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4 Flashcards

1
Q

Alopecia areata

Tinea capitis

A

well-demarcated, non-scarred, round patches of hair loss, exclamation point hairs, history of autoimmune conditions, nail pitting

erythema, scaling, black dot alopecia, LAD

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2
Q

Early pubic hair growth + acne with no testicular enlargement

only pubic hair with normal bone age

A

congenital adrenal hyperplasia, dx: ACTH stimulation test, elevated 17-hydroxyprogesterone, tx: hydrocortisone
idiopathic premature pubarche

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3
Q

painful oral ulcers+ rash on palms/soles/buttocks, nonitchy

HSV6

A

hand-foot-mouth disease, coxsackie virus, supportive care

roseola, rash after high fever

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4
Q

Chronic adrenal insufficiency electrolytes

A

hyponatremia, hyperkalemia, hyperchloremic metabolic acidosis
decreased hair, myalgia

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5
Q

chronic pancreatitis pain meds

A

TCAs, NSAIDs, pregabalin, conservative measures first

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6
Q

Pyelo in child

A

antibiotics before imaging

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7
Q

Pyelo in child

A

antibiotics before imaging

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8
Q

Antidepressant trial

A

6 weeks before adjusting

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9
Q

Loss of antidepressant response

A

substance use

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10
Q

post exposure HIV prophylaxis

A

triple therapy within 72 hours for 4 weeks

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11
Q

webbed neck, congenital lymphedema, high arched palate

A

Turner (random error (nondisjunction) resulting in one X, no increased risk of recurrence)
evaluate for coarctation, horseshoe kidney, celiac, hypothyroidism

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12
Q

premalignant complication of GERD

A

Barrett’s esophagus

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13
Q

PMS, increased risk for

A

mood and anxiety disorders

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14
Q

Acute heart failure that doesn’t respond to diuretics

A

vasodilator (nitroglycerin)

  • give before diuretics in flash pulm edema due to hypertension*
  • no digoxin in acute heart failure*
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15
Q

pelvic organ prolapse

A

bleeding due to erosions, treat erosions with estrogen

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16
Q

pruritic excoriated lichenified plaques

A

allergic contact dermatitis

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17
Q

exercise induced amenorrhea complications

A

osteoporosis, breast and vaginal atrophy, mild hypercholesteremia, infertility

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18
Q

febrile illness+ rash+ mucocutaneous ulcer+ leukopenia + thrombocytopenia

A

acute HIV

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19
Q

eisenmenger (unrepaired VSD->pulm htn->R to L shunt) pregnancy

A

abort

*also LVEF<40%, Class III-IV heart failure, aortic dilation>40 mm

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20
Q

if distribution tail is on the right side

if symmetric

A

median < mean and vice versa

median=mean=mode

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21
Q

stuck on lesions

A

seborrheic keratosis-do not treat unless symptomatic

itchy ones associated with GI/lung malignancies

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22
Q

iron deficiency in babies

A

cow’s milk, limit milk, rec count will rise before H/H

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23
Q

iron deficiency in babies

A

cow’s milk, limit milk, rec count will rise before H/H

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24
Q

Antiepileptics can reduce efficacy of OCPs

A

not gabapentin/ valproate

IUD/ implant preferred

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25
Q

vertigo, hearing loss, tinnitus

A

Meniere’s disease

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26
Q

Parinaud’s syndrome (no pupillary reaction, vertical gaze paralysis, no optokinetic nystagmus, ataxia)

A

pineal tumor (some secrete hcg)

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27
Q

valproic acid pregnancy

A

neural tube defects

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28
Q

Mini-mental state exam will not distinguish

late life depression linked to increased risk of

A

pseudodementia from dementia

Alzheimer, vascular dementia

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29
Q

when informing about involuntary hospitalization

A

acknowledge feelings, treatment in a safe environment

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30
Q

constructional (can’t draw) and dressing apraxia
aphasia
acalculia, finger agnosia, agraphia

A

nondominant parietal lobe
dominant temporal lobe
dominant parietal lobe (gerstmann syndrome)

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31
Q

Kawasaki

scarlet fever (strep)

A

febrile >5 days + 4/5: rash, LAD, mucosal changes, conjunctivitis, extremity erythema/edema
if not all criteria met-obtain CRP/ESR, reexamine
tx: IVIG (no live vaccines for a year), aspirin, echo at presentation and 2 and 6 wks

circumoral pallor, sandpaper rash, strawberry tongue

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32
Q

better test in study->higher power

A

better at establishing difference

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33
Q

honey colored crust

A

impetigo

tx: topical mupirocin, cephalexin

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34
Q

polymyalgia rheumatica

A

pain and stiffness in shouders, pelvic girdle

dx: ESR, tx: low dose prednisone

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35
Q

isolated elevated anti-Hbc

A

repeat serologies, measure IgM anti-Hbc and LFTs to determine acuity

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36
Q

Transfusion related acute lung injury long term

A

neurocognitive deficits, impaired muscle strength and lung function, psychiatric illness

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37
Q

Pericarditis EKG
pericarditis vs dressler syndrome
persistent ST elevation and q waves in same leads weeks post MI
post MI pericarditis treatment

A

Diffuse PR depression, ST elevation
days post Mi vs weeks
ventricular aneurysm

high dose aspirin, colchicine, narcotics

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38
Q

TSH secreting pituitary adenoma

thyroid resistance syndrome

A

elevated TSH and thyroid hormone levels, elevated alpha subunit, increased sex hormone binding globulin
tx: somatostatin analog, transsphenoidal surgery
normal alpha subunit and sex horm binding globulin

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39
Q

subclinical thyrotoxicosis

A

decreased TSH, normal thyroid hormone

40
Q

meralgia paresthetica

A

entrapment of lateral femoral nerve, lose weight, avoid tight fitting garments

41
Q

meralgia paresthetica

A

entrapment of lateral femoral nerve, lose weight, avoid tight fitting garments

42
Q

Pheo treatment

hypertensive crisis
cardiac tachyarrhythmias

A

alpha blockers after testing->imaging-> if negative, MIBG scan
optimize alpha blockade (10-14 days) and volume status before surgery

nitroprusside, phentolamine
esmolol, lidocaine

43
Q

perioral numbness, muscle cramps, twitching post massive transfusion

A

serum calcium will be normal

obtain ionized calcium

44
Q

gradual onset of fever, cough, extreme dyspnea/hypoxia, tachypneic with diffuse rales in immunocompromised

A

PCP, prevent with Bactrim

45
Q

Babies should walk by

A

16 months

46
Q

Insomnia therapy

A

CBT

47
Q

parathyroidectomy in hyperparathyroidism if

MEN 1

A

symptomatic/ urinary calcium >400/ end-organ complications/ <50 yo
calcitonin is for medullary thyroid cancer

pituitary, parathyroid, GI tumor

48
Q

splenic rupture treatment

A

supportive care

if do not improve-e lap

49
Q

Kleuihuaer-Betke test

A

detect abruptio placentae after trauma in order to give Rho-D

50
Q

Enterococcus

A

vanc, ampicillin

51
Q

primordial prevention

quarternary prevention

A

prevention of risk factors

prevent unnecessary interventions

52
Q

complex regional pain syndrome

A

allodynia, burning, edema, skin changes, decreased ROM after joint injury
tx: nerve block/ IV anesthesia

53
Q

standardized incidence ratio

A

for cancer

observed cases in population/ expected cases in gen pop

54
Q

Most effective contraception

A

implant (can cause headaches, weight gain and unscheduled bleeding)

55
Q

Tympany post lap surgery

post op urinary retention due to

A

due to insufflation of air, self-resolves

anesthesia and fluid resus, foley, voiding trial in a week

56
Q

Do not biopsy ovarian mass

pregnancy ovarian mass

A

remove in 2nd trimester, chemo can be given

57
Q

premature coronary athero in young women

A

lupus

leading cause of lupus death: heart

58
Q

ferritin < 30

target cells

A

iron deficient

thalassemia

59
Q

grapy vagina

blind vaginal pouch

A

sarcoma botyroides in childhood or infancy

mullerian agenesis

60
Q

HIV vaccines

A

pneumo, hepatitis, no live vaccines

61
Q

opioid withdrawal treatment

A

methadone/buprenorphine in controlled settings

otherwise clonidine

62
Q

lichen planus

A

skin, nails, mucous membranes, external genitalia
shiny, discrete, pruritic, violaceous plaques and papules on flexural surfaces, wrists
white lacy striae
punch biopsy
associated with hepatitis C liver

63
Q

24-28 weeks preg testing

A

cbc, 50g glucose tolerance test (if +-100 g 3 hour test)

if rh-d negative, antibody screening

64
Q

epidural contraindication

A

platelets <70k

65
Q

chronic hypopth treatment

A

vitamin d, calcium, thiazide if high urinary calcium

66
Q

TB pleural effusion

A

lymphocytic, exudative, elevated adenosine deaminase

biopsy-granulomas

67
Q

Neonatal polycythemia

A

hematocrit >65% in peripheral draw
glucose, fluids
if refractory-partial exchange transfusion

68
Q

NPH treatment

A

lumbar tap test

if improvement-VP shunting

69
Q

Acute uterine bleeding

A

stable-OCPs with high dose estrogen

D&C if unstable/ VTE/ refractory

70
Q

Any sharp object in esophagus

A

urgent flexible endoscopy

71
Q

Contraception with clots

A

CI for estrogen, not progestin
progestin also decreases bleeding
copper IUD associated with more bleeding

72
Q

Antiphospholipid antibody syndrome testing

A

lupus anticoagulant, anticardiolipin antibody, anti beta2 glycoprotein 1 antibody

73
Q

torsades de pointes

A

hypocalcemia, hypomagnesemia, hypokalemia
long QT syndrome
-> v fib -> death
give IV mag, if refractory-transvenous pacing

74
Q

odds ratio

A

odds of exposure in case group/ odds of exposure in control group

75
Q

OSA can cause mild cognitive impairment in elderly

A

don’t need daytime sleepiness

76
Q

henoch-schnonlein purpura

A

preceding URI
pediatric vasculitis from IgA deposition
abd pain and nausea due to intussusception, arthralgia, renal insufficiency, self-resolves
HUS follows bloody diarrhea

77
Q

fever in a traveller

A

<10 days: typhoid, dengue, chikungunya, influenza, legionellosis
1-3 weeks: malaria, typhoid, leptospirosis, schitosomaniasis, rickettsial
>3 weeks: TB, leishmania, enteric parasites

78
Q

young woman, 2 UTIs in 6 months or 3 in a year

A

antibiotic ppx with Bactrim, fluoros, nitrofurantoin

79
Q

Treat subclinical hypothyroidism if

A

anti-TPO antibodies, abnormal lipid profile, symptomatic, ovulatory and menstrual dysfunction

80
Q

drugs that cause hypercalcemia

A

thiazides, lithium

81
Q

feeding goal

A

30 kcal/kg/day and 1g/kg/day of protein

lower if fear of refeeding syndrome

82
Q

tamponade echo

A

early diastolic collapse of RV and right atrium

83
Q

severe aortic stenosis

A

low intensity, single second heart sound during inspiration (no split S2), delayed and diminished carotid pulse, loud and late peaking systolic murmur
*AR- wide pulse pressure (volume)

84
Q

cardiotoxic chemo monitoring (-rubicin)

A

radionuclide ventriculography/MUGA (measures EF)
EF <50%-reduce dose
<30% or more than 10 point decrease-discontinue

85
Q

hepatic adenoma in young woman

A

OCP
well-demarcated lesion with peripheral enhancement when contrast is injected
asymptomatic-discontinue OCP, serial imaging, AFP
>5 cm-resect
uniform enhancement-focal nodular hyperplasia

86
Q

Dementia workup

A

CBC, CMP, TSH, vitamin b12, folate, syphilis, vitamin D

87
Q

Immune thrombocytopenia treatment

A

isolated thrombocytopenia, antiplatelet antibodies
IVIG/steroids if platelet count <30K with mucosal bleeding
BTW, negative direct antiglobulin test

88
Q

Long term maintenance of sinus rhythm when rate control fails

A

Rhythm control: amiodarone, dofetilide

89
Q

psoriatic arthritis treatment

A

methotrexate

skin-high potency topical steroids, ultraviolet light therapy

90
Q

post MI sex

A

high risk/ intermediate risk patients (refractory angina, significant valve disease, arrythmia, class IV heart failure) should undergo testing/assessment

91
Q

Tachycardia in asthma exacerbation

A

not CI for SABA use

Mg in severe exacerbation-PEF <40% of baseline/ refractory

92
Q

Carbamazepine side effects

A

SIADH, neutropenia, bone marrow suppression, anticholinergic effects

93
Q

Akathisia treatment

A

propranolol

94
Q

Rabies

treatment

A

hydrophobia

immunized: booster (2 doses)
nonimmunized: immunoglobulin + vaccine (4 doses)

95
Q

Exercise CI in pregnancy when

A

cerclage, active vaginal bleeding, placenta previa, increased risk for preterm birth, preeclampsia, heart/lung issues

96
Q

Prevent AAA expansion

A

smoking cessation

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