Show:
All about the heart
Women's health
MSK
Instant Recall
Bugs
100
Name 2 absolute contraindications to exercise stress testing.
severe CHF, significant aortic stenosis, myocarditis, unstable angina, acute MI within 2 day, recent PE, BP >200/120
100
What do late declerations on a FHT represent?
Placental insufficiency
100
A 5y/o boy p/w acute L anterior thigh and hip pain, had a viral URI 7 days ago. The boy has a low grade fever and cannot bear weight but there is no obvious joint swelling. What is the most likely diagnosis?
Transient (toxic) synovitis. Difficult to distinguish between septic arthritis (WBC >18) and consider hip aspiration
100
A- asymmetric shape B- borders irregular C- color variegated D- diameter >6 mm E- enlargement of any lesion
Melanoma
100
At what CD4 count do you start prophylaxis for PCP? What do you use? Name 2 out of 3 posibilites.
CD4<200, TMP-SMX, dapsone, or atovaquone
200
22 yo F p/w a history of palpitations. Currently she denies any dizziness or palpitations. You capture the arrhythmia on the monitor in your office: isolated PACs. She is otherwise healthy, does not take any medications and has no FHx of arrythmia. How would you treat this patient?
No treatment unless symptomatic. A beta blocker like metoprolol may help to reduce symptomatic PACs
200
Name the 5 elements of the Bishop pelvic scoring system
1. Cervical dilation 2. Effacement 3. Fetal station 4. Cervical position 5. Cervical consistency. This is a predictive value for a successful induction. 0-4 (45-50% failure) 5-9 (10% failure) 10-13 (0% failure) If </=5 requires cervical ripening.
200
15 yo F cross country runner p/w knee pain that has been gradually increasing since the start of the season 3 weeks ago. Pain is anterior, mild swelling, + crepitus and pain worse with climbing stairs and running. What is the most likely diagnosis?
Patellofemoral syndrome. Common over use syndrome, F>M, preferred treatment is decreased activity level and quad strengthening exercises
200
S- systemic I- inflammatory R- respsonse S- syndrome List the criteria....
SEPSIS! Temp <36C, >38C HR >90 RR >24, or PaCO2 <32 Leukocytes >12 or <4, or 10% bands
200
Name the 3 most common causes of CAP?
Strep pneumoniae, H. influenzae, Atypicals
300
Which NYHA class of CHF is a good candidate for spironolactone?
has been shown to reduce mortality in patients with NYHA Class 3-4
300
What is the most common STD in the US?
HPV
300
A 2 yo M BIB by mom for not using his right arm. According to mom, the child was unwilling to leave the sand box and a tug of war ensued with mom eventually picking the child by by his forearm. What happened?
Radial head subluxation (nursemaid's elbow), radiographs are usually normal, reduction is the treatment, child shouild be using the arm normally within minutes
300
What are the indications for emergent HD?
Acidosis, Electrolytes, Ingestion (toxins), Overload (volume), Uremic symptoms (encephalopathy, pericarditis)
300
3 causes of bacterial meningitis in neonates (0-4 weeks)?
Group B strep, E.coli and Listeria
400
You have a patient who is mildly hypertensive and decide to check labs. The patient's K is 3.0. What is the most likely cause of his low potassium?
Hyperaldosteronism
400
28 yo G1P0 at 8 weeks by sure LMP presents to establish care. She is healthy, takes no medications. BP 112/68, HR 76, Temp 36.7, wt 140lbs, ht 5 feet 4 inches. She wants to know how much weight she should gain. What do you recommend.
Normal Weight 18.5–24.9: 25–35 lbs (ACOG, 1/2013)
400
What is the first ligament injured with an inversion ankle sprain?
Anterior talofibular ligament (ATFL)
400
CRASH and Burn...
Kawasaki Disease (aka Mucocutanous Lymph Node Syndrome) C-CONJUNCTIVITIS (EXTREMELY RED EYES) R- RASH (ON BODY) A- ARTHRITIS ( JOINT PAIN) S- STRAWBERRY TONGUE (RED, SWOLLEN TONGUE) H- HANDS (SKIN PEELING) BURN- UNCONTROLLED HIGH FEVER PERSISTING LONGER THAN 5 DAYS
400
Name the organism(s) responsible for toxic shock syndrome.
Staph and strep. TSS is caused by exotoxin made by certain strains of staph and strep. And only certain hosts are though to be susceptilbe due to lack of appropriate antibodies. Of note, strep toxic shock usually causes bacteremia, whereas staph TSS does not.
500
Name 3 out of 5 of the "terrible T's" of congenital cyanotic disease
Tetralogy of Fallot, transposition of the Great vessels, total anomalous venous return, tricuspid atresia, and persistent truncus arteriosus
500
A 55y/o G0 postmenopausal woman presents for routine f/u. She states that last month she had 2 episodes of vaginal spotting that self resolved. She has no other sx. You order a TVUS. At what endometrial thickness is an endometrial biopsy indicated?
>4 mm (per ACOG) >5 mm (per radiological society)
500
25 yo M p/w a h/o a soccer injury. Someone fell on his R foot while trying to steal a ball. The patient is rapidly and forcefully twisted around the fixed foot. Since then, he has had significant pain and swelling of his midfoot. Xrays show a widened space b/t first and second metatarsals. What does this patient have?
Lisfranc fracture, occurs b/t metatarsals and the tarsal bones, these fx are difficulty to identify, requires casting and NWB for 6-8 weeks, if >2mm displacement requires ORIF as this could lead to significant long term pain if not identified
500
Renal failure Fever Anemia (microangiopathic hemolytic anemia) Seizure (neurologic signs, AMS) Thrombocytopenia
TTP - HUS + fever and fluctuating neuro signs - Causes: HIV, pregnancy, OCP use - TOC: plasmapheresis
500
Diarrhea caused by this bug is associated with Hemolytic Uremic Syndrome.
E.coli