Rosh PEARLs Flashcards
antidote for malignant hyperthermia
dantrolene
What is the black box warning for meloxicam
its use in CABG patients increases the risk of MI and stroke.
management of subacute thyroiditis (de Quervians thyroiditis)
Propanolol (sx management)
ASA (pain)
Tx for hereditary angioedema
FFP
What can be used to monitor the progression of acute rheumatic fever?
CRP
ESR
(nml result a few weeks after completion of tx indicates resolution)
What confirmatory test should be done next if a patient has a positive RPR?
FTA-ABS test
What is the most common complication of ankylosing spondylitis?
anterior uveitis
What 4 diseases are associated with HLA-B27
(PAIR)
Psoriatic arthritis
Ankylosing Spondylitis
IBD
Reactive Arthritis
Which electrolyte abnormalities can cause a long QT syndrome
hypokalemia
hypomagnesemia
tx for pulmonary artery hypertension
Osteosarcoma is related to what other conidtion
retinoblastoma
is anterior or posterior HIP dislocation more common?
How will their leg be laying
Posterior MC- leg aDducted, flexed and internally rotated
anterior- leg aBducted, flexed and externally rotated (shortened)–> ABE lincoln
what 2 structures are at highest risk of compromise in a knee dislocation
popliteal artery
common peroneal nerve
What is seen if the peroneal nerve is damaged?
(occurs with knee dislocation, tibial plateau fx, etc)
foot drop
T/F: Cortisone injections are the TOC for patellar tendinitis
FALSE
contraindicated due to risk of patellar tendon rupture
what ligament is most commonly damaged by eversion ankle injuries
deltoid ligament
Test for achilles tendon rupture
Thompson test
what other condition is polyarteritis nodosa a/w?
hep B
What 3 special tests are for subacromial impingement
Neers
Hawkins
Drop arm
4 Indications for ortho referral
- multiple metatarsal fractures
- intra-articular fractures
- first metatarsal fracture
- second to fifth metatarsal fracture displaced greater than 3-4 mm
tx for cat scratch dz
- supportive
- Severe cases or immunocompromized:
- 1st line= azithro
- rifampin
- bactrim
- cipro
tx for salicylate toxicity
sodium bicarb
(HD in severe cases)
What is the MCC of an intracranial neoplasm
Mets
(#1= lung. melanoma, renal breast, colorectal)
MC primary brain tumor?
MC malignant brain tumor?
meningioma
Glioma
What grade fever and neutrophil count= neutropenic fever?
- Fever:
- 101degF orally once OR
- 100.4degF orally twice, taken 1 hr apart
- Neutropenia
- <1,500
- severe= <500
- profound= <100
tx for croup that has shown decrease in repeat visits?
dexamethasone
what biomarkers are seen in RA? which is most specific
RF
anti-cyclic citrullinated peptide antibodies (most specific)
MCC post influenza bacterial pneumonia?
staph aureus (gram + cocci in clusters)
Necrotizing PNA
tx for tourettes
Pimozide
tx for Ankylosing spondylosis after failing NSAIDS
infliximab (TNF inhibitor’
tx for secondary syphilis if PCN allergic
Doxy
where does the spinal cord terminate in adults?
In kids?
adults: L1-L2 (so LP at: L3-L4, L4-L5 or L5-S1 interspace)
Kids: L3 (So LP at: L4-L5)
Tx for autonomic sxs a/w MVP
atenolol
What drugs prolong QT
- TCAs (amitriptyline, despiramine, Doxepin, imipramine, nortriptyline)
- Abx
- macrolides
- FQs
- imidazole antifungals
- antimalarials
- Haldol
- Pentamidine
tx for congenital long QT syndrome
BB
tx for HCM
BB + Disopyramide
ACLS- what are the Hs (6) and Ts (5) that should be considered in a patient with PEA
- Hs
- hypovolemia
- hypoxia
- H+ (acidosis)
- hyper/hypokalemia
- hypoglycemia
- hypothermia
- Ts
- Toxins
- tamponade (cardiac)
- tension pneumo
- thrombosis (coronary and pulmonary)
- trauma
Tx for brugada syndrome
BB + defibrillator
(can lead to vfib/tach)
MC type of ASD
ostium secundum atrial septal defect
what toxicity graph is used to determine if tx is necessary for tylenol overdose
Rumack-Mathew Nomogram
definitive tx for Brugada syndrome
implantable cardioverter defibrillator
What 2 meds should be avoided in Brugada Syndrome
Flecainide
Procainamide
(sodium channel blocker)
What is seen on ECG in Brugada SYndrome
RBBB pattern and STE in V1-V3
tx for sick sinus syndrome
pacemaker
Pulsus paradoxus (decr. in SBP/radial pulse on inspiration) is a finding in what 5 conditions?
- cardiac tamponade
- constrictive pericarditis
- chronic sleep apnea
- croup
- obstructive lung disease
What is a contraindication to immediate MANUAL reduction of a tibiofemoral/posteriolateral knee dislocation?
“Dimple sign”
(transverse groove at the medial joint lign)
–> this is a SURGICAL EMERGENCY
+Anti-Jo
+Anti-SRP
Polymyositis
What are the stages (based on GFR) of CKD?
Stage 1: GFR > 90
Stage 2: GFR 60-89
Stage 3: GFR 30-59
Stage 4: GFR 15-29
Stage 5: GFR < 15
Pts with PKD have increased risk of what?
Berry Aneurysm
Tx of prolonged QT syndrome (if hemodynamically stable)
metoprolol
What 5 meds should be given w/in 24hrs in a patient with ischemic heart disease?
Aspirin
nitrates
clopidogrel
heparin
beta-blockers
What is the MC tachydysrhythmia a/w sick sinus syndrome
A-fib
(A flutter, sinus tach and PSVT are also a/w SSS but not as common)
preventative tx for cluster headaches
CCB- verapamil
What electrolyte abnormalities can be seen with Thiazides?
Hypokalemia
hypomagnesemia
hypercalcemia
hyperuricemia
hyponatremia
Acute management of Pulmonary ededma/CHF
(LMNOP)
Lasix
Morphine
Nitrates
Oxygen
Position (place upright)
For high risk individuals, when do you start screening for HLD?
(high risk= >1 RF- HTN, smoking, FHX)
Men: 20-25
women: 30-35
For lower risk individuals, when do you start screening for HLD?
Males: 35
Females: 45
For pts 20-79 w/o CVD, how often should they be screened for CVD?
q4-6yrs to calculate 10yr CVD risk
Tx for myocarditis?
Management is supportive
ACE inhibitors help reduce myocardial inflammation.
What is the medical managment of HCM?
What 2 classes of meds should be avoided?
Tx= BB or CCB (verapamil/Diltiazem)
AVOID: Nitrates and positive inotropes
what genetic abnormality is a/w COA? Tetralogy of Fallot?
COA= Turners Syndrome
Tetralogy of Fallot= DiGeorge Syndrome
