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Set 8 Flashcards

1
Q

Tx diphenhydramine OD

A

Physostigmine to counter-act anti-cholinergic effects of diphenhydramine

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2
Q

dermatitis herpetiformis, a/w? Tx?

A

a/w celiac disease, tx = dapsone and diet

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3
Q

4 indications for endometrial bx in DUB?

A

> 35yo, DM, HTN, obesity

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4
Q

Complication of amniocentesis, tx?

A

amniotic fluid embolism –> possible DIC

Tx = facemask ventilate +/- intubate, IVF +/- vasopressors

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5
Q

Indications for clopidogrel. MoA?

A

UA / NSTEMI = 12mo
post-PCI = 1mo if bare-metal stent, 12mo if drug-eluting stent
MoA = ADP antagonist

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6
Q

Thigh adduction

A

obturator nerve

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7
Q

Pruritic, purple,.polygonal, planar papules and plaques

A

Lichen Planus

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8
Q

sawtooth infiltrate of lymphocytes at dermal-epidermal jxn (BM)? a/w?

A

Lichen Planus, a/w hepatitis C

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9
Q

Recent MI and crackles on lung exam/ dyspnea? Tx? what NOT to give?

A

Flash pulmonary edema 2/2 acute heart failure
Tx = furosemide (diurese and venodilate –> decrease preload)
do NOT give BB

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10
Q

Dx test vasovagal syncope

A

tilt-table test +/- isoproterenol

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11
Q

Tx cocaine-induced angina? what NOT to give?

A

benzodiazepine, ASA, nitroglycerin and CCB

do NOT give BB

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12
Q

Quad screen findings in Downs (AFP, estriol, BhCG, inhibin A)

A

increased: BhCG, inhibin A
decreased: AFP, estriol

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13
Q

Quad screen findings in Edwards syndrome (AFP, estriol, BhCG, inhibin A)

A

decreased: AFP, estriol and BhCG

Normal inhibin A

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14
Q

Overdose characterized by wheezing, hypotension and bradycardia? Tx?

A

Beta Blocker

Tx = IVF, atropine, if fails then glucagon

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15
Q

18 yo with amenorrhea, normal internal female anatomy, clitoromegaly, high testosterone, FSH, LH, but low estrogen, multiple ovarian cysts?

A

Aromatase deficiency

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16
Q

Wedge on thoracic CT?

A

PE!! +/- pleural effusion

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17
Q

Gestational diabetes timing and algorithm

A

at 1st visit if high risk, at 24-28wks otherwise
1 hr 50g OGTT –> do 3 hr 100g
abnormal if 2 or more : fasting >95, 1hr >180, 2hr >155, 3hr >140

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18
Q

Kid with recent/active eczema develops umbilicated vesicles, LAD and fever? Tx?

A

Eczema herpeticum –> primary HSV infection superimposed on healing atopic dermatitis lesions.
Tx = acyclovir

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19
Q

18 yo girl with amenorrhea, full breasts, no axillary/pubic hair, blind vaginal pouch, no uterus, normal external genitalia, high testosterone and 46 XY?

A

Androgen insensitivity syndrome (testicular feminization)
MIF by testes inhibits uterus/ovarian formation
breasts via peripheral E2 converison, no hair b/c no androgen receptors

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20
Q

Why is nifedipine (Dihydroppyridine CCBs) CI in STEMI?

A

causes peripheral dilation and reflex tachycardia –> worsens ischemia

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21
Q

immunocompetent pt with CXR that shows dense consolidation/ cavity and CT shows pulm nodule with ‘halo sign’ or lesion with air crescent.

A

Invasive aspergillosis

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22
Q

string of pearls appearance on adnexal US

A

PCOS

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23
Q

Tx HELLP

A

DELIVER THE BABY

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24
Q

BhCG levels needed for visualization of fetus with transabd vs. transvag US

A

transabdominal = 6500
transvaginal = 1500
If inadequate, repeat BhCG in 48hrs

25
What is serum inhibin B measured for?
determination of ovulatory reserve
26
Causes of symmetric IUGR
body/head proportionately small due to FETAL factors: chr abn, congen anom, TORCH
27
Causes of asymmetric IUGR
weight due to MATERNAL factors: | HTN, pre-e, uterine abnormalities, smoking*, APLA
28
best method to estimate fetal weight in suspected IUGR
abdominal circumference
29
blood at the urethral meatus, inability to void, high-riding prostate on DRE? possible other findings? POA?
posterior urethral injury | Dx = retrograde urethrogram, NOT a foley
30
perineal or scrotal hematoma, think
pelvic fracture
31
Dense deposits that stain C3? MoA?
MPGN --> persistent activation of alternative complement pathway
32
HIV patient with esophagitis showing multiple well-circumscribed, small volcano-like ulcers, biopsy showing ballooning degeneration and eosinophilic intranuclear inclusions? Tx?
HSV, tx acyclovir
33
HIV patient w/ esophagitis showing large, shallow, superficial ulcers. biopsy showing intranuclear AND intracytoplasmic inclusions? Tx?
CMV, Tx ganciclovir
34
Immunosuppressant causing diarrhea, leukopenia and hepatotoxicity
azothioprine
35
Variable decels? Tx?
``` cord compression (low AFI or nuchal cord) Tx = O2, change maternal position, stop oxytocin ```
36
Effect of pregnancy on GFR, RPF, BUN and Cr
increased GFR and renal plasma flow causes decreased BUN and Cr
37
Bounding pulses, widened pulse pressure
AR --> bound pulse is due to increased SV from previously regurgitated volume
38
50yo with dysmenorrhea, menorrhagia, symmetrically enlarged uterus? ddx?
MCC adenomyosis | ddx = leiomyoma (similar but IRREGULAR shape on US)
39
Active genital herpes, is C-section necessary?
YES
40
Tx mild vs. severe cellulitis
mild = dicloxicillin | severe (systemic sx) = IV nafcillin or cefazolin
41
HSIL found on PAP in pregnant woman, management?
do colposcopy; if normal --> repeat + bx after preg. | if colpo suggests invasive CA, excise
42
PCOS, Tx and MoA?
for infertility, tx = clomiphene citrate (E2 analog enhances GnRH release --> ovulation) Metformin helps improve ovulation
43
55yo female with abd pain, nocturia, dyspareunia, urinary urgency relieved by urination, x1mo?
interstitial cystitis (i.e. painful bladder syndrome)
44
suspected placental abruption, w/u?
rosette test--> materno-fetal hemorrhage, if negative --> give regular dose anti-rho(d) if + --> kleihauer-Betke stain or fetal RBC stain to adjust anti-D dose
45
when to test for GBS in pregnancy and Tx
test at 35-37wks vaginal and rectal swab | if +, tx = PCN or ampicillin at delivery
46
IgA vs PSGN?
IgA --> hematuria DAYS after infxn with normal serum complement levels PSGN --> week(s) after infxn with LOW serum complement levels
47
neonate is tachypneic/cardic, restless, poor weight gain and has cardiomegaly, must consider...
Neonatal thyrotoxicosis 2/2 maternal grave's disease (even if post-graves surgery)
48
acute cervical LAD in non-toxic kid <5yo?
MCC staph aureus
49
HSIL found on PAP in pregnant woman, management?
do colposcopy; if normal --> repeat + bx after preg. | if colpo suggests invasive CA, excise
50
PCOS, Tx and MoA?
for infertility, tx = clomiphene citrate (E2 analog enhances GnRH release --> ovulation) Metformin helps improve ovulation
51
55yo female with abd pain, nocturia, dyspareunia, urinary urgency relieved by urination, x1mo?
interstitial cystitis (i.e. painful bladder syndrome)
52
suspected placental abruption, w/u?
rosette test--> materno-fetal hemorrhage, if negative --> give regular dose anti-rho(d) if + --> kleihauer-Betke stain or fetal RBC stain to adjust anti-D dose
53
when to test for GBS in pregnancy and Tx
test at 35-37wks vaginal and rectal swab | if +, tx = PCN or ampicillin at delivery
54
acute cervical LAD in non-toxic kid <5yo?
MCC staph aureus
55
IgA vs PSGN?
IgA --> hematuria DAYS after infxn with normal serum complement levels PSGN --> week(s) after infxn with LOW serum complement levels
56
neonate is tachypneic/cardic, restless, poor weight gain and has cardiomegaly, must consider...
Neonatal thyrotoxicosis 2/2 maternal grave's disease (even if post-graves surgery)
57
2 indications for draining a pleural effusion
pH <60
58
Management of different BPP scores
go fuck yourself

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