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Comlex 3 2

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ruhland1's version from 2018-08-30 16:01

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studyalpha thallesemia, orbital cellulitis, polymalgia rheumatic, roseola
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Question Answer
polymyalgia rheu sxworse in morning, proximal m. + MDD
temporal arteitis assoctemporal arteritis
fibromyalgia dx1. pain all 4 quad 2. 11 of 18 tenderpoints
tx polymyalgia rheumlong term steroids
tx RA first lineNSAIDS
OMT tendepointsindic fibromyalgia
topical analgesicsindic osteoarthritis
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kawasaki dzkid + b/l conjunct + strawberry tonge + UE and LE edema + truncal rash + fissured lips
Scarlet feverbug is strep pyogenes
Scarlet fever sxsore throat, F strawberry tounge "sandpaper rash", need abx
Follows group A strep infxnrheumatic fever
inoves heart, skin, joints, brainrheumatic f sx
roseolabug Human herpes virus 6
high F then rash after Froseola
slapped cheeckerythema infectiosum
erythema infectiosumparvo B19
kawasaki txASA and IVIG
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Question Answer
prinzmetal anginanitrate and CCB
angina both at rest and exertion in early morning and nightprinzmetal angina
screen gest DM if no risk factorsonce in 2nd trimester between 24-28 wk
prev GDM, obesityscreen 1st and 2nd ttrimester
Fe defpallor, glossitis, spoon nails
child drinks primarily cows milkconcern Fe def, must ask parents if they are supplementing diet with iron rich foods
when to give cows milkif > 1yo
vit Chelps absorb non-heme iron
african asian mediterraneanup alpha thallesemia
alpha thalHepsplen-meg, frontal bossing, gallstones
lead painthomes prior 1978 up sideroblastic anemia
dx lead dzbone marrow bx prussian blue ringed sideroblasts
lead sxdumb, short, abd pain, dn coordination
kid + new asthmatic/allergic sxask about pets
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Question Answer
orbital cellulitisF, eye sx, proptosis = bad, need admit and IV anx
complic orbital cellulitiscavernous sinus thrombosis and subperiosteal abscesses
pre-septal cellulitisoral abx, absence of pain with eye movement, 0 F, 0 vision changes
bact conjuncttopical abx
ACEi angioedemagive ARB with caution
pap-smear find ASC-USHPV test, return in 3 years if neg
find ASC-US and HPV +get colposcopy
barotrauma ventilationdevelop tension pneumo
suspec tension pneumothoracostomy before CXR
exhalation dysfwill move caudad during exhalation but not move cephalad during inhalation, stuck in exhalation
rib 6-10bucket handle
key rib exhaltion dysftop rib (BITE)
new dyspnea during central line placementvenous air embol
dn card output, cool skincardiogenic shock
"mill-wheel" murmurvenous air emboilism
venous air emboli txaspirate cath, 100% o2, place pt lateral w left side down
chest tube indictension pneumo
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postpericardiotomy synddressler synd
post-MI, 3 weeks out chest pain malaise fever, both pleural and cardic friction rubsdressler syndrome (AI etio)
tx dressler syndNSAID
dressler ppxcolchicine
sharp, persistent mid-sternal chest pain radiates to mid-scapular refion + pericardial fricton rub w/o pleural friction rubpost-infarction pericarditis
PE triadvenous stasis, vasc injury, hypercoag state
dizziness + ringing in ears + comaASA OD
anorexia, N/V, malaiseAPAP OD
AST ALT in APAP OD12 hours post-ingest
ASA OD txbicarb + dialysis
ASA ABGmixed resp alk and metab acid, up AG
carbamazepine"jagged" neuralgia, trigeminal neuralgia indic
osgood-schlattertibial tubercle 2/2 oversure, 10-15yo,
legg-calve-perthavasc nec of hip, age 4-10, thigh and knee pain with painful limp, tx splinting and decreased weight bearing
septic arth bugstaph aure
monitor septic arthwith ESR
slipped capital femoral epiphysisobese age 10-15 "ice cream falling of cone", tx surgical pinning
transient synovitis4 to 8 yo and hx of URI. tx NSAIDS
late pubertyif >14 girls if > 15 boys
precocious pubertyif <8 girls, if < 9 boys
thelarachebreast development, avg age 10.5 yo, first sign of puberty
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molluscum contagiosymumbilicated papules
henderson-paterson bodiesmolluscum contagiosum histo
atypical lymphocytes histoEBV
EBV then given ampicillingerupt maculopapular rash
owl's eye histoCMV
CMV txgancyclovir
sarcoptes scabieitopical permethrin
tx molluscum contagiosumconservative, remove if persists
metabolic synd1 of these (T2DM, impaired glucode) + 2 of the following (on anti-htn, SBP > 140, DBP > 90, TG >150, HDL <35, BMI > 30, waist to hip ratio)
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Question Answer
sitigliptinDPP4 inhib
metforminlactic acidosis, up risk contrast-induced nephropathy
glimipiridehypoglc, sulfonurea
-glitazoneTZD
battery in esphimmediate remove
battery in lg/sm intestine and stableobserve
most effective means of post-coital contraception w/in 72 hoursplace copper IUD
unstable and penetrating abd injurylaparotomy, if stable first do u/s
pheo dx24hr unrine catecholamine and metanephpine and MRI/CT
levonorgestereldn menstrual bleeding
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Question Answer
adams forward bend testscoliosis eval
gowers signpushes on knees in order to stand in Duchenne musc dyst
confrim ducchene m dystm biospy, waddling gait, X-linked recessive
dandy-walkerabsence of cerebellar vermis and enlargement of 4th venticle, poor coordination of axial musculature
rett syndx-linked dominant
Leiber hereditary optic neuropathymitochondrial inheritence, myoclonic epilepsy, red ragged m fibers
mort from Duchenneresp failure, mort approx age 25
men aged 65-75 + smokedget u/s for abd aortic aneur
ruptured berry aneurysmPCysticKD, marfan, ehler danlos
ruptured membrane "water-broke"vaginal pooling, fetal fibronectin, nitrazine tests
nitrazine testalkaline aminotic fluid vs acidic vaginal
fern testestrogens in amniotic fluid
fetal fibronectingmarker to assess likelyhood of preterm labor between 22-34 wks preg
FHT late decelerationuteroplacental insuff
FHT early decelerationfetal head compressions
FHT variable decelumb cord compression
late decelbad, not normal in labor
late decel and fetal brady and non-responsice to resuscimmediate c-sec
leopold manuversto determine position on fetus
scapel in abd + suedres ipsa loquitur
eval GB and u/s equivocalget HIDA
Klumpke palsyC8 T1 intrinsic hand muscles
Erb-ducheenechildbirt c5/c6, arm adducted and internally rotated, "waiters tip"
post-ictal paralysistodd's paralysis, resolves by 48 hr
anal fissurestool softeners and Sitz baths
last line tx anal fissuresphincterotomy
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