Step 3 Random Qbank

zms2187's version from 2015-12-15 02:30


Question Answer
Inflammatory joint fluid qualifications>2000 WBCs or >75% PMNs
What does RBC cholinesterase activity diagnoseorganophosphate poisoning, can assess degree of poisoning
Breast milk jaundicecommon cause of indirect hyperbili, develops in first 3-5 days of life and peaks at 2 weeks. Due to high beta-glucuronidase activity in breast milk that deconjugates intestinal bili and allows for intestinal absorption of bili. Babies are asx and well-appearing
Blood type most common for alloimmune hemolytic dz of newbornMom is usually O blood type and Rh-
Tx of breast milk jaundicecontinue breastfeeding, rarely leads to kernicterus. Should spontaneously resolve by 3mo
ARDS criterianon-cardiogenic, acute in 1 week of known clinical insult. Bilateral diffuse infiltrate c/w pulm edema, no signs of cardiac volume overload w/objective evidence like ECHO to exclude cardiac cause, PF ratio <300 (mild 200-300, mod 100-200, severe <100)
Primary physiologic disturbance in ARDS?Shunting
Goals of mechanical ventilation in ARDSPlateau pressures <30, Low tidal volumes around 8mL/kg predicted weight initially--> down to 6ml/kg, achieve PaO2 55-80. If trying to improve oxygenation increase PEEP rather than Fio2 to recruit more alveoli
Tx of phototoxic sunburn due to drug like doxysupportive to alleviate pain/itch--> nsaids. Oral steroids only for very severe cases
Managing insulin inpt in DM1 who are not eating/drinking normallydecrease basal insulin dose (do not stop it) by 20-30% and do SSI . Even in DM2 pts should continue basal insulin if this is what they were on as outpt
Dx of stress fractureclinical dx, often plain films are negative during first few weeks, after 4 weeks can see periosteal elevation, bone sclerosis, cortical thickening, and/or visible fx line. If definite dx is needed can do MRI
Associated defects w/Turners syndromeCardiac (coarctation of Aorta, MVP, bicuspid Ao valve), horseshoe kidney, visual/hearing defects, increased risk for endocrinopathies particularly hypothyroidism

Section 2

Question Answer
what is akathisia and tx?feeling of restlessness 2/2 anti-psychotics (haldol or atypicals). Tx with beta blocker
horners syndromemiosis, ptosis and anhidrosis--> disruption of sympathetic nn . *thick abt carotid a dissection*
acute tx of torsadesiv mag (regardless even if mag is normal), if no improvement that temp transvenous pacing
tx of crypto meningitisampho + flucytosine
How to tx pts with crypto meningitis (on approp anti-fungal tx) who have signs of increased ICPserial LPs to remove large volumes of csf
how to prevent recurrence of crypto meningitis in pts who are HIV +daily fluconazole (low dose)
Endoscopy for patients with pernicious anemia may show?glandular atrophy in gastric body/fundus, intestinal metaplasia, and inflammation--> gastritis called autoimmune metaplastic atrophic gastritis *** high yield**
Are ppx abx needed for pts with bicuspid aortic valve prior to dental procedure?NO- they are at higher risk but still abx not recommended
when does physiologic jaundice in newborn present?24hrs AFTER birth
absolute contraindications to combined hormonal OCPsmigraine w/aura, >15 cigs/day with age>35, stage 2 htn, hx VTE/stroke/CAD, breast cancer, cirrhosis/liver cancer, major surg w/prolonged immobility, <3 weeks postpartum
improved back pain w/flexion (grocery cart), sittingspinal stenosis
when to test for gestational DM and general pathwaytest 24-28 wks, give 50g then check 1hr later; if >140 then give 100g load and monitor, if <140 no DM
best tx for bipolar in pregnancyhaldol or ect (no lithium or anticonvulsant mood stabilizers like depakote or carbamazepine)

Section 3

Question Answer
when to use irradiated blood productsBMT patients, blood from 1st/2nd degree relatives, acquired or congenital cellular immunodeficiency
when to use leukoreduced blood productschronically transfused pts, possible transplant recipient, previous transfusion rxn, at-risk pts (AIDS, transplant pts)
most reliable confirmation of ET tube placementcapnography
PPx for close contacts of meningitis ptrifampin best, otherwise cipro or IM ctx
Most common source of diverticular bleed, arterial or venous?arterial
After parathyroidectomy for hypercalcemia, what can happen?hungry bone syndrome 2-4 days post-op due to sudden withdrawal of PTH and causing influx of Ca into bone from circulation
when to use pentamidine for PCP?pts who are intolerant to bactrim for cases of mod-severe PCP
when to use steroids for PCP?A-a of 35+ and/or PaO2 <70 on ambient air
heberden's vs bouchards nodules?Heberdens are DIP nodules, Bouchards PIP nodules
exogenous insulin, c-peptide?LOW