11.7 Flashcards by Moniyka Sachar

impaired cough and shallow breathing

hypoxia
increased RR
low pCO2

= atelactasis = loss of lung volume

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ppx of atelectasis

pain control ICS direct coughing early mobilization

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oozing from venipuncture sites
sepsis
trauma
malignancy
OB c/b

DIC
long PT/PTT
low fibrinogen
high D-dimer
schisotcytes

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dilated fluid filled stomach
dilated proximal intestinal segment
no intraluminal fluid in rest of bowel

duodenal atresia

causes: polyhydramnios bc you can’t swallow

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VACTERL

vertebral
anal atresia
cardiac
TE fistula
esophageal /duodenal atresia
renal 
limb

if any defect, need to evaluate for the rest of these

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associations of duodenal atresia

downs

VACTERL

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COL1A1 defect

osteogenesis imperfect

frequ fractures
blue sclera
conductive hearing loss
dental  issues
joints hypermobile

(only T2 is lethal)

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chlamydia and gonorrhea in women

cervicities
urethrtisi perihepatitis

tx:

chlam: azithro
gono: both azithro + CTX

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PID can be c/b

tubo ovarian abscess = fever + adnexal mass

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degenerating subserosal uterine leiomycoma

abdominal pain
fever
irregularly enlarged focally tender uterus

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ground glass ovary on U/S

endometriosis

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adnexal mass w/ solid components + hyperechoic nodules

mature cystic teratomya

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symmetric juvenile arthritis versus asymmetric juvenile arthritis?

symmetrical: JIA: tx w/ naproxen, will be worse in AM

asymmetric:
if vesiculopustual lesions: gonococcal arthritis = tx w/ CTX

if erythema migrains, lyme, tx w/ doxy

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painful, fluctuant mass 4-5cm cephalad to anus w/ purulent blood drainage

pilonidal disease = infected hair follicle

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perianal fistula vs abscess

fistula = drains purulent material

abscess = does not drain

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sudden onset RDS, hypoxia, shock, or cardiac arrest s/p CVC placement, PPV, or neurosurgery

venous air embolism = can go to RV outflow tract and cause an obstruction

leads to dyspnea, RDS, obstructive shock causing cardiac arrest

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discomfort, heaviness of scrotum, pampiniform plexus increases w valsalva

varicocele, increases infertility and testicular atrophy

if BL, c/f malignancy

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GBS - ascending weakness + areflexia + high protein on CSF w/ abnormal EMG/NCS, ENHANCEMENTS OF ANTERIOR NERVE ROOTS ADN CAUDA EQUINA

TX?

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1) SPIROMETRY TO DETERMINE MUSCLE STRENGTH
IF LOW fvc, THEN YOU NEED TO INTUBATE

2) if severe dysautonomia, widened pulse, RDS, or low FVC, then intubate

otherwise IVIG

In which settings can succinylcholine use cause hyperkalemia?

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skeletal mm trauma
burn injury
stroke
GBS

postsynpatic ach receptors are upregulated in these conditions, so instead use vecuronium and recuronium

3 wk hx of weight loss abdominal pain nausea plus hypotension and lyte abnormaliites

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addison’s disease

SIADH

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hypotonic hyponatremia

serum osm<275 = LOW
urine osm>100 = HIGH
urine sodium >40 = HIGH

nitrates work by?

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systemic vasodilation
decreased cardiac preload
decrease in LVEDV
reduction in LV stress
decreased in oxygen demand

pleural effusion w/ glucose<50 and high LDH could be

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empyema
cancer
TB
RA

when do you not give a beta blocker in acute MI?

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hypotension
bradycardia
acute HF
heart block

when do you give atropine in acute MI?

unstable sinus brady

when do you not give nitrates in acute MI

if hypotensive right ventricular infarct severe aortic stenosis

in metabolic acidosis, what is the urine pH

high, because the kidneys release extra bicarbb to alkalinize the urine and hold onto extra H+

what happens to aldosterone in contraction alkalosis

when volume contracts, aldosterone goes up to resolve intravsacular volume and results in H+ loss and Na+ retention

what drugs cause a false + PCP test?

``` dextromethorphan diphenhydramine ketamine tramadol venlafaxine ```

``` hypotension bradycardia bronchospasm altered mental status seizures ```

BB toxicity tx w. fluids, atropine, and glucagon

TB tests ranges that you can do nothing about <5 mm <10 <15

<5 HIV+ patients, recent CONTACTS of known TB, NODULAR/FIBROTIC CHANGES on CXR c/w prior healed TB, ORGAN transplant recipients <10: IMMIGRANTS, IV DRUGS, prisons, shelters, hospitals, lab workers, CHRONIC DISEASE (DM, LEUKEMIA, ESRD), KIDS<4 <15 everyone else

If TB test is positive but negative chest x ray how do you treat?

9 months of INH + pyridoxine or 4 mos of rifampin

how to treat active TB

RIPE for 8 weeks then I+R for 4 months

AUB management

<45 =OCP | >45 OR FAILED OCP OR OBESE or on tamoxifen = endometrial biopsy

if psychosis in PD, what do you do?

reduce carbidopa levodopa unless resurgent motor symptoms, then treat w/ quetiapine

high testosterone high estrogen no LH surge = no follicle maturation

PCOS

FTT, diarrhea, LAD, PCP pneumonia in infant =

HIV in infant | tx w/ immediate ART

In pulmonary fibrosis what happens to A-A gradient?

increased, and decreased diffusion capacity for CO

stealing objects of low monetary value and not needed for personal use

kleptomania

blunt chest trauma w/ tension pneumo + crepitus --> despite CT, rapid reaccumulation OF PTX & rapid airleak of CT

bronchial rupture

intermittent abdominal pain after eating decreased food consumption weight loss

mesenteric ischemia dx w/ mesenteric angiography

How to treat ischemic stroke in SCD?

exchange transfusion (or simple transfusion) heparin is not given in stroke

how to manage primary amenorrhea

pelvic ultrasound to exclude anatomic abnmls

what is primary amenorrhea

no period at age>15 but breasts no period at age>13 and no breasts

11.7 Flashcards

(44 cards)