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82 Cards in this Set

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After having CINII/III, how many normal culposcopies do you need to have before going back to annual pap smears?
three negative exams done at six months apart.
How do you prevent the flushing associated with niacin treatment?
take an aspirin 30 minutes before treatment
What test do you HAVE to do if you suspect primary syphilis?
dark field microscopy
most common cause of death after subarachnoid hemorrhage?
vasospasm and resultant infarction
hwo do you treat vasospasm in subarachnoid hemorrhage?
calcium channel blockers
what heart valve problem gives you malar flush
mitral stenosis
what's an "early thrid heart sound?
pericardial knock
what is Kussmaul's sign
increase in JVD with inspiration
findings with constrictive pericarditis
kussmaul's sign, pericardial knock,
what is pulsus paradoxus
fall in systolic blood pressure >10mmHg with inspiration
do you see pulsus paradoxus with constrictive pericarditis?
no, only if an effusion is present
what is piebaldism?
inherited lack of melanocytes, involves face and chest
where does vitiligo usually start?
around body orifices
What do you do if pt has HCV but normal LFTs?
check yearly LFTs
what is the most common acid-base disturbance in hospitalized pts?
metabolic alkalosis--think about diuretics, diarrhea, NG suction
describe post-operative endopthalmitis
occurs within 6 weeks of eye surgery, it's an infection--usually of the vitreous, pt has swollen eyelids and conjunctivae
management of endophthalmitis?
send vitreous for GS and culture, can do intravitreal abx injection
antidote for iron poisoning?
deferoxamine
antidote for lead poisoning?
EDTA
what is "soap bubble" appearance of distal femur?
giant cell tumor of bone
si/sx of giant cell tumor of bone?
knee pain, usually 20-40 year old female, some swelling
is giant cell tumor malignant or benign?
benign but locally aggressive, recurs frequently after curettage
four stages of labor
1: onset of labor until full cervical dilation (divided into latent phase--up to 2cm dilation, and active phase--2cm til 10cm)
2: full dilation and delivery of fetus
3: delivery of placenta
4: 6 hours after delivery
what's the most likely cause of syncope that occurs at rest?
arrhythmias
Define labor
progressive cervical effacement and dilation, or both resulting from uterine contractions which occur at least every 5 minutes and last at least 30-60 seconds
what are the contractions like during false labor?
painless, sporadic, not accompanied by cervical change (that's the biggie)
how do you know if a woman is having a hypotonic contraction?
the uterus is easily indentable
how do you treat hypertonic contractions
turn off pitocin, give morphine, rest
what phase of labor should epidurals NOT be given, and why?
during the latent phase, because they will cause a decrease in contractions
What does fetal sleep look like on the heart tone monitor?
a decrease in long-term variability
What causes early decels?
fetal head compression
what causes late decels?
uteroplacental insufficiency
what do you do with a positive ppd?
get a chest xray
what do you do if a pt has a positive PPD and a negative chest xray?
give isoniazid prophylaxis for nine months
what are the main side effects of isoniazid?
hepatotoxicity, peripheral neuropathy (secondary to B6 deficiency)
how do you treat a pregnant woman with TB?
rifampin, isoniazid, ethambutol for nine months
which TB drug do you NOT want to give to pregnant women?
streptomycin--it's ototoxic to the fetus
in what pts is an PPD positive with >5mm induration?
1. pts with close contact to someone with TB
2. pts with fibrotic TB-like changes on chest x-ray
3. HIV pts
4. organ transplant recipients
5. immunocompromised (chronic steroids, etc.)
how do you treat afib in unstable pts?
electrocardioversion
how do you treat chronic afib in stable pts?
rate control then anticoagulation
what drugs do you use for rate control in afib?
diltiazem, beta blockers, digozin if pt has CHF
what kind of arrhythmias do you use lidocaine for?
ventricular arrhythmias
how does allopurinol work?
it inhibits xanthine oxidase
in the glasgow coma scale--what are the three categories?
1. eye opening
2. verbal response
3. motor response
what is the scoring for eye movements in the glasgow coma scale?
1--no eye opening
2--opens eyes to pain
3--opens eyes to command
4--spontaneously opens eyes
what is the scoring for verbal response in the glasgow coma scale?
1--no response
2--incomprehensible sounds
3--inappropriate words
4--disoriented words
5--oriented
what is the scoring for motor response in the glasgow coma scale?
1--no motor response
2--decerebrate posturing
3--decorticate posturing
4--flexor withdrawal from pain
5--withdraws to pain
6--follows commands
what score of the glasgow coma scale does a minor head injury get?
>14
what score on the glasgow coma scale does a moderate head injury get?
<13, but >9
what score does a major head injury receive on the glasgow coma scale?
<8
what is a flank mass in a child less than 3 years old?
neuroblastoma
what is a flank mass in a child greater than 3 years old?
wilms tumor
what cells do neuroblastomas arise from?
neural crest
what cells do wilms tumors arise from
metanephros-->becomes renal parenchyma
how long does it take for kayexalate to work?
6-12 hours
what does acidosis do to K levels?
it increases K levels, because H+ ions go into cells, displacing K+ into the blood stream
risk factors for pancreatic carcinoma?
smoking, chronic pancreatitis, diabetes, obesity, high fat diet, family history
what is sick euthyroid syndrome?
abnormal thyroid tests in sick pts
what causes sick euthryoid syndrome?
caloric deprivation, cytokines,
What do the throid tests look like in sick euthyroid syndrome?
low T3, with normal T4 and TSH. This is because there is a decrease in peripheral conversion of T4 to T3
Which neuromuscular blocker is best for pts with renal and/or liver disease? Why?
atracurium, because it degrades spontaneously in the plasma
why does appendicitis cause peri-umbilical pain?
because visceral pain fibers from the appendix enter the spinal cord at the T10 level
why would a pt get respiratory distress after a large ventral hernia repair?
because the hernia contents are pushed into the peritoneum causing increased pressures and decreasing thoracic cavity volumes and hypoventilation. It can take a pt a week to adjust, and PT is a good idea for them
in a pt with tylenol poisoning, is alcohol use hepatoprotective or toxic?
It depends. Acute alcohol intake is hepatoprotective. Chronic alcohol ingestion is hepatotoxic.
name some drugs that are ototoxic
loop diuretics, aminoglycosides, vancomycin, quinine, chloroquinine, aspirin only in very high doses
What type of hyponatremia can NSAIDS cause?
euvolemic hyponatremia due to SIADH
what do you do if someone is exposed to HBV after they've been vaccinated with a documented titre?
nothing, they're okay
what do you do if someone is exposed to HBV after they've been vaccinated, but their titre is unknown?
do another course of vaccination, unless of course they already are infected, with anti-HBVAg
What do you do if someone is exposed to HBV after they've been vaccinated, but their titres are negative?
treat with HBIG and vaccination
what worm causes itchy butt in kids?
enterobius vermincularis (pinworm)
treatment for pinworm?
albendazole or mebendazole
what's the most common fracture in an MVA?
tibial fracture
what is Todd's paralysis
paralysis after a seizure
name some injectable depot antipsychotics
haldol, fluphenazine
How do NSAIDs cause nephropathy?
They cause papillary necrosis because of vasocontriction of the vasa recta
aspirin toxicity causes what metabolic derangement?
respiratory alkalosis and metabolic acidosis
which salivary glands most commonly form stones?
1st is submandibular, then sublingual, then parotid
how do you diagnose stones in salivary glands?
x-ray--the stones are opaque
si/sx of sialolithiasis
post-prandial swelling and pain
how does subarachnoid hemorrhage cause communicating hydrocephalus?
it destroys arachnoid villi and cisterns, so CSF can't be reabsorbed
what is the msot common cause of communicating hydrocephalus?
subarachnoid hemorrhage
si/sx of retinal detachment
photopsia (flashes of light), floaters, "a curtain coming down over my eyes," grey elevated retina on ophthalmoscopic exam