Board Vitals Most Missed

jmanderson's version from 2017-06-18 18:12

board vitals

Question Answer
5-6 Ranson’s criteria for pancreatitis prognosis40% 5yr
Abx for shigellaMacrolides (azithromycin)
Child with abd pain, cramping, gross bloody diarrhea, pets at homeC jejuni
Child with 9 d h/o fever, diarrhea, b/l conjunctivitis, sick contacts, preauricular LADadenovirus
MCC mesenteric ischemiaEmbolism to SMA
Dx- fever, fatigue, itchy rash, jt pain, jaundice, elevated ALT/ASTAcute hep b
Best image to localize abd ulcerCT abd/pelvis
Type of anemia assoc with hookworm infxnFe loss
Spinal level tested in resisted wrist extensionC6
False ribs8-12 (don’t directly attach to sternum)
5 elements of primary respiratory motion- Motility of brain and spinal cord; Fluctuation of CSF; Mobility of intracranial and intraspinal membranes; mobility of cranial bones; involuntary mobility of the sacrum
ME for exhalation rib s/d Rib 1pt raises head to ceiling
ME for exhalation rib s/d Rib 2pt turns head 30 deg away, head to ceiling
ME for exhalation rib s/d Ribs 10-12pt adducts arm
Heel walk tests what spinal levelL5
Absolute CI to CSTSkull fxr, inc ICP, acute bleed
Relative CI to CST Known sz d/o, TBI
Why L4-5 is common for herniationPosterior longitudinal ligament is thinner
what CNs exit superior orbital fissureIII, IV, V1
Mc type of lymphoma in MALT lymphomaNon-hodgkin's b cell lymphoma
Adolescent with abd distension, ileocecal mass, bx with LN, t(8;14) c-myc;IgMBurkitt lymphoma
Subjects perform according to expectationsPygmalion effect
Pts report effect in previously ineffective rxSubject-expectancy effect
Type of study with monozygotic v dizygotic twins to examine heritability of a d/oconcordance
Wt and gender are what variable typesRatio (wt) and nominal (gender)
% subjects w/in 1, 2, and 3 SD from mean68%, 95%, 99.7% (68 - 95 - 99.7 rule)
Term - prob a study will find a statistical diff when one does truly existPower (increased by N)
s/e of 2nd gen antipsychoticsWt gain, HoTN, inc BG, HLD
Psych pt >50 y/o with acute AMS, nxt stepBrain MRI (r/o SAH or fxr)
Rx that increase lithium levelsNSAIDs, ACEIs, ARBs, diuretics (renally exc)
Donepezil (for alzheimer’s) s/eGI upset, brady, heart block, sick sinus synd
Abx for chlamydia PNA in pregnancyAzithromycin (50s synth inh macrolide)- tetracyclines (doxy) are c/i
Post op c-sect fever that doesn’t respond to abx, no abscess or infected hematoma, dx?Septic pelvic thrombophlebitis (start IV heparin)
Chemo for uterine ca that causes hematuriaIfosfamide (coRx with mesna to prevent)
Mcc of fetal tachy, and txSVT, digoxin to prevent hyrdops fetalis
How to improve post-op outcome for gyn surgAbx ppx, smoke cess, post-op feeding, BB
Gestational age where heart probs most likely occur w/ teratogensWk 3-6
Gestational db dx1hr 50g OGT >140 plus >2 of … 3hr 100g (FBG >95, 1hr >180, 2hr >155, 3hr >140)
Test to confirm mosaicism in CVSAmniocentesis to confirm karyotype
Fastest test for aneuploidies in uteroFISH and QF-PCR
Asx pregnant woman with recent flu exposureGive oseltamivir for ppx
Tumor marker for ovarian caCA 125
Warm agglutinin autoimmune hemolytic anemia - type of HSRType II (cytotoxic, IgG/IgM bound to cell surface w/ compliment)
Immunocompromised kid w/ VZV mgmtIVIG VZV
Dx and ca assoc - wk, fatigue, tensilon +Myasthenia gravis (ct for thymoma)
Dx and periph smear - sz, recur skin and uri infxn, albinismChediak-higashi (AR, LYST gene), giant granules in PMNs
Mcc PNA in HIVCAP (even more than p jiroveci)
Tx of serum sicknessGlucocorticoid taper and H2blockers
Dx- >4y/o gets anaphylaxis after IVIGIgA def.
HSR of sarcoidosisT4 HSR (noncaseating granulomas, T-cell)
Young male recurrent uri/lri infxn, no sisters have it, low B cells - dx and txBruton or x-linked agammaglobulinemia, order western blot (Btk protein, low Igs)
Dx- young male with recurrent bact, vir, fungal infxn with low plt and eczemaWiskott-aldrich syndrome (WASp def), tx supp, abx, IVIG, bone marrow transplant
Dx- high fever, maculopapular rash from chest out, 5th day no fever, but stocking glove erythema and B-sxHHV-6 Roseola
Rx to increase breathing in croupDexamethasone (humidified O2, racemic epi)
Mcc atraumatic hip pain in <6y/oTransient synovitis (tx- nsaids, rest)
Infant with fatty foul diarrhea, growth failure, recurrent infxn, AML, aplastic anemia- dxshwachman -diamond syndrome (AR d/o with pancreas, bone marrow, and blood abnl)
dx lipid d/o - hepatosplenogaly, MR in infantile formGaucher’s (glucocerebroside high, def. beta-glucosidase)
dx lipid d/o- hepatosplenogaly, MR, not infantile formKrabbe’s dz (galactocerebrocide high, def. beta galactosidase)
Child with rash, kidney failure, pain in LE, siblings with kidney failureFabry’s
Age to draw square5
Dx- partial albino, whtie forelock, hearing lossWaardenburg syndrome (AD)
Dx- young F with recurrent ENT infxn, cardiac d/o, cleft palate, hypoCa DiGeorge Synd (22q11 deletion)
MCC afebrile sz in newbornhypoNa (2/2 water intoxication)
Dx- fever, sore throat, n/v, bloody diarrhea after sick dog exposureYersinia
Testicular feminization pt wants to get preg., w/uOrder karyotype (XY in androgen. insensitiv.)
Oral hypoglycemics with no wt changeDdp4 inhibitors (sitagliptin) and acarbose
Itchy extremity papules in ESRD/DB ptKyrle dz (assoc. Chr dialysis)
Child w/ maculopapular rash starts on head move to trunk, fever, cervical LAD, HARubella (german measles) via togavirus (ssRNA enveloped)
Other rx that can cause SJSAllopurinol, carbamazepine, phenytoin
Apocrine gland NT innervAdrenergic (assoc. with hair follicles)
Immunocompromised pt with blood ca, in shock, oval lesions with halo erythema and necrotic centerEcthyma gangrenosum (pseudomonas infection)
Abx for lung abscessClindamycin (anaerobes and strep)
Ventilation adjustment in ARDs to improve survivalDecrease Vt
DOC for CF assoc. w/ P aeruginosaInhaled tobramycin 28d
Rx for paranoid delusions in Parkinson’sQuetiapine (atypical antipsychotic) due to low D2 and ACh blockade (worsens Parkinson’s)
Cofactor for B6 in tx of WernickeMagnesium
Rx for migraine ppx in heavy ptTopiramate (se of wt loss)
Dx- teen goes to bed late and has hard time waking in mornDelayed sleep phase syndrome (circadian d/o)
Antiepileptic Rx with SE of aggressionlevetiracetam
Dx- pt with spastic paresis and low proprioception of LE, takes Zn Cu def. 2/2 inc. Zn intake
Dx- F w/ hx pelvic ca has radicular pain in LE with asymmetric sensory and motor lossCauda equina syndrome
Antibody for peripheral neuropathy 2/2 SCCanti-Hu (anti-ANNA-1)
Dx and w/u- PP female with HA, increased ICP, hx of dvtCerebral venous sinus thrombosis, order MR-venography
Ptosis (lid lax) worse in evening, suggestsMyasthenia gravis
Postpartum CMP sx and txLV systolic dysfxn, MR. Tx with ACEI
Clinical exam finding for pericardial tamponadePulsus paradoxus (BP cuff on arm, let air out slow, listen sounds during expiration. This # minus pulse #)
R heart overload (increased pulm vasculature), RVH on ekg, fixed split S2ASD
What HTN Rx is DOC in pregnancyLabetalol (low AEs), methyldopa (more AEs)