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Boards Studying > Week 1 > Flashcards

Week 1 Flashcards

1
Q

nephrotic syndrome surprisingly includes

A

hypercoag leading to risk of renal vein thrombus

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2
Q

drugs turning pee red

A

macrobid and rifampin

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3
Q

parasite causing hematuria

A

schistosomiasis - eggs laid in Gu cells - 15% of people is some areas of africa - 150,000 deaths, common cause of CKD

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4
Q

bleeding issues in CKD

A

platelet dysfunction from uremia, needs dAVP

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5
Q

Branham sign

A

occlude AV fistula, get drop in HR, indicates high output heart failure on a dialysis patient from the AV fistula

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6
Q

PD related peritonitis

A

100WBC and 50% neutrophils. this is lower than the 250 neutophil cutoff for sbp in cirrhosis

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7
Q

stagnorn stones

A

made of struvite, klebliessa making urea stones

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8
Q

radio-lucent stones

A

uric acid stones - gout, leukemia, high protein diets

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9
Q

prostatitis and epididymitis treatment

A

under 35 tx like PID - ceftriaxone IM and doxy for 10 days. over 35 tx with bactrim for 2-4 weeks for e coli

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10
Q

lymphogranuloma venereum -

A

chlamydia, painless ulcer then inguinal adenopathy with pus possible, tx with doxy.

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11
Q

prehn sign

A

relief of pain with elevation of testicle - suggests epididymitis and not torsion

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12
Q

erythema multiforme

A

most commonly caused by HSV - target lesions develop over 72 hours - palms, trunk, and mucosal lesions - similar but different from SJS and TEN - tx with steroids

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13
Q

SJS and TEN

A

SJ is less than 10% (TEN)
HIV is x1000 risk
burn unit, eye consult

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14
Q

SSSS

A

exotoxin, usually kids <6, pos nikolsky, painful, erythema that is like sandpaper, tx with abx and ICU admit

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15
Q

exfoliative dermatitis

A

increased cell turnover leading to erythema then scaling tight skin, water and heat loss or regulation leads to 30% mortality

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16
Q

impetigo

A

honey colored staph and GAS infection on face in kid under 6 or elderly pt. bullous form in toxin and makes bullae/vesicles up to 3cm

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17
Q

erysipselas

A

raised erythematous plaque acute onset from strep - very SHARP boarder - amoxicillin unless systemic symptoms

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18
Q

nec fasc

A

clinda stops the toxin formation so it is first line - LIRNEC score

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19
Q

kerion

A

boggy bald circle - immune response to tinea capitis - tx with antifungal AND steroids

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20
Q

tzanck smear

A

HSV smear - mostly replaced by culture and PCR

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21
Q

herpetic whitlow

A

dont confuse with paronychia - its full of dead epithelial cells instead of pus - dont want to spread herpes into deep tissues

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22
Q

scabies tx

A

5% permethrin on days 1 and 7 of full body. or ivermectin on day 1 and 14 (non preg/breast feeding)

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23
Q

erythema nodosum

A

cancer, lung infections, IBD, OCPs. mosly young women. NSAIDS and elevation is tx after work up

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24
Q

pemphigus vulgaris

A

autoimmune loss of keraton adhesion causing plastering and mucous membrane involvement, much like SJS. 40-60yo patients. nikolsky posistive (SJS, TEN, SSSS, PV), not to be confused with bullous pemphigOID that is older than 60 and better prognosis. both tx with steroids

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25
Q

BCC

A

most common skin cancer
waxy, nodular, wxy, shinny red
resection or chemo

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26
Q

SCC

A

ulcerating cecnter - resection cures >90%

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27
Q

melanoma

A

most deadly skin cancer by far, the ABCDE mole of melanoma

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28
Q

animal bits and fight bite that are high risk of infection

A

leave them open and let antibiotics and washout help

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29
Q

hantavirus

A

aerosolized rodent feces - pulmonary and fever - can be fatal

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30
Q

rat bite fever

A

brain and myocardial involvement in febrile illness after a rat bite

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31
Q

black widow

A

antivenom only for severe symptoms. it comes from horses so risk of anaphylaxis or serum sickness.
otherwise watch or benzos, is an Ach release neurotoxin leading to cramping and spasm

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32
Q

brown recluse

A

necrotic initially painless wound - no antidote - supportive care

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33
Q

what is serum sickness

A

immune response delayed by 1 week after antigen exposure

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34
Q

scorpions

A

antivenom only indicated for bark scorpion and only available in AZ

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35
Q

stinger fish (zebra and lion, urchin)

A

venom can be inactivated by hot water for 1.5 hours

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36
Q

jelly fish

A

immerse in vinegar, then remove stingers. box jellyfish has antivenom

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37
Q

tetrodotoxin

A

blocks Na channels - leads to paralysis

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38
Q

pit vipers

A

rattle, copperhead, water moccasin(cottonmouth)

cro-fab, elevate

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39
Q

coral snakes

A

Ach receptor binding - can lead to paralysis, anti-venom, intubation?

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40
Q

malignant hyperthermia - patho and tx

A

genetic
Ca release from skeletal muscles after succ or inhaled anesthetics
tx with dantrolene

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41
Q

heat stroke

A

hyperthermia and AMS
usually >40C
hepatic damage
anti-pyretics don’t work

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42
Q

Frostbite

A

warm water rapid rewarming

leave the blisters in place or needle aspirate

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43
Q

trentch foot

A

unlike frostbite - this is above freezing temps but for prolonged time, also called immersion foot - this is rewarmed dry

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44
Q

hypothermia cutoffs

A

30, 32 and 35 C

shivering decreases at every stage mild to severe

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45
Q

core temp during ACLS

A

needs 32C to be declared dead

only need to shock once until above 32C

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46
Q

lightning 3` facts

A

lichtenberg fern figures
do CPR on pulseless during mass triage, they may just need time
cataracts years later

47
Q

retina htn

A

flames, papilledema, exudates

48
Q

TG for pancreatitis

A

500+

49
Q

VSD

A

most common heart defect
not cyanotic
presents with poor weight gain, large liver

50
Q

post rosc cooling (who?)

A

post Vfib arrest

51
Q

arterial gas embolism

A

diving injury where alveoli rupture and air ebmolism goes to circulation system

52
Q

water hemlock

A

looks like parsnips, gaba blocker leading to status and can be lethal

53
Q

foxglove and oleander, lily of the vally

A

digoxin - Na K atpase block

54
Q

anti cholinergic plants and treatment

A

jimsonweed

physostigmine is reversal

55
Q

roccuronium reversal

A

suggamadex

56
Q

anemia MCV

A

low - dont make heme (chronic, iron, lead)
normo - destruction or hemorrhage
high - cant divide (b12, folate)

57
Q

HUS

A

MAHA from Ecoli with renal dysfunction

58
Q

TTP

A

MAHA from ADAMTS13 deficiency - FATRN w/ jaundice

tx with plasma exchange

59
Q

DIC vs TTP vs autoimmune

A

DIC has higher fever
autoimmune has pos coombs
fibrinogen low in DIC

60
Q

aplastic crisis

A

Hb drop of 2 without reticulocytosis

parvovirus

61
Q

polycythemia vera

A

thrombosis and bleeding

62
Q

methemoglobinemia

A

tx with metholine blue (not if g6pd)
oxidized iron
86% pulse ox
brown blood

63
Q

CML

A

hardly see it. most rare, mostly adults, phili 9-22 switch. usually asymptomatic

64
Q

AML

A

most common ACUTE leukemia in adults (65)
blasts, variable white count
bone marrow biopsy

65
Q

CLL

A

MOST common adult leukemia
lymphocytes >5000, with neutropenia, anemia, tpn
dx with cytometry

66
Q

ALL

A

childhood leukemia - ages 2-5 onset

blasts -> biopsy

67
Q

hodgkin lymphoma

A

20s and 50s
cervical painless lymphadenopathy with pain after drinking
owl eye cells
very treatable

68
Q

non Hodgkin lymphoma

A

elderly people, a grab-bag of B and T cell malignancies

69
Q

burkitt lymphoma

A

EBV infection leading to lymphoma common in africa

70
Q

ITP

A

treat with IVIG or steroids in adults, most kids just avoid sports and climbing for 2 months.

71
Q

transfusion graft vs host

A

80% fatal - immunocompromised patients should get irradiated blood

72
Q

von willebrans

A

desmopressin for mild
factor 8 for bleeding - acts like hemophilia A - von willebrand factor is carrier protein for factor 8 which is a cofactor for platelets

73
Q

when to give platelets

A

50000 and bleeding

10,000 prophylaxis

74
Q

reactive arthritis

A

reider syndrome (or urethritis)
post chlamydia or diarrheas illness
tx with NSAIDS

75
Q

lefort

A

1 - hard palate
2 - into orbits
3 - hear no evil - zygoma

76
Q

who needs ct before LP

A

altered, seizure, neuro deficit, papilledema. give abx, you have 2 hours for LP without effect on csf

77
Q

procainamide dosing

A

50 mg per min up to 17 mg/kg

78
Q

dementia types
frontal temporal
lewy body
prion

A

FT - behavioral, quick decline
lewy - visual hallucinations
prions - MSK - myoclonus and chorea

79
Q

traveler’s diarrhea

A

azithro 1000mg for SE asia

cipro 750 x1 from latin america

80
Q

HCAP risk factors

A

snf, 2 day admission, iv abx at home, dialysis, chemo

81
Q

pelvic fracture types

A

AP - open book, bleeding, binder

vertical shear - sacral fx and sacral nerve root injuries

82
Q

when not to use succ

A

Neuromuscular disease, stimulants, malig hyperthermia hx. or crush burn sepsis stroke after 5 days.

83
Q

START system of triage

A

first priority is RPM
RR 30
Perfusion issue
Mental status cant follow commands

84
Q

what is charcoal good for

A

delayed absorption recent ingestions that do not act on local tissues

85
Q

gout arthrocetesis cells

A

neg birefringent cells
pseudo gout is pos (p and p)
20,000 WBC

86
Q

burst vs chance fracture

A

burst is retropulsion from anterior compression
chance is disruption in horizontal plane
both with seatbelts

87
Q

replacing factor

A

assume 0, get to 100 in in head injury, 1u/kg raises 2%

start factor before CT

88
Q

gonorrhea artitis

A

multiple joints, swab other placed because joint fluid may be negative, IV ABX not surgical wash out, look for papules

89
Q

tumor lysis syndrome abnormalitis

A

high - urate, K, phos

low - Ca (ca urate crystals build up in urine)

90
Q

headache tx with o2

A

cluster - tearing,

91
Q

dantrolene

A

treats NMS

92
Q

benztropine

A

helps you move but not your bowels
tx for parkinsons
treats dystonia (along with benadryl)
causes constipation

93
Q

IIH

A

usually well appearing with insidious vision changes in obese female - tetracycline, ocp, vit A

94
Q

pna in hiv

A

most common still strep pneumo

PCP pneumonia is CD4<200

95
Q

platelet transfusion

A

goes up 30,000
dont need to match ABO
dont give in itp/ttp/hit

96
Q

FFP

A

is 1 L (4 doses of 250)
needs ABO
is fibrinogen and factors

97
Q

Cryo

A

has 8,13,fibrinogen, and vWF

does NOT need ABO match

98
Q

PCC

A

TRANSIENT FAST replacement of 2.7.9.10

also give vitK

99
Q

hyperCa - work up, tx, symptoms, ekg

A

often from Cancer
give lots of fluids
stone, bones, groans, psych overtones
short QTc

100
Q

type 1 and 4 reactions

A

1 is IgE with mast cell degranulation

4 is T cells attacking antigens directly (contact dermatitis)

101
Q

acute closure glaucoma treatment

A

timolol, then Diamox, then pilocarpine drops

102
Q

dissection and stemi

A

15% of dissections show myocardial focal ischemia, consider dissecting off a coronary, be careful

103
Q

cavernous sinus thrombosis

A

CN 3,4,5, fever, headache, post viral

104
Q

PCI timing

A

under 2 hours of symptoms gets 1 hour to cath

>2 hours gets 2 hours to cath

105
Q

iron antidote

A

deferoxamine

106
Q

charcoal does not bind to what?

A 
C-phails
caustics
pesticides
hydrocarbons
alcohols
iron
lithium
solvents
107
Q

RMSF tx and where it is endemic

A

Doxy for all ages

midwest and southeast - weird!

108
Q

compartment pressures

A

delta and absolute of 30 are concerning lines

109
Q

hard signs to go to OR in neck stab wound

A

expanding hematoma
pulsatile bleeding
neurologic injury

110
Q

ear infections and tx
AOM
AOE
malignant OE

A

amox (over 2 waits 2 days)
abx/steroid drops
oral cipro for malignant

111
Q

reasons for hyperbarics

A

neuro, cardiac changes, 25% CO, or 15% CO and pregnancy

112
Q

CF pneumonia

A

staph aureus is most common, pseudomonas colonizes 80% by adulthood

113
Q

yersinia enterocolitica

A

looks like appy
needs special stool culture or stool PCR
undercooked pork

114
Q

MCC of acute chest

A

mycoplasma and chlamydia (no longer strep pneumo with vaccines)

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