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Medicine > Rosh 1 > Flashcards

Rosh 1 Flashcards

1
Q

What are the risk factors, symptoms, and treatment for HAPE?

A

2-4 days after reaching 10,00 feet, dyspnea, cough with clear sputum, rales, and hypoxemia. Desent, oxygen, and Nifedipine 30 mg BID

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2
Q

Treatment for suspected or confirmed septic joint?

A

IV Vancomycin and Ceftriaxone (and of course ortho consult and likely wash out)

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3
Q

New treatment recommendation for suspected or confirmed STI (Gonorrhea and Chlamydia) ?

A

500 mg IM Ceftriaxone and 7 day course of doxycycline 100 mg BID

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4
Q

What medication is most often used as prophylaxis for acute mountain sickness?

A

Acetazolamide

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5
Q

Most common pathologic murmur in childhood?

A

Holosystolic harsh murmur associated with VSD

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6
Q

Symptoms and EKG findings in HyperCalcemia? Treatment?

A

Bones, stones, groans and psychiatric overtones (Constipation, nausea, AMS) . Shortened QT interval, widening of the QRS. Aggressive IV hydration with normal saline, Calcitonin, bisphosphanates, steriods etc..

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7
Q

What EKG findings will you have in Hypocalcemia? Chief complaint?

A

Long QT, muscle cramping and parethesias

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8
Q

Diagnosis and treatment for alcoholic ketoacidosis?

A

Near normal pH but with AGMA, low ETOH level, pt usually malnourished from not eating and only drinking. May have altered mental status. Give crystalloid, dextrose, and thiamine.

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9
Q

What is a dangerous side affect of huffing or bagging hydrocarbons?

A

Cardiac arrhythmias. “Sudden sniffing death”. Excitable myocytes from abuse that are pushed during exercise of exertion.

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10
Q

Risk factors and concurrent risk in Hypokalemic periodic paralysis?

A

Asian decent, autosomonal dominant, intermittent weakness. Provoked by cold, stress, alcohol. Correlation with thyoid disease. Can also occur with Hyperkalemia.

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11
Q

Presentation in Legg-Calves Perthe disease?

A

also known as idiopathic avascularnecrosis of the proximal femoral epiphysis. 3-12 year olds, boys more commonly. Pain, worse during internal rotation, limping.

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12
Q

What are the symptoms of compartment syndrome? Most sensitive? Pressure to be worried about?

A

6 P’s. Pain, Pulselessness, Pallor, Paresthesias, Paralysis, Poikilothermia. Pain aggravated by passive stretching is the most sensitive. 30, or delta of 30 (30 lower than diastolic BP).

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13
Q

What is the number for permissive HTN in ischemic stroke? When should you treat?

A

Treat only if > 220/120. Goal is 15% reduction over the first 24 hours.

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14
Q

How does febrile non-hemolytic transfusion reaction present? What causes it? What patients are at highest risk?

A

Fever, can have dyspnea, myalgias, tachycardia etc. Happens with a reaction from recipient antibodies to donor leukocytes. People who have gotten lots of transfusions, multiparous women.

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15
Q

What is the most sensitive finding in Cauda Equina Syndrome?

A

Urinary retention (post void residual of over 100 cc)

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16
Q

What infection will cause pseudoappendicitis? What is additional feature of this infection? Where is it most commonly found?

A

Yersenia Entercolitica. Bloodly diarrhea. Europe.

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17
Q

Time frame for Acute Stress Disorder versus PTSD?

A

< 30 days, greater than 30 days. Increased risk of suicide, substance abuse, outbursts.

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18
Q

What is cushing’s triad and symptoms of inpending brain herniation?

A

Bradycardia, hypertension, and respiratory irregularities.

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19
Q

What size of ET tube should I use for a 6 year old? Formula?

A

4 + age/4, 5 1/2

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20
Q

How will an adolescent or adult present with coarctation of the aorta?

A

Generally hypertensive, notching of ribs on xray, BP in UE>LE.

21
Q

What is the positioning of the glottis in pediatric airways? Depth of the tube?

A

Superior and anterior. Especially in infants younger than 2. 3 x size of the tube is ideal depth.

22
Q

Treatments to consider in moderate/severe asthama acutely?

A

B-agonists, Duonebs if COPD component. Prednisone 40 mg -60 mg for 5 days. If still needing additional meds consider 2 mg of Magnesium or 0.25 mg Sc of terbutaline.

23
Q

Dosing of Epinephrine in Anaphyalxis for pediatrics? In Cardiac Arrest?

A
  1. 01 ml/kg of 1 mg/ml (1:1000) IM.

0. 1 ml/kg of 0.1 mg/ml (1:10000) IV or IO

24
Q

First line IV antibiotic in PNA requiring admission in vaccinated child? Unvaccinated child?

A

Ampicillin, Ceftriaxone

25
Q

First line treatment for annular ligament subluxation (nursemaids elbow)? Age group highest at risk?

A

Hyperpronation while pushing on the radial head. 1-4 year olds. No need for rouitine imaging.

26
Q

Most common presentation in arrhythmogenic right ventricle cardiomyopathy? Pathophys?

A

Syncope, fibrofatty infiltration
Will have T wave inversions in V1-V3
Epsilon wave (small positive deflection at the terminal end of the QRS) generally in V1

27
Q

STEMI Criteria

Exceptions and Ages?

A

More than 1 mm elevation anywhere other than V2/V3

2.5 mm in V2/V3- men under 40
2 mm in V2/V3- men over 40
1.5 mm in V2/V3- women

28
Q

Most common presentation in arrhythmogenic right ventricle cardiomyopathy? Pathophys?

A

Syncope, fibrofatty infiltration
Will have T wave inversions in V1-V3
Epsilon wave (small positive deflection at the terminal end of the QRS) generally in V1

29
Q

STEMI Criteria

Exceptions and Ages?

A

More than 1 mm elevation anywhere other than V2/V3

2.5 mm in V2/V3- men under 40
2 mm in V2/V3- men over 40
1.5 mm in V2/V3- women

30
Q

Scarbosa Criteria? How many points is considered a STEMI?

A

STE of more than 1 mm with concordant ST complex (5 points), ST depression with > 1mm concordant depresssion in V1, V2, V3 (3 points), ST elevation of more than 5 mm (or >25% of proceding S wave) of discordance ( 2 points).
More than 3 points should be a cath lab activation.

31
Q

What infectious etiology is associated with complete heart block?

A

Lyme’s disease

32
Q

Treatment for mild/moderate frostbite that is acute?

A

Wet rewarming. Water that is appx. 98 F.

33
Q

What is the Kanavel criteria for flexor tenosynovitis?

A
  1. Tenderness along the course of the flexor tendon, fusiform (sausage like) swelling of the digit, pain with passive extension, flexed posture of the finger
34
Q

What is erythema nodosum?

A

Tender, erythematous nodules, usually on the anterior shins. Usually a delayed hypersensitivity reaction to abx or infection.

35
Q

How to do calculate the shock index?

A

HR/SBP. >0.7 is concerning for shock, especially in trauma.

36
Q

Lethal triad in Trauma?

A

Coagulopathy, metabolic acidosis, Hypothermia

37
Q

Definition of orthostatic hypotension?

A

Fall in systolic BP by 20, Diastolic by 10 when standing.

38
Q

At what temperature can you declare a pt who is hypothermic and has arrested?

A

32 C, 89.6 F

39
Q

What is Faget’s sign? What infectious diseases characteristically cause?

A

Fever with relative bradycardia (not tachycardic), Typhoid fever, legionella, myoplasma
As well as some other non endemic infectious diseases

40
Q

How does Seritonin Syndrome Present? Drugs taht cause it? Neuroleptic malignant syndrome?

A

AMS, hyperreflexia, clonus, autonomic instability. Usually from anti-depressants. NMS is usually from anti-psychotics and has lead pipe rigidity but is otherwise similar.

41
Q

Presentation of post strep glomerulonephritis?

A

HTN, hematuria, and periorbital edema

42
Q

How long after chemo is the nadir for neutropenia? How long does it take to recover from this point?

A

6 to 10 days after chemo. usually lasts 5 days. ANC of less than 500 with fever of greater 38.3 or sustained 38 for more than 1 hour.

43
Q

How does TRALI (transfusion related acute lung injury) present?

A

Hypoxemia, bilaterally lung infiltrates, fever, hypotension, tachycardia. Usually within 6 hours from infusion.

44
Q

Electrolyte abnormalities in Rhabdo? Definition? Urinary findings?

A

Hypocalcemia, hyperK, Hyperphosphatemia. 5x normal limit of CK (usually more than 1000 units/L, Will have 3+ blood, no RBC’s.

45
Q

What type of herniation leads to a blown pupil? On which side is the mass/bleed?

A

Uncal, anisicoria on the ipsalateral side.

46
Q

If a woman presents with umbilical cord prolapse what should you do?

A

Try and reduce and fetal part that is out. Have mother go on all 4’s butt in the air

47
Q

Classify primary, secondary, tertiary, and quadernary blast injuries?

A

Primary is from shock wave (TM, hollow vicus), 2nd is from shrapnel from explosion. Tertiary is getting thrown into something (blunt trauma), Quadernary is from radiation

48
Q

Presentation and treatment of HACE (high altitude pulmonary edema)?

A

Descent, oxygen, dexamethasone

49
Q

Treatment for croup? Typical presenation?

A

Single dose PO Dexamethasone even for mild, anti-pyretics, humidifier. If moderate to severe should give nebulized (racemic) epinephrine as well. Typically presents after a fever and cough prodrome for a few days. Then patient will develop some stridor. Most commonly parainfluenza virus.

Medicine (3 decks)

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