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PANRE > buzz words 2 > Flashcards

buzz words 2 Flashcards

1
Q

tx pcp pneumonia

pneumocystis jiroveci pneumonia

A

bactrim

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2
Q

tx for tetanus

A

pcn
immune globulin
supportive care - resp esp.

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3
Q

how do hookworm larvae enter the body

A

through the skin

usually the soles of the feet

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4
Q

tx hookworm

A

azoles

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5
Q

what type mosquitoes carry malaria

A

anopheles

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6
Q

tx white oral plaques that can be scraped off

A

candida

topical nystatin or oral fluconazole 1mg

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7
Q

ct scan shows ring enhancing lesions in an HIV pt

dx

A

toxoplasmosis

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8
Q

drug of choice for toxoplasmosis

A

bactrim

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9
Q

what organism causes toxoplasmosis

A

toxoplasma gondii

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10
Q

what drug do you use to treat pinworm

A

everyone in the house with albendazole

tx again 2 weeks later

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11
Q

scotch tape test dx?

A

pinworm

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12
Q

nisseria gram + or -

A

gram -

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13
Q

syphilis is caused by what organism

A

treponema pallidum

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14
Q

gram positive organism in chains

dx

A

strep

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15
Q

gram - diplococci

dx

A

neisseria

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16
Q

most common pre-op prophylaxis

A

ancef, cephalexin

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17
Q

oral abx for pseudomonas

A

cipro

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18
Q

suffix for most fluoroquinolones

A

oxacin

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19
Q

why aren’t fluoroquinolones used more often

A

lots of side effects

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20
Q

pt with ruptured achilles tendon

recent abx, which class

A

fluoroquinolones

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21
Q

why can’t you give fluoroquinolones to kids

A

cause cartilage development problems

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22
Q

class of abx for community acquired pneumonia

A

macrolides

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23
Q

list macrolides

A

erythromycin
azithromycin
clarithromycin

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24
Q

abx class for chlamydia

A

macrolides

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25
Q

class of abx for its effects on increasing GI motility

A

macrolides

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26
Q

which is worse for pads

tetracycline or aminoglycoside

A

tetracycline

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27
Q

pizza pie retinopathy

dx

A

CMV

cytomegalovirus

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28
Q

pt with metallic taste and dark brown urine

what abx on?

A

flagyl

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29
Q

abx most likely to cause c.diff

A

clindamycin

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30
Q

drug of choice MRSA

A

vancomycin

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31
Q

pt on rifampin

warn of what side effect

A

orange-red discoloration of body fluids

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32
Q

infuse vanc too fast

A

red man syndrome

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33
Q

2 oral meds for MRSA

A

linezolid (zyvox)

bactrim

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34
Q

organism most commonly responsible for community acquired pneumonia

A

strep pneumoniae

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35
Q

most common organism for UTI

A

E. Coli

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36
Q

gummas or granulomatous nodules

dx?

A

tertiary syphilis

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37
Q

bloody stool with cysts and trophozoites

dx

A

amebiasis

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38
Q

community acquired carditis is most often caused by one of the HACEK organisms

List HACEK organisms

A 
haemophilus
actinobacillus
cardiobacterium
eikenella
kingella
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39
Q

3 meds combined to tx h pylori

A

omeprazole (prilosec)
clarithromycin
amoxicillin

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40
Q

prophylactic abx before dental procedure

dose?

A

amoxicillin

2gm po 1 hr before procedure

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41
Q

pregnant women and cat litter

dx?

A

toxoplasmosis

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42
Q

tx for urethritis neisseria

dx?

A

ceftriaxone

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43
Q

klebsiella gram + or -

A

gram -

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44
Q

gram + clusters

dx

A

staph

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45
Q

best test for dx rocky mountain spotted fever

A

indirect immunofluorescent antibodies

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46
Q

gram - coccobaccili found in sputum with pneumonia

dx

A

H flu

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47
Q

med used as prophylaxis for meningococcal meningitis

A

rifampin

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48
Q

secretory phase of the menstraul cycle

day 14-28 is dominated by what hormone

A

progesterone

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49
Q

nulliparous or multiparous women more likely to develop preeclampsia

A

nulliparity

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50
Q

since a genetic cause is the number one reason for primary amenorrhea

one important test

A

karyotype

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51
Q

purulent cervical dc

dx

A

neisseria gonorrhoeae

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52
Q

young girl with a web neck or wide chest

dx

A

turner’s syndrome

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53
Q

cervical bx comes back as CIN1 next step

A

repeat pap smear in 6 months and repeat colposcopy in 12 months

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54
Q

most common cause of secondary amenorrhea

A

pregnancy

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55
Q

3 labs if considering secondary amenorrhea

A

beta hcg
tsh
prolactin

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56
Q

define premature birth

A

delivery 20-36 weeks

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57
Q

a unilateral, single, mobile, firm, non-tender solid breast mass
dx

A

fibroadenoma

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58
Q

metrorrhagia

A

bleeding between menstrual cycles

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59
Q

postmenopausal bleeding

dx

A

endometrial cancer

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60
Q

what portion of the menstrual cycle does pms occur

A

second half and menstruations should relieve sxs

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61
Q

BV tx

A

flagyl x 7 days

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62
Q

location within the pelvis is endometriosis found

A

on an ovary

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63
Q

gold standard lab for chlamydia

A

nucleic acid amplification test

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64
Q

are fibrocystic breast masses usually b/l or unilateral

A

bilateral

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65
Q

definitively dx endometriosis

A

ex lap

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66
Q

most common uterine tumor

A

leiomyoma, fibroids

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67
Q

ethnic background increased risk of fibroids

A

AA 5x more likely

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68
Q

tx vaginal candida

A

fluconazole po 1 dose or azole cream x 1 week

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69
Q

1st step of tx for endometrial cancer

A

total hysterectomy and b/l salpingo-oophorectomy

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70
Q

chocolate cyst

dx

A

endometrioma

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71
Q

surge in what hormone leads to ovulation

A

luteinizing hormone

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72
Q

irregular menses, hirsutism and infertility

dx

A

PCOS

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73
Q

what endocrine issues is associated with PCOS

A

insulin insensitivity

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74
Q

pt with PCOS wants to get pregnant

2 meds to start on

A

metformin

clomid

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75
Q

medical tx for early ectopic

A

methotrexate

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76
Q

ovarian cyst with hair and teeth

dx

A

teratoma

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77
Q

mean age for ovarian cancer

A

63

think of in an older pt with vague and sxs

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78
Q

second stage of labor

A

fully dilated to delivery

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79
Q

66yo female pt with bouts of N, wt loss, vague and pain

dx

A

ovarian cancer

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80
Q

when to begin pap smears

A

when you are sexually active or 21 yo

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81
Q

cervical bx CIN2 or CIN3

next step

A

excision
LEEP
cold knife (incompetent cervix)
cryotherapy

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82
Q

2 risk factors for cervical ca

A

multiple sexual partners

smoking

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83
Q

how much time needs to pass before dx secondary amenorrhea

A

if cycles have been nl 3 months

if cycles have been irregular 6 months

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84
Q

what is a cystocele

A

a herniation of the bladder into the vagina

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85
Q

tx for turners syndrome

A

cyclical estrogen

progesterone

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86
Q

3 txs for uterine prolapse

A

pessary
kegel maneuvers
surgery

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87
Q

most common organism for mastitis

A

staph aureus

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88
Q

about how pregnant is the uterus at the umnilicus

A

20 weeks

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89
Q

most common cause of postpartum hemorrhage

A

uterine atony

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90
Q

defined missed ab

A

no vaginal bleeding, cervix is closed, POC inside

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91
Q

what age is primary amenorrhea dx

A

14 if no secondary sex characteristics

16 is some secondary development

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92
Q

tx for mastitis

A

1st line dicloxacillin

2nd line cephalexin or erythromycin

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93
Q

should breast feeding stop for mastitis

A

mastitis no

abscess yes

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94
Q

PE- retroverted uterus or uterosacral ligament nodularity

dx?

A

endometriosis

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95
Q

at how many weeks can you do an amniocentesis

A

15-20 weeks

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96
Q

5 risk factors for breast cancer

A 
BRCA1 or 2 positive
unopposed estrogen
nulliparity
early menarche
late menopause
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97
Q

avg age of menopause

A

51

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98
Q

cottage cheese dc

dx

A

vaginal candidiasis

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99
Q

follicular phase of menstruation dominated by what hormone

A

estrogen

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100
Q

how wt should you gain during pregnancy

A

20-35 lbs

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101
Q

thin, sticky, malodorous vag d/c

dx?

A

BV

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102
Q

vaginal infection with motile flagellated protozoa

dx

A

trichomonas

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103
Q

2 meds used for htn in pregnancy

A

methyldopa

labetalol

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104
Q

triad of pre-eclampsia

A

htn
edema
proteinuria

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105
Q

why is ovarian cancer so hard to dx

A

there are no good markers and sxs are very vague

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106
Q

2 important things to tell its on flagyl

A

stay out of the sun

no alcohol

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107
Q

define inevitable ab

A

vaginal bleeding
cervix is open
POC inside

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108
Q

how is the first day of the menstrual cycle defined?

A

1st day of menstrual bleeding is 1st day of the cycle

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109
Q

what is the karotype for patient with turner’s syndrome

A

(45,X)

they are missing one sex chromosome

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110
Q

give the time frame for preterm labor

A

20-37 weeks

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111
Q

pt presents with mucopurulent dc and CMT

dx

A

chlamydia - cervicitis

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112
Q

4 human papillomaviruses are linked to cervical ca

A

16, 18, 31, 33

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113
Q

clue cells

dx?

A

BV

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114
Q

hallmark of PE for placenta previa

A

trick ?

never do a pelvic on someone with presumed placenta previa

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115
Q

medium to grow out gonorhea

A

thayer-martin

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116
Q

age range for HPV vaccination

A

9-26 yo

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117
Q

pt with primary amenorrhea and low FSH

dx

A

hypothalamic pituitary insufficiency

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118
Q

characteristic that sets apart PID from other and issues

A

bilateral pain

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119
Q

6 risk factors for ovarian ca

A 
BRCA1
family hx
nulliparity
late menopause
caucasian 
asian
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120
Q

define ab

A

delivery of urerine contents before 20 weeks

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121
Q

mastitis tend to be unilateral or bilateral

A

unilateral and only one quadrant

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122
Q

full term?

A

37-42 weeks

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123
Q

when does quickening occur

A

nulliparous 18-20 weeks

multiparous 14-16 weeks

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124
Q

quickening

A

the first motion of a fetus in the uterus felt by the mother

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125
Q

5 risk factors for placental abruption

A 
htn
smoking
ama (advance maternal age)
cocaine use
PROM
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126
Q

tx for ovarian ca

A

total hysterectomy
bilateral salpingo-oophorectomy
chemo + radiation

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127
Q

pt is pregnant and slight blue on cervix

name of that sign?

A

Chadwick’s sign

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128
Q

how many weeks when uterus is at the level of the symphysis pubis

A

12 weeks

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129
Q

snowstorm appearance on US

dx?

A

hydatidiform mole

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130
Q

med used to control bleeding due to uterine atony

A

oxytocin (pitocin)

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131
Q

term when placenta is implanted directly over the cervical os

A

placenta previa

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132
Q

at how many weeks of pregnancy can chorionic villus sampling be done?

A

10-13 weeks

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133
Q

why is folic acid given in pre-natals

A

low folic acid can lead to neural tube defects

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134
Q

most common endometrial ca

A

75% are adenocarcinomas

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135
Q

strawberry cervix with copious yellow/green dc

dx?

A

trichomonas

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136
Q

what organism causes us to warn pregnant pt to not eat deli meats and soft cheeses

A

listeria

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137
Q

baby was delivered several mins ago
sudden increase in blood flow from vagina and cord lengthens
cause?

A

placental separation

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138
Q

2 meds to induce labor

A

cervidil (prostaglandin gel applied to the cervix) - which encourages cervical ripening

oxytocin - encourages uterine contractions

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139
Q

antepartum testing a + stress test

what does that mean?

A

they have had 2 heart rate accelerations in a 20 min period of 15 beats above baseline for at least 15 secs, this is a good thing

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140
Q

is FSH high or low in turner’s syndrome

A

high

there are no ovaries to respond to FSH and so there is no negative feedback

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141
Q

most common ovarian cyst

A

functional cyst - no tx

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142
Q

define threatened ab

A

vaginal bleeding, closed cervix, POC inside

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143
Q

10 risk factors for endometrial cancer

A 
chronic unopposed estrogen
nulliparity
early menarche
late menopause
tamoxifen
dm
obesity
htn
breast ca
ovarian ca
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144
Q

what do you see on a KOH prep if pt has vaginal candidiasis

A

pseudohyphae

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145
Q

1 cause of septic arthritis is sexually active young adults

A

gonorrhea

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146
Q

how many days after conception is a serum beta positive

A

8

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147
Q

if the pap smear results come back anything other than negative or ASCUS
next step?

A

colposcopy and bx

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148
Q

3 risk factors for an ectopic

A

previos ectopic
scarred tubes (hx PID or salpingitis)
IUD

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149
Q

grape-like vesicles or a sack of grapes on US

dx?

A

hydatidiform mole

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150
Q

what med is used to increase surfactant levels and help with lung maturity if you are worried about pre-term labor

A

betamethasone

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151
Q

2 tocolytic meds

A

mag sulfate

calcium channel blockers

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152
Q

tocolytic meds

A

anti-contraction medications or labor repressants

medications used to suppress premature labor

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153
Q

pt thinks in pre-term labor, 1st tx

A

give IV fluids

most often just dehydration

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154
Q

pap smear comes back ASCUS next step

A

repeat pap in 4-6 months

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155
Q

3 ways you can check for ruptured membranes

A

ferrying pattern on a slide
visualize leakage from the cervix
pooling in the vagina

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156
Q

nl fetal heart rate

A

120-160

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157
Q

menorrhagia?

A

heavy prolonged menstraul flow

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158
Q

Rh combo for mom and dad might cause the mother to create antibodies against the baby’s red blood cells

A

mom rh -

dad rh +

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159
Q

at what point is PhoGAM given

A

28 weeks

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160
Q

complete ab?

A

vaginal bleeding
cervix open
POC have passed

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161
Q

gestational DM - mom and baby at risk for 3 things

A

preeclampsia
macrosomia (traumatic birth)
slowing in fetal lung development

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162
Q

painful 3rd trimester bleeding

A

placental abruption

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163
Q

3 causes fro a postpartum hemorrhage

A

uterine atony
genital laceration
retained placenta

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164
Q

3rd stage of labor

A

delivery of baby to delivery of placenta

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165
Q

what meds tx a postpartum metritis

A

clindamycin and gentamicin together

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166
Q

most common STD

A

chlamydia

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167
Q

interference with work or school is part of which PMS syndrome

A

premenstrual dysphoric disorder

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168
Q

which reproductive cancer carries the higher rates of death in women

A

ovarian cancer

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169
Q

most common infection after c-section

A

metritis

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170
Q

tx trich

A

flagyl

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171
Q

define incomplete ab

A

vaginal bleeding
cervix is open
POC partially passed

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172
Q

what is the most common site of an ectopic

A

within a fallopian tube

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173
Q

early in pregnancy how often beta double

A

48-72 hours

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174
Q

define procidentia

A

uterine prolapse beyond the introitus

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175
Q

what is the more popular term for stein-leventhal syndrome

A

PCOS

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176
Q

formula for calculating EDD

A

first day of last period +7 days - 3 months

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177
Q

5 parts of the biophysical profile

A 
non-stress test
fetal breathing
2 gross body movements
fetal tone
amniotic fluid index
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178
Q

define 1st stage of labor

A

onset of contractions to full dilation of the cervix

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179
Q

rope like breast mass

dx

A

fibrocystic breast mass

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180
Q

what should a pcp do for a presumed retinal detachment

A

refer & position patient with head down

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181
Q

what age range do you expect to find amaurosis fugax

A

older then 50

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182
Q

1 cause of retinal artery occlusion

A

carotid atherosclerotic disease

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183
Q

tx for herpes keratitis

topical antiviral, topical steroid or both

A

don’t use steroids

topical antiviral
refer

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184
Q

pt describes his vision loss as a curtain coming down and going back up
dx?

A

amaurosis fugax

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185
Q

Amaurosis fugax

A

sx CAD - occurs when a piece of plaque in one of these arteries breaks off and travels to an artery in the eye.

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186
Q

pt with a painful red nodule on the eye lid

dx? tx?

A

hordeolum (sty)

warm compress and progress to topical abx if needed

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187
Q

fundal exam shows a cherry-red spot

dx

A

central retinal artery occlusion

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188
Q

college student with a little purulent drainage from one eye and contender pre auricular lymphadenopathy
dx and pathogen?

A

chlamydia conjunctivitis

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189
Q

what should pcp due with presumed central retinal artery occlusion

A

ophthalmic emergency

refer and intermittent pressure and release of the eye

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190
Q

pt with unilateral blurriness over a few days
fundal exam shows a “blood and thunder” pattern
dx

A

central vein occlusion

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191
Q

tx for central vein occlusion

A

self limited

tx underlying dx

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192
Q

glaucoma more prevalent in males or femaales

A

females 3:1

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193
Q

2 risk factors for glaucoma

A

african american

DM

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194
Q

yellow brown fleshy mass on the conjunctiva, usually doesn’t interfere with vision

A

pinguecula

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195
Q

fundal exam shows a cup to disc ratio of >0.5
vessels bending over the disc
dx

A

glaucoma

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196
Q

pt presents saying he doesn’t need glasses anymore after 30 yrs
dx

A

cataract

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197
Q

pt has metamorphopsia and central blind spot

dx

A

macular degeneration

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198
Q

metamorphopsia

A

type of distorted vision in which a grid of straight lines appears wavy and parts of the grid may appear blank

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199
Q

most likely quadrant for a retinal detachment

A

superior temporal

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200
Q

pt presents with pain in one eye
cornea is hazy and pupils are fixed
dx?

A

glaucoma

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201
Q

most common way of testing for metamorphopsia

A

amsler grid

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202
Q

notice drusen deposits on fundal exam

dx?

A

macular degerneration

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203
Q

drusen deposits

A

yellow deposits under the retina, the light-sensitive tissue at the back of the eye.

Drusen are made up of lipids, a fatty protein.

204
Q

pt presents with irritated, burning and tearing eyes
some scurf and scales
where do you begin tx?

A

dx - blepharitis

tx - good hygiene and abx as needed

205
Q

pt has a hx of multiple stys
now with painless nodule on his eyelid and minor conjunctivitis
dx?

A

chalazion

206
Q

most common colors lost in color blindness

A

red and green

207
Q

term for eyelids that turn in

A

entropion

208
Q

term for bilateral yellow plaques near the eyes

A

xanthelasma

209
Q

fundal exam shows an opalescent retina and boxcarring of arterioles
dx

A

central rentinal artery occlusion

210
Q

most common preceding event for orbital cellulitis

A

URI

211
Q

vision loss described as curtain coming down

dx

A

retinal detachment

212
Q

bowing of the iris on exam

dx

A

glaucoma

213
Q

CT scan of the head shows broad infiltration or orbital fat

dx?

A

orbital cellulitis

214
Q

pt presents with watery bilateral d/c from eyes and nontender per auricular adenopathy
dx?
most common pathogen?

A

viral conjunctivitis

adenovirus

215
Q

how do you test for color blindness?

A

ishihara plates

216
Q

pt with hx of asthma presents complaining of stringy d/c from both eyes and severe swelling around the eyes
dx?

A

allergic conjunctivitis

217
Q

name of the triangular or wedge shaped growth on the conjunctiva that may interfere with vision

A

pterygium

218
Q

name of the test for dry eyes

A

schirmer’s test

219
Q

pt having undergone cataract sx presents complaining of vision loss in the operative eye
dx?

A

retinal detachment

220
Q

pt presents with sudden painless complete unilateral vision loss
dx?

A

central retinal artery occlusion

221
Q

dendritic lesion is seen with fluorescein stain

dx

A

herpes keratitis

222
Q

which nerve is involved in herpes zoster ophthalmicus

A

trigeminal nerve, CN 5

223
Q

hutchinson’s sign

dx?

A

herpes zoster ophthalmicus

224
Q

pt with a dense corneal infiltrate and an epithelial defect seen with fluroescein stain
dx

A

corneal ulcer

225
Q

feathery border on eye exam

dx?

A

fungal infection

226
Q

pt in recovery room after foot sx is complaining of severe photophobia, feels like there is something in her eye
dx?

A

corneal abrasion

its scratch their eyes before they are awake from anesthesia

227
Q

tx for subconjunctival hemorrhage

A

reassurance

228
Q

19yo male took an elbow to the face while playing basketball
whole face is swollen and can’t look up
dx?

A

orbital fracture

229
Q

pt ℅ of seeing halos and rainbows around lights
also ℅ of moderate photophobia
dx

A

glaucoma

230
Q

1st thing you should be thinking of if a peds pt comes in with blood in the anterior chamber of the eye (hyphema)

A

child abuse until proven otherwise

231
Q

how long after radiant energy burn do symptoms typically show

A

6-12 hours

232
Q

term for eyelids that turn out

A

ectropion

233
Q

initial tx for a chemical burn to the eyes

A

irrigate, irrigate, irrigate

234
Q

color blindness genetics

A

dominant x-linked

235
Q

term for nearsighted?

type of lens to correct it?

A

myopia

concave lens

236
Q

college student with copious purulent drainage from one eye

dx

A

neisseria conjunctivitis

237
Q

1st line tx for orbital cellulitis

A

IV abx, then 2 weeks po abx

238
Q

term for being farsighted

type of lens to correct it

A

hyperopia

convex

239
Q

what is tonometry used for

A

determining intraocular pressure

240
Q

most common pt complaint with emphysema

A

SOB

241
Q

at what age should vaccinations for pneumonia begin

A

65 yo

242
Q 
prolonged expiration (low FEV1) 
dx?
A

asthma or COPD

243
Q

hampton’s hump on CXR

dx?

A

PE

244
Q

hampton’s hump?

A

shallow wedge-shaped opacity in the periphery of the lung with its base against the pleural surface.

245
Q

how long after given ppd do u read it

A

48-72 hours

246
Q

pt w/o a functioning spleen is more susceptible to what organism

A

encapsulated organisms

most commonly strep pneumonia or H flu

247
Q

most common cause of pneumonia in children less than 1 year old

A

RSV

248
Q

tx for PCP pneumonia

A

bactrim

249
Q

what occupations are associated with berylliosis

A

aerospace

nuclear plant workers

250
Q

CXR finding for berylliosis

A

diffuse infiltrates with hilar adenopathy

251
Q

gold standard for dx of pleural effusion

A

thoracocentesis

252
Q

when performing a decompression for a tension pneumo where do u put the needle

A

2nd interconstal space at the midclavicular line

253
Q

tamiflu can be given to childer over what age

A

1

254
Q

Zanamivir (relenza) maybe given to kids over what age

A

7

255
Q

HIV pt with ground glass appearance on CXR

dx?

A

PCP

256
Q

noncaseating granuloma

dx

A

sarcoidosis

257
Q

pearl formation on CXR

dx

A

squamous cell lung cancer

258
Q

Ghon or Ranke complexes on CXR

dx

A

TB

259
Q

westermark sign on CXR

dx

A

PE

260
Q

mesothelioma most common lung location

A

80% in the pleural lining

261
Q

CXR that will make you think of mesothelioma

A

pleural thickening

262
Q

hyperinflation on CXR as well as eosinophilia on CBC

dx

A

asthma

263
Q

organism is most common cause pneumonia in a pt with CF

A

pseudomonas

264
Q

college student with pneumonia

2 organisms?

A

chlamydia

mycoplasma

265
Q

at what size in HIV pt is ppd +

A

5mm

266
Q

suspect pneumo

instructions for CXR

A

should be an end expiratory view in order to look for visceral pleural air

267
Q

3 most commonly used med txs for COPD

A

O2
ipratropium
albuterol

268
Q

4 meds that might cause asthma

A

beta blockers
NSAIDS
ACEI
ASA

269
Q

nodular opacities in the upper lung fields

dx?

A

silicosis

270
Q

initial tx for active TB

A

INH + RIF + PZA + EMB x several months

followed by INH + RIF after sensitivities come back

271
Q

caseating granulomas

dx?

A

TB

272
Q

blue bloater

dx?

A

chronic bronchitis

273
Q

contralateral mediastinal shift

dx?

A

tension pneumo

274
Q

best test dx bronchiectasis

A

CT

275
Q

main side effects of isoniazid 2

A

hepatitis

peripheral neuropathy

276
Q

treating a pt for TB
noticed orange tint
cause?

A

rifampin

277
Q

ethambutol has what 2 major side effects

A

optic neuritis

red green vision loss

278
Q

rats and pt with pneumonia

organism?

A

yersinia pestis

279
Q

most common organism causing pneumonia in COPD pts

A

Haemophilus influenzae

280
Q

where is a pancoast tumor found on CXR

A

at the apex of either the right or left lung

281
Q

tb in upper or lower lobes on CXR

A

upper

282
Q

pt has pneumonia with rust colored sputum

dx?

A

strep pneumonia

283
Q

coal miners lung often shows nodular opacities in what lung fields

A

upper lung fields

284
Q

when you step up dx from intermittent asthma to mild persistent asthma what med should you add

A

an inhaled steroid like fluticasone

285
Q

rabbits and pneumonia

dx

A

tularemia

286
Q

dullness to percussion

dx

A

lobar pneumonia

287
Q

young child in er, tripod position

dx

A

epiglottitis

288
Q

+ppd in healthcare worker

A

10mm

289
Q

6 extra pulmonary complications of lung cancer

A 
SPHERE
SVC syndrome
pancoast tumor
Horner's syndrome
endocrine problems
recurrent laryngeal sxs
effusions (exudative)
290
Q

currant jelly sputum

dx

A

klebsiella pneumoniae

291
Q

what happens to total lung capacity in sarcoidosis

A

it goes down

292
Q

what will the likely findings be on a CXR of a pt with asbestosis

A

linear opacities at the bases with pleural plaques

293
Q

tympany to percussion

dx

A

large pneumo

294
Q

3 most common cancers to mets to the lungs

A

breast
liver
colon

295
Q

thumbprint sign on X-ray

2 dxs?

A

lateral C-spine = epiglottitis

abd= intestinal ischemia

296
Q

barrel chest

dx

A

emphysema

297
Q

are the lungs noisy or quiet in COPD

A

quiet

298
Q

4 indications for the flu vaccine

A

kids 6-59 months (5yo)
pregnant female
healthcare worker
older then 50

299
Q

posttussive rales

dx

A

TB

300
Q

parenchymal mets and blebs on CXR

dx

A

emphysema

301
Q

rhonci or wheezes that clear after coughing

dx

A

bronchitis or atelectasis

302
Q

does FEV1 go up or down with asthma

A

down

303
Q

very sick pt with diffuse infiltrates that spare costophrenic angles
dx

A

ARDS

304
Q

most common cause of bronchiectasis

A

CF

305
Q

gold standard to dx CF

A

sweat chloride test

306
Q

exudative pleural effusion

dx

A

TB

lung cancer

307
Q

tx for epiglottitis

A

2nd or 3rd generation cephalosporin (ceftriaxone)

macroclides may also be used (clindamycin)

308
Q

transudative pleural effusions

dx

A

CHF

309
Q

2 lung cancers typically found centrally on CXR

A

small cell lung cancer and squamous cell

310
Q

2 lung cancers typically found peripherally on CXR

A

adenocarcinoma

large cell

311
Q

pertussis most commonly treated with what abx

A

erythromycin

312
Q

4 most common places lung ca will met to

A

bone
brain
adrenals
liver

313
Q

pt with erythema nodosum and an enlarged parotid gland

dx

A

sarcoidosis

314
Q

erythema nodosum

A

tender red nodules

usually on the shins

315
Q

thin looking heart
flattened diaphragm on cxr
dx?

A

emphysema

316
Q

alcoholic who has pneumonia

most likely organism

A

klebsiella pneumonia

317
Q

honeycombing and tram tracks on CXR

dx

A

bronchiectasis

idopathic pulmonary fibrosis

318
Q

paradoxical pulses in what pulmonary disorder

A

asthma

319
Q

older pt with pneumonia and diarrhea

dx

A

legionella pneumonia

320
Q

eggshell opacities on the CXR

dx

A

silicosis

321
Q

4 causes of decreased tactile fremitus

A

copd
asthma
pleural effusion
pneumothorax

322
Q

hyperresonance to percussion

dx - 3

A

emphysema
pneumo
asthma

323
Q

crackles in the lung files

4 pulmonary issues in differential

A

pneumonia
fibrosis
CHF
bronchitis

324
Q

does total lung capacity go up or down in COPD

A

goes up

325
Q

3 things on diff with wheezes

A

asthma
copd
bronchitis

326
Q

pt says “ee” but on auscultation you here “ay”

A

egophony

327
Q

PE - egophony

dx

A

lobar pneumonia

328
Q

cxr shows vascular redistribution and blurred vascular outlines
dx

A

CHF

329
Q

difficulty swallowing

A

dysphagia

330
Q

birds-beak esophagus on barium swallow

dx

A

achalasia

331
Q

most common location for an anal fissure

A

posterior midline

332
Q

crown’s is found where in the GI tract

A

esophagus to anus

333
Q

HBsAg (hep B surface antigen) indicate

A

active hep B infection

334
Q

tx for achalasia

A

loosen up the muscle
botox
dilation or
sx

335
Q

a corkscrew appearance on barium study

dx

A

esophageal spasms

336
Q

epigastric abdominal pain rad to back

dx

A

pancreatitis

337
Q

in order to contract hep D what must you already have

A

hepatitis B

338
Q

LLQ pain

dx

A

diverticullitis

339
Q

tx for most mallory-weiss tears

A

watchful waiting

typically resolve within 48 hours

340
Q

thumbprint on an and film

dx

A

intestinal ischemia

341
Q

bowel sounds be early on in a SBO

later?

A

early hyperactive

late they are absent

342
Q

pt has gerd for yrs
past year increase in difficulty swallowing his food
dx

A

esophageal strictures

343
Q

2 txs for esophageal strictures

A

dilation of the esophagus

long term PPIs

344
Q

2 predisposing factors for esophageal varices

A

portal htn

cirrhosis from alcoholism

345
Q

common sx with CP from gerd pts

A

dry cough

346
Q

med most commonly used for long term tx of GERD

A

PPI
omeprazole
lansoprazole
pantoprazole

347
Q

imaging for pancreatitis

A

CT

348
Q

best test to check for h pylori

A

urea breath test

349
Q

PUD more common in the duodenum or stomach

A

duodenum

350
Q

most common location for a pancreatic tumor

A

75% occur in the head of the pancreas

351
Q

gastric ulcer

sxs exacerbated or relieved with food

A

exacerbated

352
Q

fasting gastrin will be above what level with gastrinoma

A

> 150 pg/ml

353
Q

projectile vomiting

sx

A

pyloric stenosis

354
Q

most gall stones made of what

A

cholesterol

355
Q

pt shows inhibited inspiration with pressure over RUQ

dx

A

murphy’s sign

cholecystitis

356
Q

most specific test for acute chole

A

HIDA

357
Q

gold standard for dx, tx of bile duct stones

A

ERCP

358
Q

charcot’s triad

A

RUQ pain
fever
jaundice

ascending cholangitis

359
Q

reynold’s pentad

why does it matter

A

charcot’s triad
+ htn+AMS

indicates a high risk of sepsis

360
Q

dx as an immunologic response to gluten

A

celiac

361
Q

rick factor for esophagitis

A

immunocompromised pt

362
Q

an endoscopy for presumed esophagitis shows multiple shallow ulcers
dx

A

herpes simplex virus

363
Q

list 4 common offending agents for pill induced esophagitis

A

NSAIDS
KCl
iron
abx

364
Q

30yo AA women with dyspagia
thickened skin
barium swallow demonstrates the absence of peristalsis
dx

A

scleroderma

365
Q

pt ℅ of regurgitating undigested food several hours after a meal
dx

A

zenkers diverticulum

366
Q

most common cause PUD

A

h pylori

367
Q

most specific dx test for PUD

A

endoscopy

368
Q

only curative tx for gastric adenocarcinoma

A

surgical resection

369
Q

pt ℅ RUQ pain 20 mins after meals

dx

A

cholecystitis

370
Q

ERCP stand for

A

endoscopic retrograde cholangiopancreatography

371
Q

most common cause of acture bacterial cholangitis

A

choledocholithiasis

372
Q

onion ring fibrosis from a bile duct bx

dx

A

primary sclerosing cholangitis

373
Q

2 viral hepatitis infection are self limiting

A

hep A and E

374
Q

pica often related to what anemia

A

iron deficiency anemia

375
Q

what does an Anti-HBc (hep B core antibody)

A

previous or ongoing hep B infection

376
Q

what does Anti-HBs (hep B surface antibody)

A

recovery from infection or immunization to hep B

377
Q

recommended tx for hep C infection

A

pegylated interferon aplha-2

378
Q

what med is used in hep B infection helps prevent the need for liver transplant

A

lamivudine

379
Q

vaccines for which 2 heps

A

hep A and hep B

380
Q

pt with achalasia have dysphagia to liquids, solids or both

A

both

381
Q

heartburn that does not improve with meds

dx

A

gastrinoma

382
Q

2 main complications of cirrhosis

A

portal HTN

liver insufficiency

383
Q

2 main causes of pancreatitis

A

cholelithiasis

ETOH

384
Q

cullen’s sign

A

umbilical ecchymosis often related to pancreatitis

385
Q

5 points of ranson’s criteria on admission

A 
older then 55
wbc > 16
glucose >200
LDH >350
AST >250
386
Q

1st step in treating GERD

A

lifestyle modifications

387
Q

steatorrhea

dx

A

pancreatitis

388
Q

courvoisier’s sign

A

contender palpable gallbladder which may indicate pancreatic neoplasm

389
Q

tumor marker can be used to follow pancreatic ca

A

ca-19-9

390
Q

pt ℅ of periumbilical pain which has moved over mcBurney’s point
dx

A

appendicitis

391
Q

how to do psoas sign

A

pt is supine and attempts to raise R leg against resistance

392
Q

term for painful swallowing

A

odynophagia

393
Q

how to perform the obturator sign

A

pt is supine and attempts to flex and internally rotate right hup

394
Q

best imaging for acute appy

A

ct

395
Q

2 blood test to dx celiac

A

IgA endomysial abtibody

IgA tTG antibody

396
Q

how much fiber do you need in a day

A

30 grams

397
Q

tx should be started for asymptomatic diverticulosis

A

none

398
Q

is sx curative for crohn’s or ulcerative colitis

A

UC

399
Q

what causes mallory-weiss tears

A

forced vomiting or retching

often involving alcohol

400
Q

colonoscopy that shows cobblestone or skip lesions

dx

A

crohn’s disease

401
Q

class of medication is 1st line to treat inflammatory bowel disease in the maintenance phase

A

5-ASA products

sulfasalazine, mesalamine

402
Q

currant jelly stool

dx

A

intussusception

403
Q

severe abd pain 30 mins after a meal

dx

A

intestinal ischemia

404
Q

most common cause lower GI bleed

A

diverticulosis

405
Q

most common location of colorectal cancer

A

cecum about 38%

406
Q

colorectal ca its are almost all older than what age

A

90% older then 50

407
Q

epigastric olive-shaped mass

dx

A

pyloric stenosis

408
Q

an elevated serum amylase and lipase dx

A

pancreatitis

409
Q

age begin screening colonoscopies

A

50

410
Q

1 cause SBO

A

postop adhesions

411
Q

air fluid levels on abd X-ray

dx

A

bowel obstruction

412
Q

which hernia more likely to pass into the scrotum

direct or indirect

A

indirect

413
Q

string sign on barium swallow

dx

A

pyloric stenosis

414
Q

1st line tx for an anal fissure

A

fluid and fiber

415
Q

4 things that an anal fissure off midline might suggest

A

crohn’s
syphilis
hiv
neoplasm

416
Q

med tx for gastrinoma

A

PPI

417
Q

term for an abscess in the sacroccygeal cleft

A

pilonidal dx

418
Q

tx for H pylori

A

PPI + 2 abx
omeprazole + clarithromycin and amoxicillin
or
PPI + flagyl + tetracycline

419
Q

painless bright red blood per rectum

dx

A

hemorrhoids

420
Q

pt on sulfasalazine for an inflammatory bowel disease should be supplemented with what vitamin

A

folate

421
Q

most common anorectal problem affecting its over 50

A

hemorrhoids

422
Q

a gastrinoma is aka what syndrome

A

zollinger-ellison syndrome

423
Q

salivary amylase breaks down what macronutrient

A

carbs

424
Q

medical term for feelings like there is a lump in your throat

A

globus

425
Q

most common vessel blocked with intestinal ischemia

A

superior mesenteric artery

426
Q

describe Grey-Turner’s sign

A

flank ecchymosis

often related to pancreatitis

427
Q

1st 3 steps of managing pancreatitis

A

NPO
pain meds
fluids

428
Q

pt presents with unproductive retching, acute localized epigastric distention and inability to pass NG tube
dx

A

gastric volvulus

429
Q

most common cause folate deficiency

A

alcoholism

430
Q

should diverticulitis always be admitted

A

no mild cases can be outpt

rest and clear fluids

431
Q

which NSAID has the highest rate of peptic ulceration

A

naproxen

432
Q

diagnostic test of choice for Zenker’s diverticulum

A

barium swallow

will show the diverticulum

433
Q

leading cause of iron deficiency anemia

A

chronic GI bleed

434
Q

age start fecal occult blood tests

A

50 and yearly

435
Q

how often should its with pernicious anemia have a screening endoscopy

A

every 5 years

looking for signs of gastric carcinoma

436
Q

are one half of all adult hernias direct or indirect inguinal hernias

A

indirect inguinal hernias makeup 50% of all adult hernias

437
Q

how is celiac dx most commonly diagnosed

A

endoscopic biopsy

438
Q

define pellagra

A

niacin (B3) deficiency

439
Q

an endoscopy for presumed esophagitis shows several solitary deep ulcers
dx

A

cytomegalovirus

440
Q

which are more painful, hemorrhoids above or below the dentate line

A

below

internal hemorrhoids are not painful

441
Q

an abd exam with pain out of proportion to the exam

dx

A

intestinal ischemia

442
Q

does adenocarcinoma arises from the proximal or distal esophagus

A

distal

443
Q

german measles is aka

A

rubella

444
Q

bruises may be purple, green, yellow, and brown

A

purple 1-5 days
green 5-7 days
yellow 7-10 days
brown 10-14 days

445
Q

pain with movement of the pinna or tragus

dx

A

otitis externa

446
Q

1st line tx for pertussis

A

erythromycin

447
Q

by what age should a child be able to hold up her head

A

3 months

448
Q

a salter harris type 1 fracture affects what area of the bone

A

only the physis (growth plate)

449
Q

by what age should a child be able to sit up

A

6 months

450
Q

an overweight 15 yo boy with a limp presents to the office with knee pain
no hx trauma
dx

A

slipped capital femoral epiphysis

451
Q

premature infant with hyaline membrane disease will have what appearance on CXR

A

bilateral atelectasis or ground glass appearance

452
Q

atypical or walking pneumonia

what pathogen

A

mycoplasma

453
Q

abx 1st line for mycoplasma pneumonia

A

a macrolide

454
Q

a pt is having seizures along with a mouse-like odor from the urine
dx

A

phenylketonuria

455
Q

description of a dew drop on a rose petal

dx

A

chickenpox

456
Q

pale and boggy nasal mucosa

dx

A

allergic rhinitis

457
Q

5 major jones criteria for dx rheumatic fever

A 
polyarthritis
carditis
subcuticular nodes
erythema marginatum
chorea
458
Q

describe erythema marginatum

A

pink rings on the trunk and inner surfaces of the limbs

459
Q

a child with bulky greasy stool

dx

A

cystic fibrosis

460
Q

at what age should an infant begin cooing

A

2 months

461
Q

what is the most common cause of an URI

A

rhinovirus

462
Q

koplik spots are clusters of white clustered lesions on the buccal mucosa
what virus

A

measles/rubeola

463
Q

1st line abx for otitis media

A

amoxicillin

464
Q

tx a pt with respiratory syncytial virus

A

albuterol
steroids
fluids

465
Q

child presents with painful ulcers in his mouth
PE- also on hands and feet
virus?

A

coxackie virus

466
Q

what is the gold standard for the dx of cystic fibrosis

A

sweat chloride test

467
Q

by what age able to walk

A

12 months

468
Q

FB obstructing a child’s breathing what type of CXR

A

expiratory view looking for hyperinflation due to air trapping

469
Q

medical term for lazy eye

A

amblyopia

470
Q

pt presents with a staccato cough but no fever

dx

A

chlamydia pneumoniae

471
Q

most serious complication of kawasaki syndrome

A

aortic aneurysm

472
Q

a musical vibratory murmur best heard at the apex in a child

dx

A

still’s murmur

473
Q

kawasaki syndrome

A

is an immune disease in which the medium-sized blood vessels throughout the body become inflamed. It is largely seen in children under five years of age. It affects many organ systems, mainly those including the blood vessels, skin, mucous membranes, and lymph nodes;

474
Q

still’s murmur

A

benign or “innocent” functional heart murmur that is not associated with any sort of cardiac disorder or any other medical condition.[1] It can occur at any age although it is most common among children two to seven years of age and it is rare in adulthood.

475
Q

palpable olive shaped epigastric mass in a 1 month old

dx

A

pyloric stenosis

476
Q

at what age should a child be able to use a spoon and stack 3-4 blocks

A

18 months

477
Q

x-ray finding that supports dx of a slipped capital femoral epiphysis

A

ice cream falling of the cone

478
Q

viral exanthem often has conjunctivitis as one sx

A

measles/rubeola

479
Q

most common congenital heart defect

A

VSD

480
Q

boot shaped heart of cxr

dx

A

tetralogy of fallot

481
Q

PE- tubular or sausage-shaped mass

dx

A

intussusception

482
Q

tx for a volvulus in a child

A

barium enema

483
Q

by what age should a child be able to roll over

A

4 months

484
Q

what is pertussis aka

A

whooping cough

485
Q

which heart valve is most associated with rheumatic fever

A

mitral

486
Q

loud harsh holosystolic murmur in a child
best heard at the LLSB
dx

A

VSD

487
Q

child with paroxysmal abd pain, nausea, vomiting and diarrhea
dx

A

intussusception

488
Q

child begin to feed themselves

A

6 months

489
Q

currant jelly stool

dx

A

intussusception

490
Q

is an URI include hoarseness bacterial or viral

A

viral

491
Q

describe barlows test

A

adduct and internal rotation of the hips

492
Q

CXR finding of notched ribs in a child

dx

A

coarctation of the aorta

493
Q

how long should you wait for a swallowed marble to pass before considering sx

A

24 hours

494
Q

4 yo boy presents between october and march with wheezing, coughing, a runny nose and increased respiratory rate
pathogen?

A

RSV

495
Q 
describe wt gain in an infant over the following time periods
1 week
6 months
12 months
3 yo
4yo
A 
newborns lose 10% of birth weight and are back to birth at 10 days
6m = 2x birth
12m = 3x birth
3yo = 30 lbs and 30 inches
4yo - 40 lbs and 40 inches
496
Q

what age should a child be able to kick a ball

A

24 months

497
Q

child with a fever lasting longer then 5 days

dx

A

kawasaki syndrome

498
Q

widely split fixed S2

dx

A

atrial septal defect

499
Q

nasal polyps

dx

A

cystic fobrosis

500
Q

in order to diagnose rheumatic fever what 1 thing

A

evidence of a strep infection

2 major criteria or 1 major and 2 minor criteria

501
Q

forchheimer spots

A

rubella

502
Q

salter-harris type III fx what area of the bone

A

the physics (growth plate) as well as the epiphysis

503
Q

a lacey pink rash

dx

A 
erythema infectiosum 
aka
5th disease
aka
slapped cheek
504
Q

unilateral purulent rhinitis

dx

A

FB

505
Q

medical term for cross-eyed

A

strabismus

506
Q

organism most common cause of otitis media

A

strep pneumonia

507
Q

at what age to say mamma, dadda

A

12 months

PANRE (4 decks)

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