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Flashcards in Rosh 2 Deck (18)
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1
Q

Right Bundle Branch Block (RBBB) ecg

A

wide QRS
QRS interval will be > 0.12 s

predominantly positive QRS in V1
rSR or rsR in lead V1
Wide S in lead I and V6

2
Q

Osgood-Schlatter disease

A

acute inflammation of the patellar ligament at the tibial tuberosity

manifests as tenderness and swelling at the insertion of the patellar tendon on the tibial tubercle and pain with knee extension against resistance

3
Q

most commonly detected viruses in croup are

A

parainfluenza
respiratory syncytial virus
rhinovirus.

4
Q

treatment of croup

A

is based on the severity of symptoms.
corticosteroids
racemic epinephrine for stridor at rest.
antipyretics

5
Q

Management after racemic epi for croup

A

Patients who are treated with racemic epinephrine should be observed for a minimum of 3 hours to ensure that stridor and airway obstruction does not recur.

Patients with persistent stridor at rest, retractions, tachypnea or hypoxia, or those who require more than two treatments of racemic epinephrine should

6
Q

What classic X-ray finding is seen in croup?

A

Subglottic trachea narrowing (Steeple sign).

7
Q

Laryngotracheitis (Croup) basics

A

Patient will be a non-toxic appearing child, 6-months to 3-years-old
Complaining of URI symptoms with barky, seal-like cough, inspiratory stridor, low-grade fever
X-ray will show “steeple sign” on PA view
Most commonly caused by Parainfluenza virus
Treatment is steroids, aerosolized epinephrine

8
Q

most common complication of diverticulitis

A

abscess formation

9
Q

AFib with RVR stands for?

A

atrial fibrillation with rapid ventricular response

10
Q

There are 2 major strategies in the care of patients with AFib with RVR

A

rhythm control and rate control.
Rhythm control involves converting the patient from AFib to normal sinus rhythm.
Rate control involves reducing the ventricular response but leaving the patient in AFib.

11
Q

__________ is a cardiac glycoside that acts at the AV node for rate control.

A

Digoxin

12
Q

Atrial Fibrillation > 48 hours and cardioversion

A

anticoagulate for 21 days prior to cardioversion

Determine the need for anticoagulation by using CHADS2

13
Q

patients taking INH and showing evidence of toxicity such as seizures and metabolic acidosis should be treated with ____________ and dose!

A

B6. The empiric dose of pyridoxine is 5 g IV slow IV push.

Isoniazid (INH) Toxicity

↓ B6 → ↓ GABA → refractory seizures with AG metabolic acidosis
Antidote: B6

14
Q

S1Q3T3 pattern associated with right heart strain means?

A

An S wave in lead I, and a Q wave and inverted T wave in lead III

15
Q

rx for body packers- aka swallowed packets of drugs

A
  • Admit for tele
  • Whole bowel irrigation with polyethylene glycol to speed gastrointestinal passage of the packets.
  • Activated charcoal
  • Endoscopic retrieval of the packets is not first-line treatment because of concern for packet rupture during the procedure.
  • In the case of rupture, may be taken emergently to the OR to try to remove the packets and save the patient’s life.
16
Q

Pertussis (“Whooping Cough”) rx

A

Most commonly caused by Bordetella pertussis

Treatment is a macrolide - azithromycin

17
Q

Boerhaave Syndrome

A

Diagnosis is made by esophogram with water-soluble oral contrast

Chest X-ray will show pneumomediastinum

Treatment is emergent surgical consult and broad-spectrum antibiotics

18
Q

Serum Sickness

A
  • type III hypersensitivity reaction/ immune complex-mediated reaction
  • immune complexes are deposited on vessel walls leading to local inflammation and eventually tissue injury
  • presents with rash, fever, polyarthralgias and polyarthritis usually begins 1-2 weeks after exposure to a causative agent.