11/3's practice Flashcards
murmur associated with rheumatic fever?
mitral regurgitation
What is the definitive test result for polycystic ovary?
LH:FSH ratio of 2:1 or greater
What cancer is associated with pheochromocytoma?
Medullary thyroid CA
What is the diagnostic test for amoebiasis?
indirect hemagglutination test for amoebiasis
A 30-year-old man presents with a 1-year history of watery diarrhea. He has lost 5 kg. He has joint pains of 1-month duration. His stool examination for occult blood is negative. Stool culture is negative. No ova and cyst are seen in the stool. Laboratory tests fail to reveal rheumatoid factor or anti-nuclear antibodies. Serum calcium, phosphorous and alkaline phosphatase is 9.2 mg/dl, 4 mg/dl and 110 U/L respectively. A biopsy taken from the upper intestine shows distended macrophages in the lamina propria, which is found to be positive with PAS stain. What is the most likely diagnosis in this case??
Whipple disease - macrophages indicate infection
What demographic factors influence one’s risk for SCC?
male gender, caucasian, light eyes
What lab test is ordered in an adolescent female to assess when she may begin menses?
FSH
What is the APC genetic test for?
familial adenomatosis polyposis syndrome
What is the MSH2 genetic test for?
hereditary non-polyposis colon cancer syndrome
What is the RET genetic test for? Associated conditions (3)?
multiple endocrine neoplasia syndrome type II (MEN-II), which is typically associated with medullary thyroid cancer, parathyroid adenomas, and pheochromocytomas
What do ACE inhibitors do to oral hypoglycemics?
Increase their activity, increasing the risk of hypoglycemia
Patient with diarrhea, dermatitis, and dementia, diagnosis? Treatment?
Niacin deficiency - diet high in tryptophan
What is the most common location of an anal fissure?
Posterior
What is the first line treatment for an acute Meniere’s disease flare of symptoms?
Benzos (valium)
What is the threshold of outbreaks/year for beginning prophylactic herpes therapy?
> = 6/year
At what point after an acetaminophen overdose do LFTs start to rise?
12 hours
What medication is given to decrease the size of fibroids?
Lupron
What is preferred management for SVC syndrome?
stenting/radiation
A 20 yo woman p/w malodorous vaginal discharge. Physical examination reveals a homogeneous gray discharge. Some of the vaginal discharge is obtained and mixed with 10% KOH, whereupon a fishy amine odor is produced. A Gram stain of the vaginal discharge reveals diagnostic “clue” cells. Diagnosis?
Bacterial vaginosis
A 72-year-old man presents with double vision, weakness, fatigue, nausea, and abdominal discomfort. Med list: Digoxin, Furosemide, Potassium, Acetylsalicylic acid, Amoxicillin. What is the culprit?
Digoxin
Infant with a loud systolic ejection murmur is ascertained at the left upper sternal border. An EKG reveals normal sinus rhythm and the chest X-ray reveals a “boot shaped” cardiac shadow. Diagnosis?
Tetralogy of Fallot
child with fever then rash
roseola
floppy newborn of a mother with a mono-like illness at some point in pregnancy, bulging fontanelles. Normal CSF. Diagnosis?
Toxoplasmosis
Patient with encephalopathy has an MRI scan of the brain demonstrates low-density lesions in the brain; they represent areas of gross demyelination. What is the most likely diagnosis??
HSV encephalitis
What’s the first blood test to change in anemia?
Red Cell Distribution Width (RDW)
A patient presents with multiple angular, mildly pruritic, flat-topped violaceous papules on both shins as well as Wickham’s striae. Diagnosis?
Lichen planus
Pt has a superficial form of cellulitis caused by B-hemolytic streptococci. It most typically occurs on the cheek. Diagnosis? Lab finding?
Erysipelas, lymphocytosis
A 19-year-old college student presents with numerous mildly erythematous oval lesions with fine scaling over her chest and trunk which appear to follow the cleavage lines of the skin. A week prior to the outbreak of her rash, she noticed a single, similar but larger lesion below the right clavicle. Diagnosis?
Pityriasis Rosea
A patient complains of severe itching on the wrists and hands. Examination reveals pinpoint vesicles and pustules, some arranged in an irregular linear fashion. Diagnosis?
Scabies
In severe contact dermatitis, what is the treatment?
Prednisone for 12-14 days with a taper
An adult presents with diffuse, raised, target-like lesions with two zones of color change. Lesions affect approximately 50% of body surface. He has a recent history of sulfonamide treatment. What is the most likely diagnosis?
Toxic epidermal necrolysis denotes >30 % BSA skin loss with lesions as observed. A drug reaction is the most common cause in adults.
What is the treatment for TTP?
Plasma exchange
- A 4-year-old is brought to the clinic with a bright red rash on his face. He had a fever and was irritable for two days prior. Exam reveals a deep red macular facial rash with circumoral pallor. A fine lacy rash is visible on the trunk and shoulders. He is currently afebrile. What is the most likely cause?
erythrovirus aka parvovirus B19 is responsible for erythema infectiosum, also known as “slapped cheek” or “5th disease.”
A 23-year-old female at 26 weeks gestation presents with myalgias, headache, and fatigue 10 days after returning from a camping trip in the mid-Atlantic US. Exam reveals a nontender, slightly raised, red lesion with central clearing on the lower posterior left thigh. Diagnosis? What is the recommended treatment?
Lyme disease: amoxicillin
Pt has a positive geimsa-stained blood smear, dx?
Giemsa-stained blood smears are diagnostic for malaria. The density of parasitemia may correlate with severity of infection.
Which class of antibiotics work by inhibiting cell wall synthesis?
PCNs
Which of antibiotics class is most strongly associated with an increased risk of prolonged QT syndrome?
macrolides
Sulfonamides are antibacterial due to their ability to inhibit what?
folic acid
