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15 Cards in this Set
- Front
- Back
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1. Which antihypertensive class is first-line in patients with the following problems? (FA2 p61, B&W p3)
• no comorbidities • diabetes • heart failure (multiple) • BPH • left ventricular hypertrophy • hyperthyroid |
• no comorbidities thiazides
• diabetes ACEI or ARB • heart failure (multiple) ACEI or ARB, beta-blocker, aldosterone antagonist • BPH alpha-blockers • left ventricular hypertrophy ACEI or ARB • hyperthyroid propranolol |
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2. What chelation agents are used in patients with lead poisoning? (FA2 p462, B&W p116)
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calcium EDTA, succimer, or dimercaprol (BAL)
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3. What is the cause of low back pain given the following hints at presentation? (FA2 p242, B&W p328)
• pain increases with passive straight leg raise • pain lessens with flexion at the hips (eg. bending over shopping cart) • elderly, weight loss, pain constant but worse when supine • acute urinary retention • pain made worse by walking and standing (AKA pseudoclaudication) • loss of foot dorsiflexion and pain on crossed straight leg raise |
• pain increases with passive straight leg raise disc herniation (radiculopathy)
• pain lessens with flexion at the hips (eg. bending over shopping cart) spinal stenosis • elderly, weight loss, pain constant but worse when supine spinal tumor • acute urinary retention cauda equina syndrome (late) • pain made worse by walking and standing (AKA pseudoclaudication) spinal stenosis • loss of foot dorsiflexion and pain on crossed straight leg raise disc herniation (radiculopathy) |
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4. What is the classic presentation and preferred treatment for scabies? (FA2 p91, B&W p401)
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• Sx: pruritic papules and burrows in intertriginous areas (e.g., webs of fingers and toes)
• Tx with Permethrin cream (Elimite) 5% apply from head to bottom of feet (avoid mouth, nose, eyes) and wash off after 8-10 hrs. May need to repeat in 7 days. Do not use in < 2 mo. 30 gm is typical adult dose. Be sure to tx the whole family • Do not use lindane because it can cause seizures in children. • Pt may get post-scabetic eczema that can be tx with hydrocortisone cream 1%. |
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5. What is the difference between a macule, papule, and patch? (FA2 p73, B&W p381)
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• macule flat discoloration, <1cm in diameter
• papule elevated discoloration, <1cm in diameter • patch elevated skin lesion, >1cm in diameter |
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6. What is the difference between an early deceleration, a late deceleration, and a variable deceleration? (FA2 p304, B&W p235)
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Type of Decel; Appearance; Etiology
Early; Begins with onset of contraction, mirrors contraction; Head compression (physiologic, normal) Variable; Shaped like a V, rapid dip in FHR and rapid return to baseline; Cord compression (often due oligohydramnios after membrane rupture) Late; Begins after the onset of contraction and usually returns to baseline after contraction end; Uteroplacental insufficiency and fetal hypoxemia! |
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7. What is the differential diagnosis for fetal tachycardia? (FA2 p304, B&W p235)
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- maternal fever, infection, or dehydration
- chorioamnionitis - fetal anemia - maternal thyrotoxicosis - fetal tachyarrhythmias (HR > 200) - drugs or medications (terbutaline, atropine) - fetal immaturity - fetal hypoxia |
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8. How is Kawasaki’s disease diagnosed? (FA2 p370, B&W p289)
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Fever (> 40C or 104F) lasting at least five days in addition to 4 of the following 5 symptoms (CRASH):
• Conjunctivitis (bilateral, nonexudative, painless) • Rash (truncal) • Adenopathy of the cervical lymph nodes • Strawberry tongue and diffuse mucus membrane erythema • Hands and feet have edema with induration, erythema, or desquamation Coronary artery aneurysms can occur within weeks of the illness onset, but are not included in the diagnostic criteria. |
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9. What is the hallmark physical finding of acute otitis media? (B&W p284)
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decreased mobility of the tympanic membrane
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10. What are the W’s of post-op fever? (FA2 p459, B&W p151)
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Wind (atelectasis)
Water (UTI) Walking (DVT) Wound (wound infection) Wonder drugs (drug reaction, often antibiotics) Wein (thrombophlebitis) (Sinusitis) |
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11. What is the Parkland burn formula? (FA2 p459, B&W p158)
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• LR at 4mL/kg/%burn area in first 24hrs AND maintenance IVF
• Dose half of this volume over first 8 hrs, then the other half over next 16hrs |
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12. What medications are most useful for generalized anxiety disorder? (FA2 p388, B&W p352)
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SSRIs, venlafaxine, buspirone, or beta-blockers (possibly limited use of benzos)
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13. What are the symptoms of major depressive disorder (FA2 p392, B&W p343)
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SIGECAPS
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14. What is the differential diagnosis for a patient presenting to the ER for loss of consciousness? (B&W p154)
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AEIOU TIPS: Alcohol, Epilepsy/Environment (temp), Insulin (+/-), Overdose, Uremia (electrolytes), Trauma, Infection, Psychogenic, Stroke
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15. Why is thiamine given in a glucose infusion to alcoholics with hypoglycemia? (FA2 p292, B&W p376)
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Glucose administration in the absence of thiamine can theoretically exacerbate damage to the mamillary bodies and worsen Wernicke’s encephalopathy.
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