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.RoshReview > Sept '21 > Flashcards

Sept '21 Flashcards

1
Q

Which muscles do the motor fibers of the trigeminal nerve innervate?

A

muscles of mastication

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2
Q

What is the most frequent cause of stroke in patients <45 yo?

A

carotid artery dissection

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3
Q

carotid artery dissection symptoms

A

unilateral neck pain, or headache around the eye or frontal area. abrupt in onset.

partial ipsilateral horner syndrome without anhidrosis

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4
Q

vertebral artery dissection symptoms

A

marked occipital or posterior neck pain and may have FND, including facial numbness and CL pain and temp sensory loss

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5
Q

treatment of a pt with a brain abscess and signs of increased ICP?

A

surgical drainage

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6
Q

which type of vertigo is vertical nystagmus always associated with?

A

central vertigo

periph is associated with horizontal or horizontal rotatry nystagmus

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7
Q

afferent pupillary defect and loss of monocular partial or complete vision

A

optic neuritis

concern for MS, infection, autoimmune, methanol poisoning, B12 deficiency, diabetes

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8
Q

bilateral internuclear ophthalmoplegia is pathognomonic for

A

MS

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9
Q

what class of medications used to treat peripheral vertigo?

A

antihistamines

meclizine 25

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10
Q

abx for neonatal sepsis

A

ampicillin plus either gentamicin or cefotaxime

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11
Q

MC congenital heart defect

A

VSD

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12
Q

classic VSD murmur

A

holosystolic and best heard at left lower sternal border

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13
Q

fixed split S2 and a loud S1

A

ASD

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14
Q

when is vasospasm most common after a subarachnoid hemorrhage?

A

2 to 21 days

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15
Q

Marcus Gunn pupil

A

afferent pupillary defect

bilateral pupil constriction when shining light in the unaffected eye but pupil dilation when light shines in the affected eye

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16
Q

How will a pt with MG respond to edrophonium chloride testing if she is having a cholinergic crisis?

A

muscle fasciculations, cholinergic symptoms, and respiratory depression will occur within a few minutes

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17
Q

acute spinal cord disorder characterized by paraplegia, a transverse level of sensory impairment, and sphincter disturbance

A

transverse myelitis

sometimes noted to follow a viral infection, aka post infectious myelitis

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18
Q

Where does syringomyelia most often occur?

A

cervical spine

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19
Q

causes of transverse myelitis

A

viral, autoimmune, idopathic

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20
Q

fluctuating headache with seizure activity should prompt clinician to consider

A

cerebral venous thrombosis

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21
Q

How are migraine headaches affected by pregnancy

A

vastly improve in most women

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22
Q

first line treatment for chemoprophylaxis for exposure to bacterial meningitis?

A

rifampin, with cipro as alternative

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23
Q

what is the name of the toxin associated with tick paralysis?

A

ixobotoxin

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24
Q

What is the Miller fisher variant of GBS?

A

affects eye muscles and presents with triad of ophthalmoplegia, ataxia, and areflexia

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25
which anatomical location does ALS involve?
anterior horn cells
26
MCC of chronic stridor in infants?
vocal cord paralysis
27
torus fracture
buckle fx
28
Triangular metaphyseal fragment in the mataphysis from a salter harris type II fx
Thurstan Holland sign
29
which anatomical regions of the brain does infectious encephalitis have a predilection for?
gray matter of the temporal lobes and inferior frontal lobe
30
how long until the onset of action of penobarbital?
onset is 15-30 min
31
What is the MC aura associated with migraines?
visual - scintillating scotomas or flashing lights
32
meningitis suspected, AMS, what is the order of tx?
dexamethasone, empiric abx, CT head, LP
33
most reliable physical exam finding in patients with meningitis?
jolt accentuation - baseline headache increases when the patient turns the head horizontally two or three rotations per second
34
MC location for pediatric pseudosubluxation?
C2 on C3
35
how do you correct for pseudosubluxation during radiography?
pt placed in cervical extension
36
How long do you monitor a pt with TCA overdose?
until ECG normal for 12-24 hours
37
kid with status asthmaticus, not responding to initial therapies, next line?
IV mag sulfate smooth muscle relaxant, acting on Ca channels to competitively block calcium influx and promote bronchodilation
38
CSF findings suggestive of MS?
pleocytosis, elevated gamma globulin, oligoclonal banding
39
How many g/dL of deoxygenated blood is classically required before cyanosis is apparent?
5g/dL
40
classic EKG findings in tetralogy of Fallot?
RV hypertrophy (dominant R wave in the right precordium) and right axis deviation
41
AMS, cerebral edema, hepatic dysfunction in a kid that has had a viral syndrome
Reye Syndrome from aspirin progressive encephalopathty with hepatic dysfunction
42
What are three substances that contain salicylates?
aspirin, bismuth subsalicylate, and oil of wintergreen (methyl salicylate)
43
URI prodrome, then high fever, inspiratory and expiratory stridor in kid
bacterial tracheitis
44
test for exogenous v endogenous insulin
c- peptide level low in patients taking exogenous insulin
45
encephalitis v meningitits
AMS and FND is more likely encephalitis
46
in kids under 8 what is the most common fx of the elbow?
supracondylar fx, usually due to a FOOSH
47
What division of the median nerve is damaged in supracondylar elbow fx and how do you test for it?
anterior interosseous make the OK sign/strength
48
what happens with instillation of cold water into ear of comatose pt?
tonic deviation toward the ear with cold water inserted
49
clusters of myoclonic seizures, hypsarrhythmia on EEG, and developmental delay, onset 4-8 months old
West syndroma/infantile spasms
50
less than 5 yo and painless rectal bleeding
meckels diverticulum
51
abx for brain abscess from sinus or oral source?
IV metronidazole + ceftriaxone or cefotaxime, +/- vanc
52
what renal disorder puts patient at higher risk of cerebral aneurysm/SAH?
autosomal dominant polycystic kidney disease
53
BP goal for SAH
140-160
54
MC tumor of cerebellopontine angle?
vestibular schwannoma
55
MC tumor of the CNS
meningioma
56
how long should facial sutures in children be left in place?
3-5 days
57
MCC of congenital hydrocephalus?
aqueductal stenosis
58
pt with fatigue, diplopia, and asymmetric paresthesias and weakness after heat exposure
Multiple sclerosis
59
correct formula to calculate systolic hypotension in children?
70 + (age x2) is the lower limit of normal BP for children aged 1 to 10 years
60
What CSF opening pressure is diagnostic for idiopathic intracranial HTN?
250 mm H2O or 25 cm H2O
61
Most sensitive lab test for spinal epidural abscess?
ESR
62
combination of acute HTN and endothelial dysfunction resulting in bilateral symmetric vasogenic edema
posterior reversible encephalopathy syndrome (PRES)
63
which antihypertensivese agents are recommended in the treatment of PRES
labetalol or nicardipine
64
MC sign of a CNS tumor in infants and young children?
macrocephaly
65
type of tracheoesophageal fistula that usually presents after the newborn period
an H type tracheoesophageal fistula
66
when should children with umbilical hernia be referred to a pediatric surgeon
at 2 yo or sooner if symptomatic
67
at what blood pressure should antihypertensives be given prior to the administration of tPA?
185/110 mmHg
68
VP shunt overdraining and associated headaches
slit ventricle syndrome
69
symptoms most sensitive for VP shunt failure?
nausea, vomiting, and decreased LOC
70
high RDW is common in what type of anemia
fe deficiency
71
what diseases should be considered when a patient has thrombocytopenia associated with anemia?
HUS and TTP
72
IV lorazepam or diazepam for seizure and why?
lorazepam, shorter time to peak effect and significantly longer effective duration of action
73
best benzo for seizure if no IV access?
IM midazolam
74
tx of akathisia?
antihistamine, like benadryl
75
tx for transverse myelitis?
IV glucocorticoids

.RoshReview (11 decks)

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