Week 1 Flashcards
<2 year old fever, rhinorrhea (coryza), cough 18 hours and labored breathing 1 hour, exam reveals tachypnea, hypoxia, crackles, coarse breathe sounds +/- Wheezing. What is the diagnosis?
Bronchioloitis caused by RSV
Tx. Supportive
Hemochromatosis can have what complications
HCC, Cirrhosis, CM (CHF), arrythmias, DM, impotence, arthropathy, hypopituitarism
Contralateral paresis and sensory loss in the face and arm, gaze preference towards side of the lesion
MCA Stroke
Left (dominant) - Aphasia
Right (non dominant) - neglect
SOB in someone with rib fracture, no breath sounds, unstable BP 80/60, next step?
needle thoracostomy
87 year old w/dementia in nursing home with UTI, had a catheter for urinary incontinence for a week, what could have prevented this?
incontinence briefs instead of a catheter
how to treat superficial thrombophebitis
NSAIDS, warm compress
37 immigrant from pakistan, 2 week RUQ pain, fever, increased T bili 1.4, Alk phos 120, AST 40, on US see right cystic mass of the liver, what is this?
Entamoeba histolytia, diagnose with serum antibody for E histolytica, tx with metronidazole. Can also cause blood diarrhea.
Just started HCTZ feel fatigued, which electrolyte abnormality?
hypoKALEMIA, can also cause, hyponatremia, hyperglycemia, hypelipidemia, hyperuricemia, hypercalcemia, sulfa allergy
Tinea versicolor, doesn’t tan in sun, what to treat?
selenium sulfide or topical azoles, dx KOH spahgetti and meatballs
Kid with scalp scattered papules and scaly ares, and short broken hairs in patches
Tinea corpis, from sharing hat probably, Dx KOH, 2/2 tricohophyton, tx griseo or terbinafine)
6 month old chronic constipation, no stool in ampulla, next step dx
anorectal manometry detects failure of the internal sphincter to relax after distention of rectal lumen, used in atypical preso older children
4 year old with ear pain, bulging TM, edematous auditory canal, small amount MC discharge, tenderness behind ear, EAR IS LATERALLY DISPLACED, 1 CM freely mobile NT mass over L anterior neck, next step
CT scan Temporal bone … ABSCESS!
guy works as a pharmacist, advised to lose weight, high T4, very high T3, very low TSH, decreased uptake on radioactive thyroid scan and small gland, what is the cause?
EXOGENOUS ADMIN thyroid hormone
30 min after fluid resuscitation with crystalloid solution and transfusion of 4 units crossmatched PRBC, SOB and diffuse rhonchi and crackles, what is cause?
Fluid overload, Transfusion induced lung injury
prego who is vegetarian, what additional supplementation vitamin for pregnancy and lactation?
B12
47 yo male knee pain, fracture when 16, progressively worse now, can’t walk
post traumatic arthritis
What to decrease Renal Ca++ stones
- Increase fluid intake
- Decrease Na+ intake
- NL Ca++ intake
How to treat uric acid stones
- Hydration
- Alkalinize urine 6-6.5 w oral K/citrate
- Decrease pruine diet
Asthma, chronic rhinosinusitis w/nasal polyposis, and bronchospasm or nasal congestions following ASA or NSAIDS is
Aspirin exacerbated respiratory disease
How to treat recurrent variable decelerations? (occur with >50% of contractions)
Maternal repositioning, left lateral 1st line may reduce cord compression and improve blood flow to the placenta, 2nd line amnioinfusion
DiGeorge Syndrome Pathogenisis
Chromosome 22q11.2 deletion, defectiev development of pharyngeal pouches
Clinical Features DiGeorge syndrome
Conotruncal cardiac defects (truncus arteriosis)
Abnormal facies (low set ears, microagnathia)
Thymic aplasia/hypoplasia
Cleft palate
Hypocalcemia
Can also have T cell lymphpenia and increased risk viral and fungal infections
What to order if suspect DiGeorge syndrome?
Serum Ca++ and echo
Chronic granulomatous disease
-XLR
-Recurrent pulm and skin infections
-Catalase +
Dx: neutrophil function testing, dihydrorodamine 123, nitroblue tetrazolium test