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Rosh > Last Go Round > Flashcards

Last Go Round Flashcards

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1
Q

Outside Hx with redness and pustule and pain in localized area

A

think bee sting or ant bite

  • Local=ice/Nsaids
  • think anaphyalxis
  • if 1 week out from it= serum sickness!
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2
Q

anterior cord syndrome?

A

Motor and pain/temp

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3
Q

Lymes ppx

A

1x dose of Doxy 200

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4
Q

10 year old with abnormal vitals and SVT firs tTx? Adenosine fluids or shock?

A

Shock (adenosine if stable)

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5
Q

Sudden hadache, visual stuff, Hyperdensity in sella?

A

Pituitary apoplexy - sudden hemorrhag or inafractin of th epituitary gland likely in the setting of a mass

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6
Q

Can TTP be acquired? What are the cuases?

A 
Yes
Preggos
Drugs (tacro, anti-immunes)
Auto immune disorders
Bacterial illness
AIDS
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7
Q

What is TTP Pentad

A 
Fever
Anemia
Thrombocytopenia
Renal 
AMS
needs staroids, big line for PLEX
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8
Q

Order of Thyroid meds?

A

Propanolol, PTU
Iodine
Steroids

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9
Q

Neg FAST, GSW to abdomen/flank - next step

A

Ex lap

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10
Q

Kid IV access= No IOs in the lower extremities due to fractures. hem shock so no EJ an dno IV in the arms - next place for resuscitation…

A

Femoral Vein

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11
Q

ph 7.3 but CO2 10 — gotta think

A

Slaicylate posioning - CO2 should be 30 so now we have a resp alk on top of it

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12
Q

What is brpnchiloitis oliterans?

A

submucosal lymphocytic inflammation can disrupt the epithelium of the small airways followed by an ingrowth of fibromyxoid granulation tissue into the airway lumen, which can lead to obliteration of the airway lumen

Usually chornic lung transplant rejection

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13
Q

Always chack what is preg VB? What and hwo much do you give?

A

Mom is Rh Neg = 300 mcg rhogam if under 20 weeks

if > 20 weeks need the KB test to see how much rhgam to give

remember if she is Rh(-), there is a risk for Ab to be formed to the ag and risk for subsequent pregnancies

Rh(-) mom, rh + dad and then a Rh + baby later= Ab cros splaenta and attack and fetal hemolysis

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14
Q

Difference in CCB vs BB overdose?

clonidine?

A

HypoG is BB

pinpoint pupils is clonidine (the other is big pupils)

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15
Q

infant with bilious emesis - KUB or gi series , VS nomral

A

GI sereis for malroation

VS abnromal = X ray

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16
Q

outpatient fight bite meds- PCN allergy

A

doxy clinda

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17
Q

kidney stne 2 mm, UTI, VS normal- can you DC?

A

ROsh says yes. Urology follow up, abx, flomax. If there is obstruction (significant), fever than inpatient admission

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18
Q

figure 3 sign chest x ray

A

aortic coaractaion

look for rib notching

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19
Q

labrythinitis tx

A

steroids

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20
Q

severe sepsis out of favor

A

now septic shock

sepsis is used for SOFA scoring

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21
Q

+ romberg test means

A

Vestibular system is out

  1. msk proprioception
  2. Vestibular
  3. vision
  4. PNS + 5. CNS sytheszing the info
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22
Q

rapid ascent diving SOB

A

PTX

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23
Q

cold and feet
Damp, non freezing- red and burning
wet, non freezing
freezing

A

pernio or chilblains
trenchfoot
frostbite

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24
Q

ingown toenail tx

A

partial nail removal near the edge with digital block

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25
PLacental abrption is painful or not
painful. +/- bleeding depdning on where tje placenta is
26
Salicylate txicity | ABG, tx
met acid, resp alk - low bicarb, hyprevent and low co2. alinlize the serum. lactic acidosis too Low Co2, low bicarb!
27
acute chest tx
fludis, abx, transfusion therpay
28
high risk laryngospasm for ketamine
<3 months | URI in a kid
29
ear hematoma tx
ID at bottom of it, compressive dressing ID after 48 hours or big >2 cm Needle apsiration if <48 <2 cm
30
Nasal bone fx, packing, abx decision
Pack it, no abx (controversial) take packing out in 3 days and follow up ENt 1 week
31
preggo, hypotensive, LUQ pain
Splenic artery aneyrusm rupture (MC in preggos)
32
Ketosis w.out acidosis
Isopropyl Elevated osmol gap no role for fomepizole- supportive
33
Tx for eye chlamydia infant
Or erythromycin | Not topical
34
Refractory htn, alkalosis, hypok
Renal artery stenosis
35
Soilled teacup
Lunate If upright it is capitate
36
Nms tx
Benzo
37
ascending paralysis, hyporeflexia, intact sensation...
tick paralysis
38
what suture should you do on the volar aspact of the hand?
Horizontal (straight line) mattress - reduces skin necrosis
39
what bite or sting? oral secretions + nystagmus
scorpion
40
How to treat CAP -
no more HCAP | go off of risk factors
41
give tamiflu to old lady hospitlaized after 3 days of symptoms?
yes
42
Where do you put abx for periotneal dialysis infection
intraperiotneal
43
diving
Ascent: Air embolus- 100% oxygen decomrpession sickness- bends- hours Descent: nitrgne narocsis 100 ft barotisis 30 ft
44
Recent C section with foul semlling and pain= Tx Cervicitis tx
Clinda gent endometritis Azithr CFTX
45
hyperoxia test, symptoms improve with ___ problems
Lung if not, its heart and give PGE1
46
oral or topical acycolivr for herpes eye?
Oral + topical steroids
47
ischemic stokre < 3 months ago tp a conteaidicitaion?
yes
48
flail chest tx
basically jus tpain control
49
stipid heme
``` PV= phleboomty PLasmaphereisis= MM and proteins leukaphroeis= AML ```
50
conreal ulcer vs abrasion looks
sharply demarcated with grey ring around it
51
All ICDs are also..
Ventricular pacemakers | MAgnet = Pacing mode and defbrillator off
52
atrial myxoma associated with what disease?
raynauds
53
what is hellp and how do you treat
Form of severe Pre-E- Abd pain/SOB/blurry vision + PLts/LFts/Anemia Mg + Labetalol + Delivery
54
obvious urethral injury - suprapubic cath or Uroloy consult for repair
suprapbuic cath - they repair these weeks after injury
55
rash around dickhole without getting better on abx and now spreading?
think SJS!
56
BIpap in COPD
Remember fio2 and pep is oxygen | so put the diriving pressure up and go 12/4 and allows less PEEP (the 4) and more time to exhale
57
CT head or give factor first in a truama?
Give factor, you would do that in head trauma and a neg ct anyway
58
osler weber syndrome?
AVMs, epistaxis, Telangiesctaisa on the mouth
59
Minimal VB in first trimester pregnant bleeding- give rohgam
controversial but Guidleines say yes the Ab portion of the test actually looks at Anti duffy Ab Give if Rh negative
60
lidocaine dosing in a code?
1.5 mg/kg - then half
61
What is rhematic fever | what is scaret fever
JONES after strep | Big rash during strep
62
If stable on trauma go to CT scanner first
63
peds svt dsing adenosine | electricity
.1 mg/kg > .2 mg/kg | 0.5J/kg then 2x it
64
what physical exam do you do for costochondritis
hands behind head and posterior retractionog elbows
65
bells palsy tx
Steroids | +/- anitvirals
66
predicotrs for head bleed
loss of consciousness, seizure prior to the injury, advanced age (age greater than 60 years), amnesia after the event, intoxication, or a coagulopathy.
67
SSS vs NMS
SSS is quickly after a change (hyper/clonus) | NMS is after a long time on psych meds (rigidity, autonomic instabiltiy, fever)
68
Tx for a hearald patchand then rash
Pit rose | no tx
69
Lunate dislocation next step
transfer for ortho hand reduciton Lunate is spilled mEDIAN NERVE PALSY!
70
lata vs accuminata difference
lata is flat and pale (secondary syhp and)painless Accumiante is pink and much more beefy - warts HPV
71
erythemas!
``` Nodosum= SLE, sarcoid, malignancy Multiforme: EM from drugs or infections Infectioisum: Pervo Migrans: lymes Marginatum: Rheamtic fever (JONES) ```
72
HSV eye tx
Trifluridine or acyclovir topcial
73
scarelt fever
is associated WITH phayrhngitis (still jsut abx not other tx) Rhemuatic fever- AFTER infection
74
light bulub sign (there is rotatio nwhere you dont see greater tuberoisty)
posterio shoulder dislocation
75
elli0s 2/3
clina or augmention + calcium or znic sealant
76
tx brugada
ICD
77
afib wpw tx
procain | NOT BB- it uses accessory pathway
78
MVC with a horizontal SPine fx- associated injury?
Bowel injury | unstable fx- spine Chance fx
79
tx kawasaki
high dose aspirin IVIG admit
80
shock
``` Class 1- Pulse pressure 15 class 2- tachycardia 30 class 330-40 BP class 4-40 ```
81
pterygium tx
nothing unless covers pupil | optho
82
osms
NA x2 Glucose / 2 BUN/ 2.8 218 218
83
Jones and stuff
Jones (worse and more distal and bigger) psuedojoens is avulsin fx and walking boot Lisfranc- WB, 2nd metatarsal
84
triads
cushings
85
alveolar osteotis (dry socket)
Clove oil-Eugenol
86
digoxin stuff
Dig effect- scooped st depressin (not toxic) | Toxicity is VT, arrythmia, PVC stuuff
87
Jesserson hangman clay shoverelver
Jeff- axial load c 1 (you would see dens to see c1) hanfman- bilateral c2 fx clay shovel- stabel c7 SP fx
88
Neck zones
1- bottom up to cric (trach one finer in) 2- cric to madible (cric someone) 3- mandible and up (bag someone with three fingers)
89
airway peds
get it in OR not ED
90
saline soaked gauze for a tooth and transfer them
toth avulsion
91
Ccb and bb OD tx
``` Calcium Glucagon (imaptied gluconeogenesis and pressorh in heart adenylate cyclase myocarial, bypasses BB recepotr and works in minutes- first line) High dose insulin (positivr inotrope) Fluids Pressors Lipid emulsion ```
92
Spironolactone can cause…
HyperK
93
LP spot for infants??
L45 | Lower for yiung infants
94
First thiing that shows in 3 weeker with meningitis?
Pradoxical irritability | Cries when you pick it up
95
Ehat does extenral validlity also mean
Is the study geneaizable
96
Hyoothermia tezt iok answer- sklwiing warming in eztenral- nezt sept
Intebtla re wamring.

Rosh (14 decks)

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