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World week 1 > 5/3 > Flashcards

5/3 Flashcards

1
Q

Why are cephalohematomas limited to surface of one cranial bone

A

Subperiosteal hemorrhages

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2
Q

What is caput succedaneum

A

A diffuse, sometimes ecchymotic swelling of the scalp usually involving the portion of the head presenting during vertex delivery
may cross suture lines

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3
Q

Two big patterns of Crohn’s

A

Fibrostenotic obstructing pattern or penetrating fistulous pattern

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4
Q

GI granulomas w/ what diseases besides CD

A

GI TB
Sarcoidosis
Yersinia infections

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5
Q

What is torus palatinus

A

Fleshy, immobile mass on midline hard palate

young folks

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6
Q

Who should be tested for GC

A

All sexuality active women 24 and younger

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7
Q

Best GC screening test

A

Nucleic acid amplification test

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8
Q

First Workup for missed abortipn

A

Fetal heart tones and pelvic US

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9
Q

Exam of uterine atony

A

Soft (boggy) uterus that is enlarged

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10
Q

What does a thin endometrial stripe on postpartum US mean

A

Empty and normal uterine cavity

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11
Q

4 big risks for uterine atony

A
  1. Prolonged labor
  2. Induction of labor
  3. Operative vaginal delivery
  4. Fetal weight >4000g (8.8 lbs)
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12
Q

Uterine atony tx

A

Bimanual message, IV fluids/O2, and oxytocin (methylergonovine if oxytocin doesn’t work)

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13
Q

Contra to carboprost in uterine atony

A

Asthma (causes bronchial constriction)

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14
Q

Hemodynamic monitoring in septic shock

A

Low PCWP
Low SVR
Increase CO
High mixed venous O2 sat%

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15
Q

What should be suspected in any HTN pt with hypokalemia

A

Primary hyperaldosteronism (these pt’s also more prone to diuretic induced hypoK if not baseline)

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16
Q

MC nutritional def in kids

A

Iron def

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17
Q

Gold standard for HIV dx in kids form birth to 18 months? why?

A

PCR –> HIV ab testing unreliable due to passing of maternal antibodies to fetus

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18
Q

CT of porcelain gallbladder? inc risk of?

A

Calcified rim in gallbladder wall with central bile-filled dark area
Inc risk of gallbladder adenocarcinoma

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19
Q

What should raise suspicion for MAC in aid’s pt

A

Non spec systemic symptoms (fever, cough, diarrhea) plus splenomegaly and elevated alk phos

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20
Q

Lyme arthritis features

A

Usually knee

Synovial fluid shows leukocytes around 25k

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21
Q

Dx of lyme arthritis? tx?

A

Confirm with ELISA and western blot

Tx is oral doxy or amoxicillin

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22
Q

B2 (riboflavin) def

A
  • Angular cheilosis, stomatitis, glossitis
  • Normocytic anemia
  • Seborrheic dermatitis**
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23
Q

B6 (pyridoxine def) features

A
  • Cheilosis, stomatitis, glossitis

- Irritability, confusion, depression

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24
Q

Primary solitary brain mets from what cancers

A

Breast, colon, renal cell

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25
Q

Stage 1 hepatic encephalopathy featurs

A

Sleep pattern disturbances and impaired cognition)

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26
Q

Murmur of IVDU endocarditis

A

Tricuspid regurg (holosytolic increasing with inspiration)

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27
Q

Good screening for microalbuminuria

A

urine microalbumin/creatinine ratio

24 urine collection better but inconvenient

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28
Q

Pneumo vaccine for HIV patients

A

PCV 13 1x

PPSV23 8 weeks later, then every 5 years

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29
Q

What is elevated in PCP PNA

A

Serum lactate dehydrogenase

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30
Q

Severe PCP features and tx

A

PaO2 (70 or A-a gradient >35 on room air

TMP-SMX + corticosteroids

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31
Q

Contrast enema of meconium ileus

A

Microcolon (caused by viscous meconium accumulation and obstruction in terminal ileum)
contrast enema can also tx by breaking up

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32
Q

CXR of radiation fibrosis

A

Volume loss with coarse opacities

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33
Q

Aspergilloma CXR

A

Mobile intra-cavity mass with an air crescent in the periphery

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34
Q

Most common paraneoplastic syndrome with squamous cell lung Ca

A

Hypercalcemia from PTrP

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35
Q

Mixed cryoglobulinemia features

A

Hep C usually

Arthralgia’s, palpable purprua, and elevated transaminase + nephrotic syndrome

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36
Q

Risk calculation

A

Divide number of diseased subjects by overall subjects at risk

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37
Q

What causes Zener’s diverticulum

A

Posterior herniation b/w the fibers of the cricopharyngeal muscle

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38
Q

If test result is negative, probability of having the disease formula

A

1- negative predictive value

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39
Q

Sarcoidosis big symptoms

A

Cough, erythema nodosum, anterior uveitis, and arthritis

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40
Q

Metformin should not be given with what acutely ill patients

A

Acute renal failure, liver failure, or sepsis

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41
Q

Chronic cough that is worse at night likely? Workup?

A

Asthma

PFTs for workup

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42
Q

Varicella post exposure ppx for healthy and immunocompromised

A

Healthy: Varicella vaccine w/in 3-5 days
Immunocompromised: varicella zoster Ig

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43
Q

Varicella complications

A

Bacterial superinfection in children

Pneumonia in adults

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44
Q

Akathisia tx

A

Propranolol or lorazepam

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45
Q

New antipsychotic med and pt won’t sit down think

A

Akathisia

46
Q

Initial massive hemoptysis mgmt

A

Establish airway, maintain perfusion, and ensure hemodynamic stability
place bleeding lung in dependent position

47
Q

Most common rotator cuff injury? Why

A

Supraspinatus –> repeated bouts of ischemia near its insertion on the humerus induced by compression b/w humerus and acromion

48
Q

Positive drop arm test in shoulder injury

A

Rotator cuff tear

49
Q

Acalculous cholecystisis presentation

A

Unexplained fever an RUQ pain in severe sick

Leukocytosis on lab

50
Q

Physiologic leukorrhea

A

Copious white vaginal d/c that doesn’t stink and no other findings

51
Q

Mild hyperkalemia in ckd pt tx

A

Remove K from body w/ loop diuretics (driving into cells will only transiently change)

52
Q

What should be suspected in all children w/ recurrent intussusception

A

Meckels (most common GI abnormality)

53
Q

Sporadic burkitt’s lymphoma often affects

A

Distal ileum

54
Q

When to operate on a hydrocele? why?

A

After 1 year old, due to risk of inguinal hernia

55
Q

Physical/sexual child abuse risk factors

A
  1. Unexplained changes in behavior or scholastic performance
  2. Unstable family economic conditions
  3. Caregiver hx of substance abuse
56
Q

Focal nodular hyperplasia in liver features

A
  • Ass w/ anomalous arteries

- Arterial flow and central scar on imaging

57
Q

Elevated what in hepatocellular adenoma

A

Alpha fetoprotein

58
Q

COPD exacerbation 3 features

A
  1. Increased dyspnea
  2. Cough
  3. Sputum production change
59
Q

Drug induced parkinsonism tx

A

Benztropine or Diphenhydramine

60
Q

AIDs exposure ppx

A

Tenofovir-emtricitabine w/ raltegravir

61
Q

Detrusor instability w/ what type of urinary incontenence

A

Urge

62
Q

How can an epidural cause sustained bladder dysfunction

A

Over distends it, causing impaired ability to contract causing retention and overflow incontinence

63
Q

ITP tx when platelets below 30k

A

IvIg or glucocorticoids

platelet transfusion rare because it can cause further platelet destruction–> only in very severe cases

64
Q

Common complication of intraventricular hemorrhage in neonates

A

Communicating hydrocephalus –> blood irritates arachnoid villi, impairing its ability to reabsorb CSF

65
Q

Lights criteria**

A

Exudate if:

  1. Pleural protein/serum > 0.5
  2. Pleural LDH/serum > 0.6
  3. Pleural fluid LDH > 2/3 upper limit normal for serum
66
Q

Plural fluid glucose

A

Empyema or rheumatic effusion

-Due to high metabolic activity of leukocytes/bacteria in fluid

67
Q

What is a hepatic hydrothorax

A

Increased permeability of right hemidiaphragm leading to R pleural effusion in cirrhosis (transudate)

68
Q

Why is R kidney easier to palpate that left

A

Lies lower than left kidney

69
Q

ADPKD exam

A

HTN and palpable kidneys

70
Q

Increased levels of what in hemolytic anemia

A

LDH and bilirubin

71
Q

Elevated alk phos out of proportion to LFTs suggest

A

Intrahepatic cholestasis or biliary obstruction

72
Q

Best test for histo in immunocompromised pt’s

A

Urine or serum assay for histoplasma antigen

73
Q

Tx for histo

A

Itraconazole

Ampho if really really bad

74
Q

Treatment resistant schizophrenia drug

A

Clozapine (after 2 failed trials)

75
Q

What causes intermittent claudication

A

Atherosclerotic narrowing of the arteries feeding the leg

76
Q

Why is cooking bad for folate

A

Folate is heat sensitive

77
Q

How long for B12 to be depleted in healthy adults

A

3-4 years

78
Q

Suspect Diamond-Blackfan syndrome in who

A

In a child with microcytic anemia, low retic count, and congenital anomalies

79
Q

Absent thumbs in what disease

A

Fanconi’s anemia

80
Q

Preferred tx for MCL tears

A

Early ambulation (rarely surgery)

81
Q

Hyperthyroid induced myopathy favors what

A

Proximal hip flexors and quadriceps, can progress to involve proximal muscles of UE

82
Q

Most common DM neuropathy

A

Symmetric and distal sensorimotor polyneuropathy

83
Q

Chorioamnionits dx with maternal fever plus what?

A

1 of: Uterine tenderness, maternal or fetal tach, malodorous amniotic fluid, or purulent vaginal discharge

84
Q

What are tocolytics for

A

To prevent labor

85
Q

Why iron def in celiac dz

A

Poor iron absorption secondary to duodenal villous atrophy

86
Q

2 common ass. w/ celiac dz

A

Type 1 DM and Dermatitis herpetiformis

87
Q

What causes Meckels

A

Incomplete obliteration of the fetal vitelline (omphalomesenteric) duct

88
Q

What does pos anserinus pain syndrome present with

A

Localized pain and tenderness over the anteromedial part of the tibial plateu just below the just line of the knee

89
Q

Where does patellofemoral syndrome hurt? what makes it worse

A

Anterior knee pain

Worse with activity of prolonged sitting (sustained flexion)

90
Q

3 types of diabetic retinopathy

A
  1. Background (simple) - micro aneurysms, hemorrhages, exudate and edema
  2. Pre-proliferative - with cotton wool spots
  3. Proliferative - newly formed vessels
91
Q

What part of vision does macular degeneration affect

A

Central vision

92
Q

Characteristic systemic blasto features

A

Ulcerated skin lesions and lytic bone lesions

93
Q

What is Small intestine bacterial overgrowth ? dx?

A

Malabsorption due to anatomic or dysmotility disorders with bloating, flatuence, and diarrhea
Dx: endoscopy with jejunal aspirate showing >10(5) organisms/mL

94
Q

What should a healthy 6 month old baby be able to do

A

Sit momentarily on propped hands, transfer objects from hand to hand, and respond to name

95
Q

What is the Hawthorne effect

A

Tendency os study population to affect the outcome since they are aware they are being studied

96
Q

Congenital syphillis

A

Hepatosplenomegaly, cutaneous lesions, jaundice, and rhinorrhea

97
Q

Congenital rubella

A

Sensonerual hearing loss, cataracts, HEART DEFECTS, blueberry muffin rash

98
Q

Nocardia micro

A

Filamentous, aerobic, gram + acid fast bacteria

99
Q

Rickets exam findings

A

Craniotabes, rachitic rosary, and gene varum

100
Q

What should be immediately ruled out in a patient presenting with sudden onset severe SOB

A

Upper airway obstruction

101
Q

Quad screen of trisomy 21

A

Dec A-fetoprotien and estriol

Inc B HCG

102
Q

Quad Screen of trisomy 18

A

Dec A-feto and estriol

DEC B -HCG

103
Q

Inhibin A in quad screen of trisomy 18 vs 21

A

18: Normal
21: Increased

104
Q

DOC to treat opiod withdrawal

A

Methadone

105
Q

Raising the cutoff of a test (smaller inclusion) effect on sensitivity and specificity

A

Increases specificity
Decreases sensitivity
(false and true positives decrease)

106
Q

3 big causes of symmetric IUGR

A

-Genetic disorders (aneuploidy)
-Congential heart dz
-Intrauterin infection
(fetal factors)

107
Q

Substance abuse disorder causes what kind of IUGR

A

Asymmetric (maternal factor)

108
Q

DOC for stabilizing bony mets

A

Bisphosphonates (presents hypercalcemia of malignancy and pathologic fractures)

109
Q

What is calcinosis cutis

A

Deposition of Ca and PO4 in the skin –> scattered whitish papules, plaques or nodules

110
Q

Chronic tophaceous gout tumors

A

Chalky white

111
Q

Extra-renal manifestations of ADPKD

A
  1. Hepatic cysts (most common(
  2. Berry aneurysms
  3. Valvular heart dz (MVP and aortic regurg)
  4. Colonic diverticula
  5. Abdominal wall and inguinal hernia
112
Q

Heated cysts from? features?

A

Areas where sheep are raised
Fluid filled cysts with an inner germinal layer and outer acellular laminated membrane (germinal layers give rise to 2ndary daughter cysts)

World week 1 (17 decks)

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