Rosh questions Flashcards
(136 cards)
1
Q
“weakness with overhead activity”
A
rotator cuff tear
2
Q
Supraspinatous movement
A
Abduction
3
Q
infraspinatous movement
A
ER
4
Q
teres minor movement
A
ER
5
Q
subscapularis
A
IR
6
Q
pain with reaching up back; brushing hair
A
rotator cuff tear
7
Q
+ drop arm
A
rotator cuff
8
Q
+ empty can test
A
rotator cuff
9
Q
+ neer test
A
rotator cuff
10
Q
+ hawkins
A
rotator cuff
11
Q
Congenital cardiac malformation associated with maternal lithium use
A
Ebstein’s anomaly
12
Q
stable SVT tx
A
vagal (valsalva, cold water) –> adenosine
13
Q
unstable SVT
A
cardiovert
14
Q
Pounding pulses with machine like murmur
A
PDA
15
Q
PDA radiates to?
A
back
16
Q
What do you use to close a PDA?
A
indomethicin
17
Q
back pain better with flexion, worse with extension?
A
spinal stenosis
18
Q
pneumothorax: tactile fremitus
A
decresed
19
Q
pneumothorax: resonance
A
hyper-resonance
20
Q
in a tension pneumothorax the trachea deviates?
A
away from affected side
21
Q
what is the most commonly damaged intra-abdominal structure in blunt abdominal trauma?
A
spleen
22
Q
What do you do if you have a positive FAST exam?
A
CT scan
23
Q
unstable + negative FAST?
A
repeat fast or DPL
24
Q
unstable + positive FAST?
A
laparotomy
25
gold standard for management of intra-abdominal bleeding following trauma?
lapartotomy
26
what is the active ingredient in anti-freeze?
ethylene glycol
27
anti-freeze/ethylene glycol OD CM?
early: N/V, CNS depression
Late: anion gap metabolic acidosis, hypocalcemia, kidney failure, maltese crosses
28
antidote for anti-freeze/ethylene glycol OD?
fomepizole
29
MCC of anterior knee dislocation?
MVA
30
Knee instability in multiple directions?
anterior knee/tibiofemoral dislocation
31
Tx of anterior knee dislocation
immediately reduced
32
Likely structures damaged in anterior knee dislocation?
common peroneal nerve; popliteal artery
33
When is reduction CI in knee dislocation?
"dimple sign" which indicates posterolateral dislocation
34
Posterolateral knee dislocation tx
immediate open reduction
35
MCC of atlanto-occipital dislocation?
high-speed MVA
36
MC population for atlanto-occipital dislocation?
children
37
closure of PDA begins when what increases in the immediate post-natal period?
bradykinin
38
HCM inheritance pattern?
AD
39
crescendo-decrescendo pattern loudest over LLSB
HCM
40
ECG of HCM?
LV hypertrophy, prominent septal Q waves
41
Tx of HCM?
avoid activity, BB
42
MC presenting symptom of HCM?
dyspnea on exertion
43
MCC of SCD in young athletes
HCM
44
Heat stroke body temp
>104 F
45
heat stroke symptoms
AMS, organ damage, anhidrosis
46
Tx heat stroke
whole body cooling and IV fluids
47
heat exhuastion temp
100-103
48
heat exhuastion symptoms
dehydration, N/V, weakness
49
heat exhaustion tx
fans, oral water
50
heat cramps symptoms
muscle cramping of calves/abdomen
51
heat cramps tx
oral water
52
lead poisoning can present like?
microcytic anemia
53
Basophilic stippling of RBC with GI/CNS symptoms
lead poisoning
54
tx for lead poisoning
succimer (sucs to eat lead)
55
What type of bursitis occurs commonly in runners?
pes anserinus
56
what muscles insert at pes anserinus?
gracillis, sartorius, and semitendinosus
57
anterior medial knee pain below joint like and TTP over bursa
pes anserinus
58
benzo antidote
flumazenil
59
APAP antidote
N-acetylcysteine
60
opioid antidote
naloxone
61
WPW (narrow) stable tx
1) vagal
| 2) adenosine
62
unstable WPW (narrow) tx
synchronized cardiovert
63
antidromic (wide complex) tx
procainamide
64
WPW in pregnancy tx
sotalol or flecainide
65
myocarditis can result in what type of cardiomyopathy?
dilated
66
gold standard for diagnosing myocarditis
endomyocardial biopsy
67
first line meds for prevention/tx of OA
bisphosphonates (alendronate, ibandronate, risedronate, zoledronic acid)
68
iron is directly corrosive to?
GI mucosa
69
When should you get serum levels of iron OD?
4 hours after ingestion
70
Brugada syndrome is assoc with what arrythmia?
V. fib
71
MC arrythmia associated with TCA tox
sinus tach
72
pupils in TCA OD?
mydriasis
73
TCAs result in what toxic syndrome?
anticholinergic
74
antidote for TCAs?
sodium bicarb
75
Scleroderma: crest syndrome?
calcinosis, raynaud's, esophageal dysmotility, sclerodactyly, telangiectasias
76
ductal-dependent cardiac lesion
coarctation of the aorta
77
Temporal arteritis tx?
no vision loss: prednisone
| Vision loss: methylprednisolone IV
78
anterior/posterior fat pad in adults?
radial head fx
79
anterior/posterior fat pad in kids?
supracondylar fx
80
Increased ventricular chamger with normal or reduced wall thickness
dilated cardiomyopathy
81
Only BB proven in HF
bisoprolol, carvedilol, metoprolol
82
MC cardiomyopathy
dilated
83
what types of bites should close by secondary intention?
animal bites on hands and feet
84
MC long bone fx
tibia
85
MC cancers presenting as spinal cord compression
lung, prostate, breast
86
when should you think spinal cord compression?
LBP + history of CA
87
What tool is used with APAP toxicity?
Rumack-Matthew Nomogram
88
When is Rumack-Matthew Nomogram used?
4 hours after APAP toxicity
89
If after 8 hours of ingestion of APAP?
give 140 mg/kg loading dose N-acetylcysteine
90
SE of NAC?
anaphylactoid rx
91
How many steps in Ottawa ankle rules?
4 steps
92
How many cm in Ottawa ankle rules?
distal 6 cm
93
Burn with no blisters
1st degree
94
burn with blisters
superficial partial thickness (2nd degree)
95
burn that is white, leathery, and painless
deep partial thickness (second degree)
96
full-thickness = what degree?
third
97
parkland formula:
4 mL/kg x % total BSA
| 50% in first 8 hours, remainder over 16 hours
98
Bilateral facet dislocation occurs with what MOI?
hyperflexion of neck
99
What med should be considered in patients with chronic stable angina who remain symptomatic despite optimal agents of BB, CCB, nitrates?
ranolazine
100
First line tx of tension pneumo
thoracostomy at 2nd ICS and midclavicular line with chest tube placement
101
Tx to remove fluid from pleural space?
thoracocentesis
102
How many doses is human rabies immunoglobulin?
one dose
103
How many doses is the inactivated rabies vaccine?
4x over 14 d
104
Not-previously vaccinated w/ rabies exposure
RIG 10 U/kg infiltrate wound
| Vaccine 1 mL IM delt day 0, 3, 7, 14
105
Previously vaccinated w/ rabies exposure
RIG not indicated
| Vaccine 1 mL IM delt day 0, 3
106
MC congenital heart disease
VSD
107
What rabies treatment is never given alone?
human rabies immunoglobin
108
AMS CM?
HA + GI upset, weakness, fatigue, dizzy, lightheadedness, insomnia
109
AMS tx?
stop ascent, supportive care (APAP, ibuprofen)
| -Acetazolamide, oxygen
110
High altitude cerebal edema?
ataxia, confusion, AMS
111
high altitude cerebral edema tx?
immediate descent
112
Cyanotic congenital heart diseases start wtih what letter?
T
113
Common spinal fx in football?
Jeferson fx
114
Acute SCFE CM?
ER deformity, limited ROM at hip, inability to bear weight
115
chronic SCFEE CM?
dull, achy pain in hip, groin, thigh, or knee
116
OD on BB tx?
atropine
117
What cholesterol med can exacerbate gout?
Niacin
118
Calcaneal apophysiitis?
Sever disease
119
apophysitis of tuberosicty of 5th metatarsal
Islen's
120
Salicilate toxicity (ASA) acid/base
metabolic acidosis and respiratory alkalosis
121
OD with v/d, fever, tinnitus, and vertigo
ASA/salicylate
122
antedote for salicilate toxicity (ASA)
sodium bicarb
123
Organophosphate toxicity results in what toxidrome?
cholinergic
124
cholinergic mneumonic
SLUDGE: salivation, lacrimation, urination, diarrhea, GI cramps, emesis
DUMBBELLS: diarrhea, urination, MIOSIS, brady, bronchospasm, emesis, lacrimation, lethargy, salivation/seizure
125
organophosphate treatment
1) decontamination
2) atropine
- pralidoxime is definitive antidote
126
proximal humerus fracture tx
immobilization
127
common n injured in proximal humerus fracture
axillary
128
Acetaminophen toxicity stages
I: <24 hours; anorexia N/V
II: 1-3 d; transaminitis, increased INR, increased bilirubin, RUQ pain
III: 3-4 d: multiorgan failure, coma, death
IV: 4d-2 weeks: resolution
129
Hyphema categories:
I: <1/3
II: 1/3 - 1/2
III: >1/2
IV: total anterior chamber volume
130
What EKG findings show concern for left main coronary artery?
ST elevation in aVR >1 mm or greater than the elevation seen in the ST segement of V1
131
PCI contact to device time
90 minutes
132
Non-PCI center: transfer if contact to device can be less than?
120 minutes
133
non-PCI center: thrombolytics if contact to device >
120 minutes
134
thrombolytics in x minutes of ED arrival, if selected
30 minutes
135
Meperidine eyes?
causes miosis, but in cases of toxicity, unlike other opioids, causes mydriasis in cases of toxicity
136
Hematoma more likely to be associated with concurrent brain injury and parenchymal damage?
subdural hematoma
