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STEP 2 > Pestana Misses > Flashcards

Pestana Misses Flashcards

1
Q

Post trauma pericardial tamponade

A

Pericardial Window …. Thoracotomy …. Ex Lap. If location of the wound strongly suggests tamponade proceed with thoracotomy

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2
Q

Severe Chest Pain with Shock.

A

Cardiogenic post MI, treat as a MI. Confirm then thrombolytics.

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3
Q

LL Chest Wall tenderness and ribs 8,9,10 fractured

A

Ruptured spleen.

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4
Q

Blood in the meatus or pelvic fracture

A

Retrograde urethrogram.

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5
Q

Put in a foley and get frank blood

A

Bladder Injury, retrograde cystogram, if that is normal get a CT scan to look at the kidneys

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6
Q

Guy gets hit in the nuts and has a scrotal hematoma the size of a grapefruit, next step ?

A

Sonogram to confirm. Only treat symptomatically.

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7
Q

Bent Penis,

A

Fracture of the tunica, urological emergency. Surgery

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8
Q

Human Bite on finger,

A

Rabies and surgical exploration.

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9
Q

Indolent punched out ulcer that is chronic.

A

Also how Basal Cell Carcinoma can persent.

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10
Q

Only test that can rule out breast cancer

A

Excesional Biopsy

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11
Q

Orbital Cellulitis

A

CT scan and surgical drainage.

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12
Q

Progressive Dysphagia

A

Barium swallow then endoscopy w/ biopsy then CT Scan

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13
Q

Mallory Weiss vs Borhaave

A

Borhaave will have severe epigastric and lower sternal pain. Gastrograffin swallow.

Mallory Weiss you work up with endoscopy.

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14
Q

Management of internal and external hemmhorids

A

Always rule out cancer first.

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15
Q

Management of anal fissure,

A

Rule out cancer… Exam under anesthesia.

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16
Q

Multiple unhealing anal ulcers and anal fissure

A

Rule out cancer. Exam under anesthesia with biopsies. Usually think churns.

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17
Q

If the prevalence of the disease changes what statistical variable will also change

A

PPV.

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18
Q

Variable that is unmeasured

A

Confounding variable

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19
Q

Microscopic hematuria

A

KUB or sonogram

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20
Q

Intestinal obstruction with bird beak sign

A

Sigmoid Volvulus

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21
Q

Patient on OCP’s becomes suddenly hypotensive and faints.

A

Ruptured hepatic adenoma.

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22
Q

Liver Abscess in a patient from mexico

A

Amebic Abscess. Give him metronidazole. Do not drain it.

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23
Q

Cholidocholithiasis ascending cholecystitis and a liver abscess

A

Pyogenic abscess. This needs drainage.

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24
Q

Indirect hyperbili in an old lady

A

Hemolytic jaundice.

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25
Q

Hypo K + Acidic urine + Non-Anion Gap Acidosis

A

RTA - 2 Inability to reabsorb Bicarb.

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26
Q

Non-Anion Gab Acidosis, Hypo K, Aklaline Urine

A

RTA - 1 Inability to secret H+ , Stones, Give Bicarm

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27
Q

Oligohydramlos with hepatomegaly and dilated bile ducts.

A

ARPKD

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28
Q

Pulsus Paradoxis is found in ?

A

COPD and panic attacks.

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29
Q

Chlorodiazopoxide

A

A bento that can treat delirium tremens

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30
Q

Purulant discharge out the urethra that can not be visualized on gram stain

A

Chylamida urethritis.

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31
Q

Inabiliity to stay awake early in the evening.

A

Advanced sleep phase disorder.

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32
Q

What age are stable infants given their immunizations based on ?

A

Chronological age.

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33
Q

Floating spots and blurred vision in one eye after penetrating injury to the other eye.

A

Sympathetic opthalmia. The breaking of the barrier of the other eye uncovers hidden antigens.

34
Q

Akanthosis Nigricans

A

Insulin resistance, (PCOS / Diabetes / Obesity ) or GI malignancy in the elderly.

35
Q

Syncope and hemodynamic collapse

A

Massive PE. Look for underlying malignancy. This will be accompanied by Right Ventricular dilation and hypertrophy.

36
Q

Reversable airway obstruction that responds to bronchodilation with normal CO diffusion capacity.

A

Asthma.

37
Q

Treatment of HELLP

A

Immeidate induction of labor.

38
Q

First and second things to check when working up amenorrhea ?

A

bHCG, Prolactin/TSH/FSH

39
Q

Obstructive type PFT’s with normal DlCO. FEV-1 returns to normal with bronchodilators.

A

ASTHMA

40
Q

Premature ovarian failure.

A

Increased FSH and Estradiol before the age of 40.

41
Q

Pilonodal cyst vs abscess.

A

Pilonodal cyst is an infected hair follicle. is over an area of high friction. Whereas an abscess will be a tender fluctuant.

42
Q

Bulging eardrum and fever

A

Acute Otitis Media.

43
Q

Middle ear effusion without inflammation.

A

Acute Otitis Media with effusion.

44
Q

Liquid filled blister on the tympanic membrane.

A

Bullious Mygritis.

45
Q

Meningitis and circulatory collapse with large petechiae and purpura.

A

Waterhouse Friedrichson Syndrome.

46
Q

Systolic murmer that decreases with squatting, leg raises, and hand grip.

A

Hypertrophic Cardiomyopathy.

47
Q

Digoxin Toxicity

A

Nausea, Vomiting, Decreased appetite, confusion.

48
Q

Workup of digoxin Toxicity.

A

Digoxin Level, ECG, PT/INR,

49
Q

Adverse Effects of PTU ?

A

Hepatic failure and ANCA associated vasculitis.

50
Q

Pathophysiology of atelectus

A

V/Q mismatch causing dyspnea and tachypenia. The hyperventilation will cause respiratory alkylosis.

51
Q

Relation between hypothyroidism and hyperprolactinemia.

A

Prolactin production is inhibited by dopamine and stimulated by serotonin and TRH. Increased prolactin will suppress GnRH and thus cause amenorrhea.

52
Q

Hard testicular mass. Ultrasound shows high likelihood it is a tumor. Next best step ?

A

Radical orchiectomy. You do not biopsy scrotal cancer because this can allow the cancer to spread.

53
Q

How do you treat active Toxoplasmosis in an aids patient ?

A

Sulfadiazine and Pyramethazine.

54
Q

Respiratory Quotient of the major energy substrates

A

RQ: 1.0 Carbs
RQ: 0.8 Protein
RQ: 0.7 Fatty Acids

55
Q

Akathasia (Ants in the pants) Treatment

A

Benzodiaziapine.

56
Q

Febrile Nonhemolytic transfusion reaction within 1-6 Hours.

A

Give Leukoreduced blood products.

57
Q

Furuncliosis that progresses to RLQ pain and positive psoas sign.

A

Psoas Abscess.

58
Q

Low AFP and Low Estrol

A

Downs Syndrome

59
Q

DD of increased maternal serum AFP

A
  1. Neural Tube Defect
  2. GI Tract Defect
  3. Multiple Gestation, Uterus will be enlarged.
60
Q

Pneumococcus recommendations for HIV patients.

A

PCV 13 followed by PPSV23 8 years later and a booster Q5 years.

61
Q

When can an AIDS patient get MMR and Varicella `

A

CD4 over 200 with no history of AIDS defining illness.

62
Q

Chronic Chondrocalcinosis DD

A

Hypo Mg
Hyperparathyroidism
Hemachromatosis.

63
Q

Workup of lactose intolerance

A

Give the patient lactose and measure H+ in the breath.

64
Q

Antimitochondrial Ab

A

Primary Biliary Cirrhosis.

65
Q

When do you give Ca-Gluconate in a patient with really high K+ ?

A

If they have EKG changes, K over 7, or rapidly rising K.

66
Q

Patient has an enlarged prostate, how should you screen them for prostate cancer ?

A

Just discuss the options with the patient.

67
Q

ARDS Diagnostic Criteria

A

PaO2 / FiO2

68
Q

Carpal Tunnel in a pregnant patient

A

Splint

69
Q

The NPV of a test varies with ?

A

Pretest Probability of a disease.

70
Q

Treatment guidelines for patients with influenza

A

Neuroamidase Inhibitors if caught within 48 hours of symptom onset.

71
Q

Hypothyroidism and hepatocellular injury and pulmonary fibrosis are a side affect of what drug ?

A

Amidarone.

72
Q

Iron Intoxication

A

Desferoxamine

73
Q

Mobile cavitary mass with progressive hemoptysis

A

Aspergillious.

74
Q

Absent CD-55

A

PNH

75
Q

Workup of hereditary spherocytosis

A

Low MCV and Increased MCHC. Eosin-5-Malenide Binding Test.

Treat with folic acid.

76
Q

Classic triad of hereditary spherocytosis

A

Hemolysis, Splenomegaly, Jaundice.

77
Q

Patient is pronounced braindead and decision needs to be made about removal of vent. Who do you ask ?

A

You do not need to ask anyone. Diagnosis of Braindeath is enough.

78
Q

Most common site of hypertensive hemorrhage

A

Putamen.

79
Q

Cardiac defects in turners

A

Coarctation of the aorta and Bicuspid aortic valve.

80
Q

Pneumococcal vaccination recs in adults.

A

PPSV-23 alone in 19-64 for patients at low risk. PSV13-PPSV23 for patients at high risk or over 65

81
Q

Long term treatment of duodenal ulcers

A

Pantoprazole and Triple Therapy.

82
Q

Dude has syphillus and is allergic to penicillin

A

Doxycycline

STEP 2 (9 decks)

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