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PEER Review Flashcards

1
Q

Erythema Nodosum

A

Red tender nodules on extensor surfaces
2/2 IBS, infx, meds
a/w HLA-B27

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2
Q

HSP

A 
pediatric vasculitis (nonblanching palpable purpura)
GI: intussusception
Renal: hematuria, protinuria
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3
Q

Pyoderma gangrenosum

A

gangrenous lesions + IBS

a/w skin trauma

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4
Q

Eyes:

  • Cherry macula
  • Blood & Thunder
  • Flame hemorrhages & papilledema
A
  • CRAO
  • CRVO
  • HTN emergency
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5
Q

Thyroid Storm tx

A 
TIC-B
Thionamide (PTU or Methimazole) - decr production
Iodine - neg feedback
Corticosteroids - stop T4 to T3
B-blockers
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6
Q

Scorpion toxicity

A

oral secretions
muscle jerking
wandering eyes (opsoclonus)

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7
Q

Black widow toxicity

A

alpha toxin (norepi) - HTN and tachy

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8
Q

Brown Recluse

A

Necrotic skin, hemolysis (DIC)

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9
Q

von Willebrand dz

A

Dysfunctional plt adhesion

Tx: factor VIII (similar to hemophilia A)

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10
Q

Infant weakness/paralysis w/ preserved deep tendon reflexes

A

Infant botulism

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11
Q

Pemphigus vulgaris

A

Elderly skin & mucosal blisters - FLACCID w/ +Nikolsky

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12
Q

Bullous pemphigoid

A

elderly skin blisters - TENSE, – Nikolsky

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13
Q

Gen. edema, protinuria, low albumin, high cholesterol

– Thrombophilic (hypercoagable)

A

Nephrotic Syndrome

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14
Q

Differentiate Anticholinergic and Sympathomimetic

A

DRY vs WET skin

(both hot, dilated, delirious

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15
Q

Anticholinergic toxidrome

A

delirium, DRY, flushed, hot, dilated

2/2: atropine, diphenhydramine, antipsych, jimson weed

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16
Q

Sympathmomimetic toxidrome

A

WET, hot, dilated

2/2: PCP, cocaine, ecstacy, meth

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17
Q

Infectious liver abscess (southwest)

A

Entamoeba histolytica (tx: IV metronidazole)

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18
Q

GI complication of HSP

A

Intussesseption

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19
Q

ABI (ankle-brachial index)

A

SBP of DP / SBP of arm
>0.9 is normal,
<0.5 severe impairment of flo

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20
Q

Tx of HTN emergency

A

Lower by 25% over 1 hour and to 160/110 over the next 6 hours

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21
Q

LBBB on EKG

A

QRS > 120
V1 & V2 - broad and deep S wave
V5 &V6 - broad and clumsy notched R wave

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22
Q

RBBB on EKG

A

QRS > 120

V1 & V2 - RSR’ (‘M’)

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23
Q

STEMI on ECG

A
  • > 1 box elevation in 2 contiguous leads
  • New LBBB
  • reciprocal changes = worse prognosis

(historically there should be 1.5 or > elevation in V2/V3)

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24
Q

Stye (hordeolum) vs Chalazion

A

Hordeolum - lashline

Chalazion - eyelid

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25
Pacemaker undersensing & oversensing
inappropriate pacer spikes (under) not enough pacing / syncope (over)
26
Wet/Dry Beriberi
Thiamine (B1) Deficiency - Wet = CHF w/ dyspnea & pulm edema - Dry = Neuro w/ AMS, ataxia (Wernicke-Korsakoff)
27
High CO heart failure
Anemia Thyrotoxicosis AV Fistula Beriberi
28
SIADH
Lung Cx - inapproprate salt wasting - tx: fluid restriction
29
Acute Porphyia
Increased heme | - psychosis and abdominal pain
30
Wilson's Disease
increased copper (decr ceruloplasmin) - change in personality - tremor/ataxia - K-Fleischer ringxs
31
von Willebrand disease Tx
Factor VIII is the treatment for bleeding (25-50 U/kg)
32
Tumor Lysis Syndrome
``` HyperK HyperPhos HyperUremia HypoCa Acute renal failure ```
33
Platelet transfusion level with acute bleeding
<50,000
34
Hemophilia A replacement
Factor VIII - 25 u/kg moderate injury - 50 u/kg severe injury
35
TTP pentad
``` F - fever A- anemia (hemolytic, schistocytes) T- thrombocytopenia R- renal failure N- Neuro (AMS) -- Tx: plasma exchange ```
36
DIC labs
Low platelets and fibrogen | Elevated PTT, PT, INR, dimer
37
Virchow node
Supraclavicular lymph node in peds and adults that signifies intraabdominal cancer
38
Guillain-Barre | - Miller-Fisher varient
Ascending paralysis, areflexia | - MFV = ophthalmoplegia
39
Methanol Ethylene glycol Isopropanol
M - blindness, formeldhyde, folic acid EG - CaOx crystals, fluoresent urine Iso - Osm gap but NO AGAP (acetone)
40
"OK" sign strength tests which nerve
Median
41
Centripetal Rashes
(move centrally - extremities to trunk) | - RMSF, syphilis, dengue, Kaposi, coxsakie
42
Digoxin toxicity tx rules (2)
- AVOID using calcium to treat hyperK, "stone heart" | - arrhythmia are treated with Fab NOT electricity
43
(triad) severe epigastric pain, vomiting, inability to pass NG tube
gastric volvulus | - stomach has duel blood supply so recovery is good
44
Benztropine
anti-cholinergic tx of EPS sxs
45
Unstable spinal fractures
Jefferson fracture (C1 burst) flexion teardrop bilateral facet d/l Hangman (C2 fracture and dislocation)
46
Juvenile arthritis (Stills dz)
- F > M - around 2 years of age - large joints (hips) - painless morning limp that improves throughout the day
47
TM perf tx (wet vs dry)
Dry perf - supportive care only | Wet perf - anti-pseudo abx
48
Epiglottitis tx
Airway Humidified oxygen Ceftriaxone (steroids and rac epi have no role)
49
Entamoeba histolytica
liver abscess, fever (latino) fecal-oral transmission Metronidizole
50
Uremic patients who are bleeding
Desmopression, dDAVP (increases VIII and vWF)
51
bitemporal vision loss
pituitary tumor
52
Lupus testing
ANA - most sensitive | Anti-Sm - most specific
53
highest electrical resistance
fat, tendon, bone
54
Primary adrenal insuff | Addisons dz
- hyperpigmentation - hypoNA - HyperK - hypoGluc
55
Secondary Adrenal Insuff
low ACTH levels - normal pigmentation - low NA and gluc - high K
56
MC cause of atraumatic hip pain in children
Transient synovitis (no fever, normal ESR) - Tx: rest and NSAIDS
57
Anterior Cord Syndrome
hyperflexion injury - spinothalamic tract (pain and temp loss) - corticospinal tract (motor loss)
58
Mallet finger
disruption of the extensor tendon at the level of DIP | forced flexion
59
Jersey finger
disruption of the flexor tendon at the DIP joint | forced extension
60
Bennett fracture
intra-articular fracture of the base of the thumb
61
trigger finger
stenosis of the flexor tendon sheath, prevents extension
62
Gamekeeper thumb
avulsion of the ulnar collateral ligament at the thumb MCP (forced abduction and extension)
63
hyperosmolar hyperglycemic syndrome (HHS) electrolyte abnormality
All are hypokalemic and hypovolemic
64
Retrophyringial abscess measurements
C2 > 7 mm (adult or children) C6 > 14 children C6 > 22 adult
65
TLS electrolytes
High K, Phosp, Uric acid, LDH | Low Ca
66
Leptosporitia
Hawaii - fresh water w/ animal urine - spiralcetes | - hepititis, nephritis, DIC
67
doxycycline in kids <8 yo
Treatment of RMSF
68
Waterhouse-Friderichsen
meningococcemia w/ shock, petechiae, and adrenal insufficency
69
RMSF that invades WBCs
Ehrlichiosis -- diffuse rash, leukopina, DIC
70
Rubeola
measles | - facial rash that spreads to body
71
Acute Interstitial Nephritis (AIN)
Allergic reaction in a kidney - reaction to a drug (PNC, sulfa, diuretics, NSAIDs) - fever, rash, eosinophilia, WBC casts
72
petechiae of the wrist and ankles
Meningococcemia
73
Roseola infantum
Fifths disease | - fever 3-4 days, then rash
74
Rash + LAN post auricular and occipital
Rubella
75
condyloma lata
secondary syphilis
76
congenitally absent parathyroids
DiGeorge Syndrome
77
Hyperviscosity syndrome
- hyperleukocytosis seen in AML | - pathologic proteins in multiple myeloma
78
BP management in stroke
``` Iscemic stroke (<185/110 for tPA, otherwise do not correct unless >220/120) Hemorrhagic (correct to 140-160) ```
79
HTN + edema + proteinuria
Nephrotic syndrome - hypoalbuminemia - Thrombophilia - Hyperlipidemia
80
Hard signs of vascular injury | no further workup -> OR
- pulsless extremity - bruit or thrill - shock - expanding hematoma
81
Cyproheptadine
Serotonin antagonist | - tx: serotonin syndrome
82
Digitalis Ab (Fab) indicators
- hyperkalemia - ventricular dysrhythmias - coingestions
83
how to evaluate for pelvis instability
lateral compression of the iliac wings (no "opening" manuvers)
84
IV BP med of choice for hypertensive crisis
Nitroprusside
85
fever, myalgias, rash to ankles and wrist
RMSF - adults, KIDS, and TERM pregnancy get doxycycline - early pregnancy get Chloramphenicol
86
Gray baby syndrome
Chloramphenicol (CAM)
87
Cloudy vision with floaters
vitreous hemorrhage
88
pupil that dilates in swinging flashlight test
optic neuritis
89
MC organ injuried in blunt trauma (kids and adults)
Spleen
90
Guillain-Barre
Ascending paralysis - areflexia - CSF with high leukocytes
91
Elderly with fever, h/a, abrupt personality change
HSV encephalitis
92
Infections that cause Erythema Multiforme (target lesions)
HSV | Mycoplasma pneumoniae
93
Confusion, ataxia, oulomotor dysfunction (nystagmus); normal coordination & cerebellar testing
Wernicke encephalopathy (etoh abuse,
94
MI in LBBB | Sgarbossa
concordant STE >1 mm ST depression >1mm V1-V3 discordant STE >5mm
95
Strawberry cervix / froathy d/c
Trichamonus
96
Chalazion
(CHRONIC, internal granulomatous swelling of the eyelid) - minimally tender, NOT an infection
97
SO4, LR6, Everything else 3
Oculormotor: CN4: superior oblique; downward rotation to look to nose CN6: lateral rectus; abduction, lateral gauze CN3: all other eom, eyelid opening, pupilary response (CN7: eyelid closing)
98
Marcus Gunn pupil
Swinging light test - afferent pupil defect (CN2) - no response to direct light - will constrict to contralateral light - Abnormal eye will appear DILATED - optic neuritis (MS)
99
Defect in sympathetic pupilary input
Horner's syndrome: - ptosis - miosis - anhydrosis
100
CN3 palsy
-Cant open lid -down and out dilated eye (only SO4 & LR6 work)
101
CN6 palsy
cant look laterally
102
absent knee jerk | absent ankle jerk
L4 | S1
103
bi-temporal hemianopsia vs homonymous hemianopsia
pituitary tumor; optic chiasm | vs cerebellar defect; stroke
104
lateral vs medial epicondylitis
extensor (lateral) vs flexor (medial) overuse
105
Tx of HSV keritits
antivirals (NO steroids)
106
Leptospirosis
fresh water exposure -- conjunctivitis, jaundice, renal failure. SHIN RASH. Tx: doxy or PNC

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