Set 8 Flashcards
Tx diphenhydramine OD
Physostigmine to counter-act anti-cholinergic effects of diphenhydramine
dermatitis herpetiformis, a/w? Tx?
a/w celiac disease, tx = dapsone and diet
4 indications for endometrial bx in DUB?
> 35yo, DM, HTN, obesity
Complication of amniocentesis, tx?
amniotic fluid embolism –> possible DIC
Tx = facemask ventilate +/- intubate, IVF +/- vasopressors
Indications for clopidogrel. MoA?
UA / NSTEMI = 12mo
post-PCI = 1mo if bare-metal stent, 12mo if drug-eluting stent
MoA = ADP antagonist
Thigh adduction
obturator nerve
Pruritic, purple,.polygonal, planar papules and plaques
Lichen Planus
sawtooth infiltrate of lymphocytes at dermal-epidermal jxn (BM)? a/w?
Lichen Planus, a/w hepatitis C
Recent MI and crackles on lung exam/ dyspnea? Tx? what NOT to give?
Flash pulmonary edema 2/2 acute heart failure
Tx = furosemide (diurese and venodilate –> decrease preload)
do NOT give BB
Dx test vasovagal syncope
tilt-table test +/- isoproterenol
Tx cocaine-induced angina? what NOT to give?
benzodiazepine, ASA, nitroglycerin and CCB
do NOT give BB
Quad screen findings in Downs (AFP, estriol, BhCG, inhibin A)
increased: BhCG, inhibin A
decreased: AFP, estriol
Quad screen findings in Edwards syndrome (AFP, estriol, BhCG, inhibin A)
decreased: AFP, estriol and BhCG
Normal inhibin A
Overdose characterized by wheezing, hypotension and bradycardia? Tx?
Beta Blocker
Tx = IVF, atropine, if fails then glucagon
18 yo with amenorrhea, normal internal female anatomy, clitoromegaly, high testosterone, FSH, LH, but low estrogen, multiple ovarian cysts?
Aromatase deficiency
Wedge on thoracic CT?
PE!! +/- pleural effusion
Gestational diabetes timing and algorithm
at 1st visit if high risk, at 24-28wks otherwise
1 hr 50g OGTT –> do 3 hr 100g
abnormal if 2 or more : fasting >95, 1hr >180, 2hr >155, 3hr >140
Kid with recent/active eczema develops umbilicated vesicles, LAD and fever? Tx?
Eczema herpeticum –> primary HSV infection superimposed on healing atopic dermatitis lesions.
Tx = acyclovir
18 yo girl with amenorrhea, full breasts, no axillary/pubic hair, blind vaginal pouch, no uterus, normal external genitalia, high testosterone and 46 XY?
Androgen insensitivity syndrome (testicular feminization)
MIF by testes inhibits uterus/ovarian formation
breasts via peripheral E2 converison, no hair b/c no androgen receptors
Why is nifedipine (Dihydroppyridine CCBs) CI in STEMI?
causes peripheral dilation and reflex tachycardia –> worsens ischemia
immunocompetent pt with CXR that shows dense consolidation/ cavity and CT shows pulm nodule with ‘halo sign’ or lesion with air crescent.
Invasive aspergillosis
string of pearls appearance on adnexal US
PCOS
Tx HELLP
DELIVER THE BABY
BhCG levels needed for visualization of fetus with transabd vs. transvag US
transabdominal = 6500
transvaginal = 1500
If inadequate, repeat BhCG in 48hrs
What is serum inhibin B measured for?
determination of ovulatory reserve
Causes of symmetric IUGR
body/head proportionately small due to FETAL factors: chr abn, congen anom, TORCH
Causes of asymmetric IUGR
weight due to MATERNAL factors:
HTN, pre-e, uterine abnormalities, smoking*, APLA
best method to estimate fetal weight in suspected IUGR
abdominal circumference
blood at the urethral meatus, inability to void, high-riding prostate on DRE? possible other findings? POA?
posterior urethral injury
Dx = retrograde urethrogram, NOT a foley
perineal or scrotal hematoma, think
pelvic fracture
Dense deposits that stain C3? MoA?
MPGN –> persistent activation of alternative complement pathway
HIV patient with esophagitis showing multiple well-circumscribed, small volcano-like ulcers, biopsy showing ballooning degeneration and eosinophilic intranuclear inclusions? Tx?
HSV, tx acyclovir
HIV patient w/ esophagitis showing large, shallow, superficial ulcers. biopsy showing intranuclear AND intracytoplasmic inclusions? Tx?
CMV, Tx ganciclovir
Immunosuppressant causing diarrhea, leukopenia and hepatotoxicity
azothioprine
Variable decels? Tx?
cord compression (low AFI or nuchal cord) Tx = O2, change maternal position, stop oxytocin
Effect of pregnancy on GFR, RPF, BUN and Cr
increased GFR and renal plasma flow causes decreased BUN and Cr
Bounding pulses, widened pulse pressure
AR –> bound pulse is due to increased SV from previously regurgitated volume
50yo with dysmenorrhea, menorrhagia, symmetrically enlarged uterus? ddx?
MCC adenomyosis
ddx = leiomyoma (similar but IRREGULAR shape on US)
Active genital herpes, is C-section necessary?
YES
Tx mild vs. severe cellulitis
mild = dicloxicillin
severe (systemic sx) = IV nafcillin or cefazolin
HSIL found on PAP in pregnant woman, management?
do colposcopy; if normal –> repeat + bx after preg.
if colpo suggests invasive CA, excise
PCOS, Tx and MoA?
for infertility, tx = clomiphene citrate (E2 analog enhances GnRH release –> ovulation)
Metformin helps improve ovulation
55yo female with abd pain, nocturia, dyspareunia, urinary urgency relieved by urination, x1mo?
interstitial cystitis (i.e. painful bladder syndrome)
suspected placental abruption, w/u?
rosette test–> materno-fetal hemorrhage, if negative –> give regular dose anti-rho(d)
if + –> kleihauer-Betke stain or fetal RBC stain to adjust anti-D dose
when to test for GBS in pregnancy and Tx
test at 35-37wks vaginal and rectal swab
if +, tx = PCN or ampicillin at delivery
IgA vs PSGN?
IgA –> hematuria DAYS after infxn with normal serum complement levels
PSGN –> week(s) after infxn with LOW serum complement levels
neonate is tachypneic/cardic, restless, poor weight gain and has cardiomegaly, must consider…
Neonatal thyrotoxicosis 2/2 maternal grave’s disease (even if post-graves surgery)
acute cervical LAD in non-toxic kid <5yo?
MCC staph aureus
HSIL found on PAP in pregnant woman, management?
do colposcopy; if normal –> repeat + bx after preg.
if colpo suggests invasive CA, excise
PCOS, Tx and MoA?
for infertility, tx = clomiphene citrate (E2 analog enhances GnRH release –> ovulation)
Metformin helps improve ovulation
55yo female with abd pain, nocturia, dyspareunia, urinary urgency relieved by urination, x1mo?
interstitial cystitis (i.e. painful bladder syndrome)
suspected placental abruption, w/u?
rosette test–> materno-fetal hemorrhage, if negative –> give regular dose anti-rho(d)
if + –> kleihauer-Betke stain or fetal RBC stain to adjust anti-D dose
when to test for GBS in pregnancy and Tx
test at 35-37wks vaginal and rectal swab
if +, tx = PCN or ampicillin at delivery
acute cervical LAD in non-toxic kid <5yo?
MCC staph aureus
IgA vs PSGN?
IgA –> hematuria DAYS after infxn with normal serum complement levels
PSGN –> week(s) after infxn with LOW serum complement levels
neonate is tachypneic/cardic, restless, poor weight gain and has cardiomegaly, must consider…
Neonatal thyrotoxicosis 2/2 maternal grave’s disease (even if post-graves surgery)
2 indications for draining a pleural effusion
pH <60
Management of different BPP scores
go fuck yourself
