Book practice Flashcards
Age 25-35, Aphthous ulcers, genital ulcers, uveitis, inflammatory arthritis, skin lesions, relapsing/remitting course
Behçet syndrome
Pitting nails, multi joint inflammatory arthritis, 2 weeks later scaling skin lesions
Psoriatic arthritis
first line treatment in afib with any symptoms or abnormal vital signs
cardioversion
urethritis, conjunctivitis, arthritis, prior gi illness or STD
reactive arthritis
female black pt with fever, malaise, weight loss and skin changes
SLE
Cards common medication that can cause hyperthyroidism
amiodarone
Only treatment of hyperthyroidism in pregnancy
PTU
What is the role of b-blockers in hyperthyroidism?
relieves symptoms only
Why/what is treatment for a ganglion cyst?
treat if symptomatic: immobilization then aspiration and/or cortisone
At what post partum minutes are apgar scores recorded?
1 and 5 mins
pt being treated for TB presents with difficulty seeing, dull eye pain, loss of color discrimination. Which drug is to blame?
ethambutol
pt being treated for TB presents with jaundice, rash and flu-like illness. Which drug is to blame?
rifampin
pt being treated for TB presents with hepatitis and peripheral neuropathy. Which drug is to blame?
isoniazid
pt being treated for TB presents with hyperuricemia and hepatitis. Which drug is to blame?
pyrazinamide
what types of organisms are being tested for using a blood agar medium?
s. aureus and strep
What is being tested for with a 20% KOH solution direct microscopy study?
fungus/dermatophyte
What condition is a straight leg raise test evaluating?
possible disk disease of the lower back
What is considered a positive straight leg raise test?
Pain in passive ROM >= 60 degrees in the ipsilateral leg
First line management for patient with kidney stones?
pain control with narcotics
What is the imaging modality of choice for nephrolithiasis?
helical CT
young pt with tragal ttp, itching and inflammation of the ear canal and no ttp to mastoid, diagnosis?
acute otitis externa
young pt with edema of external auditory canal, anterior and inferior displacement of auricle with ttp posteriorly, diagnosis?
mastoiditis
What condition causes the total lung capacity to be increased on pfts?
emphysema, normal in chronic bronchitis
what does COPD do to diffusing capacity on PFTs?
emphysema reduces it, normal in chronic bronchitis
Characteristics of neurogenic shock
hypertensive, normal/tachycardic, decreased svr
Characteristics of cardiogenic shock
hypotension, tachycardia, decreased cardiac index, increase svr, metabolic acidosis (LA), elevated BUN/Cr
treatment of choice/secondary for trigeminal neuralgia?
carbamazepine/oxcarbazepine, phenytoin is second line
symptomatic relief for trigeminal neuralgia?
aspirin/acetaminophen
young patient with anterior tibia pain, diagnosis? muscle affected?
Osgood-Schlatter disease, quadriceps muscle (stair climbing)
Young pt with hip/knee pain that is worsened with internal rotation, diagnosis?
Legg-Calve-Perthes disease
pt with insidious b/l u/le muscle weakness, diagnosis?
polymyositis
pt with extremity pain, insidious onset fever, malaise and waight loss, diagnosis?
polyarteritis nodosa
Harsh holosystolic grade 3/4 murmur on L sternal border with wide radiation and fixed split s2, diagnosis?
Ventricular septal defect
During which portion of the heart beat cycle is an aortic regurgitation heard?
Diastolic
Continuous murmur accentuated late in systole
PDA
What primary lab result indicates a diagnosis of primary hyperparathyroidism?
serum calcium elevation
Pt with pain or paresthesia around the outer aspect of the thigh, diagnosis? nerve involved?
Meralgia paresthetica, lateral femoral cutaneous
What patient injures or has osteoarthritis and cannot extend a PIP joint, diagnosis?
Boutonniere’s deformity
Pt overextends thumb and hears a ripping sound, diagnosis?
Gamekeeper thumb - injury to the lateral collateral ligament of first MCP of thumb
Pt strikes finger causing forced flexion and inability to extend DIP, diagnosis? need for surgery?
Mallet finger, surgery only if associated with an avulsion fracture
Mass on the testicles that enlarges with valsalva, diagnosis?
varicocele
What does the orthopedic Lachman test examine?
anterior cruciate ligament tears
What does the orthopedic McMurray test examine?
medial meniscus injury
What does the orthopedic Finkelstein test examine?
de Quervain tenosynovitis
What type of crystals are present in an aspirate of a gouty knee?
urate crystals
What type of medication should gout prone patients avoid?
thiazide diuretics (increase purine retention in kidneys)
Diagnostic mode of choice for multiple sclerosis? What is the pathoneumonic finding?
MRI – multiple foci of neurological degeneration
What is the indication for treatment with Atomoxetine (strattera)?
ADHD
What is the indication for treatment with Carbamazepine (tegretol)?
Schizoaffective disorder – particularly depressive variety
What is the indication for treatment with Nefazodone (serzone)?
Major depression SNRI
What is the mechanism of action of Olanzapine (zyprexa)?
SDA (seratonin-dopamine agonist) used in treating schizophrenia and schizoaffective disorder
What is the indication for treatment with Risperidone (risperdal)?
SDA (seratonin-dopamine agonist) used in treating schizophrenia and schizoaffective disorder
What is the EKG change of pericarditis?
global ST elevation throughout leads
What is a positive ASO titer useful in diagnosing?
confirms antibodies to streptococcus
Person with sickle cell trait at high altitude or under physical stress may experience what?
painless hematuria → rhabdomyolysis
What is the test of choice to confirm tarsal tunnel syndrome?
nerve conduction velocity test
What is the number one preventable cardiac risk factor?
Smoking – decreases by 50% 1 year after quitting
What is the first line antibiotic for sinusitis in a pen-allergic, antibiotic naïve patient?
Bactrim
What is the first line antibiotic for sinusitis in a patient with recent antibiotic use?
levaquin
Describe the ideal candidate for Niacin as a first line agent in hyperlipidemia
Non-diabetic (may increase insulin resistance), non cirrhotic (risk for hepatotoxicity), person with high LDL and low HDL and not necessarily high triglycerides as it has no effect on them
Pt previously in good health with new onset shoulder/hip girdle pain or hip/neck pain which was initially unilateral but became bilateral over a few weeks. Pain is associated wit stiffness severe enough to cause difficulty rising from a chair or turning over in bed. Stiffness is worst after periods of rest. Symptoms followed by periperal joint swelling. Diagnosis?
Polymyalgia rheumatica
Another name for the statin medications (mechanism)?
HMG-CoA reductase inhibitor
Full activity of statins cause what changes in lipids?
decrease triglycerides/LDL, raise HDL
Classic triad of preeclampsia
hypertension, proteinuria, thrombocytopenia
What is Takotsubo cardiomyopathy?
a transient cardiac syndrome involving LV apical akinesis mimicing ACS. Pts have ST-elevation, elevated trops, CT angio shows apical ballooning and no coronary artery stenosis. R/O pheochromocytoma/endocarditis before making the diagnosis
What is the physiology of an S3 heart sound?
heart failure: indicative of increased ventricular filling may also be due to severe MR or TR “slosh-ing-in”
What is the physiology of an S4 heart sound?
caused by stiffening of ventricular walls (usually left) producing turbulent flow with atrial contraction. More apparent with exercise “a-stiff-wall”
What is the major difference in symptoms you’d expect in pericarditis from an MI?
Pericarditis usually produces pleuritic sharp stabbing pain
Which should be longer in a normal Rinee test? Air conduction or bone conduction?
Air conduction
Describe the results of a webber hearing test
Lateralizes to the side of an obstructive hearing loss, away from the side of a neural hearing loss
What is the incubation time for giardia?
1-3 weeks
What is the incubation period for salmonella typhoid?
5-14 days
What is the incubation period for common salmonella gastroenteritis?
8-48 hours
List macrocytic anemias
B12/Folate deficiency, Pernicious anemia, megaloblastic anemia (bone marrow deficiencies), alcoholism
List microcytic anemias
B-Thalasemia, iron deficiency, sideroblastic anemia, lead poisoning
List nomocytic anemias
aplastic anemia, sickle cell disease (not trait), fluid overload (pregnancy), B2 (riboflavin) deficiency
hypersegmented neurotrophils on peripheral smear, diagnosis?
megaloblastic anemia
Most common pathogens for pneumonia following flu? Population?
S. Aureus, Strep pneumo, H. flu - Elderly, pts with lung pathology or metabolic disorders
For whom is klebsiella pneumoniae the most common cause of pneumonia?
alcoholics and diabetics
For whom is mycoplasma pneumoniae the most common cause of pneumonia?
young adults in an ambulatory setting
young pt with DOE, prominent JVD, harsh systolic murmur at second and third left intercostal space radiating to left shoulder and early systolic sound precedes the murmur during expiration. EKG shows right axis deviation. Diagnosis?
Pulmonic stenosis
Harsh systolic murmur heard on the right with early systolic click, EKG shows LVH. Diagnosis?
Aortic stenosis
Location of mitral regurgitation murmur? EKG finding?
apex, EKG shows left axis deviation or LVH
Location of tricuspid regurgitation murmur? EKG finding?
Third to fifth intercostal spaces, EKG shows Right axis deviation
Patient with pruritus and progressive jaundice and no stones in his bile duct on ERCP. Diagnosis?
Primary sclerosis cholangitis
Constipation relief for renal patients. Dos and don’ts
Colace, metamucil and lactulose are okay, MOM is not okay d/t risk of magnesium overload
What is the second stage treatment for rheumatoid arthritis after NSAIDs?
DMARDs (bridge with steroids)
What is the treatment for severe RSV infections?
Ribavirin
Which medications can trigger an acute asthma attack?
B-blockers, NSAIDs/Aspirin
What is the most sensitive and definitive test for a stress fracture?
Bone scan
What is the acute management of a cluster headache?
Oxygen or injectable or nasal triptan
What is a good prophylactic treatment for cluster headaches?
Lithium or methysergide
65 yo male with intense pruritus after bathing unrelieved with OTC meds h/o intermittent HA, facial fullness, weakness, fatigue and dizziness. Physical significant for splenomegaly and htn. Diagnosis?
polycythenia vera - get Cbc with smear
child with abrupt episodes of diminished attention where he disconnects briefly from conversations yet has no awareness of these lapses, diagnosis? EEG findings?
petit mal seizure (absence), during event would show 3-Hz spike-and-wave activity
Pt with recent african travel history presents with high biphasic fever, myalgias, arthralgias, HA, bachache, sore throat and malaise. Pt also reports a rash beginning as blotches which developed into a maculopapular rash sparing the palms and soles. Diagnosis?
Dengue fever
Definitive diagnosis for Malaria?
parasite in stained peripheral blood smear
CT showing ring enhancing lesions
Toxoplasmosis
How do you distinguish actinic keratosis from squamous cell carcinoma?
biopsy
Differentiate between Meniere’s disease, labrynthitis and benign positional vertigo
Meniere’s disease is associated with episodic vertigo, hearing loss, tinnitus and nystagmus with caloric testing. BPV can be induced with Dix-Hallpike maneuver. Labrynthitis presents with persistent vertigo and hearing loss only of several days to a week , vertigo gradually improves but hearing loss may be permanent.
treatment of choice for Meniere’s disease
Antihistamines and diuretics (acetazolamide) and low salt diet. Steroid injections by ENT may provide symptomatic relief.
Pt develops back pain and hematuria during a random donor platelet transfusion, what is the next step?
stop the transfusion and follow the acute transfusion reaction protocol
Pt develops acute onset of shaking chills 10 mins into a random donor platelet transfusion and a mild fever. Vitals are normal and there are no other symptoms, what is the next step?
slow the transfusion and administer acetaminophen and diphenhydramine (common in up to 30% of transfusions)
What is the first line treatment for ventricular tachycardia?
Amiodarione
What vitamin deficiency causes night blindness?
Vitamin A
Pt with inflammated gingivae, petechiae, rough, dry skin, anemia and impaired wound healing, diagnosis?
Scurvy - vitamin C deficiency
What vitamin deficiency causes areflexia and gait disturbances?
Vitamin E
What ethnic group has the highest incidence of Rh (-) blood types? Lowest?
Caucasians 15-16%
Lowest North American Indians 1%, Indo-Eurasians 2%
What is definitive diagnosis/treatment for pediatric intussusception? incidence?
barium or air enema has a 75% resolution rate
What is the most common valvular abnormality after rheumatic fever?
Mitral stenosis
Pt presents with minimally pruritic facial lesions x 1 week: scattered discrete macules approximately 1cm with orange-red greasy scale on cheeks and nasolabial folds. Diagnosis? Treatment?
Seborrhea keratosis - treatment with hydrocortisone
What is the treatment of choice in inflammatory (viral) pericarditis?
NSAIDs
What is the most common cause of pericarditis?
viral
What dermatological diagnosis is established with a wood’s lamp?
dermatophytosis
What is the indication of a punch biopsy vs an excisional biospy?
If the size of the lesion is too large for safe excisional biopsy, then punch biopsy is performed
What electrolyte abnormality can be caused by ACE inhibitors?
hyperkalemia
Pt presents with hypertension and palpable abdominal mass other findings include edema, microproteinuria. His father died from complications of chronic kidney disease. UA is positive for blood and protein. Diagnosis?
Polycystic Kidney disease
What is the mechanism of diarrhea in cholera?
Colonization of the small intestine and release of enterotoxin by the pathogen which induces profound GI secretion
Distinguish late epididymitis from testicular torsion?
Typically elevation of the scrotum will alleviate pain in epididymitis
What should be suspected if a newborn does not pass meconium?
Hirschsprung disease: lack of parasympathetic ganglion cells in a segment of the colon leads to disruption of motility
What is the normal window for a newborn to pass meconium?
24-48 hours
How do you evaluate a suspected non obstructive cause of urinary retention?
cystometric testing
What is the typical manifestation of chondroblastoma? What is it?
Young patient with long bone pain - rare benign neoplasm that develops in the epiphyses
What type of cancer is most commonly associated with amyloidosis?
Multiple myeloma
At what stage of cervical dilation does the second stage of labor begin?
10cm
6 yo female 2 weeks post upper respiratory infection is walking with a limp and complaining of pain in the anterior thigh. CBC/ESR are normal and xrays are negative. What is the diagnosis? Treatment?
transient synovitis most common ages 3-10 after URI, treatment is symptomatic
What leukemia is associated with the philadelphia chromosome?
CML chronic myelogenous
What is the most common acquired hernia?
direct inguinal hernia
Under what circumstances is high flow oxygen effective to speed resorption of a pneumothorax? mechanism?
mildly symptomatic, patient unlikely to cooperate with follow up, will create a nitrogen gradient to speed resorption
What is the treatment of choice for otitis externa?
topical aminoglycoside (neomycin/polymyxin/ofloxacin) or fq often combined with a topical corticosteroid
What is the treatment for cerumen impaction?
disimpaction often with wax dissolving agents murine or debrox (carbamide solutions)
What is the difference between somatoform disorder and conversion disorder?
conversion manifests only one symptom which is unsubstantiated by a medical work up rather than multiple complaints of somatoform
Young patient with chronic cough and foul smelling phlegm had recurrent pulmonary infections and presents with crackles and digital clubbing. Diagnosis?
Bronchiectasis
What is the monitoring recommendation of DEXA scanning by T score?
-1 to -1.5: every 5 years, -1.5 to -2 every 3-5 years, less than -2, every 1-2 years
young pt presents with insidious progressive malaise, fever, weight loss and dyspnea which have not improved with macrolide antibiotics or supportive measures. CXR shows bilateral hilar and right paratracheal adenopathy, ESR is elevated, WBCs are low. diagnosis? initial managment?
sarcoidosis, corticosteroids
post partum female presents with double vision worsening throughout the day, easy fatiguability, difficulty swallowing, ptosis and limited EOM movement. Diagnosis? Confirmatory testing?
Myasthenia gravis, acetylcholine receptor antibody assay
macrocytic anemia with hypersegmented neutrophils, patient with neuropathy and a pulmonary flow murmur
vitamin B12 deficiency
how long should facial skin sutures stay in?
4-5 days
What is a common organism in puncture wounds?
pseudomonas
young patient presents with fatigue and weakness, low grade temp, purpura, pallor and traces of gingival bleeding. There is no hepatosplenomegaly. CBC shows normochromic normocytic anemia, granulocytopenia and thrombocytopenia. Diagnosis?
pancytopenia caused by aplastic anemia - bone marrow failure
What is the cardiac enzyme with the shortest half-life? utility?
ck-mb 24-48 hours, useful to determine if a re-infarction is occuring
What is the most common cause of small bowel obstruction?
adhesion
Pt has petechiae, headache, neurologic disturbances. Labs reveal anemia, thrombocytopenia, elevated LDH, BUN/Cr and peripheral smear shows fragmented RBCs, shistocytes and helmet cells. Diagnosis?
TTP
Pt has had a URI then mucosal and skin bleeding. Labs reveal anemia, thrombocytopenia, peripheral smear normal. diagnosis?
ITP
what is the gynecologic schiller test?
It evaluates the cervix after a positive pap with iodine to identify areas of rapid cell turnover
What test is best for the evaluation of new vulvar lesions?
biopsy
young patient complains of anterior shoulder and arm pain when lifting or pushing. Pain is acute 3 inches below the anterior acromion. What is the diagnosis? What additional test will confirm it?
Bicipital tendonitis will be exacerbated by the palpation of the tendon within the bicipital groove and with supination against resistance
Can mitral valve prolapse cause chest pain?
yes
What valvular disorder is associated with a midsystolic click?
typically, mitral valve prolapse, may be followed by a late systolic murmur indicating regurgitation
Where is the apical pulse heard in CHF?
left axilla
What is the normal respiratory rate of a newborn?
30-60
What is the diagnosis associated with multinucleated giant cells? what is the diagnostic test
herpes/varicella zoster skin infection - done with tzanck smear
What is the most common cause of osteomyelitis in sickle cell anemia? treatment?
S. Aureus - fq x 6 weeks
What is the difference between treatment for trichomonas and bacterial vaginosis?
Length and dose of metronidazole: 2g x1 for trichamoniasis, 500BID x7days for BV
Patient with aches took aspirin and presents the next day with anemia, jaundice and dark urine. Smear reveals Heinz bodies and bite cells. Diagnosis? Treatment?
G6PD deficiency can cause hemolytic anemia when combined with aspirin. Hemolytic episodes are usually self limiting. Avoid oxidant drugs
What condition is associated with retinal drusen deposits on fundoscopic exam?
Age-related macular degeneration
A patient presents with postauricular ecchymosis (battle sign) and peri-orbital bruising (raccoon eyes) what is the diagnosis?
basilar skull fracture
What is the treatment for a < 15% ptx without any signs of tension or underlying lung disease?
bedrest as an outpatient
patient has focal motor symptoms or somatosensory symptoms but no mental status changes. These episodes are the same and occur periodically without apparent trigger. Diagnosis?
simple partial seizure
Patient experiences a sudden loss of motor tone in either a limb or full body. The episodes occur at apparently random intervals without trigger. Diagnosis?
Atonic seizure
What GI bug causes a longer waxing/remitting course with foul smelling bulky stools?
Giardia
What is the hematologic osmotic fragility test used to diagnose?
spherocytosis
What is the definitive confirmatory test for sickle cell disease?
hemoglobin electrophoresis
Trauma patient who had been intubated presents several weeks after discharge with SOB, cough and inability to clear secretions. He has coarse breath sounds in both lung fields and is afebrile. Diagnosis?
Tracheal stenosis - can occur weeks later
What is the definitive diagnostic test for Herpes Zoster?
PCR of skin scraping
What is an indication for a 24 hour eye patch?
corneal abrasion
What helps in symptomatic relief of allergic eye disease?
cold compresses/ topical antihistamines
What are the risk factors for cataracts? (6)
congenital rubella, trauma, systemic diseases (dm, htn), systemic or inhaled corticosteroid use, uveitis and excessive sun exposure
What is the treatment of sialadenitis?
IV antibiotics + supportive care (hydration, warm compresses, sialagogues, gland massage)
Lace like blue patterned rash on LEs when exposed to col relieved with rewarming. Diagnosis? cause? concerning for?
Livedo reticularis - caused by vasomotor instability. Concerning for anti-phospholipid antibody syndrome
What is the probability of recurrence after a spontaneous pneumothorax is reduced with a chest tube?
30% in 2 years
What is the primary empiric treatment for atypical pneumonia?
Erythromycin or doxycycline
What is the primary indicator of a positive finding on an exercise stress test?
ST depression
Differentiate between a brain abscess and encephalitis
Encephalitis usually has higher fever, stiff neck, no focal neurological deficits. Abscess presents with headache and focal neurological deficits and low grade fever
What is the treatment of choice in acute gout?
NSAIDs - indomethacine or naproxen
Patient with transient painless monocular visual loss lasting seconds to 30 minutes
Amaurosis fugax
Patient with painless, total or near total black-out vision
Central retinal artery occlusion - exam reveals retinal opacity distal to the occlusion
What diagnosis is associated with calcium pyrophosphate crystals found on joint aspirate?
pseudogout
What is the treatment in a patient with a history of FOOSH, snuffbox pain and negative xray?
Spica splinting and repeat xray in 2 weeks
What is a common side effect requiring routine monitoring for the schizophrenic medication clozapine?
cbc every week to monitor for agranulocytosis
What diagnosis is associated with a maculopapular butterfly rash?
SLE
Patient presents with dysphagia dysmotility and pulmonary fibrosis, also reporting thickening of skin, telangiectasias and pigment changes. Diagnosis?
Scleroderma (systemic sclerosis)
What condition is almost exclusively seen in the COPD population presents with tachycardia and multiple distinct P waves and PP intervals?
multifocal atrial tachycardia
What is the treatment of choice for pertussis?
macrolide (erythromycin)
What is the treatment of choice for chlamydia?
macroclide abx (emycin) or tetracycline (doxy) in adults only
Soft tissue head imaging for non-infectious etiology is done preferably with which test?
MRI
What change in blood pressure can be expected for a hypertensive patietn who embarks on an aerobic exercise regime 30 mins 5-7 days per week?
4-9mm Hg
What is the laboratory test that is the greatest confirmation of preeclampsia in a gravida patient presenting in hypertension with a HA?
proteinuria
What is the treatment for delayed blood transfusion reactions? Timeline?
3-21 days (MC 5-10 days) usually d/t hemolysis, watchful waiting if mild, prednisone if severe
Young patient with dyspnea despite quitting smoking and adaquate bronchodilation family history of liver dysfunction, what is his diagnosis? tx?
alpha-1 antitrypsin deficiency, treat with alpha 1-antitrypsin
In a patient with obvious complicated prostatitis, what is the investigative/confirmatory study for diagnosis?
Transrectal ultrasound
What class of medication does ritalin belong to?
Methylphenidate medications
What is generally accepted as the first line treatment in acute mania?
Depekote (divalproex)
What organism causes tinea versicolor?
Malassezia furfur
A young patient with T1DM has a joint infection, what is the initial treatment of choice?
3rd gen cef - ceftriaxone
What is the diagnosis when a patient appears hyper thyroid and their studies are elevated TSH, T3 and T4?
likely primary pituitary dysfunction possibly adenoma
What parts of the mini-mental status exam are first indicators of alzheimer’s dementia?
Word recall (recent memory) and drawing a clock
What does nitrazine paper turning blue when touched by vaginal fluid indicate?
amniotic fluid and rupture of membranes
What is the likely organism in any IV drug user infection?
S Aureus
What is the initial method of evaluation for a suspected basal cell skin cancer?
punch biopsy or shave biopsy
A 15-year-old patient p/w fever, malaise, sore throat and difficulty swallowing. He has enlarged anterior and posterior cervical nodes, palatal petechiae and severely enlarged “kissing” tonsils without exudate. What is the diagnosis? Treatment?
Mononucleosis - corticosteroids are the treatment of choice for reducing lymphoid enlargement threatening an airway, maximum of 10 days with taper
Patient just off a long coarse of steroids presents with neuro complaints, diagnosis?
pseudomotor cerebri (benign intracranial hypertension)
What is the recommended treatment for a dendritic optic lesion?
Trifluridine (antiviral) for 2-3 weeks in immunocompetent people
64 yo male c/o pain and swelling of the penis. Exam reveals swollen retracted foreskin with marked edema and mucopurulent drainage. Diagnosis?
paraphymosis
In a patient with SLE and elevated BUN/Cr who has HTN, what is the class of choice to treat her HTN?
ACE
What is the distinction between preterm labor and braxton-hicks contractions?
cervical dilation in response to contractions
What does Phalen’s test of the wrist evaluating for?
Carpal tunnel syndrome
A patient complains of pain when he moves his right thumb or wrist and is ttp over the radial stylus. Finkelstein’s test is positive. What is the diagnosis?
de Quervain’s tenosynovitis - inflammation of the abductor pollicis longus and extensor pollicis brevis
What are Ranson’s criteria for severe acute pancreatitis? (5)
Age > 55, WBCs > 16k, f/s > 200, LDH > 350, AST > 250
Young man has a chronic lump on his neck that hadn’t bothered him until today after a long night out drinking with his friends. Diagnosis?
Hodgkins lymphoma
What is a Myerson sign? (neuro) What condition does it represent?
A positive Myerson sign is reflexive, sustained eye blinking in response to repetitive tapping just above the nasal bridge between the eye aka glabellar reflex. Frequently observed in Parkinson’s patients.
What is the initial management of IBS?
Reassurance, increase water intake, avoid caffeine and keep a food diary to identify trigger foods.
What is the initial management of a black widow spider bite?
narcotics and methocarbamol (muscle relaxer robaxin)
Bell’s palsy is associated with which nerve?
Facial
What does a thyroid storm do to lab values?
They’re usually normal, it is a clinical diagnosis
What is the treatment of thyroid storm?
symptom control - rate control of tachycardia, temperature control with acetaminophen, and antithyroid medications (PTU)
What is therapeutic for benign positional vertigo?
Dix-Hallpike maneuver inducing vertigo is diagnostic as well as therapeutic
What type of chest pain to PE patients usually report?
pleuritic - increases with respiratory movements
How do you definitively diagnose endometriosis?
Laparopscopy - direct visualization
What OTC medication directly supresses cough?
dextromethorophan
What is an orthopedic Thompson test?
Test for achilles tendon rupture squeeze the calf and the foot should plantarflex
What do you call a localized painful, distinctly demarcated, raised erythema and edema often with streaking and prominent lymphatic involvement? cause?
Erysipelas - usually cellulitis caused by strep pyogenes
What is the first line antibiotic for legionalla pneumonia?
Levaquin or azithromycin
What psych medication is frequently associated with causing hypothyroidism?
Lithium
What medication is given to treat a patient with worsening alcoholic liver?
Pentoxifylline - increases kidney perfusion by making rbcs flow better and more malleably, preventing the development of hepatorenal syndrome
In a patient with Barrett’s esophagus, how often should screening endoscopy be performed?
Every 3-5 years
What is an effective pharmacological treatment of benign tremor?
Propranolol either continuously or intermittantly
What is the best treatment for an infection of the tear duct?
surgical intervention: dacrocystorhinostomy
A patient with painless unilateral blindness on exam has dilated vessels, intraretinal hemorrhages and cotton-wool spots. Diagnosis?
Retinal Vein occlusion
What is the most important intervention to prevent venous stasis ulcers?
decreasing edema with compression stockings to improve venous return
What is the follow up for children with carditis with rheumatic fever once they have been treated for their acute illness?
Monthly PCN for 5 years after the initial illness as long as they have not had any recurrences
A 17-year-old male presents with pain and swelling of the right testis. He is febrile and nauseous. There is marked swelling of his parotid glands and enlargement of the submaxillary lymph nodes. Diagnosis? Tx?
Mumps orchitis, supportive care and scrotal support
What is the treatment for papillary thyroid cancer?
surgical excision
In a patient with hereditary spherocytosis and repeated aplastic crises, what intervention can prevent future episodes?
Splenectomy
What is normal intraocular pressures?
10-21mmHg
