One Liners part 4 Flashcards Preview

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Flashcards in One Liners part 4 Deck (17)
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1
Q

What 2 things do if 1 day old infant now satting at 80%

A
  1. ) Give 100% oxygen

2. ) If not improve, give prostaglandin E1

2
Q

Why give PGE1 for R-L shunt in newborn?

A

Prostaglandin E1 is a vasodilator can prevent PDA from closing

3
Q

Why remove gonads in 46 X,Y appearing female after puberty?

A

Cryptorchid gonads 1-5% risk dysgerminoma or gonadoblastoma after puberty
So keep in to get benefits of puberty
Complete androgen insensitivity

4
Q

Recurrent intrusive thoughts about wanting to stab a loved one, need to perform ritual to get past, 3-5x / day. Tx?

A

Obsessive Compulsive Disorder

- SSRI - Fluoxetine + CBT

5
Q

Why give Epi for anaphylaxis?

A

b2 agonist - bronchial SM relaxation

a1 agonist - vasoconstrictor to raise BP

6
Q

What happens in nursemaid’s elbow?

A

Radial head sublaxation

  • kids 1-5 - lifted/pulled by hand/arm
  • radial head slips through the annular ligament
  • kid keeps it pronated
7
Q

Hemiphyerplasia?

A

Overgrowth of one side of the body

  • assoc w/ Beckwith-Wiedemann syndrome
  • also macroglossia, omphalocele
  • hyperinsulinism due to pancreatic hyperplasia
8
Q

How treat GDM LGA clavicular fracture in newborn?

A

If non-displaced – heal spontaneously w/ no long-term sequelae so reassurance + gentle care

9
Q

What surges w/ refeeding in refeeding syndrome?

A

Insulin

  • get Na/H2O retention
  • which decreases K, P, Mg (cellular uptake)
10
Q

Clinical manifestation of Refeeding-Syndrome?

A

Arrhythmia (low K & Mg)
Wernicke encephalopathy (low thiamine)
Seizures
CHF + pulmonary edema + peripheral edema

11
Q

Test for Addison’s ?

A

ACTH stimulation test:

  • compare baseline cortisol level to 1 hour after ACTH injection
  • normally cortisol level doubles
12
Q

How treat adrenal crisis?

- think Addison’s, Waterhouse-Friderichsen

A

IV fluids w/ D5 (normal saline)

  • need the sugar to prevent hypoglycemia
  • need the NS to prevent hyponatremia
13
Q

Test for glucocorticoid excess?

- think cushing, iatrogenic

A

Dexamethasone suppression test

  • give this in the evening and it should suppress the morning physiologic rise in cortisol
  • we will NOT see this suppression in GE
14
Q

How Dx T1DM?

A

Random blood sugar draw > 200 with…

  • weeks of polyuria
  • weeks of polydipsia
  • weeks of nocturia
15
Q

What is Somogyi phenomenon?

A

Some mornings…too high evening Insulin =
- hypoglycemia in early morning
- get epi & glucagon released to counter
- so high blood glucose + ketones in AM
Tx: lower evening dose of insulin!

16
Q

Ketonuria + bicarb < 15 mmol/L . . . also x2?

A

pH < 7.3 and hyperglycemia > 300 mg/dL
(anion gap metabolic acidosis)

Diabetic Ketoacidosis

17
Q

Rapid and deep (kussmaul) respirations?

A

DKA:

  • insulin deficiency means low cellular glucose (despite high serum)
  • cells need energy so convert FFA’s into ketones