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Flashcards in The 3rd Semester "I'm Getting Desperate" Flashcards Deck (286)
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1
Q

Tullio phenomenon

A

Loud noises causing dizziness, needs work up with a CT to determine pathology

2
Q

Mandibular fractures of the condyle typically occur from the chin…. while angle fractures require workup of….

A

…hitting the curb

…..wisdom teeth integrity

3
Q

Kiesselbach’s plexus

A

Formed via anastamosis of internal and external carotids and is located in the anterior nasal septum and most common cause of anterior epistaxis (why we hold the lower portion of the nose not the bridge when trying to stop a bleed)

4
Q

Dental occlusion classes (4)

A

normal I
overbite II
Underbite III
Open bite

5
Q

Lefort fracture classifcation (3)

A

I palate alone
II includes nose
III complete craniofacial dislocation including zygomatic bone

6
Q

Weber test

A
  • Doesn’t lateralize is normal

- lateralizes to one ear indicates conductive hearing loss of said ear or sensorineural hearing loss of opposite ear

7
Q

Rinne test

A
  • test with air conduction greater than bone is normal or confirmatory of sensorineural loss of the contralateral ear from the side lateralized to on the weber test
  • Test with bone conduction greater than air conduction is confirmatory of conductive loss of the ipsalateral ear of the side lateralized to on weber test
8
Q

Torus palentine

A

Large bumps of overgrown palate, harmless unless overgrows then needs surgical removal

9
Q

Exostosis

A

torus palentine but of the ear, benign multiple growths of external auditory canal in dinviduals repeatedly exposed to cold water (surfers ear), can be surgically removed if too large

10
Q

Most common cause of conductive hearing loss in children and how is it treated?

A
  • Otitis media

- oral antibiotics

11
Q

Viral cochleitis definition

A

Sudden hearing loss, vertigo, facial paralysis or pain, most common sensorineurall cause of sudden hearing loss in adults, treated with oral steroids

12
Q

Meniere disease

A

episodic vertigo and hearing loss that usually lasts for hours, fullness and tinnitus, hearing loss that is low frequency and progress but is usually unilateral, treated with diet/lifestyle changes, diuretics, or surgery

13
Q

Acoustic neuroma

A

Most common benign tumor that originates int he vestibule of the 8th cranial nerve presenting with unilateral or asymetric hearing loss, tinnitus, dizziness, headaches

14
Q

Tragus tenderness automatically makes you think of what pathology?

A

Otitis externa

15
Q

Serous otitis media vs acute

A

Serous is sometimes seen at beginning and end of acute otitis media infection (where the tympanic membrane is bulging) as well as in cases of allergies and does not require antibiotics

16
Q

Tympanogram interpretation

A
  • if peaks negative indicates eustachian tube dyfunction

- if flattened (less compliant) classic otitis media

17
Q

Otitis media treatment options (4)

A
  • amoxicillin
  • augmentin
  • 2nd gen cephalosporin
  • ciprodex if perforation or ostomy tubes
18
Q

Neurofibromatosis

A

Genetic condition that causes tumors to form in brain, spinal cord, and nerves, type 1 causes skin changes (6+ cafe olait spots) and deformed bones typically in childhood sometimes even present at birth, type 2 causes hearing loss ringing in ears and often poor balance in teen years and has bilateral vestibular schwanomas

19
Q

Herpes zoster oticus (ramsay hunt sydnrome)

A

Shingles of the facial nerve near one of the ears

20
Q

Hemmotympanum

A

Common result from temporal bone fracture causing disruption of ossicular chain and subsequent middle ear hearing loss requiring urgent referral, also see battle sign bruising behind ear

21
Q

Otitis externa treatment (3)

A
  • ofoxacin otic
  • cipro otic
  • ciprodex
22
Q

Sensens duct

A

Empties parotid salivary gland and enters buccal mucosa opposite 2nd molar, sees facial nerve passing thru gland

23
Q

Uvula deviates ___ lesion on vagus or peritonsillar absess, tongue deviates ___ lesion on hypoglossal nerve

A

away, toward

24
Q

How to differentiate CSF from mucus?

A

Glucose strip test

25
Q

Wegener’s granulomatosis with polyangitis

A

Inflammatory disease of blood vessels that if left untreated can be fatal, caused by autoantibodies and often has sore eye, ear, stuffy nose and trhoat, cough, treated with immunosuppressants

26
Q

Why is azithromycin preferred to doxy for chlamydia treatment?

A

Better compliance as only 1 g dose 1 time

27
Q

Gonorrhea treatment

A

Azithro or doxy + ceftriaxone

28
Q

Chlamydia treatment

A

Azithro or doxy

29
Q

Diptheria presentation (3)

A

pseudomembrane
sore throat
bullneck

30
Q

Diptheria treatment (2)

A

diptheria antitoxin or erythromycin

31
Q

Red petechiae on soft palate….

A

…..strep pharyngitis

32
Q

Strep pharyngitis treatment

A

Oral penV

33
Q

Brachial cleft cyst

A

Congenital failure of obliteration of brachila cleft during fetal development seen in late childhood or early adulthood as lateral portion of neck large mass, surgically excised

34
Q

Most comon agent of otitis externa

A

P aeruginosa

35
Q

Opioid antitussives suppress cough by…

A

…acting on CNS respiratory centers in medulla raising threshold

36
Q

Dextromorphan

A

OTC derivative of morphine with no analgesic or addictive properties so used OTC cough preps not safe for children still

37
Q

Reye’s syndrome

A

Rare disorder following viral illness, occurs in children resulting in brain and liver damage result of giving ASA to children

38
Q

Bacterial sinusitis vs viral signs (4)

A
  • long time of infection +10 days
  • tends to be worse in morning
  • got better then got worse
  • severe facial pain
39
Q

Acute epiglottitis definition and how is it treated (3)?

A

Bacterial infection of epiglottis sees rapid progression of symptoms including sore throat, dysphagia, hot potato voice, tripoding, drooling, distress, thumb brint sign on x ray
-o2, dexamethasone, empiric antibiotics

40
Q

Orbital cellulitis will see this key feature

A

pain with EOMs

41
Q

Orbital blowout fracture

A

Entraps inferior rectus and medial rectus impinging upward and lateral gaze dysufnciton respectively, treated with surgical decompression and followup

42
Q

Ludwig’s angina

A

Bacterial infection of floor of mouth under tongue that occurs soon after tooth abscess, can eventually block off airway and is managed with antibiotics

43
Q

Oral thrush can be ___, vs leukoplakia which cannot

A

brushed off

44
Q

Reinke’s edema

A

vocal fold mass cauinsg progressive deepening of voice often in smokers

45
Q

Pterygum

A

Surfer’s eye, noncancerous growth of the conjuncitva in wedge shape that will eventually cover the pupil, common in people who spend time outdoors and requires surgical removal

46
Q

Conjunctivitis vs uveitis

A

Conjunctivitis has preserved visual acutiy, usually infectious, while uveitis loses acuity and is often autoimmune

47
Q

Glaucoma

A

2nd most common cause of blindness due to optic nerve damage from increased pressure in anterior chamber of eye, either open angle or closed (emergency with acute pai, blurred vision, nausea, halos, elevated iop), risk factors include age, diabetes, high blood pressure

48
Q

Hordeolum

A

classic stye, affects eyelash which is part of memobian glands and becomes occulded and infected, 2ndary progression into a chalazion

49
Q

Pingulum

A

accumulation of conjunctival tissue at the nasal or temporal junction of the sclera and cornea that dones’t cover the pupil unlike pterygum

50
Q

Strabismus

A

eye malalignment

51
Q

Ambylopia

A

Monocular blindness due to failure to develop visual plexus capable of vocusing eye

52
Q

Binocular vision loss lasting hours indicates…

A

…vertebrobailar insufficiency

53
Q

Radiation pneumonitis

A

Condition occuring 4-12 weeks after chest radiaiton that presents with cough, dyspnea, chest pain, low grade fever can be treated with steroids but can cause lung fibrosis

54
Q

Preop radiation is called ___, post op is ___

A

neoadjuvant, adjuvant

55
Q

BI-RADS scoring

A

score of risk of breast mass being cancer with 0 being inconclusive, 1 being normal, 5 being highly suspicious and 6 a proven malignanc

56
Q

Pagets disease

A

Rare cancer that begins iwth changes of skin cells at nipple scaling eventually becoming a red lesion almost 100% being associated with ductal carcinoma in situ, symptoms include senitivtiy, burning, pain, bloody discharge

57
Q

Inflammatory breast Cancer

A

Rare type of cancer that causes severe swelling and redness and edema often presenting as peau d’orange seen in young women and is much more aggressive form of cancer

58
Q

prostate cancer presenting symptoms

A
  • weak interupted urine flow
  • burning sensation when peeing
  • low back pain or hip or thigh pain
  • difficulty with erections
59
Q

AML

A

80% of all acute leukemias, most frequent in neonates, letahl without intesnive chemo, fever, fatigue, leukemia cutis, auer rods on labs, treated with 7+3

60
Q

APL

A

Emergency form of AML, dumbell nuclei, worrisome for hemorrhage, <1 month survival if lef untreated, treated with 7+3 regimen and at risk of cytokine storm

61
Q

CML

A

Presents with fatigue, malaise, absolute basophilia**, triphasic coursse beginning asymptomatic then accelerating to resemble AML before death, phillie chromosome, treated with transplant or gleevec

62
Q

ALL/LBL

A

Most common childhood malignancy, can occur with phylie xsome, hypercvad regimen or TKI if xsome pos. is treatment

63
Q

CLL/SLL

A

Not related to radition exposure but sees waxing and waning lymphadenopathy of waldeyers ring, sudge cells, diagnosed via absolute lymphcyte count

64
Q

NHL

A

Insidious, can cause compression of diddferent organs if severe, treated with R CHOP

65
Q

HL

A

Reed stinberg cells, asymtpmatoci lymphadenopathy, generalized pruritis, ruberry lymph nodes, treated with ABVD regimen plus radiaiton

66
Q

MM

A

Plasma cell malignancy, diagnosed via bone marrow plasma cells and CRAB (hypercalcemia, renal insuficiency, anemia, bone lesions), bnees jones proteins presence, punched out lesions on radiograph

67
Q

Lynch syndrome

A

hereditary nonpolyposis colon cancer, collection of cancers related to defective tumor suppresor gene causing colon cancer without polyps

68
Q

Pancoast tumor

A

High riding lung tumo puts pressure on brachila plexus resulting in horner syndrome, treated with wedge resection

69
Q

What type of withdrawals are fatal (2)?

A

Alcohol and benzos

70
Q

Naltrexone

A

pure opiod antagonist prevents euphoria with alcohol and opioid abuse

71
Q

Methadone

A

opioid narcotic for pain but also used to decrease cravings for other more serious narcotics in withdrawal during abuse

72
Q

Tramadol

A

Non opiod central acting PO agent for moderate to severe pain

73
Q

Diclofenac

A

Topical solution for treatment of osteoarthritis or musculoskeletal pain

74
Q

MCV

A

Determiens presence of macro or microcytic anemia by measuring avg size of RBC, if presence of both might look normal but then look at RDW and see its high

75
Q

Macrocytosis causess

A

folate or b12 deficiency

76
Q

Microcytosis causes

A

chronic iron deficiency

blood loss

77
Q

MCHC

A

measures hemoglobin in avg RBCcorresponding to degree of chromasia (redness of RBC)

78
Q

Anisocytosis

A

Presence of RBC of varying sizes

79
Q

Polkiocytosis

A

Presence of RBC of varying shapes

80
Q

High reticulocytes indicates

A

Anemia because bone marrow is working to replensih supply

81
Q

RDW

A

Red cell distribution width measures variation on rbc size with deficinecy anemias tending to have higher RDWs

82
Q

Most sensitive test for iron deficiency

A

Serum ferratin

83
Q

G6PD deficiency

A

can cause sudden hemolytic episodes despite normal health between, triggered by febrile illness, sulfonamides, or fava beans, sees Heinz bodies (small blue dots in RBC) and bite cells

84
Q

Thalassemias

A

reduced or absent produciton of one or more chains of hemoglobin

85
Q

sickle cell trait

A

Normal but can see sickling under strenuous conditions requiring accommodations (sickle cells are ischemic to tissue because shape cannot pass capillaries and those with sickle cell d;isease die by age 50)

86
Q

Hydroxyurea

A

Reactivates fetal hemoglobin helping alleviate frequency of pain episodes from sickle cell disease

87
Q

Pernicious anemia

A

Deficiency due to low b12 due to lack of IF

88
Q

Polycythemia vera

A

Too many RBC, itching after hot shower, treat with phlebotomy

89
Q

Hemochromatosis

A

Cirrhosis, diabetes, skin pigmentation in late dz

90
Q

Factor v leidan

A

Most common herediatary hypercoaguable dz

91
Q

Von willebrand

A

Most comon bleeding disorder, treat with tranexamic acid clotting promotr

92
Q

SIADH

A

Causes retention of water

93
Q

Diabetes incipdus

A

Cuases inappropritae secretion fo water

94
Q

Prerenal causes of deizease

A

-lack of blood flow or perfusion (renal artery stenosis, dehydration)

95
Q

Intrarenal causes of dizease

A

GLomerular or vascular damage

96
Q

Postrenal causes of disease

A

Stone, tumor, bph, cancer

97
Q

FeNa <1%

A

Means kidneys are holding onto sodium indicating hypovolemic state (prerenal cause of disease), unless on diuretics

98
Q

FeNa >2%

A

Indicates acute tubular necrosis

99
Q

Fibromuscular dysplasia

A

beading of medium arteries in body particularly to kidneys, most awlays in women and progressive

100
Q

Takasu arteritis

A

Inflammatory arteritis of aorta, genetic, seen in female asians with uncontrolled hypertension

101
Q

Kawasaki disease

A

5+ day fever without other explanation, polymorphous rash, lympahdenopathy, treat with aspirin

102
Q

What kills from renal failure?

A

Hyperkalemia leading to heart arrhythmia

103
Q

BUN

A

Produced in liver and decreased in liver failure and increased in certain states like fever, some is normaly reabsorbed but some should be filtered

104
Q

Creatinine

A

Produced by muscle breakdown and is filtered and secreted

105
Q

BUN to Cr ratio

A

<10:1 indicates rhabdo, cirrhosis, SIADH
10:1- 20:1 normal
>20:1 indicates prerenal azotemia or uremia

106
Q

Normal GFR

A

Estimated from serum creatinine levels which are filtered in a healthy funcitoning kidney and should be between 85-115ml/min

107
Q

most common kind of kidneys tones

A

calcium oxylate

108
Q

kidney stones in women with uti

A

struvite, staghorn

109
Q

gout patient kidney stones

A

uric acid

110
Q

genetically predisposed patients kidney stones

A

cysteine

111
Q

Gold standard diagnosis and one alternative for kidney stone

A

CT, ultrasound

112
Q

Meckel diverticulum

A

2% of population, 2 ft form ileocecal valve, 2 inches in lenth, presents at 2 years o fage, surgical removal of ectopic gastric mucosa is treatment

113
Q

what does heme breakdown into

A

bilirubin

114
Q

Pain out of proportion of physical exam indicates

A

mesenteric infarct

115
Q

Rosving sign

A

RLQ pain with palpation of LLQ for appendicitis

116
Q

psoas sign

A

RLQ pain with flexion of right hip against resistance for appendicitis

117
Q

Kernigs sign

A

Flexion of hip at 90 degrees then extension of knee pain indicating meningitis

118
Q

Murphy’s sign

A

Pain on catch on breath by palpating RUQ, indciative of acute cholecystitis

119
Q

Duodenal ucler pain is ___ by food intake, gastric is ___

A

relieved, brought on

120
Q

Mallory weiss tear

A

Nonbloody emesis followed by bloody

121
Q

ischemic bowel patients vs peritonitis

A

Cant get comfortable vs lie deathly still

122
Q

True refleciton of decreased liver function

A

INR elevation

123
Q

AST/ALT

A

slight elevations indicate low grade inflammation, huge elevations indicate acute liver necrosis/injury but normal do not exlcude pathology

124
Q

Alk phose

A

Elevated in indication of bile duct inflammation by either obstruction, infection, etc

125
Q

Bilirubin

A

> 4 sees jaundice

126
Q

AST/ALT > alk phos

A

Hepatocellualr injury

127
Q

Alk phos > AST/ALT

A

Obstruciton (liver or bile duct)

128
Q

first sign of liver dz

A

thrombocytopenia

129
Q

Hep B is RNA or DNA

A

DNA

130
Q

Hep B vaccine antibodies

A

-only pos for he b surface antibodiy

131
Q

immune from reocvery of diseease hep B antibodies

A

positive for hep b surface antibody and core antibody

132
Q

infectious acute hep b antibodies

A

positive for hep b surface antibodies and core antibody and E antigen

133
Q

Chronoic hepatitis b carrier antibodies

A

positive for hep b surface antibody and core antibody and e antibody***

134
Q

Cullen and grey turner indicate

A

acute pancreatitis

135
Q

IBS

A

Late 20’s onset, recurrent abd pain releaved with defecation, cahnge in stool frequency or appearane

136
Q

Crohn’s

A

full thickness of bowel in patchy noncontinuous distribution can cause fistulas invooling mouth to anus

137
Q

UC

A

primarily in mucosa uniform and continuous only in colon with bloody diarrhea being hallmark

138
Q

Diverticulosis vs diverticulitis

A

presence of diverticula, when diverticula are inflamed with most common on sigmoid colon causing left lower quadrant pain

139
Q

Goodnell sign

A

Softening of uterus indicating pregnancy

140
Q

Human placentallactogen

A

Antagonizes cellular action of insulin decreasing glucose utilizinato and increasing risk of gestational diabetes

141
Q

Schedule of preterm visits

A

Q 4 wks to week 28, Q 2 wks to 28-36, Q wk for wks 36 until delivery, 2x/wk for >42 weeks

142
Q

AFP

A

Produced by fetal liver, measured in 2nd trimeseter, elevated in pregnanceis with neural tube defects and low in cases of down syndrome

143
Q

Neagle rule

A

estimated date of delivery = 1st day of last menstrual period + 7 - 3 months + 1 year

144
Q

Best mehtod to predict due date

A

1st semester ultrasound measuring crownrump length earlier the better

145
Q

DOC for ectopic pregnancy if not surgical indicated

A

methotrexate

146
Q

Criteria to determine labor commencement

A

4 contractions over 20 min or 8 over 60+ cervical changes

-cervical dilation and effacement

147
Q

Shorter cervical diameter greater risk of…

A

…impending delivery

148
Q

Short term variability in fetal heart rate

A

5-15bpm amplitude good autonomic interplay with <5 idicating cns depression or fetal sleep period

149
Q

Long term variability in fetal heart rate

A

3-25bpm

150
Q

Fetal ead compression

A

Predicitble event as uterus compressed head engaged causing vagal slowing causing early deceleration and ends at same time as contraciton not considered sign of distress

151
Q

Uteroplacental insufficiency

A

Predictible event as uteus compressed engaged head causing vagal slowing causing late deceleartion of fetal herat rate comparison to uterine contraction, requires change in maternal position, stopping oxytocin, and providing o2 to manage

152
Q

Cord compression

A

causes variable decelearation of fetal heart rate and if prolonged causes hpyoxia

153
Q

Categories of fetal heart rat(3)

A

1 - normal, predictive of normal acid base status at delivery
2 - indeterminite, require eval and continued surveillance
3 - abnormal, associated with abnormal fetal acid base balance

154
Q

Placental abruption

A

premaure separation of normally implanted placenta either complete or partial causing painful hemorrhage of maternal bloo

155
Q

Placenta previa

A

Implatnation of uterus over internal os partial or complete causing painless hemorrhage of mostly fetal blood

156
Q

uterine atony treatments (3)

A

oxytocin
prostaglandin
bakri balloon

157
Q

Pre-eclampisa HELLP syndroem

A

hemolysis
elevated liver enzymes
low platelet count

158
Q

Treatment of eclamspia seizure

A

magnesium sulfate

159
Q

Perineal degrees of lacerateion (4)

A
  • 1st degree just tears mucosa
  • 2nd tears superficial muscle
  • 3rd tears anal sphincter
  • 4th enters directly into rectum
160
Q

Cardinal movements of labor

A

engagement, descent, flexion, internal rotation, extension, external rotation

161
Q

Jjauncide in the 1st 24 hours of life

A

pathologic, physiologic breast feeding jaundice is fine in days after that

162
Q

APGAR scores

A

taken at 1 and 5 min, <7 concerning

163
Q

Tantrums

A

normally apepar at end of 1st yea of life and peak in prevalence between 2-4. lasting more than 15 or regularly occuring 3 times a day may reflect underlying issue

164
Q

breast feeding guidelines

A

exclusive up to 6 onths then continued 1 year with other additions, wait till after 4-6 months to introduce allergic foods and do so one at time

165
Q

omphalmocele vs gastroschisis

A

herniation of intestinal contents thru abominal wall into peritoneum covered sac vs without sac covering

166
Q

Fat and cholesterol guidelines

A

not restricted under age 2, 12-24 months consume whole cow milk then older than 2 fat free or low fat milk

167
Q

iron suplmeent in baby

A

4 motnhs

168
Q

vit d supplement in baby

A

first few days

169
Q

fluoride supplement in baby

A

6 month

170
Q

Rooting reflex

A

Turn head towards mouth towards finger stroking cheek laterally

171
Q

sucking reflex

A

tendency to instinctively suck vigorously at anything touching the mouth and swallow it regardless if hungry or not

172
Q

moro reflex

A

child is slowly lowered head down their upper limbs abduct (thrown up)

173
Q

grasp reflex

A

Instinctively grasp any object placed in palm and cannot voluntarily let go until 1 year of age, same with toes

174
Q

placing reflex

A

pick foot up if held in front of table edge and place it on table

175
Q

asymmetrical tonic neck reflex/fencer reflex

A

when lying supine turn head 90 degrees they take on a fencing pose

176
Q

walking reflex

A

when held above ground will place one foot in front of another

177
Q

Tonic vs clonic

A

contraction of muscle vs jerking

178
Q

juvenile myoclonic seizures

A

occur in morning and resolve by adulthood

179
Q

most common causes of status epilepticus (seizure lasting longer than 30 min)

A

-prolonged febrile seizure

180
Q

SALTR Harris classification

A
Same level of physis only
Above (metaphysis)
Lower (epiphysis)
Through (metaphysis thru epiphysis)
R-crush injury to the physis
181
Q

Physis

A

Growth plate

182
Q

Epiphysis

A

Cartilagenous end of bone that articulates

183
Q

Metaphysis

A

The neck of bone near the physis

184
Q

Diaphysis

A

the shaft of the long bone

185
Q

Legg calve perthes

A

Presents as younger hcild limping and is avascular necrosis demonstrated on x ray

186
Q

slipped capital head of femur

A

older hcildren tend to be overweight

187
Q

paraphimosis is a medical…

A

….emergency, unlike phimosis which can be treated with steroids daily to loosen ring

188
Q

march of dimes

A

no induction of labor before 39 weeks

189
Q

caput succedanoeum

A

crosses suture lines on infant typically self resolving

190
Q

cephalhematoma

A

does not cross suture lines on infant typically self resolving

191
Q

Umbilical vein carries _____, umbilical vein carries ___

A

oxygenated nutrient rich blood from placenta to fetus, deoxygenated nutrient depleted blood from fetus to placenta

192
Q

Bell clapper deformity predisposes one to what?

A

Testicular torsion

193
Q

testicular torsion

A

lack of cremasteric reflex and neg prehns sign adn doppler ultrasound

194
Q

epididymitis

A

preserved cremasteric reflex and positive prehns sign (relief elicited upon raising the affected testicle)

195
Q

hydrocele

A

collection of fluid in tunica vaginalis of testes, many present at birth, painless and resolved by 18 months, translumination shows enlargement of scrotum, requires referral to surgery urology as it is associated with a hernia

196
Q

blue dot sign

A

appendiceal testes torsion, subacute pain

197
Q

orchitis

A

entire testes swollen, think mumps

198
Q

does a varicocele need treatment?

A

generally drains on own

199
Q

incarceration

A

not easily mannually reduced inguinal hernia

200
Q

strangulation

A

surgical emergency from inguinal hernia

201
Q

caloric restriction theory

A

well researched effective means of slowing the aging process

202
Q

urge incontennce

A

overactive detrusor

203
Q

stress incontinence

A

incompetent urethral sphincter

204
Q

overflow incontinence

A

loss of detrusor sensation and bladder overflows

205
Q

polymyalgia rheumatica

A

quick onset mostly over 65 muscle pain and morning stiffness, associated with temporal arteritis

206
Q

MS

A

autoimmune llong lasting diz that can affect brain, spinal cord and the optic nerves in eyes can cause problems with vision, balance, muscle control and other basic body functions, treated with low dose corticosteroids and immunosuppressants

207
Q

DJD vs inflammatory arthritis

A

pain with use vs pain and stiffness in morning better with use

208
Q

sarcoidosis

A

noncaseaiting granulomas form

209
Q

inflammatory RA spares the….

A

…DIPs and lumbar area

210
Q

HLA27

A

seen in ank spondy

211
Q

schobers maneuver

A

test for ank spondy

212
Q

systemic sclerosis with limited scleroderma

A

CREST syndrome (calcinosis, raynauds, esophageal dysmotility, sclerodactyly, telangeectasia)

213
Q

gout crystals

A

strongly negative bifringent on aspiration

214
Q

pseudogout crystals

A

weakly positive bifringent crystals

215
Q

normal blood ph

A

7.35-7.45, less acidotic, more alkalotic

216
Q

normal blood pCO2

A

35-45, greater than 45 acidosis, less than 35 alkalosis

217
Q

normal blood hco3

A

22-26, less than 22 acidosis, greater than 26 alkalosis

218
Q

normal base excess

A

+/-2

219
Q

If ph and co2 is increased/decreased in same direction, then

A

metabolic

220
Q

If ph and co2 is increased/decreased in opposite directions, it is

A

respiratory

221
Q

causes of increased anion gap

A
mudpiles
methanol
uremia
dka
paraldehydes
iron
lactic acid
ethylene glycol
salicylates
222
Q

Most specific and sensitive test for TB

A

quantiferon TB

223
Q

most toxic inhalant

A

silica

224
Q

strain pattern on ekg for LVH

A

s1q3t3

225
Q

obstructive dz examples

A

asthma
copd
bronchiectasis, bronchiolitis, upper airway obstruction, FEV1 decreases, scooped out appearance, FEV1/FVC <70% predicted

226
Q

restrictive dz examples

A

parenchymal dz (interstitial lung dz), pleural lung dz, chest wall dz, neuromuscular dz, fvc decrease, witch’s hat apperance, fev1/fvc normal range

227
Q

emphysema

A

alveolar duct/alveoli problem, long expiratory phase

228
Q

chronic bronchitis

A

hyperplacia of bronchioles and excess mucus secretion

229
Q

copd is obstructive or restrictive

A

obstructive

230
Q

precentral gyrus is ___, postcentral is ___

A

motor, somatosensory

231
Q

upper motor neuron injury

A

spasticity, increased tone, clonus babinski

232
Q

lower motor neuron injury

A

atrophy, weakness, fasciculations

233
Q

posterior column

A

crosses at medulla senses fine touch, vibration, proprioception

234
Q

spinoathalamic column

A

crosses at spinal level senses crude touch, temp, pain

235
Q

corticospinal tract

A

crosses at medulla provides motor innervation

236
Q

most common site of stroke

A

middle cerebral artery

237
Q

gcs score 3-15,

A

8

238
Q

GCS

A
best eye opening
1) does not open
2) open to painful stimulus
3) opens to voice
4) opens spontaneously
best verbal score
1) no sounds
2) incomprehensible
3) inappropriate
4) confused
5) oriented
best motor score
1) none
2) extensor posturing
3) flexor posturing
4) withdraws to pain
5) localizes to pain
6) obeys commands
239
Q

spondylosis

A

2ndary degenerative changes including disc degeneration, dessication, height loss, herniation, joint degradation, ligamentous thickening, age 40-60,

240
Q

spondylitis

A

inflammation of the vertebrae

241
Q

spondylolysis

A

fracture of pars interarticularis without vertebral transfer (scottie dog)

242
Q

spondylothesis

A

fracture of pars interarticularis without vertebral transfer

243
Q

frontotemporal dementia (picks disease)

A

change in behavior to inappropriate, lack of social tact, increased sex drive, impulsivity

244
Q

ulnar gutter splint fixes

A

boxers fracture

245
Q

thumb spica fixes

A

gamekeepers thumb, de quarvian tenosynovitis

246
Q

cock up splint treats

A

carpal tunnel

247
Q

femoral neck fracture 3 findings

A

positive leg role
positive heel strike
positive stinchfield sign

248
Q

c5 motor function and reflex

A

deltoid/biceps, biceps

249
Q

c6 motor funciton and reflex

A

biceps/wrist extension, brachioradialis

250
Q

c7 motor function and reflex

A

triceps/wrist flexion, triceps

251
Q

c8 motor function and reflex

A

finger flexion, none

252
Q

t1 motor function and reflex

A

finger abduction, none

253
Q

anterior wall mi leads

A

v1-4, lad

254
Q

inferior wall mi leads

A

ii and iii and avf, rca

255
Q

lateral wall mi leads

A

i, avl, circumflex artery

256
Q

big 6 to rule out chest pain

A
mi
aortic dissection
boerhaave syndrome
pe
tension pneumothorax
cardiac tamponade
257
Q

s3 gallop

A

dilated ventricle, systolic dysfunction

258
Q

s4 gallop

A

stiff ventricle, diastolic dysfunction

259
Q

mid systolic ejection click

A

mitral valve prolapse

260
Q

nonblack patients htn treatment

A

thiazide, ace or arb or b blocker or ca2+ channel blocker

261
Q

black patients htn treatment

A

thiazide diuretic, nondihydropiridine ca2+ channel blocker

262
Q

1st degree av block

A

> .2sec pr interval

263
Q

2nd degree av block type 1

A

pr longer then it drops

264
Q

2nd degree av block type 2

A

normal pr interval then p wave not followed by qrs complex periodically

265
Q

3rd degree av block

A

no relationship between p and qrs

266
Q

right BBB

A

bunny ears v1 and v2

267
Q

lvh indication ekg

A

large s in v1 and large r in v5

268
Q

von willebrand is __ disorder and factor v leidan is ___ disorder

A

bleeding, clotting

269
Q

hyper vs hypokalemia ekg

A

peaked t waves vs flattened

270
Q

pericarditis ekg

A

diffuse st segment elevation

271
Q

qrs up in I and up in AVF means

A

normal axis

272
Q

qrs up in I and down in avf means

A

left axis deviaiton

273
Q

qrs down in I and up in avf means

A

right axis deviation

274
Q

qrs down in i and down in avf means

A

extreme right axis deviaiont

275
Q

most common murmur in children

A

stills murmur - cooing dove

276
Q

difference between anticoholinergic and sympathomimetic

A

anticholinergic has no sweating

277
Q

dka vs hhs gluocse levels

A

<600 vs >600

278
Q

adult burn estimation

A

Face - 9%, neck - 1%, Front core - 18%,back core - 18%, arm - 9%, leg – 18%

279
Q

4:2:1 rule

A

4ml for fisrst 10 kg, 2 for next 10, 1 for rest

280
Q

central cord syndrome

A

Most common type of cord syndrome, due to injury of corticospinal tract causing loss of motor function, can occur with hyperextension injury with cervical stenosis, can see with falling forward onto face, typically caused by vascular compromise of the anterior spinal artery, lower extremity less effected than upper and tends to recover before upper but typically permanent hand disability at least

281
Q

anterirrior cord syndrome

A

Injury to ventral 2/3 of spinal cord psaring posterior column, see paraplegia (loss of motor) and sensory loss of pain/temp (spinothalamic), posterior column is still intact, due to infarction of cord in anterior spinal artery territory, has poor prognosis

282
Q

hesselbachs triangle

A

inguinal ligmaent, lateral borderr of inferior epigastric vessels, medial border of rectus abdominis sheath

283
Q

treatment of malignant hypothermia

A

dantrolene and cooling

284
Q

1st 24 hours after surgery at risk for ___, next 2 days ___, days 3-4 ___, day 4-5 ___ and after ____

A
atelectasis
urinary tract infection
wound infection
dvt 
wonder drugs
285
Q

If external opening of fissure lies anterior to midline and is <3 cm, then ____, if posterior, ___. if anterior and >3cm, then ___

A

opens straight line, loops curves, loops curves

286
Q

Which of the following forceps would work best for gripping less delicate tissue such as skin or fascia and are commonly used to manipulate skin while suturing?

A

adson

Decks in 3rd Semester Final Class (248):