Step studying 6 Flashcards
Order of pubertal events
(Think: Tits, pits, mits, and lips) ♣ Thelarche (Breasts) (8) ♣ Pubarche (Axillary and pubic hair) (9) ♣ Growth (10) ♣ Menarche (11)
What is the older version of conduct disorder
Antisocial personality disorder
Is conjugated bilirubin considered direct or indirect
Direct
What disease presents with sharp triphasic waves on EEG
Creutzfeldt Jakob (spongiform encephalopathy)
Diagnosis of aortic dissection
♣ Transesophageal echo (TEE) – preferred method in patients with renal insufficiency of hemodynamic instability
♣ CT angiography with contrast – preferred in hemodynamically stable patients; requires contrast so avoid in renal insufficiency
♣ MR angiography – time consuming; avoid in patients with kidney disease
Most common cause of liver mets
Colorectal cancer
Indications for statin therapy
♣ Clinically significant ASCVD (ACS, stable angina, arterial revascularization (e.g. CABG), stroke, TIA, PAD)
♣ LDL >/= 190
♣ Age 40-75 with DM and LDL of 70-189
♣ Age 40-75 w/o DM with estimated 10-year ASCVD risk >/= 7.5%
What is the pathogenesis of tardive dykinesia in patients on antipsychotics
Dopamine D2 receptor upregulation and supersensitivity resulting from chronic blockade of dopamine receptors
Tx of chest pain in acute cocaine toxicity
- Benzos for BP and anxiety – reduction of sympathetic outflow, thus improving BP and HR
- Aspirin – reduces thrombus formation
- Nitroglycerin and CCB for pain – vasodilation
- Beta blockers contraindicated
- Immediate cardiac catheterization with reperfusion when indicated
Time frame of major depressive disorder
> 2 weeks (5/9 of SIGECAPS)
Definition of bipolar II
♣ Hypomanic episode + major depressive episode
Definition of dysthymia
♣ May have major or minor depressive symptoms
• Lasting > 2 years
• Can’t go more than 2 months without symptoms within the 2 years
Time frame of grief to distinguish it from MDD
12 months
Time frame of postpartum blues
<2 weeks
What is the duration of sx on the schizophrenia spectrum
♣ Brief psychotic disorder > 1 day and < 1 month
♣ Schizophreniform disorder > 1 month and < 6 months
♣ Schizophrenia > 6 months
What is schizoaffective disorder
♣ Mood episodes and active symptoms of schizophrenia occurring at the same time + at least 2 week lifetime history of delusions or hallucinations in the absence of prominent mood symptoms
♣ Aka normal schizo sometimes and schizo + mood at other times
Tx of tardive dyskinesia
Antimuscarinics (Benztropine or Trihexaphenydyl)
Tx of neuroleptic malignant syndrome
Dantrolene
First line medication for anorexia nervosa
Antipsychotics
First line medication for bulimia
SSRI
What is the time cut-off between acute stress disorder and PTSD
o ASD lasts > 3 days and < 1 month
o PTSD lasts > 1 month
Greatest risk involved in parenteral nutrition
Bloodstream infection
The risk of cholecystitis (secondary to cholestasis) increases if pt has been on TPN >2 weeks
Definition of FHR acceleration
An increase in 15 BPM above baseline for 15 second duration
Definition of FHR moderate variability
6-25 bpm
What will you see in CSF in bacterial meningitis
- Cells
- Protein
- Glucose
- Other
Cells = neutrophils Protein = high Glucose = low Other = + culture/gram stain
What will you see in CSF in viral meningitis
- Cells
- Protein
- Glucose
- Other
Cells = lymphocytes Protein = high Glucose = normal Other = + viral PCR
What will you see in CSF in TB meningitis
- Cells
- Protein
- Glucose
- Other
Cells = lymphocytes Protein = high Glucose = very low Other = acid fast bacilli
What will you see in CSF in Guillain Barre
- Cells
- Protein
- Glucose
- Other
Cells = none (normal leukocyte count) Protein = high Glucose = normal
What FEV1/FVC ratio indicates obstructive lung disease and restrictive lung disease
Obstruction = <80% Restriction = >80% (FEV1 and FVC will both be decreased but FVC is more decreased)
What are considered adequate uterine contractions
Q2-3 min
When is amniotomy indicated
For labor induction only if fetus is well applied to the cervix to prevent umbilical cord prolapse (e.g. not indicated if fetus is at -4 station)
What is Light criteria for pleural effusion
Exudative = 1/3 criteria
- Pleural fluid protein/serum protein ration >0.5
- Plerual fluid LDH/serum LDH ration >0.6
- Pleural fluid LDH >2/3 upper limit of normal serum LDH
What can you use to determine cause of ascites
Serum ascites albumin gradient (SAAG)
> 1.1 = occurs when there is not a lot of stuff in ascites e.g. caused by hydrostatic pressure pushing fluid out
<1.1 = lots of stuff in ascites e.g. caused by oncotic pressure pulling fluid in to belly
What SAAG will you see in cirrhosis
SAAG >1.1
Treatment of hemodynamically stabe V-tach
Anti-arrythmics
- Lidocaine
- Procainamide
- Amiodarone
What is Adenosine used for
Supraventricular arrhythmias
Describe how chronic kidney disease affects calcium, phosphate, and PTH
Kidney is not able to form active form of Vitamin D = decreased absorption of calcium (hypocalcemia) and decreased secretion of phosphate (hyperphosphatemia) = PTH increases to try to get more calcium (parathyroid hyperplasia) = PTH stimulates bone resorption (renal osteodystrophy)
Tx of overflow incontinence
Cholinergic agonists (opposite of oxybutynin) = Want to increase bladder contractility
What is used for spontaneous bacterial peritonitis prophylaxis
Fluoroquinolones
Most common cause of pneumonia in sickle cell patients
Step pneumo (pt’s are at higher risk to encapsulated organisms secondary to asplenia)
What are the 4 major side effects of antipsychotic
- Dystonia
- Akithisia
- Parkinsonism
- Tardive dyskinesia
Tx of extrapyramidal side effects
Antimuscarinics (Benztropine or Diphenyhydramine)
First step in tx of infertility in PCOS
Weight loss
What structure might be damaged in fracture to radial shaft
Radial nerve
What structure might be damaged in anterior shoulder dislocation
Axillary nerve
What does elevated lactate dehydrogenase indicate
Hemolysis
What drugs are used for rate control in A-fib
Beta blockers (Metoprolol) Non-dihydropyridine CCB (Verapamil, Diltiazem)
Diagnose: anemia, renal insufficiency, hypercalcemia, fatigue, and weight loss
Multiple myeloma
Tx of agitation in the elderly
Haloperidol
What will you see in a pt with Lennox-Gestaut syndrome
Multiple types of seizures (beginning at age <7) + mental retardation
