Test 52 - Created Aug 14 Flashcards

(29 cards)

1
Q

Wallenberg syndrome (some characteristic features)

A

vertigo, nystagmus, ipsi limb ataxia, loss of pain/temp in ipsi face and contra trunk/limbs, dysphagia, dysarthria, dysphonia, ipsi Horner’s, bad hiccups, lack of automatic respiration

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2
Q

location of lesion in Wallenberg syndrome

A

lateral medulla

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3
Q

general rules for localizing brain lesions

A
  1. thalamus/cortex - sensory loss in contra face/body
  2. cortex - aphasia, neglect, or agraphesthesia
  3. brainstem - CN’s; impaired sensory over ipsi face and contra body
  4. cerebellum - ataxia, discoordination
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4
Q

cranial nerves in each of the following: midbrain, pons, medulla

A

midbrain: 3, 4
pons: 5, 6, 7, 8
medulla: 9, 10, 11, 12

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5
Q

correlation of increases in specificity or sensitivity and (+) and (-) predictive values

A

increased sPecificity, increases PPV

increased seNsitivity, increases NPV

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6
Q

presentation of adjustment disorder

A

stressor within the last 3 months, sxs started after it, having mixed sxs of MDD/anxiety/adhd

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7
Q

tx of adjustment disorder

A

short-term psychotherapy; zolpidem to help w/ sleep

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8
Q

presentation of stress-induced (takotsubo) CMP

A

postmenopausal F with recent physical or emotional stressor -> CP, decompensated HF, moderated troponin elev., some ischemic changes

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9
Q

diagnosis of stress-induced (takotsubo) CMP

A

cath: no obstr. CAD
echo: LV apical hypokinesis, basilar hyperkinesis

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10
Q

GI bleeding from angiodysplasias are associated with what diseases

A

end-stage renal disease, aortic stenosis, and von Willebrand disease

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11
Q

presentation of G6PD def. in newborn

A

unconjugated hyperbili and anemia on D.O.L. 2-3

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12
Q

when Rhogam is given in pregnant Rh(D) neg pt

A
  1. once at 28-32 wks GA
  2. once postpartum
  3. any time mom’s and baby’s blood may mix (abortion, mole, villi sampling, trauma, etc.)
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13
Q

definition of severe aortic stenosis

A

aortic jet velocity >4.0 m/sec or mean transvalvular gradient >40 mmHg

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14
Q

indications for aortic valve replacement in aortic stenosis pt

A

severe AS plus 1/+ of:

  1. sxs
  2. LVEF <50%
  3. undergoing other cardiac surgery
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15
Q

what to suspect when thrombocytopenia found on labs in HIV pt? treatment?

A

if isolated -> HIV-associated thrombocytopenia; tx = HAART

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16
Q

drop of viral load in HIV pt on HAART

A

(logarithmic drop)
4 wks: <5000 copies
8-16 wks: <500
16-24 wks: <50

should be <50 by 6 mo. mark

17
Q

1st line meds for Raynaud phenomenon

A

“-dipine” (nifedipine, amlodipine)

Raynaud people have cold hands, which are used to “dip” ice cream.

18
Q

when is further evaluation indicated for Raynaud phenomenon pt

A

when there are sxs suggestive of systemic disease

19
Q

signs of adrenal failure

A

weight loss, weak/lacks energy, eosinophilia, borderline sodium levels, hyperkalemia, mild anion gap acidosis, prerenal azotemia, low blood glucose

20
Q

diagnosis of adrenal failure

A

cosyntropin stimulation test

21
Q

protective factors against suicide

A

social support/family connectedness, pregnancy, parenthood, religion and participation in religious activities

22
Q

presentation of bowel injury and what to do next

A

fever, leukocytosis, abdominal pain/guarding, N, ileus; do abd. CT w/ oral contrast to find site of leakage

23
Q

tx of Mobitz type II 2* AV block

A

unstable - IV atropine

stable - pacemaker

24
Q

tx of central venous sinus thrombosis

A

heparin or LMWH

25
fetal postmaturity syndrome
SGA, wrinkled/peeling skin, long/thin body, decr. fat, long fingernails, sparse lanugo hair but increased scalp hair, meconium-stained (green/black) placenta (and possibly meconium covered baby too)
26
tx of epistaxis refractory to pinching for 10 minutes | listed in order of when to do it
1. oxymetazoline on cotton 2. chemical or electrical cautery 3. bacitracin-covered sponge
27
who is most at risk of postop pulmonary complications; what to do about these prior to surgery
COPD, cig smoking, sleep apnea, heart failure stop smoking 4 wks prior; optimize COPD and HF
28
1st line tx of cocaine-related CP
1. BONA (benzo, O2, nitrates, aspirin) 2. phentolamine for resistant HTN 3. morphine for resistant CP 4. PCI if all else fails
29
next step when pt who ingested cocaine has persistent CP despite medicines and new neuro findings
do imaging to look for dissection of ascending aorta CTA, MRA, or TEE