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MCCQE Part 1 > All Subjects > Flashcards

All Subjects Flashcards

1
Q

Presbycusis is . . .

A

Age related hearing loss - bilateral symmetric

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2
Q

What are the two crises of sickle cell anemia

A

Aplastic crisis = low retic count without splenomegaly

Splenic sequestration crisis = normal retic count with splenomegaly

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3
Q

Side effect of high dose niacin therapy is . . .

A

Cutaneous flushing and generalized pruritus due to peripheral vasodilation

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4
Q

Rubella signs are (beware rubella in the unvaccinated child)

A

Aphalocaudalrash with localized lymphadenopathy and athralgias

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5
Q

Who boo sicker rubella or measles

A

M eagles! Similar symptoms but measles has prodrome of cough and conjunctivitis

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6
Q

What are the signs of autoimmune hepatitis

A

Abnormal hepatic cellular lab pattern (increased AST and alt ) otherwise asymptomatic w mo other identifiable aetiology

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7
Q

Alcohol hepatitis expect what lab pattern

A

AST to ALT of 2 to 1

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8
Q

What are the best predictors of postoperative lung resection outcomes

A

FEV1 and DLCO

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9
Q

What does hypoosmolality in stool indicate

A

Addition of dilutants to stool osmolality generally remains constant in organic GI disease

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10
Q

Elevated Mg or phosphate in stool electrolytes suggests what

A

Overuse of saline osmotic ( laxatives)

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11
Q

What are the CSF findings in aseptic viral meningitis

A

Lymphocytosis mildly elevated protein and normal glucose

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12
Q

Common court of viral meningitis in adults

A

Enterovirus but also HIV (in sexually active)

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13
Q

Vitiligo creates _____________ macules due to _________

A

Flat, white macules due to melanocyte destruction often associated with (autoimmune disease (type 1 dm)

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14
Q

What is the tumor antigen pattern for cholangiocarcinoma and hepatocellular carcinoma

A

Cholangiocarcinsma increased CA-19-9/CEAwith normal AFP

Hepatocellular carcinoma normal CA-19-9/CEA and increased AFP sometimes

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15
Q

Acute organ rejection is in what timeframe

A

6 worths of transplant (T cell mediated response)

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16
Q

Describe acute, unilateral cervical lymphadenitis

A

Children with recent respiratory infection present with enlarged markedly tender worm erythematous cervical nodule with but well-appearing

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17
Q

Treatment for acute unilateral cervical lymphadenitis in children

A

Clindamyain

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18
Q

Describe group b streptococci

A

Gram positive cocci in pairs and chains called streptococcus agalactiae

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19
Q

While GBs is most common cause of early neonatal sepsis in the first week it can also cause late onset infection de to

A

Horizontal transmission in the home

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20
Q

How des hyperthyroidism cause A. Fib

A

Increased beta adrenergic receptor expression that’s why treat with beta blockers

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21
Q

What does beta blocker toxicity look like

A

Hypotension bradycardia bronchospasm aLOC Hypoglycemia

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22
Q

Antipsychotics cause side effects because they block the blockage of dopamine so we see

A

Hyperprolactinemia girecomastia galactorrhea menstrual cycle dysfunction decreased libido

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23
Q

Why do adolescents who recently started menstruating have regular cycles and heavy or prolonged seeding

A

Docto immaturity of the pituitary ovarian axis can cause duration takes awhile to mature and regularized

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24
Q

Prepubertal boy with soft coiled rightsided scrotal mass that fails to decompress when supine Diagnosis is

A

Secondly varicocele _ look for source of venous compression

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25
Q

Symptoms of increased intracranial pressure

A

Headache. (Worse at night) nausea and vomiting mental status change SoCal neurological signs (vision changes unsteady gait)

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26
Q

Signs and symptoms of Kawasaki disease

A

Fever for more than five days, conjunctivitis, mucositis (strawberry tongue), cervical lymphadenopathy rashs erythema Edema of hands/feet increased WBC and platelets decreased hemoglobin

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27
Q

Describe the celiac stool

A

Foul smelling greasy abating stool (steatorrhea)

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28
Q

Tuberous sclerosis signs and symptoms

A

Derm stuff, neurological (enslestons, epilepsy, autism, intellectual disability)

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29
Q

Tumor factors for ovarian vs. Colorectal

A

Ovarian ca-125

colorectal CEA

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30
Q

Discuss pCO2 in acute asthma exacerbation (normal, elevated?)

A

Should be low, if normal or elevated this suggests impending respiratory failure

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31
Q

What is a common cause of pericardial effusion

A

Malignancy

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32
Q

Low do you treat pericardial effusion

A

Pericardiocentesis initially then pericardial window or prolonged catheter to prevent reaccumulatlon

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33
Q

PDE-5 inhibitors are contraindicated in patients taking nitrates because

A

Can head to severe hypotension

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34
Q

Most common organism to cause epiglottitis

A

Haemophilus influenza B and staph aureus so have to cover both with antibiotics (vancomycin and ceftriaxone)

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35
Q

Treatment for pinworm (enterbius vermicularis)

A

Pyrantel pamoate or albendazole

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36
Q

What nerve can brachial artery canullation injure

A

Median

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37
Q

Infective endocarditis following dental procedures is most commonly caused by what bug

A

Viridian’s streptococci

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38
Q

Nitroprusside is often used in hypertensive emergencies what do You have to watch out for with prolonged infusions or high dose.

A

Cyanide toxicity because metabolized to nitric oxide and cyanide ions

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39
Q

Symptoms of cyanide toxicity

A

Altered LOC, lactic acidosis, seizures, coma.

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40
Q

Name the 4 lung cancers and their main differentiating signs

A

Adenocarcinoma = clubbing
squamous cell carcinoma = hypercalemia cavitation
small cell carcinoma = Cushing syndrome SIADH
large cell carcinoma = gynecomastia galactorrhea

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41
Q

If you suspect-spinal metastasis that are causing cord compression what is first action

A

Glucocorticoids without delay then imaging

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42
Q

Symptoms of ethylene gland poisoning are

A

Flank pain, Hematuria with oliguria and cranial nerve palsies and hypocalcemia

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43
Q

Treatment of ethylene glyadl poisoning is

A

Fomepizole a competitive inhibitor

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44
Q

What test is strongly indicative of patellofemoral pain syndrome

A

Tonic contraction of quadriceps causing pain (ex. Squatting)

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45
Q

Small painful papules in the beard area diagnosis likely

A

Pseudofolliculitis barbae

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46
Q

Signs of severe aortic stenosis

A

Exercise intolerance exertion dysprea, left ventricular hypertrophy on ECG syncope

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47
Q

Best antibiotic for UTI’s in children

A

Cefixime

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48
Q

What is the big concern with posterior knee dislocation

A

Popliteal artery injury need thorough vascular exam (ABI, U/S, pulses)

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49
Q

Do VSD’s need treatment usually

A

No most close-spontaneously worry if hemodynamics instability

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50
Q

Young women with abdominal bruit and other signs of unilateral renal artery stenosis is vary indicative of

A

Fibromuscular dysplasia

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51
Q

What is the active precursor to T3 and T4 and where is it produced

A

Thyroglobulin produced by normal or cancerous thyroid tissue (can track as a pseudo tumour marker)

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52
Q

Carbadopa-levodopa can cause what concerning side effect and what do you do

A

Psychotic symptoms so consider dose lowering

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53
Q

Patients who experience sexual assault are at high risk for developing what 2 psychiatric issues

A

PTSD and depression with suicidality

54
Q

Abx safe in pregnancy are

A

Penicillins cephalosporins (cephalexin) and Fosfomycin

55
Q

Aspirin exacerbated respiratory disease is characterized by

A

Asthma, bronchospasm/nasal congestion following ingestion of NSAIDs with chronic rhinosinusitis and nasal polyposis

56
Q

What is the initial management of neonate with billious emesis peritoneal signs and hemodynamic instability

A

Emergency exploratory laparstory

57
Q

Undiagnosed pleural effusion best evaluated by

A

Thoracentesis

58
Q

What is gaucher disease

A

Autosomal recessive disorder of lysosomal storage

59
Q

Features of gaucher disease

A

Hepatosplenomegaly anemia, thrombocytopenia, bony pain, failure to thrive delayed puberty

60
Q

What is the lung complication of neonates with mothers with uncontrolled diabetes

A

Delayed lung maturation heading to respiratory distress syndrome

61
Q

Hemi section of the spinal cord (brown-sequard syndrone) presents how

A

Ipsilateral hemipareisis ipsilateral diminished procisception/vibration/light touch and contralateral diminished pain and temperature sensation

62
Q

What are the signs of intussusception on ultrasound

A

“Target’ sign “ colon wall, lumen, and then another structure which is the ilieum - this is diagnostic

63
Q

Treatment of intussusception

A

Air or water soluble contrast enema

64
Q

Most common cause of heavy regular menses in adolescents

A

Von willebrand disease-will see normal coagulation studies or prolonged PTT

65
Q

Name 3 bacteria within the viridas gap streptococci

A

Strep mutants, S mitis S oralis S sanguinis

66
Q

Viridans grap streptococci common where and what disease do they often cause

A

Oral mucosa - cause IE following dental procedures with underlying value defects

67
Q

What are 6 indications for cervical CT

A

High-energy mechanism, neurological deficit, spinal tenderness, aLOC, intoxication, distracting injury

68
Q

What is the triad of IgA vasculitis (henoch-scholein Purpura)

A

Hip arthralggia abdominal pain lower extremity petechial rash

69
Q

Treatment of massive hemoptysis

A

Bronchoscopic intervation emobilization or resection

70
Q

What procedure increases risk of cervical insufficiency

A

Cervical cone biopsy

71
Q

Sign and Symptoms of Eustachian tube defects

A

Ear fullness/discomfort tinnitus conductive hearing loss “popping” sensation

72
Q

Prophylactic treatment of non-bleeding esophageal varices

A

Non-selective beta blockers or variceal ligation

73
Q

What is post streptococcal glomerulonephritis

A

Immune-mediated disease where immune complexes are deposited in the GBM after a group A strep infection

74
Q

What is subclavian steal syndrome

A

Stenosis or occlusion of the proximal subclavian artery and reversal of flow in ipsilateral vertebral artery causing upper extremity ischemia, dizziness, ataxia, and disequilibrium

75
Q

What bug is associated with nasspharnygeal carcinomas

A

Reactivation of epstein-barr virus

76
Q

Manifestations of nasopharyngeal carcinomas

A

Epistaxis, headaches, cranial nerve palsies, and otitis media

77
Q

Antibiotics can cause a serum sickness like syndrome in children manifesting as

A

Low grade fever urticarial rash arthralgia - resolve without sequelae .

78
Q

What is the difference between a coroner and medical examiner

A

Medical examiners are pathologists, coroners can be pretty much any professional

79
Q

What deaths have to be reported to coroner or ME

A

All provinces have different document but querally sudden or unexpected deaths, or deaths resulting from evidence, accidents negligence misconduct malpractice or self-inflicted

80
Q

What is the coroners mandate to answer)

A

Who when where why (cause of death) and by what means (manner of death - by balance of probabilities) - it is fact finding only not fault

81
Q

Autopsies arc ordered when and done bny

A

Only ordered when manner of death cannot reasonably be determined conducted by pathologist

82
Q

Name the 4 ethical pillars

A

Autonomy beneficence non-maleficence justice

83
Q

Capacity is dynamic rector each decision determined by the physician but competence is

A

Competence is a legal term deeded by the courts

84
Q

Years of Medical car act and Canada health act

A

1966-federal gov. Pays 50% of medical insurance

1984-imposed conditions on Federal funding

85
Q

What are the 5 principles of the Canada Health act

A

Public administration, comprehensiveness, universality, portability, accessibility

86
Q

What is the process for getting mard approved

A

Provincial form complete witnessed properly, then 2 clinical assessment it death foreseeable, no extra or waiting not foreseeable more safeguards minimum 90 dayassessment

87
Q

Canada’s age of consent is and the nuances

A

16, but 18 if partner in position of power or authority, 14 and 15 year olds can consent to 5 years older and 12 and 13 year olds can consent to 2 years older.

88
Q

What sexual activity of a minor must you report and where

A

any sexual activity that is non-consensual either by person report or by age of consent laws and report to MCFD (in BC)

89
Q

What is the public safety exception of reporting

A

can break confidentiality and report if there is a clear risk to an identifiable person or group of persons and there is clear, imminent risk to those peoples.

90
Q

definition of a stillbirth

A

over 20 wks GA OR weighs more than 500 grams. - all stillbirths must be reported!

91
Q

What is the RADAR acronym for IPV

A 
Remember to ask 
Ask directly 
Document findings 
Assess for safety 
Review options after 
Follow up
92
Q

What are the five phases of pain

A 
transduction 
conduction 
transmission 
modulation 
perception
93
Q

What is morphine equivalence

A

dose of opioid that will give the same effect as 1mg of morphine

94
Q

What are the seven common side effects of opioids

A 
nausea 
constipation 
drowsiness/confusion 
dizziness 
dry skin 
vomiting 
sweating
95
Q

What are 5 complications of prolonged opioid use

A 
hypogonadism 
sexual dysfunction 
sleep apnea 
opioid induced hyper analgesia 
opioid use disorder
96
Q

what is an appropriate starting MME dose for opioid naive patient and how do you titrate

A

30, titrate by no more than 10 mg/day or approx. 25% of total dose, commonly see increase by 10% of total daily dose if need more pain coverage

97
Q

definition of cultural competence

A

a set of congruent behaviours attitudes and policies that come together in a system agency or among professionals and enable that system or those professionals to work effectively in cross-cultural situations.

98
Q

What opioids are okay in pregnancy and which are not so much

A

morphine and hydro morph are okay

tramadol and fentanyl should be avoided

99
Q

define gender

A

cultural constructed roles, behaviours and expressions

100
Q

define sex (as in male and female)

A

biological attributes, internal and external genitals and hormones, gene expressions, karyotype. Assigned at birth by appearance of external genitals.

101
Q

define gender identity and gender expression

A 
identity = sense of who you are and who you perceive yourself to be 
expression = how we choose to present ourselves to the world.
102
Q

For a plaintiff to be successful in a claim against a doctor they must prove what 4 things

A

Duty of Care
Breach of Duty
Harm or Injury
Causation

103
Q

What do we prevent with erythromycin at birth

A

Infant gonococcal conjunctivitis (eyelid swelling, purulent drainage and injection)

104
Q

What blood thing is a contraindication to OCP

A

Thrombophilia (factor V Leiden antiphospholipidsyndrome)

105
Q

With dilated cardiomyopathy and history of alcohol abuse once all other diagnoses have been excluded consider

A

Alcoholic cardiomyopathy

106
Q

What is the antibody present in 90% of hashimoto’s thyroid disease

A

Anti thyroid peroxidase (anti-TPO) and antithyroglobulin

107
Q

What is antiphospholipid syndrome

A

Autoimmune disorder can present with recurrent pregnancy loss venous thrombosis and mild thrombocytopenia prolonged PTT

108
Q

Antiphospholipid syndrome can cause what false positive

A

VDRL test (syphilis)

109
Q

What are the H’s and T’s

A

Hypo volemia, hypoxia, hypothermia, hyper/hypokalemia, hydrogen (acidosis)
Tension pneumothorax, tamponade, toxins, thrombosis (cardiac or pulmonary)

110
Q

Lacunar strokes of the posterolateral Thalamus present with

A

Sudden onset contralateral sensory loss and then later a thalamic pain syndrome (paroxysmal burning pain exacerbated by light touch)

111
Q

Male secondary hypogonadism can be caused by what 3 things

A

opioids
glucocorticoids
exogenous androgens

112
Q

symptoms of digoxin toxicity

A 
anorexia 
N/V
abdominal pain 
fatigue 
confusion 
weakness 
colour vision alterations 
life threatening arrhythmias
113
Q

How does Pre-eclampsia precipitate acute ischemic stroke

A

endothelial cell damage

114
Q

what does a posterior hip dislocation look like

A

shortened leg internally rotated with hip held in flexion and adduction

115
Q

congenital adrenal hyperplasia - what is it

A

autosomal recessive disorder of 21-hydroxylase deficiency which presents ambiguous genitalia in girls.

116
Q

CHARGE syndrome =

A 
Coloboma (iris defects) 
Heart defects
Atresia Choanae (nasal blockade) 
Retardation of growth/development
Genitourinary anomalies 
Ear abnormalities
117
Q

What is Galactosemia

A

newborn autosomal recessive GALT deficiency where can’t metabolise galactose to glucose.

118
Q

clinical findings of Galactosemia

A

jaundice and hepatomegaly
vomiting/failure to thrive
cataracts
increased risk of E Coli sepsis

119
Q

U/S findings of epithelial ovarian carcinomas are

A

solid mass with thick septations

ascites

120
Q

Systemic arterial pressure normally falls less than 10 mmHg during inspiration an exaggerated from is referred to as pulses paradoxus and is most commonly seen in patients with what

A

cardiac tamponade
severe asthma
COPD

121
Q

What precautions are required for measles

A

airborne

122
Q

genitourinary symptoms of menopause include:

A

vulvovaginal dryness, irritation, pruritus, dysparenuria, vaginal bleeding, urinary incontinence, recurrent UTI’s and pelvic pressure.

123
Q

what is the treatment of ankylosing spondylitis

A

NSAIDS, COX-2 inhibitors - first line

TNF-alpha inhibitors or Anti-IL-17 antibodies.

124
Q

Most common cause of an isolated asymptomatic elevation of alkaline phosphatase in an elderly patient is

A

Paget disease of bone

125
Q

What is Beckwith-Wiedemann Syndrome

A

overgrowth disorder due to chromosomal mutation.

126
Q

what are the signs/symptoms of Beckwith-Wiedemann Syndrome

A

fetal macrosomia, rapid growth until late childhood, omphalocele or umbilical hernia
macroglossia and hemihyperplasia.

127
Q

clinical presentation of polycystic kidney disease

A

asymptomatic until 30-40 then flank pain, hypertension, and palpable bilateral above masses with abnormal kidney labs

128
Q

Syringomyelia is a disorder where a fluid-filled cavity forms within the spinal cord and symptoms include:

A

dissociated sensory loss (loss of pain/temp but not vibration), often in a cap distribution, and weakness that affects the upper extremities

129
Q

What is blepharospasm

A

form of focal dystonia characterised by recurrent forceful contraction of the eyelid muscles - bright lights can acts as a trigger

130
Q

what are the most common drug induced haemolytic anemia triggers

A

NSAIDS, Cephalosporins (ceftriaxone), Penicillins (Pip-Tazo), - mediated by hapten hemoysis

131
Q

what is erythema multiforme

A

MCCQE Part 1 (1 decks)

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