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Step 2 DIT 😱 > 3, 4, 5 Star topics 4 > Flashcards

3, 4, 5 Star topics 4 Flashcards

1
Q

CYP450 inducers (3)

A 
Ken(ytoin) Rides Shotgun in Barbie's Girl Car
Phenytoin
Rifampin
St. John's wort
Barbiturates
Griseofulvin
Carbamazepine
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2
Q

Medications that reduce OCP effectiveness (3)

A

Rifampin (griseofulvin lesser)
Antiepileptics including phenobarbital
St. John’s wort

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3
Q

Suspicious findings on mammogram (5)

A

Hyperdense regions

Microcalcifications

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4
Q

PE findings in breast cancer (5)

A

Solid, immobile* breast lump
Peau d’orange (lymphedema and skin thickening)
Nipple retraction (new)
Skin dimpling
Axillary lymphadenopathy (poor prognosis)

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5
Q

MC breast cancer, MC site (5)

A

Ductal (80%) > Lobar (20%)
Infiltrating ductal is MC
Upper outer quadrant is MC site

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6
Q

Breast cancer in unilateral ducts w/o stromal invasion (5)

A

Ductal carcinoma in situ (DCIS) (pre-malignant)

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7
Q

Breast cancer in lobules w/o stromal invasion, can be multifocal and/or bilateral (5)

A

Lobular carcinoma in situ (LCIS)

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8
Q

Breast cancer in ducts w/ invasion and fibrotic response (5)

A

Infiltrating ductal carcinoma

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9
Q

Breast cancer in lobules w/ infiltration and some fibrotic response, frequently b/l or multifocal (5)

A

Infiltrating lobular carcinoma

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10
Q

Ductal breast carcinoma w/ rapid progression and angioinvasion, poor prognosis (5)

A

Inflammatory carcinoma (can mimic multiple mastitis)

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11
Q

Eczema-like patches on nipple and areola (5)

A

Paget’s disease of breast (suggests underlying DCIS)

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12
Q

DCIS treatment (5)

A

Lobectomy +/- radiation

Masectomy if high risk

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13
Q

LCIS treatment (5)

A

Observation + tamoxifen or raloxifene (all LCIS is ER+ and PR+)
Can do prophylactic bilateral masectomy (higher risk of invasive cancer overall than DCIS)

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14
Q

Invasive breast cancer treatment (5)

A

Lumpectomy (early focal cancers)
Masectomy (multifocal or prior breast radiation)
+Radiation (>5 cm)
Sentinal LN biopsy (axillary node dissection if +)
Systemic therapy (chemo/hormones) for LN+, size >1 cm, aggressive histology

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15
Q

Hormonal testing and treatment for breast cancer (5)

A

Test all breast cancers for estrogen and progesterone receptors (tamoxifen, raloxifene)
And for HER-2-neu receptors (trastuzumab)

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16
Q

Common breast cancer mets (5)

A

Bone, thoracic cavity, brain, liver

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17
Q

Developmental milestones at 2 months (4)

A

Social smile
Lifts head 45 degrees
Eyes follow object to midline
Coos

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18
Q

Developmental milestones at 4 months (4)

A

Laughs, aware of caregiver, localizes sound
Lifts head 90 degrees
Eyes follow object across midline

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19
Q

Developmental milestones at 6 months (4)

A

Differentiates parents, stranger anxiety
Rolls over, holds self up with hands, sits w/o support
Grasps/rakes, attempts to feed self
Babbles

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20
Q

Developmental milestones at 9 months (4)

A

Interactive games, separation anxiety starts
Crawls, pulls to stand
Grasps with thumb
First words

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21
Q

Developmental milestones at 12 months (4)

A

Separation anxiety continues
First steps, walks w/ help
Pincer grasp, tower of 2 blocks
~2-10 word vocabulary

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22
Q

Developmental milestones at 18 months (4)

A

Parallel play
Walks well, walks backward
Tower of 4 blocks, uses cup/spoon
10-50 word vocabulary, 2 word sentences

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23
Q

Developmental milestones at 2 years (4)

A

Dresses self w/ help
Runs, climbs stairs
Tower of 6 blocks
50-75 word vocabulary, 2-3 word sentences

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24
Q

Developmental milestones at 3 years (4)

A

Magical thinking
Climbs and descends stairs, jumps w/ 2 feet
Tower of 9 blocks, can draw circle
Dresses self

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25
Q

Developmental milestones at 4 years (4)

A

Plays with others
Hops on 1 foot
Able to draw line image, closed line drawing
250+ word vocab, 4 word sentences

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26
Q

Developmental milestones at 6 years (4)

A

Can distinguish fantasy from reality
Skips
Draws a person
Fluent speech

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27
Q

Neonate spider webbing/marbling of skin (3)

A

Cutis marmorata (not concerning)

28
Q

Neonate 2-3 mm yellow pustule w/ red base (looks like whiteheads) in first 24-72 hrs, numerous eosinophils (3)

A

Erythema toxicum neonatorum (self-limiting by 3 weeks)

29
Q

Neonate reddening of gravity-dependent side and blanching of nondependent side w/ line of demarcation, most common in first few days of life (3)

A

Harlequin color change (self-limiting in days to 3 weeks)

30
Q

Neonate vascular malformations MC on nape of neck, upper eyelids and middle of forehead (reddish areas) (3)

A

Macular stains (stork bites) (benign but permanent)

31
Q

Neonate pustules due to accumulation of sweat beneath ducts obstructed by keratin, usu in 1st week, associated w/ excess warmth (3)

A

Milia (no treatment, maybe loose clothing and cool baths)

32
Q

Neonate bluish discoloration over buttocks and base of spine, probably also present in 1 of parents (3)

A

Mongolian spot (benign, usu fades in 1-2 years, needs documentation to avoid confusion w/ bruises later)

33
Q

Neonatal acne age of onset (3)

A

Usu 3 weeks (will resolve in 4 months, can use benzoyl preoxide or topical retinoids on severe cases)

34
Q

Infantile acne age of onset and presentation (3)

A

Usu 3-4 months, yellow papules around nose and cheeks (usu resolves by age 1, may last til 3, can use benzoyl preoxide or topical retinoids on severe cases)

35
Q

Neonate superficial pustules overlying hyperpigmented macules (3)

A

Transient neonatal pustular melanosis (self-limiting)

36
Q

Cough + coryza + conjunctivitis + Koplik spots + red, maculopapular rash (lasts 4-5 days, darkens) starting at head and spreading to feet 3-5 days later (4)

37
Q

Malaise, fever, anorexia + red, tender maculopapular rash (lasts 5 days, doesn’t darken) starting at face then spreading 1-5 days later + suboccipital and posterior cervical lymphadenopathy (4)

A

Rubella (German measles)

38
Q

“Sandpaper-like” “sunburn-like” coarse, red, blanching rash, starts on trunk and spreads, sparing hands and feet + strawberry tongue, beefy-red pharynx and cervical LAD (4)

A

Scarlet fever, strep pyogenes

39
Q

Causes of desquamation of hands and feet in kids (4)

A

Scarlet fever
Kawasaki disease
TSS
Mercury poisoning

40
Q

Oral vesicles + small, tender maculopapular/vesicular rash on hands and feet that lasts 3-5 days (4)

A

Coxsackie hand, foot and mouth disease

41
Q

Sudden high fever (>102) x3-4 days then rash starting on trunk and spreading over body x24 hrs w/ erythematous papules on soft palate and uvula, edematous eyelids (4)

A

Roseola infantum (HHV-6)

42
Q

Acute, bilateral cervical LAD in children (4)

A

Usu viral
URI: rhinovirus, adenovirus, influenza, GAS
Mono: EBV, CMV, mycoplasma
HIV, HSV

43
Q

Acute, unilateral cervical LAD in children (4)

A

Usu bacterial

S. aureus, GAS > anaerobes, GBS

44
Q

Chronic, unilateral cervical LAD in children (4)

A

Bartonella henselae
Toxoplasmosis
TB
Actinomyces israeli (sinuses drain pus)

45
Q

Noninfectious (rare) causes cervical LAD (4)

A

Kawasaki disease

Hodgkin’s lymphoma

46
Q

Fever + aphthous ulcers + pharyngitis + adenitis every 28 days with NO neutropenia, cough, coryza, diarrhea, abdominal pain, rash, arthritis, neuro deficits (4)

A

PFAPA syndrome (benign, self-limiting, avg duration 4.5 years)

47
Q

7-10 day incubation + 7-10 day mild URI + 1-6 week paroxysmal cough often worse at night (4)

48
Q

Pertussis treatment (4)

A

Azithromycin, other abx

49
Q

Boy w/ recurrent bacterial infections, no B cells on peripheral smear, low levels all Igs (4)

A

Bruton agammaglobulinemia (X-linked B cell deficiency w/ defective tyrosine kinase)

50
Q

Recurrent viral, fungal, protozoal infections w/ congenital heart/great vessel defect and hypocalcemia (4)

A

Thymic aplasia (DiGeorge syndrome) (3rd and 4th pouches fail to develop -> no thymus or PTH)

51
Q

Severe recurrent infections (including candidiasis, PCP, viral) + chronic diarrhea + failure to thrive + no thymic shadow (4)

A

SCID (multiple causes inc. adenosine deaminase deficiency) - NO LIVE VACCINES

52
Q

Recurrent candida albicans infections (4)

A

Chronic mucocutaneous candidiasis (T-cell dysfunction)

53
Q

Treatment chronic mucocutaneous candidiasis (4)

A

Antifungals (-azoles)

54
Q

Recurrent pyogenic infections + thrombocytopenia and purpura + central eczema (4)

A

Wiskott-Aldrich Syndrome

55
Q

Wiskott-Aldrich syndrome s/sx (4)

A 
WAITER
Wiskott
Aldrich
Immunodeficiency
Thrombocytopenia and purpura
Eczema (more trunk than extremities)
Recurrent pyogenic infections
56
Q

Cerebellar ataxia + poor smooth pursuit of moving target with eyes + facial telangiectasias > 5yo + increased AFP >8 months (4)

A

Ataxia-Telangiectasia (IgA deficiency; increased risk lymphoma and leukemias, radiation sensitivity; avg age of death = 25 years)

57
Q

Recurrent sinus and lung infections + atopy or asthma + possibly European descent + transfusion anaphylaxis (4)

A

IgA deficiency

58
Q

Recurrent S. aureus, E. coli, Klebsiella, Aspergillus, Candida infections w/ negative nitroblue tetrazolium test (4)

A

Chronic granulomatous disease (lack of NADPH oxidase activity -> impotent phagocytes)

59
Q

Treatment chronic granulomatous disease (4)

A

Prophylactic TMP-SMX

IFN-gamma

60
Q

Catalase + organisms (4)

A 
CGD patients susceptible to these
S. aureus
E. coli
Klebsiella
Aspergillus
Candida
61
Q

Partial albinism + recurrent respiratory and skin infections + neurologic disorders (peripheral neuropathy, seizures, etc) (4)

A

Chediak-Higashi disease (defective LYST gene -> defective lysosomal transport)

62
Q

Diagnostic for Chediak-Higashi disease (4)

A

Giant cytoplasmic granules in PMNs (defective phagocyte lysosomes)

63
Q

Eczema + recurrent cold S. aureus abscesses + coarse facial features (broad nose, frontal bossing, deep set eyes, “doughy” skin) + retained primary teeth (4)

A

Hyper IgE syndrome (Job syndrome) (deficient IFN-gamma -> impaired neutrophil chemotaxis -> high IgE and eosinophils)

64
Q

Delayed separation of umbilical cord (4)

A

Leukocyte adhesion deficiency syndrome (abnormal integrins -> phagocytes can’t exit circulation)

65
Q

Female w/ short stature, infertility, neck webbing (4)

A

Turner syndrome (45 XO)

66
Q

MCC primary amenorrhea (4)

A

Turner syndrome (45 XO)

67
Q

Cardiac abnormality associated w/ Turner syndrome (4)

A

Coarctation of aorta

Step 2 DIT 😱 (23 decks)

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