UW Flashcards
Presentation of Benzo OD
Slurred speech Unsteady gait Drowsiness Normal pupils Mild resp depression
Phenytoin toxicity presentaiotn
Horizontal nystagmus
Cerebellar Ataxia
Confusion
Presentation of opiod intoxication
Resp depression
Miosis
Sedation
Presentation of Lithium toxicity
Tremor
Hyperreflexia
Ataxia
Seizures
TX for pneumothorax
Needle thoracostomy
Presentation of pneumothorax
Rapid onset SOB Tachycardia Tachypnea HypoTN Neck vein distension = SVC compression
Presentation of Rotor syndrome
Jaundice, dark urine
Normal LFTs
Defect of hepatic storage
Conjugated Hyperbilirubinemia
95% of Circulating BR is what?
Unconjugated = insoluable in water
Tightly bound to albumin
Cannot be filtered by glomerulus so not excreted in urine
Gilbert syndrome presentation
Icterus
Mild UNconjugated HyperBR
malaise, fever, fatigue, abd discomfrot
Stress induced
Diphenhydramine toxicity Presentation
Drowsiness, confusion Dry mouth Dilated pupils Blurred vision Reduced bowel sounds Urinary retention
TX for diphenhydramine toxicity
Physostigmine
= Cholinesterase inhibitor
DOC for delirium in elderly
Low dose Haloperidol
Management of mechanical ventilation in ARDS
- FiO2 should be < 40%
2. Add PEEP
What are ways to improve oxygenation
- Increase FiO2
2. Add PEEP
What does PEEP do
Prevents alveolar collapse
Can reopen some alveoli that are collapsed
Long term neuro sequelae of Bacterial Meningitis
- Hearing loss
- Loss of cognitive fnc
- Seizures
- MR
- Spasticity of paresis
Anemia in chronic phenytoin use
Mild megaloblastic anemia
- others; primidone, phenobarb
MOA: impaired absorption of folic acid in SI
Drugs that cause folic acid deficiency
Phenytoin Phenobarb Primidone Trimethoprim MTX
Renal colic w no stones Id’d
- Radiolucent stones - uric acid, xanthine stones
- Calcium stones < 1-3mm
- Non-stone urethral obstruction - blood clot/tumor
TX for uric acid stones
- Hydration
- Alkalinize urine to 6-6.5 w Oral Potassium citrate
- Low purine diet
MC Peripheral Neuropathy in diabetics
Symmetrical Distal Polyneuropathy
Shoulder pain w No response to lidocaine injection
Rotator Cuff injury
TX for hoarding disorder
SSRI
DBS if refractory
Imaging modality for splenic rupture
CT w contrast
Next step in management of hemodynamically stable splenic rupture
CT w contrast
Next step in management of hemodynamically UNstable pt w splenic rupture
Urgent Laparotomy
Bite wound TX
Amoxicillin-clavulanate
DOC dog bites
Amoxicillin-clavulanate
Active uncontrolled bleeding and Placenta Previa management
Emergency C section
Presentation of ovarian and adnexal torsion
Sudden onset
mod-severe pelvic pain (R»L)
N/V
Abnormal vag bleeding - less common
TX for ovarian/adnexal torsion
Immediate detorsion w emergency laparoscopic surgery
Labs for G6PD
Low hemoglobin Low Haptoglobin High Indirect BR High LDH Coombs negative
Presentation ischemic hepatic injury/shock liver
Septic shock
High LFTs - AST/ALT in thousands
Neurofibromatosis w cafe au lait spots, macrocephaly, feeding probs
NF 1
NF with BL acoustic neuromas and cataracts
NF 2
Acanthosis Nigracans Presentation
Symmetrical
Hyperpigmented
Velvety plaques
Axilla, groin, neck
Acanthosis Nigricans ass’d with
Insulin resistance - DM, PCOS
GI Malignancy
Waldenstrom’s macroglobinemia
- IgM spike
2. Hyperviscosity
Pseudomonas aerg TX
Cefepime
Pipercillin-tazobactam
What does hepatojugular reflex indicate
Failing RV that cannot accomodate an increase in venours return w abdominal compression
Cardiac findings in Down Syndrome
- Complete AV septal defect
- VSD
- ASD
Narrow QRS complex tachycardia Mangement
IV Adenosine
MOA Adenosine
Slows sinus rate
Increases AV nodal conduction delay
Transient block in AV node conduction
Mammogram Screening - how often
Every 2 years in women 50-75
Hyperlipidemia Screening
Every 5 years for Men 35+
Anovulation due to morbid obestiy labs
Normal FSH and LH
Premature ovarian failure labs
High FSH and LH
Most common origin for ectopic foci that cause A fib
Pulmonary veins
