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Set 10 Flashcards

1
Q

Tx GC and Chlamydia

A 
GC = ceftriaxone
CT = azithro x1 or 10d of doxy
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2
Q

Fever 1–.4, leukocytosis, blood clots in vagina after delivery? worrisome sx?

A

NORMAL in first 24hrs post-partum

worry if high fever, foul-smelling lochia, tender uterus

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3
Q

Lupus patient develops NV, abd pain and hypotension and hypoglycemia post-op?

A

adrenal insufficiency!! 2/2 not getting steroids

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4
Q

What anti-Rh Ab titer level do you give rhogam for? what level is fetus at risk for hemolytic disease?

A
  • 1:6 - mom is already sensitized - rhogam won’t help. monitor closely for hemolytic disease.
  • > 1:8-1:32 - fetus at risk for hemolytic disease.
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5
Q

female with rash that starts on face and progresses downward + arthritis?

A

consider rubella

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6
Q

Clubbing in COPD, think…

A

MALINGNANCY (unlike other clubbing scenarios)

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7
Q

3 drugs to treat UTI in pregnancy

A

nitrofurantoin, amoxicillin, 1st gen cephalosporin

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8
Q

arm held abducted and externally rotated, which dislocation?

A

anterior (fall on outstretcehd arm)

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9
Q

arm held adducted and internally rotated, which dislocation?

A

posterior (seizure, electrocution)

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10
Q

Neonated with microcephaly, small body, hypoplastic distal phalanges, excess hair, cleft palate and developmental delay?

A

fetal hydantoin syndrome = phenytoin or carbamazepine during pregnancy

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11
Q

management of post-patum hemorrhage

A

bimanual uterine massage, IVF, uterotonic meds (oxytocin, methylergonovine, carboprost) +/- blood transfusion

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12
Q

MC age range Legg-Calve-Perthes? Tx?

A

boys 4-10 (5-7*)

Tx observation and bracing, surgery only if femoral head not contained well in acetabulum

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13
Q

boy with hip, groin, knee pain and limping gait

A

think Legg-Calve-Perthes

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14
Q

next step if amenorrheic girl has no uterus on U/S?

A

karyotype and serum test

  • 46 XX and female test level –> abnormal mullerian devel
  • 46 XY and male test level –> AIS
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15
Q

Timing for CVS vs. amniocentesis

A

CVS = 10-12wks
amnio = 16-18wks
(possible to do ~earlier amnio of CVS unavailable)

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16
Q

what do mom and baby’s blood types have to be for hemolytic disease of the newborn? what type of Ig? which can cross placenta?

A

mom = O
baby = A or B
Results in mild disease, unlike Rh incompat.
It is IgG bc only IgG can cross the placenta

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17
Q

dyschezia, dyspareunia, dysmenorrhea and difficulty conceiving? 3 tx?

A

endometriosis

Tx = OCPs (combined), leuprolide, danazol

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18
Q

6 indications for hemodialysis

A 
refractory hyperK
refractory edema/pulm edema
refractory metabolic acidosis
uremic pericarditis
uremic encephalopathy/neurophathy
coagulopathy 2/2 renal failure
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19
Q

kindey d/s a/w Hodkgkin’s lymphoma

A

Minimal Change Disease! (nephrotic syndrome –> decr alb, normal globulin)
(also can have FSGS)

20
Q

Test for cervical incompetence? Normal value?

A

transvaginal US –>funneling of cervix/cervical length which should be >25mm at 24wks

21
Q

Tx PID and when should you admit?

A

Outpt = IM cefoxitin + PO probenecid + PO doxy OR IM ceftriaxone + PO doxy
hospitalize if: high fever, N/V and cant take pill, pregnant*, teenager/low socioeconomic status
inpt = IV cefotetan or cefoxitin + doxy OR IV clinda/gent

22
Q

foul-smelling sputum, think…Tx?

A

think anaerobic pneumonia 2/2 aspiration

Tx = clindamycin

23
Q

Asian w/ epistaxis, neck swelling, sinusitis and nasal mass? RFs?

A

nasopharyngeal CA

RF = EBV!!!, smoking and nitrosamines too

24
Q

When is cephalic version indicated?

A

37+ weeks

25
Q

5 components of BPP

A 
NST
tone (flex/extend, extend)
movement (2x/30min)
breathing movement (20sec/30min)
AFI (5-25)
26
Q

5 indications for intubation during acute asthma exacerbation

A 
normal/increased PaCO2 (should be decr. from hyperventilation)
decreased breath sounds
no wheezing
AMS
hypoxia +/- cyanosis
27
Q

Early Tx of pre-eclampsia

A

Methyldopa 1st line = central alpha-agonist to decr symp outflow and vasodilate
Labetolol for HTN

28
Q

Pregnant lady with severe vomiting, wt loss, ketonuria and transaminitis / bili?

A

hyperemesis gravidarum
can also have elevated lipase/amylase
MCC b/w 4-10wks

29
Q

SE niacin? MoA, Tx?

A

flushing + pruritis 2/2 PG-induced periph vasodilation and histamine release
Tx = low dose ASA 30min before niacin

30
Q

Acute bloody diarrhea and abd pain w/o fever? complications?

A

EHEC from undercooked beef

Complications = HUS, TTP

31
Q

Tx vaginal SCCA

A

stage 1/2 = excise. If >2cm, radiation

Stage 3/4 or >4cm = combo chemo if healthy, otherwise radiation

32
Q

Tx bartonella henselae

A

azithromycin

33
Q

indications for treating hyperkalemia

A

cardiac toxicity (EKG), muscle paralysis/paresis, K >6.5

34
Q

W/u HTN (4)

A 
UA = hematuria, prot/cr ratio
chemistry panel
lipid panel (CAD)
EKG (CAD/LVH)
35
Q

MC renal d/s a/w cancers?

A

Membranous glomerulonephritis (except hodgkins –> MCD)

36
Q

goal BG level in gestational DM? Tx?

A

75-90, low sugar diet +/- subQ insulin

37
Q

Effect of E2 therapy on L-thyroxine requirements normally and during pregnancy?

A

Both require increase in L-thyroxine

38
Q

Tx lichen sclerosis?

A 
steroid cream (clabetasol)
\+/- bx due to risk of vulvar SCCA
39
Q

Tx early syphilis if penicillin allergy

A

azithro or doxy

40
Q

6 RF for placenta previa?

A

multiparity, adv mat age, prior CS, smoking, mult gestation, previous hx

41
Q

COPD and asthma, respiratory alkalosis or acidosis?

A 
COPD = resp acidosis (trap air?)
asthma = resp alkalosis (hyperventilate)
42
Q

hexagonal crystals on UA and CN nitroprusside test positive? MoA?

A

cystinuria –> defective AA transport by renal tubule and GI cells. Autosomal recessive

43
Q

N/V/D then splinter hemorrhages, conjunctival hemorrhages, periorbital edema, myositis and eosinophilia?

A

trichinosis (trichinella roundworm) from undercooked PORK (3 stage d/s)

44
Q

Indications for GBS prophylaxis if status unknown?

A

deilvery 18hrs
GBS bacteruria at any time during current pregnancy
prior baby with GBS sepsis

45
Q

palpable purpura, proteinuria, hematuria, HCV?

A

mixed essential cryoglobinemia

+/- arthralgias, HSM and low complement

46
Q

Tx TB?

A
  • active dz - RIPE, then just RI for 6 mos (rifampin, INH, pyrazinamide, ethambutol)
  • positive PPD but asymp - INH for 9 mos
  • ALWAYS give B6 with INH to prevent neuropathy*
    get LFTs for INH

Step 2 (20 decks)

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