Em Killer Foils

Front 1

Ranson's Criteria

Back 1

Acute Pancreatitis
1. Age >55
2. WBC> 16,000 mg/dL
3. Glucose> 200
4. AST >250
5. LDH>350

Front 2

Jones Criteria

Back 2

Rheumatic Heart disease

Major: Carditis, arthritis,syndeham's chorea, erythema marginatum, subsutaneous nodules

Minor: Previous history of RF/ RHD, Arthralgias, Elevated ESR, Prolonged PR, and Fever

(2 Major or 1 Major/2 Minor)

Front 3

Phimosis

Back 3

Unable to retract foreskin (rarely emergent)

Front 4

Paraphimosis

Back 4

Retracted foreskin -necrosis of glans

Emergent

"Call the paramedics"

Front 5

Osler- Weber-Rendu Syndrome

Back 5

Hereditary hemorrhagic telangiectasia; Telangiectasias of the skin, mucous membranes, GI tract

recurrent GI episodes of bleeding

Front 6

Hepatitis Markers
1. HBsAg
2. HBsAb
3. HBeAg
4. HBcAb

Back 6

1. sAg: (+) early infections
2. sAb: (+) immunity after vaccine
3. eAg: (+) super infection
4. cAb: (+) immunity after previous infection

Front 7

Ulcerative Colitis

Back 7

1. Rectum and colon (small bowel not affected)
2. Blood diarrhea
3. Risk of cancer > 30x's

Front 8

Crohn's Disease

Back 8

1. Mouth to anus
2. Skip lesions: gross blood is uncomin
3. Increased oxalate absorption leads to calcium oxalate kidney stones

Front 9

Behcet's syndrome

Back 9

1. Painful oral/ genital ulcers
2. Arthritis, vasculitis, neurolgic, uveitis/ retinal vasculitis
3. Prednisone for flair ups

Front 10

Guillan Barre Syndrome

Back 10

Progressive ascending motor weakness with sensory component (loss of DTRs)
Causes: campylobacter/flu vaccine
Respiratory support, plasmapheresis/ immunoglobulin

Front 11

Multiple Sclerosis

Back 11

Demylenating in the central nervous system.
1. Optic neuritis (painful visual loss)
2. Bilateral internuclear opthalmoplegia (eyes can't look at nose)
3. Mutiple areas of sensory/ motor issues that make no sense

Front 12

Myasthenia Gravis

Back 12

Autoimmune AB's to AcH receptors- muscles weaken with repeative use

Limb weakness proximal> distal

Muscle weakness and fatiguability with diplopia and ptosis

Front 13

Dressler's Syndrome

Back 13

Pericarditis 2-8 weeks post-MI

Fever, leukocytosis, friction rub, pericardial and pleural effusions

Treat: NSAIDs adn steroids

Front 14

Kleihauer-Betke Test

Back 14

Test in pregnancy for women who sustained abdominal trauma to detect/quantify the amount of fetomaternal hemorrhage that has occured

Front 15

Transient global amnesia

Back 15

sudden, transient amnesia - where patient is unable to form new memories (short: hours - a day)

Front 16

leptomeningeal cyst

Back 16

(skull fx): 'growing fracture' in pediatrics that enlarges overtime aand associated tear of underlying dura - initially have >4mm fragment separation.
-re xray in 2 months for signs of growing fracture

Front 17

Hamman's crunch

Back 17

Mediastinal friction rub with heart beat (associated with tracheobronchial injury and diving injuries)

Front 18

Low Sodium (3) [Hyponatremia]

Back 18

1. Rocky mountain spotted fever
2. Necrotizing fasciitis
3. SIADH

Front 19

Ramsey Hunt Syndrome

Back 19

Herpes zoster oticus causes deafness, vertigo, facial palsy; grouped vesicles on an erythematous base inside the ear canal.

Front 20

Carbon Monoxide
a. measure it
b. symptoms
c. treatment

Back 20

a. Pulse OX ABG = normal; carboxyhemoglobin
b. family that presents with headache, nausea, confusion, coma, seizures, and not cyanotic - get a delayed neuropsychiatric syndrome
c. 100% oxygen and HBO

Front 21

Hydrogen sulfide

Back 21

rotten eggs - don't go in you will die

treat: cyanide antidote kit

Front 22

What two drugs are contraindicated in MAOI?

Back 22

Meperidine and dextromethorphan - can cause severe hypertermia

Front 23

Opisthotonus

Back 23

back muscle spasms, body arched (occurs in stychnine toxicity and NMS)

Front 24

Neuroleptic Malignant Syndrome

Back 24

AMS, severe hyperthermia (106F), rigidity, opisthotonos, hypertension, tachycardia

Treatment: fever control, dantrolene, paralysis, bromocriptine

Front 25

Serotonin Syndrome

Back 25

Lower extremity rigidity >> UE rigidity
Rapid onset, myoclonus/hyperkinesia, ⇑BP/TEMP/HR

Distinguished from NMS [slow in onset, associated with bradykinesia and lead pipe rigidity]

Treatment: cypoheptadine

Front 26

Strychnine Toxicity

Back 26

CNS hyperstimulation -muscle twitching, facial grimacing, extensor spasm, opisthtonos

rx: airway, benzodiazepines, may require paralytics

Front 27

Acute Periodic Paralysis

Back 27

Rapidly progressive extremity weakness in young males - after exercise

Associated with hypokalemia, thyrotoxicosis

Front 28

Tensilon test

Back 28

Increases ACH by blocking break down of AcH by cholinesterase = increases muscle strength (EMG= rapid fatigue)

can cause: AV block and cardiac arrest - atropin at bed side

Front 29

ALS

Back 29

degeneration of upper and lower motor neurons

NO SENSORY defects

UMN: spasticity, no sensory defects
LMN: atrophy and fasciculations

Front 30

Normal pressure hydrocephalus

Back 30

Wet Wild Wacky

dementia, ataxia, urinary incontinence

Treatment: shunt

Front 31

Jefferson Fracture

Back 31

Burst fracture of atlas (C1) Unstable fracture due to axial compression such as diving

Front 32

Brown-Sequard Syndrome

Back 32

Ipsilateral weakness, loss of position/vibration sense

Contralateral loss of pain and temperature sensation

Front 33

Diagnostic criteria for Kawasaki disease?

Back 33

Fever for last 5 days plus at least 4 of the following:
- Bilateral non-exudative conjunctivitis
- Changes of lips/oral mucosa (fissured lips; strawberry tongue)
- Changes in extremities (erythema of palms/soles, edema, periungal desquamation)
- Polymorphous rash
-Cervical lymphadenopathy (at least one node >1.5 cm)

Front 34

Treatment of Kawasaki's?

Back 34

ASA (80-100mg/kg/day)
Single infusion of IVIG (2g/kg)

DO NOT GIVE STEROIDS

Front 35

Henoch-Schonlein Purpura

Back 35

The most common acute vasculitis in children

ARENA
A= Abdominal pain (bloody stool/intussusception)
R= Rash, purpuric in dependant areas (legs and butt)
E= Edema
N= Nephritis (microscopic hematuria)
A= Arthralgias

Front 36

Severe's Disease

Back 36

Norweigian Scabeies that is seen in immunocompromised patients

Front 37

Rocky Mountain Spotted Fever

Back 37

Rickettsia rickettsii; Dermacentor tick

Rash starts on ankle/wrists/palms/soles and then moves centrally becomes palpable and non-blanching

Treatment: doxycycline

Front 38

Diptheria

Back 38

Cornybacterium diphtheria (Gram + bacillus)

Thick grayish membrane with sharply defined borders; sore throat, dysphagia; can cause myocarditis and airway obstruction

Treatment: Respiratory isolation and erythromycin for 14 days

Front 39

Pertussis

Back 39

Bordetalla pertussis (Gram neg coccobacilli)

Three phases with barking cough; whoop and post tussive emesis

Front 40

Babesiosis

Back 40

Tick (Ioxedis)

Hemolytic anemia (elevated bilirubin and LDH)

Front 41

Ehrlichiosis

Back 41

obligate intracellular rickettsia-like coccobacilli

Thrombocytopenis and leukopenia

Front 42

Dengue Fever

Back 42

Viral infection in the tropics and subtropics (Aedes mosquito)

Acute, self-limiting fever, myalgias, headaches, rash, lymphadenopathy, leukopenia

Front 43

Rabies

Back 43

Acquire from bats, raccoon, fox skunk

Post exposure: 5 doses of vaccination and HRIG 20 IU/kg

Front 44

Tichinosis

Back 44

Trichinella spiralis - ingestion of infected pork

Eosinophilia

Treatment: mebendazole

Front 45

Tetanus Prophylaxis

Back 45

1. Clean wounds
a. primary series completed w/ last booster >10 years ago: Td
b. Unknown status: Td

2. All other wounds
a. Primary series completed >5 yr: Td
b. Unknown: Td and TIG

Front 46

Rubella

Back 46

German Measles

Rash spreads from head to feet

Prominent lymphadnopathy: posterior auricular, cervical, and occipital

Front 47

Rubeola

Back 47

(Measles)
Fever, cough, conjuctivitis, coryza

Koplik spots

Maculopapular red-brown morbiliform rash spreads from head to feet

Front 48

Roseola Infantum

Back 48

HHV 6/7

High fever => rash with defervescence
Febrile seizures common
Pink macules on trunk that can spread to neck, face, extremities

Front 49

Erythema Nodosum

Back 49

Painful, non-ulcerative, violacesous nodules loncate on anterior tibia, arms, and trunk;

Often a marker for systemic disease (drug reaction, infection, sarcoid, IBD, Malignancy)

Front 50

Carcinoid tumor

Back 50

circumscribed tumors occuring in small intestines, appendix, stomach,, colon

secretes serotonin: skin flushing, watery stools, hypotension, vasodilation, edema, ascites, and bronchoconstricution

Front 51

Pheochromocytoma

Back 51

Tumor of adrenal medulla cells that secrete NE causing elevated HTN

Diagnosis w/ catecholamines and VMA in 24 hr urine

Front 52

Acoustic Neuroma

Back 52

Benign tumor of CN VIII

Atacia, deafness, and ipsilateral facial weakness

Front 53

TTP

Back 53

⇓⇓platelets, severe microangiopathic hemolytic anemia; transient neuro defects; renal failure; fever

release of vWF and consumption thrombocytopenia

Treatment: steroids, plasmapheresis, FFP

NO PLATELETS

Front 54

ITP

Back 54

Generally no other findings than thrombocytopenia (low platelets) and petechia/purpura

Treatmet: platelets; IVIG

Front 55

Tumor Lysis Syndrome

Back 55

Massive lysis of cancer cells from chemotherapy 12-72 hr post treatment

Treatment
a elevated PO4/K - hydration/forced diresis
b. Decrease uric acid build up by alkalinzation of urine
Calcium supplimentation if cv instability

Front 56

Central Retinal Artery Occlusion

Back 56

Sudden, painless visual loss (embolic) causing monocular blindness

Pale retina, fixed dilated pupil with cherry-red spot on macula and box-car look to retinal artery

Front 57

Temporal Arteritis

Back 57

3 of the 5 criteria
a. age >50
b. New onset headache or localized cephalgia
c. Temporal artery tenderness
d. Decreased pulsation not related to carotid disease
e. ESR>50 mm

Ischemic of muscles of mastication cause painful chewing

Front 58

Treatment for temporal arteritis

Back 58

Opthalmology consult, high-dose prednisone or IV prednisolone

Front 59

Treatment for acute angle glaucoma

Back 59

1. Decrease aqueous humor production (topical β-blocker, alpha agonist acetazolamide)
2. Mannitol
4. Topical miotic (pilocarpine) - facilitates aqueous humor drainage

Front 60

Horner's syndrome

Back 60

Loss of sympathetic chain

ptosis, miosis (constriction) and anhydrosis

Front 61

CREST syndrome

Back 61

Scleroderma
Calcinosis: subcuaneous calcifications (fingers)
Raynauds phenomenon
Esophagitis (due to LES sclerosis-> reflux)
Sclerodactyly (fibrosed skin causes immobile digits and rigid facies
Telangiectasis

Front 62

vWF deficiency

Back 62

Most common inherited bleeding dz

⇑ bleeding time and ecchymoses, normal PT/PT

Treatment DDAVP

Front 63

HELLP syndrome

Back 63

Hemolysis
Elevated LFTs
Low Platelets

Front 64

Sarcoidosis

Back 64

bilateral hilar adenopathy; uveitis (can be bilateral) noncaseating granulomas on biopsy of lungs

Rx: steroids

Front 65

Marfan's

Back 65

Genetic collegen defect

Increased risk for aortic dissection, MVP, joint laxity, optic lens dislocation and blue sclera

Front 66

Osteogenesis Imprefecta

Back 66

"brittle bone disease" and blue sclera

mutation in defective collegen synthesis

Front 67

Paget's disease

Back 67

Increased activity of both osteoblasts and osteoclasts - diffuse fractures and bone pain

HIGH OUTPUT CARDIAC failure (increased alkaline phosphatase)

Front 68

G6PD

Back 68

AR X-linked; causing hemolytic anemia with administration of certain drugs (antimalerias, sulfonamides, and nitrofuratoin)

RBCs are unable to produce gluthione that protects hemoglobin from oxidative denaturation

Front 69

Botulism

Back 69

Acute DESCENDING flaccid paralysis cause by Clostridium botulinum 0 ingestion of spores in honey

Front 70

Lambert Eaton Syndrome

Back 70

similar to MG + Cancer

Weakness and fatigue of proximal muscles especially thigh/hips but IMPROVES with use

Treatment: remove tumor and plasmaphoresis

Front 71

Subacute Cerebellar Degeneration

Back 71

deterioration of the area of the brain concerned with muscle coordination and balance

Front 72

Wernicke's encephalopathy

Back 72

occulomotor crisis, CN VI palsy (lateral rectus), nystagmus, ataxia, global confusion

Front 73

Korsakoff's syndrome

Back 73

retrograde amnesia and confabulation

Front 74

Trimetaphan

Back 74

drug that counteracts cholinergic tranmission bloking both SNS and PNS acting as a non-depolizing antagonis at the nicotinic receptor

use; hypertensive crises, dissecting aortic aneurysm, and treat pulmonary edema

Front 75

Phentolamine

Back 75

alpha adrenergic antagonis causes vasodilation

Used in cocaine induced hypertension; hypertensive emergencies and pheochromocytoma

Front 76

Pyridostigmine

Back 76

parasympathomimetic and a reversible cholinesterase inhibitor - used to treat MG