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Flashcards in 5/10 Deck (80)
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1

Who is ECT best for

Depressed geriatric patients who are not eating, drinking, psychotic, or actively suicidal

2

3 systems TCA overdose involved

1. CNS (seizures, coma)
2. Anticholinergic
3. Cardiac

3

TCA effect on myocardium

Inhibits fast Na channels in the His-Purkinje system and myocardium

4

Cardioprotection for TCA overdose

Sodium bicarb (when QRS inc. pH and extracellular sodium, deceasing drug avidity for Na channels

5

Pneuomo vaccine for high risk pt's (not very high risk)

PPSV23 alone at 19-64
*then normal schedule at 65*

6

All pt's w/ bilateral Carpal tunnel should be screened for

Hypothyroidism

7

Two common complications w/ SS trait

1. Hematuria from sickling in the renal medulla
2. Isosthenuria (impaired concentrating ability)

8

What kind of Anemia does B6 def cause

Sideroblastic (microcytic but elevated total serum iron and dec TIBC)

9

2 Tet murmurs

1. Harsh systolic ejection murmur at left upper sternal border
2. Single S2 (from pulmonary stenosis)

10

Tx for any pt post stent placement

Dual anti platelet (aspirin and P2y12 receptor blocker)

11

Big B and T cell markers

B = CD19
T=CD3

12

What causes B-cell dysfunction in SCID

Absent T cells

13

What kids should get a renal US w/ UTI

-All under 24 months (when febrile)
-Recurrent in any age
-Fam hx or poor response to Ab

14

Typical x-ray of supracondylar fracture of the humerus

Triangular anterior fat pad and posterior fat pad (lucent on X-ray)

15

Two late findings of compartment syndrome

Pulselessnes and paralysis

16

Red flags for orbital cellulitis vs preseptal

1. Decreased visual acuity
2. Diplopia
3. Ophthalmoplegia
4. Proptosis

17

Hyperandrogenism during pregnancy usually from

Ovarian masses (Luteoma - bilateral and solid)

18

Bilateral theca lutein cyst ass w/

Molar pregnancy and multiple gestation

19

First step for suspected VAP, then what?

1. CXR
2. Lower respiratory tract sampling and empiric antibiotics

20

What is Enthesitis

Inflammation and pain at sites of tendon and ligament attachment to bone
Commonly found in AS

21

Metastatic bone pain features

Constant progressive pain that wakes the patient up at night

22

Common clinical features of Vasa previa

-Painless vaginal bleeding that occurs with rupture of membranes
-Fetal deterioation (sinusoidal tracing or brady)
-Maternal vital signs unchanged as bleeding comes from fetus

23

Retinal harmartoma typical of

Tuberous sclerosis

24

What is primidone? what can it cause?

Anticonvulsant that converts phenylethylmalonamide and phenobarbital
Can cause acute intermittent porphyria

25

Acute intermittent porphyria symptos

Abdominal pain, neuralgic and psychiatric abnormalities

26

Anemia on methotrexate

Macrocytic

27

Antimitochondrial Ab for

Primary biliary cholangitis

28

What must be done if a patient on warfarin needs emergent surgery

Reversal with FFP

29

What causes itchy butt worms? tx?

Enterobius vermicularis
Tx is Albenazole

30

Most common neuro symptoms of HHS

1. Decreased consciousness (MCC)
2. Blurred vision

31

What is positive in UC

p-ANCA (also see it w/ AS)

32

What causes symptoms in cardiac tamponade

Exaggerated shift of inter ventricular septum toward left ventricular cavity, which reduces left ventricular pre-load, SV, and cardiac output

33

Leukemoid reaction vs CML

1. High LAP score
2. Greater proportion of late neutrophil pre-cursors
3. Lack of absolute basophilia

34

Tx for complicated diverticulitis w/ abscess formation

CT-Guided percutaneous drainage

35

Who gets nasopharyngeal carcinoma? ass w/?

Mediterranean and far est
Ass w/ EBV infection

36

Nasopharyngeal carcinoma presentatoin

Recurrent otitis media (from eustachian tube obstruction by tumor)
Recurrent epistaxis
Nasal obstruction

37

Lichen sclerosis exam

Porcelain-white atrophy and "cigarette paper" skin
*punch biopsy these*

38

Hyatic cyst buzzword

Cystic hepatic lesion with eggshell calcification

39

Hyatid cyst tx

Surgical resection under the cover of albenazole

40

How does dipyridamole cause coronary steal

Redistributes blood flow to non-disease segments (diseased segments already maximally dilated)

41

Suspect leprosy in who? how do you dx

Asian patient with an insensate, hypo pigmented patch of skin
Dx by acid fast bacilli on skin biopsy

42

Randomization used to control what in a study

Confounders

43

First line tx of atopic dermatitis

Topical emoilments

44

How can SS cause folate def

Increased red blood cell turnover and increased consumption of folate in bone marrow

45

What should be suspected in a cyanotic infant w/ LAD

Tricuspid valve atresia

46

Goodpastures dx by

Renal biopsy showing linear IgG antibodies along the glomerula basement membrane

47

Laryngomalacia features

-Inspiratory stridor what worsens in the supine position and w/ crying
-Peaks at 4-8 months
-Dx w/ flexible laryngoscopy

48

NNT formula

1/ARR

49

ARR formula

Incidence without treatment - incidence with treatment

50

Underlying pathology of lacunar strokes

Microantheroma and lipohyalinosis

51

Most common site for a lacunar infarct w/ features

Internal capsule --> pure motor stroke (w face, arm and leg equally)

52

Exam of open angle glaucoma

Cupping of the optic disk w/ loss of peripheral vision

53

Open angle glaucoma first line

Timolol eye drops

54

Tina capitis treatment

Oral griseofulvin

55

2 mCC of epilgottitis in adults

H influenza
Streptocus progenies

56

MC complication seen post thyroidectomy

Hypocalcemia

57

MC presenting symptoms of whipples disease

Chronic malabsorptive diarrhea, weight loss, migratory arthritis, lymphadenopathy, and low grade fever

58

Anti-neutrophil cytoplasmic antibodies ass w/

Wegener's (granulomatosis w/ polyangitis)

59

Ab ass w/ systemic sclerosis

Anti-nuclear
Anti-topoisomerase-1

60

First line for osteoarthritis pain

Acetaminophen

61

Fatigue and dyspnea w/ splenomegaly and reticulocytosis

Autoimmune hemolytic anemia

62

Liver abscess + Mexican + recent bloody diarrhea

Amebiasis w/ Entamoeba histolytic
Tx Metronidazole

63

What has decreased passive and active range of motion int he shoulder

Adhesive capsulitis

64

Classic presentation with a clavicle fracture kid walks in

Supporter w/ contralateral hand

65

Thiazide diuretics metabolic AE**

Hyperglycemia
Increased LDL cholesterol and plasma triglycerides

66

Thiazide electrolyte abnormalities

Hyponatremia
Hypokalemia
Hypercalcemia

67

Postpartum endometritis tx

Iv Clindamycin and gentamicin

68

Why is GERD more common in kids

1. Shorter esophagus
2. Incomplete closure of LES
3. Grat time spent in the supine position

69

A puncture wound in an adult resulting in osteomyelitis most likely due to

Pseudomonas aeruginosa

70

Acute liver failure most often due to

1. Acute viral hepatitis
2. Acetaminophen toxicity
3. ischemic hepatopathy (shock liver)

71

When did blood start getting tested for Hep C

1992

72

UA w/ normal appearing RBCs

Papillary necrosis

73

Classic extra pulmonary manifestation of mycoplasma pneumonia

Erythema multiforme

74

Drug that inhibits ventricular remodeling after MI

ACE inhibitors

75

Lung contusion CXR

Patchy, irregular alveolar infiltrates

76

Bite from family dog w/ unknown rabies exposure

Observe animal for 10 days
Don't start PEP yet

77

Wide complex tachycardia drug

Amioderone or lidocaine

78

Narrow complex (SVT) drug

Adenosine or vagal manuevers
*Can unmask "hidden" P waves in pt's with a-flutter or atrial tachycardia*

79

Cryptococcal meningitis

Amphoteric B + flucytosine

80

CT scan and colonoscopy of ischemic colitis

CT: Thickening of the bowel wall
Colonoscopy: Cyanotic mucosa and hemorrhage ulcerations