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Rosh Review > Rosh 2 > Flashcards

Rosh 2 Flashcards

1
Q

Treatment for pt with Von willebrand dz with bleeding?

A

Desmopressin

-If severe, factor8 concentrate

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2
Q

What are some indications for emergent HD in aspirin/salicylate toxicity?

A
  • Salicylate level > 100 mg/dL
  • rapidly rising levels
  • AMS (cerebral edema)
  • Seizures
  • kidney or liver failure
  • pulm edema
  • severe acid base abnormality
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3
Q

For every ___ mL of sodium bicarb given, serum pH rises by 0.1

A

50

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4
Q

Initial screening test for Lyme?

A

ELISA testing with western blot and PCR

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5
Q

What drug might you want ready for RSI in kids <2 yo?

A
  • Atropine

* tought to attenuate reflex bradycardia from succynylcholine administration

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6
Q

A boutonniere deformity is caused by _____ and looks like ______.

To fix it, splint should____

A
  • Central slip injury (inserts at base of middle phalanx and lateral edges of distal phalanx), aids in extension
  • PIP in flexion, DIP in hyperextension

-Splint: PIP in extension. DIPand MCP full ROM

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7
Q

What are some signs of cor pulmonale on EKG?

A
  • RAD
  • prominent R in V1
  • inverted T waves in V1-v3 or 4
  • Large S wave in I, II, III
  • Large Q wave in III
  • Tall P waves in II, III, AvF
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8
Q

What level are ICPs in patients with IIH (aka pseudotumor cerebri)?

A

> 20 in non-obese

>25 in obese

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9
Q

Tx for cryptococcal meningitis?

A
  • Amphotericin B + Flucytosine x2 weeks

- Fluconazole for 8 weeks after that

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10
Q

Diagnostic criteria for Kawasaki disease?

A

Fever for 5 days plus 4/5 of the following:

  • Cervical LAD
  • oropharyngeal changes
  • b/l conjunctivitis
  • Rash on torso
  • Erythema or desquamation on hands or feet
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11
Q

Formulas for determining whether CO2 retention/acidosis is acute vs chronic?

A
  • Acute: delta pH 0.008 x (40 - CO2)

- Chronic: same but with 0.003

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12
Q

What drugs can cause drug-induced Lupus syndrome?

A
  • Hydralazine
  • Isoniazid
  • Procainamide
  • Phenytoin

also..methlydopa, chlorpromazine, quinidine, minocyclin

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13
Q

Triple therapy meds for H pylori?

A
  • Clarithromycin
  • Amoxicillin (or Flagyl)
  • PPI

10-14 days**

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14
Q

What is the treatment for TCA overdose? (other than supportive stuff)

A

-NA-Bicarb.

50 meq IV at a time until QRS normalizes and bicarb drip

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15
Q

How do you calculate Shock index? What does it tell you?

A
  • HR / SBP

- 0.5 -0.7 = normal, >0.7 = more sensitive than VS alone in diagnosis occult shock/need for transfusion

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16
Q

What is the Amsel criteria for diagnosing bacterial vaginosis?

A
  • Thin, white homogenous discharge,
  • clue cells,
  • pH > 4.5,
  • positive whiff test.
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17
Q

Tx for Bacterial vaginosis?

A

_Flagyl 500 mg po BID x7 days

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18
Q

On Lateral elbow Xray…no visible fracture but post + anterior fat pads visible….

  • Diagnosis in adults?
  • Diagnosis in kids?
A
  • Adults: Radial head fracture

- Kids: Supracondylar fracture

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19
Q

What should be immediate treatment in Digoxin toxicity?

A
  • Digoxin immune Fab
  • It also improves hyperkalemia. DON’T give Calcium, as it can cause “stone heart” since calcium is already high with digoxin use
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20
Q

What type of cardioversion should be used when needed for SVT?

A

-Synchronized

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21
Q

What’s a good drug to start for Pt w/ ascending aortic dissection?

  • Why?
  • What dose?
A
  • Esmolol
  • Decreases HR too. Dropping just BP can lead to reflex tachy. Easily titratable
  • Blous of 500 mcg/kg then infusion 50-200 mcg/kg/min
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22
Q

Main derrangement clinically and metabolically in Cyanide poisoning?

treatment?

A
  • Severe met. acidosis. Severe dyspnea, LOC, seizures, dysrythmias
  • Nitrites or Thiosulfate
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23
Q

Tx of choice for sinus Brady 2/2 Beta Blocker Overdose?

A

Glucagon

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24
Q

What surgery is often complicated by complete heart block?

A

Aortic valve repair or replacement

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25
Q

EKG findings in pericarditis?

A
  • PR depression

- diffuse STE

26
Q

Target SBP for ruptured/leaking AAA patient with hypotension?

A

80 - 100. Give NS or blood

27
Q

With traumatic hyphema rebreeding tends to occur within ______days/hours.

A

72 hours. Treatment is supportive. Just stop anti platelets, AC, etc, eye shield to avoid repeat trauma

28
Q

What is the management for traumatic iritis?

A
  • Cycloplegics such as homatropine. This paralyzes the ciliary body
  • Maybe topical steroids (discuss with ophtho)
29
Q

Treatment for UV keratitis (aka superficial punctate keratitis)

A

topical NSAIDs

30
Q

When is surgery indicated for orbital floor fracture?

A

> 50% of floor, extra ocular must. entrapment, exophthalmos, diplopia

31
Q

Target ocular pH when flushing/irrigating a chemical burn of the eye?

A

7 - 7.2

32
Q

What is the goal PaO2/SpO2% for an intubated ARDS patient?

A

55-80 PaO2 or 88-95% SpO2

33
Q

How should octreotide be dosed in upper GI bleed?

A

bolus of 50 mcg followed by an infusion of 50 mcg/hour.

34
Q

What is initial treatment of mild IBD?

A

Mesalamine

35
Q

Which lab marker elevation has the highest positive predictive value for a biliary etiology in patients diagnosed with acute pancreatitis?

A

ALT

-ALT levels more than 150 IU/L have 96% specificity and 95% positive predictive value for gallstone pancreatitis.

36
Q

Treatment for Peds shigellosis (when required, i.e sick patient)?

A

-Ceftriaxone 50 mg/Kg IV daily

can also do copra

37
Q

What serologies will be positive in acute hep B infection?

A
  • HBsAg

- Anti hep B core antigen IgM

38
Q

what is the best marker of HBV immunity?

A

Anti-Hepatitis B surface antibody (anti-HBsAb)

39
Q

What organism is likely responsible for a cavitary lesion on CXR in alcoholic patient with fever/chills/cough?

A

Klebsiella

-Tx: 3rd gen cephalosporin and aminoglycoside

40
Q

What are adverse effects of Zanamivir? In which patients is it contraindicated?

A
  • Wheezing, severe bronchospasm, resp distress
  • Asthma, COPD, other structural lung disease

*Zanamivir is an inhaled version of Tamil essentially

41
Q

What is the lowest you should enter for a thoracentesis?

A

-8th intercostal space (posterior)

42
Q

Diagnosis in a patient who handles fish/works at aquarium….develops skin lesion over course of weeks after an abrasion/laceration, gets red, tracks up lymphatics?

treatment?

A
  • fish tank granuloma
  • Mycobacterium marinum

-Tx: Minocycline or Clarithromycin

43
Q

What findings/lab values would you expect to see with an exudative pleural effusion?

A
  • pH < 7.2
  • Glucose < 60
  • WBC > 50K
  • pleural fluid protein to serum protein is greater than 0.5
  • pleural fluid LDH to serum LDH is greater than 0.6
44
Q

Pyridoxine needs to be administered in conjunction with ______ (medication) to prevent ______

A
  • Isoniazid

- neuropathy, seizures, etc

45
Q

The “blush sign” on CT around the Spleen is an indication for ________

A

Angioembolization via IR

*Only if HD stable

46
Q

What deficits do you expect with anterior cord syndrome?

A
  • Complete loss of Moto, pain, and temperature sensation below injury
  • Intact proprioception/vibratory sensation
47
Q

What deficits do you expect with central cord syndrome?

What is the usual mechanism?

A
  • Sensory and motor deficits upper > lower

- Forced hyperextension

48
Q

What is normal intra-occular pressure?

A

10 - 21 mm Hg

49
Q

What vascular structure is at risk of injury with a proximal fibular fracture?

A

Anterior tibial artery.

50
Q

What nerve/nerves provides sensation to lateral aspect of dorm of the foot?

A

Sural nerve and lateral dorsal cutaneous nerve

51
Q

What nerve(s) provide sensation to the medial malleolus area?

A

Saphenous nerve and Medial sural cutaneous nerve

52
Q

What nerve provides sensation to posterior calf?

A

Saphenous and rural nerves

53
Q

Most common nerve injury with distill radius fracture?

A

-Median nerve

54
Q

Indications for emergent surgery in a patient with a subdural hematoma include _________

A

neurologic deterioration
or
midline shift > 5 mm on CT

55
Q

How do you calculate MAP?

A

DBP + 1/3(SBP-DBP)

56
Q

Management of pt with orbital blowout fracture with entrapment?

A
  • Ice
  • elev HOB during sleep
  • nasal decongestants
  • no blowing nose
  • NSAIDs
  • Antibiotics (augmentin)

**OK to discharge!

57
Q

EKG features of WPW?

A
  • Slurred upstroke of QRS complex (delta wave)
  • Widened QRS
  • Shortened PR
58
Q

Most common organism for pediatric PNA in the following age groups:

  • 0-3 weeks?
  • 3 wk - 3 mo?
  • 3 mo - 5 y?
  • 6-8 y?
A
  • GBS
  • Chlamydia trach.
  • RSV
  • Mycoplasma
59
Q

Which statistical values are influenced by prevalence?

A
  • PPV

- NPV

60
Q

Treatment of Sporothrichosis?

A
  • Itraconazole

* Amphotericin for severe, systemic disease

Rosh Review (7 decks)

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