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Study ITE Flashcards

1
Q

LAD MI leads to what EKG complications

A

LAD -> RBBB and LAFB

Inferior= AV block- reposive to atporine early. may TQ pace but it resolves!

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2
Q

sick sinus syndroime tx

A

Pacemaker

antidysrhtimics for tachy stuff

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3
Q

magnet does what ot AICD

A

turn off defib and pacemaker to synchronous mode

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4
Q

why do we treat strep throat?

A

prevent rheuamtic fever

psgn

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5
Q

asymettric arthrits after pus outcha dick?

A

HLAB27 reiters

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6
Q 
Scleroderma crsisi tx
Renal
raynauds
GI
Derm
Lung
A 
ace-i
CCB
PPi
MTX
mycophenolate

steroids + NSAIDs to

muscles ache and pericardial effusion as well

SLE- diffuse alvolae hemmrohage!

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7
Q

rheum pulm + AKI?

A

wegeners

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8
Q

Plateltes

A

petechia- not enough or dysfunctional platets
Rx- Asa (life of plate 10 days) Nsaids, PLavix

  1. Not enough - aplastic enamia, infections, maligniacy
  2. destruction- ITP, TTP, DIC, HUS
  3. Lost- Bleeding, HD
  4. Bound up- spleen

50K w/ severe bleeding
20 K without bleeding
+ steorids or IVIG

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9
Q

prolongation of PTT?

A

Heparin (potentiates antithormbiin and 10a so antithrombin!)
Vwf disease
Hemophila A and B

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10
Q

When to give FFP when to give cryo

A

Cryo- it has 8, Willi and Fibrinogen =give in DIC with low fibrinogen, Vwf or Hemophilia [ ] and low volume,

FFP- give in trauma for coagulapthy- Elevated INR, TTP for ADAMSt13, many other clotting factors

PCC= 2 7 9 10 for warfarin or give vit K

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11
Q

HIT

A
  1. Stop heparin
  2. give argatoban (firect throbmin inhibtor)
  3. reverse warfain- ont givr it (if protein C is inihbited and HIT Igg around = clots)
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12
Q

with the DOACs it is renally excreted, consider HD for bleeding not these agents – flip over

A

remmebr Desmopressin for vwf diseaseor hemphilia A

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13
Q

acute chest transfusion or no?

A

yes if they are reuqiring oxygen, symptomatc and can give reds to higher their hgb

exhcage trnasfusion if worse

otherwise, bronchodilators, steroids, fluids, abx (aplesnicusually), pain control, oxygen

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14
Q

croup tx

bronchiloti

A

Sterois, rac epi
barky cough, stridor, steeple sign, larugntracheities

supportive, watch out for apnea, admit if retracting

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15
Q

bacterial trach

A

nafcillin CFTX
intubate
after URI with high fever

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16
Q

FOreign body

A

back blows < 1 yr old
hemilich >1 yr old
no blind sweeps!

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17
Q

RPA dx and tx

A

6 at c2, 22 at c6

iv abx and drain in OR

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18
Q

pertusis

A

high WBC
apnea
Catarrhal – URI symptoms for 3 weeks; Paroxysmal = “whooping” phase; Convalescent = recovery
WBC >15k is classic for pertussis

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19
Q

PNA in kids

A

newBorn- group B strep
3 weeks- 3 months= strep pneumo
4 months to 4 years- Viral
5 years to 15= mycosplasm

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20
Q

buzzzzz

A

Cricoid Cartilage = most narrow
Cystic Fibrosis = Pseudomonas, Staph aureus
Cystic Fibrosis = rectal prolapse, meconium ileus
Staccato cough = Chlamydia
Bullous myringitis = Mycoplasma

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21
Q

pyloric stneosis met derganements

A

hypoCL hypoK met alkalsosi

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22
Q

HUS tx

A

supportive no abx

coags good, platelts down, watch out for kidneys

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23
Q

Derm PEDS

A

EM- HSV, mycoplasma, drugs
Varicella- mucous membrans, various, itchy
menigcoccemia- VERY sick, mottling, CFTX
TSSS- clinda, young fmeial hypotneisve, multi organ failrue

HSP- renal involvement, UA, HTN, Iga Vasc, and pain

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24
Q

peds

A

neonate- amp gent acylcivr if hypthermic

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25
ductal depenent lesions
Hypoplastic L heart, Severe Coarctation, Critical Aortic Stenosis + TOF = PGE apnea! poor feeding, failure to thrive, tachypnea, sweating with feeds, cyanosis with crying then cardiogenic shock on day 3-7 of life
26
HOCM tx
BB
27
rheuamtic fever
after URI group A strep infeciton
28
kawaksaki tx
asa, IVIG | admit for coroanry artery ansyusm
29
menintigits pearls kids
strep pneumo if older thna2 months or H flu | avoid cftx in <2 months for biliary sludings
30
limping, not fat, knee pain
legg- AVN of femoral head- looks like line thru instead of malalaingment
31
SALTER
``` Stright across above lower thru- surgery Crush ``` trnsient synovitis is after URI, NSAids
32
carido version Jouls w/ pulse w/out pulse needle crix for kids < ____
1 2 8
33
NRP
First 30 seconds: warm, dry, stimulate, suction After 30 seconds: If HR <100, give PPV for 30 seconds After 60 seconds (total): if HR <60, start compressions/epi No compressions until at least 1min and adequate PPV 3:1 compressions/breath “1 and 2 and 3 and breathe”
34
ant vesivle mouth kid post vesicle mouthg kids HR SVT in infants? seborrheic demraitis tx
herpetic ginigovstomatitis herpangina 220 selenesium sulfide
35
Floppy + constipation = HTN= think---- cough, tachypena at 2 weeks ols
botulism Renal chlamydia send hoem with reassurance is usually worng- acution test!
36
hyphema + FB=
globe open rust rings= optho in 24 hours alkali liquefactive acid= coag necrosis
37
hyphema tx
``` head of bed glaucoma stuff dialte steroids ophtho ```
38
CRVO tx
consult - maybe asa sae with retinal detachment
39
24 hours baby conjucitivitis?
chemical conjuctivitis remember- preseptal cellutlits is no involvment of eye at all
40
epislceritis scleritis uveitis enopthlamitis
between slcera and cornea- NEXT WEEK sclera- get rheum work up - NEXT DAY iris + ciliary body + chroird - cell and flare steroids, flush eyelid close is CN7, eyelid open is CN 3 (ptosis, down and out, dilated pupuil) - SAME DAY cylcoplegics like atoprine help with painful eye stuff epislecritis with hypopyn is bad news - endopahtlmtiis
41
acute angle cglaucmoam tx
``` timolol brimopidine pilocarpine lataoprotst pref orte ```
42
hyperCa TX
fludis cisphosphos calicotnin HD if renal failure short QTC\ ``` MISHAP malignancy ingestion Sarcoid hyperPTH alkali milk pagets ```
43
SIADH
``` low NA low osms high urine osms give HTS if siezing midline tumors ```
44
hyeprviscous blood sndrome
fludis | pehreis
45
low glucose, low Na hyper K---- think
adrneal insfuficiy | usualy with precipitating event
46
what is neutropenia
<500 neuts 7-10 days out from chemo 38 deg temp psedumonas and mrsa
47
give me TLS
uric acid, LDH, K, phos high | low Ca
48
what si scarlet fever and hwo doyou treat
basically strep throat + strawberry tougnue and rash- treat like strep then 2-3 weeks later is rheuamtic frever
49
PATHOPHYS TO AKA AND TX
ETHANOL LEADS TO MORE NADH THAN NAD TO MAKE ACETONE too much NADH means no more eglcuoneogeniss and keotsis give glucose give thiamine to replete NAD fluids
50
HD in hyeprcalecmia?
18 AMS CHF ARF
51
HypoK ekg
low ts, U , peaked Ps, ST depression and long QT
52
sharply defined circular ulcers with tender, enlarged inguinal lymph node-painy peny
ducreiy- azithro cftz
53
out vs inpt tx pyelo
septic, preggo, cant tolerate po, vitals | 7 days
54
recent uri with puffy face, protein i nurine
PSGN - ASO titer - HTN - PCN! supportive HD if they are overload into lungs
55
wegeners? | Goodpasture?
Nose congesiton rpoblems + AKI | AKI + pulm - type 4 collagen - PLEX
56
HD indications
``` BUN 100 hyperK acidosis toxins HTN ```
57
NV lightheaded, Headache, htn post dialysis?
Dysibelqibirum- osmolality problem - cerebral edema if bleedding- figure 8 it- vascular staph is most common infeciton
58
dispo with peritoenal dialsysi 100 wnc?
intra abx and dc
59
5 stoen admits
``` obsturction infection PO Pain solidatry kidney ```
60
``` lata= accuminata= painless with LA= painful woth LA= donovan bodies ```
``` syph HPV chlamydau ducreyi granuloma inguinale- klebsiella ```
61
next step torsion
urology open boook in meantime not US
62
lenght of treatment for cysitits
3 days | think std if not getting ebtter
63
buzz
New murmur with AKI = Renal embolism Blue dot sign = testicular appendage (appears similar to torsion) Seminoma** = MC malignancy in young men, 20s, ultrasound for diagnosis Hematuria in elderly** = bladder cancer, need cystoscopy
64
mass cass stuff
dont forget AMS cant folow commands is Red
65
vulvovaginiits in prepubertal females give
amoxicillin- not FB
66
MC site for foriegn bodies to get stuck in peds
c6 cric
67
gastric empyting in caustic ingesiton?
no
68
button battery in stomach needs?
repeat x ray in 48 hours?
69
PUD + early satiety and vomtning?
gastric outlet syndrome give HBIG fi unknown vaccination status for hep b exposure Hbeg- highly infectious (unless ab= low infectivity) core= igm new igg old SBP 1000 WBC
70
porcelin gallb;adder increased risk of
cancer
71
obsturction vs volvlous
NG tube vs surgery
72
hernias indirect through: direct trhu: femoral under
process vaignalis trasnveralis fasica ligmaemtn incercerated is irrediudible
73
crohsn + back pain and limp?
PSoas abscess
74
prolalpsed internal hemorrhoid=
surgical | external and acute= take out urself
75
diarrhea 12 hours later... watery diarrhea undercooked beef
c perf]\ bloody + bradycardia= slamonella
76
where to cut on pericardium?
anterior pericariditis is PR depression!
77
flank hematoma after abd injury think
RP injury
78
extrapeitoneal bladder injury
MC and foley mamangememt?! | if you think urethrel ainjury gt retro gram prior to foley
79
nevres or arteries frst in cmoaprtment syndrome
nerves
80
tdap
if clean 10 years | if dirty 5 years and if not then Ig
81
epiglottis tx
direct layngsocpy in OR
82
airwayFB
< 1 yo back blows | >1 yo Heimlich
83
Bullous myringitis = Mycoplasma
yup
84
HUS dont give
abx
85
disseminited minigcocommenia
cftx
86
kawaskai labs
steriel pyria inflam markers up IVIG ASA
87
simple seizures
6mo-5 years GTC, <15min One event per 24h No deficits or focality
88
peds meningitis
``` <2 mo of age E.Coli, GBBS, Listeria Ampicillin for Listeria Coverage Avoid Ceftriaxone – biliary sludging Amp + Gent/Cefotax ```
89
nrp
First 30 seconds: warm, dry, stimulate, suction After 30 seconds: If HR <100, give PPV for 30 seconds After 60 seconds (total): if HR <60, start compressions/epi No compressions until at least 1min and adequate PPV 3:1 compressions/breath “1 and 2 and 3 and breathe”
90
kerion tx
STERIODS + ORAL ANTIFUNGALS SEB DERM= SELENIUM SULFIDE SHAMPOO
91
SCAPHOLUNATE DISSOCATION TX
outpatient splint calc if isolated salter 2 lis franc surgery or immediate follow up
92
hypoNA, HyperK, HypoG , hypotension
addisons primary adrenal failure 100 hydrocort d5NS
93
diabetes insipidius is
NO ADH or renal resistance, very dilute urine- hypernatremic
94
cardiac arrest in DKA from...
hypoK
95
nroml glucose, WGMA, ketones=
AKA- D5NS, thimaine, folate
96
myxedema coma tx
Hydrocortisone, IV thyroxine | IVF, glucose, abx tx underlying cuase
97
cushings
too much steroids form brain or drugs. remove them. that si t. LApha block first then beta block for pheos
98
osmolality equation
2NA + BUN/2.8 + glucose/18

Rosh (14 decks)

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