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