Rosh stuff Flashcards
what pediatric disease causes the triad of acute renal failure, thrombocytopenia, and microangiopathic hemolytic anemia? what are other sx?
hemolytic uremic syndrome (HUS)
sx: decr. urine output, irritability, lethargy, siezures, encephalopathy
*dt abx tx of gastro in E.coli O157:H7 infections bc of Shiga-like toxin release
for patients anticoagulated with heparin, what is the reversal agent of choice?
how is it administered and why?
Protamine sulfate
administered slowly thru IV to avoid hypotension
what is given for emergent reversal of warfarin?
vitamin K
Which agent is preferred over protamine for reversal of anticoagulation when intracranial hemorrhage is associated with low-molecular-weight heparin?
Andexanet alfa
What are three complications of bacterial sinusitis?
Meningitis, orbital cellulitis, and sinus bone osteitis
what are the components of Beck’s triad?
muffled heart sounds
JVD
hypotension
other tampanode findings: pulsus paradoxus, pericardial friction rub
cardiac tamponade
in irritable bowel syndrome (IBS), are sx typically improved or worsened with defecation?
improved
How is irritable bowel syndrome (IBS) dx?
Rome IV criteria:
Recurrent abdominal pain at least once/week for 3 months associated with two or more criteria
* Related to defecation
* Associated with change in stool frequency
* Associated with change in stool form
Sx of HYPOmagnesium?
EKG findings?
sx:
* muscle cramping
* weakness
* hyperreflexia
* ataxia
* seizures
EKG:
* QT prolongation
* PVCs
* tachydysrhythmias
What is the treatment for life-threatening hypermagnesemia?
Intravenous calcium (either calcium chloride or calcium gluconate) and dialysis.
general post exposure prophylaxis with needle stick injuries
HIV
* PEP given with mucous membrane exposure or skin compromise
* Tenofovir + emtricitabine + raltegravir
HBV
* Prior vaccination: PEP not needed
* No prior immunization: HBIG + HBV vaccine
HCV
* No PEP available
What is the most common autoimmune blistering disease in older patients?
is it Nikolsky sign negative or positive?
Bullous pemphigoid
Nikolsky NEGATIVE
MS risk factors?
- female sex
- age less than 50
- birth in temparate (northern) latitudes ~thought to be linked to vit D deficiency
MRI and CSF findings in MS
MRI: periventricular white matter lesions
CSF: oligoclonal IgG bands, WBC pleocytosis
What chemical skin exposures should NOT be treated with water irrigation?
Dry lime - brush off skin
*makes stroke base when combined with water
Elemental metals (sodium, potassium, phosphorus, lithium) - apply mineral oil
*may combust or make hazardous byproduct when exposed to water
phenol - wipe off with sponge soaked in polyethylene glycol
what are the clinical findings commonly seen in anticholinergic toxicity?
- hyperthermia
- tachycardia
- mydriasis (dilated pupils)
- dry skin/mucous membranes
- AMS, disorientation, bizzare behavior
- constipation, urinary retention
after a tick bite, when is a preventative dose of doxycycline indicated
- Tick is identified as Ixodes
- Tick is attached for ≥ 36 hours based on engorgement
- Prophylaxis begins within 72 hours of tick removal
- Doxycycline is not contraindicated
what is the onlytherapy with the greatest impact on mortality for patients with COPD?
long-term supplemental oxygen therapy
What physical exam finding is a hallmark of pericarditis?
pericardial friction rub
abdominal pain out of proportion to exam should make you think?
Mesentaric ischemia
The triad of episodic HA, diaphoresis, and tachycardia with hypertension should make you think of what dx?
Pheochromocytoma
What is the classic electrolyte abnormality that must also be addressed in patients with rhabdomyolysis?
Hyperkalemia
bilateral facial nerve palsy is pathognomonic for what disease in children?
Lyme disease
What is the most common manifestation of late Lyme disease?
arthritis
