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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
How many mL of acute blood can accumulate in the pericardial sac before clinical tamponade sets in?
60 to 100 mL.
26
What is considered a hard sign of a penetrating neck injury?
- Expanding hematoma - airway obstruction - Localizing neuro signs - decr/absent radial pulse - fluid non-responsive shock - severe acut bleeding - vascular bruit or thrill
27
What are the landmarks for Zone II of the neck?
The cricoid cartilage to the angle of the mandible.
28
Which of the following is the most common location for pediatric pseudosubluxation?
-C2-C3 less commonly c3-c4
29
Common organisms for infant meningitis?
GBC, E coli, Listeria
30
What antibiotic(s) should empirically be used to treat meningitis in an infant less than 28 days old?
Ampicillin plus cefotaxime or gentamicin.
31
What bug will cause bacterial conjunctivitis 5 to 14 days after birth?
Chlamydia -tx with erythromycin HSV can also have delayed presentation
32
Management of neonatal gonorrheal conjunctivitis?
- Hospitalization - Single dose ceftriaxone - full sepsis workup
33
What study should be performed in a patient with a classic presentation of pyloric stenosis but a normal ultrasound?
An upper GI contrast series, which not only can confirm pyloric stenosis but rule out reflux, malrotation, or an antral web.
34
At what respiratory rate should a newborn be ventilated?
40 to 60
35
What is the classic appearance of midgut volvulus on upper GI series?
Corkscrew appearance.
36
What is the most common rhythm in pediatric cardiac arrest?
asystole
37
What is seen on smear in pts with G6PD deficiency/
Heinz bodies (denatured hemoglobin clumps in RBCs)
38
Clinical picture of TCA OD?
- Anticholinergic (dilated pupils, tachy, dry, hot, urinary retention) - Sodium channel blockade (wide QRS, terminal avR) - Alpha-1 blockade (vasodilation, hypotension - GABA blockade (seizures)
39
What skin disease may present with corneal ulcers and punctate corneal lesions?
SJS
40
Dispo for pregnant pt with pyelo?
Admit for IV abx
41
Most common organism is R sided vs L sided endocarditis?
Right - Staph | Left - Strep Viridans, Staph
42
Safe dose of lidocaine 1%?
5 mg/kg, | 1% contains 10 mg/mL
43
most common side effect of colchicine
gastroenteritis
44
What is the first line treatment of multiple sclerosis exacerbations?
High-dose methylprednisolone followed by a prednisone taper.
45
Criteria for steroids in PCP PNA?
- PaO2 < 70 | - A-a gradient > 35
46
antidote for anticholinergics?
Physostigmine
47
Sulfonylurea OD antidote?
Octreotide and glucose
48
What size foreign bodies should be removed from the stomach?
longer than 5 cm or wider than 2.5 cm diameter should be removed as they are highly unlikely to pass the duodenum.
49
Indications for HD in lithium toxicity?
- 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
EKG findings in lithium Tox?
Bradycardia, t wave flattening, QT prolongation
51
TB PPD test cutoffs
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
Prefered regimen for cystitis in 1st trimester
- Amoxicillin, augmentin, cefpodoxime, fosfomycin, keflex | * Macrobid probably ok, but not in 3rd trimester
53
What findings will pt have with S1 radiculopathy?
- Pain radiating to posterior calf - decr plantar flexion - lateral foot numbness
54
Impetigo tx?
Mupirocin topical -systemic abs only if severe and signs of systemic illness
55
what med can be given in sulfonylurea OD to reduce insulin secretion?
Octreotide
56
Which bacterial gastrointestinal organism is associated with development of Henoch-Schönlein purpura?
Campylobacter jejuni enteritis
57
HIV post-exposure prophylaxis... - Within how long after exposure should you start? - Duration of Tx?
- 72 hours (but most effective within 2 hours | - 28 days
58
Antibiotic choice for endocarditis
Vanc + gentamicin *add rifampin if prosthetic valve
59
Treatment of CRAO?
- Ophtho consult - Decr IOP (Acetazolamide, Mannitol) - Vasodilators: Pentoxifylline, Nitro, Isosorbide
60
Diagnostic criteria for HEELP syndrome?
- BP > 140/90, though may even be normal - E/o hemolysis - AST >2x normal - Platelets < 100K
61
Tx for Beta blocker OD?
- High dose insulin - Glucagon - Calcium

Rosh Review (7 decks)

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