Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
173 Cards in this Set
- Front
- Back
|
What is the typical complaint of a patient with retinal detachment? |
Acute painless "curtain like" loss of vision (shade comes down over one eye), flashing lights, floaters |
|
|
What is the treatment of BPPV?
|
Epley Manuever (used to resposition the otolith) |
|
|
What is Todd's Paralysis? |
Post-ictal motor/sensory loss lasting between 15 to 24 hours |
|
|
What drugs when combined with SSRI's are known for causing Serotonin Syndrome? |
Antidepressants: MAOis (isocarboxazid, phenelezine), SNRIs (venlafaxine, duloxteine, trazodone), SSRIs (citalopram, fluoxetine), Buproprion Anti-migraine Triptans St. Johns wort Cocaine, ectasy Serotonin syndrome symptoms - agitation or reslessness, AMS, tachycardia, Clonus |
|
|
What is the most common cause of sensorineural hearing loss? |
Sensorineural: Presbycusis (high frequency hearing loss in elderly)
|
|
|
What is the most common cause of conductive hearing loss? |
Otosclerosis (abnormal bone growth in the middle ear) |
|
|
What is the most common complication of recurrent otitis media? |
hearing loss |
|
|
An elderly patient presents to the ED with a HA and dilated R pupil. During the history she reports falling at home 5 days ago. What is the most likely diagnosis? |
Subdural hematoma - located on the side of the dilated pupil (compression of CN3) |
|
|
What medications other than stimulants are used in the treatment of ADHD |
Atomoxetine (NE reuptake inhibitor asst'd with suicidal ideation and liver injury |
|
|
What medications are used in the treatment of Tourette's? |
Dopamine receptor antagonist (haloperidol, pimozide***) or clonidine
|
|
|
What are the most worrisome side effects of the ADHD drug Atomoxetine |
Increased suicidal ideation and elevation of LFTs |
|
|
What is the definitive treatment for an epidural or subdural hematoma? |
Evacuation of the hematoma with a burr hole |
|
|
What lab abnormalities would be seen in a patient with bacterial meningitis |
Inc WBC ct with left shift (bandemia), hyponatremia (from SIADH) |
|
|
A patient comes to the clinic with the complaint of "hearing loss and vertigo". On exam of the tympanic membrane you note a whitish gray pearly lesion involving the TM. What is the diagnosis? |
Cholesteatoma |
|
|
What are the usual imaging studies in a trauma series? |
AP Chest |
|
|
What do a low EPO, elevated HCT, and normal O2 saturation suggest?
|
PCV (polycythemia vera)
|
|
|
Hampton's Hump on Xray is associated with
|
PE
|
|
|
A mother who is frustrated with her child yells are her husband. What defense mechanism is she displaying?
|
Displacement
|
|
|
In which immunodeficiency are there chronic respiratory infections and a positive nitroblue tetrazolium test?
|
Chronic Granulomatous Disease
|
|
|
What is the natural history of leiomyoma
|
Will normally regress on own with estrogen withdrawal at menopause
|
|
|
What antihtn meds are used in a patient with severe preeclampsia?
|
Labetalol |
|
|
What type of headache causes unilateral, severe periorbital headache with tearing?
|
Cluster
|
|
|
What type of back pain is
1 exacerbated by standing and walking 2 relieved with sitting and hyperflexion |
Spinal Stenosis
|
|
|
What is the most common cause of "Traveler's Diarrhea"
|
ETEC
|
|
|
In what circumstances should confidentiality not be protected?
|
Harm to self
Harm to others AMS |
|
|
What causes flat-topped purplish pruritic papules?
|
Lichen Planus
check for HCV |
|
|
EKG abnormality in Hypothermia
|
J wave (osbones)
|
|
|
Treatment of lead poisoning in adults?
Children? |
EDTA, dimercaprol
succimer |
|
|
What is the Parkland Burn Formula?
|
4ml LR x (BSAburned) x (Kg wt)
give 1/2 in first 8 hours, 1/2 in following 16 + maintenance fluids |
|
|
What is the treatment of black widow spider bite?
|
Wound Care
24 obs Erythromycin +/- Dapsone If Lactodactism --> Calcium Gluconate, Benzo, methocarbamol |
|
|
What is the treatment for a skin alceration on the dorsum of the hand that resulted for a closed first hitting a victims mouth?
|
Keep would open
Start ABx Irrigate XR for FB |
|
|
What is the next step in the mgmt of a pt that presents to the ER with organophosphate poisoning?
|
Remove clothes
Atropine Pralidoxime |
|
|
What classic toxic ingestion management options should not be chosen in patients presenting with alkaline fluid ingestion?
|
Do not induce emesis
Do not attempt acid/base balancing Do not place NG tube |
|
|
What medications are used in cases of cyanide poisoning?
|
Thiosulfate
Nitroprusside (or Amyl nitrate) Hydroxycobalamin |
|
|
A COPD patient presents to the ER with tacchycardia and hypotension. During the evaluation he begins to have seiuzes. What is the most likely etiology?
|
Theophylline overdose
|
|
|
What are the causes of PEA? (H/Ts)
|
Hypovolemia |
|
|
What is the treatment for hyperparathyroidism due to parathyroid hyperplasia?
|
Removal of 3.5 glands
Mark last area with surgical clip for observation Possible autotransplant to forearm (MENI) |
|
|
What mineralocorticoid medication is used in the treatment of aldosterone deficiencies such as Adrenal insufficiency and 21-hydroxylase deficiency?
|
Fludrocortisone
|
|
|
A lesion to which area of the brain is responsible for the following clinical scenarios?
Contralateral hemiballismus |
Subthalamic Nuclei
|
|
|
A lesion to which area of the brain is responsible for the following clinical scenarios?
Hemispatial neglect |
R parietal Lobe
|
|
|
A lesion to which area of the brain is responsible for the following clinical scenarios?
Coma |
RAS (pontine most commonly)
|
|
|
A lesion to which area of the brain is responsible for the following clinical scenarios?
Poor Repitition |
Arcuate Fasiculus
|
|
|
A lesion to which area of the brain is responsible for the following clinical scenarios?
Poor comprehension |
Wernicke's
|
|
|
A lesion to which area of the brain is responsible for the following clinical scenarios?
Poor vocal expression |
Broca's
|
|
|
A lesion to which area of the brain is responsible for the following clinical scenarios?
Resting Tremor |
Basal Ganglia (Substantia Nigra)
|
|
|
A lesion to which area of the brain is responsible for the following clinical scenarios?
Intention Tremor |
Cerebellar Hemisphere
|
|
|
A lesion to which area of the brain is responsible for the following clinical scenarios? |
Kluver Bucey
bl amygdala |
|
|
A lesion to which area of the brain is responsible for the following clinical scenarios?
Personality Changes |
Frontal Lobe
|
|
|
A lesion to which area of the brain is responsible for the following clinical scenarios?
Dysarthria |
Cerebellar Vermis
|
|
|
A lesion to which area of the brain is responsible for the following clinical scenarios?
Agraphia and Acalculia |
L side Parietal
|
|
|
At what age do physicians begin to dose dexamethasone with/prior to first dose of ABs in suspected bacterial meningitis
|
>6mo
|
|
|
What drugs are commonly used in renal disease to bind phosphate in order to prevent hyperphosphatemia
|
Calcium carbonate
Calcium acetate calcitriol avoid Calcium Citrate, increases aluminum can be toxic to kidney |
|
|
What is the classic presentation of a patient in aspirin overdose?
|
Respiratory Alkalosis
Metabolic Acidosis |
|
|
What is the antidote to the following?
Salicylates |
Sodium Bicarbonate
|
|
|
What is the antidote to the following?
Beta Blockers (or verapamil) |
1 IVF and atropine
*2 Glucagon *3 Calcium *4 Insulin + Glucose 5 Dextrose |
|
|
What is the antidote to the following?
Digoxin |
Digibind
Correct K+ Charcoal Atropine |
|
|
What is the antidote to the following?
Iron |
Deferoxamine
|
|
|
What is the antidote to the following?
Copper |
Pencillamine
|
|
|
What is the antidote to the following?
tPA, streptokinase |
Aminocaproic Acid
|
|
|
Most likely cause of chest pain -
ST segment elevation only during brief episodes of chest pain |
Prinzemetal's Angina
|
|
|
Most likely cause of chest pain -
Patient able to point to location of pain |
musculoskeletal / costochondritis
|
|
|
Most likely cause of chest pain -
Chest wall tenderness on palpation |
Musculoskeletal
|
|
|
Most likely cause of chest pain -
Rapid onset sharp chest pain with radiation to scapula |
Aortic Dissection
|
|
|
Most likely cause of chest pain -
Rapid onset sharp pain in a 20 year old with dyspnea |
Spontaneous Pneumothorax
|
|
|
Most likely cause of chest pain -
Occurs after heavy meals and improved by antacids |
GERD / Esophageal Spasm |
|
|
Most likely cause of chest pain -
Sharp pain lasting hours-days and is somewhat relieved by sitting forward |
Pericarditis
|
|
|
Most likely cause of chest pain -
Pain made worse by deep breathing and/or motion |
Musculoskeletal
|
|
|
Most likely cause of chest pain -
Chest pain in a dermatomal pattern |
VZV
|
|
|
Most likely cause of chest pain -
MCC of noncardiac chest pain |
Non-ulcer dyspepsia
|
|
|
Most likely cause of chest pain -
Acute onset SOB, tachycardia, and confusion in a hopsitalized patient |
Pulmonary Embolism
|
|
|
Most likely cause of chest pain -
Pain began the day following an intensive new exercise program |
Costochondritis / Musculoskeletal |
|
|
Most likely cause of chest pain -
Widened mediastinum on CXR |
Aortic Aneurysm |
|
|
*What is the MCC chest pain in a patient with sudden tearing chest pain radiating to the back?
|
Aortic Aneurysm
|
|
|
*what is the MCC of death in patients with acute MI?
|
arrhythmia
|
|
|
What lipid lowering medication matches the following description?
SE Facial Flushing |
Niacin
admin w aspirin |
|
|
What lipid lowering medication matches the following description?
SE Elevated LFTs, myosis |
Statins
Fenofibrates (Gemfibrozil, Fenofibrate) |
|
|
What lipid lowering medication matches the following description?
SE - GI discomfort, bad taste |
Bile acid sequestrants (Cholestyramine, Colestipol, colesevelam)
|
|
|
What lipid lowering medication matches the following description?
Best effect on HDL |
Niacin
|
|
|
What lipid lowering medication matches the following description?
Best effect on TGs |
Fibric Acids
|
|
|
What lipid lowering medication matches the following description?
Best effect on LDL/Cholesterol |
Statins
|
|
|
What lipid lowering medication matches the following description?
Binds c diff |
Cholestyramine
|
|
|
MOA -
streptokinase |
activation of plasminogen --> plasmin, breaks up fibrin
|
|
|
MOA -
Aspirin |
Irreversible inactivation of TxA2 and Prostaglandins
|
|
|
MOA -
Clopidogrel |
blocks ADP receptions on platelets, preventing platelet aggregation
|
|
|
MOA -
Abciximab |
inhibition of GpIIb/GpIIIa binding, preventing clot formation
|
|
|
MOA -
Tirofiban |
inhibition of GpIIb/GpIIIa binding, preventing clot formation
|
|
|
MOA -
Ticlopidine |
blocks ADP receptors
|
|
|
MOA -
Enoxaparin |
Increased activity of ATIII leading to inhibitin of thrombin and Xa
|
|
|
MOA -
Eptifibatide |
inhibition of GpIIb/GpIIIa binding, preventing clot formation
|
|
|
What type of heart block
PR > .2 |
1st degree AV
|
|
|
What type of heart block
no relationship between P waves and QRS |
3rd degree AV
|
|
|
What type of heart block
PR interval becomes progressively longer until a beat is blocked |
2nd Degree Type I (Wenkebach)
|
|
|
What type of heart block
PR interval fixed but with occasional blocked beats |
2nd degree type II
|
|
|
What medications should post-M patients receive as outpatients
|
Beta blockers |
|
|
Narrow QRS not a/w p waves, rate 60
|
3rd Degree
|
|
|
Chaotic, erratic, wide QRS
|
Vfib
|
|
|
Wide QRS no a/w p waves, rate b/t 40-100
|
Accelerated Idioventricular
|
|
|
Narrow QRS not a/w p waves, rate >100
|
Junctional Tacchycardia
|
|
|
Wide QRS not a/w p waves, rate 20-40
|
Ventricular rhythm |
|
|
Wide QRS not a/w p waves rate >100
|
Vtacc
|
|
|
Narrow QRS not a/w p waves, rate 60-100
|
accelerated junction rhythm
|
|
|
Erratic QRS that varies in amplitude in a repeating pattern
|
Tosade des pointes
|
|
|
What is the treatment of PACs?
|
Nothing |
|
|
Which antiarrhythmic should be avoided in patients with preexisting lung disease?
|
Amiodarone
check LFT, PFT, TFT |
|
|
What is the DOC for acute onset Afib with RVR in a patient with WPW
|
Amiodarone
Procainamide Electrical cardioversion |
|
|
An EKG shows complete independence of P waves and QRS complexes. What is the next step in management
|
Pacemaker
|
|
|
What is the DOC in PSVT?
|
Carotid massage / valsalva
Adenosine |
|
|
Which heart valves should blood be flowing through during systole
|
Aortic
Pulmonic |
|
|
What are the systolic heart murmurs
|
Aortic/Pulmonic Stenosis |
|
|
What heart valves should blood be flowing through during diastole?
|
Mitral and Tricuspid
|
|
|
What are the diastolic murmurs?
|
Aortic Regurgitation
Mitral Stenosis |
|
|
What is the classic appearance of the heart on a CXR of a patient with pericardial effusion?
|
"water bottle" enlargement
|
|
|
*What would you find on physical exam of a patient with pericardial effusion?
|
diminished heart sounds
difficult to palpate apical |
|
|
*In what scenarios might you see Kussmaul's sign?
|
Constrictive Pericarditis |
|
|
*What disease has sign of HF + DM + LFT^?
|
Hemachromatosis
|
|
|
*In which etiology of restrictive cardiomyopathy is the pathology reversible with phlebotomy
|
Hemochromatosis
|
|
|
*What is the next step in the work-up of a low-grade systollic murmur in otherwise healthy, asymptomatic patient?
|
observation
|
|
|
*Short systolic murmur at the apex that decreased with squatting and is sometimes associated with benign chest pain and last only a few seconds
|
MVP |
|
|
*When might subclinical mitral stenosis from RHF become clinically apparent
|
Volume overload states (ex pregnancy)
|
|
|
*What commonly causes HF in young patients?
|
*Myocarditis |
|
|
What is the treatment for Tamponade
|
Immediate pericardiocentesis |
|
|
What medications are important in the outpatient treatment of chronic CHF
|
beta blockers
ACEi Diuretics Aspirin |
|
|
What is the acute treatment for exacerbations of CHF
|
Loop Diuretics
Morphine Nitrates Oxygen (or niseritide) Positioning Pressors |
|
|
What type of murmur fits the following description?
Diastolic murmur heard best @ the left lower sternum, that increases with inspiration? |
Tricuspid Stenosis
|
|
|
What type of murmur fits the following description?
Later diastolic murmur with OS |
Mitral Stenosis
|
|
|
What type of murmur fits the following description?
Systolic murmur heard best in the second right interspace |
Aortic stenosis
|
|
|
What type of murmur fits the following description?
Systolic murmur heard best in the second left interspace |
Pulmonic Stenosis
|
|
|
What type of murmur fits the following description?
Late systloic murmur best heard at the apex |
MVP
|
|
|
What type of murmur fits the following description?
Diastolic murmur with a widened pulse pressure |
AR
Pulsus et tardus |
|
|
What type of murmur fits the following description?
Holosystolic murmur that is louder with inspiration at the LL sternum |
TR
|
|
|
What type of murmur fits the following description?
Holosystolic murmur heard at the apex and radiates to the apex |
MR
|
|
|
What is the treatment for premature atrial contractions
|
nothing brah
|
|
|
What is the next step in the workout of any diastolic murmur
|
Echo
|
|
|
What is the treatment of cardiogenic shock
|
Dobutamine
|
|
|
What systemic diseases can cause nephritic syndrome
|
DM
SLE Wegner's Amyloidosis |
|
|
1 Hypoxemia
2 Pulmonary Edema 3 Normal pulmonary capillary wedge pressure |
ARDS
|
|
|
What disorder is present in a teenager with a history of theft, vandalism, and violence towards family pets
|
Conduct Disorder
|
|
|
What causes a continuous machine-like murmur
|
PDA
|
|
|
What would you suspect in a woman with preeclampsia in the first trimester?
|
Hyatidaform mole
|
|
|
What CSF findings would you see in a case of Subarachnoid hemorrhage
|
Increased protein
Elevated CSF pressure RBCs 3 consecutive tubes, Xanthochromia is >1d old |
|
|
What acid-base disturbance is commonly seen in pregnancy
|
Respiratory Alkalosis |
|
|
A husband asks that his wife not be told about her recently discovered cancer
|
Ask him why he feels this way
Still tell patient if invalid reasoning |
|
|
Does a case-control study measure incidence or prevalence
|
neither
|
|
|
What is the first line treatment for a growth hormone secreting pituitary adenoma
|
Transsphenoidal tumor resection
|
|
|
What are the indications for surgical repair of an AAA
|
1 >5.5cm
2 rapidly enlarging 3 symptomatic or ruptured |
|
|
What characteristics of a nevus suggest that it may actually be a melanoma
|
Asymmetric
undefined borders Variable coloring Depth |
|
|
Low urine specific gravity in the presence of a high seurm osmolality
|
Diabetes Insipidus
|
|
|
What is the treatment of Atrial fibrillation of unknown duration
|
Rate control
3 weeks anti-coagulation - cardiovert - 4 weeks anticoagulation or rate control, TEE, cardiovert, 4 weeks anticoagulation |
|
|
Which lung cancer is associated with SIADH
|
Small cell carcinoma
|
|
|
What important SEs are common to many of the atypical antipsychotics
|
Weight gain
|
|
|
What is the most common location for an ectopic pregnancy
|
Fallopian Tubes (Ampulla)
|
|
|
Uterine bleeding at 18 weeks gestation + no products expelled + membranes ruptured + cervical os open
|
Inevitable abortion
|
|
|
ICU patient is awake and alert but cannot move anything the eyes and eyelids -- What is the diagnosis
|
Lock-in Syndrome
|
|
|
*What radiographic study is used to diagnose injury to the urethra?
|
Retrograde cystourethogram
|
|
|
*What are the symptoms of basilar skull fracture?
|
Raccoons Eyes
Battles Sign hemotympanum CSF drainage |
|
|
*Chest Trauma + Hypotension + JVD + distant heart sounds
What is the next step in the management of this patient? |
Periocardiocentesis
|
|
|
*Chest Trauma + Hypotension + JVD + Respiratory distress
|
Chest Tube placement (needle compression first)
|
|
|
*What is the next step in the evaluation of penetrating injuries to the different zones of the neck?
|
Zone 1 - CTA (4 vessel angiogram)
Zone 2 - surgical exploration Zone 3 - CTA, triple endoscopy |
|
|
*What interventions are effective in the management of elevated intracranial pressure?
|
Elevated head of bed
If intubate, admin lidocane first Mannitol Intubate + Hyperventilate +/- decompressive craniectomy |
|
|
What is the next step in the evaluation of the following patients?
Pelvic Fractuce + DPL shows blood in pelvis |
Emergency Laparotomy
|
|
|
What is the next step in the evaluation of the following patients?
Pelvic fracture + DPL shows urine in the pelvis |
Urgent (not emergent) laparotomy
|
|
|
What is the next step in the evaluation of the following patients?
Pelvic fracture + DPL shows nothing + hemodynamic instability |
Angiography with possible embolization
|
|
|
What is the next step in the evaluation of the following patients?
Blunt abdominal trauma + unstable vital signs + FAST shows fluid |
Emergent Laparotomy
|
|
|
What is the next step in the evaluation of the following patients?
Blunt abdominal trauma + unstable vitals + FAST shows no fluid in pelvis |
Retroperitoneal hematoma
Angiography w poss embolization |
|
|
What is the next step in the evaluation of the following patients?
Blunt abdominal trauma + unstable vitals + FAST inconclusive |
Diagnostic Peritoneal Lavage
|
|
|
What is the next step in the evaluation of the following patients?
Blunt abdominal trauma + stable vitals |
CT abdomen and pelvis
|
|
|
What is the next step in the evaluation of the following patients?
Abdominal stab wound + hypotensive or signs of peritonitis |
Emergency surgical exploration
|
|
|
What additional studies can be performed in the case of a stable patient with an abdominal stab wound that penetrated the peritoneum |
DPL
Upright CXR Diagnostic US Abdominal CT w contrast Diagnostic laparoscopy |
|
|
How should you treat a patient that has been bitten by an an animal suspected of having rabies or an animal that cannot be observed for 10 days? |
Previously vaccinated: 2 dose of rabies vaccine Non-vaccinated: - 1 dose rabies IG via IM, 4 doses of vaccine
|
|
|
A patient is brought into the ER with progressive muscle weakness, retained sensation, headache, vomiting, neck pain, and fever. CSF analysis show increased lymphocytes and normal glucose and protein. What life threatening complication can result if this disease progression? |
LP with lymphocytes and normal protein and glucose - think viral etiology Weakness = most likely polio Polio complication = respiratory depression, permanent paralysis Polio invades the anterior horn cells of the spinal cord |
|
|
What other term should you rembember when considering Reye syndrome |
Hepatoencephalitis |
|
|
A patient is admitted to the hospital with a presumptive diagnosis of viral meningitis. An MRI of the head shows lesions of the R temporal lobe. What pathogen is most consistent |
HSV encephalitis - start empiric acyclovir |
|
|
A pt is recovering in the ICU after suffering a subdural hematoma that occurred b/c of a MVC. The neurosurgery team performed a craniotomy and drain placement to evacuate the clot. For the past few days the drainage in the collection bulb was serous. Now however, the drainage is thick and yellow. Along with this, the pt's neurological exam has deteriorated. What is the likely cause of this clinical picture? |
Dx: abscess within subdural space |
