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Rosh Review > Rosh 7 > Flashcards

Rosh 7 Flashcards

1
Q

Tx for Neurocysticercosis?

A

Albendazole

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2
Q

What is the time course of acute organ rejection?

What is the pathology?

A

1-12 weeks after transplant

CD8 mediated, leukocyte infiltration of Grady vessels, impairing perfusion

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3
Q

Patient with painful genital lesions and tender inguinal LAD?

Diagnosis?

Organism?

Treatment?

A

Chancroid

Hemophilus ducreyi

Options:

  • azithro 1g PO
  • ctx 250 IM
  • cipro 500 PO

*consider empiric tx for syphyllis

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4
Q

What medications can induce acute angle closure glaucoma?

A
  • antihistamines
  • anticholinergics
  • sympathomimetics
  • topical mydriatics

Anything that dilates pupils

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5
Q

What classes of medications (and examples for each) are used to treat acute glaucoma?

A
  • topical beta blockers (Timolol)
  • topical alpha agonists (apraclonidine)
  • CA inhibitors (acetazolamide, dorzamide)
  • topical muscarinic agonists (pilocarpine)
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6
Q

What med is contraindicated during thyroid storm because it increases serum T4 and T3?

A

Aspirin

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7
Q

Partial thickness burns > what % requires burn center?

A

10

*exception = hand or genital involvement

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8
Q

What abx for NEC in newborn?

A

Cefotaxime
Ampicillin
Flagyl

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9
Q

In frost bite, should blisters be de-brided?

A
  • yes for 2nd degree (clear blisters)

- No if 3rd degree (hemorrhagic blisters)

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10
Q

Woman who recently gave birth, having seizures, without hx of seizure? Dx and management?

A

Eclampsia (can occur up to 6 weeks post partum)

Tx with IV Magnesium
-4 to 6 g bolus then 1-2g/hr drip

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11
Q

How can you distinguish LV aneurysm from stent thrombosis?

A

Lack of pain, no reciprocal changes

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12
Q

What cofactor needs to be administered in ethylene glycol poisoning?

Methanol poisoning?

A
  • thiamine

- folate

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13
Q

Child 1-5 years old pw abdominal mass, asymptomatic. Diagnosis?

A

Wilm’s tumor (nephroblastoma)

-May also have hematuria or HTN

Tx = surgery and chemo (good prognosis)

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14
Q

How can you differentiate staph scalded skin syndrome from SJS/TEN?

A

SSSS = no mucous membrane involvement, usually preceding infectious symptoms, no medication exposures

*both SJS/TEN and SSSS can have bullae and nikolsky sign

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15
Q

Treatment options for low flow priapism?

A
  • cavernosal phenylephrine 100 - 500 mcg
  • terbutaline subq or PO
  • cavernosal methylene blue
  • blood aspiration
  • in sickle cell —> exchange transfusion
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16
Q

How does head impulse test help differentiate peripheral and central vertigo?

A
  • normal = central

- abnormal = peripheral

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17
Q

Patient with risk factors presents with no chest pain, but has biphasic or inverted T waves in anterior leads without ST changes….management?

A

Catch lab

*wellen’s EKG. Signifies critical LAD lesion. Usually an area that gets re-perfused with collaterals

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18
Q

Wellen’s sign is ______ on EKG.

A

Deep inverted T waves or biphasic T waves in sterile leads, usually V2 and V3.

Frequently chest pain free!

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19
Q

What is de-winter’s ekg ?

A
  • acute LAD lesion

- ST depression of 1-3 mm with rapid upslope into peaked T waves in precordial leads

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20
Q

Aside from elderly or infant patients, who else needs ampicillin added to meningitis empiric treatment?

A
  • chronic alcoholics

- immunosuppressed

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21
Q

XR in primary TB vs reactivation?

A

Primary = Ghon focus, unilateral peri-hilar or peri-tracheal LAD, sometimes normal CXR

reactivation = upper lobe infiltrate/consolidation, Cavitary lesion

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22
Q

Antibiotic choice for pre-septal cellulitis?

A

Something with MRSA coverage

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23
Q

How do patients with Sarin gas poisoning present?

A

Cholinergic toxidrome

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24
Q

1st line Abx for bacterial tracheitis?

A

Unasyn or clinda + ceftriaxone

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25
Q

Bilateral facial nerve palsy = ?

A

Lyme

26
Q

Management of myxedema coma

A
  • airway (can have macroglossia and decr respiration’s)
  • hydrocortisone
  • T4

Plus minus T3

27
Q

Treatment for bullous pemphigoid?

A
  • topical steroids for localized

- systemic steroids for widespread diffuse, severe cases

28
Q

What does actinic keratosis look like and what is it a precursor for?

A
  • well defined red or brown thickened, scaly lesions on sun exposed areas on fair skinned pts
  • squamous fell CA
29
Q

What is most recent recommendation for work up for r/o SAH within 6 hours?

A

New generation scanners = CT only, no need for LP

30
Q

What is desired UOP for patient getting hydration for rhabdo?

A

200-300 mL/hr

31
Q

Diagnosis in diver who develops confusion and impaired coordination upon reaching depth?

A

Nitrogen narcosis

32
Q

What are the only FDA approved meds to help with etoh abuse?

A

Naltrexone

Acamprosate

33
Q

At what Tylenol level would treatment with NAC be warranted at 4 hours?

A

150

34
Q

Most common cause of osteomyelitis in all age groups except neonates?

A

Staph

*exceptions = salmonella most common in SIckle cell

Pasteurella when 2/2 penetrating dog bite

35
Q

Patient on psych med people AMS, muscle rigidity, fever, autonomic instability….diagnosis and treatment?

A

NMS

Stop agent, supportive care, dantrolene, bromocriptine

36
Q

Most common organisms causing SBP?

A

E. coli and klebsiella

37
Q

Treatment for seizing hyponatremic baby and dose?

A
  • hypertonic saline

- 4-6 mL/Kg

38
Q

Aside from COOx level, what other features warrant hyperbaric tx for CO poisoning?

A
  • LOC
  • acidosis pH < 7.1
  • signs of end organ ischemia
39
Q

Pressor of choice in kid in shock who feels cold vs kid who is hot, flushed, etc?

A

Cold = epi

Hot = levophed

40
Q

Patient with whitish plaque on lateral tongue that doesn’t scrape off…..

Diagnosis?
Associated condition?
Associated virus?

A

Oral hairy leukoplakia

HIV

EBV

41
Q

What are indications for admitting a pt with hyphema? (Not necessarily surgery, but admission)

A
  • 50% or greater hyphema

- risk factors like sickle cell, anticoagulantion, bleeding disorders

42
Q

Patient with symptoms of CHF that is warm and well perfused, bounding pulses, hyperdynamic heart?

Diagnosis and possible etiologies

A
  • high output Heart failure

- AV fistula/malformation, hyperthyroidism, Beriberi (thiamine def), paget’s disease, severe anemia, pregnancy

43
Q

What factors increase the likelihood of a child with febrile seizure going on to develop epilepsy?

A
  • 1st degree relative with epilepsy
  • complex febrile seizure
  • abnormal neurological or developmental status prior to febrile seizure
44
Q

What is reversal for dabigatran?

A

Idarucizumab

45
Q

At what CRL do you start to see fetal heart tones?

A

5 mm

46
Q

What central line location has lowest rate of infection and thrombosis?

A

Subclavian

47
Q

Patient is a building fire with lactic acidosis….diagnosis and treatment?

A
  • cyanide poisoning

- 1st line = hydroxocobalamin, 2nd = amyl nitrite or sodium thiosulfate

48
Q

What does hyperbaric O2 therapy prevent?

A

Neurological sequelae

*no effect on mortality, MI, dysrrhythmia

49
Q

First step in managing patient with traumatic urethral injury with large distended bladder?

A
  • suprapubic cath

* even before urology consult for surgery (surgery often delayed a while 2/2 inflammation)

50
Q

Patient with recent ear piercing with erythema and tenderness around cartilage…

Diagnosis, etiology, management?

A

Perichondritis

Infection 2/2 pseudomonas most commonly

Ciprofloxacin

51
Q

Indication for excising thrombosis hemorrhoid?

A

Presenting within 72 hours

52
Q

Management of isolated public rami fractures?

A

Conservative. PT, etc

53
Q

EKG findings in hypercalcemia?

A

Shortened QT

*think this in metastatic CA patient and show that ekg

54
Q

For high altitude Pulm edema, what can you give other than O2 and hyperbarics?

A

Nifedipine

55
Q

What are features of type 1 hypersensitivity?

A

IgE

Anaphylaxis, urticaria, angioedema

Requires 2 separate exposures

56
Q

Characteristics and examples of type 2 hypersensitivity?

A

IgG or IgM antibodies react with cell antigens resulting in COMPLEMENT activation

Autoimmune hemolytic anemia, Erythroblastosis fetalis, goodpasture syndrome

Also requires 2 exposures

57
Q

Type 3 hypersensitivity features

A

IgG or IgG immune complex activation and deposition in tissues

Serum sickness, SLE, rheumatoid arth , post strep glomerulonephritis

58
Q

Formula for serum osmolarity?

A

2(Na) + BUN/2.8 +glucose/18

59
Q

Fever 39 deg, unknown source….who gets urine sent? Who gets CBC and cultures?

A

Urine = girls < 2, uncircumcised boys < 1, circumcised boys < 6 mo

CBC and cultures = unvaccinated, < 6 months old, ill appearing or immunosuppressed

60
Q

What antibiotic drops are safe in ruptured TM?

A

Cipro or ofloxacin

61
Q

Indications for exploratory thoracotomy in setting of hemothorax? 6 things

A
  • initial drainage of 20/kg or 1500cc
  • > 200/hr for 3+ hours
  • persistent bleeding > 7 cc/kg/hr
  • increasing size on XR
  • remains hypotension despite blood transfusions (without other source of bleeding)
  • pt decompensates after initial response to resuscitation

Rosh Review (7 decks)

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