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214 Cards in this Set
- Front
- Back
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clinical findings cardiac tamponade
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visible jugular pulsations
decreased brachial pulse intensity in inspiration distant heart sounds |
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cause of pericarditis in JRA
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when steroids are tappered in JRA pt present with pericarditis
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urticaria pigmentosa clinical findings
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brown macules and papules that become red and edematous on rubbing
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IQ average for Down Syndomre pt
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40 to 70, majority of this patients have mid to moderate MR
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AGN presentation
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hematuria
hypertension edema |
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AGN workup
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complement 3
UA ANA anti DsANA |
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low C3 AGN differential
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postreptococal
lupus membranoproliferative |
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normal C3 AGN differential
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IgA GN
alport membranoproliferative |
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treatment AGN
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restrict fluids if HTN
renal biposy if high creat |
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salmon colored thin scaling plaques
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pytiriasis rosea (NO TRETMENT NEEDED)
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eating disorder during pregnancy will cause what on baby
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low birth wight, microcephaly
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conjunctivitis/arthritis/urethritis (reiter) common paathogen involved
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chlamydia trachomatis
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IUGR, deaf, catarats (no RR), mom during pregnancy with rash
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rubella
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diplopia, dysphagia, dry mouth, diarrhea, shortness of breath
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botulism
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SIADH treatment
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fluid restriction, demeclocycline
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autoimmune acute hemolytic anemia
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pallor, icteric, abdominal pain, dark urine
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test for acute severe anemia
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coombs
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HSV encephalitis
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fever, disorientation, dysphagia, personality changes, seizures
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management of exposed pt to active Tb case
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treat! (even if PPD and chest X ray are negative) and retest PPD in 12 weeks
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most common cause seizures neonates
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HIE
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perinatal asphyxia seizures are described as
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clinoc, multifocal, rhythmic, migratory
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DEFINITION of concussion
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head trauma WITH loss of consiousness
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subdural hematomas
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concave, bleeding of bridging veins
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epidural hematoma
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LOC -> lucid -> rapid deteroriation
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distal weakness, facial weakness, absent reflexes, dx:
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Guillian Barre Synd
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SLE pt w abdominal disconfort, tachycardia, vomiting
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think CARDIAC TAMPONADE!
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achondroplasia
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fibroblast growth factor receptor gene 3 in chromosome 4
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most common cause death in achondroplasia
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cervicomedullary junction compresion
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to determine fetal lung maturity a single useful test (to avoidnl/s ration use)
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phosphatidylglycerol
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most common asoc anomaly of ARPKD
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hepatic fibrosis
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type II immunologic reaction
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antigen-antibody (like Rh imcomp)
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type II immunologic reaction
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IgG mediated with complement cascade (ie serum sickness)
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type IV immunologic reaction
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delayed hypersensitivity (ie PPD)
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type I immunologic reaction
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IgE- attached to mast cells -> degranulation: rash, emesis
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acute weakness muscular origen
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polymyositis, dermatomyositis, Mc Ardle, periodic paralysis
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chronic weakness muscular origen
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mitochondrial defeect, muscular distrophy
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weakness can be caused by deffects in: (levels)
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muscle, neuromusc junctions, peripheral nerve, spine, brainstem, cerebrum
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acute weakness from neuromusc junction
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miastenia, boltulism
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acute weakenss from peripheral nerve probles
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ABSENT REFLEXES:
Guillian Barre, poliomyelitis, ticjk paralysis, |
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polymyositis clinical presentation
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acute to subacute weakness, normal refelxes, HIGH AST and LDH, high CK
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HELIOTROPIC rash, GROTTONS papules, nailfold telangiectasias
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dermatomyositis
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Alagille synd
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1) paucity bile ducts/jaudice, FTT, 2)vertebral anomalies, 3)cardiac anomalies (systolic murmur) Autosom Dominant.
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distant heart murmur, WIDE QRS
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hyperkalemia
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salt and pepper retinopaty, thrombocytopenia, purpura, hearing loss
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congenital rubella
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herbal medicine contraindicated in pt taking immunosupressive therapy
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echinacea
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herbal medicines that interact with antocoagulants, steroid, antiplatelets
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gingsen, St John's wort
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most common side effect oral tacroliumus
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hyperglycemia
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delayed teeth eruption is associated with
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hypothyroidism, hypocalcemia, hypopit,
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enlarged lymph nodes, SERRATIA isolated
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CGD
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typical LAD white count
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30000
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newborn with continuos murmur and WIDE PULSE PRESSURE
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PDA
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newborn with LOUD 2ND HEART SOUND, hypoxic
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persistent pulmonary hypertension
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PDA treatment
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ligation, indomethacin
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intraabdominal calcifications
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think meconium ileaus
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complications of phototherapy
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heat production
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complications exchange transfusion
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hypOcalcemia,
thromocyopenia NEC graft vs host |
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erythroblastosis fetalis
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hemolytic ds by Rh antigens, can cause hydrops
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clinical syndrome that precedes kernicterus
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hypotonia ->hypertonia -> deafness -> cereb palsy/motor deficit
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wilson-mikity syndrome
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pulmonary fibrosis, chronic lund ds in preterm with no previous RDS that start at 1 month age
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soap bubbles sign in CXR, bilat infiltrate, multicystic lesions
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wilson mikity syndrome
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EKG duration little box
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0.04 sec
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EKG duration big boxes
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0.2 secs
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PR duration
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less than 200milisecs
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QRS duration
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less tahn 120 milisecs
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leads to look at QRS for AXIS
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lead 1 and AVF
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P wave hieight in atrial hypertrophy
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more tahn 3 mm
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wide QRS w rabitt ears
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right blocked bundle branch
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diffuse elevated ST segments
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pericarditis
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most common irregular rythm
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sinus arrythmia (due to breathing: HR increases in breathing in)
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newborn->"skipped" heart beat
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PAC (benign)
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ASYMPTOMATIC pt with unifocal (same shape) wide QRS every several beats on EKG
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PVC (bening)
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typical anatomy of a heart with SVT
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normal heart anatomically!!!
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how long does it take to go to CHF in SVT
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50% will be in CHF after 24 hrs
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SVT preventive/chronic treatment
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digoxin, propanolol, verapamil, amiodarone
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in SVT if using digoxin be careful pt is not showing signs of _____ if they do they are at risk of _____
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WPW, risk of V-Fib!!!!
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EKG with "sawtooth" pattern
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atrial flutter
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atrial fib and flutter are associated to which cardiac anomalies?
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thiank ENLARGED atria:
mitral regurg, ebstein's anomaly, AFTER REPAIRS OF CHD |
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when treating atrial fibrilation you need 3 steps:
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- cardioversion
- slow down AV conduction (digoxin, B blocker, calcium channel blocker) - control the arrythmia (amiodarone) |
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pt on A fib for over 2 hrs after slowing the AV node AND BEFORE starting meds to control arrythmia we need to:
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treat for at least 2 weeks with COUMADIN
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wide QRS tachycardia, muffled heart sounds
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ventricular tachycardia
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treatment ventricular tachycardis
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cardioversion, IV lidocaine, amiodarone
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causes of adquired prolong QT and torsades de pointes
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tricyclics, hypokalemia, hypocalcemia, hypomagnesemia, ANTIHISTAMINES,
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congenital prolonge QT and torsades de pointes
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jervel-lange-nielsen synd
romano-ward syndrome (AD) |
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treatment of otrsades de pointes
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magnesium sulfate, isoproterenol --- shock ONLY IF NOTHING ELSE WORKS
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PREVENTION on torsades de pointes in long QT
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beta blockers, pacing
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congenital complete heart block caused by
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IgG- antiRo, antiLa
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most common birth deffect
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congenital heart disease
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most common birth deffect
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congenital heart disease
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most common birth deffect
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congenital heart disease
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heart deffect in Trimy 21
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AV canal
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heart deffect in Trimy 21
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AV canal
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heart deffect in Trimy 21
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AV canal
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heart deffect Turner's
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coarctation
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heart deffect Turner's
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coarctation
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heart deffect Turner's
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coarctation
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5P CRI DU CHAT HEART DEFFECT
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VSD
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5P CRI DU CHAT HEART DEFFECT
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VSD
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5P CRI DU CHAT HEART DEFFECT
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VSD
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22q11 (dx by FISH) associated with which congenital heart defects?
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truncus arteriosus
interrupted aortic arch pulm atresia TOF |
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CHD in noonans
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pulmonic stenosis
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CHD marfan
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aortic dilation/dosection
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willijam synd CHD
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peripheral arterial pulmonay stenosis
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holt oram
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radius malform, ASD, VSD
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rubella's CHD
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PDA, PPS
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coxsaquie B in pregnancy asoc with
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neonatal miocarditis
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eisenmenger syndrome
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irreversible pulmonary hypertension from left to right shunt
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diagnose of pt with SINGLE LOUD second heart sound
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pulmonary hypertension
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BOUNDING pulses means
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PDA
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treatment od PDA
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indomethacin
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palpable RV, soft SEM LUSB, SPLIT SECOND HEART SOUND
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ASD
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types od ASD
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osteum secundum, osteum primum, sinus venosus
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acyanotic defect with left axis deviations\ in EKG
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AV canal,
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left to right shunt lesion that causes myocardial infarction in NB to 4 week babies
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anomalous LEFT coronary artery
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oxygen test: PAO2 increases
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lung ds
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oxygen test PAO2 no change
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heart ds
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cyanotic baby, failes oxygen test, CXR with decrease pulmonary flow
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TOF or tricuspid atresia (obstruction to pulmonary flow)
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treatment in obsatruction to pulmonary flow
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protaglandins!
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cyanotic heart defect with LEFT axis deviation
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tricuspid atresia
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surgery for obstructed pulmonary blood flow
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BT shunt (subclavian to pulmonary artery)
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fontan procedure
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IVC and SVC shunt to pulmonary artery (done at 1 or 2 yrs of age)
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CXR with boot shaped heart
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TOF
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CHD with CXR like a snowman
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TAPVR
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CHF in first wk of life cause and treatment
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coarctation of aorta, remeber besides dobuta to keep ductus open (add PGE1)
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pathognomonic aschoff body
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rheumatic fever
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viral myocarditis most common causes
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coxsaquie B and echovirus
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3 yr old, fever, PULSES PARODOXUS, JVD, hepatomegaly, muffled heart sounds
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pericarditis/ pericardial effusion/ tamponade
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aneuploide
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more or less chromosomes tahn the norm 46
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47 XXY
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klinefelter (tall, small testes, infertility)
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wolf hirchhorn
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4p- (
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WAGR syndrome
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Wilms tumor
Anhiridia GU anomalies MR |
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marfan synd is a deffect in the ____ gene
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fibrilin (AD)
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alagille synd
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AD, paucity bile ducts, PPS, butterfly vertebrae
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achondroplasia
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AD, sporadic causes as well
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CHARGE syndrome
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Coloboma
AD, Heart deffect Coanal atresia Retardation (mental) GU anoma/ Ear anom |
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OI
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AD
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AR
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CF
Hemoglobinopathies |
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X-linked
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duchenne musc distrophy
incontinentia pigmentia G6PD, RETT synd, Alport, Aicadi |
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MR, happy pupet, sz
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angelman
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imprinting deffect
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prader willi,
angelman, beckwidth wiedderman |
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trinucleoitide repeats
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fragile X
Huntingtons Myotonic dystrophy |
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risk to sibs in multifactorial inheritance
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2-5%
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molar tooth sign, absence cerebellar germis, polidactily,
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joubert synd
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nail hypoplasia, microcephaly,cleft lip
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hydantoin intrauterine exposure
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genetic ds w failure to thrive
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cornelia de lange
russell silver noonan williams |
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genetic ds with risk of cancer
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ataxia telengactasia
bloom syndrome fanconi, brutton X linked, CGD |
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gram positive cocci in clusters
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staph aureus
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sickle cell and osteomyelitis
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salmonella
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congenital heart ds -> cerebral abcess
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staph aureus
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MRSA in blood treated with
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VANCOMYCIN
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staph aureus best treated with
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nafcillin (oxacillin) or vanco
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CHICKENPOX NOW FEVER/SORE THROAT/SEPTIC
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STREP PYOGENES
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toxic shock and tampon
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staph
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toxic shock syndrome criteria
|
fever
3 organ involved hypotension rash |
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treatment for toxic shock
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if staph oxacillin and clinda
if strep penicillin and clinda |
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trep pneumo treatment
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ceftriaxone
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pastia lines
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group A strep
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deep TENDER skin infection with a "leading edge"
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strep pyo (GAS)
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necrotizing fasciitis treatment
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surgical debridement plus penicillin and clinda (GAS)
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strep agalactiae presentation early onset
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(GBS) bacteremia or pneumonia (meningitis is NOT a concern)
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enterococus treatment
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amp/pen or vanco!!!
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pregnant woman eating goat cheese/hotdogs/milk/ then fever/sick
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listeria
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non immunized gray phrayngeal membranes exudates
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diphteria
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anthrax
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PAINLESS ulcer (95% skin) or WIDE mediastinum (5% PNA)
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fried rice / chinese food left outside
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B Cereus
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toxin for clostridiums
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ALPHA toxin
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dirty wound- tetanus prophilaxis?
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if more than 5 yrs from last booster: Tdap only
|
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tetanus immunoglobuline never needed as long as more than how many Iz
|
3
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neisseria meningitidis meningitis prophilaxis indications
|
just close contacts: intimate oral contact (mouth to mouth or intubating) (except if a pregnant woman)
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neonatal abx ointements prevents______ and DOES NOT prevent
|
revents gonorrhea, NOT chlamydia
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IV drgus teen and endocarditis
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pseudomonas
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leukemic on chemo septic with round indurated black lesion
|
pseudomopnas (ecthyma gangrenosum)
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iguana you think infection with
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salmonella non typhi
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"rose spots" and fever
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salmonell typhi
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daycare diarrhea + rectal proplase/seizres/bandemia
|
shigella
|
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hot tub rash
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pseudomonas
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treatment of shigella
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rocephin or azithro
|
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travelers diarrhea cause and treatment
|
E Coli - bactrim
|
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neonates with citrobacter, order:
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spinal tap AND CTHead (brain abcess)
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pseudoappendicitis
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yersinia enterocolitica
|
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yersenia pestis
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fleas
|
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rabbit/dear/tick-> ulcer and lymph node (arkansas, missouri, oklahoma)
|
francisella tularensis (tularemia) treat with streptomycis or tetracycline
|
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southeast/midwest + tick bite + pancytopenia
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erlichiae
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northeast + tick bite + pancytopenia
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anaplasma
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swimmer/fish tanks with ulcers
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mycobacterium marinium
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teenager with IUD and gets PID
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actinomyces
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teenager with PNA and wheezing
|
chlamydophila pneaumoniae
|
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staccatto cough if a 4 month baby
|
chlamydia trachomatis
|
|
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swimming w dog contact and headache + fever +
|
leptospirosis (tx doxy)
|
|
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skin scrape with spagetti and meatballs
|
malassezia furfur (tinea versicolor)
|
|
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treatment for sporothricosis (rose thorns/plants)
|
oral potasium iodine or ITRACONAZOLE
|
|
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cat litter box and parasite
|
toxoplasma
|
|
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cytiwide outbrake of diarrhea and parasite
|
cryptosporidium
|
|
|
raspberries or strwaberries and a parasite
|
cyclospora
|
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maltese cross and a parasite
|
babesia
|
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rabitt and infect ds
|
tularemia
|
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guinea pigs and infect dz
|
lymphocytic choriomeningitis
|
|
|
Q fever etiology
|
coxiella bernetti
|
|
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pneumonia and splenomegally near cattle/cats
|
Q fever
|
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|
pneumonia and splenomegaly and near a BIRD
|
psittacosis
|
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cat bite organism
|
pasteurella
|
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treatment for cat bite on PNC ALLERGIC pt
|
clinda PLUS bactrim
|
|
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pneumonia, hepatomegaly, EOSINOPHILIA
|
toxocara
|
|
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west nile wivures symptomatic in whoat %
|
80
|
|
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west nile virus neruo
|
fever, weakness, GI symptoms, rash, ATAXIA, CN abnormalities, sz
|
|
|
west nile virus dx
|
IgM ELISA in serum of CSF
|
|
|
strep pyogenes (Group A strep) toxic syndrome tx
|
PNC AND clinda
|
|
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pseudomonas tx IV
|
zosyn
|
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pseudomonas PO tx
|
NO tx PO
|
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enterococus tx
|
ampicillin
|
|
|
10 yr old c meningitis empiric tx
|
vanco and ceftriaxone
|
|
|
empiric tx endocarditis IV drugg user
|
gent AND vanc
|
|
|
1 month odl with meningitis
|
vanc + ceftriaxone + ampicillin
|
|
|
leukemic pt with neutropenia and blood culture with gram neg rods (pseudomonas)
|
ceftazidime + aminoglyc or imipinem + aminoglic
|
|
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redman syndrome to vanco cause
|
NOT allergic: is mast cell reaction
|
