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MS3 > Step studying 3 > Flashcards

Step studying 3 Flashcards

1
Q

Define Bipolar I

A

1 manic episode (+/- depressive or hypomanic episode)

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2
Q

Define Bipolar II

A

Hypomanic episode + >/= 1 major depressive episode

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3
Q

What do different fetal decelerations mean

A

VEAL CHOP
o V = variable decelerations . . . C = cord compression
o E = early decelerations . . . H = head compression
o A = acceleration . . . O = oxygenation
o L = late decelerations . . . P = placental insufficiency (fetal hypoxia)

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4
Q

What acid-base abnormality will you see in primary hyperaldosteronism

A

Metabolic alkalosis (due to increased hydrogen excretion)

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5
Q

Best diagnostic test for bronchiectasis

A

CT chest - will show bronchial dilation, lack of airway tapering, and bronchial wall thickening

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6
Q

Name 3 causes of delayed passage of meconium

A
  1. imperforate anus
  2. meconium ileus
  3. Hirschsprung
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7
Q

Diagnosis of imperforate anus

A
  • Physical exam
  • US of anus
  • Cross table x-ray (to determine severity)
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8
Q

What else should you look for in a pt with imperforate anus

A 
Part of a syndrome called VACTERL
•	V = vertebral anomalies
•	A = imperforate Anus
•	C = cardiac
•	T = tracheoesophageal fistula
•	E = esophageal atresia 
•	R = renal
•	L = limb
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9
Q

Cause of meconium ileus

A

Cystic fibrosis = leads to obstruction of the ileum and a narrow, underdeveloped colon

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10
Q

What are the syndromes of defect in bilirubin conjugation

A
  • Neonatal physiologic jaundice (newborns have low UGT activity)
  • Gilbert (mildly low UGT activity)
  • Crigler-Najjar (absence of UGT)
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11
Q

What are the syndromes of impaired transport of bilirubin

A
  • Dubin Johnson (deficiency in bilirubin canalicular transport protein; black liver but clinically benign)
  • Rotor (milder version of Dubin Johnson with no black liver)
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12
Q

What is the difference between breast milk jaundice and breastfeeding jaundige

A
  • Breast feeding jaundice is a problem of quantity (Decreased intake causes decreased stooling and therefore decreased bilirubin elimination and increased intrahepatic circulation)
  • Breast milk is a problem of quality (Thought to be due to human milk causing increase of intestinal absorption of bilirubin)
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13
Q

Tx of breast feeding jaundince

A

Feed baby more

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14
Q

Tx of breast milk jaundice

A

Switch to formula for 12-24 hours, then can resume breast feeding

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15
Q

Diagnosis of pyloric stenosis

A

US will show donut sign/target sign (thickened pylorus)

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16
Q

Tx of pyloric stenosis

A

Pyloromyotomy

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17
Q

What is the difference between duodenal atresia and intestinal atresia

A
  • Duodenal atresia (congenital failure of duodenal development)
  • Intestinal atresia (caused by vascular accidents in utero e.g. mom does cocaine and cuts off blood supply to gut)
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18
Q

Diagnose: Premature neonate + GI bleed

A

Necrotizing enterocolitis

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19
Q

Tx of necrotizing enterocolitis

A

NPO, IVF, TPN

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20
Q

Best diagnostic test of intussusception

A

Air enema

This is also treatment

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21
Q

Where does Meckel diverticulum most often occur

A

2 feet from ileocecal valve (RLQ pain)

22
Q

Diagnosis of Meckels

A

♣ Tc-pertechnetate scintigraphy
• Tc-pertechnetate radioisotope has an affinity for parietal cells of gastric mucosa
• Will have increased uptake in the area of diverticulum due to gastric epithelium

23
Q

Tx of allergic rhinitis

A

Intranasal steroids

24
Q

What should you think of if you see multiple duodenal ulcers

A

Zollinger Ellison

25
Q

Why might Zollinger Ellison cause steatorrhea

A

Excess acid in intestines causes inactivation of pancreatic enzymes

26
Q

What coronary artery supplies

  • Anterior (V1-V6)
  • Inferior (II, III, aVF)
  • Posterior (depression in V1-V3)
  • Lateral (I, aVL, V5, V6)
A
  • Anterior = LAD
  • Inferior = RCA or LCX
  • Posterior = LCX or RCA
  • Lateral = LCX
27
Q

Definition of Pre-eclampsia

A

o New hypertension (>20 weeks gestation)
♣ >140/90 on two occasions at least four hours apart

o Proteinuria
♣ Urine P:C > 0.3
♣ 24hr urine protein > 300mg

28
Q

What are severe features of pre-eclampsia

A
  • Thrombocytopenia (platelets <100,000)
  • Impaired LFTs (2x normal)
  • Renal insufficiency (Cr > 1.1)
  • Pulmonary edema (SOB)
  • New onset cerebral disturbance, or visual impairment (HA, vision changes)
  • Epigastric/RUQ pain
  • BP >160/110
  • Proteinuris >500mg
29
Q

Management of Pre-E w/o severe features

A
  • Deliver at 37 weeks

- Mg typically not needed

30
Q

Management of Pre-E with severe features

A
  • Deliver at >/= 34 weeks
  • O2
  • MgSO4 for seizure ppx
  • Anti-hypertensives if HTN >160/110
31
Q

What antihypertensives are used in Pre-E

A

Labetalol, Hydralazine, Nifedipine

32
Q

Most common complication of sickle cell TRAIT

A

Painless hematuria (due to sickling in renal medulla)

33
Q

What is Centor criteria

A 
•	Used for evaluation of group A strep pharyngitis 
•	Criteria:
o	C = absence of Cough
o	E = tonsillar Exudates
o	N = Nodes (lymphadenopathy)
o	T = temperature >/= 38 C
34
Q

What are the L to R shunts

A

ASD, VSD, PDA

35
Q

What will you hear in ASD

A

Fixed split S2

- increased blood in R heart delays closure of pulmonary valve

36
Q

What is PDA

A

Persistent connection between aorta and pulmonary artery

37
Q

What will you hear in PDA

A

Continuous machine like murmur

38
Q

Tx of PDA

A
  • Indomethacin to close PDA

- Prostaglandins keeps PDA open

39
Q

What are the R to L shunts

A 
o	Truncus arteriosus (1 vessel)
o	Transposition (2 switched vessels)
o	Tricuspid atresia (3 = tri)
o	Tetralogy of Fallot (4 = tetra)
o	TAPVR (5 letters in the name)
40
Q

What is the risk factor for transposition of great vessels

A

Diabetic mother

41
Q

Components of tetralogy of fallot

A

o (a) Pulmonary valve stenosis
o (b) RV hypertrophy
o (c) VSD
o (d) Overriding aorta (sitting over VSD)

42
Q

Tx of croup

A
  • Supportive

- Racemic epi, steroids, O2

43
Q

Tx of epiglottitis

A
  • Intubation in the OR

- IV abx

44
Q

Bug responsible for epiglottitis

A

H. flu

45
Q

Dx of retropharyngeal abscess

A

CT scan

46
Q

Tx of retropharyngeal abscess

A

I&D + IV abx

47
Q

Tx of peritonsillar abscess

A

I&D + IV abx

48
Q

What is Legg-Calve-Perthes

A

o Idiopathic avascular necrosis of the femoral head
o Typically presents as thigh or knee pain with limp in a child
o X-ray in the frog position will show joint space widening due to loss (necrosis) of the femoral head height

49
Q

Tx of Legg-Calve-Perthes

A

♣ Pt made non-weight bearing with immediate ortho referral
♣ Goal is to prevent further necrosis and promote bone remodeling by maintaining femoral head within the acetabulum
♣ Best accomplished by casting the affected leg in abducted and internally rotated fashion

50
Q

What type of pt has a slipped capital femoral epiphysis (SCFE)

A

o Fracture through the growth plate (physis), which results in slippage of the overlying end of the femur (metaphysis)
Occurs in overweight patients or patients going through a growth spurt

51
Q

Tx of SCFE

A

Surgery

MS3 (88 decks)

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