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163-220 Flashcards

1
Q

What is the next step in managing someone with intermediate probability for strep (2/4) and a negative rapid?

A

Culture, do not treat empirically

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2
Q

What is a PDA associated with other than a continuous to-and-fro murmur?

A

Bounding pulses and a widened pulse pressure

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3
Q

What is the next step in management after gastric adenocarcinoma is concerned by biopsy?

A

CT Scan, EUS (H pylori screening only indicated if it’s gastric lymphoma)

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4
Q

How is DI treated?

A

Intranasal desmopressin

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5
Q

How is Legg-Calvé-Perthes treated?

A

Ibuprofen, rest, and close followup

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6
Q

What are the symptoms of cerebellar hemorrhage?

A

Ataxia, vomiting, occasional headache, and gaze palsy

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7
Q

What is the first step if child abuse is suspected?

A

Detailed physical exam

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8
Q

What common analgesic potentiates the effects of warfarin?

A

Acetaminophen

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9
Q

What post-MI complication presents with persistent ST elevations months after the MI?

A

Ventricular aneurysm

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10
Q

How long does lithium therapy last for bipolar disorder?

A

1 year

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11
Q

Kid with scrotal mass that transilluminates… next step?

A

It’s a hydrocele, you can reassure.

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12
Q

Patient is diagnosed with essential HTN… What are the next steps in management?

A

FLP and urinalysis

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13
Q

Fetus is exhibiting sinusoidal fetal heart tracing after rupture of membranes… diagnosis?

A

Vasa previa

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14
Q

Treatment for hemodynamically stable SVT?

A

DC cardioversion

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15
Q

Fundoscopic findings associated with central retinal vein occlusion?

A

Hemorrhage, dilated veins, cottonwool spots (“blood and thunder”

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16
Q

What should be tested prior to initiating lithium therapy?

A

TFTs and serum creatinine

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17
Q

How can polymyositis and steroid-induced myopathy in the context of temporal arteritis be distinguished?

A

Polymyositis almost always has an elevated ESR, whereas steroid myopathy does not.

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18
Q

What is the most common cause of constrictive pericarditis in the developing world?

A

TB

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19
Q

Describe laryngomalacia

A

Congenital flaccid larynx. Produces an inspiratory noise. The child should never be fed while laying down and should be held upright after feeding

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20
Q

Presentation and fundoscopic findings in open-angle glaucoma?

A

Loss of peripheral vision, cupping of optic disk

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21
Q

How can you distinguish a ruptured berry aneurysm from a basal ganglia deficit if motor exam cannot be performed?

A

Gaze palsy

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22
Q

Next step in diagnosing ankylosing spondylitis after clinical suspicion arises?

A

X-ray of the spine; HLA-B27 not the next step. Likely to be positive, but not diagnostic

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23
Q

Rash associated with tinea versicolor?

A

Velvety pink or whitish hypopigmented macule that do not appear scaly

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24
Q

How do you distinguish premature ovarian failure from diminished ovarian reserve?

A

Amenorrhea is present in premature ovarian failure, whereas diminished ovarian reserve jut describes why it’s more difficult for older women to conceive

25
Q

When do you give the varicella vaccine post-exposure?

A

To every asymptomatic and immunocompetent patient; although it works best within 3-5 days of exposure, it can still help prevent transmission

26
Q

How do you manage a tylenol overdose?

A

Get a serum acetaminophen level at 4 hours post-exposure

27
Q

Describe laryngomalacia

A

Congenital flaccid larynx. Produces an inspiratory noise. The child should never be fed while laying down and should be held upright after feeding

28
Q

Presentation and fundoscopic findings in open-angle glaucoma?

A

Loss of peripheral vision, cupping of optic disk

29
Q

How can you distinguish a ruptured berry aneurysm from a basal ganglia deficit if motor exam cannot be performed?

A

Gaze palsy

30
Q

Next step in diagnosing ankylosing spondylitis after clinical suspicion arises?

A

X-ray of the spine; HLA-B27 not the next step. Likely to be positive, but not diagnostic

31
Q

Rash associated with tinea versicolor?

A

Velvety pink or whitish hypopigmented macule that do not appear scaly

32
Q

How do you distinguish premature ovarian failure from diminished ovarian reserve?

A

Amenorrhea is present in premature ovarian failure, whereas diminished ovarian reserve jut describes why it’s more difficult for older women to conceive

33
Q

When do you give the varicella vaccine post-exposure?

A

To every asymptomatic and immunocompetent patient; although it works best within 3-5 days of exposure, it can still help prevent transmission

34
Q

How do you manage a tylenol overdose?

A

Get a serum acetaminophen level at 4 hours post-exposure

35
Q

How many days after birth does chlamydial conjunctivitis present?

A

5-15

36
Q

How do you distinguish Todd’s paralysis from an acute stroke?

A

Focal neurologic deficits resolve within 24 hours

37
Q

Parkinson’s medication associated with anticholinergic toxicity?

A

Trihexyphenidyl

38
Q

CBC abnormalities associated with HS?

A

elevated MCHC, elevated RDW

39
Q

What is the most common cause of aortic regurgitation in young adults?

A

Bicuspid aortic valve

40
Q

How do you distinguish breast milk jaundice from breastfeeding jaundice?

A

Breastfeeding failure jaundice: First week of life

Breast milk jaundice: Unconjugated hyperbilirubinemia in the first 3-4 weeks of life

41
Q

A patient with urosepsis that was treated develops ATN… what drug is the likely offender?

A

Amikacin (as the urosepsis was likely caused by gram negative rods

42
Q

How do you distinguish polymyalgia rheumatica from polymyositis?

A

PMR usually prevents with pain in neckshoulders/pelvic girdle, whereas polymyositis presents with weakness

43
Q

What is the diagnostic test for pseudotumor cerebri?

A

LP with opening pressure

44
Q

Child with increasing head circumference and elevated ICP… what is the next step in diagnosis?

A

CT scan

45
Q

What kind of acne patients get oral isotretinoin?

A

Patients with moderate to severe acne, specifically in nodulocystic form and those that have scarring

46
Q

What is the NBME-preferred definitive modality for treating Graves disease?

A

Radioactive iodine ablation

47
Q

How do you distinguish Kaposi’s sarcoma from Bacillary angiomatosis?

A

KS: Papules-plaques are the skin lesions
BA: Bright red, firm, friable masses

48
Q

What is the treatment for cellulitis with systemic signs?

A

IV Nafcillin

49
Q

Patient has an endoscopy, develops problems breathing, chest pain, tachycardia and tachypnea. Diagnosis?

A

Boerhaave syndrome

50
Q

How do you treat sphincter of Oddi dysfunction?

A

ERCP sphincterotomy

51
Q

What distinguishes the presentation of Bartter’s syndrome from a reninoma?

A

The absence of hypertension

52
Q

What distinguishes CMV from HSV retinintis?

A

CMV: painless, fluffy/granular lesions near retinal vessels
HSV: retinal necrosis with follicles

53
Q

At what age is bedwetting abnormal?

A

> 5 years old

54
Q

What is the most important pathophysiologic factor in the development of cardiogenic edema?

A

Renal hypoperfusion secondary to overactivation of the RAAS

55
Q

How do you treat variable decelerations?

A

Change maternal position

56
Q

How do you distinguish inflammatory from noninflammatory nonbacterial prostatitis?

A

The inflammatory form has >10 WBC/HPF

57
Q

What’s a synonym for Paget’s disease?

A

Osteitis deformans

58
Q

When do you do a VCUG in peds patients with UTI?

A

Only if the renal ultrasound is abnormal

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