11.9

Question 1

fatigue, palpable purpura, renal disease, peripheral neuropathy

Answer 1

mixed cyoglobulinemia = HCV or SLE. HBV, HIV.

dx= serologically low complement + cryooglobulis + skin/renal biopsy. plasmapharesis _ immunosuppression for pts w/ rapidly progressive & life threatening courses

Question 2

common symptoms of superior sulcus tumors

Answer 2

shoulder pain, horner syndrome, arm pain + hand weakness

Question 3

postpartum depression that doesn’t resolved after 2 weeks

Answer 3

= postpartum depression, not just blues

Question 4

refractory tx for anorexia versus bulimia versus bingeating disorder

Answer 4

anorexia = olanzapine

bulimia = fluoexetine

binge-eating disorder = lisdexamfetamine, SSRI

Question 5

hiradentitis treatment

Answer 5

doxycycline

Question 6

pubic symphisis diastasis

Answer 6

difficulty ambulating + radiating suprapubic pain + pubic symphyses tendernress + intact neurologic examination

Question 7

spinal back pain fever + FNDs after an epidural

Answer 7

epidural abscess

Question 8

after mcrobert maneuver, umbness of anterior/medial thigh

Answer 8

femoral nerve damage

Question 9

causes of fetal tachycardia

Answer 9

fetal hyperthryoidism
maternal fever
beta agonist side effects

Question 10

causes of fetal bradycardia (<110)

Answer 10

hypothermia in mother

fetal hypothyroidism or fetal heart block

Question 11

>34 weeks w/ 140/90 + either
160 OR /110
p<100k
Cr>1.1
elevated transaminases
pulmonary edema
headache

Answer 11

delivery

if <24 weeks, then just do IV labetalol, hydralazine, nifedpine + mag sulfate

Question 12

most common lobar pneumonoia versus bilateral pneumonia in kids?

Answer 12

lobar = spneumo = oral amoxicilin or IV AMPICILLIN OR CTX

bilateral = mpneumo, cpneumo, macrolide

Question 13

erythematous papular rash on anterior trunk + LAD + oropharynx w/ tonsilar exudates + soft petechiae

Answer 13

scarlet fever (Strep pharyngitis)

versus hand foot mouth disease that causes lesions on hands/feet + oral ulcerations

Question 14

what is erythema infectiosum

Answer 14

slapped cheek rash by parvovirus b19

Question 15

high fever followed by a morbilliform rash

Answer 15

roseola

Question 16

systemic sclerosis AB?

Answer 16

scl-70 OR topoisomerase, anticentromere, ANA antibody

Question 17

common causes of aseptic mengintis

Answer 17

1) enterovirus = maculopapular rash = PCR test
2) acute HIV infection = maculopapular rash =general LAD
3) LYME = ERYTHEMA MIGRANS

Question 18

2 options if 40-70 glucose on CSF

Answer 18

viral meningitis = high lymphocytes (HIV, lyme, enterovirus)

GBS (super high protein, no lymphocytes)

Question 19

sinusitis + nasal polyps differential

Answer 19

if asthma and in adulthood = esosinophilic granulomatosis w/ polyangitis

if w/ clubbing, poor growth, epistaxis, bleeding, CF (given ADEK difficulties) = CF

if no other sx = allergic rhinitis

Question 20

RFs for atraumatic splenic rupture

Answer 20

leukemia, lymphoma
infection (CMV, EBV, malaria)
inflammatory disease (SLE, apncreatitis)
splenic conestion (corrhosis, pregnancy)
medications (anticoagulation, G-CSF)

Question 21

shinty tongue

Answer 21

B12
RIBOFLAVIN
NIACIN
FOLIC ACID
IRON