Rosh Flashcards
Two MC systems affected after lungs w/ sarcoidosis
? sense organ is MC affected
How is prolactinoma Tx
Skin, Nodes
Eyes
Dopamine agonists: Carbergoline*, Bromocriptine
? is Necrotizing Enterocolitis Dx
Most Pts will be ? w/ ? RF association
How do they present
Abdominal x-ray
Premature; aggressive feeding
First days of life w/ distension, vomit, bloody stool, pneumatosis intestinalis
What meds are associated w/ causing Necrotizing Enterocollitis
? muscle is affected w/ anserine bursitis
Where does this muscle insert and how is it innervated
Indomethicin
Vit E
Gracilis
Inferior pubic ramus; Obturator L2-4
? concomitant knee injury needs to be evaluated for in Pts w/ Pes Anserin bursitis
MC extramural cause of small bowel obstructions
MC mural cause of large bowel obstruction
MCL tear
Adhesions
Neoplasm
? is the MCC of intussusception in adults
? is the MCC of severe gastroenteritis in children
How is this MC Dx
Tumors
Rotavirus d/t fecal-oral transmission
ELISA, Latex agglutination
Rotavirus vaccine is c/i in Pts w/ ? MedHx
? is first line HTN therapy for Pts w/ chronic, stable angina and CADz
ASA is the first line antiplatelet therapy for stable agina in all cases except ? two in which case ? is used
Intussusception
BBs- Atenolol
Recent MI, Coronary stents;
Clopidogrel
? is the most appropriate long term management for patello femoral pain syndrome
What ellicits pain w/ this Dx
What PE test is used for Dx
Physical therapy
Loaded flexion- climbing, jumping, theater sign
Patellar grind test
? medical condition is associated w/ Strep Bovis endocarditis
How is cholera Tx w/ ABX
? is cholera Tx in pregnancy/peds
Colorectal Ca
Doxy, Cipro
Azithromycin
Triad of Menieres Dz
How is this managed
? is the MC solid renal tumor of childhood <15y/o
SNHL Episodic vertigo (x20min) Tinnitus
Meclizine Diazepam Hydrochlorothiazide Pred
Nephroblastoma, Wilms tumor
Peak presentaton: 3y/o
Brain atrophy and head trauma put Pts at risk for ? bleed
? two populations are at risk
What will be seen on imaging
Subdural hematoma
Elderly, Alcohol users
Non-contrast CT showing crescent shape d/t blood between dura and arachnoid
Antisocial Personality D/o traits
These Pts have a strong associated w/ ?
Pheo meds for pre-op and for during crisis
Disregard for rights of others
Lack of remorse
Manipulate/lie
Friendly on surface
Drug/Alcohol abuse
Pre-Op: Phenoxybenzamine
Crisis: Phentolamine Nicardipine Sodium nitroprusside
Pheos are associated w/ ? three hereditary syndromes
How does prostate Ca present on DRE
? lab test will remain positive for Pts Tx for syphilis and tested again in the future
von Hippel Lindau MEN-2 NF-1
Asymmetric area of induration
Fluoroscent treponemal Ab Absorption
What MedHx makes COX-2 inhibitors c/i for life
How is gonococcal ophthalmia neonatorum Tx
? are the three neonatal conjunctivitis and how are they differed by time
Hx of peptic ulcers
Topical erythromycin 0.5%
Chemical: first 24hrs of life
Gonococcal: 3-5d after birth
Chlamydial: 5-10 days
? is a congenital RF for cervical insufficiency
How is this condition managed
How is malaria Dx
Ehlers Danlos
Cerclage placement at 12-14wks
C/i if membrane ruptured
Thick/Thin smears
? form of malaria is most severe
What forms of malaria have fever every other day
What forms have fever every third day
P falciparum
Vivax Ovale Falciparum
Malariae
How is chloroquine sensitive malaria Tx
How is chloroquine resistant malaria Tx
How are complicated cases Tx
Chloroquine phosphate
Hydroxychloroquine
Quinine+Doxy
Atovaquone-proguanil
Mefloquine
Artesunate (IV preferred)
Quinine dihydrochloride
Quinine gluconate w/ doxy or clinda
What is Blackwater Fever
Genital herpes puts Pt at risk for acquiring ? Dz
How are mature cataracts Tx
Hemoglobinuria from hemolytic anemia d/t malaria
HIV
Phacoemulsification w/ lens implantation
? is leading cause of blindness world wide
What is a key part of the Hx during PMS work up
What lab test should be ordered for all PMS work ups
Cataracts
Absent Sxs during follicular phase
TSH
? is a relieving factors for spinal stenosis
What sign is this relieving factor called
Flu vaccine data
Bending forward
Shopping cart sign
Pts >6mon old
Egg allergy not a c/i for receiving
MC microbe causing lung abscesses
What ABX are used for lung abscess Txs
Key finding for fungal diaper dermatitis and how is it Tx
Anaerobes
Ampicillin-Sulbactam
Carbapenem
Beefy, scaling lesions sparing inguinal folds;
Topical Nystatin/Azoles
MOA of Nitrofurantoin
MCC of UTIs
MCC of maternal death globally
Inhibits cell wall synthesis
E Coli
Post-partum bleeding
How is post-partum hemorrhage managed
What is the MOA of the drugs used
When are the drugs c/i for use
Uterine massage
Oxytocin
Carboprost and Methylergonovine
Carbo: prostaglandin analog stimulating uterine contractions
Carbo: C/i asthma d/t bronchosopams
Methy: HTN, CADz d/t vasospasms
What are the 4 T’s of Postpartum Hemorrhage
? type of d/o is Marfans Syndrome
What unique PE finding may differ Marfans from Ehlers Danlos
Atony- MC
Trauma to birth canal
Tissue retention
Thrombin d/o
Autosomal dominant mutation of FBN-1 for Fibrillin 1
ED- loose skin w/ laxity
How does Immune Thrombocytopenia present
How is it Dx
? is the vasopressor of choice for Tx septic shock
Petechial rash/bruising in otherwise healthy Pt
Platelet <100K
Normal CBC and peripheral smear
NorEpi- A-adrenergic agonist to inc constriction/BP and B-adrenergic agonist to inc CO
Vasopressor w/ highest to lowest A-affinity
Vasopressors w/ highest to lowest B-affinity
? adrenergic function causes an increased cardiac output
Epi, NorEpi, Isoproterenol
Isoproterenol, Epi, NorEpi
Beta
MCC of hand, foot and mouth Dz
? S/Sxs make kids unable to attend daycare
? PE test isolates appendix to rectrocecal/pelvic location
Coxsackie A
Fever
R: Psoas
P: Obturator
How is Otitis Externa Tx
Black Widows belong to ? group
A widow bite will cause a release of ?
Hydrocortisone/Neomycin/Polymyxin B (Mod/Sev: Cipro)
Latrodectus mactans
Acetycholine; NorEpi
? is MC congenital bleeding d/o
What will be seen on lab results
How are these Tx
Von Willebrand Dz, deficient factor 8
Abnormal bleed time;
Normal PT, PTT, INR
Desmopressin
VWF replacement
Two first line medical therapies for Crohns Dz
Any Ped Dx w/ Juvenile Idiopathic Arthritis needs ? referral and f/u
? is hallmark Sxs of cholesteatomas and how are they managed
Mesalamine
Sulfasalazine
Ophth w/ slit lamp q3mon x 4yrs
Painless otorrhea;
Refer to otolarnygologist
How does diabetic neuropathy present
How can it be medicinally managed
What meds are used for acute angle closure glaucoma
Burn/tingling worse at rest
Pregablain, Amytriptyline
Timolol Apraclonidine Pilocarpine- empiric
Acetazolamide Mannitol- systemic
Three findings highly suggestive of glomerulonephritis
How does Minimal Change Dz present and how is it managed
? finding suggests nephrotic syndrome and moves Dx away from glomerulonephritis
Hematuria RBC casts Proteinuria
Proteinuria Edema HTN; steroids
No hematuria/RBC casts
Hemophilia B is AKA ?
Other than complete and frequent feedings, how can lactational mastitis be controlled/reduced
How does RMSF present, Dx and Tx
Factor 9 deficiency- Christmas Dz
Ointments for excoriation/cracking
High fever, Arthralgia, Myalgia, Petechial rash- starts ankle/wrist and moves centrally
Indirect immunofluorescence assay
Doxy, Chloramphenicol
