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Procedures > Midterm Reverse > Flashcards

Midterm Reverse Flashcards

1
Q

1 wk then 1, 2, 4, 6, 9, 12, 15, 1824, 30 monthsEvery year from 3 to 21

A

When to get Well Child Checkups?

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2
Q

2 y/oalso start taking BP

A

When do you start charting BMI?

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3
Q

1.Screening - anemia, vision, hearing, dentalMaybe TB, HIV, lead, inherited disorders2. Mental health & risky behaviors3. Immunizations4. Anticipatory edu

A

What are the goals of WCC?

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4
Q
  1. Newborn2. Infancy 0-12mo3. Early childhood 1-4yrs4. Middle childhood 5-10yrs5. Adolescence 11-20yrs
A

What are the stages of development?

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5
Q

> 2 mo. <2 - rectal

A

At what age do you switch to ear temp?

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6
Q
  1. Appearance2. Pulse3. Grimace4. Activity5. Respiration
A

What are the components of an APGAR score?

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7
Q

4-26 mo

A

When does the anterior fontanelle close?

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8
Q

by 2 mo

A

When does the posterior fontanelle close?

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9
Q

Yes

A

Is S3 normal in infants?

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10
Q

by 2 wks

A

When does the umbilical cord remnant fall off?

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11
Q
  1. Palmar grasp2. Plantar grasp3. Moro reflex4. Asymmetric tonic neck reflex5. + Support reflex6. Anal reflex7. + Babinski
A

What are the newborn reflexes?

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12
Q
  1. Triceps2. Brachioradialis3. Abdominal Present starting at 6 mo
A

What are the infant reflexes?

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13
Q

4 y/o

A

When do maxillary sinuses appear?

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14
Q

After 6 mo

A

When should you start to give an infant food?

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15
Q

Autism Screen at 18 mo visit

A

What does the M-Chat look for?

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16
Q

3.2 kg50 cm

A

What is the average birth weight & length?

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17
Q

10kg 75 cm12.5 8515 100After that they grow 5-6 cm/yrBoys grow ~14 in & girls ~12 in at puberty

A

How much does the average 1, 2 & 4 y/o weigh & length?

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18
Q

Girl >12 Boy >14

A

At what age would puberty be said to be delayed?

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19
Q

Screening for eating disorders in adolescents

A

What is SCOFF?

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20
Q

Way to estimate gestational ageHigher # = more maturity

A

What is the Ballard score?

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21
Q

Intrauterine growth restrictionMultiples, malnutrition, toxins, placental instability

A

What is IUGR & some causes?

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22
Q

Gestational diabetes >90%

A

What is a cause for LGA?

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23
Q
  1. Cataracts (maybe due to infection)2. Retinoblastoma Emergency - see ophthamologist
A

What are some causes of an absent red reflex?

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24
Q

when bowel dies from intussusception

A

When do you see currant jelly stools?

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25
Q

likelihoood of appendicitis

A

What is an Alvarado score?

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26
Q

Girls <9

A

At what age should you be concerned if a child hits puberty?

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27
Q

30-40Can be 60-80 during birth

A

What is a normal respiratory rate in a kiddo?

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28
Q
  1. Female2. Breech3. 1st born 4. FH
A

Risk factors of hip dysplasia

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29
Q

2 mo

A

When should a baby lift his head?

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30
Q

8 mo

A

When should a baby pull himself up to stand?

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31
Q

7-9 mo

A

When should a baby start crawling?

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32
Q

2 mo

A

When should a newborn bring his hands together?

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33
Q

Of sexual development

A

What is Tanner staging?

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34
Q
  1. Tay-Sachs2. PKU3. Hypothyroidism4. Congenital adrenal hyperplasia5. Galactosemia
A

What are the screenings for infants?

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35
Q

Kid 2 or under w/ weight plotting below the 5& for age on more than 1 occasion or whose wt crosses 2 major percentiles downward on a standardized growth grid.

A

What is failure to thrive?

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36
Q

Perform less invasive maneuvers early & potentially distressing maneuvers near the end 1. Observation2. Head, neck, heart, lungs, abdomen, GU3. Lower extremities, back4. Ears, mouth5. Eyes6. Skin7. Neurologic system8. Hips

A

What is the sequence for examining newborns?

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37
Q

Sign of congenital heart diseaseTongue & oral mucosa

A

Where are the best places to look for central cyanosis in kiddos?

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38
Q
  1. Erythrocyte mass & plasma vol inc. 2. CO inc. 3. Systemic vascular resistance & pressure fall
A

CV changes during pregnancy

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39
Q

From wt gain & relaxin1. Lumbar lordosis2. Ligamentous laxity in the SI joints & pubic symphysis

A

MSK changes during pregnancy

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40
Q

Blue cervix & vagina from inc. blood flow

A

What is Chardwick’s sign?

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41
Q

Naegele’s ruleTake 1st day of LMP, add 1 week, subtract 3 mo & add 1 year

A

How do you determine expected delivery date of a baby?

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42
Q
  1. Doptone - 10-12 wks2. Fetoscope - 18 wks3. Fetal mvmt - 18-24 wks4. US
A

How can you verify EDD & when?

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43
Q

BP >140/>90 before 20 wks

A

What is chronic HTN in a pregnant lady?

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44
Q

BP >140/>90 after 20 wks

A

What is gestational HTN?

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45
Q

BP >140/>90 after 20 wks w/ protein in urine

A

What is preeclampsia?

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46
Q
  1. CBC2. Blood typing3. Hep panel4. HIV5. Syphilis6. UA & culture7. PAP smear8. GC
A

What initial lab work should you do on a pregnant lady?

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47
Q
  1. UA for glucose & protein2. WBC
A

What lab work should you do in pregnant ladies throughout their pregnancy?

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48
Q
  1. Nutrition2. Wt gain3. Exercise (30 min/day)4. Smoking cessation, alcohol, drugs5. Screen for domestic violence6. Immunizations
A

Health promotion for pregnancy

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49
Q

to Rh - women at 28 wks & w/in 3 days of delivery

A

When do you give RhoGAM?

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50
Q
  1. Tetanus2. Flu (2&3rd trimesters)
A

Which immunizations should pregnant ladies get?

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51
Q
  1. Unpasteurized dairy products2. Soft cheeses3. Raw eggs4. Delicatessen meats5. Large amounts of Vit A6. Sea-going fish
A

What foods should pregnant people avoid?

52
Q

Blue

A

What is the ‘sterile’ color?

53
Q

In front from shoulder to waist levelSleeves from cuff to 2 in. above elbow

A

Where are gowns considered sterile?

54
Q

12 inches

A

How far away must nonsterile people be from a sterile field?

55
Q
  1. High Flow Nasal Cannula (HFNC)2. Continuous Positive Airway Pressure (CPAP)3. Bilevel Positive Airway Pressure (BiPAP)
A

What are the types of Noninvasive Positive Pressure Ventilation? (NPPV)

56
Q
  1. Impaired level of consciousness2. Respiratory arrest/apnea3. Cardiac arrest4. Acute MI5. Inability to protect airway6. Excessive secretions7. Vomiting8. Upper airway obstruction9. Facial trauma10. Burns involving face/airway
A

Contraindications to NPPV

57
Q
  1. Dec. myocardial perfusion2. Barotrauma3. Pneumothorax/pneumomediastinum4. Aspiration5. Anxiety6. Nosocomial infections7. Iatrogenic respiratory alkalosis
A

ADRs NPPV

58
Q

Difficult to measure & regulate the end-expiratory pressureHigher risk of ADRs

A

What is a big disadvantage to high flow nasal cannulas?

59
Q

dec. preload & afterload

A

How does CPAP effect L sided heart failure?

60
Q
  1. Acute respiratory failure2. Apnea3. Impending respiratory failure4. Inability to oxygenate or ventilate using NPPV5. OD, head/spinal cord injury, anaphylaxis, infectious process needing airway
A

Indications for mechanical ventilation

61
Q
  1. Tidal volume (Vt)2. Respiratory Rate (RR) 3. FiO2 - % of oxygen4. PEEP
A

Settings for ventilation

62
Q

Continuous Mandatory Ventilation Machine does all breathing Know exact ventilation

A

CMV

63
Q

Assist controlMachine makes breaths but Pt can make machine breaths too Risk of hyperventilation, air trapping, inc. intrathoracic pressure

A

AC

64
Q

Synchronized Intermittent Mandatory Ventilation Machine makes breaths but Pt can make own breaths

A

SIMV

65
Q

Pressure Support Ventilation Machine gives extra push to Pt breaths

A

PSV

66
Q
  1. Chronic end stage heart failure if at risk of death from cardiogenic shock2. LV EF
A

Indications for LVAD

67
Q
  1. >
    1. Diabetes w/ end organ damage3. Chronic renal failure (Cr >2.5)4. Comorbidites that predict poor long term survival (CA, CVA, COPD)5. Social History
A

Who is not eligible for heart transplant?

68
Q
  1. Aspirate & ID stomach contents2. Differentiate upper/lower GI bleed 3. Remove air, blood, ingested substances & gastric contents4. Provide nutritional support
A

Indications of NG tube

69
Q
  1. Esophageal stricture or alkali ingestion2. Recent surgery on esophagus/stomach3. Gastrectomy/bariatric surgery4. Severe coagulopathy5. Facial trauma/basilar Fx
A

Contraindications of NG tubes

70
Q
  1. Trauma - bleeding2. Place tube into trachea/lung3. Gastric hemorrhage4. Aspiration PNA5. Sinusitis
A

Complications of NG tubes

71
Q
  1. Inject air while auscultating LUQ2. Aspirate contents & Check pH (<3)3. Xray - Gold Standard
A

How might you check NG tube position?

72
Q
  1. Central venous pressure monitoring2. Rapid volume resuscitation3. No peripheral IV sites4. Routine serial blood draws5. Infusion of hyperalimentation & other solns6. Placement of pulmonary artery catheter, transvenous pacemaker, performance of cardiac cath, hemodialysis
A

Indications for Central line

73
Q
  1. Useful in trauma - cervical collar not in way2. Preferred during CPR3. L subclavian has direct route to SVC so preferred for pacemaker placement & CVP monitoring
A

Indications for subclavian central line

74
Q
  1. Useful during CPR2. Arterial punctures easy to control3. R IJ has direct route to SVC
A

Indications for internal jugular central line

75
Q
  1. More simpler anatomy & superficial2. Emergency cardiopulm bypass for resusciation3. Charcoal hemoperfusion in OD4. Dialysis accessHigher rates of infection
A

Indications for femoral central line

76
Q
  1. Local cellulitis 2. Distorted anatomy or landmarks3. Morbid obesity4. Combativeness5. Suspected proximal vascular injury6. Bleeding disorders7. Anticoag/thrombolytic therapy8. Previous radiation therapy
A

Contraindications of central lines

77
Q

Same side as trauma - risk of pneumo

A

Which side should you put a subclavian central line if there is trauma on one side?

78
Q

SAME side

A

What side should you do a central line if you had other failed attempts?

79
Q
  1. Cellulitis2. Osteomyelitis3. Iatrogenic Fx of physeal plate injury in kids4. Fat embolism
A

Complications of IO access

80
Q
  1. Proximal Fx2. Ipsilateral vascular injury3. Severe osteoporosis
A

Contraindications of IO access

81
Q
  1. Proximal tibia2. Medial mallelous3. Distal femur4. Sternum5. Humerus6. Ileum
A

What bones can you use for IO access?

82
Q
  1. Benzocaine (Anbesol)2. Cocaine3. Novocaine (Procaine) 4. TetracaineAll pretty fast acting & short duration
A

What are the ester anesthetics?

83
Q
  1. Lidocaine (Xylocaine)2. Mepivacaine (Carbocaine)3. Bupivacaine (Marcaine)4. Dibucaine (Nupercaine)5. Prilocaine (EMLA)
A

What are the amide anesthetics?

84
Q

1% 4.5mg/kgw/ epi - 7 mg/kg

A

Max dose of lidocaine w/ & w/o epi?

85
Q

0.25%2 mg/kgw/ epi - 3.5 mg/kg

A

Max dose of Bupivacaine w/ & w/o epi?

86
Q
  1. Temp2. Sensation3. Pain4. Touch5. Deep pressure6. Motor
A

Order of effect from anesthetics?

87
Q

junction of dermis & hypodermiswhere nerves are transversing

A

Where do you inject local anesthetics?

88
Q

Estersalso more likely to have allergies

A

Which types of anesthetics are more likely to have liver/renal potency?

89
Q

Cocaine

A

Which anesthetic is NOT a vasodilator?

90
Q

Fingers, toes, nose & hoes(penis, scrotum)

A

Where should you avoid using epi w/ anesthetics?

91
Q

EMLA in babies <1y/o

A

Which drug do you worry about methemoglobinemia with?

92
Q
  1. UnTx hyperthyroidis2. Pheocromocytoma3. Appendages4. CAD
A

Contraindications to epi?

93
Q
  1. Epi2. Benadryl3. CorticosteroidsAlways observe for late reactions
A

Tx anaphylaxis?

94
Q
  1. Benadryl2. Normal saline3. Conscious sedation4. Topical Gauber’s cold spray
A

What are alternatives to anesthesia?

95
Q

Mucous membranes

A

Where is viscous lidocaine used?

96
Q

Benadryl 5% 1 mL + 4 mL normal saline

A

How do you make a Benadryl solution for anesthesia?

97
Q
  1. Gauze2. Chlorhexidine3. Isopropyl alcohol4. Iodine solution
A

Wound cleansing materials?

98
Q

1% Lidocaine + 1% Carbocaine1. Procedures on distal to midproximal phalanx2. Nail avulsion3. Paronychial4. Finger lacerations

A

What do you use for digital blocks & indications?

99
Q

Wallerian degeneration

A

What way do nerves heal?

100
Q
  1. Dec. time to healing2. Reduce infection likelihood3. Dec. scarring4. Repair the loss of structure & function5. Cosmetic improvements
A

Goals of wound closures?

101
Q
  1. Open >8h2. FB3. Extensive wounds w/ neurovascular compromise
A

Contraindications to wound closure

102
Q
  1. Hemostasis2. Inflammation3. Proliferation4. Remodeling
A

Steps of wound healing

103
Q

Primary intention - all layers closed, least scarring, done on clean/clean-contaminated woundsSecondary - Deep layers closed & outer close on ownDelayed primary closure - Deep layers close the reassess on 4th day & close if no infection

A

Wound closure classifications

104
Q
  1. Old wounds2. Deeper3. Avulsion injury4. Devitalized tissue5. Contaminated6. Gunshot7. Crush wounds8. Burn9. Frostbite10. Corneal abrasions
A

What are the tetanus prone wounds?

105
Q
  1. Trismus2. Nuchal rigidity3. Dysphagia4. Severe spasms5. Opsithotonus6. Resp. failure7. Death
A

S/S tetanus

106
Q

Tetanus prone wound - current vaccines - update if >5yrsNon-tetanus prone - Vaccinate if >10yrs Tetanus prone & unknown - update & give TIG

A

Rules for tetanus immunizations

107
Q

Horizontal mattress stitch

A

What kind of stitch is good for old farts?

108
Q
  1. Old wounds >12h2. Bites3. Crush wounds4. Contaminated wounds5. Wounds involving avascular areas6. Open Fx or deep wounds beyond fascia7. Severe paronychia or felons8. Pts w/ valvular heart disease9. Immunocompromised
A

When should you write antibiotics when suturing?

109
Q
  1. Meningitis2. Subarachnoid hemorrhage3. Tx pseudotumor cerebri4. CNS syphilis5. Unexplained seizures6. Administration of meds7. Suspected demyelinating/inflammatory CNS process8. CNS CA
A

Indications for LP

110
Q
  1. Inc. ICP2. Local infection3. Coagulation disorder
A

Contraindications to LP

111
Q

After LPLay supine CSF leak at puncture site Better w/ smaller needle/noncutting needleTx - blood patch, caffeine

A

Who gets postdural puncture HAs?

112
Q
  1. Postdural puncture HA2. Herniation3. Nerve damage4. Infection5. Bleeding6. Epidermoid tumor7. Backache & radicular Sx8. Needle breakage
A

Complications of LP

113
Q

0.35 mL/min

A

How fast is CSF produced?

114
Q

A - L1I - L3

A

Where does the spinal cord terminate in infants & adults?

115
Q
  1. Pneumothorax2. Cough3. Infection4. Hemothorax, splenic or hepatic injury, abdominal hemorrhage, air embolism, unilat pulm edema
A

Complications of thoracentesis

116
Q

1-2 ICS below highest level of effusion in midscapular/posterior axillary lineNot lower than btwn 8&9th ribsScapula comes down to 7th rib

A

Where do you inject for thoracentesis?

117
Q
  1. Pneumothorax2. Hemothorax3. Empyema
A

Indications of tube thoracostomy

118
Q
  1. Infection2. Laceration of intercostal vessel3. Laceration of lung4. Intra-abdominal or solid organ placement5. SQ emphysema6. Tube dislodgement/incorrect placement
A

Complications of tube thoracostomy

119
Q

2nd ICS midclavicular

A

Where do you stab for tension pneumothorax?

120
Q

Mid to anterior axillary line in 4th/5th ICS Incision site should be lateral to the edge of the pectoralis major & breast tissue

A

Insertion site for tube thoracostomy?

121
Q

Should be removed w/in 1 wk for infections1. Improvement in resp status2. Drainage

A

When do you remove a chest tube?

122
Q
  1. Adhesions2. Bowel obstruction3. 2/3rd trimester of pregnancy
A

When should you use US guidance w/ paracentesis?

123
Q

Best is based on prior paracentesisOR2cm below belly buttonEither lower quadrant, 4-5cm cephalad & medial to ant. sup. iliac spine

A

Site of entry for paracentesis

124
Q
  1. Pericardial effusion2. Tamponade
A

Indications of pericardiocentesis

125
Q

Btwn xiphoid process & L costal margin at 30-45 degree angle to the skinAim at L shoulder

A

Where to stab for pericardiocentesis?

Procedures (4 decks)

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