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Rosh Review > Rosh 5 > Flashcards

Rosh 5 Flashcards

1
Q

Target temperature when cooling someone with heat stroke?

A

102F

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2
Q

Criteria for simple febrile seizure?

A
  • Age 6 mo to 5 years
  • GTC
  • only 1 sz in 24 hours
  • non-focal
  • normal neuro exam
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3
Q

How is malrotation diagnosed?

A

Upper GI series

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4
Q

When is surgery indicated in hyphema?

A

When IOP is uncontrolled

  • > 25 after 24 hours in sickle patients
  • > 50 for 6 days in healthy patients

*Also pediatric its with grade 4

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5
Q

Tx of septic joint in sickle cell patient?

A

Vanc + Cipro for better coverage of salmonella

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6
Q

PNA tx for cystic fibrosis pt?

A

-Vanc, Zosyn + amino glycoside for double pseudomonas coverage

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7
Q

Clinical presentation TTP?

Treatment?

A
  • fever, thrombocytopenia, hemolytic anemia, neuro sx, renal failure
  • PLEX + steroids
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8
Q

diagnosis in anemic patient with low MCV and target cells?

A

Beta thalassemia

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9
Q

Nerve commonly injured in peri-lunate dislocation?

A

Median

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10
Q

What nerve often gets injured with anterior knee dislocation?

What deficits do you get?

A
  • Common Peroneal
  • Impaired dorsiflexion
  • sensory: Lateral lower leg, dorm of foot sparing lateral aspect
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11
Q

Which STEMI typically causes Papillary muscle rupture?

A

Inferior (STE in II, III, aVF)

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12
Q

How long after ingestion Acetaminophen should a level be checked?

A

4 hours

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13
Q

What dose of Tylenol is thought to = toxic dose?

A

150 mg/Kg

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14
Q

What meds can cause an increase in lithium concentration?

A

Diuretics, particularly thiazides.

Lithium excreted Renally

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15
Q

Indications for HD in lithium OD?

A
  • level > 5
  • level > 4 with any renal dysfunction
  • seizure
  • dysrythmia
  • AMS
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16
Q

Most reliable lab abnormality in heat stroke?

A

Elevated AST/ALT

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17
Q

When should a febrile neonate receive acyclovir?

A
  • ill appearing
  • mucocutaneous vesicles
  • maternal hx of genital herpes
  • seizures

60 mg/kg/day divided TID

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18
Q

Fracture of what carpal bone is associated with ulnar nerve injury?

A

Hamate

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19
Q

What factors increase risk of non-union in clavicle fractures?

A
  • elderly
  • high risk mechanism
  • female
  • medial 1/3
  • severely comminuted > 2 cm
  • severely displaced > 100%

*n/v compromise, skin tenting, open fx = ortho consult

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20
Q

Slow A-fib = think patients with _____?

A

Hypothyroid (myxedema coma)

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21
Q

Mgmt post-strep glomerulonephritis

A

Lasix if edemetous

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22
Q

Polycythemia Vera treatment?

A

Hydroxyurea, aspirin, phlebotomy

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23
Q

Most common brain mass in kids?

-features?

A

Medulloblastoma

  • solid appearing, homogenous, midline posterior fossa mass
  • HA, n/v, ataxia, CN6 palsy
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24
Q

Features of astrocytoma in kids?

A
  • cystic appearing

- rim enhancement with central necrosis

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25
Q

What 2 situations can lead to false negative d-diner?

A
  • anticoagulation

- subacute thrombus > 7 days

26
Q

What is seen on XR in intussusception?

A

Dilated small
Bowel

Absent has in colon

Obscured liver margin

27
Q

Above what BP to you need to lower with meds before giving tPA for stroke?

A

185/110

28
Q

Tx of herpes zoster ophthalmicus?

A
  • oral acyclovir/valcyclovir
  • topical steroids
  • ophtho consult
29
Q

How longs after chemotherapy are patients at highest risk of neutropenia and infection?

A

7 days

30
Q

What electrolyte abnormality must be corrected for urinary alkalinization to be effective?

A

hypokalemia

31
Q

What meds should you give in CCB overdose?

A
  • calcium IV
  • IVF
  • insulin
  • glucagon
  • pressors if needed
  • intralipid if needed
32
Q

How is peritonitis diagnoses in a pt with peritoneal dialysis catheter?

How is it treated?

A
  • > 100 wbc, > 50% neut

- intraperitoneal Abx

33
Q

Indications for digibind in digoxin toxicity?

A
  • elevates dig level 10-15
  • potassium > 5
  • dysrhythmias
  • don’t give calcium….stone heart
34
Q

Indications for HD in tumor lysis syndrome?

A
  • potassium > 6
  • creatinine > 10
  • Uric acid > 10
  • phos > 10
  • volume overload
  • symptomatic hypocalcemia

*give IVF, rasburicase, allopurinol

35
Q

What meds should you administer to a woman with Pre-term, premature rupture of membranes (P-PROM)?

A
  • steroids
  • ampicillin or amoxicillin
  • consider tocolysis
36
Q

What size is diagnostic for appendicitis on ultrasound?

A

-6-7 mm non compressible tubular structure

37
Q

Indication for methylene blue in methemoglobinemia

A

Methemoglobin level 20% or greater

38
Q

Dose for pediatric adenosine?

A

0.1 mg/kg

39
Q

Patient with tongue or lip telangiectasis, hx of nosebleeds, could be ____?
- Emergencies related to this disease?

A
  • Osler Weber Rendu syndrome

- AV malformations in brain, liver, lung –> bleeding. Sometimes high output heart failure

40
Q

Management of jellyfish sting?

*4 things

A
  1. remove nematocysts (scrape off)
  2. Hot water immersion 40 to 45 degC
  3. Acetic acid
  4. antivenin if applicable
41
Q

In patients with PID who have an IUD in place, do you need to remove IUD?

A

No!

42
Q

Pt with PID and strawberry cervix (punctate hemorrhages)….what organism is responsible?

A

Trichomons vaginalis

43
Q

When should etoh or fomepazole be given in Methanol intoxication?

A

Methanol level > 20

  • Can also give Folate
  • Dialysis if very sick or level >50
44
Q

management of CRAO?

A
  • Orbital massage
  • Acetazolamide or mannitol or timolol
  • Vasodilators (pentoxyfylline, nitroglycerin, isosorbide)
  • ophtho consult
45
Q

What are the 2 earliest clinical indicators of a significant radiation exposure?

A
  • Decr in absolute lymphocyte count

- Vomiting

46
Q

Is blunt abdominal trauma an indication for Rho-Gam in a pregnant Rh neg mom?

A

Yes! even without e/o bleeding

Dose: 300 mcg, but 50 if < 12 weeks

  • Though giving 300 is not harmful
  • Given IM
47
Q

Epi dose for Peds cardiac arrest?

A

0.01 mg/Kg IV

48
Q

Hordeolum (stye) vs Chalazion?

A

Hordeolum:

  • At or near eyelash follicle
  • Tender
  • bacterial infection

Chalazion:

  • Above eyelashes usually upper lid
  • Painless
  • blocked oil gland
49
Q

EKG finding in hypothermia?

A

-Osborne waves

Positive deflection at ST segment

50
Q

EKG findings in ARVD?

A
  • Epsilon wave (positive deflection after QRS)
  • TWI in V1-V3 without RBBB
  • Prolonged S wave upstroke in V1-V3
51
Q

What is the treatment of a pregnant patient with syphilis and a penicillin allergy?

A

Admission for penicillin desensitization as only penicillin is effective in these patients.

52
Q

what med should you avoid in pt w GBS?

A

-Succynylcholine

53
Q

Early manifestation of cystic fibrosis?

A

Meconium ileus

54
Q

All infants with meconium ileum should be tested for _____?

A

Cystic fibrosis (sweat test)

55
Q

How do you diagnose meconium ileum?

A

Hyperosmolar contrast enema

*can also be therapeutic

56
Q

circumstances for closing a dog bite?

A
  • Clinically not infected
  • < 12 hours old
  • Not deep and no crush injury
  • Not on hand or foot
57
Q

What infectious process should you suspect in someone traveled to Africa or S America, who initially has viral like syndrome, followed by improvement, who then goes on to dev. febrile illness again with multi-organ dysfunction including severe GI bleed and Leukopenia?

A

Yellow fever

58
Q

How is alteplase (t-PA) dosed in ischemic CVA?

A

0.9 mg/kg (up to 90 mg) with 10% of the dose given as a bolus and the rest of the dose given as an infusion over 1 hour.

59
Q

Under what age is a surgical cricothyrotomy not recommended?

A

4 years old

60
Q

What to administer for someone with active Tetany having truisms, muscle spasms, etc?

A
  • Tetanus toxoid
  • Tetanus Immunoglobulin
  • Flagyl
  • Benzos for spasms
61
Q

Nausea in pregnancy, which meds to use and when?

A
  1. Pyridoxine alone or with doxylamine for early n/v
  2. Add Benadryl or meclizine
  3. Zofran for severe sx, ketonuria, weight loss, etc

Rosh Review (7 decks)

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