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ABEM Recert Exam 2015 > ABEM Recert Exam pt. 4 > Flashcards

ABEM Recert Exam pt. 4 Flashcards

(94 cards)

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1
Q

Macule: Definition

A

<1 cm, non-palpable

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2
Q

Papule: Definition

A

<1cm, palpable

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3
Q

Patch: Definition

A

> 1cm, non-palpable

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4
Q

Plaque: Definition

A

> 1cm, palpable

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5
Q

Vesicle: Definition

A

<1cm papule with clear fluid

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6
Q

Bullae: Definition

A

> 1cm plaque filled with clear fluid

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7
Q

What conditions is Nikolski’s sign seen with?

A

SSSS, TEN/SJS, Pemphigus Vulgaris

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8
Q

Bullous pemphigoid vs Pemphigus vulgaris: How to diff?

A

Bullous pemphigoid doesn’t have Nikolski’s sign

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9
Q

HUS-TTP: Rx

A

Exchange transfusion

NO PLATELETS, since it’s a consumptive process

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10
Q

Bullous pemphigoid and Pemphigus vulgaris: Appearance

A

Large, flat bullae

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11
Q

Leptosporosis: How is it transmitted?

A

Through contact with urine in a contaminated water source (e.g. exposure as a cattle rancher or through recreation in water)

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12
Q

Babesiosis: si/sx

A

Similar to malaria

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13
Q

Babesiosis: Geographic distribution

A

Found in New England

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14
Q

Babesiosis: Pathophysiology

A

Intracellular parasite which infects RBCs

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15
Q

Yersinia pestis (plague): Appearance

A

Patients have a bubo (infected, tender, swollen lymph node)

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16
Q

Tularemia: Geographic distribution

A

Found world-wide, but often in California on board questions

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17
Q

Tularemia: Reservoir, vector and how it’s spread

A

Reservoir = Rabbits
Vector = Fleas / ticks
Can’t be spread human to human

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18
Q

Tinea: Rx

A

Must use oral antifungal if involves hair or nails, otherwise can use topical

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19
Q

SJS/TEN vs SSSS: How to diff?

A

SSSS usually doesn’t have mucous membrane involvement

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20
Q

SJS/TEN: Typical cause

A

Medications (often sulfa or antiepileptic)

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21
Q

Hemophilia A: Cause

A

Factor 8 deficiency

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22
Q

Hemophilia B: Cause

A

Factor 9 deficiency (Christmas disease)

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23
Q

Will PT, PTT, or both be abnormal in hemophilia?

A

Only PTT is abnormal

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24
Q

von Willebrand’s disease: Rx

A

DDAVP for mild disease

Factor 8 for severe disease

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25
ITP: Rx
Steroids | NO platelets
26
TTP: si/sx
``` FAT-RN Fever Anemia Thrombocytopenia Renal involvement Neurologic changes ```
27
TTP: Rx
Plasma exchange transfusion Steroids NO platelets
28
Microcytic anemia: Causes
Lead Iron deficiency Sideroblastic Thalassemia
29
Normocytic anemia: Causes
Decreased production of normal RBCs (anemia of chronic disease, aplastic anemia) Destruction of normal RBCs (hemolysis, blood loss) Uncompensated increase in plasma volume (pregnancy, fluid overload)
30
Macrocytic anemia: Causes
Alcohol B12/Folate deficiency COPD G6PD
31
AML vs CLL: How to diff
AML usually dosen't have lymphadenopathy, CLL usually does CLL always has increased WBCs, AML may have low, normal, or high WBCs
32
Optic neuritis: si/sx
Eye pain Blurred vision APD Is unilateral, never bilateral
33
Normal ESR: How to calculate
(age + 10) / 2
34
Encephalitis: Definition
Fever Headache Neurologic changes
35
Encephalitis: MRI findings
Edema and/or hemorrhage in temporal lobe
36
Epidural abscess: Causative agent
Most are Staph aureus
37
Encephalitis: CSF findings
Increased protein
38
Guillane Barre syndrome: Most common preceding infection
Camplobacter jejuni
39
Myasthenia gravis: Pathophysiology
Antibodies form against postsynaptic ACh receptors
40
Myasthenia gravis vs organophosphate poisoning: How to diff
MG gets better with edrophonium (Tension) | Organophosphate gets worse
41
Organophosphate poisoning: Pathophysiology
Excess cholinesterase inhibitor which causes functional decrease in ACh
42
Pseudotumor cerebreri: What is typical opening pressure?
>25 cm H2O
43
Febrile seizures: Ages affected
6 mo - 6 yo (but usually 12-18 months)
44
Primary CNS tumors: What type are most?
50% are gliomas
45
Tumors which met to brain
Lung > Breast > Melanoma
46
Hiccups: Rx
Thorazine
47
Boerhaave's sydrome: Pathophysiology
Full-thickness esophageal tear
48
Narrowest part of esophagus
``` Kids = C6 criccopharyngis muscle Adults = T11 GE junction ```
49
How to tell if a coin is in esophagus or trachea?
Flat in AP projection = esophagus Thin line in AP projection = trachea Flat in sagital / cross section view = trachea
50
Hepatic encephalopathy: precipitants / causes
``` LIVER Librium Infection Volume loss Electrolyte disorders RBCs in gut (GI bleed) ```
51
What does IgM indicate?
Acute infection
52
What does Anti HBS indicate?
Patient is not infectious
53
What does HBS antigen indicate?
Patient is infectious
54
What does Anti HBc indicate?
Patient has low levels of infectivity
55
What does HBAg indicate?
Patient has high levels of infectivity
56
What does HBCAb (Hep B core Ab) indicate?
Previous Hep B infection
57
Ascending cholangitis: si/sx
Charcot's triad 1. Fever 2. RUQ abd pain 3. Jaundice Reynold's pentad adds 4. Hypotension 5. Altered MS
58
Pancreatitis: xray findings
Colon cut off sign (abrupt cut off of colon near left side of abdomen on KUB) Sentinal loop (air fluid levels near pancreas on KUB)
59
Ranson's criteria
``` GA-LAW Glucose > 200 AST > 250 LDH > 350 Age > 55 WBC > 16,000 ``` ``` <3 = mild disease 3+ = severe disease ```
60
Malrotation with midgut volvus: si/sx
bilious emesis | Usually affects age
61
Most common protozoal diarrhea in US
Giardia
62
Salmonella: Rx
TMP-SMX or quinolone
63
Shigella: Rx
TMP-SMX or quinolone
64
Most common bacterial diarrhea
Camplobacter
65
Camplobacter diarrea: Rx
Quinolone or erythromycin
66
Vibrio cholera: Rx
Doxycycline, TMP-SMX, or Cipro
67
Indications for thoracotomy after chest tube placement
>1500 ml blood out initially | >200 ml/h blood out for 4 hours
68
Traumatic pericardial tamponade: Rx
Thoracotomy | Pericardiocentesis not effect
69
Aortic dissection: Width on PA CXR
8 cm
70
At what level on chest can you have penetrating trauma cause intrathoracic and/or intraabdominal contents?
Nipple line
71
Blunt diaphragmatic injury usually affects the (LEFT / RIGHT) side. Why?
Left side, because liver protects on right
72
Duodenal hematoma: Usual mechanism and si/sx
Handle bar hit kids in abdomen while riding bike Causes abdominal pain and vomiting Will see on CT
73
Pelvic fractures: Types
1. AP compression - highest rate of GU injuries 2. Lateral compression - most common 3. Vertical sheer - fall from height; highest rate of hemorrhage
74
Which type of pelvic fracture is most common?
Lateral compression
75
Which type of pelvic fracture has the highest rate of GU injuries?
AP compression
76
Which type of pelvic fracture has the highest rate of hemorrhage?
Vertical sheer
77
Retroperitoneal hemorrhage in trauma: When to suspect
Patient with normal CXR and FAST who remains hypotensive despite fluid resuscitation NOT seen on FAST
78
Hematuria in children after trauma: When to work up?
>50 RBC/hpf
79
DPL: Definition of (+)
>10 mL blood on initial aspirate | >100,000 RBC/mL after instilling 1L fluid
80
FAST: What are 4 components
1. RUQ view (Morrison's pouch/hepatorenal recess) 2. LUQ view (area around spleen and diaphragm) 3. Subcostal view (fluid around heart) 4. Pelvic view (pelvic free fluid)
81
Where does traumatic TM perforation usually occur?
Pars tensa
82
Traumatic TM perforation: Disposition
If in posterior superior quadrant or from penetrating trauma, needs ENT f/u within 24h
83
Raynaud's disease: Color progression
Red -> Blue -> White
84
Reiter's syndrome: New name
Reactive arthritis
85
SLE triad
Fever Rash Joint pain
86
Drug-induced lupus: What marker do you see
Anti-histone Ab
87
Drug-induced lupus: Common drugs causing
``` HIPPS Hydralazine INH Phenytoin Procainamide Sulfonamides ```
88
Bechet's disease: Pathophysiology
Medium and large vessel vasculitis
89
Bechet's disease: Si/sx
Chronic recurrent oral and genital ulcers | May also have uveitis and optic neuritis (if does = admission)
90
Bechet's disease: Rx
High dose steroids
91
Thromboangitis obliterans: Pathophysiology
Medium and small vessel vasculitis
92
Thromboangitis obliterans: Typical patient affected
Young male smoker
93
Thromboangitis obliterans: Si/sx
Superficial thrombophlebitis and necrosis of distal digits
94
Thromboangitis obliterans: Rx
Smoking cessation

ABEM Recert Exam 2015 (7 decks)

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