1 Flashcards
(241 cards)
1
Q
What improves mortality hepatorenal syndrome?
A
Albumin
2
Q
Skin ulcer lesion, joint pain and diarrhea, what dz
A
Ulcerative colitis
3
Q
Child sickle who stroked tx ?
A
Exchange transfusion
No fibrinolytics
4
Q
Kid with clinical picture of appy symptoms improved with abx and US unable to visualize, next step to rule out?
A
CT or MRI
5
Q
Sinusitis indication for antibiotics
A
Worsening symptoms after initial improvement
More or equal to 10 days
6
Q
How long for Molluscum contagion to improve
A
Months to years
7
Q
Mallory weis vs Boerhaave presentation
A
Both tears after vomiting
Boerhavve present sick
8
Q
Septic Pt with plum HTN what to be careful with?
A
Fluids, will increase right sided pressure and worsen right sided failure
Nitric oxides is a treatment, decrease pulm resistance and improve right failure
9
Q
Acute myeloid leukemia with stroke symptoms what lab abnormality
A
Leukocytsis causing viscosisty
10
Q
Conductive hearing loss causes
A
Otitis media
Wax
11
Q
Low sodium
Neuro sx
Tx?
A
Hypertonic saline
12
Q
Persistently hypothermic after warm blankets tx
A
Warm fluids (internal rewarming)
13
Q
Measles rash is
A
Diffuse rash with white spots on bucks mucosa
14
Q
Most common complaint of scuba drivers
A
Middle ear barotrauma
15
Q
Max amount of intrathoracic blood that can be missed on CXR
A
1L
16
Q
Acute lithium overdose management
A
Whole bowel irrigation
17
Q
Isopropyl alcohol ingestion lab finding
A
Osmolar gap
No anion gap
18
Q
Bronchilitis sign of impending failure
A
Increase retractions
Decrease breath sounds
Decrease responsiveness
19
Q
Herberden nodes associated with which arthritis
A
Osteo
20
Q
CO vs cyanide poisoning
A
Cyanide extremely high lactate
CO carboxyhemoglobin > 10% to be toxic
21
Q
Homeless
Metabolic acidosis
Optic neuropathy
Toxin? And metabolite
A
Methanol
Formic acid
22
Q
Snake bite with systemic signs type
A
Coral snake
23
Q
Pneumomediastinum management
A
If isolated issue
Supportive care
24
Q
HF exacerbation related to aortic stenosis best tx
A
Bipap
Lasix and nitro drop preload
25
Repeat dvt presentation test
Repeat duplex
26
Paronychia tx
I&d and cephalexin if immuncomp/steroids
27
Hypothyroidism associated lab abnl
Hyponatremia
28
Migrating arthritis
Fever
Skin lesions
Dx
Disseminated gonorrhea
29
Crohns exam findings
Full thickness bowel lesions
| Abscess
30
How many does post chemo does neutropenia happen
7-14 days
31
Universal donor for FFP
AB
32
Cyanide treatment
Hydroxocobalamine
33
Schizoid characteristics
Avoids relationships
34
Routine care for sexual assault
```
Empiric abx for sti
Hep B vaccine if not
HIV exposure meds
HPV vaccine
Emergency contraceptive
```
35
Contraindication methotrexate for ectopic
Unstable
Ruptured
Sac > 4cm
Fetal heart activity
36
Febrile infant between 30-60 days old eval
Urine and blood cultures to start, don’t need LP
37
Most common bugs causing food borne disease
Salmonella
| Campy
38
Post strep glom lab finding, not antibody test
Decreased C3
39
Knee aspiration method
Anterolateral towards femur
40
Febrile kiddo for 5 days management
UA and PO challenge
41
Intusseception in adult tx
Exploratory lap
42
Kiddo with vesicles and ulcers in posterior pharynx dx and cause
Herpangina
| Cocksakie
43
Serve malaria drug tx
Artesunate
44
When to medicate SVT
5cm from the deep system
45
Myocardial contusion post complication most likely
Pericardial effusion
46
Contraindication to LP
Vertebral trauma, overlying infection, CNS mass, spinal mass, plt 20, cogulopathy
47
Intracranial bleed BP goal
Systolic 140-180
48
Best test for ACL
Lachman better than anterior draw
49
Isolated pleural effusion with no other findings consider
PE
50
Bowel obstruction kid dx and tx
Volvulus/malrotarion
| Surgery
51
Lithium toxicity due to meds
Hydroclorothiazide, ACEi or ARBs, NSAID
52
Viral labyrinthitis tx
Steroids
53
Inj ass with posterior hip dislocation
Acetabular frx
54
Necrotizing entercolitis tx
NG tube
55
G6PD def lab finding
Heinz bodies peripheral smear
56
New murmur, multiple joint pain, fever dx
Rheumatic fever
57
Ketamine dose for agitation and procedural sedation
1-2mg/kg IV
58
Scleroderma renal crisis UA
Normal
59
Highest sensitivity and specificity for gonorrhea and chlamydia
Vaginal or cervical PCR
60
Lab test indicative of cirrhosis
Thrombocytopenia
61
Type 1 hypersentiviry is
Anaphylaxis, hives
62
Pneumomediastinum healthy young person next step
Dx home
63
ST elevation in aVR and/or V1 where is MI
Left main
64
Rust ring tx
Optho follow up 24 hours
65
COPD exacerbation with prior pseudomonas infections abx choice
Cipro
66
Fail Romberg with eyes closed cause
Vestibular, need eyes
67
Recent dental extraction, severe pain dx
Dry socket
| Acute alveolar osteitis
68
Azithromycin in HIV Pt is for
When CD4 count is below 50 for MAC risk
69
Most likely complication of endometriosis
Infertility
70
Nigerian with info def most likely cause
Beta thalassemia
71
Septal hematoma tx
I&D
72
Watery Diarrhea most likely bug
Rotavirus
73
Peritoneal dialysis Pt with peritonitis tx
Intraperitoneal abx
74
Alcoholic pneumonia abx choice
Azithromycin and ceftriaxone
| Do not do anaerobic coverage unless abscess or empyema
75
Probable abdominal injury persistently hypotensive with negative FAST tx
Ex lap
76
Most combine bug for
| Osteo
Staph
77
Loud diastolic murmur with wide pulse pressure
Aortic regurgitation
78
Hydrogen sulfide tx
Sodium nitrite
79
Serotonin syndrome antidote
Cyproheptadine
80
Hepatorenal syndrome histo of kidneys
Normal
81
HTN before 24 weeks of pregnancy dx
Molar pregnancy
82
Ehrlichiosis tx in child
Doxycycline
83
Cyanotic baby likelt cardiac defect, egg on string, but is not better with squatting dx and tx
Transposition of arteries
| Prostaglandin E
84
Enlarged ltmph node in neck in old chacetic is and ass with
Virchow node
| Gastric cancer
85
Ranson score ast and glucose leveks
250
| 200
86
Munchausen is also called
Factitious disorder
87
First symypoms aortic stenosis
Shortness of breath
88
Overdose diltiazem persotent hypotentsive bradycarida adter fluids, calcium and atropine tx
Insulin and glucose (pacing might not work)
89
Painful squishy bullae dx
Pemphigus vulgaris
90
Dc anaphylaxais rx beside epi
No others recommended
91
Post exposure pertusis adult tx
Azithro 500 then 250 from 2-5 days
92
Maintenance fluids kids calc
100 cc/kg for first 10 kg + 50 cc/kg for next 10 + 20 cc/kg for rest
93
Refractory anaphylaixs to epi on beta blocker tx
Glucagon, beta blocking epi
94
Sickle cell and blood in anyerior chamber avoid
Acetazolamide causes sickling and increase pressure
95
Leg swelling and pin no clot risk factors testing
D-dimer and if neg dc
96
Tx syphilis
Onde dose IM pencillin
97
Red and itchy tip of oenis dx and tx
Balantitis
| Clotrimazole cream
98
Most common cause chorea no genetic
Stroke
99
Spiral frx in what age is ok
9 month to 3 years
100
Septic with hernia nwxt step
Surg consult
| Dont reduce will make sepsis worse
101
Young adult constipated with volvulos on xray dx
Cecal volvulos (sigmoid is old pt)
102
Radiation exposure signs of sig exposure
Decrease lymphocyte
| Vomiting
103
Mycotic aneursym cause
By septic emboli usualy endocarditis
104
Torsade no pulse tx
Defib regardless of energy
105
Cardiac complication f hyperthyroid
Cardiomyopthy > high output failure from tachy
106
Fat embolism syndrome is and presents as
Embolism everywhere
| Resp distress, altered, petechial rash
107
When to give HIV pt witu PCP steroids
Hypoxia
| PaO2 less than 70 or a-a gradient more than 35
108
Neceotizing enterocolitis presents in age pts
First three weeks
109
DVT distal when to tx
If symptomatic
110
Fast high rate, weight loss, heat intolerance on amio dx
Hyperthyroid
111
When to tx lobar pna with vanc and zosyn
Recent antibiotics or prior clx wirh staph or pseudomonas
112
Ethylene glycol poisoing need supplement what
Thiamin and B6 (used up in metabolism)
113
MS flare tx
Steroids (interferon is maintenance)
114
Hypotensive pelvic trauma OR or IR
OR and pack
115
Distal finger fracture what splint
DIP extension only
116
The forst acidnbase abnl in asa od
Respirstory alkalosis, asa makes you breath fast
| Then metabolic acidosis
117
Most common hernia innwomen
Inguinal
118
Erythema nodosum ass with
Strep infxn
119
Side effect of prostaglandin
Apnea, hypotension, hyperthermia
120
Febrile seizures stop at age
5
121
Corneal ulcer abx coverage in contact wearer
Tobramycin
| Cipro
122
Elevated calcium in sarcoidosis is from
Macrophage production of calcitriol
123
Test for severity of bleeding in placentsl abruption
Fibrinogen
124
Most commin oresentstion of hypertrophic cardiomyopathy
Shortness of breath
125
Young pt gum bleed and noseblleds woth petechial rash and low plt tx
Steroids for ITP
126
Reed sternberg cells ass with what dx
Hodgkin lymphoma
127
Minor mvc pregnant no sx next step
Give rhogam
128
Painful red knee, with mild white count in knee, neg gram stain and neg crytsals what is it
Lyme or reactive arthritis
129
Ct finding for cebreal venous thrombosis
Delta sign
130
Preseptal vs orbital cellulitis
Not painful with movement
131
Facial frx le fort numbers mean
1 maxilla
2 max and nose
3 max, nose and cheeks
132
Glyburide is what kind of drug
Sulfonyurea
133
Direct vs indirect ingunial hernia
Indirect down into scrotum
| Direct into abdominal wall
134
Flexion tesrdrop fracture is what
Unstable
135
Blotchy rahs that coalesced and heat worsens it dx
Rheumatic fever
136
10 day old, cyanosis what congentical defect
Transposition of great vessels
137
Most common comprtment in lower leg for compartment syndrome and ass lack of function
Anterior
| Dorsiflexion
138
Viral meningitis lp
Some wbc, but not that high
Normal protein (bacteria is high)
Glucose is low in everything
139
Esophagitis in hiv pt
CD4 is 90
Dx
Candida
| CMV is CD4 50 or less and tend to have fever and burning pain
140
Thyroid storm med order
Propanalol (control sympathetic hyperactivit)
PTU (or meth to prevent thryoid hormon and before iodid whoch can increase)
iodide, steroids
141
DKA when to given insulin and potasium
K 3.5 to 5.5
142
Cd4 vs cd8 organ rejection
4 is chrinic and 8 is acute
143
Enterococcus uti abx
Amoxicillin, resists others
144
Dissection cusijg neuro sx on what side
Opposite side of vessel
145
Testiculr torsion tx
Medial to later more than 360 degrees
146
Cholrine gas exposure is from im industrial setting from what
Chloramine (ammonia and blech mixed)
147
Amox/sulbactam is what abx
Unysyn
148
Oral infxn woth fever abx choice
Unasyn over augmentin
149
Endometritis abx
Clinda and gent
150
S/p FB from ear tx
Cipro drops and close follow up
151
Concern for ludwigs next step
Early intubation
152
Refeesing sundrome most common electrolyte abnl
Low phos, also loe K and Mg
153
When give trtanus imminuglobin
If they never got their childhood series
154
URI sx followed by toxic, increase work of breathing, stridor dx and cause
Bacterial tracheoitis
| Staph
155
Iron toxicity causes
GI sx, metabolic acidosis, liver failure
156
Felon define
Fingertip abcess
157
Left main EKG findings
St elevation in aVR, with depressions in inferior leads
158
Tx acute dystonic rxn from new osych med
Benadryl or beztropine
159
Thyroid storm meds mechanism
Steroid and propanalol peripheral conversion
PTU and meth synthesis
Iodine stored hormone
160
Endometrosis tx
Augmentin
| Or clinda and gent
161
Appy size on US
6-7mm or greater
162
Imaging for hirschprung
Barium enema
163
Young female hearing loss dx
Otosclerosis
164
Define presbycusis
Age related hearing loss
165
Proststis tx length
4-6 weeks
166
Persistent st elevations after mi and treated dx
Ventricular aneurysm
167
Uri them comes back toxic with stridor dx
Bacterial tracheitis
168
Prevent lyme disese after dinding tick tx
One dose
| Doxy
169
Blowout ocular frx with entrapment can wait 48hrs to see opth outpt
170
Contraindicated in frostbite
Massaging
171
Leg affected in stroke what artery
Anterior, coveres top and middle cleft of brain
| Arm is middle
172
Large gums side in seizure pt from
Phenytoin
173
Neuroleptic malignant syndrome tx
Benzos
174
Perforated eardrum tx
Discharge and follow up
| If obvious signs of infection oral amox
175
Postpartum vaginal bleeding tx
Conjuagted esteogen
176
Food Bug causes preterm labor
Listeria
177
Kid with lower extrmitiy paralysis nl CSF DDX
Tick paralysis
178
Foodboarne bacteria cause illness via preformed toxin
Bacillus
179
G tube fell out less than 4 weeks new tx
Admit for abx and monitor for peritonitis
180
Labs ass with heat stroke
Elevated LFTs
181
Peds code epi dose
0.1 mg/kg
182
What ekg finding supprst VT
Fusion beats
183
Dilated and fixed pupil where is the bleed
Putamen
184
Rocky mountain fever describe rash
Centripetal
185
Kid fall on bike handle comes in with vomiting dx
Doudenal hematoma
186
St depressions in V1 and V2 with cp dx and tx
STEMI posterior
| Cath
187
Transplant rejections options
Hyperacute, acute, chronic
188
Delta for comprtment syndrome
30 or lower
189
Sudden shortness of breath after diving woth rapid ascent dx
Pneumo more common than embolis
190
HIV lobar penoumnia bug
Strep pneumo
191
Post flu pneumonia bug most likely
Strep pneumo
192
Most common macrocytic anemi
Pernicous/ b12 and folate def
193
Bacterial meminigits glucose and protein
Glucose low
| Protein high
194
Viral infection in kid, then HF sx what test and dx
Echo
| Myocarditis
195
Colorado tock fever vs ehrlichiosis
Colorado biphasic fever
| Erhlichosis abnl labs
196
Femur frx concerning for elserly abuse
Midshaft
197
Most common cause of vertigo
BBPV
198
Pericarditis s/p MI dx
Dressler syndrome if one to sveral months out
199
Pyloric stenosis lab abnl
Hypochloremic hypokalemia alkalosis
200
Back pain, blood in urine but UA positive for blood but no RBCs dx and mech
Rhabdo
| Increase calcium in cells
201
Acute mountain sickness elevation onset
6500 ft
202
Smallpox rash first sign
Intraorao enanthem
| Forehead rash starts after as macules
203
HIV prophylaxis best if ststted when
2hrs post
204
Elevated magnesium tx
Fluids for vasodilation
Lasix to help excretion
Calcium for arythmias
205
Broken nose dows not need abx
206
Mono test is called a
Heterophile test
207
Hypithermia tx
Warm the core
208
Bleeding fistula not responding to compression tx
Suture
209
Gasoline exposire managmenet
Obs and cxr
210
AML presenting with fluid overload from white cells tx
Chemo
211
Afrin is
Oxymetazoline
212
Stridor not is resp ditress next step
Xray to dx
213
Febrile but bormal heart rate can be cause by what bug
Samanella typhi
214
Uganda bloddy diarrhea bug
Ebola
215
Scorpion clincal signs
Hyerpsalivate
| Got the jits
216
Gold standard for malrotaion testing
Upper GI
217
Meneire vs labrynthitis dx
Meneire multiple episodes
| Labrynth only one
218
Post LP headsche risk factors
Large bore (20 guage), multiple attemots, cutting needle
219
Isolated peripheral nerve issue testing
Electromyelogrpahy
220
Old guy with prostatist tx
Cipro (not cef amd doxy not sexually)
221
MI most likely need transvenoys pacing
Anterior do to more like unstable
222
SBP bug causes
E coli
| Kleb, prtoteus, entercoccus, strep pneumo, pseudomonas
223
Bullseye rash isolated rahs name
Erythema migrans
| Multiforme is multiple rashes
224
Leading tox morbidity and mortalitiy
CO
225
Deprecompression sickness can happen when
Minutes to hours
226
Type 1 vs 2 depcomoresions sickness
1 - joints and skin
| 2 - lung and brain
227
Lithium causes thyroid issue
Hypothyroid
228
Premie comes back woth poor feeding, tachy, fever
Air in intestines/ necrotizing
229
Tx helps COPD mortslity
Oxygen
230
Cerebellar stroke test that would find cause
Echo show heart and aortic arch
| Carotids dont feed posterior brain
231
Velvety vaginal warts is dx
Syphilus
232
Cancer pleural effusion same profile as infectious
233
Hr and BP goal for aortic dissection
HR<60
| BP 100-120
234
Untavle pepvic frx with neg fast next step
IR
235
Most common sx aortic dissection
CP
236
Indications for hyperbaric for CO
Neuro sx inculding syncope
237
Hydrocarbon huffing caridact arrest tx
Esmolol
238
Steve johnson vs TEN
TEN is worse
239
Tx for MAC infxn
Azithromycin or clarithromycin
| And rifabutin and ethambutol
240
TTP vs ITP
TTP effects everything and tx woth olasma exchange
| ITP plts abd IVIG
241
Glaucoma eye drops
Timolol
| Apraclonidine
