ACP 2017 Flashcards
1
Q
GI: Most common congenital malformation of the gastrointestinal tract
A
Meckles diverticulum
2
Q
GI: Condition associated with periodic acid-Schiff-positive macrophages and negative acid-fast stain
A
Whipple disease
3
Q
GI: SAAG and ascitic protein concentration thresholds associated with constrictive pericarditis
A
SAAG ≥ 1.1
Protein ≥ 2.5 g/dL
4
Q
GI: A typically transient anemia complication of TIPS
A
Hemolytic anemia
5
Q
GI: Antibiotic most commonly responsible for drug-induced liver disease
A
Amoxcillin-clavulaunate
augmentin
6
Q
ID: Enterohemorrhagic E. coli (EHEC) can produce this toxin
A
Shiga toxin
7
Q
ID: CDC prefers IGRA over tuberculin skin testing in patients with this medical history
A
BCG vaccination
accept BCG treatment
8
Q
P: INR range for treatment of pulmonary embolism
A
2.0-3.0
9
Q
P: Diagnosis in ventilated patient for hypotension, decreased left breath sounds and left deviated trachea
A
R mainstem bronchus intubation
10
Q
P: acid base disturbance in malignant hyperthermia
A
Respiratory acidosis
11
Q
P: Liver condition that may result in brown pleural effusion
A
Amebic abscess
12
Q
P: Most common antecedent of critical illness polyneuropathy
A
sepsis
13
Q
HO: most pts at risk for leukostasis also at risk for…
A
TLS
14
Q
HO: playing this musical instrument is classically associated with intravascular hemolysis
A
bongo drum
15
Q
HO: Two diagnoses most commonly accounting for acute fall in hemoglobin in patients with sickle cell anemia
A
aplastic anemia
hemolytic crisis
16
Q
HO: Definitive treatment for porphyria cutanea tarda
A
Phlebotomy
17
Q
HO: Giant hemangiomas can be associated with this coagulation disorder syndrome
A
DIC
18
Q
HO: Eponym for hereditary nonpolyposis colorectal cancer
A
Lynch syndrome
19
Q
HO: Standard initial therapeutic approach for patients with metastatic prostate cancer
A
Androgen deprivation therapy
20
Q
HO: Histological stain used to diagnose AL amyloidosis
A
congo red stain
21
Q
HO: mutation in non-small cell lung cancers predicts favorable response to specific tyrosine kinase inhibitors
A
EGRF activating mutation
22
Q
HOP: Cancer suggested by positive immunostaining for chromogranin A or synaptophysin
A
neuroendocrine carcinoma
(accept: - small cell lung cancer
- carcinoid
- islet cell tumor)
23
Q
R: quotidian fevers, arthritis, an evanescent rash and markedly elevated serum ferritin concentrations
A
adult stills
24
Q
R: Besides the sun, common source of UVB radiation that may result in photosensitive reactions
A
flurescent light bulbs
25
R: Condition associated with pain at the radial side of the wrist during pinch grasping or during thumb and wrist movement
De Quervain’s tenosynovitis
26
R: two most common ocular syndromes associated with giant cell arteritis
Amaurosis fugax
| Anterior ischemic optic neuropathy
27
E: 2 test to eval amenorrhea after pregnancy test
FSH
| prolactin
28
E: Precise time of day for testosterone measurement in evaluation of hypogonadism
0800 AM
29
E: Specific diagnostic antibody associated with Graves disease
Thyroid stimulating hormone receptor antibody
30
E: All normotensive patients with adrenal incidentaloma are screened for these 2 endocrine disorders
Pheochromocytoma
| Cushing syndrome
31
E: Diagnosis for bone fragility and dentinogenesis imperfecta
osteogenesis imperfecta
32
N: Autosomal dominant disorder causing benign hematuria
Thin basement membrane disease
33
N: Surgical procedure associated with oxalate nephropathy
gastric bypass
34
N: Preferred statin for patients on dialysis for end-stage kidney disease
NONE!!!
35
N: Most common disease cause of proximal RTA (Fanconi's syndrome) in adults
Monoclonal gammopathy
(accept - multiple myeloma
- amyloidosis
- light chain disease)
36
HO: Classical presentation is painless localized cervical lymphadenopathy
hodgkin lymphoma
37
HO: Preferred drug class for postmenopausal women with HR-positive early stage breast cancer
aromatase inhibitor
38
HO: +S100
melanoma
39
HO: renal side effect of EGFR inhibs
proteinuria
| accept HTN
40
HO: RANKL
denosumab
41
ID: Indication for infective endocarditis prophylaxis following cardiac transplantation
Valvulopathy
42
ID: two most important human ehrlichial diseases
Human monocytic ehrlichiosis
| Human granulocytic anaplasmosis
43
ID: Acute febrile reaction, headache and myalgia within the first 24 hours of erythema migrans treatment
Jarisch-Herxheimer reaction
44
ID: Interval following Td vaccination appropriate for Tdap vaccination
Anytime!
45
ID: L. monocytogenes meningitis treatment in penicillin allergic patient
TMP-SMX
46
NR: Most common presenting severe symptom of diabetic amyotrophy
pain
47
NR: Most effective drug treatment for trigeminal neuralgia
Carbamazepine
48
NR: Tremor that occurs exclusively with writing
Primary writing tremor
49
NR: Ice-pack test is associated with this autoimmune neuromuscular disorder
Myasthenia gravis
50
P: Specific quantitative criterion represented by R in the CURB-65 score
RR > 30
51
P: High resolution CT shows diffuse, homogeneous, < 1cm diameter thin-walled cysts
Lymphangioleiomyomatosis
(accept LAM)
Lymph - angio - leio - myo - matosis
52
P: Pulmonary artery wedge pressure required for a diagnosis of pulmonary arterial hypertension
= 15 mm Hg
53
P: pleural fluid TB test
adenosine deamianse
| ADA
54
C: 2 most common structural diseases a/w syncope
HOCM
| AS
55
C: Statin therapy decreases risk of this post-CABG arrhythmia
A-fib
56
C: Condition associated with rising venous pressure, falling arterial pressure, and decreased heart sounds
Pericardial tamponade
57
C: Cardiac condition associated with Carney complex
Atrial myxoma
58
R: SLE skin diagnosis responsible for the "butterfly rash" (malar rash)
Acute cutaneous lupus erythematosus
59
R: noninflammatory disease associated with calcification and ossification of spinal ligaments and of peripheral entheses
Diffuse idiopathic skeletal hyperostosis (DISH)
60
R: entrapment of the median nerve in the proximal forearm where it passes through the pronator teres muscle
Pronator teres syndrome
61
R: ENT complication shared by primary atrophic rhinosinusitis, relapsing polychondritis, and granulomatosis with polyangiitis
Saddle nose deformity
62
E: Antibody predicts poor response to oral hypoglycemic drug therapy
Anti-GAD (glutamic acid decarboxylase) antibody
| also accept islet cell antibody [ICA]
63
E: Next diagnostic step for thyroid nodule associated with low TSH
```
Thyroid scintigraphy
(accept iodine or technetium scan or nuclear scan)
```
64
E: Q: Enhanced susceptibility to statin-associated myopathy occurs in patients with this endocrine disorder
hypothyroidism
65
HO: Q: Diagnosis suggested by aquagenic pruritus and elevated hematocrit
PV!
66
HO: Q: Condition associated with "Waring blender syndrome" causing fragmentation hemolytic anemia
Malfunctioning mechanical prosthetic valve
| accept prosthetic valve, paravalvular leak
67
HO: Hydroxyurea therapy in sickle cell disease increases this hemoglobin type
Hemoglobin F
68
HO: Thalassemia diagnosis associated with 90% hemoglobin A and elevations of A2 and F
Beta thalassemia minor
69
HO: Preferred treatment for RBC transfusion-dependent deletion 5q syndrome
Lenalidomide
70
N: Which renal tubular disorder is associated with impaired ammoniagenesis
Type 4 renal tubular acidosis
| accept hyporeninemic hypoaldosteronism
71
N: Gi procedure a/w acute phosphate nephropathy
Colonoscopy
| accept sodium phosphate bowel prep for colonoscopy
72
N: Most common pattern of glomerular injury associated with hepatitis C infection
Membranoproliferative GN
73
N: circulating peptide secreted by osteocytes and osteoblasts that causes renal phosphate wasting
Fibroblast growth factor 23 (accept FGF23)
74
D: painful, chronic and recurrent sterile abscesses
Hidradenitis suppurativa
75
GI: Q: Most consistently effective biological therapy for recurrent and antibiotic refractory C. difficile infection
Fecal microbiota transplantation (accept fecal transplantation)
76
GI: To reduce false-negative urea breath test results, the patient should be off antibiotics for this length of time
4 wks
77
GI: Two conditions associated with the highest serum gastrin level measurements
Atrophic gastritis
Zollinger-Ellison syndrome
(accept gastrinoma)
78
ID: Most common indication for treating asymptomatic bacteruria in women
pregnancy
79
ID: Q: Varicella vaccine can be given to patients with HIV infection and this CD4 count
CD4 >/= 200
80
ID: IDSA definition of the cfu threshold in a voided urine specimen defining asymptomatic bacteruria in women
>/= 100,000k
81
ID: Antibiotic always included in a multiple antibiotic regimen for anthrax meningitis
ciprofloxacin
82
ID: IDSA recommended combination antibiotic therapy for severe Babesia microti infection
PO quinine
| IV clindamycin
83
ID: IDSA recommended combination antibiotic therapy for severe Babesia microti infection
PO quinine
| IV clindamycin
84
C: TIMI =
Thrombolysis in Myocardial Infarction
85
C: Valvular heart lesion associated with nail bed pulsations
aortic regurgitation
86
C: Postmenopausal women account for most cases of this syndrome of transient regional LV dysfunction
Takotsubo cardiomyopathy
87
C: USPSTF grade assigned to screening for abdominal aortic aneurysm in women
D
88
NR: First-line oral drug for symptomatic treatment of myasthenia gravis
pyridostigmine
89
NR: age exclusion for TPA between 3.5 - 4 Hrs
age >80
90
NR: Likely diagnosis for neck pain, partial Horner syndrome, and TIA or stroke
Carotid artery dissection
91
NR: Effective injectable therapy for prevention of chronic migraine headache
botox
92
R: Most common joint condition associated with anserine bursitis
Osteoarthritis
93
R: Disease most commonly associated with "capillary dropout" on nailfold capillary microscopy
Systemic sclerosis
| accept scleroderma
94
R: Bacterial organisms known to trigger reactive arthritis (6)
```
Chlamydia
Yersinia
Salmonella
Shigella
Campylobacter
Clostridium difficile
```
95
R: Diagnosis for a painful and stiff glenohumeral joint that has lost distensibility of the capsule and range of motion
Frozen shoulder
| adhesive capsulitis
96
R: Most common form of lung inflammation associated with Sjögren's syndrome
Nonspecific interstitial pneumonia
97
E: MEN 2A and MEN 2B have these 2 conditions in common
Medullary thyroid cancer
| Pheochromocytoma
98
E: most common sex chromosome abnormality
Turner syndrome
99
E: Syndrome of vitiligo, autoimmune thyroid and adrenal disease , type 1 DM, and hypopituitarism
Polyglandular autoimmune syndrome
100
E: Adjuvant treatment for thyroid storm that blocks release of T4 and T3
Iodine (accept lithium)
101
E: Mediator of transient subclinical hyperthyroidism during first half of pregnancy
HCG
102
HO: Leukemia most commonly associated with leukostasis syndrome
AML
103
HO: Most common thrombophilia associated with warfarin skin necrosis
Protein C deficiency
104
HO: Patients with hemochromatosis are at risk for this bacterial infection (4)
V. vulnificus,
Y. enterocolitica
L. monocytogenes
Klebsiella sp (any one)
105
HO: Diagnosis accounting for Coombs-negative hemolytic anemia and Budd-Chiari syndrome
Paroxysmal nocturnal hemoglobinuria
106
HO: Myelodysplastic syndrome-associated skin condition that may herald change to acute leukemia
sweet syndrome
107
HO: Class of drug for hormone-receptor positive early stage breast cancer in premenopausal women
Selective estrogen receptor modulator
| accept SERM or tamoxifen
108
HO: Leukemic variant of cutaneous T cell lymphoma commonly presenting with erythroderma and generalized lymphadenopathy
Sézary syndrome
109
HO: Most likely primary cancer accounting for metastatic squamous cell carcinoma to upper cervical lymph node
Head & Neck
110
A/I: Most sting-related reactions are caused by this order of insects
Hymenoptera
111
A/I: Condition associated with urticaria pigmentosa
Mastocytosis
112
A/I: Fish-related poisoning often misdiagnosed as "seafood allergy"
Scombroid poisoning
113
N: Most common cause of primary glomerulopathy in developed countries
IgA nephropathy
114
N: Non-inflammatory, nonatherosclerotic disorder that leads to arterial stenosis, occlusion, aneurysm, and dissection
Fibromuscular dysplasia
115
N: Antihypertensive drug class that decreases risk of acute gout
Calcium channel blockers
| would also accept losartan but not ARBs
116
N: Diagnostic urinalysis finding associated with acyclovir acute kidney injury
Needle shaped crystals
| accept crystals or crystalluria
117
P: Timing of initial imaging follow up for 4 mm pulmonary nodule on CT scan in high risk patient
1 year
118
P: First line treatment for reversible posterior leukoencephalopathy
lower blood pressure
119
P: The strategy of permissive hypercapnia is used to manage this mechanical ventilation complication associated with COPD
Auto-PEEP
120
P: The strongest risk factor for critical illness myopathy
IV glucocorticoids
121
P: Acid-base disorder characteristic of propofol infusion syndrome
```
Metabolic acidosis
(accept increased anion-gap metabolic acidosis)
```
122
C: Atrial fibrillation ablation therapy involves this cardiac structure
Pulmonary vein
123
C: Most likely finding on ECG prior to this Vtach
prolonged QT
124
C: Headache drugs implicated as a cause of valvular heart disease
Ergotamine
125
C: Lenient atrial fibrillation heart rate shown to be non-inferior to <80/min
<110/min
126
C: Late gadolinium enhancement on CMR is associated with this condition
myocarditis
127
GI: Sigmoidoscopic finding associate with anthraquinone laxative abuse
melanosis coli
128
GI: Diagnosis associated with acute upper abdominal pain, vomiting, and an inability to pass a nasogastric tube
gastric volvulus
129
GI: Concurrent inflammatory bowel disease that may be found with celiac disease
microscopic colitis
130
GI: Parasitic disease causing Symmer's pipestem fibrosis, splenomegaly and portal hypertension
Schistosomiasis
131
NR: Encephalitis associated with muscle weakness and extrapyramidal symptoms
West Nile virus encephalitis
| accept Japanese encephalitis
132
NR: Treatment as effective as plasma exchange for Guillain-Barr? syndrome
IVIG
133
NR: Term describing a form of hypertonia with an involuntary variable resistance during passive movement
Paratonia
| or gegenhalten
134
HO: Factor that carries factor VIII in the circulation
vWF
135
HO: Four vitamin K dependent coagulation factors
2, 7, 9, 10
136
HO: metalloproteinase that is deficient in patients with TTP
ADAMTS-13
137
HO: Therapy that decreases recurrent stroke in sickle cell disease
Exchange transfusion
138
HO: Cause of splenomegaly and hepatomegaly in myelofibrosis (myeloid metaplasia)
Extramedullary hematopoiesis
139
HO: Q: Lung cancer complication suggested by dyspnea, cough, and facial swelling
Superior vena cava syndrome
140
HO: Components of FOLFOX chemotherapy
- Folinic acid (leucovorin)
- 5-FU
- Oxaliplatin
141
HO: Cancer treatment cause of LV dysfunction that is not dose dependent
Trastuzumab
142
N: correct hypoNa, locked in syndrome
Osmotic demyelination syndrome
| accept central pontine myelinolysis
143
N: Diagnosis associated with this skin finding (photo of hypopig patch) and angiomyolipomas or tubers of the skin, retina, brain, and kidneys
Tuberous sclerosis
144
N: Syndrome caused by metabolism of ADH by circulating vasopressinase
Gestational diabetes insipidus
145
N: Therapeutic infusion associated with type B lactic acidosis, rhabdomyolysis, and hyperlipidemia
propofol
