HWK SB1 (F) Flashcards
W1 HWK blocks (3,5,7) Deck is full (83 cards)
1
Q
How does neuroleptic malignant syndrome present?
A
- F > 104 F
- confusion
- muscle rigidity
- autonomic instability (abn vitals, sweating)
- rhabdomyolysis
2
Q
How does serotonin syndrome present?
A
- F > 104 F
- tremor
- incr DTR
- myoclonus
- V/D
3
Q
How does hereditary spherocytosis present?
A
- hemolytic anemia
- jaundice
- splenomegally
- *indirect hyperbilirubinemia**
4
Q
what is a common complication of hereditary spherocytosis?)
A
pigmented gallstones
5
Q
What does the direct coombs test test for?
A
- antibodies attached to RBC
- AI hemolytic anemia
6
Q
what does the indirect coombs test test for?
A
-antibodies against foreign RBC
7
Q
a 95% CI that does not span 1 corresponds to what p-value?
A
p < 0.05
8
Q
What happens to CI when n= is increased?
A
CI narrows
9
Q
what bacteria is a partially acid fast, filamentous branching rod on gram stain?
A
nocardia
10
Q
What does nocardia cause?
A
pulm and/or disseminated (esp. neuro) nocardosis in IMMUNOCOMPROMISED pts
11
Q
What is the 1st line tx for norcardosis?
A
trimethoprim-sulfamethoxazole
12
Q
why does hemophilia cause joint pain?
A
-bleeding into the joint space –> hemosiderin deposition –> synovitis –> fibrosis
13
Q
is arthritis 2/2 gonnococcal infec likely to last 6 mos?
A
NO (most infec are not likely to last that long)
14
Q
How does acute mediastinitis present?
A
- fever
- chest pain
- incr WBC
- mediastinal widening on xray
15
Q
What is the tx for acute mediastinitis?
A
-drainage, surgical debridement, prolonged ABX
16
Q
what is post-pericardiotomy syndrome?
A
- AI condition (usually)
- occurs a few weeks s/p pericardial incision
- presents w/ F, incr WBC, tachy, chest pain
17
Q
MC locations arterial vs venous ulcers?
A
arterial = tips of toes venous = pretibial area, above medial maleolus
18
Q
what is sheehan’s synd?
A
post-partum ischemic necrosis of anterior pituitary gland
= comp of massive post-partum hemorrhage
19
Q
how does sheehan’s synd present?
A
lactation failure (decr prolactin), hypotension, anorexia
20
Q
when do you treat HSV in pregnancy?
A
- week 36 –> delivery (+/- lesions, +/- prodrome)
- any time lesions are present
- *c-sec if active infec @ time of delivery**
21
Q
What are the causes of cyanotic heart dz in newborns?
A
5Ts
- Transposition of the great vessels
- ToF
- Tricuspid atresia
- Truncus arteriosus
- Total anomalous pulm venous return w/ obstruction
22
Q
Which of the 5 causes of cyanotic heart dz in newborns DO NOT present w/ murmur?
A
- total anomalous pulm venous return w/ obstruction
- transposition of the great vessels (+/- VSD)
23
Q
which congenital heart defect presents w/ single loud S2? (hint: MC congenital cyanotic heart defect in neonatal period)
A
transposition of the great vessels
24
Q
How do you dx pneumocystitis pneumonia?
A
- Respiratory secretion (sputum sample/ broncoalveolar lavage specimen) analysis
- special stains = toluidine blue, silver stain
25
Vit B12 def --> _______ --> ineffective erythropoesis presenting as megaloblastic anemia
defective DNA synthesis
26
what is the MOA of risperidone (2nd gen antipsychotic)?
serotonin 2A & dopamin D2 antagonist
27
why does risperidone cause fewer extrapyramidal s/e compared to gen1 antipsychotics?
antagonizes serotonin 2A receptors
28
what drug's MOA = NE + dopamine reuptake inhib?
bupropion
29
anti-mitochondrial Ab is associated w/ what dz?
PBC
30
anti-smooth muscle Ab is associated w/ what dz?
AI hepatitis
31
anti-topoisomerase Ab is associated w/ what dz? (Bonus: what is the alt name of this Ab?)
diffuse scleroderma
| Bonus: anti-Scl-70 Ab
32
pt presents after possible suicide attempt but denies attempted suicide. what do you do and why?
- admit (voluntarily or involuntarily)
| - even w/ denial risk of future attempt is HIGH and you must protect the pt
33
How does the timeline differ between chlamydial and gonococcal conjunctivitis?
```
chlamydial = age 5-15 days
gonococcal = age 2-5 days (this is why we give ppx drops right after birth)
```
34
How does chlamydial vs gonococcal conjunctivitis present?
```
chlamydial = watery drainage + sm. edema
gonococcal = pus + lg edema
```
35
what heart rhythms can cause syncope?
- afib
- ventricular tachycardia
- bradycardia w/ sinus arrest
36
syncope that occurs suddenly and w/o prodrome is likely caused by what abn heart rhythms (if cause is cardiogenic)?
- afib
- ventricular tachycardia
* *FAST RHYTHM = FAST ONSET = NO TIME FOR PRODROME**
37
syncope that occurs after prodrome is likely caused by what abn heart rhythm (if cause is cardiogenic)?
-bradycardia w/ sinus arrest
38
what s/s might the prodrome prior to a syncopal event include?
- nause
- diaphoresis
- palor
- light headednes
- vision and/or hearing changes
39
what is angiosarcoma?
malignant tumor of the lining of blood vessels and lymphatics
40
what increases risk of angiosarcoma?
1. local radiation exposure
| 2. chronic lymphadema
41
why are ACEi useful post-MI?
they limit ventricular remodeling and decr ventricular dilation
42
2* polycythemia vera exhibits ___ serum EPO
increased
43
how might materal parvovirus B19 infection cause fetal demise?
virus --> feral RBC precursor destruction --> anemia --> high output heart failure --> hydrops fatalis --> death
44
what are the MC causes of 2* polycythemia vera?
- renal cell ca (tumor produces EPO)
| - chronic hypoxia (cardiopulm dz, OSA)
45
What are the distinquishing features of the various TORCH infxns?
```
CMV = periventricular calcifications
toxo = intracerebral calcifications
syphillis = desquam rash
rubella = cataracts, heart defects
```
46
What are the MC causes of OTM vs OE?
```
OTM = m caterhallis, s aureus, h influ (nontypable)
OE = psuedomonas
```
47
What are the causes of telogen effluvium vs alopecia areata?
telogen effluvium = stress
| alopecia areata = AI
48
What location is affected by telogen effluvium vs alopecia areata?
telogen effluvium = diffuse
| alopecia areata = patches
49
What portion of the hair shaft is affected by telogen effluvium vs alopecia areata?
telogen effluvium = normal shaft
| alopecia areata = hair shafts narrow @ surface
50
On EKG, electrical alternans + sinus tach = very specific for what?
large pericardial effusion (b/c heart swings w/in the fluid filled pericardial sac)
51
what is electrical alternans?
varying amplitude of QRS complex (seen w/ Lg pericardial effusions)
52
What does rib notching on CXR suggest?
coarctation of the aorta
53
What is coarctation of the aorta?
narrowing of the desc. aorta --> incr prox arterial pressure load
54
how does coarctation of the aorta present?
- UE BP > LE BP
| - CXR shows inferior rib notching of ribs 3-8
55
how does parovirus B19 infection present in the average adult?
- MC = asymp or flu-like s/s
| - can present like RA
56
how does pneumocystic PNA present in pts w/o HIV?
F + dry cough + fulminant resp failure
57
how does s aureus post-viral PNA present?
- F + worsening resp s/s s/p initial improvement
| - HIGH F + cough w/ hemoptysis + leukopenia + multilobar + cavitary infiltrates
58
what is borderline personality disorder characterized by?
- unstable relationships
- unstable self-image
- mood instability
- impulsivity (ex. throwing/breaking things, binging, h/o mult MVA)
59
when do you make a dx of intermittent explosive disorder?
- aggressive outbursts that are out of proportion
| * *ONLY MAKE THIS DX IF NO ADDED FEATURES THAT SUGGEST ANOTHER DX**
60
when do you obtain an MRI as part of the headache w/u?
- new or worsening HA
| - high risk features including age >50, thunderclap onset, immunosuppression, h/o malig
61
how do med overuse HA present?
= chronic, near-daily HA in setting of chronic HA med use w/ pre-existing HA disorder
-HA are often present upon waking and briefly remit before rebounding later in the day
62
what is oligohydramnios a marker for and what must be done to tx it?
- placental insufficiency
| - immediate delivery
63
when is amnioinfusion indicated?
to tx variable decels 2/2 oligohydramnios from ROM + fetal cord compressions
64
what routine monitoring do late/post-term pregnancies receive?
routine NS test + AFI
65
what is a nL AF volume?
single deepest pocket >= 2 cm and < 8 cm
66
how does phenylketonuria present?
- intellectual disability
- fair complexion
- eczema
- musty/mousy odor
67
what causes phenylketonuria?
phenylalanine hydroxylase def --> build-up of phenylalanine + neurotoxic metabolites
68
how do you screen for PKU and how do you dx if pt skipped screeing?
- screen = mass spec
| - dx test = quantitative amino acid analysis
69
how does galactosemia present?
jaundice, hepatomegally, FTT after consumption of breast milk or reg infant formula
70
what causes galactosemia?
absence of galactose-1-phophate uridyl transferase activity in RBC
71
what do the eyes do in stroke/hemorrhage of the Thalamus?
eyes look Toward the hemiparesis (away from lesion)
72
what do the eyes do in stroke/hemorrhage of the cerebrAl lobe?
eyes look Away from hemiparesis (toward the lesion)
73
what do the eyes do in stroke/hemorrhage of the Pons?
Pinpoint Pupils
74
what is a common site of hypertensive intraparenchymal hemorrhage?
basal ganglia (putamen) w/ internal capsule involvement
75
how do you tx neonatal clavicular fracture during deliver?
- reassurance and education on how to handle gently (will heal in 7-10 d)
- can imobilize arm by bending at the elbow and pinning long-sleeve to shirt
76
when do you do EGD to remove a foreign body from the esophagus?
incr risk of perforation 2/2 ingestion of a sharp (or caustic) object
77
how do you manage neonatal chicken pox?
- isolate baby from sick contact (likely mom)
| - give varicella-zoster IgG to baby if mom developed infx btwn 5d prior to thru 2d after delivery
78
how do you passively immunize?
give antibody
79
how can prosthetic valve thrombosis present?
- new murmur
- heart failure 2/2 valve stenosis or regurg
- thromboembolic event (TIA or stroke)
80
what should be considered the source of thromboembolism until proven otherwise?
prosthetic heart valve
81
how does vertebral osteomyelitis present?
```
+ pain w/ gentle SP percussion = MC
+/- incr ESR (COMMON)
+/- incr plt (marker of inflam) (FAIRLY COMMON)
+/- F (UNCOMMON)
+/- leukocytosis (UNCOMMON)
```
82
how does brown sequard synd present?
- ipsilat hemiparesis
- ipsilat loss of proprioception, vibratory and light touch sensation
- contralat lost of pain and temp sens (2 levels below injury)
83
how do you determine the level of spinal cord injury in brown sequard synd?
level of injury = 2 levels above start of contralat pain and temp loss
