Rosh Flashcards
Diagnosis? Treatment, if asymptomatic? symptomatic?
AVNRT
Asymptomatic- adenosine, metoprolol, dilt
Symptomatic- sedation and cardioversion1
ECG differences between pericarditis and MI?
MI has reciprocal changes (ST depression)
If allergic to lidocaine, what alternative should anesthetic solution can be used?
Procaine, chloroprocaine
Amides vs esters anesthetics?
Amides have to “i”
esters have i
What steroids are used in asthma exacerbation?
Systemic steroids
Cause? First-line therapy?
Hyperkalemia, calcium gluconate.
Cause? Name?
“U” waves, most common finding in hypokalemia
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
Side effect on Prednisolone in children?
Emesis
Most common cause of botulism?
infantile
MoA of botulism?
Inhibits the release of ACH from motor end plates
Pathogen that presents similar to appendicitis?
Yersinia enterocolitica
Extraintestinal manifestations of shigella?
reactive arthritis, seizures, and hallucinations
High urine sodium (>20)?
renal damage (htn, etc)
Signs of transudative effusion?
LDH < 0.6
Protein < 0.5
LDH < 2/3 upper normal
Glucose is > 60
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
Prearrival instruction?
Instructions provided to callers by the emergency medical dispatcher intended to assist in providing patient care prior to EMS arrival
Effect of bite?
CNS excitation, muscle cramps
Effect of bite?
local tissue destruction
Emergent management of tension pneumothorax?
Needle decompression
Is the superficial femoral vein important in DVTs?
Yes, blood thinners should be used
What atients with PID should be admitted to the hospital?
Pregnant women
How should shingles be managed?
Pain control
Risk for periorbital burns?
Delayed labial artery bleeding
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?
- Duty to perform with reasonable care
- Failure to perform a duty like a reasonable practicioner
- Some damage of injury must occur
- 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
