Term
| What factors would determine air transport (HEMS) is necessary over ground transport for EMS? |
|
Definition
| Time and distance factors as well as traffic or weather delays that may affect the pt adversely |
|
|
Term
| What is your initial workup for DUB focused on? |
|
Definition
| pt's volume status and degree of anemia |
|
|
Term
| If pts have DUB but are hemodynamically stable, what exams should you perform? |
|
Definition
| bimanual, rectovaginal, pelvic speculum, abdominal, DRE (stool guiac), femoral and inguinal lymphs |
|
|
Term
| If pt presents with DUB as well as obesity, acne, and palpable enlarged ovaries and complains she has had to wax her face more often recently, what condition should you suspect? |
|
Definition
|
|
Term
| If pt presents with DUB, and also has visible petechiae and purpura and c/o bleeding with brushing her teeth, what underlying pathophysiology would you suspect? |
|
Definition
|
|
Term
| If pt presents with DUB and has multiple spider angiomas, palmar erythema, as well as ascites and scleral icterus, what underlying pathology might you suspect? |
|
Definition
|
|
Term
| If pt presents with DUB and has tremors, changes in skin texture, weight changes, what condition do you suspect? |
|
Definition
|
|
Term
| Which imaging study is used primarily for cancer staging if CA is the suspected cause of DUB? |
|
Definition
|
|
Term
| What imaging study is the best for acute abdominal or pelvic pain? |
|
Definition
|
|
Term
| If a pt presents with DUB, what would be indicative of an endometrial bx? |
|
Definition
Women > 35y/o
Obese Pts
Prolonged periods of unopposed Estrogen stimulation
Chronic Anovulation |
|
|
Term
| What is the initial treatment for pts with DUB who are hemodynamically unstable? |
|
Definition
| aggressive resuscitation with saline and blood |
|
|
Term
| If DUB is profuse and pt is unresponsive to initial fluid management what can be given IV to cause cessation of bleeding? |
|
Definition
| IV conjugated estrogen (Premarin) IV q 4 - 6 hrs until bleeding stops |
|
|
Term
| What is the tx for SEVERE, PERSISTENT uterine bleeding? |
|
Definition
|
|
Term
| What is a useful tx for women who have anovulatory DUB b/c they have unopposed estrogen stimulation? |
|
Definition
| Progesterone - stabilizes an immature endometrium |
|
|
Term
| If pt has DUB, is not pregnant and has no anatomic abnormalities, and the bleeding is no causing hemodynamic instability, what can you use to treat it? |
|
Definition
| Combo OCs (containing 35 mcg of ethinyl estradiol taken for 7 days) |
|
|
Term
| For pt with with DUB in whom medical therapy has failed and pts doesn't desire to have kids, what gyn procedure can be used to cease the bleeding? |
|
Definition
| endometrial ablation or hysterectomy |
|
|
Term
| Which type of Gestational Trophoblastic Disease is described as a deformed, partial fetus? |
|
Definition
|
|
Term
| Which type of Gestational Trophoblastic Disease is described as no actual fetus? |
|
Definition
|
|
Term
| Pt presents with vaginal bleeding, you have a +BhCG and levels are very high. Based on LMP pt is in their 11th gestational week. On U/S of uterus you see lucent areas interspersed with brighter areas appearing "grape-like". What is your diagnosis? |
|
Definition
| Hydatidiform Mole (Complete based on U/S results) |
|
|
Term
| Pt presents with vaginal bleeding, you have a +BhCG and levels are very high. Based on LMP pt is in their 18th gestational week. On U/S of uterus you see an enlarged uterus with no fetal parts. Also, on U/S the ovaries are enlarged bilaterally and contain multiple peripheral cysts. What is your diagnosis? |
|
Definition
| Hyadatidiform Mole; Partial (b/c of U/S findings) |
|
|
Term
| Pt is spontaneously opening their eyes, has inappropriate verbal responses, and localizes pain, what is their score on the Glasgow coma scale? |
|
Definition
Eye = 4
Verbal = 3
Motor = 5
Total = 12 |
|
|
Term
| On the glasgow coma scale, what are the levels of eye opening? |
|
Definition
Spontaneously - 4
(Response) To Speech - 3
(Response) To Pain - 2
None - 1 |
|
|
Term
| On the glasgow coma scale, what are the levels of Verbal Response? |
|
Definition
Orientated - 5
Confused - 4
Inappropriate - 3
Incomprehensible - 2
None - 1 |
|
|
Term
| On the glasgow coma scale, what are the levels of Motor Response? |
|
Definition
Obeys Commands - 6
Localizes to Pain - 5
Withdrawals from Pain - 4
Flexion to Pain - 3
Extension to Pain - 2
None - 1 |
|
|
Term
| Pt is incomprehensible on presentation, withdraws from pain and opens eyes with pain. On the glasgow coma scale, what is their score? |
|
Definition
Eye open to pain - 2
Incomprehensible - 2
Withdraws from pain - 4
Total - 8 |
|
|
Term
| Pt opens eyes in response to speech, has no verbal response and has flexion to pain. On glasgow coma scale, what is their score? |
|
Definition
Eye to speech - 3
No Verbal Response - 1
Flexion to pain - 3
Total - 7 |
|
|
Term
| Pt opens eyes spontaneously, appears oriented and obeys commands. What is their glasgow coma scale score? |
|
Definition
Spontaneous eye opening - 4
Oriented to Verbal response - 5
Obeys commands - 6
Total = 15 |
|
|
Term
| Pt does not open their eyes, has a confused verbal response, and extension to pain.(if this is possible...) what is their Glasgow coma scale score? |
|
Definition
No eye opening - 1
Confused verbal response - 4
Extension to pain - 2
Total = 7 |
|
|
Term
| When should APGAR scores be taken? What are the expected scores at those times? |
|
Definition
Taken at 1 min - score > 5
Taken at 5 mins - score > 7 (if score is below 7 take scores every 5 min for the next 20 min) |
|
|
Term
| What are the levels of the Appearance category for APGAR scores? |
|
Definition
Appearance =
Blue/Pale - 0
body pink, hands/feet blue - 1
pink - 2 |
|
|
Term
| What are the levels of the Pulse category for APGAR scores? |
|
Definition
Pulse =
Absent - 0
< 100 bpm - 1
> 100bpm - 2 |
|
|
Term
| What are the levels of the Grimace category for APGAR scores? |
|
Definition
Grimace =
No Response - 0
Some Motion - 1
Cry - 2 |
|
|
Term
| What are the levels of the Activity category for APGAR scores? |
|
Definition
Activity =
Limp - 0
Some Flexion - 1
Good Flexion - 2 |
|
|
Term
| What are the levels of the Respiration category for APGAR scores? |
|
Definition
Respiration =
None - 0
Weak Cry - 1
Strong Cry - 2 |
|
|
Term
| Baby is blue at hands and feet and pink on body, is flexing at the wrists, has a weak cry, grimace with suction, pulse > 100bpm. What is this newborn's APGAR score? |
|
Definition
|
|
Term
| Newborn is crying loudly and is bringing arms into his chest, pulse is 94bpm, hands and feet are blue, body is pink, and he pulls away from the suction. What is the APGAR score for this newborn? |
|
Definition
|
|
Term
| Newborn is limp, pulse is 67bpm, cry is weak, grimace with suction, blue appearance to lips and paleness throughout. What is this newborn's APGAR score? |
|
Definition
|
|
Term
| What is the MC location for an ectopic pregnancy? |
|
Definition
| The ampulla of the fallopian tube |
|
|
Term
| What are the major risk factors for the development of an ectopic pregnancy? |
|
Definition
Previous ectopic pregnancy
Previous tubal surgery
Documented tubal pathology
Maternal exposure to DES in utero |
|
|
Term
| What is the classic triad of symptoms for an ectopic pregnancy? |
|
Definition
abdominal pain
amenorrhea
(abnormal) vaginal bleeding |
|
|
Term
| 38 y/o female with a hx of a tubal ligation at age 36, G3P3033 presents with abdominal pain and abnormal vaginal bleeding. She has been having dizzy spells and feels very weak. She has felt like she is coming down with the flu and has passed out once yesterday, which is why she is here today. On work-up her BhCG levels indicate she is pregnant. What condition are you suspecting? What is the best imaging study to use to confirm your diagnosis? What is the treatment? |
|
Definition
Suspect - Ectopic Pregnancy
Transvaginal U/S (detects fetus at lower levels of BhCG)
Current standard of tx = MTX |
|
|
Term
| What is the preferred surgical approach for an ectopic pregnancy? |
|
Definition
|
|
Term
| What is the treatment for a pt with hyperemesis gravidum? |
|
Definition
First line tx = rest and avoidance of sensory stimuli that may act as a trigger
Frequent small meals (avoid spicy or fatty foods, increase high-protein snacks)
IV (LR or NS)
Antiemetic Drugs (phenergan, zofran) |
|
|
Term
| 23 y/o postpartum female Pt presents with a persistent fever of 39C (102.2F), and foul-smelling, profuse vaginal discharge and abdominal pain. What condition do you suspect? |
|
Definition
|
|
Term
| If a pt presents with symptoms that lead you to suspect a postpartum infection and they also have shaking chills, what does this suggest? |
|
Definition
|
|
Term
| If a non-pregnant pt presents with abdominal pain and you believe it is PID, what is the Gold Standard Imaging test to dx this disease? |
|
Definition
|
|
Term
| What can a pelvic/transvaginal U/S be useful in diagnosing in a non-pregnant female? |
|
Definition
PID
Torsion
Tuboovarian abcess
Leiomyoma
Ovarian Cysts |
|
|
Term
| What imaging study is best when appendicitis is suspected in a non-pregnant female? |
|
Definition
|
|
Term
| What does complete cervical effacement and fetal presentation at the introitus tell you? |
|
Definition
|
|
Term
| Which specific population of pregnant females can progress very rapidly through delivery? |
|
Definition
|
|
Term
| What is the typical delivery position? |
|
Definition
|
|
Term
| What are the stages of fetal descent during labor and delivery? |
|
Definition
| Engagement - Flexion - Descent - Internal Rotation - Extension - External |
|
|
Term
| What should be done after the delivery of the fetus's head? |
|
Definition
|
|
Term
| What should be done in a newly delivered baby if meconium aspiration is suspected? |
|
Definition
| airway assessment and possible intubation BEFORE stimulating the child to breathe spontaneously |
|
|
Term
| When is the placenta delivered? |
|
Definition
|
|
Term
| What maneuver can reduce the risk of uterine inversion, tearing of the cord or disruption of the placenta? |
|
Definition
| Aggressive traction on the cord |
|
|
Term
| What can be administered to maintain uterine contraction to aid in the pt passing the placenta? |
|
Definition
| Oxytocin (also uterine massage can help pt pass the placenta) |
|
|
Term
| A 26 y/o pregnant (in her 22 week) pt presents with complaints of HA, abdominal pain, visual disturbances and edema. Her BP is 146/94. On U/A there is proteinuria. What condition does this pt have? |
|
Definition
|
|
Term
| What is the BP requirement for a dx of pre-eclampsia? |
|
Definition
| BP 140/90 or higher after 20 weeks of gestation |
|
|
Term
| If pt is pregnant (in 28th week) and has a BP of 160 / 94, what would confirm a dx of preeclampsia? |
|
Definition
|
|
Term
| What are the symptoms of pre-eclampsia? |
|
Definition
| HA, visual disturbances, edema and abdominal pain |
|
|
Term
|
Definition
| Superimposition of seizures on pre-eclampsia or aggravated HTN |
|
|
Term
| What is the tx for eclampsia? |
|
Definition
| Methyldopa (250mg q 6 hr and titrated) for chronic HTN |
|
|
Term
| Which type of abortion is described as loss of pregnancy, <20 wks or fetus weighing <500g? |
|
Definition
|
|
Term
| Which type of abortion is pregnancy-related bloody d/c or frank bleeding (first half of pregnancy) without cervical dilation? |
|
Definition
|
|
Term
| Which type of abortion is described as vaginal bleeding and cervical dilation? |
|
Definition
|
|
Term
| Which type of abortion is described as passage of only parts of the POC? |
|
Definition
|
|
Term
| Which type of abortion is described as passage of all fetal tissue, including trophoblast and all POC before 20 weeks of gestation? |
|
Definition
|
|
Term
| Which type of abortion is described as fetal death at <20 weeks gestation, without passage of any fetal tissue for 4 weeks after? |
|
Definition
|
|
Term
| What complication of an abortion is described as infection at any stage of abortion? |
|
Definition
|
|
Term
| A pt presents with acute onset pruritis, you notice the pt is flushed and an urticaria is present on their chest and back. The pt c/o of a sense of fullness in their throat, lightheadedness and chest tightness, and the pt appears anxious. What condition do you suspect? |
|
Definition
|
|
Term
| What med may cause a pt in anaphylaxis to be resistant to epinephrine? |
|
Definition
| Pt on beta-blockers (larger doses must then be used, also glucagon may be useful in this circumstance) |
|
|
Term
| What med can rapidly reverse airway obstruction in anaphylaxis? |
|
Definition
|
|
Term
| How are GI symptoms caused by anaphylaxis treated? |
|
Definition
| H1 antihistamines and Epi |
|
|
Term
| What are the initial steps in treating a pt with anaphylaxis? |
|
Definition
Cardiac/Respiratory Monitoring
Large-bore IV with isotonic crystalloid solution
Epi if Airway compromise is present |
|
|
Term
| In which pts are cutaneous findings of anaphylaxis less prevalent? |
|
Definition
|
|
Term
| What are the MC body systems that are the origin of infection in sepsis? |
|
Definition
| Respiratory Tract Infections and Urinary Tract Infections |
|
|
Term
| What organism from the Respiratory Tract are the MC cause of sepsis? |
|
Definition
Strep Pneumo
Klebsiella
Staph Aureus |
|
|
Term
| What organism from the Urinary Tract are the MC cause of sepsis? |
|
Definition
|
|
Term
| A pt presents s/p GW to the abdomen and has the following signs, has a HR of 130bpm, BP 80/60, is cool, pale and pulses in extremities are weak, capillary refill in the feet > 6 secs. Pt is very confused. What serious condition do you suspect? |
|
Definition
|
|
Term
| What are signs of cerebral hypoperfusion in pts in hypovolemic shock? |
|
Definition
| hypo-alertness, confusion and ultimately lethargy |
|
|
Term
| What is COPD MC secondary to? |
|
Definition
|
|
Term
| What is the classic triad of COPD? |
|
Definition
| chronic bronchitis, emphysema and asthma |
|
|
Term
| Which type of condition is described as excessive mucous production with airway obstruction and notable hyperplasia of mucous producing glands? |
|
Definition
|
|
Term
| 76 y/o female Pt presents with productive cough that has progressively worsened over the past 6 mo. They have intermittent dyspnea and have been seen and treated over the past yr 5 times for URIs. What condition might you suspect? |
|
Definition
| COPD - Chronic Bronchitis |
|
|
Term
| A 64 y/o male presents with c/o frequent expectorant cough. You note the pt is obese, has accessory muscle use, has course rhonci and wheezing, no elevated JVD, no ascites, no peripheral edema. What condition do you suspect? |
|
Definition
| COPD - Chronic Bronchitis |
|
|
Term
| How can a pt with Chronic Bronchitis be distinguished (at bedside) from a pt with CHF? |
|
Definition
|
|
Term
| Which type of condition is described as destruction of airways distal to the terminal bronchiole? |
|
Definition
|
|
Term
| 56 y/o Pt presents with a 3 yr history of progressive dyspnea and began to have a non-productive cough 1 month ago. They also c/o occasional excessive mucous production for short periods of time. What condition do you suspect? |
|
Definition
|
|
Term
| A 60 y/o male with a PMH of smoking (25 pack/yr hx), quit when he married his 2nd wife at a 45 y/o. He appears very thin and has a large chest. His lips are pursed with inhalation and wheezing is heard. Heart sounds are distant and chest is hyper-resonant. What condition do you suspect? |
|
Definition
|
|
Term
| In COPD, what lab will provide the best clues as to acuteness or severity of the disease? |
|
Definition
|
|
Term
| What lab can help distinguish COPD from CHF? |
|
Definition
|
|
Term
| On CXR a patient with COPD shows increased bronchovascular markings and cardiomegaly, which type of COPD is this indicative of? |
|
Definition
|
|
Term
| On CXR a patient with COPD shows a small heart, hyperinflation of lungs, flat diaphragm, which type of COPD is this indicative of? |
|
Definition
|
|
Term
| Which type of bacteria causing pneumonia can cause rust-colored sputum? |
|
Definition
|
|
Term
| Which type of bacteria causing pneumonia can cause green-colored sputum? |
|
Definition
Pseudomonas
Haemophilus
Pnuemococcal |
|
|
Term
| Which type of bacteria causing pneumonia can cause foul-smelling sputum? |
|
Definition
|
|
Term
| Which type of bacteria causing pneumonia can cause currant jelly sputum? |
|
Definition
| Klebsiella and Type 3 pneumococci |
|
|
Term
| If pt has upper respiratory sx including green expectorant, and has rigors or severe shaking chills, what type of pneumonia do you suspect? |
|
Definition
|
|
Term
| If pt presents with upper respiratory symptoms, as well as HA, N/V/D, what type of pneumonia do you suspect? |
|
Definition
|
|
Term
| Pt presents with coryza ("head-cold"), fever of 99.8F, rhinorrhea, and a non-productive cough. What condition do you suspect? |
|
Definition
|
|
Term
| Which type of pneumonia, bacterial or viral, is characterized by sudden onset of symptoms, and rapid illness progression? |
|
Definition
|
|
Term
| On PE, what lung findings are characteristic of pneumonia? |
|
Definition
| Cyanosis, decreased breath sounds, wheeze, rhonchi, rales, egophony, pleural friction rub, and dullness to percussion |
|
|
Term
| What lab evals can be helpful in diagnosing pneumonia? |
|
Definition
|
|
Term
| What lab finding can be characteristic of impending sepsis following pneumonia? |
|
Definition
|
|
Term
| Why are ABGs used in pneumonia w/u? |
|
Definition
| used to assess for hypoxia and respiratory acidosis |
|
|
Term
| What pulse-ox finding indicates hypoxia in a pt with pneumonia? |
|
Definition
|
|
Term
| What lab abnormals may be indicative of Legionella pneumonia? |
|
Definition
| hyponatremia and microhematuria |
|
|
Term
| On CXR you see air bronchograms, what type of pneumonia is this consistent with? |
|
Definition
|
|
Term
| On CXR, cavitary lesions and bulging lung fissures are seen. What pathogenic cause of pneumonia is this characteristic of? |
|
Definition
|
|
Term
| On CXR, cavitation and associated pleural effusions are seen. What pathogenic cause of pneumonia is this characteristic of? |
|
Definition
S aureus
Anaerobic
Gram-neg
TB |
|
|
Term
| Which lobes of the lung does Legionella prefer? |
|
Definition
|
|
Term
| Which lobes of the lung does Klebsiella prefer? |
|
Definition
|
|
Term
| What CXR findings in pneumonia have been associated with higher incidence of bacteremia? |
|
Definition
| Frank Consolidation and Air Bronchiogram signs |
|
|
Term
| Pt presents with new onset of wheezing, CP, SOB, and upper abdominal pain. On PE the pt has chest wall tenderness, and a new onset cardiac arrhythmia, O2 Sat of 90%, pulse of 105bpm. What condition are you suspecting? |
|
Definition
|
|
Term
| What is the MC study used for the detection of a PE? |
|
Definition
| MDCTA - Multidetector Computed Tomographic Angiography |
|
|
Term
| Which test can evaluate for a DVT in the legs? |
|
Definition
|
|
Term
| What is the expected result of CXR in a pt with a PE? |
|
Definition
|
|
Term
| What sign might be seen on a CXR with a PE? |
|
Definition
| Watermark Sign (rarely seen) |
|
|
Term
| If CXR shows a dilation of the pulmonary vessels proximal to an embolism along with a collapse of distal vessels, sometimes with a sharp cut-off, what sign is this? What does it indicate? |
|
Definition
| Watermark Sign; Indicates a PE |
|
|
Term
| When is V/Q scanning indicate for a PE? |
|
Definition
| Indicated when CTA is unavailable or contraindicated |
|
|
Term
| What is historically the GOLD STANDARD for diagnosis of a PE? |
|
Definition
|
|
Term
| What test may be abnormal with a PE, but is not specific to a PE? |
|
Definition
|
|
Term
| A cough with rhinorrhea, sinusitis, pharyngitis and/or laryngitis is indicative of what? |
|
Definition
|
|
Term
| What does a productive cough (of short duration) usually indicative of? |
|
Definition
|
|
Term
| Is pneumonia usually productive or non-productive? |
|
Definition
|
|
Term
| If pt has cough with wheezing and dyspnea, what condition might you suspect? |
|
Definition
|
|
Term
| What is the treatment for a pt with a small, primary spontaneous pneumothorax who is stable? |
|
Definition
| O2, Observed for 3 - 6 hrs, CXR in 12 - 48hr |
|
|
Term
| What is the treatment for a pt with larger, unresolving pneumothorax? |
|
Definition
Catheter Aspiration
Standard Chest tube thoracostomy with underwater seal drainage |
|
|
Term
| What is the treatment for most pts with pneumomediastinum? |
|
Definition
| admitted and observed for signs of severe complications (pneumothorax, tension pneumo, mediastinitis) |
|
|
Term
| What is the MC cause of an UGIB? |
|
Definition
|
|
Term
| Pt presents with fever, RLQ pain and anorexia. On PE there is guarding and tenderness on palpation and on DRE. as well as a + Rovsings sign. What condition do you suspect? |
|
Definition
|
|
Term
| Pt presents with crampy and intermittent abdominal pain with bilious vomiting, and admits to 5 days since last bowel movement. On PE there is diminished bowel sounds. What condition do you suspect? |
|
Definition
|
|
Term
| Pt presents with crampy and intermittent abdominal pain with feculant vomiting, and admits to 4 days since last bowel movement. On PE there is diminished bowel sounds and abdominal distension. What condition do you suspect? |
|
Definition
|
|
Term
| What is the imaging study used to diagnose a bowel obstruction? |
|
Definition
| Flat/Upright Abdominal x-ray - identifies free air or masses |
|
|
Term
| What imaging study can distinguish a partial obstruction from a complete obstruction? |
|
Definition
|
|
Term
| What is the tx for true mechanical obstruction of the intestine? |
|
Definition
|
|
Term
| What is the treatment for a volvulus? |
|
Definition
| decompress via sigmoidoscopy and insertion of rectal tube |
|
|
Term
| What is the treatment for closed-loop obstruction? |
|
Definition
| Immediate surgical intervention (d/c meds that inhibit bowel activity) |
|
|
Term
| What is the treatment for bowel necrosis? |
|
Definition
| Immediate surgical intervention, broad-spectrum antibiotics if septicemia is suspected |
|
|
Term
| What is the treatment for cecal volvulus? |
|
Definition
| Immediate surgical intervention |
|
|
Term
| Pt presents with constipation, mucoid stools and rectal bleeding that comes and goes for the last 6 months. With this current 'attack' he has complained of painful red nodules on his shins. Stool O&P is neg. What condition do you suspect? |
|
Definition
|
|
Term
| 45 y/o female comes into your clinic with c/o constipation, mucoid stools, and rectal bleeding for the past three years in occasional bouts of approximately 1 week in length 1-2 times per month. Currently she has a fever, has noticed weight loss over the past month, pain in her eyes and photophobia, and her knees are aching. On physical exam the patients HR is 95bpm and she has a temp of 99F. Her eyes are red and inflamed and pupil has an irregular shape (uveitis). What condition are you suspecting? |
|
Definition
|
|
Term
| What are the complications of UC? What are the risks of UC? |
|
Definition
Toxic Megacolon is the complication
UC places pt at a high risk of Carcinoma |
|
|
Term
| How is a diagnosis of UC made? |
|
Definition
| Colonoscopy (most sensitive method for making the diagnosis) with Biopsy |
|
|
Term
| Which chronic inflammatory GI condition is found mostly in the rectum? |
|
Definition
|
|
Term
| Which chronic inflammatory GI condition is found anywhere from mouth to anus? |
|
Definition
|
|
Term
| Pt presents with long-standing diarrhea, anorexia, abdominal pain and unintended weight loss. What do you suspect? |
|
Definition
|
|
Term
| On Colonoscopy of a pt complaining of chronic diarrhea, you find segmental narrowing of the large colon, but the rectum appears normal. What GI condition do you suspect? |
|
Definition
|
|
Term
| What is the most sensitive diagnostic test for dx Crohns? |
|
Definition
|
|
Term
| What are some complications of crohns? |
|
Definition
| perianal fissures, fistulas, abscesses, rectal prolapse and intestinal obstruction |
|
|
Term
| Pt presents c/o diarrhea, tenesmus (feeling of needing to constantly pass stools) and LLQ pain, as well as an increase in urinary frequency, and dysuria. On PE there is tenderness on the L side with DRE, pt's temp is 100.7F. What condition do you suspect? |
|
Definition
|
|
Term
| What is the procedure of choice for diagnosing diverticulitis? |
|
Definition
|
|
Term
| On abdominal CT, pericolic fat, thickening of the bowel wall or peridiverticular disease. What is this a confirmation of? |
|
Definition
|
|
Term
| Can barium contrast studies diagnose diverticulitis? |
|
Definition
| NO, it can however demonstrate diverticula |
|
|
Term
| What are the MC causes of pancreatitis? |
|
Definition
|
|
Term
| A 32y/o pt with a hx of RUQ pain after eating heavy meals presents with boring, constant RUQ pain radiating to her back for the last 2 hours. She says she left work and came straight to the ER because the pain became so severe it was unbearable! She feels very nauseas and didn't want to eat this morning. On PE she has a fever of 101F. Based on the symptoms, what condition are you suspecting? What labs will be essential in the diagnosis? |
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Definition
| Pancreatitis; Serum Amylase and Lipase Elevation and Glucose Elevation |
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Term
| What is the mainstay of Pancreatitis treatment? |
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Definition
| Fluid resuscitation, NPO, also tx with narcotics and antiemetics |
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Term
| There is a laceration from the base of the thumb across the palm to the 2nd finger. Because you are awesome at wound laceration closing, you are going to use sutures and close the wound. What nerve block would you use? |
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Definition
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Term
| There is a laceration on the dorsal side of the hand that almost spans the entire width of the hand and wraps around the pinky side onto the palmar surface. Your attending has observed for deep injuries and has found none, and wants you to close the final dermis and epidermal layers. What nerve block would you use? |
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Definition
| Ulnar N Block and Radial N Block |
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Term
| Which wrist block causes anesthesia to the nailbeds of the thumb, 1st and second finger? |
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Definition
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Term
| Which wrist block causes numbing of the pinky finger? |
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Definition
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Term
| Which wrist block will anesthetize the dorsum of the hand and the first 3 fingers proximal to the DIP joints? |
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Definition
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Term
| Which nerve block is EXCELLENT for fingers including laceration repair, I&D of paronychia and finger/toenail removal or repair? |
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Definition
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Term
| Which n. blocks are used for laceration repair or minor surgical procedures on the toes? |
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Definition
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Term
| Which n block is useful for surgical procedures of the foot? |
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Definition
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Term
| What are most renal stones comprised of? |
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Definition
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Term
| Pt presents with flank pain that radiates around the abdomen from the front to the back, and also radiates to his testicles. He awoke in the middle of the night with the pain and was nauseated and vomited 2 times. He appears to be in intense pain, is diaphoretic and is pacing around his ER bed. What condition do you suspect? |
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Definition
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Term
| What will be significant findings on PE with renal or ureteral stones? |
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Definition
| CVA tenderness, elevated BP and tachycardia (from pain), fever |
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Term
| What is the preferred modality for diagnosing renal stones? |
|
Definition
|
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Term
| 20 y/o female present with painful urination, a sense of urgency and frequency of urination, hesitancy to urinate, and a fullness/discomfort in her pelvis. What condition do you suspect? |
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Definition
|
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Term
| What is the tx for Renal stones? |
|
Definition
IV opiates with NSAIDS
Antiemetic |
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Term
| What is considered a complicated UTI? |
|
Definition
Recurrent or Obstructive UTI
UTI in pregnant pts
UTIs in children, elderly or in pts with comorbidities (DM, HIV) |
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Term
| What is the MC pathogen causing UTIs? |
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Definition
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Term
| A 23 y/o male presents with c/o pain when urinating. On PE you note d/c from the urethra of the penis. What is the most likely pathogens causing this pts condition? What is his dx? |
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Definition
gonococcal, chlamydia, STD related
Urethritis is dx |
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Term
| 30 y/o Female Pt presents with dysuria, frequency and CVA tenderness. She is experiencing chills and has a fever of 102F. What condition do you suspect? |
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Definition
| Acute Pylonephrtitis with UTI |
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Term
| What is the diagnostic test for a UTI? What findings are positive? |
|
Definition
U/A - clean catch
Positive urinary dipstick nitrite or leukocyte esterase (support dx of UTI, but neg finding does not exclude it) |
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Term
| If pt has suspected acute pyelonephritis, what diagnostic lab should be done? |
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Definition
|
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Term
| What is the usual 1st line therapy for a UTI? In which pt population should it be absolutely avoided? |
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Definition
| Flouroquinolones (Ciprofloxin); MUST be avoided in pregnant women |
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Term
| What is the treatment for pregnant women with UTI? |
|
Definition
| Nitrofurantoin or a cephalosporin |
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Term
| What med effectively covers all common UTI pathogens plus chlamydia and gonorrhea? |
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Definition
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Term
| If a pt with a UTI has intense dysuria, what can you give them to ease the pain? In which pts shouldn't you use it in? |
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Definition
| phenazopyridine (pyridium); Pts with a sulfa allergy |
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Term
| What condition is described as an ascending infection from the cervix and the vagina? |
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Definition
|
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Term
| What are the long-term sequelae of PID? |
|
Definition
| Tubal factor infertility, ectopic pregnancy, chronic pain |
|
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Term
| What are the MC pathogens leading to PID? |
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Definition
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Term
| 26y/o pt presents with abdominal pain. She is sexually active and in a monogamous relationship with her boyfriend of 4 years. On PE she has adnexal tenderness, and Chandelier's sign, what condition do you suspect? |
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Definition
| PID (Chandelier's sign is Cervical Motion Tenderness) |
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Term
| What is the treatment for PID? |
|
Definition
| eradicate underlying infectious cause, laparoscopy for drainage of tubo-ovarian abscess |
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Term
| Which classification of ARF is described as GFR is depressed by compromised renal perfusion? |
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Definition
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Term
| In which type of ARF is there normal tubular and glomerular function? |
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Definition
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Term
| Which type of ARF is described as disease condition primarily affecting the glomerulus or tubule which are associated with release of renal afferent vasoconstrictors? |
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Definition
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Term
| What is the MC cause of intrinsic renal failure? |
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Definition
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Term
| Which type of ARF is described as being caused by an initial increase in tubular pressure, decreasing the filtration driving force which is followed by an equalization of the pressure gradients and maintenance of a depressed GFR which is dependent on renal efferent vasoconstriction? |
|
Definition
| Post-obstructive Renal Failure |
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Term
| Which condition is described as a persistent, painful, pathologic erection? |
|
Definition
|
|
Term
| What is a common cause of priapism in children? |
|
Definition
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Term
| What meds can lead to priapism? |
|
Definition
ED Meds - papaverine, prostaglandin EI, Sildenafil
HTN Meds - hydralazine, pazosin, Ca channel blockers, )
Psychotherapeutic Agents |
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Term
| What is the treatment for priapism? |
|
Definition
| Initial tx with terbutaline (B2 adrenergic receptor agonist) is most effective AND adequate analgesia |
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Term
| What is the treatment for PERSISTENT priapism? |
|
Definition
| Corporal aspiration followed by irrigation with normal saline or alpha-adrenergic receptor agonists |
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Term
| What condition is described as inflammation of the glans and foreskin? |
|
Definition
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Term
| A male pt presents with a c/o "tender and discolored" penis. On examination you note that the glans and foreskin is malodorous, purulent, excoriated and tender. What does this pt have? What is the treatment? |
|
Definition
Balanoposthitis;
Tx = Cleansing with mild soap and water, antifungal creams, recommend circumcision |
|
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Term
| If pt has recurrent balanoposthitis, what underlying condition should you be concerned about that may be predisposing this pt to these infections? |
|
Definition
| Diabetes (balanoposthitis can be sole presenting sign of diabetes) |
|
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Term
| What is the MC specimen that causes balanoposthitis? |
|
Definition
#1 - Candida
#2 - Gardnerella |
|
|
Term
| What condition is described as the inability to retract the foreskin proximally and and posterior to the glans penis? |
|
Definition
|
|
Term
| What are the causes of phimosis? |
|
Definition
| infection, poor hygiene, previous preputial injury with scarring |
|
|
Term
| What is the definitive treatment for phimosis? What is a 2nd option for treatment? |
|
Definition
| Circumcision; Topical Steroids (for 4 - 6 weeks) |
|
|
Term
| What condition is described as progressive penile deformity with a typical c/o curvature with erections that may of may not be painful during intercourse? |
|
Definition
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|
Term
| A 38 y/o male pt presents with dysparaunia and new onset ED. On physical exam you note a thickened plaque on the dorsum of the penile shaft. What condition do you suspect? What is the treatment? |
|
Definition
| Peyronie's disease; Referral to urology (reassurance) |
|
|
Term
| Where are the plaques in peyronie's dz typically located? |
|
Definition
| On the dorsum of the penile shaft |
|
|
Term
| What are disease condition is peyronie's dz associated with? |
|
Definition
| Associated with Dupuytren's contractures of the hand |
|
|
Term
| What is the preferred lab for diagnosing an MI? When is it detectable? |
|
Definition
| Troponin; Detectable 3 - 6 hours after acute MI (necrosis) and lasts for 14 days |
|
|
Term
| What is the GOLD STANDARD for diagnosing CHF? |
|
Definition
|
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Term
| A 68 y/o pt presents with c/o palpitations and worsening edema in their legs for one week. On PE they have an elevated JVD and are tachycardic. Additionally, you hear rales on lung auscultation. What condition do you suspect? |
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Definition
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|
Term
| On CXR you note prominent superior vena cava, pleural effusion, cardiomegaly, interstitial edema and kerley B lines. What condition do you suggest? |
|
Definition
|
|
Term
| What are the preferred meds for aortic dissection? |
|
Definition
| Labetalol, nicardipine, nitroprusside (w/beta-blocker) |
|
|
Term
| In which group of pts do you RAPIDLY lower high BP? |
|
Definition
| In pts with EOD (End Organ Damage) |
|
|
Term
| What is the general rule when lowering BP? |
|
Definition
| Lower MAP by no more than 20% in the first hour of treatment - if pt remains stable, then lower BP to 160/100-110 in the next 2 - 6 hrs |
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|
Term
Preferred meds for HTN ENCEPHALOPATHY?
Meds to AVOID in this condition? |
|
Definition
Preferred - labetalol, nicardipine, esmolol
AVOID - Nitroprusside, Hydralazine |
|
|
Term
| Preferred meds for Acute Ischemic Stroke? |
|
Definition
|
|
Term
Preferred meds for Acute Intracerebral hemorrhage?
Meds to AVOID in this condition? |
|
Definition
Preferred = labetalol, nicardipine, esmolol
AVOID = Nitroprusside, hydralazine |
|
|
Term
| Which type of infection develops faster, infection from CAT bite OR infection from DOG bite? |
|
Definition
|
|
Term
| What is the current recommended med for use with a cat bite, as a prophylaxis for infection? |
|
Definition
| Amoxicillin with Cavulanate (Augmentin) |
|
|
Term
| What type of pathogen is usually found in cat bites? |
|
Definition
|
|
Term
| What is the 1st line oral therapy for dog bites? |
|
Definition
|
|
Term
| When is restrictive pericarditis MC? |
|
Definition
| After trauma, open heart surgery (pericardiotomy), with fungal or TB pericarditis and CRF |
|
|
Term
| 34 y/o female pt who has been in the hospital recovery from a MVA for the last 3 days, c/o dyspnea on exertion when walking during PT, as well as a decrease in the distance she can walk during PT. Her PT notices edema of her feet, ankles and shins. On exam there is mild ascites, a +JVD, kussmaul sign, paradoxical pulse, pericardial "knock" at apex. What condition do you suspect? |
|
Definition
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Term
| A 56 y/o pt who is 5 days post-op with an open heart surgery and coronary bypass, has been c/o trouble breathing that is worsening, especially when walking. The EKG shows inverted T-waves and low-voltage QRS complexes. What condition do you suspect? |
|
Definition
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|
Term
| What days should sutures on the face be removed? |
|
Definition
| 3 - 5 days and replace with steri strips |
|
|
Term
| On what days should sutures of the scalp be removed? |
|
Definition
|
|
Term
| On what days should sutures of the trunk be removed? |
|
Definition
|
|
Term
| On what days should sutures of the arms and legs be removed? |
|
Definition
|
|
Term
| On what days should sutures of the joints be removed? |
|
Definition
|
|
Term
| What is the MC used method for wound closure? |
|
Definition
|
|
Term
| Which closure device is the strongest? |
|
Definition
|
|
Term
| Which closure device is the most time consuming and operator dependent of all wound closure methods? |
|
Definition
|
|
Term
| What strength sutures are needed for lacerations of the hand and fingers? |
|
Definition
|
|
Term
| What strength sutures are needed for facial lacerations of? |
|
Definition
|
|
Term
| What strength sutures are needed for lacerations not on the face, hands or fingers? |
|
Definition
|
|
Term
| Which wound closure device is the least reactive of all wound closure devices? |
|
Definition
|
|
Term
| What strength of suture are cyanocrylate tissue adhesives comparable to? |
|
Definition
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