Create
Learn
Share

COMBANK Review 4

rename
jmanderson's version from 2017-06-17 01:16

section

Question Answer
abx for pyelo with GNR (moa- needs O2 in bact cells)aminogyclosides (gentamicin)
aminoglycoside teratogenecity to fetusCN VIII damage, renal damage
tetracycline teratogenecity to fetusbone damage (divalent catioins)
fluoroquinolone teratogenecity to fetuscartilage damage
chloramphenicol moa and teratogenecity to fetus50S inhibitor, gray baby syndrome
sulfa drug teratogenecity to fetuskernicterus
dx: HoT4 with HoThermia and AMSmyxedema coma
tx and w/u for myxedema comatx with glucocorticoids, check corisol and TSH
LSIG on pap, what nextcolposcopy
tx: copd with evidence of RHF, pulm HTN, Hct >55%, or hypoxiasupplemental O2
murmur and tx: mid-systolic click with late systolic murmur at apexMVP, reassurance and ECHO
dx: s/sx AKI (change Uo, wt gain, edema), rash, fever, eosinophilia and h/o NSAID useacute interstitial nephritis
etiology of acute interstitial nephritisHSR (2/2 NSAIDs, rifampin, pcn, ceph), autoimmune d/o
u/a of acute interstitial nephritiseosinophiluria
rx for acute interstitial nephritisprednisone
u/a ATNmuddy brown casts
mcc death in 1-4 y/odrowning
2nd mcc death in 1-4 y/oMVA
most sensitive/specific image test for acute cholecysititscholescintigraphy (HIDA scan)
most specific PE test for acute cholecystitismurphey sign
mc bug in acute cholee coli
CO and PVR in neurogenic shockboth decreased
complication of untreated PDApulm arterial HTN (and shunt reversal)
1st line rx for cocaine induced CPBZDs
1st line after MONA tx for STEMI w/in 90 minPCI (cath lab)
RDW in Fe def. anemiaincreased (more RBC size var.)
TIBC, Fe, and ferritin in Fe def. anemiahigh TIBC, low ferritin and Fe
dx: SZ >30 min or 2+ sz w/o full recovery btwstatus epilepticus
tx for status epilepticushigh dose BZDs and ABC mgmt (intubation)
DOC for trigeminal neuralgiacarbamazepine
mgmt: rusty cut wound and ?tetanus vacc statustetanus Ig and Td or Tdap
small vessel vasculitis in young, heavy smokers: dx and txBuerger's dz, stop smoking
parkland formula for IVF resuscitation24 hr total fluid vol = 4 x kg x TBSA % burn (give 1/2 in 8 hr and 1/2 in next 16 hr)
dx: restrictive CMP with cardiac bx showing endomyocardial fibrosis with prominent eosinophilic infiltrateLoeffler's endocarditis
memorize

section

Question Answer
pink pufferemphysema
diff chronic bronchitis vs emphysema on pftsemphysema --> low DLCO
initial tx for nasal polypsintranasal steroid spray
dx/tx: epistaxis, gingival bleed, petechia, ecchymosis with isolated low pltITP, tx with high dose prednisone 1 mg/kg
innervation of hamstringscommon peroneal and tibial branches of sciatic n
mgmt: vag bleed 36 wk gestation wiht previaemergent c section
dx: systolic murmur crescendo decrescendo without carotid radiation aortic valve calcification
s/e of cardiac cath (LE)livedo reticularis (impaired circulation to LEs)
ekg of proximal L coronary artery occlusion in anterolateral L ventricleabn Q waves on lateral leads
1st line tx epistaxiscontinuous firm P on cartilage for 30 min
ppx for toxo in HIV with CD4 < 100TMP-SMX
dx: osteonecrosis of navicular tarsal boneKohler's dz
best position in ED s/p MVA to avoid HoTNleft lateral decubitus (avoid IVC compression)
leading cause of maternal death in pregnancytrauma
pediatric bone pain in metaphysis of long bone with elevated periosteumosteosarcoma
mc mets in osteosarcomalungs (get chest CT)
w/u for potential hemorrhoidsanoscopy
contraction type with shortening length while generating forceconcentric
memorize

section

Question Answer
dx: vag d/c thin, white, pH>4.5, odorBV
dx: painless nodule near MCP jt, locking of digittrigger finger
infectious diarhea in IBD ptC diff (abn colonic flora)
precautions for flu, GAS, epiglottitis, MMR, and meningogoccola infxndroplet
precautions for TB and SARSairborn
precautions for c dif and meningitiscontact
amennorhea pt fist and 2nd test1st is bhcg, 2nd is FSH/LH
who to screen for lung ca rules55-80 y/o with >30 pack yr, current smoker or quit w/in 15 yr
mc infectious dz via blood transfusionbacterial
mc bugs necrotizing fasciitisC perfingnes, S aureus, S pyogenes
abx for necrotizing fasciitisclindamycin , pcn G, vancomycin
sirs criteria>38 deg or <36 deg, hr>90, rr>20 or co2<32, wbc >12k or <4k
long term tx for whipple dztmp/smx
dx: anteromedial knee painpes anserine burisitis
most accurate test for ZE syndromesecretin stimulation test
best screening test for ZE syndromefasting gastrin level
tx of ZE syndromesurgical resection
dx: mult recurrent ulcers in distal duodenum, diarrhea, gastrinomaZE syndrome
cushing's triad for brain herniationhigh bp, irregular high rr, and low hr
1st line tx for NSTEMILMWH, antiplt
best test to eval NSTEMIcoronary angio
thomas test of calf to evalachilles tendon rupture
memorize

section

Question Answer
w/u for nephrotic synd from T1DM24 hr urine protein
tx for nephrotic syndprotein and Na restriction, diuretic, statin
u/a sediment for nephrotic synd from T1DMmaltese cross, oval fat bodies
heel lift start for fragile vs young pt1.5 mm (1/16") fragile or 3.2 mm (1/8") young
rx for duodenal ulcers from H pyloritriple therapy (PPI, metronidazole, tetracylcine)
only mm that opens vocal cord (hoarsness with R recurrent laryngeal n injury)posterior cricoarytenoid
dx test for vocal cord paralysis (s/p thyroidectomy)fiberoptic laryngoscopy
1st line eval for renal a stenosisduplex u/s
pharm rx for renal a stenosis to prevent further blockstatin
dx: malabsorption, joint pain, neuro sxwhiplle dz (Gm + PAS +)
dx test for ALSEMG
s/e of saw palmettobleeding
SERM for ppx and tx for osteoporosis in pt with h/o breast caraloxifene
A1c goal in diabetics<7%
ulcer cause in ZE syndtoo much H+ 2/2 gastrin secreting gastrinoma in pancrease/duodenum
ZES assoc with what syndromeMEN1 (Wermer's) - hyperPTH, pituitary, pancreatic ca
1st line Rx with ZESPPI
pasteurella organism typeGNB
rx that is CI in R inferior wall infarct (STE in II, III, aVF)nitrates
ecg with irregular ventricular response w/o p wavesA fib
nxt step to eval A fib after ecg and stabilizationTEE (check for heart clot)
barrett's esoph white plaque bx showscolumnar epithelium (stratified -> columnar)
dermatome of nippleT4
dermatome of umbilicusT10
tx: methanol tox with altered vision already tx with ethonal/flumazenilhemodialysis
mgmt: adult with flu, hemodynamically stable, outside 72 hr window supportive care
memorize

section

Question Answer
mcc benign white itchy bleeding lesion on vulva of post-menop womenlichen sclerosus
EM of kidney in alport syndbasement membrane splitting
alport synd nephritic or nephroticnephritic (<3.5 g/d proteinuria)
status epilepticus mgmtABCs, 2 trials bzd, fosphenytoin. If >30 min try other rx
1st line tx for stable SVTvagal maneuvers
2nd line tx for stable SVTadenosine
dx: old pt with s/sx leukemia, smear with small lymphocytes and smudge cellsCLL
ppd + in IVDU>10 mm
female athlete triadosteoporosis, amenorrhea, eating d/o
pulse cut off for apgar>100
BV tx for pt and partnermetronidazole pt ONLY
Trich tx for pt and partnermetronidazole for pt AND partner
genu and q angle for patellofemoral syndgenu valgum (q >17 deg)
how much increase in H/H per unit of PRBCinc Hb by 1 and Hct by 3%
when to transfuse ptsHb<7 or Hb<8 with need for O2 carrying capac
memorize

section

Question Answer
dx: saddle nose defomrity, bilat auricular inflamm on mult occasionsrelapsing polychondritis
dx: old man, lethargy, wt loss, raynaud's, blurry vision, ha, M protein, nL skeletal surveywadnestrom's macroglobinemia
mgmt waldenstrom's macroglobinemiaplasmapheresis
mcc cirrhosis in asiahepatitis B
1st step mgmt in pt with upper GI bleed w/ anemiaFFP
image w/u for portal HTNegd
1st line for ascitesdiuretics and dietary Na control
vit def in wernicke's encephalopathythiamine (B1)
how to check ureters after gyn surgIV indigo carmine
strong predictor of retinopathy in DM ptskidney d/o (proteinnuria and inc BUN/Cr)
abx for infant meningitisampicillin and 3rd gen ceph (covers GBS, E coli, Listeria)
adult leukemia with basophilia and granulocytosisCML
1st line therapy for prinzmetal anginaCCB (diltiazem, nifedipine, amlodipine)
image w/u for hepatic abscessabd u/s
rx for amebic hepatic abscessmetronidazole
FEV1 in mild asthma>75%
FEV1 in moderate asthma60-80%
FEV1 in severe asthma<60%
test for asthma if pfts are nLmethacholine challenge
memorize