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PANCE prep JQ > Things I've Gotten Wrong > Flashcards

Things I've Gotten Wrong Flashcards

1
Q

MC cause of acute pericarditis

A

Idiopathic

OR

Viral (coxsackie and echovirus)

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2
Q

High pitched 3rd heart sound, dyspnea, and signs of right sided heart failure should make you think of this…

A

Constructive pericarditis

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3
Q

Describe a pericardial knock

A

High pitched 3rd heart sound that occurs due to sudden cessation of diastolic filling

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4
Q

Tx for constructive pericarditis

A

Pericardectomy

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5
Q

MC cause of myocarditis

A

Viral or postviral immune mediated damage

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6
Q

What causes rheumatic fever?

A

Acute autoimmune reaction to group A beta-hemolytic strep

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7
Q

Jones criteria for rheumatic fever

A 
MAJOR
Migratory polyarthritis
Active carditis
Subcutaneous nodules
Sydenham’s chorea 
Erythema marginatum

MINOR
Fever
Joint pain
Increased phase reactants
Prolonged PR
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8
Q

Tx for rheumatic fever

A

2-6wk Aspirin taper

Pen G

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9
Q

MC cause of mitral stenosis

A

Rheumatic heart disease

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10
Q

MC causative organism of infective endocarditis

A

Subacute course: strep virus and from oral flora

Acute course or IVDU: staph aureus

*consider enterococcus in men who had recent GI/GU procedure

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11
Q

4 peripheral manifestations of infective endocarditis

A

Janeway lesions
Roth spots
Osler nodes
Splinter hemorrhages

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12
Q

Tx of endocarditis

A

Acute native: nafcillin with gentamicin for 4-6wk

Suspect MRSA, pcn allergic, or IVDU: vancomycin with gentamicin

Prosthetic valve: vanco, genta, and rifampin

Fungal: ampho B

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13
Q

Endocarditis prophylaxis indications and tx

A
  1. Prosthetic valve
  2. Prosthetic repairs
  3. Hx of endocarditis
  4. Congenital heart dz
  5. Valvulopathy of transplanted heart

2g amoxicillin or if pcn allergic 600mg clinda

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14
Q

DVT treatment duration

A

1st episode with recent surg, transient identifiable factor, or high bleed risk: 3mo

Idiopathic 1st episode: 6mo

Recurrent episode:1yr

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15
Q

Left bundle branch block

A
  1. wide QRS
  2. Slurred R is V5-6
  3. Deep S in V1
  4. possible ST elevations in V1-3
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16
Q

Where is the infarct: ischemic changes in V1-4?

A

anterior wall

LAD

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17
Q

Where is the infarct: ischemic changes in V1-2?

A

Septal

Proximal LAD

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18
Q

Where is the infarct: ischemic changes in I, aVL, and V5-6?

A

Lateral wall

Circumflex

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19
Q

Where is the infarct: ischemic changes in I, aVL, and V4-6?

A

Anterolateral wall

Mid LAD or circumflex

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20
Q

Where is the infarct: ischemic changes in II, III, and aVF?

A

Inferior wall

Right coronary artery

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21
Q

Where is the infarct: ST DEPRESSION in V1-2?

A

Posterior wall

right coronary artery or circumflex

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22
Q

1st line tx for WPW syndrome

A

Procainamide

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23
Q

Antiarrhythmic classes

A

Class I-Na channel blockers/rhythm: procainamide, lidocaine, flecanude

Class II-beta blockers/rate: atenolol, metoprolol, esmolol, ect

Class III- K channel blockers/rhythm: amiodarone, dofetilide, sotalol

Class IV-Ca channel blockers/rate: verapamil, diltiazem

Class V-digoxin

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24
Q

Asthma classification by FEV1

A

Intermittent: >80%

Mild persistent: >80%

Moderate persistent: 60-80%

Severe persistent: <60%

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25
Q

PFTs in COPD

A

FEV1/FVC is <70%

In emphysema also look for increased lung volumes and decreased DLCO

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26
Q

Tram track appearance on chest CT, with chronic cough, mucopurulent sputum and hemoptysis

A

Bronchiectasis

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27
Q

Tx of bronchiectasis

A

ABX

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28
Q

MC cause of bronchiectasis

A

Recurrent infections - H flu

Pseudomonas in CF patients

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29
Q

Gram negative rod causing pneumonia with cavitary lesions in an alcoholic

A

Klebsiella

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30
Q

Gram negative rod causing CAP in pt with underlying lung dz

A

H flu

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31
Q

Gram positive cocci in pairs that is MC cause of CAP

A

Strep pneumo

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32
Q

Intracellular gram negative rod that causes atypical pneumonia with GI sx, hyponatremia, and elevated LFTs

A

Legionella

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33
Q

Gram positive cocci in clusters that often causes multilobular pneumonia after a viral illness

A

Strap aureus

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34
Q

MC viral cause of pneumonia

A

RSV & parainfluenza in infants and children

Influenza in adults

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35
Q

Pneumonia associated with bird/bat droppings in Ohio/Mississippi river valley

A

Histoplasmosis

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36
Q

Causative agent of bullous myringitis

A

Mycoplasma

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37
Q

Pneumonia treatment

A

CAP outpt: clarithro, azithromycin, or doxy

Inpt or ICU: add FQ or beta lactam

Hospital acquired: consider pseudomonas coverage, vanco or linezolid if MRSA, and Levi or azithro if legionella

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38
Q

Restrictive lung dz PFTs

A

Decreased lung volumes with

Normal or increased FEV1/FVC

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39
Q

Tx of active TB infection

A

4drug regiment for 2mo followed by 4mo of dual therapy

Rifampin, isoniazid, pyrazinamide, and ethambutol (or streptomycin)

RIPE or RIPS

40
Q

Rifampin MOA and adverse effects

A

Inhibits RNA synthesis

Thrombocytopenia and orange secretions

41
Q

Isoniazid MOA and adverse effects

A

Inhibits mycolic acid synthesis

Hepatitis, peripheral neuropathy (give B6 pyridoxine), rash

42
Q

Pyrazinamide adverse effects and cautions

A

Hepatitis, hyperuricemia, and photosensitivity

Caution in gout or liver dz

43
Q

Ethambutol adverse effects

A

Optic neuritis

Peripheral neuropathy

44
Q

Latent TB infection tx

A

Isoniazid with B6 for 9-12mo

45
Q

MC cause of acute bronchitis

A

Often follows viral URI

46
Q

Tx of Whooping cough

A

Supportive tx

Erythromycin or azithromycin can be considered or given to exposed contacts

*bactrim if macrolide allergic

47
Q

Who gets acute bronchiolitis and what is the MC cause?

A

Children 2mo to 2yr old

After viral infection

48
Q

RSV mainstay of tx

A

Humidified O2

*ribavirin only in severe cases

49
Q

MC cause of croup(laryngotracheitis)

A

Parainfluenza

50
Q

Compare Chet-Stokes with Biot’s breathing.

A

Cheyenne-Stokes have a regular cycle of decreased breathing leading to apnea

BUT

Biot’s breathing is iregular quick shallow breaths with irregular periods of apnea

51
Q

Normal values for determining acid-base disorders

A

pH >7.45 alkalosis
pH <7.35 Acidosis

Pco2 35-45

HCO3 22-26

52
Q

Delta waves should make you think of

A

WPW syndrome

53
Q

U waves should make you think of

A

Hypokalemia

Quinidine

Procainamide

54
Q

Flaccid bulla with positive Nikolsky sign

A

Pemphigus vulagris

55
Q

High riding humeral head on AP radiography

A

Suggestive of rotator cuff athropathy

56
Q

How do you assess the murmur from a ventricular septal defect?

A

The louder it is the smaller the defect so the better the prognosis

57
Q

What hormone replacement therapy should you recommend for menopause?

A

Uterus intact: estrogen/progesterone

Post hype rectory: estrogen only

58
Q

Idiopathic diabetes insipidus etiology and treatment

A

Destruction of hypothalamus; genetic form is autosomal dominant

DOC is desmopressin

59
Q

How does hyperaldosteronism affect blood pressure and lytes?

A

Hypertension

Hypokalemia

60
Q

MC cause of hyperaldosteronism

A

90% are primary hyperaldosteronism due to aldosterone producing tumor or bilateral adrenal hyperplasia

61
Q

How do you get toxoplasmosis?

A

Eating undercooked meat or changing kitty litter

62
Q

TB treatment for pregnancy

A

Isoniazid, rifampin, and ethambutol

Streptomycin C/I and risk of pyrazinamide unkn

63
Q

What triggers preeclampsia?

A

Placental ischemia

64
Q

MC long term complication of supracondylar fracture

A

Cubitis varus

65
Q

How do you diagnose RVS?

A

Nasopharyngeal swab

66
Q

Medications useful for anger in borderline personality disorder

A

Topirimate and lamotrigine

67
Q

How do you differentiate night terrors from nightmares?

A

Night terrors: first 60-90 minutes of sleep and associated with mental illness

Nightmares: occur during REM sleep early in the morning

68
Q

DOC for TCA poisoning (ventricular arrhythmias and hypotension)

A

Sodium bicarbonate

69
Q

How do amphetamines work?

A

Causing the release of dopamine and NE

70
Q

Crescent sign on hip x-ray

A

Avascular necrosis of the hip

*a common complication following traumatic hip dislocation

71
Q

Morphology and staining of strep meningitidis

A

Gram negative diplococcus

72
Q

When is HIV PCP prophylaxis indicates?

A

CD4 <200

Hx PCP infection

Evidence of immunocompromise (candidiasis)

73
Q

Primary treatment of tumor lysis syndrome

A

Aggressive rehydration

74
Q

Harsh bark-like cough with wheezing since infancy should make you think of this

A

Tracheomalacia

75
Q

Afebrile infant with staccato cough and eosinophilia should make you think of

A

Chlamydia trachomatis

*patchy infiltrates on CXR

76
Q

Blood test for presymptomatic MEN2 associated cancers

A

RET mutation

77
Q

Aspergilloma can be a late complication of this disease

78
Q

Brochilithiasis can be a late complication of this disease

A

Histoplasmosis

79
Q

Kernig sign indicates

A

Meningeal irritation

80
Q

Kussmauls sign indicates

A

Cardiac tamponade

81
Q

Quick’s sign/pulse indicates

A

Aortic insufficiency

82
Q

Newborn conjunctivitis based on time

A

2-5d Gono

5-14d chlamydia

83
Q

First line treatment for endometritis

A

Clinda and genta

84
Q

Post C-section fever, soft tender uterus, and foul lochia

A

Endometritis

85
Q

10-20% pts with CLL develops this

A

A secondary malignancy

86
Q

Urine casts

A

Waxy-chronic dz or vigorous exercise

Fatty-nephrotic syndrome

RBC-glomerulonephritis

WBC- pyelo or acute interstitial nephritis

Hyaline- diuretic use

87
Q

Stages of Lyme disease

A

Early localized- rash malaise & myalgiaS

Early disseminated-heart and nervous system involvement

Late/persistent- neuropsych manifestations and joint pain

88
Q

Inheritance pattern of hemophillia A and B

A

X linked recessive

Only boys will have it

89
Q

This immunoglobulin is elevated in Waldenstrom’s macroglobinemia

90
Q

This immunoglobulin is elevated in multiple myeloma

91
Q

VAP associated bacteria

A

Pseudomonas

Klebsiella

Enterobacter

Serratia

Acinetobactor

92
Q

Tx of Hodgkin lymphoma

A

Doxrubicine, bleomycin, vinbkastine, and dacarbazine

With possible radiation

93
Q

Tx of multiple myeloma

A

Lenalidomide and prednisone

94
Q

Who do you consult for drainage of a retropharyngeal abscess?

A

Otolaryngologist

95
Q

What is telogen effluvium?

A

Stress induced hair loss

PANCE prep JQ (15 decks)

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