Rosh Review Flashcards
(384 cards)
1
Q
encapsulated bugs
A
SHiN SKiS:
Strep pneumo, H.ib, neisseria meningitidis (NOT GONO), ecoli
Klebsiella, salmonella, and GBS
2
Q
charcot triad
A
fever, abdominal pain, and jaundice
3
Q
reynolds pentad
A
fever, abdominal pain, jaundice, confusion, hypotension
4
Q
MCC of biliary obstruction
A
stones, stenosis (primary biliary sclerosis,), or malignancy
5
Q
Dx cholangitis
A
RUQ US, CT, ERCP
6
Q
TX acute cholangitis
A
Zosyn and ERCP; fluids
7
Q
what is this
A
Boerhaave syndrome
8
Q
Diagnosis Boerhaave Syndrome
A
CXR, Contrast esophagram, CT
9
Q
TX Boerhaave
A
supportive, NPO, Abx (Zosyn), surgical consultation
10
Q
US findings of cholecystitis
A
GB wall thickening (>3mm), pericholecystic fluid, sono murphy sign, cholethiasis
11
Q
A
CHOLECYSTITS
12
Q
MC surgical emergency in patients >65 yo
A
acute cholecystitis
13
Q
Boas sign
A
hyperaesthesia, increased sensitivity, or altered below R scapula
for cholecystitis
14
Q
gold standard diagnostic for cholecystitis
A
HIDA
15
Q
cirrhosis + variceal bleed; what do you give to improve mortality
A
rocephin
16
Q
Vasoactive drugs for esophageal variceal bleed
A
octreotide, vasopressin (reduces portal pressure), beta blocker
17
Q
alkali ingestion type of necrosis
A
liquefactive
18
Q
acid ingestion necrosis
A
coagulation necrosis
19
Q
liquefactive necrosis can lead to
A
perforation, mediastinitis, peritonitis, and resp distress, shock
20
Q
TX caustic ingestion
A
- decontamination - irrigation vs lavage
- dilution (first 30 mins)
- NPO
- airway
5.IV PPI or H2 blocker - if suspect mediastinitis or peritonitis - abx
- GI and surgical consult
***endoscopy must be performed within 12 hours and not > 24hr
21
Q
veins that are bleeding in the setting of splenic vein thrombosis
A
short gastric veins
22
Q
TX for CMV esophagitis
A
Ganciclovir
23
Q
CMV CD4 count
A
<50
24
Q
forceful retching
A
mallory weiss syndrome
25
TX mallory weiss
supportive (Zofran), endoscopy (active bleed), acid suppression - PPI (not active bleed)
26
pathology of mallory weiss
intramural dissection (longitudinal mucosal lacerations)
27
TX of esophageal candidiasis
Fluconazole x 14-21 days for
28
CD 4 count for esophageal candidiasis
<100
29
MC location of obstruction of swallowed foreign bodies in peds
C6; cricopharyngeus muscles (UES)
30
where is the coin located
esophagus
31
where is the coin located
trachea
32
GER vs GERD (peds)
GER = normal physiological process; GERD = weight loss, anorexia, dysphagia, sleep disturbance, resp sx
33
Tx GER
smaller more frequent feeds; formula change, thickened feeds, and positioning
34
what position decreases reflux symptoms in kids
prone
35
causes of splenic infarction
1.infection - EBV, CMV, malaira, babesiosis
2. clotting - factor V
3. cancer
4. thromboembolism - afib, endocarditis, PFO
5. vasculitis
36
mesenteric ischemia artery
sma
37
splenic artery originates from
celiac trunk
38
splenic infarct
39
Tx splenic infarcts
supportive & AC (heparin)
40
lifestyle RFs for GERD
chocolate, caffeine, etoh, and nicotine
41
Causes of tracheomalacia
1. congenital
2. complication of esophageal atresia repair or tracheoesophageal fistula
42
S/Sx of tracheomalacia
expiratory stridor, brassy/barking cough
**severe biphasic stridor, dyspnea with feeding
43
dx tracheomalacia
water soluble swallow study
44
achalasia
45
S/Sx of achalasia
dysphagia to solids and liquids, difficulty belching, CP, regurg of undigested food
46
dx achalasia
esophageal manometry
47
TX achalasia
pneumatic dilation, surgical myotomy, botulinum injection
48
VACTERL
vertebral anomalies
anal atresia
cardiac anomalies
tracheoesophageal fistula
esophageal atresia
renal abnorms
limbs anomalies
49
resistance with NG tube placment
tracheoesophageal fistula
50
Dx tracheoesophageal fistula
Upper GI series with contrast, endoscopy with bronchoscopy, chest CT
51
H.Pylori treatment
triple: omeprazole, clarithromycin, and amoxicillin or flagyl
quad: bismuth, flagyl, tetracycline, omeprazole
52
MCC of impacted esophageal food boluses
schatzki rings
53
medication to help facilitate lower esophageal food bolus
glucagon
54
pyloric stenosis causes what laboratory abnormality
hypochloremic metabolic alkalosis
55
SBP fluid analysis `
PMNs >250, WBC >1000, pH <7.34
56
newborn with abdominal distention, inability to pass meconium and bilious vomiting
CF
57
bugs responsible for SBP
E.coli, klebsiella, and proteus
58
Dx pyloric stenosis
US abdomen
59
What is the most common, life-threatening cause of gastrointestinal bleeding after repair of an abdominal aortic aneurysm
aortoenteric fistula
60
carcinoid syndrome s/sx
R sided heart disease, bronchospasm, diarrhea, and skin flushing
61
dx carcinoid syndrome
urine 5 hydroxyindoleacetic acid level
CT or MRI
62
tx carcinoid syndrome
hydration, octreotide, and cyproheptadine
63
virchow node suggests
abdominal malignancy
64
virchow node location
L supraclavicular LN
65
Which of the following is the most common site of aortoenteric fistula formation?
duodenum
66
crohns disease
skip lesions, cobblestones, transmural, fistulas
mouth to anus
pANCA
nonbloody diarrhea
67
paralytic ileus has
air in colon and rectum on abdominal xr; no transition zone
68
Which of the following X-rays is the most sensitive imaging study to detect free air?
lateral chest xr
69
pneumatosis - necrotizing enterocolitis
70
Lab findings for NEC
hyperglycemia and lactic acidosis
71
TX NEC
bowel rest , NG tube, abx
72
S/sx of NEC
first few days of life; abdominal distention and vomiting, bloody stool or + guaiac ; pneumatosis
73
DX intussusception
US or contrast enema
74
abx for non-complicated diverticulitis
Augmentin
75
Salmonellosis tx
supportive care; ciprofloxacin if severe
76
pneumatosis - NEC
77
hirschsprung disease pathology
ailure of neuroblast migration so that ganglion cells do not extend to the distal end of the colon
78
hirschsprung disease s/sx
explosive passage of stook on DRE; failure to pass meconium
79
80
intestinal malrotation tx
NG tube, abx, emergent laparotomy
81
XR description of toxic megacolon
long segments of dilated colon with loss of haustra and “thumb printing” (areas of bowel wall edema).
82
DX hirshchsprung
rectal biopsy or contrast enema
83
tx of intussusceotion
air enema
84
most common cause of a small bowel obstruction in an 18-month-old previously healthy child?
Intussusception
85
cecal volvulus
86
high risk patients for sigmoid volvulus
long term care facilities; neuro and psych dz
87
tx signoid volvulus
flexible sigmoidoscopy; abdomen XR
88
lab findings with shigella
hyponatremia
89
complications of shigella
bacteremia, reactive arthritis, HUS, seizures,
90
dx intestinal malrotation
upper GI series
91
RF for NEC
prematurity
92
tx intussusception in adults
surgery
93
For which etiology of cardiac arrest does induced hypothermia carry the best improvement in survival with good neurologic outcome?
Vfib
94
what are lateral anal fissures concerning for?
systemic illness - crohns, HIV, leukemia, TB, and syphyllis
95
Aortic coarctation
96
Dx aortic coarctation
echo
97
tx pinworms
albendazole
98
tx lice and scabies
permethrin
99
tx tapeworms
praziquantel
100
beta blocker overdose presentation in children
hypoglycemia, seizures, and dysrhythmias
101
cardiac arrest due to ACS mc presents as
Vtach or Vfib
102
TX transposition of the great vessels
prostaglandin at birth (keep ductus arteriosus open), balloon septostomy, surgery
103
neonate HR < 60; first step
1 min of Pos pressure vent then compresssions
104
side effect of prostaglandin
vasodilation, hypotension, hyperthermia, and apnea
105
tx brugada
icd
106
contraindication for targeted temp management
non-compressible bleeding
107
MC location of anal fissure
posterior midline
108
dyspnea and sweating during feeds
anomalous left coronary artery
109
what is an epsilon wave?
small positive deflection buried in the end of the QRS complex
| for HOCM
110
What does an epsilon wave indicate
arrhythmogenic right ventricular cardiomyopathy; can cause sudden death in young patient.
111
Dx arrhythmogenic right ventricular cardiomyopathy
EKG, echo, cardiac MRI
112
tx of WPW orthodromic (narrow complex)
vagal, adenosine, CCB, BB, and synchronized cardioversion
113
tx of WPW antidromic (wide)
procainamide
114
meds for vtach
procainamide, amiodarone
115
SVT
116
svt
117
atrial flutter
118
afib
119
vtach
120
svt
121
blood supply to av node
RCA
122
afib with WPW
123
arrhythmogenic right ventricular cardiomyopathy
124
tx arrhythmogenic right ventricular cardiomyopathy
activity restriction, bb(Sotalol), implantable defibrillator,
125
L: orthodromic; R: antidromic
126
Why is adenosine contraindicated in antidromic WPW
adenosine can enhance anterograde conduction through the accessory pathway, leading to degeneration of the rhythm into ventricular tachycardia or ventricular fibrillation.
127
what does orthodromic mean
electrical impulse goes through the AV node into the ventricle and returns to atria via the accessory pathway.
128
electrolyte abnormalities assoc with torsades
hypokalemia and hypocalcemia
129
what is brugada
Cardiac ion channel dysfunction associated with sudden cardiac arrest
Structurally normal heart
129
fusion beats are diagnostic for
vtach
129
Lown-Ganong-Levine syndrome
cardiac preexcitation syndrome similar in category to Wolff-Parkinson-White syndrome. It causes paroxysms of tachycardia
129
criteria for lown-ganong-levine syndrome
1. short PR
2. normal QRS
3. bundle of james
130
130
130
when to defib vs synch cardioversion in vtach
unstable: synch
pulseless: defib
130
wellens; deeply inverted or biphasic t waves in V2-3
130
HOCM EKG findings
LVH, inverted deep t waves
131
Which of the following is the biggest risk factor for the development of a left ventricular aneurysm?
left anterior descending coronary artery infarction
132
persistent ste >2 weeks after MI
left ventricular aneurysm
133
HOCM murmur heard best when
standing up (+valsalva)
134
tx HOCM
beta blockers
135
Avoid what meds in HOCM
nitroglycerin, nifedipine, and diuretics
136
What is the most common presentation of a patient with hypertrophic cardiomyopathy?
dyspnea
137
low output HF
dilated cardiomyopathy, chronic HTN, and vale heart disease
138
high output HF
hyperTSH, beriberi, AV fistula, Paget disease, severe anemia, preggo
139
Sgarbossa criteria (STEMI with LBBB)
1) concordant ST elevation ≥ 1 mm in any lead with a positive QRS complex
2) concordant ST depression ≥ 1 mm in V1, V2, or V3
3) excessive discordant ST elevation as ≥ 25% of the depth of the preceding S wave
140
left ventricular aneurysm(2 weeks after MI)
141
nitroglycerin MOA
vasodilates and reduces preload and afterload
142
Which laboratory abnormality has been associated with a worse prognosis in heart failure
hyponatremia, poor kidney function, hypoalbuminemia, elevated LFTs
143
findings of a L circumflex artery occlussion
ST segment elevation in V5 and 6
144
posterior wall MI changes
STD in V1-3
145
tx NSTEMI
heparin, nitrates, and asa
146
what test has high negative predictive value and can be used to risk stratify patients with ACS
coronary CTA
147
What is the most common cause of tricuspid regurgitation?
dilation of R atrium and ventricle; usually with pulmonary HTN
148
precursor of squamous cell CA
actinic keratoses
149
actinic keratoses
150
Which of the following clinical manifestations carries the poorest prognosis for untreated aortic stenosis?
CHF
151
who gets ppx before dental procedures?
prosthetic heart valves, a history of previous infective endocarditis, unrepaired cyanotic congenital heart disease, or congenital heart disease repaired with prosthetic material or devices.
152
lipodermatosclerosis
tapering of legs above knees (upside down champagne bottle), brown/red pigmentation, venous stasis
153
murmur associated with turner syndrome
aortic stenosis
154
MC complaint of AS
dyspnea with exertion, decreased exercise tolerance, syncope, and angina
155
most common complication in patients with endocarditis?
CHF
156
Mycotic aneurysm is most commonly a complication of
endocarditis
157
ICD + magnet
turns off defibrillator
158
pacemaker + magnet
goes to default settings and pace at set rate
159
marfan associated with what murmur
AR
160
erythema nodosum
161
Erythema nodosum etiology
delayed hypersensitivity reaction; erythematous tender nodules on shins
162
Tx of erythema nodosum
NSAIDs, potassium iodide, steroids
163
Erythema multiforme
164
erythema multiforme etiology
immune mediated rash ; reactivated herpes simplex; often involve palms and soles
165
tx of erythema multiforme
supportive, topical steroids, antivirals
166
Tx of necrotizing fasciitis
vanco, zosyn, and clindamycin
167
appearance of nec fasc
cellulitis progressing to dusky blue with bullae or vesicles; pai out of portion; subq emphysema
168
Tx pityriasis rosea
supportive, antihistamine, zinc oxide
169
benign hemangioma
170
jock itch medical name and bacteria
trichophyton rubrum; tinea cruris
171
Tinea cruris characteristics
scaly dermatitis, does not fluoresce
172
difference between erysipelas and nec fasc
well demarcated borders
173
Tx erysipelas
elevated limb, mild - penicillin, amoxicillin, cephalexin
severe- rocephin
174
pityriasis rosea
175
drug induced hypersensitivity syndrome presentation
rash, elevated liver enzymes, eosinophilia, elevated ESR CRP
176
tx of drug induced hypersensitivity syndrome
corticosteroids
177
soft, mobile, nontender subcutaneous mass without surrounding erythema. what is this
lipoma
178
omphalitis
purulent discharge from umbilical stump with surrounding erythema and induration
179
tx omphalitis
vanco and gentamicin
180
tx simple cellulits
cephalexin, amoxicillin
181
tx MRSA cellulits
TMP SMX, doxycycline, clindamycin
182
tx inpatient cellulitis
Rocephin, clindamycin, zosyn +/- vanco
183
nec fasc bacteria
polymicrobial
184
description of erythema multiforme
surrounded by a pale area and halo erythema
185
tx scabies
permethrin
186
Which of the following is most commonly associated with erythema nodosum?
strepinfection
187
shingles contact precautions
airborne with contact
188
hypocalcemia s/sx
chvostek sign, perioral numbness, trousseau sign , tetany, lethargy
189
primary adrenal insufficiency electrolyte issues
Hyponatremia, hypoglycemia, hyperkalemia
190
tx primary adrenal insufficiency
hydrocortisone, supportive, fludrocortisone
191
What is the most common worldwide cause of primary adrenal insufficiency?
TB; chronic corticosteroid therapy
192
PE of primary adrenal insufficiency
hyperpigmentation, hypotension
193
s/sx of primary adrenal insufficiency
ab pain, N/V, diarrhea
194
what is associated with pemphigus vulgaris
myasthenia gravis and thymoma
195
bullae and flaccid blisters that slough easily
pemphigus vulgaris
196
Which of the following is typically seen in Korsakoff syndrome?
impairment of short term memory (long term preserved), confabulation and apathy
197
difference between TEN and SJS
TEN >30%; SJS <10%
198
causes of TEN
sulfa, carbamazepine, lamotrigine, allopurinol, NSAIDs, mycoplasma PNA
199
primary hyperPTH labs
increased PTH, increased calcium, decreased phos
200
MCC of primary hyperPTH
adenoma
201
HSP' IgA vasculitis; purpura, arthralgias, and abdominal pain (intussusception)
202
s/sx of pernicious anemia
peripheral neuropathy, ataxia, personality change, dementia, glossitis
203
staph scalded skin syndrome tx
cephalexin or dicloxacillin
204
PE of staph scalded skin syndrome
erythroderma, large, flaccid bullae, desquamation
205
206
peds dextrose administration in hypoglycemia formula
2 x age in years +8, then apply to dose
207
hypoglycemia formula for >8 year old
D50; 1ml/kg
208
hypoglycemia formula for 1-8 year olds
D25; 2ml/kg
209
hypoglycemia formula for <1 year-old
D10; 2-5ml/kg
210
what class of medications are associated with hypoglycemic episodes
sulfonylurea
211
sulfonylurea toxicity
calcium influx and stimulates insulin secretion --> increase responsiveness of beta cells
212
tx sulfonylurea toxicity
D50 & octreotide
213
MCCs of SIADH
lung infections, CNS disorders, and drugs
214
long acting sulfonylurea
glyburide
215
signs patient has renal aa stenosis
hypertension that is refractory to antihypertensive medications, hypokalemia, and metabolic alkalosis
216
laxatives can cause what electrolyte abnormality
hypermagnesemia
217
Tx hypermagnesemia
IVF, furosemide, and calcium
218
hypermagnesemia s/sx
loss of DTRs, weakness, hypotension, vasodilation, dysrhythmia, asystole
219
tx hypercalcemia
IVF, bisphosphonates, steroids, calcitonin, dialysis
220
hypercalcemia ekg changes
short QT
221
stones, bones, groans, and psych overtones
hypercalcemia
222
what is the end point of HHS
correction of serum osmolality
223
refeeding syndrome electrolyte abnormality
hypophosphatemia
224
hypermagnesemia ekg changes
prolonged qt, widened qrs, dysthymia
225
presentation of myxedema coma
thickened, nonpitting edema of skin; puffy face, enlarged thyroid, bradycardia, hypothermia
226
lab findings of myxedema coma
hypoglycemia, hyponatremia, hypoxemia, hypercapnia, prolonged QT, pericardial effusion
227
tx myxedema coma
supportive, hydrocortisone, levothyroxine
228
why does hypothyroidism cause hyponatremia
decreased metabolic rate leading to decreased kidney function and water excretion
229
subacute thyroiditis presentation
fever, myalgias, fatigue, anterior neck pain
230
lab values of subacute thyroiditis
decreased TSH and elevated T3/4
231
tx subacute thyroiditis
NSAIDs
232
types of thyroiditis
hashimoto, post partum, subacute, and infectious
233
order of tx for hyperthyroidism
propranolol, PTU, methimazole, iodine, steroids
234
Which o history or physical exam findings is most common in a child with hyperthyroidism?
goiter
235
what condition should you not give ketamine
pheochromocytoma
236
why is ASA contraindicated with thyroid storm
displaces t4 form binding proteins and potentiate thyrotoxicosis
237
what medications blocks the release of stored thyroid hormone?
iodine
238
what can distinguish primary adrenal insufficiency from secondary adrenal insufficiency?
hyperkalemia: secondary affects pt gland or hypothalamus and would have normal aldosterone
239
thyroid storm clinical presentation
tachycardia, heart failure, hypotension, afib, hyperpyrexia, agitation,
240
scorpion s/sx
extremity jerking that resembles seizures, oculomotor dysfunction, pharyngeal dysfunction, respiratory compromise, tongue fasciculations, motor restlessness, and hypersalivation.
241
components of decompression sickness
the bends - pain in joints
the staggers - neuro s/sx
the chokes - pul and cardiac s/sx
242
MC bacteria in dog bites
pasteurella
243
fatal bacteria from dog bites
Capnocytophaga canimorsus,
244
what early sign that is most suggestive of high-altitude cerebral edema?
ataxia
245
Which blood cells are preferentially damaged in acute radiation injuries?
lymphocytes
246
copperhead snake description
triangular head, nostrils pits, elliptical pupils, folding fangs
247
type 1 vs 2 of decompression sickness
1 - msk, skin, and lymphatics
2 - neuro, ear, lungs
248
acute mountain sickness elevation
6500 ft
249
keraunoparalysis
temporary paralysis of the extremities which may appear blue, mottled, and cold.
250
sea urchin tx
hot water immersion
251
tx of HACE
descent, dexamethasone,
252
what creature bite can mimic acute abdomen
black widow
253
primary cause of the septal necrosis that results from a button battery lodged in the nose?
electrical current
254
lab findings of heat stroke
transaminitis, AKI, metabolic acidosis, DIC
255
exertional heat stroke lab findings
rhabdomyolysis
256
bullous myringitis MC bacteria
strep. pneumo
257
abx after foreign body removal from ear canal
ciprofloxacin drops
258
tx perichondritis
ciprofloxacin
258
perichondritis bacteria
pseudomonas
259
necrotizing external otitis s/sx
CN palsies; otorrhea unresponsive to treatment; periauricular pain and swelling
260
tx of necrotizing external otitis
IV fluroquinolone or anti pseudomonas coverage
261
labyrinthitis s/sx
after viral infection; vertigo, hearing loss, and tinnitus; horizontal nystagmus
262
complication of bacterial labyrinthitis
meningitis
263
MCC of viral labyrinthitis
rubella and rubeola
264
caloric testing (ear)1
cold water = nystagmus opposite side; hot water = same side
265
Meniere disease triad
episodic vertigo, sensorineural hearing loss, tinnitus
266
meniere disease etiology
increased endolymph
267
when do observe vs tx otitis media
>6 months: non-severe and within 48-72 hours
268
what do you NOT do for frost bite
massage
269
abx for mastoiditis
IV Vancomycin
270
insect removal from ear steps
1. kill with mineral oil orlidocaine
2. remove
271
vestibular neuritis exam findings
positive head impulse test, neg test of skew, fall toward affected side
272
superficial punctate epithelial lesions on eye exam
radiation keratitis
273
papilledema
274
retinal vein occlusion; cotton wool spots
275
ethmoid sinusitis can lead to what
orbital cellulitis
276
optic neuritis s/sx
sudden monocular vision loss, pain with EOM, loss of r4ed vision, worsens with increased body temp
277
causes of optic neuritis
MS, infection, autoimmune, methanol, b12 def, diabetes
278
tx optic neuritis
IV steroids
279
what patients do you admit for a hyphema
sickle cell
280
chalazion vs hordeolum (stye)
chalazion = upper lid & painless
stye+ lower & tender
281
dacryoadenitis
enlarged lacrimal gland, pain, supratemporal region
282
dacryocystits
obstruction of nasolacrimal duct, painful, inframedial region
283
dendritic lesion on eye exam that stains poorly with fluorescein
herpes zoster ophthalmicus
284
drug for glaucoma
timolol
285
anterior uveitis (iritis) assoc with
ankylosing spondylitis
286
ITP lab values
normal WBC, normal hgb, thrombocytopenia,
287
ITP s/sx
petechiae, gingival bleeding, epistaxis, gi bleed, intracranial hemorrhage
288
tx ITP
IVIG, supportive, platelets, corticosteroids,
289
what does croup look similar to
bacterial tracheitis
290
TTP pentad
fever, thrombocytopenia, kidney injury, neuro findings, anemia
291
tx TTp
plasmapharesis
292
causes of TTP
preggo, AIDs, lupus, scleroderma, Sjogren, tacrolimus/cyclosporine/quinidine
293
adult vs child ITP
child = after viral infection
adult = chronic
294
pericoronitis
local inflammation/infection due to food trapping under gum flap
295
DIC labs
low platelets and fibrinogen
high PT, PTT, thrombin clotting time
296
factor replacement for hemophilia A
factor VIII
297
factor replacement for hemophilia B
factor IX
298
factor V leiden resistance to
protein c
299
MC artery to bleed with tracheostomy
innominate artery
300
tx alveolar osteitis
Iodoform gauze packing moistened with oil of clove
301
tx parotitis outpatient
augmentin or clindamycin or cephalosporin + flagyl
302
tx parotitis inpatient
ampicillin-sulbactam, cephalosporin + flagyl
303
tx epiglottitis
rocephin
304
necrotizing ulcerative gingivitis
gingival papillae, bacterial plaques, edematous gums
305
tx necrotizing ulcerative gingivitis
debridement, chlorhexidine rinse, and augmentin
306
mechanism of DIC
peripheral destruction of cells
307
RA
morning stiffness, MCP and PIP involvement, Boutonniere vs swan neck joiny deformity
308
multiple myeloma s/sx
hypercalcemia, elevated total protein, kidney insufficiency, and anemia
309
tx kawasaki disease
IVIG, aspirin, and steroids
310
acute vs chronic kidney rejection
acute: CD8+ T cell mediated process against donor tissue resulting in leukocyte infiltration of graft vessels impairing perfusion
Chronic: CD4+ T cell mediated process resulting in the proliferation of the vascular intima and fibrosis of renal vessels causing a marked decrease in lumen size
311
tx for refractory anaphylaxis
epi infusion, vasopressors, glucagon (if on beta blockers)
312
rule out SLE with
ANA
313
CREST syndrome
C - calcinosis of skin
R - Raynauds
E - esophageal dysmotility
S- sclerodactylyl
T - telangiectasia
314
scleroderma renal crisis s/sx
acute oliguria, hypertension, normal UA
315
tx RA vs OA
RA - Methotrexate
OA - prednisone
316
HSP (IgA vasculitis)
After viral illness: abdominal pain (intussusception) with heme positive stool, microscopic hematuria, proteinuria, elevated BUN/Cr, and joint pain (knees and ankles)
317
MC abx for causing serum sickness
cefaclor or amoxicillin
318
Jones criteria (acute rheumatic fever)
carditis - new murmur
polyarthritis
chorea
subcutaneous nodules
erythema marginatum
319
discoid lupus
320
tx hyperviscosity syndrome
leukapheresis
321
contact dermatitis is what type of HS reaction
type IV
322
bronchiolitis obliterans
chronic lung transplant rejection
323
mucocuntaneous lymphadenopathy aka strawberry tongue aka kawasaki
324
Zika virus s/sx
low fever, maculopapular pruritic, arthralgias, conjunctivitis
325
labs for Ehrlichiosis
leukopenia and thrombocytopenia
326
where does small pox rash start
oral xanthem
327
lyme disease prevention tx
doxycycline once
328
lyme disease tx
doxycycline 21 days
329
Which medication is the drug of choice for the parenteral treatment of severe, complicated malaria in the United States?
Intravenous artesunate
330
uncomplicated malaria tx in chloroquine resistant areas
Atovaquone-proguanil; quinine and doxycycline
331
uncomplicated malaria tx in chloroquine sensitive areas
chloroquine
332
ebola virus incubation period
3-12 days
333
eye problems that develop from lyme disease
keratitis
334
labs for hemolytic anemia
low haptoglobin and increased indirect bilirubin
335
erythema migrans
lyme disease
336
erythema marginatum
acute rheumatic fever
337
erythema nodosum
inflammatory nodules
infection, autoimmune, meds, preggo, neoplasm
338
erythema mulitiforme
immune mediated
339
Which of the following is the most accurate test for diagnosing osteomyelitis?
MRI
340
What is the most common site of osteosarcoma in children?
distal femur
341
osteochondroma XR presentation
sessile or pedunculated outgrowth along the surface of the bone.
342
rubella rash description
maculopapular, pinpoint, and pink, which starts on the face and spreads caudally to the trunk and extremities.
343
MC complication of scaphoid fracture
avascular necrosis
344
dengue fever s/sx
several days of fever, period of improvement, followed by several days of resumed symptoms
hemorrhagic fever: bleeding, thrombocytopenia
345
yellow fever initial period of infection s/sx
transaminitis
346
What is the most common cause of death in unvaccinated children infected with measles?
PNA
347
Kocher criteria (peds septic joint)
1. ESR >40
2. non WB on affected side
3. WBC > 12k
4. Fever
348
s/sx of juvenile idiopathic arthritis
poly arthritis > 6 weeks; fever at least for two weeks , salmon colored rash
349
tx juvenile idiopathic arthritis
nsaids, methotrexate, steroids, DMARDS
350
What exams are the highest sensitivity and specificity for sciatica
straight leg raise test and crossed straight leg raise
351
shoulder impingement syndrome
positive Neer and Hawkins
352
goal of fluids with rhabdomyolysis
urine output of 3ml/kg/hr
353
location of tenderness for achilles tendinitis
2 to 6 cm above posterior calcaneus
354
Which of the following is the most common finding in patients with septic arthritis?
pain with ROM
355
SCFE
356
cauda equina vs conus medullaris
cauda = hyporeflexia
conus = spasticity
357
alternative name for osgood schlatter disease
tibial apophysitis
358
labs for dermatomyositis
increased CK and adolase
359
sx for migraine vs HA
aura
360
Lhermitte sign
electrical pain that radiates down the neck and spine when head is flexed (MS)
361
VP shunt complications
overdrainage
infection
seizure
hemorrhage from catheter placement
mechanical shunt failure or blocked
abdominal injury
362
tx VP shunt failure
increase HOB, hyperventilation, osmotic diuresis, and drainage form shunt resevoir
363
trigeminal neuralgia brainstem location
trigeminal nerve (V) -> lateral pons
364
tx flexor tenosynovitis
IV amp-sulbactam and vancomycin OR IV zosyn
365
MS diagnosis modality
MRI brain and spine
366
S/Sx of transverse myelitis
symmetrical back pain, LE weakness and pain, urinary retention
367
transverse myelitis tx
methylprednisolone
368
MC finding for bacterial meningitis in <1yo
paradoxical irritability (irritable when picked up; fine when left alone)
369
MC malignant brain tumor in children
medulloblastoma
370
acute flaccid myelitis
dysfunction of anterior horn cells
371
acute flaccid myelitis s/sx
URI prodrome, rapid onset weakness, limb paralysis
372
acute flaccid myelitis dx
mri
373
acute flaccid myelitis TX
ivig, +/- steroid, PT/OT
374
brain abscess tx
Rocpehin + Flagyl +/- vanco
375
tx MG
pyridostigmine
376
tx for neurocysticercosis
albendazole +/- praziquantel
