Deck 4 Flashcards
(136 cards)
1
Q
what infection are kids with CF at risk of vs. adults
A
staph a in kids, pseudomonas in adults
2
Q
complement levels in IgA nephropathy vs. PSGN
A
normal in IgA and decreased in PSGN
3
Q
sx onset of embolic stroke
A
worse at onset
4
Q
signs of lacunar infarct
A
hemiparesis, sensory loss but NO cortical signs (aphasia, hemianopia)
5
Q
possible compilcation of chronic middle ear disease
A
cholesteatoma
6
Q
treatment of persistent pulmonary HTN in the newborn
A
inhaled NO
7
Q
treatment of GBS intrapartum
A
penicillin, clinda, then vanc (in order of first to third line treatment)
8
Q
ODD vs. conduct disorder
A
ODD is more mood related whereas conduct is disregard for others rights, stealing, breaking things etc.
9
Q
root cause analysis findings prospective or retrospective
A
retro
10
Q
methods to decrease intracranial pressure
A
hypertonic saline, hyperventilation, drain CSF, mannitol
11
Q
what is the false negative ratio
A
1-sensitivity
12
Q
what is the false positive ratio
A
1-specificity
13
Q
which hepati lesion is linked to OCP use
A
hepatic adenoma
14
Q
what is a spinal dysraphism
A
this is spina bifida aka failure of posterior vertebral arch fusion
15
Q
CT scan of eclampsia
A
bilateral frontal lobe edema
16
Q
what is herpangina and what causes it
A
this is gray ulcers and vesciles on the tonsils and palate due to coxsackie A
17
Q
treatment of intussusception
A
air enema
18
Q
treatment of volvulus
A
NPO, Ng tube, abx, surgery
19
Q
FVC in restrictive lung disease
A
decreased
20
Q
FEV1/FVC ratio in restrictive disease
A
typically increased or normal bc the FVC decreases more relative to the FEV1
21
Q
what is best to reduce adverse drug events
A
pharmacist directed interventions
22
Q
what should urine pH be if the patient is acidodic
A
it should be acidic if its not they have renal tubular acidosis
23
Q
for anyone reproductive age with uterus what do you do first for abdominal pain
A
preg test
24
Q
management of severely painful hemorrhoid (external or internal
A
urgent hemorrhoidectomy
25
when does visual screening start for kids
3+
26
pulmonary complication of preeclampsia
acute pulmonary edema due to increased blod pressure causing backup
27
signs of calcaneal apophysitis
bilateral heel pain and tenderness with squeezing the heel and on palpation of base of heel
28
does basal cell or SCC cause nerve infiltration
SCC
29
what is mittelschmerz
this is pain with ovulation and then the small amount of free fluid released from the corpus luteum irritates the peritoneum
30
vascular dementia vs. post stroke depression
vascular dementia is more associated iwth apathy rather than sadness that post stroke is associated with and post stroke is not so severely impaired
31
vitA toxicity effects on brain
IIH
32
treatment of NMS
stop antipsychotics, add a benzo, start bromocriptine (Dopa agonist) or dantrolene
33
can you undergo vaginal delivery with prior classical c section or myomectomy
NOPE
34
dx of IIH
ophthalmoligy then MRI, then LP
35
internal vs. external validity characteristics
internal is more related to causality vs. external is related to generalizability
36
signs of disseminated listeria
at birth the neonate has disseminated absceses or granulomas
37
screening after dx of popliteal aneurysm
abdominal aortic aneurysm screening
38
how long do you maintain SSRI after first episode
6mo
39
pulses in infants with coarc
diminished femoral pulses
40
hypoxia in the feet of a newborn only
likely a persistent PDA
41
treatment of thalassemia
no specific trtment
42
signs of acute fatty liver of pregnancy
acute liver failure (coagulopathy, leukocytosis, elevated AST and ALT etc)(
43
fluid collection in spleen etiology
hematogenous infection (IE), IVDU, trauma, hemoglobinopathy
44
dx of tinea
KOH prep
45
eval of continued fever in UTI of a chlid
do an U/S to eval for anotomic differences and for abcess
46
clinical signs of hereditary telangiectasia
frequent epistaxis, hemoptysis, hemorrhagic CVA, GI bleeds etc.
47
what is the dx of a patient with elevated 17-hydroxyprogesterone
congenital adrenal hyperplasia
48
lab findings in a child with CAH
no aldosterone or cortisol so they are going to have low sodium, high potassium, low glucose and elevated 17hydroxyprogesterone
49
CAH genitalia appearance
46XX are ambiguous due to excess androgens causing virulizationand 46XY are normal or virulized because they can make DHT to have external features
50
when do you hear vocal cord dysfunction
inspiration (stridor)
51
treatment of methanol poisoning
1- fomepizole or ethanol 2- sodium bicarb 3- dialysis if signs of end organ damage
52
signs of coronary artery dissection
same clincial picture as an MI but the patients are typically women, postpartum status, multip, connective tissue disorders
53
hip fracture in subtroch region
prolonged bisphos use
54
parathyroid and magnesioum relationship
low magnesium stimulates parathyroid hormone release
55
parathyroid hormone and vit D relationsihp
parathyroid hormone stimulates the kidney to convert the active form of Vit D for calcium absorbtion
56
complications of BPD
systemic hypertension due to increased catecholamines and pulmonary artery HTN
57
which twin type has increased risk of twin twin transfusion
mono di
58
what is fetal dysmaturity
this is when you have post term baby and they have wrinkled skin due to an aged placenta
59
in a box plot what do the different lines mean
these are the quartiles and distributed in evne 25% of groups
60
urine osmolality in diabetes insipidus
<300 because so much water
61
signs of ocular neurosyphilis
uveitis and optic neuritis
62
pharmacologic management of IBS abd pain
first line is antisposmodic therapy like bentyl but next is a TCA
63
alopecia skin findings
normal non erythematous skin
64
how to decrease risk of complications from diverticulosis
increase physical activity
65
which joints are affected in OA vs. RA for the hands
OA is DIPs and thumb // RA is wrist and PIPs
66
bilateral atrial enlargement with low voltage QRS dx
likely restrictive cardiomyopathy
67
most common cause of restrictive cardiomyopathy
most commonly amyloidosis
68
signs of monviable limb
no flow arterial or venous, absent cap refil, severe sensory/motor deficit
69
intervals for glucose monitoring in GDM
fasting and 1 or 2 hr postprandial
70
management of acetominophen toxicity
<4 hrs --> activated charcoal // >hrs NAC
71
sleep and steroids
they can cause insomnia
72
urine sediment in scleroderma renal crisis
often normal
73
peritoneal dialysis peritonitis signs
abdominal pain, diffuse tenderness, nausea
74
screening in obese children
need to screen them for HLD, T2DM, fatty liver, HTN, and sleep apnea
75
goal of treatment of hepatorenal syndrome
increasing mean arterial pressure to decrease RAAS activation
76
signs of veretebral compression fracture
spinal tenderness, acute back pain,
77
autoimmune conditions associated with T1DM
celiac, autoimmune thyroidiits
78
chronic groin pain during exercise and reproduced during valsalva
sports related groin pain due to repetitive stress on the musculotendinous portion of the lower abdomen and groin
79
complications of bells palsy
dry eye due to impaired eyelid closure --> trt prophylactically with eye drops and taping eye closed etc.
80
steps of child with likely abcess that is NOT having impending repsiratory compromose
CT scan of neck
81
can mono mono twins vaginally deliver
no! bc their cords can become tangled
82
what needs to be adminstered to a neonate to a mom with active HepB
HepB immune globulin and vaccine
83
signs of beckwith wiedemann syndrome
tongue, limb abnormalities, macrosomia omphalocele, umbilical hernia, screen for wilms and hepatoblastoma
84
cause of dysphagia in crest syndrome
fibrosis and smooth muscle atrophy in the eosphagus causing dysmotility, NOT achalasia
85
what cells are malignant in medullary thy ca
calcitonin secreting parafollicular C cells
86
accuracy equation
TP+TN/ (TP+FP+TN+FN)
87
reducing substances in the urine of a newborn with seizures
hereditary fructose intolerance or galactosemia
88
signs of malignant hyperthermia
rigidity, tachy, hyperthermia, rhabdo (blood in urine), hyperkalemia, HTN
89
ovarian torsion time course
can be colicky initially or if it doesnt untorse can just be constant severe pain
90
management of hemoptysis continued bleeding
bronchoscopy
91
ideal tidal volue
6ml/kg
92
where are thymomas
anterior mediastinum
93
increasing abdominal pain late in course of acute pancreatitis
likely infected pancreatic necorsis- occurs days after the initial presentation as enteric pathogens entern- CT scan
94
which virusues need to be on airborne precautions
TB, varicella, herpes zoster, measles
95
viral conjuctivitis appearance
follicular appearance of the conjunctiva
96
target blood glucose in GDM fasting, 1hr, and 2hr
fasting <95, 1hr <140, 2hr <120
97
thickness of endometrial stripe post menopause that warrants investigation
>8mm
98
signs of nicotine poisoning
biphasic response first is hypertension tachy, etc // second is inhibitory phase with hypotension, brady, coma, mainly muscarinic sx with vomiting, diarrhea
99
what does clinda cover
anaerobes, MRSA, aspiration pneumonia, skin infections
100
gabapentin MOA
binds the alpha-2-delta calcium channel
101
causes of symmetrical IUGR
aneuploidy, congenital heart disease, early TORCH infections
102
causes of asymmetrical IUGR
uteroplacental insufficiency, HTN, Rh incompatibilty
103
cushing dx vs. PAI
cushing is 24hr free cortisol // PAI is cosyntropin stim and 8am cortisol
104
eval of VAP
CXR, endotracheal sample, epiric abx while awaiting culture
105
micro causes of brain abcsesses
nocardia, viridians strep, anaerobes
106
signs of language disorder in a child
difficulty pruducing language, difficulty explaining themselves, etc.
107
calciphylaxis causes
hypercalcemia, hyperphosphatemia
108
management of pancreatic cysts
ERCP for large cysts that are >3cm, involve the duct, and are irregular
109
management of polyhydramnios
asymptomatic: just expectant management, dont have to induce // symptomatic or if preterm: amnioreduction
110
what bugs need droplet precautions
bacteria and viral
111
contact precaution bugs
MRSA, VRE, enteric bugs, parasites, viruses
112
signs of dumping syndroem
sympathetic sx, tachycardia, diaphoresis, flushing, diarrhea
113
signs of bacterial overgrowth of small intesttine
diarrhea, flatulence, malabsorption, decreased B12 (bacteria eat it up), increased folate
114
treatment of atrial flutter
same as afib- unstable do synchronized cardioversion stable do rate control and do anticoag if chadvasc needs
115
alport pathogenesis
longitudinal splitting of the glomerular basement membrane
116
steroids in stroke
NO need, only for tumors use steroids before surgery
117
management of ICH
manage airway, permissive HTN, keep ICP stable, reverse anticoagulation, surgery for >3cm
118
what do you get with cave exploring
histo
119
signs of histo on biopsy
granulomas with yeast
120
what is normal amniotic fluid index
8 to 18cm >24 is poly
121
signs of abscess after abdominal surgery
recurrent fever, abd pain several days after the op
122
clinical signs of SBO
abdominal pain, nausea, vom, constipation, distention, decreased bowel sounds, not leukocytosis
123
management of otitis media with effusion
observation and follow up
124
placental aromatase deficiency signs
both mom and baby have viruIization
125
when do the electrolyte abnormalities show in CAH
1-2 weeks after birth
126
in aspirin exacerbated respiratory disease what is the main driver of pathogenesis
leukotrienes
127
acid base changes post seizure
pts. can have anion gap metabolic acidosis due to lactate from skeletal muscle hypoxia
128
HIT type 2 signs
necrotic skin lesions, decreased platelets, acute reactions after receiving heparin
129
what type of scan is a meckel scan
nuclear scintigraphyy
130
what is hypersensitivity pneumonitis
this is an immunologic response to an inhaled antigen like mold, animal hair etc
131
signs of hypersensitivity pneumonitis
abrupt onset fever, chills, cough, leukocytosis, cxr with scattered micronodular interstitial opacities
132
differentiate between Primary ovarian insuff and hypothalmic amenorrhea
in POI, you will have NO estrogen at all which means vaginal atrophy, vasomotor sx etc, and in hypothalmic amenorrhea you have a small basal estrogen amount but still no withdrawal bleeding but no vaginal changes
133
treatment of acute iron poisonin
deferoxamine, whole bowel irrigation
134
etiology of neuro complications in friedrich ataxia
degeneration of spinal tracts causing dysarthria, ataxia, loss of vibratory sense
135
what is the only vaginitis with normal pH
candida
136
is there inflammation with BV
nope
