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Flashcards in UW 7 Deck (51):
1

Most common source of symptomatic pulmonary emobolism

Proximal deep veins - iliac, femoral, popliteal

2

When is dystonia seen with AP tx?

4 hours - 4 days

3

What is dystonia?

Muscle spasms or stiffness
Tongue protrusion/twisting
opisthotonus/oculogyric crisis

4

Tx for dystonia?

Diphenhydramine
Benztropine

5

Tx for Slipped capital femoral epiphysis

Surgical Pinning of slipped epiphysis

6

Placental abruptio Management

2 large bore IV lines
Urethral catheter
Ensure blood products available
Proceed with vaginal delivery if both mother and fetus are stable

7

MCC of acute unilateral cervical lymphadenitis in children

Staph aureus

8

Mallory-Weiss is rupture of?

Submucosal arteries of distal esophagus and proximal stomatch

9

Esophageal varices

Dilated submucosal veins at GE Junction that can rupture

10

Common cause of non traumatic avascular necrosis of femoral head

Chronic steroid use
- Progressive hip or groin pain w/out ROM, normal films

11

Dx test for avascular necrosis of hip

MRI

12

Acute onset dyspnea w wheezing and prolonged expiration

Bronchoconstriction

13

Triggers for bronchoconstriction in asthma patient

ASA
Beta Blocker

14

Complication of compartment syndrome?

Volkmann's ischemic contracture

15

What is Volkmann's contracture?

dead muscle has been replaced with fibrous tissue

16

Dull tympanic membrane that is hypomobile in an HIV pt?

Non-infectious effusion
- serous OM
- auditory tube dysfunction from HIV LA or lymphoma
- Conductive hearing loss

17

Otosclerosis

Conductive hearing loss
bony overgrowth of stapes
Middle aged individuals

18

Cherry red macula

Neimann Picks
Tay Sachs

19

Neimann-Pick's Presentation
Deficiency

Hypotonia
HSM
Cervical LA
Protruding abdomen
Cherry red spot
Def of spingomyelinase

20

Tay Sachs Presentation
Deficiency

Hyperacusis
Mental retardation
Seizures
Cherry red macula
NO HSM or Cervical LA
Def - Hexosaminidase A

21

Gaucher's Presentation?
Deficiency

HSM
Anemia
Leucopenia
Thrombocytopenia
Def in glucocerebrosidase

22

Krabbe's Presentation
Deficiency

Hyperacusis
Irritability
Seizures
Def galactocerebrosidase

23

GBS PPX for unknown GBS status

Delivery < 37 weeks
Duration of membrane rupture > 18 hours
Prior Hx of delivery of infant w GBS sepsis

24

Best next step if decreased fetal movements?

Non-stress test
Suspect fetal compromise

25

When is NST done in pregnancy?

High-risk pregnancies starting at 32-34 weeks
Loss of perception of fetal movements in any pregnancy

26

What is a reactive NST?

In 20 minutes
- at least 2 accelerations of fetal HR
- at least 15 beats/min above baseline
- Lasting 15 secs each
20-2-15-15

27

MCC of non reactive NST

Fetal sleep cycle

28

Next step if non reactive NST

Vibroacoustic stimulation

29

Next step if late deceleration on each contraction in contraction stress test

Delivery

30

What is Intrauterine fetal demise?

Death of fetus in utero after 20 weeks gestation and before onset of labor

31

IUFD presentation

Disappearance of fetal movements
Decrease/stagnation in uterine size
Fetal heart sounds not heard

32

Next step in management if IUFD suspected

Real Time US
Coagulation studies

33

Causes of IUFD

Hypertensive disorders
DM
Placental/cord complications
Antiphospholipid syndrome
Congenital anomalies
Fetal Infxn - TORCH, Listeria

34

When do we do serial b-HCG monitoring

Molar Pregnancy

35

What should be done in stillbirths?

Autopsy of fetus and placenta w/parental permission

36

Trichomonas v. Bacterial vaginosis

Trich - green/yellow d/c and pH > 4.5, vaginal and vulvar inflammation
BV - off white d/c w/fishy odor
pH > 4.5, absent vaginal inflammation
Candida - thick cottage cheese dc, vaginal inflammation
Normal pH 3.8-4.2

37

Enoxaparin (LMW Heparin), fondaparinux, Rivaroxaban CI in what group?

Renal Insufficiency (GFR < 30mL/min/1.73m2)

38

Which pts should metformin be avoided in and why?

Acute renal failure
Hepatic failure
Sepsis
Increase risk of developing lactic acidosis

39

MCC of Infective endocarditis in IVDA

Staph aureus

40

MCC of infective endocarditis in prosthetic valves, intravascular shunts, prosthetic joints

Staph epidermidis

41

Red eye with leukocytes in anterior chamber

Anterior uveitis

42

Child abuse management

1. Complete exam w/ removal of clothes
2. Secure child's safety - hospitalization
3. Report to child protective services

43

Eikenella corrodens Presentation

Gram - anaerobe
Normal human oral flora
IE w/poor dentition/periodontal

44

Streptococcus gallolyticus

Strep bovis biotype I
Colonic neoplasia and IE

45

Enterococcus faecalis

IE w/ nosocomial UTIs

46

Mets to brain - Incidence

LBMC
Lung
Breast
Melanoma
Colon

47

Multiple brain lesions in both hemispheres with edema surrounding

Mets to brain from
Lung
Melanoma

48

Brain mets that present w solitary lesion

Breast
Colon
Renal cell

49

Presentation of Gliobastoma multiforme

Solitary mass w central necrosis and vasogenic edema
Arises from w/in brain parenchyma

50

When is atheroembolism commonly seen

Complication of cardiac cath and other vascular procedures

51

MC complication of atheroembolism

Skin
- Blue toe syndrome
- Livedo reticularis
-Gangrene, ulcers