Study ITE Flashcards
LAD MI leads to what EKG complications
LAD -> RBBB and LAFB
Inferior= AV block- reposive to atporine early. may TQ pace but it resolves!
sick sinus syndroime tx
Pacemaker
antidysrhtimics for tachy stuff
magnet does what ot AICD
turn off defib and pacemaker to synchronous mode
why do we treat strep throat?
prevent rheuamtic fever
psgn
asymettric arthrits after pus outcha dick?
HLAB27 reiters
Scleroderma crsisi tx Renal raynauds GI Derm Lung
ace-i CCB PPi MTX mycophenolate
steroids + NSAIDs to
muscles ache and pericardial effusion as well
SLE- diffuse alvolae hemmrohage!
rheum pulm + AKI?
wegeners
Plateltes
petechia- not enough or dysfunctional platets
Rx- Asa (life of plate 10 days) Nsaids, PLavix
- Not enough - aplastic enamia, infections, maligniacy
- destruction- ITP, TTP, DIC, HUS
- Lost- Bleeding, HD
- Bound up- spleen
50K w/ severe bleeding
20 K without bleeding
+ steorids or IVIG
prolongation of PTT?
Heparin (potentiates antithormbiin and 10a so antithrombin!)
Vwf disease
Hemophila A and B
When to give FFP when to give cryo
Cryo- it has 8, Willi and Fibrinogen =give in DIC with low fibrinogen, Vwf or Hemophilia [ ] and low volume,
FFP- give in trauma for coagulapthy- Elevated INR, TTP for ADAMSt13, many other clotting factors
PCC= 2 7 9 10 for warfarin or give vit K
HIT
- Stop heparin
- give argatoban (firect throbmin inhibtor)
- reverse warfain- ont givr it (if protein C is inihbited and HIT Igg around = clots)
with the DOACs it is renally excreted, consider HD for bleeding not these agents – flip over
remmebr Desmopressin for vwf diseaseor hemphilia A
acute chest transfusion or no?
yes if they are reuqiring oxygen, symptomatc and can give reds to higher their hgb
exhcage trnasfusion if worse
otherwise, bronchodilators, steroids, fluids, abx (aplesnicusually), pain control, oxygen
croup tx
bronchiloti
Sterois, rac epi
barky cough, stridor, steeple sign, larugntracheities
supportive, watch out for apnea, admit if retracting
bacterial trach
nafcillin CFTX
intubate
after URI with high fever
FOreign body
back blows < 1 yr old
hemilich >1 yr old
no blind sweeps!
RPA dx and tx
6 at c2, 22 at c6
iv abx and drain in OR
pertusis
high WBC
apnea
Catarrhal – URI symptoms for 3 weeks; Paroxysmal = “whooping” phase; Convalescent = recovery
WBC >15k is classic for pertussis
PNA in kids
newBorn- group B strep
3 weeks- 3 months= strep pneumo
4 months to 4 years- Viral
5 years to 15= mycosplasm
buzzzzz
Cricoid Cartilage = most narrow
Cystic Fibrosis = Pseudomonas, Staph aureus
Cystic Fibrosis = rectal prolapse, meconium ileus
Staccato cough = Chlamydia
Bullous myringitis = Mycoplasma
pyloric stneosis met derganements
hypoCL hypoK met alkalsosi
HUS tx
supportive no abx
coags good, platelts down, watch out for kidneys
Derm PEDS
EM- HSV, mycoplasma, drugs
Varicella- mucous membrans, various, itchy
menigcoccemia- VERY sick, mottling, CFTX
TSSS- clinda, young fmeial hypotneisve, multi organ failrue
HSP- renal involvement, UA, HTN, Iga Vasc, and pain
peds
neonate- amp gent acylcivr if hypthermic
ductal depenent lesions
Hypoplastic L heart, Severe Coarctation, Critical Aortic Stenosis + TOF = PGE apnea!
poor feeding, failure to thrive, tachypnea, sweating with feeds, cyanosis with crying then cardiogenic shock on day 3-7 of life
HOCM tx
BB
rheuamtic fever
after URI group A strep infeciton
kawaksaki tx
asa, IVIG
admit for coroanry artery ansyusm
menintigits pearls kids
strep pneumo if older thna2 months or H flu
avoid cftx in <2 months for biliary sludings
limping, not fat, knee pain
legg- AVN of femoral head- looks like line thru instead of malalaingment
SALTER
Stright across above lower thru- surgery Crush
trnsient synovitis is after URI, NSAids
carido version Jouls w/ pulse
w/out pulse
needle crix for kids < ____
1
2
8
NRP
First 30 seconds: warm, dry, stimulate, suction
After 30 seconds: If HR <100, give PPV for 30 seconds
After 60 seconds (total): if HR <60, start compressions/epi
No compressions until at least 1min and adequate PPV
3:1 compressions/breath “1 and 2 and 3 and breathe”
ant vesivle mouth kid
post vesicle mouthg kids
HR SVT in infants?
seborrheic demraitis tx
herpetic ginigovstomatitis
herpangina
220
selenesium sulfide
Floppy + constipation =
HTN= think—-
cough, tachypena at 2 weeks ols
botulism
Renal
chlamydia
send hoem with reassurance is usually worng- acution test!
hyphema + FB=
globe open
rust rings= optho in 24 hours
alkali liquefactive
acid= coag necrosis
hyphema tx
head of bed glaucoma stuff dialte steroids ophtho
CRVO tx
consult - maybe asa sae with retinal detachment
24 hours baby conjucitivitis?
chemical conjuctivitis
remember- preseptal cellutlits is no involvment of eye at all
epislceritis
scleritis
uveitis
enopthlamitis
between slcera and cornea- NEXT WEEK
sclera- get rheum work up - NEXT DAY
iris + ciliary body + chroird - cell and flare steroids, flush
eyelid close is CN7, eyelid open is CN 3 (ptosis, down and out, dilated pupuil) - SAME DAY
cylcoplegics like atoprine help with painful eye stuff
epislecritis with hypopyn is bad news - endopahtlmtiis
acute angle cglaucmoam tx
timolol brimopidine pilocarpine lataoprotst pref orte
hyperCa TX
fludis
cisphosphos
calicotnin
HD if renal failure
short QTC\
MISHAP malignancy ingestion Sarcoid hyperPTH alkali milk pagets
SIADH
low NA low osms high urine osms give HTS if siezing midline tumors
hyeprviscous blood sndrome
fludis
pehreis
low glucose, low Na hyper K—- think
adrneal insfuficiy
usualy with precipitating event
what is neutropenia
<500 neuts
7-10 days out from chemo
38 deg temp
psedumonas and mrsa
give me TLS
uric acid, LDH, K, phos high
low Ca
what si scarlet fever and hwo doyou treat
basically strep throat + strawberry tougnue and rash- treat like strep
then 2-3 weeks later is rheuamtic frever
PATHOPHYS TO AKA AND TX
ETHANOL LEADS TO MORE NADH THAN NAD TO MAKE ACETONE
too much NADH means no more eglcuoneogeniss and keotsis
give glucose
give thiamine to replete NAD
fluids
HD in hyeprcalecmia?
18
AMS
CHF
ARF
HypoK ekg
low ts, U , peaked Ps, ST depression and long QT
sharply defined circular ulcers with tender, enlarged inguinal lymph node-painy peny
ducreiy- azithro cftz
out vs inpt tx pyelo
septic, preggo, cant tolerate po, vitals
7 days
recent uri with puffy face, protein i nurine
PSGN - ASO titer - HTN - PCN!
supportive
HD if they are overload into lungs
wegeners?
Goodpasture?
Nose congesiton rpoblems + AKI
AKI + pulm - type 4 collagen - PLEX
HD indications
BUN 100 hyperK acidosis toxins HTN
NV lightheaded, Headache, htn post dialysis?
Dysibelqibirum- osmolality problem - cerebral edema
if bleedding- figure 8 it- vascular
staph is most common infeciton
dispo with peritoenal dialsysi 100 wnc?
intra abx and dc
5 stoen admits
obsturction infection PO Pain solidatry kidney
lata= accuminata= painless with LA= painful woth LA= donovan bodies
syph HPV chlamydau ducreyi granuloma inguinale- klebsiella
next step torsion
urology
open boook in meantime
not US
lenght of treatment for cysitits
3 days
think std if not getting ebtter
buzz
New murmur with AKI = Renal embolism
Blue dot sign = testicular appendage (appears similar to torsion)
Seminoma** = MC malignancy in young men, 20s, ultrasound for diagnosis
Hematuria in elderly** = bladder cancer, need cystoscopy
mass cass stuff
dont forget AMS cant folow commands is Red
vulvovaginiits in prepubertal females give
amoxicillin- not FB
MC site for foriegn bodies to get stuck in peds
c6 cric
gastric empyting in caustic ingesiton?
no
button battery in stomach needs?
repeat x ray in 48 hours?
PUD + early satiety and vomtning?
gastric outlet syndrome
give HBIG fi unknown vaccination status for hep b exposure
Hbeg- highly infectious (unless ab= low infectivity)
core= igm new igg old
SBP 1000 WBC
porcelin gallb;adder increased risk of
cancer
obsturction vs volvlous
NG tube vs surgery
hernias
indirect through:
direct trhu:
femoral under
process vaignalis
trasnveralis fasica
ligmaemtn
incercerated is irrediudible
crohsn + back pain and limp?
PSoas abscess
prolalpsed internal hemorrhoid=
surgical
external and acute= take out urself
diarrhea 12 hours later… watery diarrhea undercooked beef
c perf]\
bloody + bradycardia= slamonella
where to cut on pericardium?
anterior
pericariditis is PR depression!
flank hematoma after abd injury think
RP injury
extrapeitoneal bladder injury
MC and foley mamangememt?!
if you think urethrel ainjury gt retro gram prior to foley
nevres or arteries frst in cmoaprtment syndrome
nerves
tdap
if clean 10 years
if dirty 5 years and if not then Ig
epiglottis tx
direct layngsocpy in OR
airwayFB
< 1 yo back blows
>1 yo Heimlich
Bullous myringitis = Mycoplasma
yup
HUS dont give
abx
disseminited minigcocommenia
cftx
kawaskai labs
steriel pyria
inflam markers up
IVIG
ASA
simple seizures
6mo-5 years
GTC, <15min
One event per 24h
No deficits or focality
peds meningitis
<2 mo of age E.Coli, GBBS, Listeria Ampicillin for Listeria Coverage Avoid Ceftriaxone – biliary sludging Amp + Gent/Cefotax
nrp
First 30 seconds: warm, dry, stimulate, suction
After 30 seconds: If HR <100, give PPV for 30 seconds
After 60 seconds (total): if HR <60, start compressions/epi
No compressions until at least 1min and adequate PPV
3:1 compressions/breath “1 and 2 and 3 and breathe”
kerion tx
STERIODS + ORAL ANTIFUNGALS
SEB DERM= SELENIUM SULFIDE SHAMPOO
SCAPHOLUNATE DISSOCATION TX
outpatient splint
calc if isolated
salter 2
lis franc surgery or immediate follow up
hypoNA, HyperK, HypoG , hypotension
addisons primary adrenal failure
100 hydrocort
d5NS
diabetes insipidius is
NO ADH or renal resistance, very dilute urine- hypernatremic
cardiac arrest in DKA from…
hypoK
nroml glucose, WGMA, ketones=
AKA- D5NS, thimaine, folate
myxedema coma tx
Hydrocortisone, IV thyroxine
IVF, glucose, abx tx underlying cuase
cushings
too much steroids form brain or drugs. remove them. that si t.
LApha block first then beta block for pheos
osmolality equation
2NA + BUN/2.8 + glucose/18
