UW 1

Question 1

After DX of GBS, what is most important next step in management

Answer 1

Assess Pulmonary Fnc with Serial Spirometry

Gold std = FVC to assess ventilation

Question 2

GBS pt with declining FVC

Answer 2

Impending Respiratory Arrest - may require endotracheal intubation

Question 3

WHen do we do Spinal MRI w GAD

Answer 3

Acute Transverse myelitis suspected

• Spinal cord inflammation involving thorax
• LE Diplegia

Question 4

Enlargement of central canal of SC due to CSF Retention

Answer 4

Syringomyelia

Question 5

Presentation of Syringomyelia

Answer 5

Impaired strength

Pain/Temp sensation in UE

Question 6

When is Brachial Artery injured

Si/Sx’s

Answer 6

Supra condylar Fx of humerus - children

Ischemia Si/Sx’s

Question 7

Radial Nerve injury - MC location

Answer 7

Midshaft humerus FX

Question 8

Pathophys and causes of anserine bursitis

Answer 8

Anserine bursa - location is anteromedially over tibial plateau just below joint line of knee
Causes of Inflammation = Abnormal gait
Overuse
Trauma

Question 9

Presentation of anserine bursitis

Answer 9

Localized pain over anteromedial tibia
Present overnight
PE: Tenderness over medial tibial plateau

Question 10

TX for Anserine Bursitis

Answer 10

Rest
Ice
Maneuvers to reduce pressure
Steroid injections

Question 11

Presentation of prepatellar bursitis

Answer 11

Pain and swelling directly over patella caused by trauma

Question 12

MCL Strain presentation

Answer 12

Pain along medial joint line
Aggravated by walking
Caused by valgus stress applied to lateral knee partially flexed

Question 13

Management of decreased fetal movements - testing

Answer 13

1. NST
2. CST
3. BPP if NST nonreactive

Question 14

Management of pt with normal CST in pt of 36 wks

Answer 14

Repeat antepartum Fetal testing in 1 wk

Question 15

Uterine Rupture Presentation

Answer 15

Vaginal bleeding
Intrabdominal bleeding
Fetal heart decelerations
Loss of fetal station
Palpation of fetal parts

Question 16

Painless antepartum hemorrhage ass’d with rapid deterioration of fetal heart tracings

Answer 16

Vasa Previa

Question 17

Fetal hydantoin syndrome

Answer 17

Hypoplastic fingers/nails
Cleft lip/palate
Phenytoin

Question 18

ST elevation in leads II, III, aVF is what and what part of heart involved

Answer 18

Inferior MI

1/3 = RV

Question 19

ST depression in leads I and AVL indicates ?

Answer 19

STEMI right side heart

Question 20

JVD + Kussmaul’s + clear lung fields =

Answer 20

RV Failure

Question 21

Kussmaul’s sign is

Answer 21

Increase in JVD w Inspiration

Question 22

RV Failure does what to preload, CO, BP?

Answer 22

Decreases Preload
Decreases CO
HypoTN

Question 23

Which drugs avoided in RV Failure

Answer 23

Preload Reducing

• Nitroglycerine
• Diuretics

Question 24

Labs in Paget Disease

Answer 24

Normal serum calcium, phosphate
Increased
- Alk Phosph
- urinary hydroxyproline, deoxypyridnoline, N-telopeptide, C-telopeptide

Question 25

Factor that determines need for chest tube in parapneumonic effusion

Answer 25

Pleural fluid pH < 7.2 indicates empyema and must remove fluid w thoracostomy OR Glucose < 60mg/dL

Question 26

Why are nephrotic syndrome pts at risk for stroke/MI

Answer 26

Nephrotic syndrome - alters lipid metabolism = Dyslipidemia causes increased risk for accelerated atherosclerosis

Question 27

Wiskott-Aldrich syndrome pathophys

Answer 27

Thrombocytopenia - decreased platelet production

Question 28

PE of pleural effusion

Answer 28

Decreased tactile fremitus Dullness to percussion Decreased breath sounds over effusion

Question 29

Presentation of Central cord syndrome

Answer 29

Hyperextension injuries in elderly patients Central portions of CS tracts and decussating fibers of Lateral ST tract Weakness greater in UE>>LE

Question 30

Pathophys of osteomyelitis in diabetic patient w foot ulcer

Answer 30

Contiguous spread of infxn

Question 31

Pathophys of flushing and pruritis w Niacin

Answer 31

Peripheral vasodilation = Prostaglandin-related RXN

Question 32

Recurrent bacterial infxn in adult indicative of what type of defect

Answer 32

Humoral Immunity

Question 33

VW Dz labs

Answer 33

``` Increased BT, PTT Platelet count = Normal ```

Question 34

ITP Presentation

Answer 34

``` Severe thrombocytopenia < 30,000 Megakaryocytes on PS Bleeding episodes Other labs - Normal Platelet destruction - AI ```

Question 35

TX of COPD acute exacerbation

Answer 35

Supplemental Oxygen Inhaled bronchodilators = Beta 2 agonist, anticholinergics Abx Systemic glucocorticoids

Question 36

Management of Wide complex tachycardia w AV dissociation or fusion/capture beats

Answer 36

Stable V-tach = IV Amiodarone | Unstable V-tach = Synchronized cardioversion