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1

Seizure causes

4 Ms, 4 Is

Metabolic/electrolyte/hyperthermia
Mass/hemorrhage
Missing drugs (withdrawal, noncompliance)
Miscellaneous (eclampsia, HTN cerebral edema)
Intox (cocaine, lithium, lidocaine, theoph, metal, CO)
Infection (sepsis, meningitis, abscess)
Ischemia (stroke, TIA)
Increased ICP

2

Seizure, don't know the patient...what labs to check?

Na, Ca, Glc, BUN

3

Tx for severe hypovolemic hypernatremia

Normal saline, then switch to 1/2NS once volume status is repleted

4

Tx for mild hypovolemic hypernatremia

D5 0.45% saline

5

Tx for euvolemic and hypervolemic hypernatremia

D5W (dextrose prevents the osmotic burst of free water)
Oral free water (mild)

6

Chronic cough w/ white sputum, worse at night (adult), no other URI/LRI symptoms...suspect what?

Asthma

7

Coronary angiogram and stenting --> AKI, abdominal pain, mottling of LEs, elevated eosinophils on CBC

Cholesterol emboli syndrome

8

When to Xray vs. MRI the back

XRay - osteoporosis, compression fxr, malignancy, Ank Spond, MM

MRI - sensory/motor deficits, cauda equina, epidural abscess/infection

9

Biggest risk factor for cerebral palsy

PREMATURITY (NOT hypoxia)

10

Function of adenosine in a stress test

Vasodilate the coronary vessels, thus exaggerating which vessel is blocked

11

Fever, pleuritic chest pain, hemoptysis, nodules w/ surrounding ground glass opacities in upper lobe

Invasive aspergillosis

12

Modified Wells Criteria

3 points = signs of DVT, or nothing more likely
1.5 points = previous DVT/PE, recent surg/immob, HR > 100
1 point = hemoptysis or cancer

4+ = PE

13

6-week child, dyspnea and crackles w/ feeding, VSD murmur, LUSB systolic ejection murmur, loud S2

Complete AV septal defect - DS

14

Baby, triple or quadruple gallop, LLSB systolic murmur

Ebstein anomaly

15

Baby, loud systolic ejection murmur w/ click LSB, cyanosis, tachypnea, heart failure

Truncus arteriosus - DGS

16

Baby, cyanosis, tachypnea, murmur, relatively comfortable

Transposition of great vessels

17

LE pain, pale, cool temperature, loss of distal pulses, tingling/numbness, weakness

Do what first?

LE arterial occlusion (6 Ps - pain, pallor, poikilothermia, paresthesias, paralysis, pulseless)

Anticoagulate (heparin)

18

Turner syndrome...heart anomalies?

Bicuspid aortic valve
Coarctation of aorta

19

Abnormal ABI

Considered what?

Under 0.9

Occlusive PAD

20

Meds that improve long term survival in LV dysfunction

ACEI/ARB
BB
Mineralocorticoid receptor blockers (eplerenone, Spironolactone)
Hydralazine + Nitrates (AFRICAN AMERICANS)

21

Permanent pacemaker --> R heart failure...why?

Pacemaker wire passes through tricuspid valve to supply charge to ventricles...can accidentally obstruct tricuspid valve --> TRICUSPID REGURG

22

Mid-left sternal border...murmurs?

AR, PR, HOCM

23

LLSB...murmurs?

TR, TS, VSD, ASD (really increased T)

24

RUSB...murmur?

AS

25

LUSB...murmurs?

PS, Flow murmur, ASD (really increased P)

26

L 5th intercostal (apex)...murmurs?

MS, MR, MVP

27

Stable A fib in WPW...tx options?

Ibutilide, Procainamide

28

Aortic dissection...possible complications (w/ structure) (8)

Tamponade (pericardial sac)
MI (coronary)
Stroke (carotid)
AR (aortic valve)
Abd pain (mesenteric)
Horner syndrome (superior cervical symp ganglion)
Hemothorax (pleural cavity)
LE weakness or ischemia (spinal or common iliac aa)

29

Fibromuscular dysplasia...see what?

CAROTID and RENAL stenosis

30

Drugs that increase digoxin

Symptoms?

Amiodarone
Verapamil
Quinidine
Propafenons

General, GI, Neuro, Color vision disturbance, ectopic ventricular beats/AV block/A fib/V tach