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Rosh Review > Rosh 4 > Flashcards

Rosh 4 Flashcards

1
Q

As far s lab values, which one helps differentiate between Iron deficiency anemia and thalassemia?

A

RDW

  • Iron def = increased
  • Thalassemia = normal
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2
Q

What red blood cell disorder has a characteristic increase in mean corpuscular hemoglobin concentration (MCHC)?

A

-hereditary spherocytosis

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3
Q

A flat anterior chamber indicates what diagnosis?

A

Globe rupture.

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4
Q

Elevated pleural fluid amylase suggests what possible etiologies?

A

Pancreatitis, esophageal rupture or certain malignancies.

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5
Q

What medication can you give (in addition to rectal tube + sigmoidoscopy) for its with Ogilvie syndrome? (large bowel obstructions)

A
  • Neostigmine

* do not use in its with bradycardia or soft BP

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6
Q

What should not be administered to patients with thrombotic thrombocytopenic purpura as part of therapy?

A

Platelets

Why????

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7
Q

What is the recommended regimen for outpatient management of PID?

A

Ceftriaxone 250 mg IM plus doxycycline 100 mg BID x 14 days with or without metronidazole 500 mg BID x 14 days.

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8
Q

How many days after chemo do patients experience a nadir in their ANC?

A

7 days

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9
Q

Can succinylcholine be used for rapid sequence intubation in an acute burn patient?

A

Yes. The concerning change in muscle receptors that occurs from burns takes place over 7–10 days after the burn.

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10
Q

What is a first line treatment for psoriasis?

A

Topical corticosteroids.

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11
Q

Tx for H. Pylori?

A

clarithromycin 500 mg BID, amoxicillin 1 g BID (metronidazole 500 mg BID if allergic to penicillin), and a proton pump inhibitor (such as lansoprazole 30 mg BID) for 10–14 days

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12
Q

What is the oral chelation medication for lead poisoning?

A

Succimer

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13
Q

What are the criteria for long-term oxygen therapy in COPD?

A

PaO2 <55 mm Hg, SaO2 <88%, or PaO2 between 56-59 mm Hg when pulmonary hypertension, cor pulmonale, or polycythemia is present.

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14
Q

What are some drugs that can cause noncardiogenic pulmonary edema?

A

opioids, naloxone, phencyclidine, and salicylates

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15
Q

Above what serum salicylate level should you consider hemodialysis in acute and chronic aspirin toxicity?

A

Acute toxicity > 100 mg/dL and chronic toxicity > 60 mg/dL

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16
Q

What pulm cap wedge pressure do you expect with cardiogenic vs non-cardiogenic pulm. edema?

A
  • Cardiogenic > 18

- Non-cardiogenic < 18

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17
Q

what is the first line treatment for latent TB infection?

A

Isoniazid x 9 months (6 may be okay too)

2nd line = Rifamin x4 months

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18
Q

What antimicrobial causes optic neuritis and color blindness?

A

Ethambutol

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19
Q

What drugs increase the efficacy of Adenosine?

Decrease?

A

Increase:

  • Carbamazpine, Dipyridamole, s/p transplant
  • Give smaller Adenosine dose

Decrease:

  • Methylxanthines, Caffeine, Theophylline
  • Give higher doses
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20
Q

Aside from Mg and defibrillation, what is another treatment option for Torsades?

A

-Overdrive pacing….increases HR to decr QT interval

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21
Q

What are the main concerns on EKG of a young patient who syncopized?

A
  • Short PR
  • Long QT
  • HOCM
  • ARVD
  • Brugada
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22
Q

What is the recommended compression to ventilation ratio in a newborn child?

A

3 compressions to 1 ventilation for a total of 90 compressions per minute and 30 breaths per minute.

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23
Q

What is the most frequently involved site of pediatric linear skull fractures?

A

Parietal

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24
Q

Is a scalp hematoma predictive of a skull fracture in infants?

A

Yes, if the scalp hematoma is overlying the parietal or temporal bones. Frontal hematomas are not predictive of underlying fracture.

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25
Q

How many mL of acute blood can accumulate in the pericardial sac before clinical tamponade sets in?

A

60 to 100 mL.

26
Q

What is considered a hard sign of a penetrating neck injury?

A
  • Expanding hematoma
  • airway obstruction
  • Localizing neuro signs
  • decr/absent radial pulse
  • fluid non-responsive shock
  • severe acut bleeding
  • vascular bruit or thrill
27
Q

What are the landmarks for Zone II of the neck?

A

The cricoid cartilage to the angle of the mandible.

28
Q

Which of the following is the most common location for pediatric pseudosubluxation?

A

-C2-C3

less commonly c3-c4

29
Q

Common organisms for infant meningitis?

A

GBC, E coli, Listeria

30
Q

What antibiotic(s) should empirically be used to treat meningitis in an infant less than 28 days old?

A

Ampicillin plus cefotaxime or gentamicin.

31
Q

What bug will cause bacterial conjunctivitis 5 to 14 days after birth?

A

Chlamydia
-tx with erythromycin

HSV can also have delayed presentation

32
Q

Management of neonatal gonorrheal conjunctivitis?

A
  • Hospitalization
  • Single dose ceftriaxone
  • full sepsis workup
33
Q

What study should be performed in a patient with a classic presentation of pyloric stenosis but a normal ultrasound?

A

An upper GI contrast series, which not only can confirm pyloric stenosis but rule out reflux, malrotation, or an antral web.

34
Q

At what respiratory rate should a newborn be ventilated?

35
Q

What is the classic appearance of midgut volvulus on upper GI series?

A

Corkscrew appearance.

36
Q

What is the most common rhythm in pediatric cardiac arrest?

37
Q

What is seen on smear in pts with G6PD deficiency/

A

Heinz bodies (denatured hemoglobin clumps in RBCs)

38
Q

Clinical picture of TCA OD?

A
  • Anticholinergic (dilated pupils, tachy, dry, hot, urinary retention)
  • Sodium channel blockade (wide QRS, terminal avR)
  • Alpha-1 blockade (vasodilation, hypotension
  • GABA blockade (seizures)
39
Q

What skin disease may present with corneal ulcers and punctate corneal lesions?

40
Q

Dispo for pregnant pt with pyelo?

A

Admit for IV abx

41
Q

Most common organism is R sided vs L sided endocarditis?

A

Right - Staph

Left - Strep Viridans, Staph

42
Q

Safe dose of lidocaine 1%?

A

5 mg/kg,

1% contains 10 mg/mL

43
Q

most common side effect of colchicine

A

gastroenteritis

44
Q

What is the first line treatment of multiple sclerosis exacerbations?

A

High-dose methylprednisolone followed by a prednisone taper.

45
Q

Criteria for steroids in PCP PNA?

A
  • PaO2 < 70

- A-a gradient > 35

46
Q

antidote for anticholinergics?

A

Physostigmine

47
Q

Sulfonylurea OD antidote?

A

Octreotide and glucose

48
Q

What size foreign bodies should be removed from the stomach?

A

longer than 5 cm or wider than 2.5 cm diameter should be removed as they are highly unlikely to pass the duodenum.

49
Q

Indications for HD in lithium toxicity?

A
  • level > 4 in acute Tox
  • level > 2.5 in chronic Tox
  • level elevated with any neuro symptoms
  • Renal failure
  • inability to handle fluid resuscitation
50
Q

EKG findings in lithium Tox?

A

Bradycardia, t wave flattening, QT prolongation

51
Q

TB PPD test cutoffs

A

5 mm

  • HIV
  • recent contact with someone with ACTIVE TB
  • transplant pts
  • XR findings

10 mm

  • IVDU
  • pts living in jails, homes, etc
  • recent arrivals from endemic areas
  • children < 4 and infants
  • comorbid conditions

15 mm
-anyone

52
Q

Prefered regimen for cystitis in 1st trimester

A
  • Amoxicillin, augmentin, cefpodoxime, fosfomycin, keflex

* Macrobid probably ok, but not in 3rd trimester

53
Q

What findings will pt have with S1 radiculopathy?

A
  • Pain radiating to posterior calf
  • decr plantar flexion
  • lateral foot numbness
54
Q

Impetigo tx?

A

Mupirocin topical

-systemic abs only if severe and signs of systemic illness

55
Q

what med can be given in sulfonylurea OD to reduce insulin secretion?

A

Octreotide

56
Q

Which bacterial gastrointestinal organism is associated with development of Henoch-Schönlein purpura?

A

Campylobacter jejuni enteritis

57
Q

HIV post-exposure prophylaxis…

  • Within how long after exposure should you start?
  • Duration of Tx?
A
  • 72 hours (but most effective within 2 hours

- 28 days

58
Q

Antibiotic choice for endocarditis

A

Vanc + gentamicin

*add rifampin if prosthetic valve

59
Q

Treatment of CRAO?

A
  • Ophtho consult
  • Decr IOP (Acetazolamide, Mannitol)
  • Vasodilators: Pentoxifylline, Nitro, Isosorbide
60
Q

Diagnostic criteria for HEELP syndrome?

A
  • BP > 140/90, though may even be normal
  • E/o hemolysis
  • AST >2x normal
  • Platelets < 100K
61
Q

Tx for Beta blocker OD?

A
  • High dose insulin
  • Glucagon
  • Calcium

Rosh Review (7 decks)

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