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1
Q

Viral gastro in children diet

A

age appropriate with limited sugars and fat

* do not give antidiarrheal medication*

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2
Q

SGLT2 inhibitors

A

glucosuria->polyuria, UTI, candida

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3
Q

Diagnosing preg hyperthyroidism

A

TSH (trimester specific)

first: 0.1->2.5
second: 0.2->3
third: 0.3->3

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4
Q

HIV delivery
postpartum drug for baby
feeding

A

vaginal if VL <1000
zidovudine for >=6 weeks
formula in rich countries, breastfeeding in poor

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5
Q

Type II HIT

Type I HIT

A

autoantibodies against platelet factor 4, thrombocytopenia and thrombosis
mild, heparin-induced platelet clumping

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6
Q

Nelson’s syndrome

A

Cushing->bilat adrenalectomy->loss of feedback loop-> pituitary tumor with hyperpigmentation

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7
Q

somatic symptom disorder

A

preoccupation with 1 or more medically unexplained symptoms

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8
Q

Factorial

A

> = 2 interventions and all combinations of these interventions

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9
Q

Postop hypoventilation->hypercapnia, hypoxia

A

obstructive sleep apnea

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10
Q

DM statin
retinopathy screening

ACEI if

A

40-75 yo, LDL >70
annually from time of diagnosis for DMII
starting 5 years from diagnosis for DMI
hypertensive or nephropathy

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11
Q

tinea versicolor diagnosis

treatment

A

malessezia, KOH preparations showing yeast and hyphae

topical anti-fungal, if refractory-oral antifungal

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12
Q

Stress test=

A

exercise ECG (if ambulatory and no significant ECG changes)/ myocardial perfusion imaging/ dobutamine echo

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13
Q

breast cyst

A

biopsy if complex or bloody

simple: symptomatic: aspirate, if nonbloody-f/u u/s
asymptomatic: observe

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14
Q

Spiral fracture =

A

abuse

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15
Q

Rifampin in women

A

Don’t give to people taking OCPs.

use ceftriaxone/Cipro for meningitis prophylaxis

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16
Q

Hernia

A

surgery, don’t just observe

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17
Q

HIT with PE anticoagulation

A

direct thrombin

only start warfarin once platelets > 150k

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18
Q

HHS management

A

aggressive fluid resus, then insulin

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19
Q

Inguinal hernia complications

A

bowel ischemia or testicular atrophy

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20
Q

Panic disorder vs illness anxiety disorder

A

actual symptoms

immediate: benzo, long term: SSRI

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21
Q

Multiple regression analysis

A

removes confounders

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22
Q

Intrinsic mitral valve problem vs valve dysfunction due to LV

A

primary vs secondary

primary: LVEF <60% is considered impaired

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23
Q

First trimester hyperthyroidism

A

PTU

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24
Q

Syphilis treatment
Latent
Primary (chancre), secondary (rash)
tertiary (neuro, aortitis)

A

Any neuro symptoms->LP
3 doses of IM penicillin
1 dose of IM penicillin
10-14 days of IV penicillin
If allergic-doxy, ceftriaxone for tertiary
*febrile reaction to treatment is benign and cannot be prevented.

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25
Q

mass with concentric rings at anus

A

rectal prolapse->surgery

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26
Q

Trauma imaging

A

trumped by surgery if patient is unstable

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27
Q

Radiation induced cardiotox

A

valvular abnormalities, pericardial disease, diastolic dysfunction, coronary disease, restrictive cardiomyopathy

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28
Q

Cholangitis treatment

A

ERCP, IV antibiotics, treat sepsis

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29
Q

Anterior uveitis (iritis)

A

pain, redness, visual loss, constricted irregular pupil
leukocytes in anterior segment , hazy flare
increased IOP in acute glaucoma

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30
Q

Diagnosis of acute tension pneumo

A

bedside ultrasound: no lung sliding

nonacute-upright posterior anterior

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31
Q

Compartment syndrome complication

diagnosis

A

Rhabdo->renal failure
measurement of tissue pressures
if not improving, fasciotomy
predicting prognosis-surgical intervention

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32
Q

Maintain brain-dead organ donor

A

euvolemic, normotensive, normothermic

IV fluids, desmopressin, pressor

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33
Q

ulcerating papule that drains clear, odorless fluid

treatment

A

sporotrichosis

itraconazole

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34
Q

overlapping standard error of measurement bars

A

not statistically significant

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35
Q

deeply seated painless mass, high rate of recurrence, benign

A

desmoid tumor

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36
Q

caput succedaneum

A

scalp swelling above periosteum, crosses suture lines

benign

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37
Q

IRIS

A

transient worsening of infectious symptoms in HIV after initiation of HAART, self-limited
only discontinue HAART if life-threatening

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38
Q

hepatic encephalopathy can be triggered by overdiuresis

A

hypokalemia, hypovolemia, metabolic alkalosis

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39
Q

febrile UTI in children <24 mos

A

renal and bladder u/s
if abnormal/ recurrent infections-> voiding cystourethrogram
if reflux->prophylactic antibiotics

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40
Q

Organic ED

A

Screen for PAD, if positive also screen for CAD before Viagra

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41
Q

anaphylaxis treatment

A

IM epinephrine

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42
Q

Cocaine use can cause thrombosis. In persistent symptoms and EKG changes,

A

cath

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43
Q

Primary dysmenorrhea in non sexually active

Sexually active

A

NSAID

OCP

44
Q

Fever+ cough+ coryza+ conjunctivitis+ morbilliform rash face downwards

A

measles

give vitamin A

45
Q

extremely elevated opening pressure with molluscum skin lesions

treatment

A

crypto meningitis, indolent

amphotericin B + flucytosine till asymptomatic and sterile CSF-> oral fluconazole for 8 weeks->then lower dose fluc for a year, serial LPs (VP shunt if refractory)

46
Q

most reliable method for placement of ET tube

A

capnography, rectangular waveform with 4 phases

47
Q

Brain death diagnosis

A

Clinical criteria: hemodynamically stable, imaging, no confounding factors
Then neuro exam:
Then apnea testing

48
Q

confirm eradication of h. pylori with

A

urea breath or fecal antigen testing

49
Q

NNT

A

1/ARR

50
Q

blistering and severe itching

A

contact dermatitis

51
Q

acute dystonic reaction treatment

A

anticholinergics (benztropine) or antihistamines (Benadryl)

*dantrolene is for neuroleptic malignant syndrome

52
Q

presbycusis environment

A

noisy, distracting

53
Q

HIV non transmission body fluids

A

urine, tears, feces, vomit

54
Q

Postpartum blues vs depression

antidepressant

A

2 weeks

sertraline, paroxetine

55
Q

toxic shock syndrome mechanism

A

bacterial exotoxin->activation of T cells-> cytokines

56
Q

Most important factor in periop adverse drug events in the elderly

A

polypharmacy

57
Q

Hip fracture in elderly management

A

early surgery unless demented, nonambulatory or medically unstable

58
Q

strep pharyngitis treatment

A

penicillin or amoxicillin

59
Q

distal radius fracture due to

A

FOOSH

60
Q

rapid onset of papules with central umbilication and central hemorrhage/necrosis
treatment

A

cutaneous crypto, diagnosed by biopsy

IV amphoteric B and oral flucytosine, ff by a year of fluconazole

61
Q

Protective factors against suicide

A

connection to family, pregnancy, responsibility for children

62
Q

Valve INR

A

Aortic with no risk factors: 2-3

Aortic with high risk factors to form a clot and mitral: 2.5-3.5

63
Q

Bariatric surgery BMI

A

> 40 or >35 with complications

64
Q

fracture following ground level fall

A

get DEXA

treat if

65
Q

Fever, sore throat and malaise without URI symptoms

A

strep pharyngitis
10 days of penicillin to decrease symptom severity and duration, prevent spread to close contacts, prevent complications, acute rheumatic fever
*If history of rheumatic fever-long term abx

66
Q

Post ortho VTE ppx

A

8-12 hours post to 10 days

67
Q

acute limb ischemia surgery warranted

A

loss of pulses (audible/Doppler)

68
Q

PAD treatment

A

cards risk factor management->exercise->cilostazol->revascularization

69
Q

Sudden death after steering wheel injury

A

aortic injury

70
Q

Non purulent cellulitis org

A

strep pyogenes

71
Q

HIV lipodystrophy

A

dorsocervical fat acculumation, abdominal visceral fat, loss of fat in extremities
insulin resistance and dyslipidemia

72
Q

erythema at limbus, constricted pupil, blurred vision, moderate pain

A

anterior uveitis

73
Q

Prevent cluster headaches with
Acute cluster headache
Prevent migraines with

A

verapamil
autonomic eye symptoms, 100% oxygen by nonrebreather, intranasal sumatriptan
propanolol

74
Q

constitutional pubertal delay

Kallmann syndrome

familial short stature

A

delayed secondary sexual features, bone age, short stature, family history of late bloomers
anosmia, micropenis, hypogonadotropic hypogonadism, cryptorchidism
normal bone age

75
Q

polymyositis antibodies

diagnosis

A

ANA, anti Jo 1
screen for cancer
muscle biopsy
pulm complications including ILD-get PFTs, high res CT

76
Q

high suspicion of bacterial meningitis with negative gram stain and culture

A

treat

77
Q

acute epididymitis treatment

A

ceftriaxone + doxy

levoquin if e. coli suspected

78
Q

cleft lip surgery

recurrence risk

A

reconstruction at 10 weeks, 10 g of hgb, 10 lbs

10%

79
Q

CLL
dx
poor prognosis
survival

A

B cell leukemia
peripheral smear and flow cytometry
LAD, anemia, thrombocytopenia, organomegaly
10 years

80
Q

chronic myeloid leukemia

treatment

A

translocation of 9 and 22-> Philadelphia chromosome
bcr/abl
tyrosine kinase inhibitors, bone marrow transplant

81
Q

Preventing pregnancy

STI treatment in sexual assault

A

ulipristal
copper IUD is more effective (CI in cervicitis)
G/C, trich, HIV (up to 72 hours)

82
Q

treatment of herpes zoster
post exposure prophylaxis

infectivity

A

if rash for <72 hours, 7 days of valacyclovir
if immunized/history: nothing
not: vaccine within 5 days
immunocompromised/pregnant: immune globulin/ valacyclovir
till rash is dry, cover rash, avoid preg/babies/immunocomp

83
Q

untreated acromegaly

A

cardiovascular disease (reversible after treatment) and colon cancer, diabetes, respiratory problems

84
Q

Urgent treatment of depression

A

ECT, safe in pregnancy

85
Q

Dupuytren contracture

treatment

A

thickening of palmar tendons->contracture
elderly white males, DM, smoking ,drinking
modification of hand tools, aponeurotomy, CSI, surgery

86
Q

Subacute thyroiditis

treatment

A

post viral, fever, neck pain, tender goiter, elevated ESR
thyrotoxicosis due to release of thyroid hormone->low uptake on scan
self-limited, NSAIDs, beta blocker
if refractory-steroids

87
Q

RCC management

A

if within capsule-> partial nephrectomy

capsule to gerota’s fascia-> radical

88
Q

Chronic/recurrent sinusitis causes

A

smoke exposure, inadequate treatment, allergic rhinitis, structural abnormalities

89
Q

Prolonged bleeding in renal dysfunction treatment

A

desmopressin

90
Q

PSVT associated with

A

WPW (short PR, delta wave, wide QRS)

91
Q

Preeclampsia management

A

Labetalol/hydrazaline + mag for mother

then induce if >34 weeks

92
Q

Heart failure with preserved ejection fraction

A

CHF signs, getting adequate fraction of blood out, not enough due to diastolic failure, LVH, left atrial enlargement
marginal linear densities-kerley B lines-pulm edema
BNP inaccurate in obese (lower)

93
Q

Prevent fat embolism by

treatment

A

early immobilization and fixation of fractures

supportive care

94
Q

febrile nonhemolytic reaction after blood transfusion timeline
prevent by

A

1-6 hours

leukoreduce

95
Q

initial flaccid muscles and hyporeflexia, then spastic and hypereflexia+ sensory/motor loss

A

transverse myelitis

96
Q

Amiodarone warfarin

A

decrease warfarin dose by 25-50%

97
Q

strep pharyngitis treatment

A

penicillin or amoxicillin

98
Q

Refeeding (dextrose) in alcoholic

A

hypophosphatemia->rhabdo

99
Q

Bacterial conjunctivitis
treatment

complication

A

mucopurulent discharge, matting, conjunctival erythema
topical erythromycin, polymixin-trimethoprim drops, topical fluoroquinolone in contact wearers
keratitis (photophobia, impaired vision, sensation of foreign object)-refer to ophthalmologist

100
Q

Eczema exacerbations

A

topical steroids

101
Q

cystic fibrosis pna

A

cover MRSA and pseudomonas

pseudomonas (cefepime, amikacin, carbapenems, ceftazidime, tobramycin, certain fluoros, aztreonam, colistin)

102
Q

Suspected scleroderma lungs

A

PFTs to screen for pulm htn/ILD

103
Q

Warfarin INR management

A

<5: hold
5-9: low dose vitamin K
>9: high dose vitamin K
any bleeding: IV vitamin K, FFP, recombinant factor, prothrombin

104
Q

chronic prostatitis (chronic pain) vs chronic bacterial prostatitis

A

pyuria with no bactiuria vs bactiuria

105
Q

ADPKD htn

screening

A

ACEI

>18 yo, with family history, renal u/s

106
Q

hydrocephalus, intracranial calcifications, hepatomegaly, chorioretinitis, hearing impairment in baby

treatment

A

congenital toxo (cat feces, contaminated soil, undercooked meat)

pyrimethamine,sulfadiazine, folate

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