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6 Flashcards

1
Q

strongest risk factor for PID

A

multiple sexual partners

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2
Q

wide insignificant confidence interval due to

A

small sample size

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3
Q

case fatality rate

A

no. of people who die from specific condition

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4
Q

single rubbery mobile breast mass in young woman

tender solitary mass

A

fibroadenoma

breast cyst

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5
Q

Normal breasts +no hair+ no menses

diagnosis

A

androgen insensitivity syndrome

testes, no uterus, 46 XY, adult male levels of testosterone

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6
Q

RR

OR

A

risk of developing disease->observational

exposure and outcome

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7
Q

asymmetry in funnel plot

A

publication bias

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8
Q

Preggo exercise

A

no scuba diving or contact sports

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9
Q

Clozapine side effect

A

neutropenia, monitor ANC

used for refractory schizophrenia

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10
Q

Infantile pyloric stenosis imaging

Associated with abx

A

ultrasound

erythromycin, azithromycin (post exposure prophylaxis for pertussis)

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11
Q

Preggo TB treatment

A

no pyrazinamide

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12
Q

cat scratch disease treatment

A

azithromycin

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13
Q

chronic bacterial prostatitis

treatment

A

recurrent UTI symptoms, pain during ejaculation, GU pain for >3 months
6 weeks of Bactrim/Cipro

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14
Q

Diabetes diagnosis

A

symptomatic: HgbA1c> 6.5%, fasting glucose >126, glucose >200 after tolerance test ONCE
asymptomatic: must repeat

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15
Q

Hashimoto’s thyroiditis with rapid enlargement of thyroid

A

thyroid lymphoma

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16
Q

in skewed distributions what is the most valid measure of central tendency

A

median

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17
Q

quality adjusted life years vs disability adjusted life years

A

every yr of this life to blank year of full health vs

years of life lost and years lived with disability

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18
Q

Reticular rash with arthritis

A

parvovirus, ff URI

slapped cheek malar rash

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19
Q

Tourette is associated with ADHD and OCD.

treatment

A

antipsychotics, therapy

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20
Q

persistent hematuria with peripheral eosinophilia
diagnosis
treatment

A

schistosomiasis
urine sediment microscopy
praziquantel

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21
Q

surgical correction of spine

A

convexity>60

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22
Q

Apnea of prematurity vs periodic breathing

A

> 20s, resolves by 37 weeks vs 5-10s pauses and rapid breathing, resolves by 6 mos

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23
Q

IVC filter complications

A

recurrent DVT, IVC thrombosis

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24
Q

pressure ulcer

A

moist wound environment

debride devitalized tissue

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25
Q

paget disease of the bone

A

incidental, elevated alk phos, normal calcium

bone scan and bisphosphonate

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26
Q

Acute intermittent porphyria

A

elevated urinary porphobilinogen

acute psychosis, abdominal pain, family history

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27
Q

Congenital adrenal hyperplasia

treatment

A

21 hydroxylase deficiency: no cortisol/aldosterone, elevated 17 hydroxyprogesterone
ambiguous genitalia, hyponatremia, hyperkalemia, hypoglycemia, hypotensive shock
glucocorticoid, mineralocorticoid (hydrocortisone+fludrocortisone)

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28
Q

Meds that cause SIADH

A

SSRIs, carbamazepine, valproic acid

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29
Q

knee dashboard injury

A

posterior cruciate ligament

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30
Q

kappa statistic

A

inter-rater reliability

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31
Q

First degree relative with colon cancer or adenomatous polyps <60 yo or 2 at any age

A

screen at 40 yo

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32
Q

chronic cough in children

A

spirometry to test for asthma, CXR

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33
Q

abnormal puberty evaluation

A

measure hormones first-FSH, testosterone, LH

increased prolactin and TSH decrease GnRH

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34
Q

Parkinson diagnosis

treatment

A

bradykinesia (resistance to flexion) + ridigity/ tremor

pramipexole, levodopa+ entacapone later

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35
Q

speech development at 2 yo

A

> 50 words with 2 word phrases

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36
Q

Infected obstructing kidney stone

A

perc nephrostomy or ureteral stent placement

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37
Q

down’s syndrome heart

higher risk of

A

endocardial cushion defect

acute leukemia, Alzheimer, autism, ADHD, depression, seizures

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38
Q

FOOSH with decreased grip strength, ROM, tender anatomic snuffbox

complications

A

scaphoid fracture
if initial imaging negative, splint wrist and reimage in a week
if nondisplaced->cast, otherwise ortho

avascular necrosis and nonunion

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39
Q

abnormal sperm analysis

A

intrauterine insemination/ IVF

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40
Q

v fib/VT

PEA/ asystole

A

shock

do not shock (CPR and vasopressors)

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41
Q

metastatic cancer biopsy

A

metastatic site first (lymph nodes)

42
Q

Human bites org

A

eikenella corrodens

*consider tetanus

43
Q

central venous sinus thrombosis

A

gradually worsening headache, max in morning, increases with Valsalva
neuro symptoms 2/2 venous congestion
in spite of hemorrhage, treat with heparin

44
Q

pericardial calcifications in CXR

A

constrictive pericarditis

common complication of CABG

45
Q

CHF or COPD exacerbation pre op

A

treat and delay surgery

*stop smoking 4 weeks before

46
Q

Refractory celiac

A

dietary review, endoscopy

47
Q

shared headache, nausea, malaise, dizziness (flu-like)
diagnosis
treatment

A

CO poisoning
ABG with carboxyhemoglobin
high flow oxygen through nonrebreather

48
Q

RSV bronchiolitis complication

A

recurrent wheezing, avoid triggers of airway reactivity

49
Q

carotid artery stenosis <70% or 100%

medical management

A

no CEA

aspirin, statin

50
Q

sun protection

A

SPF 15 for everyday use
SPF 30 for outdoor work/recreation
15-30 mins before, reapply q2hours

51
Q

varenicline, buproprion CI

A

psych, seizures

52
Q

invasive squamous cell skin cancer management

A

surgery, cryotherapy, electrosurgery, radiation (in older patients who refuse surgery)

53
Q

Sydenham chorea

treatment

A

manifestation of acute rheumatic fever
emotional lability, irregular rapid jerking movements, facial grimacing, decreased strength, pronator drift
penicillin till adulthood, resolves

54
Q

Grief vs MDD

A

Thoughts of suicide revolve around dead person not hopelessness/worthlessness

55
Q

seborrheic dermatitis (dandruff) retreatment

A

weekly to prevent recurrence

56
Q

Clozapine side effect

A

neutropenia, monitor ANC

57
Q

pulm fibrosis on CXR and PPD

A

latent

fibrosis not active TB

58
Q

fetal growth restriction with reversed/absent end-diastolic flow

A

deliver

59
Q

DKA glucose on insulin drip

when to stop insulin drip
how to

A

Glucose <200 + anion gap= halve insulin rate, add dextrose to fluids
gap<12, glucose <200, bicarb>15, patient able to eat
start subq insulin, continue drip for 1-2 hours

60
Q

Febrile hemolytic reaction after transfusion

A

fever, flank pain, hematuria, DIC
stop and aggressively hydrate
ABO mismatch

61
Q

ocular melanoma management
diagnosis
treatment

A

asymptomatic, <10mm by 3mm->close f/u
ultrasound
radiotherapy

62
Q

SAAG < 1.1

A

cancer, TB, renal, pancreatitis, serositis

63
Q

Pancreatitis diagnosis

A

2 of the ff: characteristic pain/ amylase or lipase/imaging

labs, no imaging needed

64
Q

necrotizing fasc organism

treatment

A

GAS
blisters, severely tender, fever, hypotension, shock
urgent surgical debridement and abx (vanc+ clinda (for toxins)+zosyn/meropenem)

65
Q

positive stress test with high risk features

A

ST depression at low workload, ST elevation, ventricular arrhythmia-> CATH
positive stress test->aspirin, statin, beta blocker

66
Q

Primary CNS lymphoma in HIV prognostic factor (EBV)

treatment

A

CD4 count

radiation, steroids

67
Q

Adenomyosis treatment

A

progestins->hysterectomy

68
Q

Nonfunctioning pituitary adenomas usually from

treatment
prolactin-secreting adenomas

A

GnRH cells, alpha subunit increased, FSH and LH decreased
transphenoidal surgery
cabergoline
nonfunctioning pit adenomas may block pit stalk and hypothalamic inhibition of prolactin secretion

69
Q

Isoniazid + pyridoxine

A

to prevent neurotoxicity

pyrazinamide-hyperuricemia

70
Q

OCP CI

A

migraines with aura, BP > 160/100, >35yo who smoke >15 cigarettes/ day

71
Q

Rapidly spreading erythema with well-demarcated raised borders, tender, tense
treatment

A

erisypelas-strep pyogenes (GAS)

penicillin
abscess is fluctuant

72
Q

Skin colored small papules with indented centers

A

molluscum contagiosum-skin to skin contact

HIV testing

73
Q

Legg-Calve-Perthes

A

AVN of hip, deformity of femoral head

74
Q

Neonatal clavicular fracture

A

supportive care
x ray only
pin arm to chest

75
Q

Graves vs postpartum thyroiditis vs silent thyroiditis

A

hyperthyroidism

high uptake vs low uptake

76
Q

Preggo TB treatment

A

no pyrazinamide

77
Q

bisphosphonate FRAX

A

> 20% osteoporotic fracture, >3% hip

78
Q

Flu vaccine CI

A

no live for anyone, just IM inactivated
mild allergy to eggs-get it
severe allergy to eggs-get it in health setting
severe allergy to vaccine itself-only CI

79
Q

Croup

RSV

A

parainfluenza, barking cough, hoarseness, stridor

nasal congestion, rhinorrhea, apnea

80
Q

use of herbal supplements

A

document

81
Q

acute chest syndrome

treatment

A

new pulm infiltrate on CXR, fever, hypoxemia, chest pain, tachypnea
cephalosporin, macrolide, pain control, IV fluids

82
Q

Antidepressant trial

A 
6 weeks
if effective but intolerable->switch within class
if ineffective->switch class
83
Q

Atopic dermatitis of the face

A

topical tacrolimus

84
Q

Colonoscopy polyps

A

> 2 cm/carcinoma in situ: 2-6 months
Familial polyps: annual
otherwise 3 years

85
Q

Amiodarone thyroid

A

impairs T4->T3: self-resolves
thyroiditis with thyrotoxicosis: steroids
hypothyroidism: levothyroxine only

86
Q

Psychosis

A

rule out substances and medical causes first

87
Q

Delirium pharm vs physical restraints

A

Haldol first.

88
Q

hyperaldosterone

A

hypertension, hypokalemia->polyuria

89
Q

epistaxis

A

nasal pinching->topical vasoconstrictor for max of 3 days

90
Q

pseudohypoparathyroidism

hypocalcemia symptoms

A

end-organ resistance to pth
seizures, muscle cramping, calcifications, hyperreflexia, cataracts
*pth decreases phosphorus by renal excretion and increases calcium

91
Q

gout htn

A

ACEI/ARB (losartan)

92
Q

brain death reflexes

A

central should be gone, peripheral may be present

93
Q

Increased risk for spontaneous abortion

A

prior, advanced maternal age, extreme BMIs, substance abuse

94
Q

SIADH treatment

A

water restrict

95
Q

Hip OA in young adults and adolescents

A

Abnormal acetabular development

shallow hip socket with inadequate support of femoral head->accelerated wearing of cartilage

96
Q

eosinophilia in diarrhea

treatment

A

parasites
pulm->GI symptoms
albendazole

97
Q

Ecthyma gangrenosum

management

A

immunocompromised, pseudomonas bacteremia
rapid evolution of lesion->erythematous macule->papule->bullae->painless, gangrenous ulcer
blood, wound cultures, two medications sensitive to pseudomonas
*painful, neutrophilic->pyoderma gangrenosum

98
Q

Secondary hypertension in children, young adults

in older adults

A

renal parenchymal disease (nephrotic syndrome)

hyperaldosteronism, renal artery stenosis

99
Q

focal, glistening, white, mound-like lesions that extend into vitreous, painful eye, decreased visual acuity in patient on TPN

treatment

A

invasive candida (endophthalmitis)

systemic antifungal (amphotericin B), intra eye injection, vitrectomy

100
Q

Post chole diarrhea

A

excess bile salts
bind with cholestyramine
also seen with ileal resection/short bowel syndrome

101
Q

levothyroxine + OCPs

A

increased TBG->decreased thyroid hormone->increase dose

steroids and androgens cause the opposite

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