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Flashcards in 5/4 Deck (91)
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1

Spinal chord compression workup

Surgery consult
Neuroimaging
IV steroid (maybe)

2

How long to treat a single episode of depression

6 months

3

Ethylene glycol tox

Hypocalcemia and calcium oxalate deposition in kidneys
-->Massive anion gap (HCO3

4

Ethylene glycol tx tx

Fomepizole or ethanol to inhibit alcohol dehydrogenase
*can also give sodium bicarb to alleviate acidosis*

5

Cat bite bacteria to worry about and tx

Pasturella
Tx w/ Amox/clavulanate

6

Growth and weight by 1 year old

Weight should triple
Height should increase by 50%

7

PSVT EKG and tx

Sudden onset, regular, and narrow complex tachycardia
Adenosine (slows AV nodal conduction)

8

1st step for A-fib w/ RVR

Rate control with B-blockers or CCB (Dilitazam)

9

Aromatase def features

XX- normal internal genitalia w/ ambiguous external genetalia, literal hypertrophy
High FSH/LH with low estrogen

10

McCune-Albright triad

Cafe au last spots
Polycystic fibrous dysplasia
Endocrine hyperfunction

11

Gold standard for dx'ing VUR

Voiding cystourethrogram

12

Tx for all children w/ a UTI age 2-24 monhs

Renal and bladder US to evaluate for any anomalies that may predispose to VUR

13

When are loop diuretics recommended for SIADH

If urine osmolarity is more than 2x serum osmolarity

14

If a girl has lots of early pubic hair but no breast budding, where is the premature adrenarche coming from

Adrenals

15

What causes isolated precocious puberty

Early HPA activation

16

What should be suspected in a well appearing neonate with painless bloody stools

Milk or soy protein proctoclitis

17

Tx for sphincter of oddi dysfunction

ERCP w/ sphincterotomy

18

2 big causes for pediatric myocarditis

Cox B
Adenovirus

19

Viral myocarditis featuers

Acute left heart failure signs after viral syndrome
Holsytolic murmur from functioning mitral regurg
Hepatomegaly and cardiomegaly

20

Biopsy shows endometrial hyperplasia: next step if atypia? if no atypia?

Atypia: Hysterectomy
No atypia: Progestin therapy

21

2 big burn sepsis bugs

S. aureus
Pseudomonas

22

Spherocytosis tests

Inc. MCHC
Osmotic fragility on acidified glycerol lysis test
Abnormal eosin-5-maleimide binding test

23

A reliable test gives what

Similar results on repeated measurements

24

Transferrin saturation highest in what

Thalassemia (Iron/TIBC)

25

Antipsychotic most likely to increase prolactin

Risperidone

26

Aripiprazole MOA

Partial D2 agonist (rather than antagonist)

27

Epo side affects

1. Worsening of HTN
2. Headaches
3. Flu-like syndrome
4. Red cell aplasia

28

COPD exacerbation tx

1. Supplemental O2 (sat 88-92%)
2. Inhaled bronchodilators (b2 agonist and anticholinergics)
3. Antibiotics
4. Systemic glucocorticoids

29

Mild intermittent asthma

1. Symptoms

30

Acetaminophen OD guidlines

Charcoal if

31

What type of cancer increases Vit D production

All lymphomas

32

CML mutation? tx?

9:22 fusion of BCR/ABLE gene
Tx with imatinib (non-receptor tyrosine kinase inhibitor)

33

What is isolated systolic hypertension? tx?

HTN in elderly patients caused by decreased elasticity of the arterial wall
Tx: thiazide, ACE, or CCB

34

Best drug to slow progression of DM nephropathy

Ace inhibitors

35

Meningococcal vaccination schedule

Age 11-12 (or 13-18 if not before)
Booster at 16-21 (if primary before 16th birthday)

36

1st step when gastric adenocarcinoma is diagnosed

Staging w/ CT scan

37

First line tx for PCOS

Weight loss and COC therapy

38

Surgical hx + bad ab pain + persistent variable decelerations worry about?

Uterine rupture
Do laparotomy and delivery (C-section)

39

Contra to catheter in trauma patient

Obvious pelvic injury or blood at the urethral meatus

40

Chronic tearing that is often unilateral in neonate

Dacryostenosis (nasolacrimal duct obstruction)

41

Endometriosis exam

May show rectovaginal tenderness or tenderness w/ movement of uterus due to tissue in rectovaginal septum, peritoneum, uterosacral ligaments

42

Thickening or uterosacral ligaments on exam

Think endometriosis

43

How does endometriosis incr. infertility risk

Chronic inflammation and adhesion formation

44

Edema in nephritic glomerulonephritis due to

Decreased GFR and retention of Na and H2O by kidneys

45

Breast feeding mastitis tx

Dicloxacillin or cephalexin

46

Things that can cause pulsus paradoxus besides tamponade? why?

Asthma and COPD (due to greatly exaggerated drop in intrathoracic pressure during inspiration)

47

Think what when CT shows gas in gallbladder? who gets it?

Emphysematous colitis
Seen in immunocompromised people (DM)

48

Aortic rupture CXR

Widened mediastinum and left sided hemothorax

49

Food borne vs non infantile botulism

Foodborn- ingestion of preformed C botulinum toxin
Non-foodborne- Ingestion of SPORES from the environment

50

Marfan mutation

Fibrillin-1

51

Visual acuity testing at well child visits

Infants: observe fixation and tracking
Older infants: cover-uncover test
Over 3: visual acuity testing begins

52

Who gets the rotavirus vaccine

2-8 months old (highest risk from severe dehydration at this age range)

53

Children who suffer from selective mutism features

Talkative at home but refuse to speak in specific settings, like school

54

Why gout in myeloproliferative disorders

Excessive turnover of purines and resulting increase in uric acid production

55

Why elevated BUN/Creatinine ratio in upper GI bleed

Increased urea production (from intestinal Hgb breakdown) and increased urea reabsorption (due to hypovolemia)

56

Why angina in aortic stenosis

Increased myocardial oxygen demand due to increased left ventricular mass

57

Hallmark of asbestosis imaging

Pleural plaques

58

Contact lens associated keratitis due to

Pseudomonas and Serratia

59

Eczema herpeticum features

Painful vesicular rash w/ "punched out" erosions and hemorrhagic crusting

60

MCC of death in acromegaly

Cardiovascular

61

Idiopathic (central) precocious puberty seen almost always in

Girls

62

Late onset CAH features

Advanced bone age
Coarse axillary and pubic hair
Severe cystic acne

63

Test to determine central vs peripheral precious puberty

LH level after GnRH stimulation (in gonadotropin independent (peripheral) LH will be low before and after)

64

Triad in disseminated gonococcal disease

1. Polyarthralgia
2. Tenosynovitis
3. Painless vesicopustular skin lesions

65

When should you suspect SBP

Any patient with cirrhosis and ascites accompanied by either fever or change in mental status

66

+ SBP test

Positive ascites fluid culture and neutrophil count >250mm3

67

When is confounding bias present

When at lest part of the exposure-disease relationship can be explained by another variable (confounder)

68

What is notorious for causing refractory hypokalemia

Hypomagnesemia (be sure to correct Mg and K)

69

Acute pancreatitis complicated by hypotension thought to arise from

Intravascular volume loss 2/2 local and systemic vascular endothelial injury

70

Smudge cells seen in

Chronic lymphocytic leukemia

71

What makes alcoholic hallucinations different from DT

24-48 hours of last drink and sensorium remains intact w/ stable vitals

72

GAD tx

SSRI or SNRI

73

What is increased in yolk sac tumor

AFP

74

What is increased in leydig cell tumors

Testosterone and Estrogen (Inc aromatase activity) w/ secondary inhibitio of LH and FSH

75

Most common ped's fracture

Supracondylar fracture of the humerus

76

Most common complication of the supracondylar fracture of the humerus

Entrapment of the brachial artery or median nerve

77

HELLP

Hemolysis
Elevated Liver enzymes
Low Platelets
*Also RUQ pain*

78

What causes pulmonary edema in severe Preeclampsia

Increased systemic vascular resistance, capillary permeability, pulmonary cap hydrostatic pressure, and decreased albumin

79

Primary vaginal cancer characterized by

Bloody malodorous discharge and an irregular vaginal lesions
*dx by biopsy before excision*

80

Aspirin is a common trigger for bronchoconstriction in what asthma patients

Those with chronic rhinitis an nasal polyps

81

What is amantadine

Dopa agonist (PD)

82

Shape of Calcium oxalate crystals

Envelope

83

What is vaginismus caused by

Involuntary contraction of the perineal musculature (psychosocial underlying cause)

84

Two things that help ARDS (vent wise)

Low tidal volumes
PEEP

85

TB common cause of what dz

Primary adrenal insufficiency

86

All patients with precocious puberty and elevated LH should get what

Brain MRI with contrast

87

Primary tx for idiopathic GDPP? why?

RnRH agonist therapy to prevent premature epiphyseal plate fusion and maximize height potential

88

What grave's dz tx can temporarily make graves opthalmopathy worse

Radioactive iodine

89

What drug is contraindicated in acute MI w/ pulmonary edema

B-blockers (but good for MIs without)

90

Rubella vaccine in pregnancy

Not recommended but probably not harmful

91

Tx to reduce hypercalcemia in immobilized people

Hydration and bisphosphonates