ROSH review flashcards
Endolymphatic hydrops
AKA Ménière disease
Unilateral hearing loss, tinnitus, and vertigo
>65 years old
Multiple episodes, hours long
Labyrinthitis
Inflammation of the cochlear and vestibular apparatus
Rapid onset of severe vertigo, nausea, vomiting, and unilateral hearing loss
Hepatic encephalopathy
Accumulation of nitrogenous waste products
Increased Ammonia–>metabolism to Glutamine in the CNS
Glutamine in the CNS–>inflammation, edema
Asterixis
Erythema infectiosum
Parvovirus B19
Slapped-cheek
Cytomegalovirus (CMV) retinitis
Opportunistic- HIV/AIDS
Blurred vision, floaters
Fluffy white perivascular lesions with areas of hemorrhage.
Cytomegalovirus treatment
Ganciclovir or foscarnet
Herpes infection treatment
Acyclovir
HINTS exam
Differentiate central vs peripheral vertigo
Normal HINTS=more likely central cause
Head impulse test
Turn head quickly 15 degrees
Normal response is eyes stay on target
Abnormal response is “dolls eye” with corrective sacade
Enteroinvasive E. coli
Stomach cramps and fever
Diarrhea due to malabsorption, bloody
Enteropathogenic E. coli
Diarrhea in infants in resource-limited countries
Lasts weeks
Does not cause bloody diarrhea or kidney injury
Enterotoxigenic E. coli
Toxin that alters chloride and sodium transport across intestinal mucosa
Doesn’t destroy the cells.
Large osmotic gradient –>profound watery diarrhea
Enterohemorrhagic E. coli
HUS
Shiga-like toxin verocytotoxin
Microangiopathic hemolytic anemia (MAHA), thrombocytopenia, and progressive kidney injury
Acute bronchitis
Cough, dyspnea, and wheezing
5 days-4 weeks
+/- sputum
Sxs relief
Steroids if COPD, asthma
Tetralogy of Fallot
Overriding aorta
VSD
R ventricular hypertrophy
R ventricular outflow tract obstruction
Tetralogy of Fallot physical exam findings
Loud, single second heart sound with a harsh systolic murmur
Boot-like appearance on CXR
Patent ductus arteriosus exam findings
Bounding pulses and a continuous machine-like murmur
Coarctation of the aorta
Upper extremity pulses > lower extremity
Epidural hematoma mechanism and source of bleeding
Usually blunt injury
Disruption of the middle miningeal artery
Subarachnoid hemorrhage mechanism
Rupture of cerebral aneurysm
Disruption of AVM
Subdural hematoma mechanism
Disruption of bridging veins
Xanthochromia
Yellowish cerebrospinal fluid
After SAH
Bacterial meningitis in neonates (1-30 days) organisms and abx
Group B strep*
E. Coli
L. Monocytogenes
Gram-negative bacilli
Abx: Cefotaxime +amp
Bacterial meningitis in children (30 days-18 years) organisms and abx
S pneumoniae
Neisseria meningitides
H. Influenzae
Abx: Ceftriaxone + Vanc
Bacterial meningitis in children (18 years-50 years) organisms and abx
Streptococcus pneumoniae
Neisseria meningitides
Abx: Ceftriaxone, vanc
Bacterial meningitis in older Adults (>50 years) or immunocomprised younger adults; organisms and abx
Streptococcus pneumoniae
Neisseria meningitides
L. Monocytogenes
Gram-negative bacilli
Abx: Ceftriaxone, vanc, ampicillin
HHS
Severe hyperglycemia-induced dehydration
Encephalopathy
Usually DM2
Serum glucose > 600 mg/dL,
Serum osmolality > 315 mg/dL
pH NORMAL
Bicarb NORMAL
+/- Anion Gap
Laryngotracheitis
Croup
Barking cough
Parainfluenza
Edema and inflammation of the subglottic airway- steeple sign
Immunizations after splenectomy
Pneumococcal,
meningococcal, and
H. influenzae type b (Hib) vaccines
Peritonsillar abscess (PTA) organism
Group A Streptococcus most common cause
Retropharyngeal abscess organism
Streptococcus viridans
Endocarditis and colorectal cancer organism
Streptococcus bovis
Osteosarcoma
Most common primary bone tumor in children
Sunburst appearance
Normal ankle-brachial index (ABI)
> 0.9
Normal EPSS
<7mm
Normal appendix diameter
<7mm
Hydroxyurea
Sickle-cell disease modifying agent
Bullous pemphigoid
60-80 years old
Tense bullae
Damage to the epithelial basement membrane
No mucous membrane involvement
ABSENT Nikolsky sign
Carcinoid syndrome
Carcinoid tumors–> neuroendocrine tumors, release serotonin, norepinephrine, histamine and dopamine
Carcinoid syndrome treatment
Octreotide
Carcinoid tumors have somatostatin receptor
Mechanism of hypercalcemia in Multiple myeloma
Neoplastic proliferation in the bone marrow, activates osteoclasts–> bone destruction
Drugs that can be dialyzed
Carbamazepine, barbiturates, ethylene glycol, isoniazid, lithium, metformin, methanol, salicylates, and theophylline
EKG findings for Digoxin use vs toxicity
Digoxin use- ST segment scooping (Dali) vs toxicity as bidirectional v tach
Smells of freshly cut hay or grass
Phosgene- acute mucosal irritation, delayed lung injury
