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Dedicated - Step 2 > 20 > Flashcards

20 Flashcards

1
Q

Patients with endometriosis are at increased risk of ___.

A

Infertility

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2
Q

What are neurofibromas?

A

Nerve sheath tumors

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3
Q

Retinal hemangioblastomas are associated with what syndrome?

A

Von Hippel-Lindau -> benign and malignant tumors

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4
Q

Manometry - periodic, high-amplitude, non-peristaltic contractions?

A

Dysfunction of inhibitory neurons -> diffuse esophageal spasm

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5
Q

Manometry - esophageal hypercontractility

A

Eosinophilic esophagitis

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6
Q

Young children with an erythematous, sharply demarcated perianal rash associated with pruritus and pain

A

Streptococcal perianal dermatitis

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7
Q

Compare populations affected by contact vs. Candida vs. perianal Streptococcus dermatitis

A

Contact: most common cause in infants
Candida: second most common cause in infants
Perianal Strep: school-aged children

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8
Q

Compare the exam findings of contact vs. Candida vs. perianal Streptococcus dermatitis

A

Contact: spares creases/skinfolds
Candida: beefy-red rash involving skinfolds with satellite lesions
Perianal: bright, sharply demarcated erythema over perianal/perineal area

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9
Q

Rx contact vs. Candida vs. perianal Streptococcus dermatitis

A

Contact: topical barrier ointment or paste
Candida: topical antifungal
Perianal Strep: oral ABX

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10
Q

Ovarian mass on U/S - homogenous cyst with internal echoes (eg, “ground glass”)

A

Endometrioma

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11
Q

Presentation - frequent fractures, joint hypermobility, see-through teeth, blue sclera, conductive hearing loss, short stature

A

Osteogenesis imperfecta

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12
Q

Inheritance pattern of osteogeneis imperfecta?

A

AD

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13
Q

___ can occur after accidental ingestion of prenatal vitamins and presents with abdominal pain, hematemesis, shock, and AG metabolic acidosis. ___ is the primary therapy.

A

Acute iron poisoning; deferoxamine

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14
Q

List the 5 major primary humoral deficiencies - what is their shared clinical feature?

A
  1. X-linked agammaglobulinemia
  2. CVID
  3. IgA deficiency
  4. Hyper-IgM syndrome
  5. IgG subclass deficiency

Recurrent and or severe sinopulmonary infections with viruses and encapsulated bacteria

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15
Q

Distinguish the 5 major primary humoral deficiencies based on lab findings.

A
  1. Bruton - decreased or absent B cells, decreased Igs
  2. CVID - normal B cells, decreased Igs
  3. IgA deficiency - normal B cells, decreased IgA
  4. Hyper-IgM - normal B cells, decreased IgG and IgA, increased IgM
  5. IgG subclass deficiency - normal B cells, decreased IgG
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16
Q

Cause of hyper-IgM syndrome?

A

X-linked defect in the CD40 ligand (prevents class switching)

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17
Q

Phenytoin commonly causes megaloblastic anemia and gingival hyperplasia due to impaired ___ absorption in the jejunum.

A

Folic acid

18
Q

Vitamin B6 (pyridoxine) deficiency is associated with ___.

A

Peripheral neuropathy

19
Q

Nitroprusside is a parenteral vasodilator with quick onset and offset of action and is commonly used for rapid blood pressure control in patients with hypertensive emergency. What can happen in patients receiving prolonged infusions or higher doses, or in patients with renal insufficiency? How does it present?

A

Cyanide toxicity; AMS, lactic acidosis, seizures, coma

20
Q

Patients with cirrhosis should undergo what screening procedure?

A

Endoscopy to exclude varices/indicate risk of variceal hemorrhage/determine strategies for prevention

21
Q

Mainstays of primary prophylaxis for esophageal variceal hemorrahge?

A

Non-selective beta blockers (propranolol, nadolol) or

Endoscopic variceal ligation

22
Q

First-line therapy for ascites 2/2 cirrhosis?

A

Furosemide and spironolactone

23
Q

What are the 3 major pathologic mechanisms of foodborne illness?

A
  1. Enterotoxin ingested
  2. Enterotoxin made in intestine
  3. Bacterial epithelial invasion
24
Q

2 bugs that cause enterotoxin-ingested illness? Features?

A

S. aureus
B. cereus

Quick onset (1-6 hours)
Vomiting predominant
25
Q

3 bugs that cause enterotoxin-produced (in intestine) illness? Features?

A

C. perfringens, C. difficile
ETEC/STEC
V. cholerae

Delayed onset (>1 day)
Watery/bloody diarrhea
26
Q

3 bugs that cause foodborne illness due to bacterial epithelial invasion?

A

Campylobacter jejuni
Non-typhoidal salmonella
L. monocytogenes

Variable onset
Water/bloody diarrhea
FEVER
(Systemic illness - Listeria)

27
Q

___ can occur due to papillary muscle displacement in patients with acute MI.

A

Acute MR

28
Q

Effects of acute MR?

A

Abrupt and excessive volume overload -> elevated L atrial and ventricular filling pressures, acute pulmonary edema

Unlike chronic MR, acute does not cause any significant change in L atrial or ventricular size and/or compliance

29
Q

General lab evaluation fo HTN (renal, endocrine, cards, other)

A

Serum lytes, Cr, UA, urine Albumin/Cr ratio

TSH, A1C, lipids

ECG, Echo (optional)

CBC, uric acid (optional)

30
Q

Recurrent bacterial infections in an adult should raise suspicion for ___. What is needed to establish the diagnosis?

A

CVID; quantitative measurement of serum Ig levels

31
Q

What is the only manifestation of Lyme disease that allows for clinical diagnosis without lab confirmation?

A

Erythema migrans

32
Q

___ is due to decreased exocrine output from the lacrimal and salivary glands. Decreased blink rates, oxidative damage, and use of anticholinergic medications can also contribute.

A

Age-related sicca syndrome

33
Q

Mechanism of hypoxemia in pneumonia?

A

Alveolar consolidation -> R to L intrapulmonary shunting (extreme V/Q mismatch, where V = 0)

34
Q

2 ways to improve oxygenation in MV patients?

A

Increase FiO2 or increase PEEP

35
Q

Features of obesity hypoventilation syndrome?

A

Obesity
Daytime hypercapnea (PaCO2 >45)
Alveolar hypoventilation

36
Q

Major risk factors for osteoporosis?

A

Advanced age
Post-menopausal
Low body weight

Modifiable - excessive alcohol intake, sedentary lifestyle, smoking

37
Q

The risk of fragility fracture is highest in what patients?

A

Those with prior history of fragility fracture

38
Q

Initial test for diagnosis and risk stratification in most patients with suspected stable ischemic heart disease?

A

Exercise stress ECG

Coronary angio if high-risk findings on initial stress test or those with high pre-test probability

39
Q

Define high pre-test probability of CAD.

A

Typical angina in men 40+ and women 60+

40
Q

Rx mucormycosis?

A

Surgical debridement
Anti-fungals (amphotericin B)
Elimination of promoting factors (Rx DM)

41
Q

Most effective emergency contraceptive method? Who can it be offered to?

A

Copper IUD; nulliparous women, adolescents

Contraindications - acute cervicitis, PID

Dedicated - Step 2 (22 decks)

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