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PANRE review > Book practice > Flashcards

Book practice Flashcards

1
Q

Age 25-35, Aphthous ulcers, genital ulcers, uveitis, inflammatory arthritis, skin lesions, relapsing/remitting course

A

Behçet syndrome

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2
Q

Pitting nails, multi joint inflammatory arthritis, 2 weeks later scaling skin lesions

A

Psoriatic arthritis

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3
Q

first line treatment in afib with any symptoms or abnormal vital signs

A

cardioversion

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4
Q

urethritis, conjunctivitis, arthritis, prior gi illness or STD

A

reactive arthritis

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5
Q

female black pt with fever, malaise, weight loss and skin changes

A

SLE

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6
Q

Cards common medication that can cause hyperthyroidism

A

amiodarone

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7
Q

Only treatment of hyperthyroidism in pregnancy

A

PTU

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8
Q

What is the role of b-blockers in hyperthyroidism?

A

relieves symptoms only

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9
Q

Why/what is treatment for a ganglion cyst?

A

treat if symptomatic: immobilization then aspiration and/or cortisone

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10
Q

At what post partum minutes are apgar scores recorded?

A

1 and 5 mins

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11
Q

pt being treated for TB presents with difficulty seeing, dull eye pain, loss of color discrimination. Which drug is to blame?

A

ethambutol

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12
Q

pt being treated for TB presents with jaundice, rash and flu-like illness. Which drug is to blame?

A

rifampin

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13
Q

pt being treated for TB presents with hepatitis and peripheral neuropathy. Which drug is to blame?

A

isoniazid

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14
Q

pt being treated for TB presents with hyperuricemia and hepatitis. Which drug is to blame?

A

pyrazinamide

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15
Q

what types of organisms are being tested for using a blood agar medium?

A

s. aureus and strep

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16
Q

What is being tested for with a 20% KOH solution direct microscopy study?

A

fungus/dermatophyte

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17
Q

What condition is a straight leg raise test evaluating?

A

possible disk disease of the lower back

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18
Q

What is considered a positive straight leg raise test?

A

Pain in passive ROM >= 60 degrees in the ipsilateral leg

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19
Q

First line management for patient with kidney stones?

A

pain control with narcotics

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20
Q

What is the imaging modality of choice for nephrolithiasis?

A

helical CT

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21
Q

young pt with tragal ttp, itching and inflammation of the ear canal and no ttp to mastoid, diagnosis?

A

acute otitis externa

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22
Q

young pt with edema of external auditory canal, anterior and inferior displacement of auricle with ttp posteriorly, diagnosis?

A

mastoiditis

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23
Q

What condition causes the total lung capacity to be increased on pfts?

A

emphysema, normal in chronic bronchitis

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24
Q

what does COPD do to diffusing capacity on PFTs?

A

emphysema reduces it, normal in chronic bronchitis

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25
Q

Characteristics of neurogenic shock

A

hypertensive, normal/tachycardic, decreased svr

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26
Q

Characteristics of cardiogenic shock

A

hypotension, tachycardia, decreased cardiac index, increase svr, metabolic acidosis (LA), elevated BUN/Cr

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27
Q

treatment of choice/secondary for trigeminal neuralgia?

A

carbamazepine/oxcarbazepine, phenytoin is second line

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28
Q

symptomatic relief for trigeminal neuralgia?

A

aspirin/acetaminophen

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29
Q

young patient with anterior tibia pain, diagnosis? muscle affected?

A

Osgood-Schlatter disease, quadriceps muscle (stair climbing)

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30
Q

Young pt with hip/knee pain that is worsened with internal rotation, diagnosis?

A

Legg-Calve-Perthes disease

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31
Q

pt with insidious b/l u/le muscle weakness, diagnosis?

A

polymyositis

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32
Q

pt with extremity pain, insidious onset fever, malaise and waight loss, diagnosis?

A

polyarteritis nodosa

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33
Q

Harsh holosystolic grade 3/4 murmur on L sternal border with wide radiation and fixed split s2, diagnosis?

A

Ventricular septal defect

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34
Q

During which portion of the heart beat cycle is an aortic regurgitation heard?

A

Diastolic

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35
Q

Continuous murmur accentuated late in systole

A

PDA

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36
Q

What primary lab result indicates a diagnosis of primary hyperparathyroidism?

A

serum calcium elevation

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37
Q

Pt with pain or paresthesia around the outer aspect of the thigh, diagnosis? nerve involved?

A

Meralgia paresthetica, lateral femoral cutaneous

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38
Q

What patient injures or has osteoarthritis and cannot extend a PIP joint, diagnosis?

A

Boutonniere’s deformity

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39
Q

Pt overextends thumb and hears a ripping sound, diagnosis?

A

Gamekeeper thumb - injury to the lateral collateral ligament of first MCP of thumb

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40
Q

Pt strikes finger causing forced flexion and inability to extend DIP, diagnosis? need for surgery?

A

Mallet finger, surgery only if associated with an avulsion fracture

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41
Q

Mass on the testicles that enlarges with valsalva, diagnosis?

A

varicocele

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42
Q

What does the orthopedic Lachman test examine?

A

anterior cruciate ligament tears

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43
Q

What does the orthopedic McMurray test examine?

A

medial meniscus injury

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44
Q

What does the orthopedic Finkelstein test examine?

A

de Quervain tenosynovitis

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45
Q

What type of crystals are present in an aspirate of a gouty knee?

A

urate crystals

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46
Q

What type of medication should gout prone patients avoid?

A

thiazide diuretics (increase purine retention in kidneys)

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47
Q

Diagnostic mode of choice for multiple sclerosis? What is the pathoneumonic finding?

A

MRI – multiple foci of neurological degeneration

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48
Q

What is the indication for treatment with Atomoxetine (strattera)?

A

ADHD

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49
Q

What is the indication for treatment with Carbamazepine (tegretol)?

A

Schizoaffective disorder – particularly depressive variety

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50
Q

What is the indication for treatment with Nefazodone (serzone)?

A

Major depression SNRI

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51
Q

What is the mechanism of action of Olanzapine (zyprexa)?

A

SDA (seratonin-dopamine agonist) used in treating schizophrenia and schizoaffective disorder

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52
Q

What is the indication for treatment with Risperidone (risperdal)?

A

SDA (seratonin-dopamine agonist) used in treating schizophrenia and schizoaffective disorder

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53
Q

What is the EKG change of pericarditis?

A

global ST elevation throughout leads

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54
Q

What is a positive ASO titer useful in diagnosing?

A

confirms antibodies to streptococcus

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55
Q

Person with sickle cell trait at high altitude or under physical stress may experience what?

A

painless hematuria → rhabdomyolysis

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56
Q

What is the test of choice to confirm tarsal tunnel syndrome?

A

nerve conduction velocity test

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57
Q

What is the number one preventable cardiac risk factor?

A

Smoking – decreases by 50% 1 year after quitting

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58
Q

What is the first line antibiotic for sinusitis in a pen-allergic, antibiotic naïve patient?

A

Bactrim

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59
Q

What is the first line antibiotic for sinusitis in a patient with recent antibiotic use?

A

levaquin

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60
Q

Describe the ideal candidate for Niacin as a first line agent in hyperlipidemia

A

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

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61
Q

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?

A

Polymyalgia rheumatica

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62
Q

Another name for the statin medications (mechanism)?

A

HMG-CoA reductase inhibitor

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63
Q

Full activity of statins cause what changes in lipids?

A

decrease triglycerides/LDL, raise HDL

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64
Q

Classic triad of preeclampsia

A

hypertension, proteinuria, thrombocytopenia

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65
Q

What is Takotsubo cardiomyopathy?

A

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

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66
Q

What is the physiology of an S3 heart sound?

A

heart failure: indicative of increased ventricular filling may also be due to severe MR or TR “slosh-ing-in”

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67
Q

What is the physiology of an S4 heart sound?

A

caused by stiffening of ventricular walls (usually left) producing turbulent flow with atrial contraction. More apparent with exercise “a-stiff-wall”

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68
Q

What is the major difference in symptoms you’d expect in pericarditis from an MI?

A

Pericarditis usually produces pleuritic sharp stabbing pain

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69
Q

Which should be longer in a normal Rinee test? Air conduction or bone conduction?

A

Air conduction

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70
Q

Describe the results of a webber hearing test

A

Lateralizes to the side of an obstructive hearing loss, away from the side of a neural hearing loss

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71
Q

What is the incubation time for giardia?

A

1-3 weeks

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72
Q

What is the incubation period for salmonella typhoid?

A

5-14 days

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73
Q

What is the incubation period for common salmonella gastroenteritis?

A

8-48 hours

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74
Q

List macrocytic anemias

A

B12/Folate deficiency, Pernicious anemia, megaloblastic anemia (bone marrow deficiencies), alcoholism

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75
Q

List microcytic anemias

A

B-Thalasemia, iron deficiency, sideroblastic anemia, lead poisoning

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76
Q

List nomocytic anemias

A

aplastic anemia, sickle cell disease (not trait), fluid overload (pregnancy), B2 (riboflavin) deficiency

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77
Q

hypersegmented neurotrophils on peripheral smear, diagnosis?

A

megaloblastic anemia

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78
Q

Most common pathogens for pneumonia following flu? Population?

A

S. Aureus, Strep pneumo, H. flu - Elderly, pts with lung pathology or metabolic disorders

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79
Q

For whom is klebsiella pneumoniae the most common cause of pneumonia?

A

alcoholics and diabetics

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80
Q

For whom is mycoplasma pneumoniae the most common cause of pneumonia?

A

young adults in an ambulatory setting

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81
Q

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?

A

Pulmonic stenosis

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82
Q

Harsh systolic murmur heard on the right with early systolic click, EKG shows LVH. Diagnosis?

A

Aortic stenosis

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83
Q

Location of mitral regurgitation murmur? EKG finding?

A

apex, EKG shows left axis deviation or LVH

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84
Q

Location of tricuspid regurgitation murmur? EKG finding?

A

Third to fifth intercostal spaces, EKG shows Right axis deviation

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85
Q

Patient with pruritus and progressive jaundice and no stones in his bile duct on ERCP. Diagnosis?

A

Primary sclerosis cholangitis

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86
Q

Constipation relief for renal patients. Dos and don’ts

A

Colace, metamucil and lactulose are okay, MOM is not okay d/t risk of magnesium overload

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87
Q

What is the second stage treatment for rheumatoid arthritis after NSAIDs?

A

DMARDs (bridge with steroids)

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88
Q

What is the treatment for severe RSV infections?

A

Ribavirin

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89
Q

Which medications can trigger an acute asthma attack?

A

B-blockers, NSAIDs/Aspirin

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90
Q

What is the most sensitive and definitive test for a stress fracture?

A

Bone scan

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91
Q

What is the acute management of a cluster headache?

A

Oxygen or injectable or nasal triptan

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92
Q

What is a good prophylactic treatment for cluster headaches?

A

Lithium or methysergide

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93
Q

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?

A

polycythenia vera - get Cbc with smear

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94
Q

child with abrupt episodes of diminished attention where he disconnects briefly from conversations yet has no awareness of these lapses, diagnosis? EEG findings?

A

petit mal seizure (absence), during event would show 3-Hz spike-and-wave activity

95
Q

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?

A

Dengue fever

96
Q

Definitive diagnosis for Malaria?

A

parasite in stained peripheral blood smear

97
Q

CT showing ring enhancing lesions

A

Toxoplasmosis

98
Q

How do you distinguish actinic keratosis from squamous cell carcinoma?

A

biopsy

99
Q

Differentiate between Meniere’s disease, labrynthitis and benign positional vertigo

A

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.

100
Q

treatment of choice for Meniere’s disease

A

Antihistamines and diuretics (acetazolamide) and low salt diet. Steroid injections by ENT may provide symptomatic relief.

101
Q

Pt develops back pain and hematuria during a random donor platelet transfusion, what is the next step?

A

stop the transfusion and follow the acute transfusion reaction protocol

102
Q

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?

A

slow the transfusion and administer acetaminophen and diphenhydramine (common in up to 30% of transfusions)

103
Q

What is the first line treatment for ventricular tachycardia?

A

Amiodarione

104
Q

What vitamin deficiency causes night blindness?

A

Vitamin A

105
Q

Pt with inflammated gingivae, petechiae, rough, dry skin, anemia and impaired wound healing, diagnosis?

A

Scurvy - vitamin C deficiency

106
Q

What vitamin deficiency causes areflexia and gait disturbances?

A

Vitamin E

107
Q

What ethnic group has the highest incidence of Rh (-) blood types? Lowest?

A

Caucasians 15-16%

Lowest North American Indians 1%, Indo-Eurasians 2%

108
Q

What is definitive diagnosis/treatment for pediatric intussusception? incidence?

A

barium or air enema has a 75% resolution rate

109
Q

What is the most common valvular abnormality after rheumatic fever?

A

Mitral stenosis

110
Q

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?

A

Seborrhea keratosis - treatment with hydrocortisone

111
Q

What is the treatment of choice in inflammatory (viral) pericarditis?

A

NSAIDs

112
Q

What is the most common cause of pericarditis?

A

viral

113
Q

What dermatological diagnosis is established with a wood’s lamp?

A

dermatophytosis

114
Q

What is the indication of a punch biopsy vs an excisional biospy?

A

If the size of the lesion is too large for safe excisional biopsy, then punch biopsy is performed

115
Q

What electrolyte abnormality can be caused by ACE inhibitors?

A

hyperkalemia

116
Q

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?

A

Polycystic Kidney disease

117
Q

What is the mechanism of diarrhea in cholera?

A

Colonization of the small intestine and release of enterotoxin by the pathogen which induces profound GI secretion

118
Q

Distinguish late epididymitis from testicular torsion?

A

Typically elevation of the scrotum will alleviate pain in epididymitis

119
Q

What should be suspected if a newborn does not pass meconium?

A

Hirschsprung disease: lack of parasympathetic ganglion cells in a segment of the colon leads to disruption of motility

120
Q

What is the normal window for a newborn to pass meconium?

A

24-48 hours

121
Q

How do you evaluate a suspected non obstructive cause of urinary retention?

A

cystometric testing

122
Q

What is the typical manifestation of chondroblastoma? What is it?

A

Young patient with long bone pain - rare benign neoplasm that develops in the epiphyses

123
Q

What type of cancer is most commonly associated with amyloidosis?

A

Multiple myeloma

124
Q

At what stage of cervical dilation does the second stage of labor begin?

A

10cm

125
Q

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?

A

transient synovitis most common ages 3-10 after URI, treatment is symptomatic

126
Q

What leukemia is associated with the philadelphia chromosome?

A

CML chronic myelogenous

127
Q

What is the most common acquired hernia?

A

direct inguinal hernia

128
Q

Under what circumstances is high flow oxygen effective to speed resorption of a pneumothorax? mechanism?

A

mildly symptomatic, patient unlikely to cooperate with follow up, will create a nitrogen gradient to speed resorption

129
Q

What is the treatment of choice for otitis externa?

A

topical aminoglycoside (neomycin/polymyxin/ofloxacin) or fq often combined with a topical corticosteroid

130
Q

What is the treatment for cerumen impaction?

A

disimpaction often with wax dissolving agents murine or debrox (carbamide solutions)

131
Q

What is the difference between somatoform disorder and conversion disorder?

A

conversion manifests only one symptom which is unsubstantiated by a medical work up rather than multiple complaints of somatoform

132
Q

Young patient with chronic cough and foul smelling phlegm had recurrent pulmonary infections and presents with crackles and digital clubbing. Diagnosis?

A

Bronchiectasis

133
Q

What is the monitoring recommendation of DEXA scanning by T score?

A

-1 to -1.5: every 5 years, -1.5 to -2 every 3-5 years, less than -2, every 1-2 years

134
Q

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?

A

sarcoidosis, corticosteroids

135
Q

post partum female presents with double vision worsening throughout the day, easy fatiguability, difficulty swallowing, ptosis and limited EOM movement. Diagnosis? Confirmatory testing?

A

Myasthenia gravis, acetylcholine receptor antibody assay

136
Q

macrocytic anemia with hypersegmented neutrophils, patient with neuropathy and a pulmonary flow murmur

A

vitamin B12 deficiency

137
Q

how long should facial skin sutures stay in?

A

4-5 days

138
Q

What is a common organism in puncture wounds?

A

pseudomonas

139
Q

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?

A

pancytopenia caused by aplastic anemia - bone marrow failure

140
Q

What is the cardiac enzyme with the shortest half-life? utility?

A

ck-mb 24-48 hours, useful to determine if a re-infarction is occuring

141
Q

What is the most common cause of small bowel obstruction?

A

adhesion

142
Q

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?

A

TTP

143
Q

Pt has had a URI then mucosal and skin bleeding. Labs reveal anemia, thrombocytopenia, peripheral smear normal. diagnosis?

A

ITP

144
Q

what is the gynecologic schiller test?

A

It evaluates the cervix after a positive pap with iodine to identify areas of rapid cell turnover

145
Q

What test is best for the evaluation of new vulvar lesions?

A

biopsy

146
Q

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?

A

Bicipital tendonitis will be exacerbated by the palpation of the tendon within the bicipital groove and with supination against resistance

147
Q

Can mitral valve prolapse cause chest pain?

A

yes

148
Q

What valvular disorder is associated with a midsystolic click?

A

typically, mitral valve prolapse, may be followed by a late systolic murmur indicating regurgitation

149
Q

Where is the apical pulse heard in CHF?

A

left axilla

150
Q

What is the normal respiratory rate of a newborn?

A

30-60

151
Q

What is the diagnosis associated with multinucleated giant cells? what is the diagnostic test

A

herpes/varicella zoster skin infection - done with tzanck smear

152
Q

What is the most common cause of osteomyelitis in sickle cell anemia? treatment?

A

S. Aureus - fq x 6 weeks

153
Q

What is the difference between treatment for trichomonas and bacterial vaginosis?

A

Length and dose of metronidazole: 2g x1 for trichamoniasis, 500BID x7days for BV

154
Q

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?

A

G6PD deficiency can cause hemolytic anemia when combined with aspirin. Hemolytic episodes are usually self limiting. Avoid oxidant drugs

155
Q

What condition is associated with retinal drusen deposits on fundoscopic exam?

A

Age-related macular degeneration

156
Q

A patient presents with postauricular ecchymosis (battle sign) and peri-orbital bruising (raccoon eyes) what is the diagnosis?

A

basilar skull fracture

157
Q

What is the treatment for a < 15% ptx without any signs of tension or underlying lung disease?

A

bedrest as an outpatient

158
Q

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?

A

simple partial seizure

159
Q

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?

A

Atonic seizure

160
Q

What GI bug causes a longer waxing/remitting course with foul smelling bulky stools?

A

Giardia

161
Q

What is the hematologic osmotic fragility test used to diagnose?

A

spherocytosis

162
Q

What is the definitive confirmatory test for sickle cell disease?

A

hemoglobin electrophoresis

163
Q

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?

A

Tracheal stenosis - can occur weeks later

164
Q

What is the definitive diagnostic test for Herpes Zoster?

A

PCR of skin scraping

165
Q

What is an indication for a 24 hour eye patch?

A

corneal abrasion

166
Q

What helps in symptomatic relief of allergic eye disease?

A

cold compresses/ topical antihistamines

167
Q

What are the risk factors for cataracts? (6)

A

congenital rubella, trauma, systemic diseases (dm, htn), systemic or inhaled corticosteroid use, uveitis and excessive sun exposure

168
Q

What is the treatment of sialadenitis?

A

IV antibiotics + supportive care (hydration, warm compresses, sialagogues, gland massage)

169
Q

Lace like blue patterned rash on LEs when exposed to col relieved with rewarming. Diagnosis? cause? concerning for?

A

Livedo reticularis - caused by vasomotor instability. Concerning for anti-phospholipid antibody syndrome

170
Q

What is the probability of recurrence after a spontaneous pneumothorax is reduced with a chest tube?

A

30% in 2 years

171
Q

What is the primary empiric treatment for atypical pneumonia?

A

Erythromycin or doxycycline

172
Q

What is the primary indicator of a positive finding on an exercise stress test?

A

ST depression

173
Q

Differentiate between a brain abscess and encephalitis

A

Encephalitis usually has higher fever, stiff neck, no focal neurological deficits. Abscess presents with headache and focal neurological deficits and low grade fever

174
Q

What is the treatment of choice in acute gout?

A

NSAIDs - indomethacine or naproxen

175
Q

Patient with transient painless monocular visual loss lasting seconds to 30 minutes

A

Amaurosis fugax

176
Q

Patient with painless, total or near total black-out vision

A

Central retinal artery occlusion - exam reveals retinal opacity distal to the occlusion

177
Q

What diagnosis is associated with calcium pyrophosphate crystals found on joint aspirate?

A

pseudogout

178
Q

What is the treatment in a patient with a history of FOOSH, snuffbox pain and negative xray?

A

Spica splinting and repeat xray in 2 weeks

179
Q

What is a common side effect requiring routine monitoring for the schizophrenic medication clozapine?

A

cbc every week to monitor for agranulocytosis

180
Q

What diagnosis is associated with a maculopapular butterfly rash?

A

SLE

181
Q

Patient presents with dysphagia dysmotility and pulmonary fibrosis, also reporting thickening of skin, telangiectasias and pigment changes. Diagnosis?

A

Scleroderma (systemic sclerosis)

182
Q

What condition is almost exclusively seen in the COPD population presents with tachycardia and multiple distinct P waves and PP intervals?

A

multifocal atrial tachycardia

183
Q

What is the treatment of choice for pertussis?

A

macrolide (erythromycin)

184
Q

What is the treatment of choice for chlamydia?

A

macroclide abx (emycin) or tetracycline (doxy) in adults only

185
Q

Soft tissue head imaging for non-infectious etiology is done preferably with which test?

A

MRI

186
Q

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?

A

4-9mm Hg

187
Q

What is the laboratory test that is the greatest confirmation of preeclampsia in a gravida patient presenting in hypertension with a HA?

A

proteinuria

188
Q

What is the treatment for delayed blood transfusion reactions? Timeline?

A

3-21 days (MC 5-10 days) usually d/t hemolysis, watchful waiting if mild, prednisone if severe

189
Q

Young patient with dyspnea despite quitting smoking and adaquate bronchodilation family history of liver dysfunction, what is his diagnosis? tx?

A

alpha-1 antitrypsin deficiency, treat with alpha 1-antitrypsin

190
Q

In a patient with obvious complicated prostatitis, what is the investigative/confirmatory study for diagnosis?

A

Transrectal ultrasound

191
Q

What class of medication does ritalin belong to?

A

Methylphenidate medications

192
Q

What is generally accepted as the first line treatment in acute mania?

A

Depekote (divalproex)

193
Q

What organism causes tinea versicolor?

A

Malassezia furfur

194
Q

A young patient with T1DM has a joint infection, what is the initial treatment of choice?

A

3rd gen cef - ceftriaxone

195
Q

What is the diagnosis when a patient appears hyper thyroid and their studies are elevated TSH, T3 and T4?

A

likely primary pituitary dysfunction possibly adenoma

196
Q

What parts of the mini-mental status exam are first indicators of alzheimer’s dementia?

A

Word recall (recent memory) and drawing a clock

197
Q

What does nitrazine paper turning blue when touched by vaginal fluid indicate?

A

amniotic fluid and rupture of membranes

198
Q

What is the likely organism in any IV drug user infection?

A

S Aureus

199
Q

What is the initial method of evaluation for a suspected basal cell skin cancer?

A

punch biopsy or shave biopsy

200
Q

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?

A

Mononucleosis - corticosteroids are the treatment of choice for reducing lymphoid enlargement threatening an airway, maximum of 10 days with taper

201
Q

Patient just off a long coarse of steroids presents with neuro complaints, diagnosis?

A

pseudomotor cerebri (benign intracranial hypertension)

202
Q

What is the recommended treatment for a dendritic optic lesion?

A

Trifluridine (antiviral) for 2-3 weeks in immunocompetent people

203
Q

64 yo male c/o pain and swelling of the penis. Exam reveals swollen retracted foreskin with marked edema and mucopurulent drainage. Diagnosis?

A

paraphymosis

204
Q

In a patient with SLE and elevated BUN/Cr who has HTN, what is the class of choice to treat her HTN?

A

ACE

205
Q

What is the distinction between preterm labor and braxton-hicks contractions?

A

cervical dilation in response to contractions

206
Q

What does Phalen’s test of the wrist evaluating for?

A

Carpal tunnel syndrome

207
Q

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?

A

de Quervain’s tenosynovitis - inflammation of the abductor pollicis longus and extensor pollicis brevis

208
Q

What are Ranson’s criteria for severe acute pancreatitis? (5)

A

Age > 55, WBCs > 16k, f/s > 200, LDH > 350, AST > 250

209
Q

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?

A

Hodgkins lymphoma

210
Q

What is a Myerson sign? (neuro) What condition does it represent?

A

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.

211
Q

What is the initial management of IBS?

A

Reassurance, increase water intake, avoid caffeine and keep a food diary to identify trigger foods.

212
Q

What is the initial management of a black widow spider bite?

A

narcotics and methocarbamol (muscle relaxer robaxin)

213
Q

Bell’s palsy is associated with which nerve?

A

Facial

214
Q

What does a thyroid storm do to lab values?

A

They’re usually normal, it is a clinical diagnosis

215
Q

What is the treatment of thyroid storm?

A

symptom control - rate control of tachycardia, temperature control with acetaminophen, and antithyroid medications (PTU)

216
Q

What is therapeutic for benign positional vertigo?

A

Dix-Hallpike maneuver inducing vertigo is diagnostic as well as therapeutic

217
Q

What type of chest pain to PE patients usually report?

A

pleuritic - increases with respiratory movements

218
Q

How do you definitively diagnose endometriosis?

A

Laparopscopy - direct visualization

219
Q

What OTC medication directly supresses cough?

A

dextromethorophan

220
Q

What is an orthopedic Thompson test?

A

Test for achilles tendon rupture squeeze the calf and the foot should plantarflex

221
Q

What do you call a localized painful, distinctly demarcated, raised erythema and edema often with streaking and prominent lymphatic involvement? cause?

A

Erysipelas - usually cellulitis caused by strep pyogenes

222
Q

What is the first line antibiotic for legionalla pneumonia?

A

Levaquin or azithromycin

223
Q

What psych medication is frequently associated with causing hypothyroidism?

A

Lithium

224
Q

What medication is given to treat a patient with worsening alcoholic liver?

A

Pentoxifylline - increases kidney perfusion by making rbcs flow better and more malleably, preventing the development of hepatorenal syndrome

225
Q

In a patient with Barrett’s esophagus, how often should screening endoscopy be performed?

A

Every 3-5 years

226
Q

What is an effective pharmacological treatment of benign tremor?

A

Propranolol either continuously or intermittantly

227
Q

What is the best treatment for an infection of the tear duct?

A

surgical intervention: dacrocystorhinostomy

228
Q

A patient with painless unilateral blindness on exam has dilated vessels, intraretinal hemorrhages and cotton-wool spots. Diagnosis?

A

Retinal Vein occlusion

229
Q

What is the most important intervention to prevent venous stasis ulcers?

A

decreasing edema with compression stockings to improve venous return

230
Q

What is the follow up for children with carditis with rheumatic fever once they have been treated for their acute illness?

A

Monthly PCN for 5 years after the initial illness as long as they have not had any recurrences

231
Q

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?

A

Mumps orchitis, supportive care and scrotal support

232
Q

What is the treatment for papillary thyroid cancer?

A

surgical excision

233
Q

In a patient with hereditary spherocytosis and repeated aplastic crises, what intervention can prevent future episodes?

A

Splenectomy

234
Q

What is normal intraocular pressures?

A

10-21mmHg

PANRE review (14 decks)

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