ROSH review flashcards

Question 1

Endolymphatic hydrops

Answer 1

AKA Ménière disease
Unilateral hearing loss, tinnitus, and vertigo
>65 years old
Multiple episodes, hours long

Question 2

Labyrinthitis

Answer 2

Inflammation of the cochlear and vestibular apparatus
Rapid onset of severe vertigo, nausea, vomiting, and unilateral hearing loss

Question 3

Hepatic encephalopathy

Answer 3

Accumulation of nitrogenous waste products
Increased Ammonia–>metabolism to Glutamine in the CNS
Glutamine in the CNS–>inflammation, edema
Asterixis

Question 4

Erythema infectiosum

Answer 4

Parvovirus B19
Slapped-cheek

Question 5

Cytomegalovirus (CMV) retinitis

Answer 5

Opportunistic- HIV/AIDS
Blurred vision, floaters
Fluffy white perivascular lesions with areas of hemorrhage.

Question 6

Cytomegalovirus treatment

Answer 6

Ganciclovir or foscarnet

Question 7

Herpes infection treatment

Answer 7

Acyclovir

Question 8

HINTS exam

Answer 8

Differentiate central vs peripheral vertigo
Normal HINTS=more likely central cause

Question 9

Head impulse test

Answer 9

Turn head quickly 15 degrees
Normal response is eyes stay on target
Abnormal response is “dolls eye” with corrective sacade

Question 10

Enteroinvasive E. coli

Answer 10

Stomach cramps and fever
Diarrhea due to malabsorption, bloody

Question 11

Enteropathogenic E. coli

Answer 11

Diarrhea in infants in resource-limited countries
Lasts weeks
Does not cause bloody diarrhea or kidney injury

Question 12

Enterotoxigenic E. coli

Answer 12

Toxin that alters chloride and sodium transport across intestinal mucosa
Doesn’t destroy the cells.
Large osmotic gradient –>profound watery diarrhea

Question 13

Enterohemorrhagic E. coli

Answer 13

HUS
Shiga-like toxin verocytotoxin
Microangiopathic hemolytic anemia (MAHA), thrombocytopenia, and progressive kidney injury

Question 14

Acute bronchitis

Answer 14

Cough, dyspnea, and wheezing
5 days-4 weeks
+/- sputum
Sxs relief
Steroids if COPD, asthma

Question 15

Tetralogy of Fallot

Answer 15

Overriding aorta
VSD
R ventricular hypertrophy
R ventricular outflow tract obstruction

Question 16

Tetralogy of Fallot physical exam findings

Answer 16

Loud, single second heart sound with a harsh systolic murmur
Boot-like appearance on CXR

Question 17

Patent ductus arteriosus exam findings

Answer 17

Bounding pulses and a continuous machine-like murmur

Question 18

Coarctation of the aorta

Answer 18

Upper extremity pulses > lower extremity

Question 19

Epidural hematoma mechanism and source of bleeding

Answer 19

Usually blunt injury
Disruption of the middle miningeal artery

Question 20

Subarachnoid hemorrhage mechanism

Answer 20

Rupture of cerebral aneurysm
Disruption of AVM

Question 21

Subdural hematoma mechanism

Answer 21

Disruption of bridging veins

Question 22

Xanthochromia

Answer 22

Yellowish cerebrospinal fluid
After SAH

Question 23

Bacterial meningitis in neonates (1-30 days) organisms and abx

Answer 23

Group B strep*
E. Coli
L. Monocytogenes
Gram-negative bacilli
Abx: Cefotaxime +amp

Question 24

Bacterial meningitis in children (30 days-18 years) organisms and abx

Answer 24

S pneumoniae
Neisseria meningitides
H. Influenzae
Abx: Ceftriaxone + Vanc

Question 25

Bacterial meningitis in children (18 years-50 years) organisms and abx

Answer 25

Streptococcus pneumoniae Neisseria meningitides Abx: Ceftriaxone, vanc

Question 26

Bacterial meningitis in older Adults (>50 years) or immunocomprised younger adults; organisms and abx

Answer 26

Streptococcus pneumoniae Neisseria meningitides L. Monocytogenes Gram-negative bacilli Abx: Ceftriaxone, vanc, ampicillin

Question 27

HHS

Answer 27

Severe hyperglycemia-induced dehydration Encephalopathy Usually DM2 Serum glucose > 600 mg/dL, Serum osmolality > 315 mg/dL pH NORMAL Bicarb NORMAL +/- Anion Gap

Question 28

Laryngotracheitis

Answer 28

Croup Barking cough Parainfluenza Edema and inflammation of the subglottic airway- steeple sign

Question 29

Immunizations after splenectomy

Answer 29

Pneumococcal, meningococcal, and H. influenzae type b (Hib) vaccines

Question 30

Peritonsillar abscess (PTA) organism

Answer 30

Group A Streptococcus most common cause

Question 31

Retropharyngeal abscess organism

Answer 31

Streptococcus viridans

Question 32

Endocarditis and colorectal cancer organism

Answer 32

Streptococcus bovis

Question 33

Osteosarcoma

Answer 33

Most common primary bone tumor in children Sunburst appearance

Question 34

Normal ankle-brachial index (ABI)

Answer 34

>0.9

Question 35

Normal EPSS

Answer 35

<7mm

Question 36

Normal appendix diameter

Answer 36

<7mm

Question 37

Hydroxyurea

Answer 37

Sickle-cell disease modifying agent

Question 38

Bullous pemphigoid

Answer 38

60-80 years old Tense bullae Damage to the epithelial basement membrane No mucous membrane involvement ABSENT Nikolsky sign

Question 39

Carcinoid syndrome

Answer 39

Carcinoid tumors--> neuroendocrine tumors, release serotonin, norepinephrine, histamine and dopamine

Question 40

Carcinoid syndrome treatment

Answer 40

Octreotide Carcinoid tumors have somatostatin receptor

Question 41

Mechanism of hypercalcemia in Multiple myeloma

Answer 41

Neoplastic proliferation in the bone marrow, activates osteoclasts--> bone destruction

Question 42

Drugs that can be dialyzed

Answer 42

Carbamazepine, barbiturates, ethylene glycol, isoniazid, lithium, metformin, methanol, salicylates, and theophylline

Question 43

EKG findings for Digoxin use vs toxicity

Answer 43

Digoxin use- ST segment scooping (Dali) vs toxicity as bidirectional v tach

Question 44

Smells of freshly cut hay or grass

Answer 44

Phosgene- acute mucosal irritation, delayed lung injury