Rosh Flashcards by Joe Dillin

Diagnosis? Treatment, if asymptomatic? symptomatic?

AVNRT

Asymptomatic- adenosine, metoprolol, dilt

Symptomatic- sedation and cardioversion1

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ECG differences between pericarditis and MI?

MI has reciprocal changes (ST depression)

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If allergic to lidocaine, what alternative should anesthetic solution can be used?

Procaine, chloroprocaine

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Amides vs esters anesthetics?

Amides have to “i”

esters have i

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What steroids are used in asthma exacerbation?

Systemic steroids

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Cause? First-line therapy?

Hyperkalemia, calcium gluconate.

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Cause? Name?

“U” waves, most common finding in hypokalemia

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Where does a great saphenous vein cut down occur?

What nerve can be damaged?

Anterior and superior to the medial malleolus

-can damage saphenous nerve, lose sensation to a small part of the foot

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Side effect on Prednisolone in children?

Emesis

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Most common cause of botulism?

infantile

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MoA of botulism?

Inhibits the release of ACH from motor end plates

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Pathogen that presents similar to appendicitis?

Yersinia enterocolitica

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Extraintestinal manifestations of shigella?

reactive arthritis, seizures, and hallucinations

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High urine sodium (>20)?

renal damage (htn, etc)

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Signs of transudative effusion?

LDH < 0.6

Protein < 0.5

LDH < 2/3 upper normal

Glucose is > 60

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What is online medical control?

EMS providers speak directly with a physician over the phone to request real-time instructions regarding patient care prior to hospital arriva

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Prearrival instruction?

Instructions provided to callers by the emergency medical dispatcher intended to assist in providing patient care prior to EMS arrival

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Effect of bite?

CNS excitation, muscle cramps

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Effect of bite?

local tissue destruction

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Emergent management of tension pneumothorax?

Needle decompression

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Is the superficial femoral vein important in DVTs?

Yes, blood thinners should be used

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What atients with PID should be admitted to the hospital?

Pregnant women

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How should shingles be managed?

Pain control

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Risk for periorbital burns?

Delayed labial artery bleeding

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Treatment for high altitude sickness?

Decent (definitive), acetazolamide, dexamethasone, and supplemental oxyden

Treatment for epididymitis

\< 35- Ceftriaxone and doxy \>35 flouroquinalones, tri/sulf

Most common findings in ovarian torsion?

Enlargement of the ovaries

Ogilve syndrome

colonic pseudoobstruction in older people treatment with neostigmine

What is routinely ordered for people with COPD, but not asthma?

CXR

Stroke that presents with ipsilateral deviation of the eyes, stupor, coma and mydriatic pupils

putamen hemorrhage

Enlarged cervical lymph node in 2 year old?

Bartonella henselae (cat-scratch disease)

Treatment for rhadomyolitis? End goal?

IV fluids End-goal- urine output of 3mL/kg/hr

“Codman’s triangle” or elevation of the periosteum of the bone? Risk in children?

Osteosarcoma Radiation exposure is the highest risk

What drugs can be delivered down the endotracheal tube?

Adults- Naloxone, atropine, Vasopressin, epinephrine, lidocaine (NAVEL) Children- Lidocaine, atropine, naloxone, epinephrine (LANE)

Treatment for pertussis?

\<1 month, azithromycin Otherwise, erythromycin

Treatment for painful eye after blunt trauma?

Homatropine drops

Benefit of hyperbaric oxygen in carbon monoxide?

It reduces risk of neurologic sequelae

fever started 3 days ago followed by a rash which started on the head and spread to the rest of the body

Rubella

What salter-harris fractures require surgical interventions?

Salter- III/IV/V

Pediattic management of glipazine overdose?

Dextrose and octeotide (blocks insulin release)

Management of anaphylaxis?

Corticosteroids, H1 blocker, H2 blocker, intramuscular epinephrine, and albuterol

Sudden onset of pain and decreased vision in one eye? Treatment?

Acute close glaucoma, Homatropine drops

Most common cause of acute urinary retention in older males?

Benign prostatic hyperplasia

pain in the anterior proximal knee or thigh that is exacerbated by activity. On exam, there is loss of hip internal rotation

SCFE

End goal for chemicals in eye?

pH 7.0 - 7.2

if aspirin allergy, what treatment should be started in possible heart attacks? MoA?

Administer clopidogrel MoA-binds to the platelet adenosine diphosphate (ADP) receptor to irreversibly inhibit activation and aggregation for the life of the platelet

How to treat HTN caused by cocaine?

Benzodiazepines and phentolamine.

Which cervical spine fracture is considered stable?

Type I odontoid fracture

Brown-Séquard syndrome?

Ipsilateral loss of motor strength, vibratory sensation, and proprioception with contralateral loss of pain and temperature sensation below the level of injury

Measles vs rubella?

Rubella- mild fever, maculopapular rash, posterior cervical lymphadenopathy Measles-infectious paroditis

Pathologies to considered with older individuals with abdominal pain?

Myocardial infarction (or ischemia), pneumonia, pulmonary embolism, pericarditis and myocarditis

First step in managing tension pneumothorax?

Needle decompression, followed by chest tube

Risk factors for ectopic pregnancy?

Tubal surgery, PID, Tobacco use, Advanced maternal age, Prior spontaneous abortion, Medically-induced abortion, hx of infertility, IUD

What is holiday heart syndrome? Treatment?

atrial fibrillation, atrial flutter, or atrial tachycardia after excessive alcohol use Treatment- observation, if \>24-48 hours, rate control

Risk factors for suicide?

Sex (Male), age, depression, previous attempt, substance abuse, loss of rational thinking, lack of support, organized plan, no spouse, sickness (SADPERSONS)

drugs that precipitate acute rejection in a lung transplant patient taking cyclosporine

Phenytoin

What water temperature is optimal for frostbite?

37-39°C

Most common cause of pneumonia?

Strep pneumoniae

Antidote for dystonic reaction?

Benztropine, diphenylhydramine

Treatment for vtach?

synchronized cardioversion

Problem?

Scapholunate dissociation

Most sensitive and specific test for acute cholecystitis

HIDA scan

hallmark of significant right-to-left shunting

Failure to arterial o2 sats to increase with supplemental oxygen

Treatment for WPW?

Procainamide

How should amputated digits be maintained?

Moist with NS in a wet towel

What are the components of negligence?

1. Duty to perform with reasonable care 2. Failure to perform a duty like a reasonable practicioner 3. Some damage of injury must occur 4. Causal relationship

Management of deep perianal abscess?

CT scan and surgical consultation

First step in managing a desat on a patient with a ventilator?

Disconnect the patient from the ventilator

Complication of bassilar skull fracture?

Cranial nerve entrapment is a complication, most common VII

What is this an example of?

positive Seidel test

copious frothy green vaginal discharge, inflamed vaginal walls, and a cervix with punctate hemorrhages

Trichomonas

Drug-induced neutropenia in children is caused most commonly by?

Antibiotics, especially macrolides, cephalosporins, and penicillins

Indications for hyperbaric oxygen in carbon monoxide?

igns of end-organ damage regardless of the measured level. Loss of consciousness (syncope), coma, seizures, confusion, focal neurologic deficits and visual symptoms

Where to apply pressure during delivery of child?

Suprapubic

First step in managing septic arthritis?

Tap the joint

Treatment for serotinin syndrome?

Benzos, Cyproheptadine, hydration/cooling

Thompson test

Plantar flexion with squeezing calf?

What vessel supplies the av node? sa?

Rright coronary artery

How does a coin in the trachea? Esophagus`

Side view, when x-ray in AP-trachea Front view-esophagus

Most common cause of v fibrillation and death?

CAD

Management of thyroid storm from taking levo too much?

beta blockers and steroids.

DIC labs?

decreased platelets. low fibrinogen levels

Mad as a hatter syndrome- cause? treatment?

Cause-anticholinergic Treatment- Physostigmine, an anticholinesterase inhibitor.

Treatment for consuming small amount of household bleach?

D/C if asymptomatic

Drug given empirically in all AMS?

Dextrose

Galeazzi Fracture

distal third of the radius with dislocation of the distal radioulnar joint

Which knee maneuver tests the knee?

McMurry

Most common presenting symptom with acute aortic dissection

Chest pain

Most common cardiac abnormality from lyme disease?

!st degree heart block

Cardiac temponade findings?

hypotension, jugular dystension, muffled heart sounds

Immunization again hep b serology

Hepatitis B surface antigen negative, Hepatitis B surface antibody positive

Most common bacteria from secretions of CF patients?

S. aureus