs?

A

MS, MR, MVP

27
Q

Stable A fib in WPW…tx options?

A

Ibutilide, Procainamide

28
Q

Aortic dissection…possible complications (w/ structure) (8)

A
Tamponade (pericardial sac)
MI (coronary)
Stroke (carotid)
AR (aortic valve)
Abd pain (mesenteric)
Horner syndrome (superior cervical symp ganglion)
Hemothorax (pleural cavity)
LE weakness or ischemia (spinal or common iliac aa)
29
Q

Fibromuscular dysplasia…see what?

A

CAROTID and RENAL stenosis

30
Q

Drugs that increase digoxin

Symptoms?

A

Amiodarone
Verapamil
Quinidine
Propafenons

General, GI, Neuro, Color vision disturbance, ectopic ventricular beats/AV block/A fib/V tach

31
Q

Amyloidosis CHF…see what?

A

Ventricular wall thickening (unlike pericarditis)

Extra-cardiac signs/symptoms

32
Q

Tx of cocaine-induced cardiac ischemia (3)

A

IV benzos to decrease HR and anxiety
CCB/nitrates for vasospasm
Aspirin to prevent clot

33
Q

CAD…typical signs

A

Substernal
Worse with exertion
Better with rest and nitro

3 = CAD
2 = Possible (atypical) CAD
1 = Unlikely
34
Q

Transfusion…fever and chills in 1-6 hours

A

Cytokines (WBCs) in blood

Leukoreduce blood next time

35
Q

Transfusion…fever, flank pain, DIC, renal failure, hgb-uria

A

ABO incompatibility (acute hemolytic)

36
Q

Transfusion…fever, hemolytic anemia 2-10 days later

A

Delayed (anamnestic ab) hemolytic

37
Q

Transfusion…shock, urticaria/angioedema, respiratory distress

A

IgA deficiency

38
Q

Transfusion…urticaria, flushing, and pruritis in 2-3 hours

A

IgE and mast cells

39
Q

Transfusion…respiratory distress and pulmonary edema in 6 hours

A

Donor anti-leukocyte antibodies (transfusion-related acute lung injury)

40
Q

Transfusion…septic shock, DIC

A

Bacterial contamination