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107 Cards in this Set
- Front
- Back
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What is the treatment for hyperparathyroidism due to parathyroid hyperplasia?
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Remove 3.5 glands, mark remaining half gland with surgical clip.
High risk of recurrence: autotransplant from neck to forearm. |
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Categorize the following drugs (neuroleptics or atypical antipsychotics):
olanzapine thioridazine quetiapine molindone chlorpromazine haloperidol fluphenazine laxopine risperidone thiothixene trifluoperazine clozapine aripiprazole paliperidone droperidol |
Neuroleptic (High potency):
Haloperidol Fluphenazine Thiothixene Droperidol Neuroleptic (Moderate potency): Molindone Laxopine Trifluoperazine Neuroleptic (Low potency): Chlorpromazine Thioridazine Atypical antipsychotic: Olanzapine Risperidone Aripiprazole Quetiapine Clozapine Paliperidone |
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What mineralcorticoid medication is used in the treatment of aldosterone deficiencies such as adrenal insufficiency and 21-hydroxylase deficiency?
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Fludrocortisone
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Lesion to which area of the brain leads to the following clinical scenario?
Contralateral hemiballismus Hemispatial neglect syndrome Coma Poor repetition Poor comprehension Poor vocal expression |
Contralateral hemiballismus: Subthalamic nucleus
Hemispatial neglect syndrome: Right parietal lobe Coma: reticular activating system (pontine lesion) Poor repetition: arcuate fasciculus Poor comprehension: Wernicke's area Poor vocal expression: Broca's area |
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Lesion to which area of the brain leads to the following clinical scenario?
Resting tremor Intention tremor Hyperorality, hypersexuality, disinhibited behavior Personality Changes Dysarthria Agraphia and acalculia |
Resting tremor: Basal ganglia
Intention tremor: Cerebellar hemisphere Hyperorality, hypersexuality, disinhibited behavior: Bilateral Amygdala lesion (Kluver bucy) Personality Changes: Frontal lobe lesion Dysarthria: Cerebellar vermis Agraphia and acalculia: Left parietal lobe |
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At what age do physicians begin to dose dexamethasone with or prior to the first dose of antibiotics in cases of suspected bacterial meningitis?
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6 months of age
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What drugs are most commonly used in renal disease to bind phosphate in order to prevent hyperphosphatemia?
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Calcium carbonate
Calcium acetate Do Not Use Calcium citrate |
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What is the classic presentation of a patient with aspirin overdose?
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Tinnitus
Starts are respiratory alkalosis (hyperventilation) becomes mixed respiratory alkalosis AND metabolic acidoses Hyperthermia Dehydration |
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What is the empiric treatment for a brain abscess?
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Antibiotics
- if from neurosurgery: Vancomycin and ceftazodine Needle Aspiration for drainage Corticosteroids |
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What is the treatment for cluster headaches?
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100% Oxygen
Ergots Sumatriptan |
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In which patient populations are -triptan drugs contraindicated?
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Pregnany
CAD Prinzmetal's angina |
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What side effects can arise from theophylline overdose?
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Seizures
Hyperthermia Hypotension Cardiac tachyarrhythmias |
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What is the following heart disease?
ST segment elevation in leads corresponding to the perfusion of multiple arteries Hypotension + distant heart sounds + distended neck veins Cardiac cath shows equal pressures in all heart chambers Chest pain that lessens when the patient leans forward |
ST segment elevation in leads corresponding to the perfusion of multiple arteries
Acute pericarditis Hypotension + distant heart sounds + distended neck veins Beck's triad of cardiac tamponade Cardiac cath shows equal pressures in all heart chambers Constrictive pericarditis Chest pain that lessens when the patient leans forward Acute pericarditis |
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Which blood pressure medications should be avoided in patients with ischemic stroke or subarachnoid hemorrhage because of the increase in intracranial pressure associated with them?
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Nitroprusside and Nitroglycerine
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What is the antidote to the following toxin?
Antimuscarinic, anticholinergic agents Benzodiazepines Tricyclic Antidepressants Warfarin Methanol, ethylene glycol Arsenic |
Antimuscarinic, anticholinergic agents
Physostigmine Benzodiazepines Flumazenil Tricyclic Antidepressants Sodium bicarbonate Warfarin Vitamin K, FFP Methanol, ethylene glycol Fomepezol, ethanol Arsenic Dimercaprol, Succimer, Penicillamine |
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What is the Parkland burn formula?
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4mL x kg (patient weight) x % of body surface burned = Lactated ringer volume (+ maintenance IV fluid)
Half in first 8 hours Second half over the next 16 hours |
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What are the symptoms of neuroleptic malignant syndrome?
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Altered mental status
Muscle rigidity Hyperthermia Autonomic instability Rhabdomyolysis |
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What is the treatment for neuroleptic malignant syndrome?
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Dantrolene (stops muscle contractions)
Discontinue medications IV fluids and cooling Bromocriptine or amantadine are alternatives |
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Compare PTH, alkaline phosphatase, serum calcium, and serum phosphate levels in patients with the following diseases:
Paget's disease Osteomalacia/Rickets Chronic renal failure Osteoporosis Osteopetrosis Primary hyperparathyroidism Hypoparathyroidism Pseudohypoparathyroidism |
Paget's disease
- PTH normal - Alk Phos elevated - Ca normal - Phos normal Osteomalacia/Rickets - PTH increased - Alk Phos normal or elevated - Ca decreased - Phos decreased Chronic renal failure - PTH increased - Alk Phos normal or elevated - Ca decreased - Phos increased Osteoporosis - PTH normal - Alk Phos normal - Ca normal - Phos normal Osteopetrosis - PTH normal - Alk Phos normal - Ca normal - Phos normal Primary hyperparathyroidism - PTH increased - Alk Phos increased - Ca increased - Phos decreased Hypoparathyroidism - PTH decreased - Alk Phos normal - Ca decreased - Phos increased Pseudohypoparathyroidism - PTH increased - Alk Phos normal - Ca decreased - Phos increased |
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What is the treatment for cluster headaches?
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100% oxygen
Sumatriptan Ergots |
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Which class of antihypertensives is contraindicated in the following patients?
- COPD - Bilateral renal artery stenosis - Pregnancy - Advanced renal failure - Gout |
COPD
- Non-selective beta-blocker Bilateral renal artery stenosis - ACE-Is/ARBS Pregnancy - ACE-Is/ARBs Advanced renal failure - (with hyperkalemia) ACE-Is/ARBs, spironolactone Gout - Diuretics |
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What heart sounds are considered benign when there is no evidence of disease?
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Low grade Systolic murmur
Split S1 Split S2 on inspiration S3 (only in asymptomatic patients) |
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What heart defect is associated with the following disorders?
- Chromosome 22q11 deletions - Down syndrome - Congenital rubella - Turner's syndrome - Marfan's syndrome |
Chromosome 22q11 deletions
- Truncus arteriosus, Tetralogy of Fallot Down syndrome - Endocardial cushion defect, VSD, ASD Congenital rubella - PDA, pulmonary artery stenosis Turner's syndrome - Coarctation of the aorta Marfan's syndrome - Aortic regurgitation |
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What is the next step once a brain tumor has been identified on CT or MRI of the head?
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Look for metastasis/source
Full body CT scan Bone scan |
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What are the W's of post-op fever?
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Wind: Atelectasis, Pneumonia
Water: UTI Wound/Wein: Wound infection, thrombophlebitis Walking: DVT, PE Wonder drugs: Antibiotics and Sinusitis |
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What medication combination is used in the treatment of TB meningitis?
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Rifampin
Isoniazid Pyrizinamide Ethambutol |
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What are the characteristic features of a patient presenting with pericarditis?
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Plueritic chest pain
Pain worse when laying down Friction rub Dyspnea Fever Cough JVD Pulsus paradoxus Diffuse ST segment elevations |
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What is the antidote to the following toxin?
Acetaminophen Lead Cyanide Methemoglobin Opioids |
Acetaminophen: N-acetylcysteine
Lead: Succimer (children), EDTA, Dimercaprol and Penicillamine (adults) Cyanide: Sodium thiosulfate, Hydroxocobalamin, Nitrates (Amyl or sodium) Methemoglobin: Methylene blue, Vitamin C Opioids: Naloxone, naltrexone |
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What are the indications for surgical parathyroidectomy in patients with a parathyroid adenoma?
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Parathyroid adenoma:
Serum Ca > 1 above upper limit Urine 24 Ca > 400 mg Cr clearance reduced by 30% Bone mineral density T score < -2.5 at any site Younger than 50 years of age |
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A 50 year old male with a 25 pack-year history presents with his second bout of pneumonia in the last 6 months. CXR reveals a lobar consolidation in the same location as the previous pneumonia. What is the next step in the management of this patient?
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CT scan of chest (rule out cancer)
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What imaging study is used to diagnose a DVT?
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Compression ultrasonography
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What radiologic study is used to diagnose injury to the urethra?
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Retrograde cystourethrogram
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What are the symptoms of a basilar skull fracture?
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Raccoon eyes
Battle sign (bruising over mastoid process) Blood behind tympanic membrane CSF draining from ear, nose |
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What is the drug of choice for trigeminal neuralgia?
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Carbamazepine
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What is the treatment for normal pressure hydrocephalus? What is the treatment for pseudotumor cerebri?
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Normal Pressure Hydrocephalus:
- Ventriculoperitoneal Shunt Pseudotumor cerebri: - Weight loss - Acetazolamide - Serial lumbar punctures - Shunting of CSF |
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What is the treatment for Guillain-Barre syndrome?
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- Plasmapharesis or IVIG
- Supportive care - Intubation if necessary |
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How do you distinguish the Somogyi effect from the dawn phenomenon?
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Both cause high morning glucose levels
Check 2-3am glucose level Somogy: glucose low -> Stress hormone release Dawn phenomenon: glucose high |
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What type of immunodeficiency increases the risk of anaphylactic transfusion reaction?
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IgA deficiency
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Which antihypertensive class is first-line in patients with the following problems?
- No comorbidities - Diabetes - Heart failure (multiple) - BPH - Left ventricular hypertrophy - Hyperthyroid - Osteoporosis - Benign essential tremor - Post-menopausal female - Migraines |
No comorbidities
- Thiazide diuretics Diabetes - ACE-Is/ARBs Heart failure (multiple) - Beta-blocker, ACE-I/ARB, Spironolactone BPH - Alpha blocker (zosins) Left ventricular hypertrophy - ACE-I/ARB Hyperthyroid - Beta-blocker Osteoporosis - Thiazide diuretics Benign essential tremor - Beta-blocker Post-menopausal female - Thiazide diuretic Migraines - Beta-blocker |
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What are the HACEK bacteria?
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Culture-negative endocarditis:
Haemophilus Actinobacillus Cardiobacterium Eikenella Kingella |
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At what point do patients with chronic COPD qualify for home O2?
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O2 Sat ≤ 88%
Pulmonary hypertension Peripheral edema Polycythemia |
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What is the initial treatment of a localized non-small cell lung cancer?
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Surgical resection
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What is the treatment for acute mesenteric ischemia?
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Hemodynamic monitoring
Pressors for hypotension Broad spectrum antibiotic NG Tube decompression and bowel rest Heparin or enoxaparin for anticoagulation Embolectomy Resection of necrotic bowel |
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When is rifampin prophylaxis indicated in cases of bacterial meningitis?
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In close contacts in patients with Neiserria meningitis of H. Influenza type b.
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What is the treatment for acromegaly?
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Transsphenoidal resection of pituitary adenoma.
External beam radiation 2nd line. Somatostatin or Cabergoline |
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What infectious agent most likely corresponds to the following statement?
- Food poisoning as a result of mayonnaise sitting out too long - Rice-water stools - Diarrhea transmitted from pet feces - Food poisoning resulting from reheated rice - Most common cause of traveler's diarrhea - Diarrhea after a course of antibiotics - Diarrhea + recent ingestion of water from a stream |
- Food poisoning as a result of mayonnaise sitting out too long: Staph aureus
- Rice-water stools: Vibrio cholera, ETEC - Diarrhea transmitted from pet feces: Yersinia enterocolitica - Food poisoning resulting from reheated rice: Bacillus cereus - Most common cause of traveler's diarrhea: ETEC - Diarrhea after a course of antibiotics: C. diff - Diarrhea + recent ingestion of water from a stream: Giardia lamblia |
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What infectious agent most likely corresponds to the following statement?
- Mild intestinal infection that can become neurocysticercosis - Food poisoning from undercooked hamburgers - Diarrhea from seafood - Bloody diarrhea from poultry - Diarrhea + pink-eye - Bloody diarrhea -> liver abscess - Diarrhea in an AIDS patient - Dehydrated child with greenish diarrhea in winter months |
- Mild intestinal infection that can become neurocysticercosis: Taenia solium
- Food poisoning from undercooked hamburgers: E. coli 0157:H7 - Diarrhea from seafood: Vibrio cholera, Vibrio parahemolyticus - Bloody diarrhea from poultry: Campylobacter, Salmonella - Diarrhea + pink-eye: Adenovirus - Bloody diarrhea -> liver abscess: Entamoeba hystolitica - Diarrhea in an AIDS patient: Cryptosporidium - Dehydrated child with greenish diarrhea in winter months: Rotavirus |
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What are the most common causes of acute pancreatitis?
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Alcohol
Gall stones Elevated TG Hyperglycemia Trauma Drugs |
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A COPD patient comes to the ER with tachycardia and hypotension. During the evaluation he begins to have seizures. What is the most likely etiology?
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Theophylline overdose
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What is the ACLS treatment for asystole?
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Transcutaneous pacing
CPR Alternating Epinephrine + Atropine |
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Which antihypertensive drug fits the following side effect?
- First dose orthostatic hypotension - Hypertrichosis - Dry mouth, sedation, severe rebound HTN - Bradycardia, impotence, asthma exacerbation - Reflex tachycardia - Cough - Avoid in patients with sulfa allergy - Angioedema - Development of drug-induced lupus - Cyanide toxicity |
- First dose orthostatic hypotension: alpha-blockers
- Hypertrichosis: Minoxidil - Dry mouth, sedation, severe rebound HTN: Clonidine - Bradycardia, impotence, asthma exacerbation: Beta-blocker - Reflex tachycardia: Vasodilators - Cough: ACE-I - Avoid in patients with sulfa allergy: Hydrochlorothiazide - Angioedema: ACE-I - Development of drug-induced lupus: Hydralazine - Cyanide toxicity: Nitroprusside |
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What is the treatment for febrile seizures?
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Observation
Supportive care (lower temperature) |
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What is the empiric treatment for pneumonia in a 2 month-old? 2 year-old?
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2 month old:
Macrolide (Erythromycin) +/- Cefotaxime 2 year old: Amoxicillin or Ampicillin |
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What are the classic findings of Henoch-Schonlein purpura (HSP)?
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Palpable purpuric rash around lower extremities
GI symptoms: abdominal pain, vomiting, intussusception Renal disease: hematuria, proteinuria Arthritis |
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What are Ranson's criteria in determining the prognosis in patients with acute pancreatitis?
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Glucose
Age LDH AST WBC Ca Hematocrit O2 BUN Base deficit Sequestration of fluid |
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What is the treatment for the following diarrheal illness?
- Entamoeba histolytica - Giardia lamblia - Salmonella - Shigella - Campylobacter |
Entamoeba histolytica: Metronidazole
Giardia lamblia: Metronidazole Salmonella: Quinolone, TMP-SMX (high risk patients) Shigella: Quinolone, TMP-SMX Campylobacter: Erythromycin |
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Which type of lung cancer is associated with the following paraneoplastic syndrome?
- Elevated ACTH-> glucocorticoid excess -> Cushing's syndrome - Elevated PTH related peptide -> Hypercalcemia - Elevated ADH -> SIADH -> hyponatremia - Antibodies to presynaptic Ca channels -> Lambert-Eaton syndrome |
Elevated ACTH -> glucocorticoid excess -> Cushing's syndrome: Small cell lung cancer
Elevated PTH related peptide -> Hypercalcemia: Squamous cell Elevated ADH -> SIADH -> hyponatremia: Small cell Antibodies to presynaptic Ca channels -> Lambert-Eaton syndrome: Small cell |
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Which type of vasculitis fits the following description?
- Weak pulses in upper extremities - Necrotizing granulomas of lung and necrotizing glomerulonephritis - Necrotizing immune complex inflammation of visceral/renal vessels - Young male smokers - Young Asian women - Young asthmatics |
Weak pulses in upper extremities: Takayasu
Necrotizing granulomas of lung and necrotizing glomerulonephritis: Wegener's Necrotizing immune complex inflammation of visceral/renal vessels: Polyarteritis nodosa Young male smokers: Buergers Young Asian women: Takayasu Young asthmatics: Churg-Strauss |
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Which type of vasculitis fits the following description?
- Infants and young children; involved coronary arteries - Most common vasculitis - A/w hepatitis B infection - Occlusion of ophthalmic artery can lead to blindness - Perforation of nasal septum - Unilateral headache, jaw claudication |
Infants and young children; involved coronary arteries: Kawasaki
Most common vasculitis: Temporal arteritis A/w hepatitis B infection: Polyarteritis nodosa Occlusion of ophthalmic artery can lead to blindness: Temporal arteritis Perforation of nasal septum: Wegener's Unilateral headache, jaw claudication: Temporal arteritis |
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Which lipid-lowering agent matches the following description?
- SE: Facial flushing - SE: Elevated LFTs, myositis - SE: GI discomfort, bad taste - Best effect on HDL - Best effect on triglycerides/VLDL - Best effect on LDL/cholesterol - Binds C. diff toxin |
SE: Facial flushing: Niacin
SE: Elevated LFTs, myositis: Statins, fibrates SE: GI discomfort, bad taste: Bile acid sequestrants Best effect on HDL: Niacin Best effect on triglycerides/VLDL: Fibrates Best effect on LDL/cholesterol: Statins Binds C. diff toxin: Cholestyramine |
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What drugs are known for causing elevated prolactin levels?
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Anti-psychotics (Dopamine antagonists)
Methyldopa Verapamil |
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What is the most common cause of aortic stenosis in a 50 year old patient?
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Congenital bicuspid aortic valve
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What is the most common cause of aortic regurgitation in a 70-year old patient?
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Senile (degenerative) calcification
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What is the classic (but rare) EKG finding in pulmonary embolism?
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S1Q3T3
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What is the most likely cause of secondary hypertension given the following findings?
- Hypertension measures in arms but low BP in LE - Proteinuria - Hypokalemia - Tachycardia, diarrhea, heat intolerance - Hyperkalemia - Episodic sweating, tachycardia |
Hypertension measures in arms but low BP in LE
- Coarctation of the aorta Proteinuria - Renal disease Hypokalemia - Hyperaldosteronism Tachycardia, diarrhea, heat intolerance - Hyperthyroidism Hyperkalemia - Renal failure, Renal artery stenosis Episodic sweating, tachycardia - Pheochromocytoma |
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An elderly female with a history of cholelithiasis presents with a 5-day history of vague, recurrent abdominal pain and vomiting. What diagnosis do you immediately suspect?
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Gall stone ileus
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A patient presents to the ER with a very painful irreducible inguinal mass. What is the next step in the management of this patient?
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Surgical correction of the incarcerated inguinal hernia
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A 4-month-old child presents with nonbilious vomiting despite changing formulas from milk-based to soy-based. What is the most likely etiology?
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Congenital pylorus stenosis
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A patient presents to clinic for follow-up and is found to have a BP of 150/85. You note in the chart that during his last visit 1 month ago, his BP was 145/90. What is the next step in the management of this patient?
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Recheck blood pressure in 2-4 weeks.
You need 3 BP on 3 different occasions to diagnose HTN. |
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Which glomerular disease would you suspect most in a pt with the following findings?
- Most common nephrotic syndrome in children - IF: granular pattern of immune complex seposition; LM: hypercellular glomeruli - IF: linear pattern of immune complex deposition - Kimmelstiel-Wilson lesions (nodular glomerulosclerosis) - most common nephrotic syndrome in adults - EM: loss of epithelial foot processes - Nephrotic syndrome a/w hepatitis B - Nephrotic syndrome a/w HIV |
Most common nephrotic syndrome in children
- Minimal change disease IF: granular pattern of immune complex seposition; LM: hypercellular glomeruli - Post-infectious IF: linear pattern of immune complex deposition - Goodpasture's Kimmelstiel-Wilson lesions (nodular glomerulosclerosis) - Diabetic nephropathy most common nephrotic syndrome in adults - FSGS or membranous? EM: loss of epithelial foot processes - Minimal change Nephrotic syndrome a/w hepatitis B - Membranoproliferative Nephrotic syndrome a/w HIV - FSGS |
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Which glomerular disease would you suspect most in a pt with the following findings?
- Anti-GBM antibodies, hematuria, hemoptysis - EM: subendothelial humps and tram-track appearance - Nephritis, deafness, cataracts - LM: Crescent formation in the glomeruli - LM: segmental sclerosis and hyalinosis - Purpura on back of arms and legs, abdominal pain, IgA nephropathy - Positive ANCA - Anti-dsDNA antibodies |
Anti-GBM antibodies, hematuria, hemoptysis
- Goodpasture's EM: subendothelial humps and tram-track appearance - Membranoproliferative Nephritis, deafness, cataracts - Alport's LM: Crescent formation in the glomeruli - Rapidly progressive LM: segmental sclerosis and hyalinosis - FSGS Purpura on back of arms and legs, abdominal pain, IgA nephropathy - Henoch-Schonlein Purpura Positive ANCA - Crescentic glomerulonephritis Anti-dsDNA antibodies - Lupus nephritis |
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What is the treatment for an MI due to cocaine overdose?
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Lorazepam
CCB for BP control Do not give Beta-blockers (unmasked alpha1 vasoconstriction -> raise BP) |
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In which immunodeficiency is there an absence of a thymic shadow on newborn chest x-ray?
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DiGeorge syndrome or SCID
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A post-op patient has poor urine output, a BUN of 85, Creatinine of 3, and clear lungs. What is the next step in the management of this patient?
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Prerenal azotemia
Give IV fluids |
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Which vaccines should not be given to an HIV positive patient?
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Live virus vaccines
- Varicella zoster - Intranasal influenza - Oral polio - Yellow fever - BCG - Anthrax - Oral typhoid - Small pox Exception: MMR is given as long as CD4 > 200 |
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When would you suspect thrombocytopenia due to heparin use? What is the most feared complication of heparin-induced thrombocytopenia?
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Heparin use and decreased Plt count by 50% suggests HIT
Thrombosis (DVT, PE, stroke) is the most feared complication |
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What is the next step in the management of a child with severe asthma exacerbation and persistently low oxygen saturation despite medication?
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Oxygen supplementation
Maintain O2 sat > 92% Intubate if necessary: - altered mental status - unable to speak due to work of breathing - O2 sat < 92% |
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What is the classic presentation of a patient with androgen insensitivity syndrome?
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Normal appearing, infertile female
46 XY Testes present No uterus, ovaries present Lab: High testosterone, high estrogen, high LH |
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What is the most common food borne bacterial GI tract infection?
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Salmonella
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What is the classic presentation of a patient with hyperprolactinemia?
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Hypogonadism
Galactorrhea Impotence (males) Prolactinoma: Visual changes Headaches |
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What lab changes will be seen in a patient with hyperaldosteronemia?
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Hypokalemia
Mild hypernatremia Metabolic alkalosis Increased 24-hour urine aldosterone |
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What is the antidote for the following overdoses?
- Opioids - Heparin - Benzodiazepines - Barbiturates (phenobarbital) - Carbon monoxide |
Opioids
- Naloxone, naltrexone Heparin - Protamine sulfate Benzodiazepines - Flumazenil Barbiturates (phenobarbital) - Bicarbonate (alkalinize urine), dialysis Carbon monoxide - 100% O2 |
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What is the definition of primary amenorrhea?
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Absence of menses at age 16 with normal growth and secondary sexual characteristics
Absence of menses at age 13 with no secondary sexual characteristics |
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What type of oral contraceptive can be given to lactating women?
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Progestin-only pills
(Estrogen decreases milk production) |
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What lab changes would you see in the following disease (Plt Count, Bleeding Time, PT, PTT)
- HUS or TTP - Hemophilia A or B - von Willebrand disease - DIC - Warfarin use - End stage liver disease - Aspirin use |
HUS or TTP
- Low Plt, High BT, normal PT, normal PTT Hemophilia A or B - Normal Plt, Normal BT, Normal PT, High PTT von Willebrand disease - Normal Plt, High BT, Normal PT, High PTT DIC - Low Plt, High BT, High PT, High PTT Warfarin use - Normal Plt, Normal BT, High PT, High PTT End stage liver disease - Low/Normal Plt, High/Normal BT, High PT, High PTT Aspirin use - Normal Plt, High BT, Normal PT, Normal PTT |
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Compare the serum iron, ferritin, and transferrin levels in iron deficiency anemia to anemia of chronic disease.
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Iron deficiency Anemia:
Decreased Serum Iron, Decreased Ferritin, Increased Transferrin Anemia of chronic disease: Decreased Serum Iron, Increased Ferritin, Decreased Transferrin |
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What medications are necessary in patients with end stage renal disease?
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Vitamin D supplementation
Phosphate binders Daily Aspirin and Statins to prevent CAD EPO supplementation (Goal Hb 11-12) BP and Glucose Control ACE-Inhibitor |
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What is the treatment for hyperkalemia?
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Insulin and dextrose
Calcium gluconate (or chloride) Alkalinize serum with sodium bicarb Albuterol Loop diuretics Kayexelate |
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What are 4 potassium sparing diuretics?
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Spironolactone
Eplerenone Triemterene Amiloride |
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What findings do the following signs describe and with what diseases are they associated with?
- Deep palpation of RUQ -> arrest of inspiration due to pain - Charcot's triad (fever, jaundice, RUQ pain), hypotension, altered mental status - RLQ pain on passive extension of the hip - RLQ pain on passive internal rotation of the flexed hip - LUQ pain and referred left shoulder pain - Ecchymosis of the skin overlying the flank - Ecchymosis of the skin overlying the periumbilical area |
Deep palpation of RUQ -> arrest of inspiration due to pain
- Murphy's sign: Cholecystitis Charcot's triad (fever, jaundice, RUQ pain), hypotension, altered mental status - Reynold's Pentad: Cholangitis RLQ pain on passive extension of the hip - Psoas sign: Appendicitis RLQ pain on passive internal rotation of the flexed hip - Obturator sign: Appendicitis LUQ pain and referred left shoulder pain - Kehr's sign: Ruptured spleen Ecchymosis of the skin overlying the flank - Grey-turner sign: Pancreatitis Ecchymosis of the skin overlying the periumbilical area - Cullen sign: Pancreatitis |
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What xray findings is indicative of croup? Epiglottitis?
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Croup: Steeple sign
Epiglottitis: Thumb sign |
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What is the treatment for RSV bronchiolitis?
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Oxygen
Maintain airway Racemic epinephrine Beta-agonists Do not use Steroids Ribavirin for last case |
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What is Beck's triad?
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Cardiac tamponade:
Hypotension Distant heart sounds Distended neck veins |
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What is the typical initial post-op fever work-up?
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CBC
UA Blood and urine culture XRay |
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What are the indications for a carotid endarterectomy?
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Carotid occlusion >70-99% + Symptomatic
Asymptomatic 80-99% (and life expectancy > 5 years) |
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What type of leukemia matches the following description?
- Most common neoplasm is children (peak age 3-4 years) - Most common leukemia in adults (average age 50) - Philadelphia chromosome is almost always seen - Smudge cells on peripheral smear - Peripheral blasts are PAS+ and TdT+ - Peripheral blasts are PAS-, myeloperoxidase+ and have Auer rods - Pancytopenia in a Down syndrome patient |
Most common neoplasm is children (peak age 3-4 years)
- ALL Most common leukemia in adults (average age 50) - CLL Philadelphia chromosome is almost always seen - CML Smudge cells on peripheral smear - CLL Peripheral blasts are PAS+ and TdT+ - ALL Peripheral blasts are PAS-, myeloperoxidase+ and have Auer rods - AML Pancytopenia in a Down syndrome patient - ALL |
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What is the next step in the management of testicular torsion confirmed with US?
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Manual detorsion
Surgical detorsion with bilateral orchioplexy |
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What are the causes of hypovolemic hyponatremia?
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Diuretics (esp Thiazides)
Addisons disease (mineralocorticoid deficiency) Fluid loss and replacement with water |
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Fever + rash + elevated creatinine + eosinophilia. What is the diagnosis?
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Acute interstitial nephritis
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What distinguishes primary biliary cirrhosis from primary sclerosing cholangitis?
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PBC:
- Positive anti-mitochondrial antibodies - Positive ANA - Females > males - A/w other autoimmune disorders PSC: - Positive pANCA - Males > females - a/w Ulcerative colitis - ERCP shows "beads on a string" |
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What is the treatment for Whipple disease?
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TMP-SMX for 1 year
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What type of current or past Hepatitis B exposure is present in each of the following scenarios?
- HepBsAg - HepBsAb - HepBcAb + - HepBsAg + HepBsAb -HepBcAb + - HepBsAg - HepBsAb + HepBcAb - - HepBsAg - HepBsAb + HepBcAb + |
HepBsAg - HepBsAb - HepBcAb +
- Window period in the acute infection HepBsAg + HepBsAb -HepBcAb + - Chronic infection HepBsAg - HepBsAb + HepBcAb - - Vaccination HepBsAg - HepBsAb + HepBcAb + - Recovery from infection |
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What is the differential diagnosis of ground-glass infiltrates on CXR?
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Interstitial pneumonia
PCP pneumonia Pulmonary edema (CHF, ARDS) Pulmonary hemorrhage Hypersensitivity pneumonitis |
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What medication is used to close a PDA?
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Indomethacin
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What complications can arise from electrical burns?
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Cardiac dysrhythmias
Compartment syndrome Bony injuries Myoglobinuria that leads to renal failure Neurologic disturbances |
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What eye abnormality is seen when there is a lesion to the oculomotor nerve (CN III)?
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Eye is "down and out"
Pupil is fixed and dilated (interruption of parasympathetic innervation) |
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What are the differing presentations of Alzheimer's dementia, Pick's disease, and Lewy body dementia?
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Alzheimers:
- MCC of dementia Pick's disease: - Personality and behavioral changes Lewy body dementia - Alzheimers with Parkinsonian symptoms - Visual hallucinations - Unexpected falls and syncopal episodes |
