Buzz words Flashcards by Megan Mathias

age for starting dexa scans

males 70, females 65

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dexa score for osteopenia, osteoporosis?

osteopenia 1-2.4, osteoporosis 2.5

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1 fracture for compartment syndrome

tibial shaft fracture

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+ smith antibodies & + double stranded DNA antibodies Dx?

Lupus

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where are bouchards nodes

PIP joint

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can an x-ray show an acute osteomyelitis

Nothing only chronic osteo

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best imaging osteo

bone scan or an MRI

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22 yr old male septic joint and lesions on knee and hands pathogen?

Neisseria gonorrhoeae

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wbc if septic joint

> 50,000 at minimum

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painless mass in R wrist

Ganglion cyst

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age range for osteosarcoma? Where most likely in body

15-25 yo males and knees

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think pt has osteoid osteoma, x-ray pending, in the meantime what med do you start?

if it is osteoid osteoma ibuprofen will resolve the pain

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clicking or locking of the knee is what diagnosis

meniscal tear

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65 year old woke up severe pain in his great toe. It is swollen, red and very tender. dx?

gout #1, consider infection

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uric acid level that confirms gout

> 7.5

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medical treatment for gout?

Allopurinol, colchicine

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+ birefringent crystals dx?

pseudogout

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pt with hx of hepatitis B presents complaining of bilateral knee pain, fever and weight loss. Dx?

polyarteritis nodosa

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suspect polyartheritis nodosa. Test for dx and what is Tx?

biopsy, high dose steroids

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ulnar deviations and swan neck deformities, dx?

rheumatoid arthritis

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+ Neer’s test dx?

rotator cuff impingement

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3 meds that cause lupus

procainamide, isoniazid and quinidine

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what test for Sjogren’s syndrome

Schirmer test

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A pt with RA is heading to OR, what x-ray do you need?

C-spine, due to concerns about instability of C1 & C2

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What carpal bone has a high rate of non-union and occult fracture

Scaphoid

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med used for pts with lupus

systemic steroids

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Scleroderma limited version has 5 main characteristics for which CREST acronym is used, what are those 5 things?

Calcinosis
Raynaud's
Esophageal dysmotility
sclerodactyly
telangiectasia

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there is a sunburst appearance on x-ray, what is the most likely Dx?

osteosarcoma

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where are 80% of clavicle fractures anatomically

middle third

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path shows negatively birefringent crystals. most likely dx?

gout

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4 muscles of the rotator cuff

SITS
supraspinatus
infraspinatus
teres minor
subscapularis

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characteristics of a lytic lesion on x-ray

speculated, elevated periosteum, bone destruction

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most common injured ligament in ankle sprain

ATFL

anterior talofibular ligament

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dx?

vasculitis with a hep B hx

polyarteritis nodosa

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most common fracture in children

clavicle

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fat pad sign on a lateral elbow x-ray means?

it is blood in the joint indicating a fracture even if a fracture line is not seen

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progressive neck and proximal muscle weakness
PE- see a reddish purple maculopapular rash
lab- anti-jo-1 antibodies
dx?

polymyositis

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what way does a collies fracture angulate dorsal or velar?

smith fracture?

colles - dorsal

smith - volar

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tenderness over anatomical snuffbox, fx?

scaphoid

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most common fracture in pt with osteoporosis?

compression fracture vertebra then hip

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15 yo night pain in pelvis

x-ray - mass with an “onion skin appearance” dx?

ewing sarcoma

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name of 4th and 5th metacarpal fx from throwing a punch

boxer’s fracture

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new mom with pain over the radial wrist
+ Finkelsteins test
dx?

de Quervain’s tenosynovitis

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+ McMurry

dx?

meniscal tear

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McMurry test

the knee is held by one hand, which is placed along the joint line, and flexed to complete flexion while the foot is held by the sole with the other hand. The examiner then places one hand on the lateral side of the knee to stabilize the joint and provide a valgus stress in order to identify a valgus deformity. The other hand rotates the leg externally while extending the knee. If pain or a “click” is felt, this constitutes a “positive McMurray test” for a tear in the medial meniscus.

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1st line treatment for carpal tunnel

night splint

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most common cause of c-spine fracture

MVC

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medical term for hunchback?

kyphosis

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another term for podagra

gout

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saddle anesthesia and loss of bowel and bladder function

dx?

cauda equina

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pt with HIV
severe groin pain
dx?

avascular necrosis of the femoral head

antiretroviral meds increase risk for AVN

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short, ext rotated leg dx?

hip fracture

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instructions when taking biphosphonates?

tx?

tx osteoporosis

upright for 30 mins

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#1 cause hip dislocation?
anterior or posterior?

MVC

posterior

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most common injured rotator cuff muscle

supraspinatus

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tennis elbow aka?

lateral epicondylitis

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1st line tx for RA

methotrexate

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baseball bat to knee, unable to extend knee

dx?

patella fracture

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most common shoulder dislocation anterior or posterior?

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most useful physical exam for ACL tear?

Lachman’s followed by anterior drawer

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Lachman’s test?

The therapist holds the patients knee between full extension and 30 degrees of flexion.
The patient’s femur is stabilized with one of the examiner’s hands (the “outside hand) while the proximal aspect of the tibia is moved forward with the other (“inside”) hand.

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most common knee injury

medial meniscal tear

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where are heberden’s nodes found?

DIP distal interphalangeal joint

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knee pain after soccer
joint line tenderness medically and locking from time to time
what 2 physical exam tests?

medial meniscal tear

McMurry and apply tests

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Pt with conjunctivitis, urethritis, arthritis and oral lesions
dx?
other lab that is +

reactive arthritis

HLA B-27

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limping, feels like kicked in back of leg but wasn’t

dx?

Achilles tendon rupture

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Anti-Jo-1 antibodies should make you think of what dx?

Polymyositis

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+ crossover test dx?

AC joint injury

acromioclavicular joint

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crossover test

Adduct arm across front of chest

Touch opposite Shoulder

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+ Hawkins test

dx?

Rotator cuff impingement

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Hawkins test

Forward flexion of the shoulder to 90 degrees and internal rotation

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+ Finkelstein’s test

dx?

de Quervain’s tenosynovitis

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Finkelstein’s test

examiner pulls the thumb of the patient in ulnar deviation and longitudinal traction. If there is an increased pain in the radial styloid process and along the length of the extensor pollicis brevis and abductor pollicis longus tendons, then the test is positive for De Quervain’s syndrome.

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+ Phalen and Tinel’s sign

dx?

carpal tunnel

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bamboo spine

dx?

Ankylosing spondylitis

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+ straight leg test

dx?

herniated disc

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straight leg raise

If the patient experiences sciatic pain when the straight leg is at an angle of between 30 and 70 degrees, then the test is positive and a herniated disc is likely to be the cause of the pain

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African American female
malar rash + double stranded DNA antibody
dx?

lupus

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carpal tunnel which nerve?

parts of hand?

median nerve

thumb, pointer and ring finger

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thenar wasting

advanced carpal tunnel

The thenar region of the palm refers to the group of muscles in the thick pad just underneath the thumb.

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silver fork deformity on x-ray

colles fracture

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+ Apley dx?

meniscal tear

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Apley test

the patient lays prone (face-down) on an examination table and flexes their knee to a ninety degree angle. The examiner then places his or her own knee across the posterior aspect of the patient’s thigh. The tibia is then compressed onto the knee joint while being externally rotated. If this maneuver produces pain, this constitutes a “positive Apley test”

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5 meds migraine prophylaxis

beta blockers
tricyclics
calcium channel blockers
NSAIDS
Valproic acid

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unable to understand speech

which aphasia?

wernicke’s aphasia

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facial paresis, arm drift and abnormal speech

first 3 tests

brain CT or MRI
glucose
o2 sat

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seizure without LOC

simple partial seizure

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stroke no evidence hemorrhage

within 48 hours thrombolytics

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painful ipsilateral third nerve palsy

dx?

posterior communicating artery aneurysm

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seizure med that causes overgrowth of gums

phenytoin

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sudden thunderclsp ha

subarachnoid hemorrhage

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Kernig’s sign

pt lies supine, flex hip while keeping knee straight

back pain is +

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definitive test subarachnoid

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lateralized throbbing ha
N/V photophobia
type ha?

migraine

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middle age male
unilateral periorbital ha daily for weeks
ha type

cluster ha

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3 drugs that tx cluster ha

O2, immitrex, stadol (butorphanol)

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34 yo relapsing and remitting x weeks,
vision issues, weakness R arm
dx

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tremor with motion in hands

meds?

beta blocker like propranolol

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shuffling gait

parkinson’s

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2 classes of drugs for parkinsons

dopaminergic (levodopa)

anticholinergics

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decreased GABA and substance P

dx?

huntington’s

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Huntington’s autosomal dominant or recessive

dominant

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weakness in lower legs and now in knees and hips b/l
progressive
dx

Gullain-barre

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% stroke ischemic

hemorrhagic

I- 80%

H - 20%

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believe stroke
aphasia, loss hearing in 1 ear, loss vision L eye
blockage posterior or anterior circulation

posterior

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when would asa or clopidogrel (plavix) as TIA prophylaxis

antiplatelet meds
used unless known cardiac etiology for embolism

if cardiac use heparin or coumadin

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asymptomatic what % blockage of carotid for sx?

symptomatic?

> 70% asymptomatic

>60% symptomatic

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worst ha of life

bp?

subarachnoid

bp elevated

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abortive meds for migraines

triptans (immitrex, zolitriptain)

ergotamine

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EEG shows focal rhythmic discharges at the onset of the seizure
dx?

simple partial seizure

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most important concern status epilepticus

airway then management hyperthermia

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brudzinski’s sign

lift its head the pt bends his hips, knees

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3 meds break a seizure

diazepam - valium
lorazepan - ativan
phenytoin - dilantin or fosphenytoin - cerebrex

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MRI result of multiple foci of demyelination in the white matter
dx?

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3 meds to tx MS

steroids
interferon beta
copolymer 1

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most common cause dementia

alzeimers 80%

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4 chromosomes linked dementia

1, 14, 19, 21

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ankle jerk reflex of lumbar or sacral origin

sacral

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intracellular neurofibrillary tangles and extracellular neuritic plaques
dx?

alzheimer’s

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aching ha which feels like band around head

dx?

tension ha

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tremor R hand
gone after a beer
dx

benign essential tremor

familial tremor

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2 meds tx essential tremor

beta blocker - propranolol

primidone

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age huntington’s appear

30 years old

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35 yo increasingly irritable and moody, restless
CT shows cerebral atrophy, atrophy of the caudate nucleus
dx?

huntington’s disease

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med for tourette’s

haloperidol

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slit lamp shows Kayser-fleischer rings

wilson’s disease

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wilson’s build up of what mineral

copper

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genetic characteristics of wilson’s

autosomal recessive

chromosome 13

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bells palsy which nerve

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LP for bacterial menigitis

wbcs, glucose, protein

wbc elevated
glucose decreased
protein elevated

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classic migraine

aura

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elevated circulating acetylcholine receptor antibodies

myasthenia gravis

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Duchenne’s and Becker’s muscular dystrophy

genetics

x-linked recessive

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age range for duchenne’s muscular dystrophy

3-5 years old

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EEG shows spikes and associated slow waves

generalized or absence seizure

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most common primary intracranial neoplasm

glioma

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most common cause subarachnoid other then trauma

ruptured cerebral aneurysm

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most common primary cancer sites that met to brain

lung, breast and kidney

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resting or pill-rolling tremor

parkinson’s

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weakness and numbness in L hand blockage of which carotid

right

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intracranial neoplasm causing auditory illusions, olfactory hallucinations and emotional changes
which lobe

temporal

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looking for lesions with MS

with or without gadolinium

with contrast

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defining sx of Alzheimer’s

progressive memory impairment

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which nerve root for knee jerk reflex

L3, L4

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EEG shows interictal spikes

complex partial seizure

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most commonly herniated disc

L4-L5 followed by L5-S1

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3 sxs are classic for normal pressure hydrocephalus

gait disturbance
dementia
urinary incontinence

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unable to speak
R sided weakness
understands and follows commands
aphasia type

broca’s aphasia

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alcohol major factor encephalopathy

wericke’s

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muscle weakness, fatigability improves with rest

myasthenia gravis

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lead pipe or cogwheel rigidity

parkinson’s

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how long panic attack last

10-20 mins

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most common hallucination with schizophrenia

auditory

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cause anorexic its to have osteopenia

a decrease in estrogen

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benzos for acute or chronic tx

acute

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most common cause PTSD in women

rape

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pt male that is hyper vigilant and hyper startle response

PTSD

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are its with phobias aware they are strange

yes

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sudden development stage freight

beta blocker

propranolol

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doughnut shaped burn

issue?

child or elder abuse

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generic prozac

fluxetine

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how long sxs for ADD

6 months

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no friends, seldom leaves house, terrified meeting people

avoidant personality disorder

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ADD sxs at school not at home

add?

no must be in both

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18 months, no speaking, does not point, no eye contact

autism

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3 + sxs schizophrenia

Hallucinations, delusions, movement disorders

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typical onset tourettes

3-8 yo

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anorexia egosyntonic or ego-dystonic

bulimia?

anorexia - egosyntonic

bulimia ego-dystonic

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Egosyntonic

referring to behaviors, values, feelings that are in harmony with or acceptable to the needs and goals of the ego, or consistent with one’s ideal self-image.
deny issue

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Egodystonic

ewers to thoughts and behaviors (e.g., dreams, impulses, compulsions, desires, etc.) that are in conflict, or dissonant, with the needs and goals of the ego, or, further, in conflict with a person’s ideal self-image.
aware issue

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3 cluster A personality disorders

“mad” schizoid
schizotypal
paranoid

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amenorrhea time

3 months if use to be regular, 6 if irregular

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16yo changed schools
quiet, mossy and not himself
6 months back to nl

adjustment disorder

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pt with major depressive disorder

once sxs resolved how long to still treat

a 6 month minimum

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meds for PPD while breast feeding

sertraline - zoloft

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strange magical thinking

schizotypal personalty disorder

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4 sxs serotonin syndrome

hyperthermia
seizure
MSC
tremor

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chronic mild depression greater 2 years

dysthymia

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whats needed for bipolar 1 dx

1 manic episode

no depressive episode needed

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major concern with using lithium

very narrow therapeutic window

monitor blood level q 4 weeks

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pt thinks 15 yo sleeping with mailman, no evidence, not interfering with DAL but thinking about a lot
dx

delusional disorder

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BMI hospitalized for anorexia

BMI < 17.5 or 20% below IBW

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term for being afraid of being out in a terrible situation with no help available

agoraphobia

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borderline personality disorder is on the border of what 2 psychological disorders

neurosis and pychosis

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waxy flexibility, dx

catatonic schizophrenia

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how long before normal grief resolves

about a year

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pt always craves attentions, often using sex
acts like a child when doesn’t get their way
dx?

histrionic personality disorder

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ADD sxs before what age

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russell’s sign

abraded knuckles from forcing oneself to vomit

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how long sxs before schizophrenia

6 months

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posturing

catatonic depression

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pt with acute paralysis left arm, doesn’t bother him
neuro work up neg
dx

conversion disorder

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psych pt with confusion, fever, lead pipe rigidity

neuroleptic malignant syndrome

occurs with high dose antipsychotics

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pt concerned that she has breast ca, full negative work up, still unsatisfied and convinced
dx

hypocondriasis

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time frame for 1st sxs withdrawal alcohol

tremor in 8-18 hours

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tx alcohol withdrawl

benzos

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list the 4 cluster B personality disorders

“bad” antisocial
borderline
histrionic
narcissistic

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2 cluster C personality disorders

“sad” avoidant

obsessive compulsive

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med clearly contraindicated in anorexia and bulimia

bupropion (wellbutrin) in can increase risk of seizures

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2 psychiatric issues more common in males then females

autism and ADD

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pt works at home, seldom leaves, no interest in meeting others and happy to be home alone
dx

schizoid personality disorder

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SSRIs

Fluoxetine - prozac
paroxetine - paxil
sertraline - zoloft
citalopram - celexa
escitalopram - lexapro
dapoxetine 
zimelidine
mesembrine
seproxetine

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pt concern can’t trust anyone, everyone out to get him, everyone else’s fault
dx

paranoid personality disorder

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pt charming, no concern for hurting or using others, no remorse
dx

antisocial personalty disorder

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antisocial personality disorder can’t be dx till what age

18 yo

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antisocial personality disorder but only 14 yo

conduct disorder

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pt splitting, all others as all good or all bad

borderline personality disorder

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type behavioral therapy works best for borderline pts

dialectical behavior therapy

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pt is arrogant with an inflated self image, feels he is special and should be treated that way
dx

narcissistic personality disorder

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Is obsessive compulsive disorder egosyntonic or ego-dystonic?
obsessive compulsive personality disorder?

OCD is ego-dystonic. OCPD is egosyntonic.

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2 things needed dx bipolar 2

one major depressive and 1 hypomanic episode

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good 1st med bipolar 1 and 2

lithium

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how is acute stress different then PTSD

acute within 1 month of event and resolved in 1 month

PTSD about 1 month after event last indefinitely

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spinal fx

elder or child abuse

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“i have been anxious for as long as I can remember”

generalized anxiety disorder

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are hallucinations normal during a normal grieving period

yes as long as they are not persistent or intrusive

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side effect stop ACEI

cough

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orthostatic hypotension

drop in systolic >20 when standing

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vibrating pulse

thrill

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3 differentials for paradoxical pulse

cardiac tamponade
pericarditis
obstructive lung disease

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paradoxical pulse

abnormally large decrease in systolic blood pressure and pulse wave amplitude during inspiration.
the drop is more than 10mm Hg

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on palpation nl size aorta

<3cm

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a fixed consistent split S2

atrial septal defect

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pathologic S3

CHF

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mid systolic click

click

MVP

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opening snap

mitral stenosis

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continuous murmur, area heart

septal defect

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continuous machine like murmur

PDA

patent ductus arteriosus

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3 meds used for pharmacological stress test

adenosine
dobutamine
dipyrudamole
persantine

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gold standard CAD

cardiac cath

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stage 1 htn

systolic 140-159

diastolic 90-99

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tx goal dm with htn

130/80

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most common cause secondary htn

chronic kidney disease

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can’t control htn no matter meds
hyper pigmented skin and truncal obesity
dx

cushing’s disease

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3 sxs of pheochromocytoma

thin
diaphorectic
tachy
agitated
hypertensive

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pt with pheochromocytoma

while waiting for sx, alpha or beta blocker

alpha

never use beta blocker

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young boy
elevated bp, no palpable femoral pulse
dx

coarctation of the aorta

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nl BMI

18.5-24.9

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1st line tx stage 1 htn

thiazide diuretic

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after thiazide diuretic start in pt with dm

and ACEI or ARB

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after MI med for htn

beta blocker

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paroxysmal nocturnal dyspnea

CHF

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most common cause CHF

CAD

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EF for pt with CHF

35-40%

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most likely dx young man who experiences sudden death while playing sports

hypertrophic cardiomyopathy

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bat wing vessels or kerley B lines on CXR dx?

CHF

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BNP level rules out CHF

<100

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INR goal after valve replacement

2.5-3.5

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1st line inotropic agent with cardiogenic shock

dopamine

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dx IVDA with heart murmur and fever

endocarditis

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dx abc prophylaxis for “dirty procedure”

Prosthetic valve
valve repair with any prosthetic material
prior endocarditis diagnosis
congential cyanotic heart defect.

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abx for dental work with MVP

no now mod risk not high risk

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3 major criteria for endocarditis

2 + blood cultures
+TEE
new murmur

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painful and found on fingers and toes

osler nodes

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4 minor criteria for endocarditis

fever
embolic event (janeway lesios, perechiae, splinter hemorrhages)
immunological event (osler nodes, glomerulonephritis
1 + blood culture

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5 components of tetralogy of fallot

ventricular septal defect
R ventricular hypertrophy
R ventricular outflow obstruction (pulm valve stenosis)
overriding aorta
R sided aortic arch

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gold standard dx myocarditis

myocardial biopsy

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where do most aortic dissections occur

the ascending or descending thoracic aorta

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severe pleuritis chest pain worse with leaning forward

dx?

pericarditis

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1st line tx for pericarditis

ASA and NSAIDS

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syndrome that involves pericarditis several days after MI

Dressler syndrome

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ER with CP
EKG shows diffuse ST elevations in all of the leads
dx

pericarditis

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paradoxical pulse

large difference in pulse pressure between inhalation and exhalation

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pulsus alternans

EKG waveform changes from beat to beat

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definitive tx for cardiac tamponade

pericardiocentesis

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harsh systolic murmur along the R sternal border

dx?

aortic stenosis

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wide pulse pressure with a blowing diastolic decrescendo murmur at the right 2nd intercostal space
dx?

aortic regurgitation

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location to hear aortic valve issues?

2nd R intercostal space

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location to hear pulmonary valve best

2nd L intercostal space

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2 abx for endocarditis

vanc and ceftriaxone together

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2 valvular issues with Marfan’s syndrome

Aortic regurg and MVP

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2 main causes of aortic stenosis

congenital bicuspid valve

calcification of the valve due to CAD

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elderly pt with dyspnea, angina and syncope on exertion
EKG nl
dx?

aortic stenosis

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harsh blowing pan systolic murmur at the apex

dx?

mitral regurgitation

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suspect mitral regurgitation, how to dx

TEE

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pt with MVP what physical characteristics

thin female

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best patient position to hear aortic regurg and aortic stenosis

sitting up and leaning forward

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Tietze syndrome

costochondritis

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are most pulmonary valve problems congenital or acquired

95% congenital

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INR after organic valve replacement

2 to 3

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60yo male in ER severe dizziness and back pain
BP dropping +abd pulsatile mass
dx

ruptured aortic aneurysm

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pt with aortic stenosis, will the PMI be medially displaced, normal or laterally displaced

laterally displaced due to LVH

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severe crushing CP
EKG shows ST segment elevations
all labs negative
dx?

prinzmetal’s angina

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key hx of prinzmetals angina

cocaine use

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+ stress test

drop in BP
new arrhythmia
increase in angina sxs
st depressions

ulcers from venous insufficiency painful or painless

painless

how long after cardiac stent on asa and plavix

1 year

issues with mitral valve best heard

apex

initial tx MI

MONA

morphine, oxygen, nitro, asa

clot busting drugs within 3 hours of which 2 cardiac events

STEMI, new LBBB

3 catastrophic complications of a MI

papillary muscle rupture
myocardial wall rupture
L ventricular aneurysm

EKG shows a regular heart rate of 200 bpms
QRS narrow
dx?

supraventricular tachyacrdia

most common cause of sudden death

ventricular fibrillation

acute endocarditis is most commonly caused by what organism

staph aureus

3 congenital heart diseases

ASD - atrial septal defect
VSD - ventricular septal defect
coarctation of the aorta
PDA - patent ductus arteriosus
tetralogy of fallot

most common cause of an atrial septal defect

patent foramen ovale

atrial septal defect best heard murmur

at the left second or 3rd interspace

a CXR shows a “3” sign with notching of the ribs

coarctation of the aorta

tx for a patent ductus arteriosus

indomethacin

blalock procedure corrects what congenital heart condition

tetralogy of fallot

loud, harsh pulmonary murmur along the left sternal border

dx?

ventricular septal defect

subacute endocarditis caused by what organism

strep viridans

most common place for an aortic aneurysm

in and and below the renal arteries

males or females more likely to have an aortic aneurysm

males are 8 times as likely

accessory pathway known as the james bundle, what syndrome

Lown - Ganong - Levine syndrome

what imaging before OR with aortic aneurysm

risk factors for an aortic dissection

htn
marfans syndrome
bicuspid aortic valve
pregnancy

tearing CP rad to back

aortic dissection

CXR for pt with aortic dissection shows

widened mediastinum

best test to dx an aortic dissection

6 P’s of an ischemic limb

pain
paresthesias
pallor
pulselessness
poikilothermia
paralysis

pt with pulses paradoxes

dx’s?

pericarditis
pericardial effusion
obstructive lung disease

pt ℅ of pain in legs with walking
goes away after sitting
term for sxs?
dx?

intermittent claudication

peripheral arterial disease

giant cell arteritis

what disease?

polymyalgia rheumatica

sawtooth pattern on EKG

atrial flutter

what accessory pathway is associated with wolff-parkinson-white syndrome

the bundle of kent

a biphasic P wave should make you think of what dx

left atrial enlargement

gold standard for dx giant cell arteritis

biopsy of the temporal artery

tx for giant cell arteritis

high dose prednisone

virchow’s triad (3)

stasis
vascular injury
hypercoagulability

calf pain

dx?

DVT

best hear issues of the tricuspid valve

along the left sternal border

most common congenital heart disease

VSD - ventral septal defect

ulcers from arterial insufficiency painful or painless

painful

3 contraindications of ACEI

bilateral renal artery stenosis
hx of angioedema
pregnancy

both lead I and AVF have + QRS complexes

axis?

normal

what med might you switch pt to for cough on ACEI

ARBs

angiotensin receptor blocker

class of cardiac meds not used in asthma

Beta blockers

blocks receptors for brochodilators

boot shaped heart on CXR

congenital dx

tetralogy of fallot

RSR prime in leads V1 or V2

dx?

RBBB

labs monitored in pt taking aldosterone antagonist

may have hyperkalemia

dest test dx CHF

echo

what cardiac med is used to help with contractility after optimizing most others?

Digoxin

blockage of which artery causes an anterior wall MI

left anterior descending artery

what lab result will increase the risk of digoxin toxicity

hypokalemia

hypercalcemia

a pt presents in acute CHF
what class of drug is 1st choice

loop diuretics

pt has a GFR of 25 and HTN
class of htn med
Loop or thiazide

loop will work no matter how low the GFR is

Thiazides will only work with a GFR over 30

anterior wall MI

V1, V2 and V3

do loop diuretics cause hyperkalemia or hypokalemia

hypokalemia

statins drug of choice for which dyslipidemia

elevated LDL

pt recently started lipitor
now with aches and pains
test to order?

serum creatinine kinase

at risk for rhabdomyolysis

how does ezetimibe (zetia) work

decreases intestinal absorption of cholesterol

which hyperlipdemia med may cause flushing

niacin

4 med “classes” for reduction in LDL

statins
ezetimibe
niacin
nicotinic acid

2 fibrin acid derivatives

fenofibrate (tricor)

gemfibrozil (lopid)

3 class 1a antiarrhythmics

disopyramide (norpace)
quinidine
procainamide

counting boxes to determine rate

300, 150, 100, 75, 60

U wave on EKG

dx?

hypokalemia

what will heart rate be if the AV node is pacing the heart

40-60 bpm

cardiac med may cause gynecomastia

spironlactone

lead I up
AVF down
axis?

LAD

Osborne or J wave on EKG

dx?

hypothermia

1st line med for symptomatic bradycardia

atropine

HR tachy or bradycardia

Tachy >100

brady <60

on EKG there is an early but o/w nl PQRS complex
then a slight pause then nl rhythm continues
term for 1 beat

PAC

tx for polymyalgia rheumatica

low dose prednisone

management of pt with SVT

vagal maneuvers
carotid massage
adenosine

1st line med for atrial flutter

adenosine

82yo with ha and jaw claudication

dx?

giant cell (temporal) arteritis

EKS shows irregularly irregular narrow QRS waves

dx?

atrial fibrillation

EKG shows a regular rate of 50 bpm
QRS is narrow no p wave
dx

junctional rhythm

common cause junctions rhythm

dig toxicity

EKG shows 2 PVC look very different

term?

multifocal PVCs

most common cause sudden cardiac death

V fib

pt with no pulse

keg wide irregular complexes, irregular rate

in V Fib

tx defibrillation

Tall peaked T waves

hyperkalemia

define 1st degree AV block

PR interval is longer then 0.2 seconds or one block on EKG

another term for mobitz type I

wenckebach

complication of giant cell arteritis

blindness

2 labs to monitor in a pt on an ACEI

serum creatinine

serum K

HR irregular can’t count boxes

another way to determine rate

count QRS waves in a six second strip and multiply by 10

tx for mobitz II AV block

pacemaker

see regular P waves and reg QRS complexes, not correlated

dx?

3rd degree AV block

aldosterone antagonists (2)

spironolactone (aldactone)

eplerenone (inspra)

short PR interval and a delta have on keg

dx?

wolff parkinson white syndrome

what 2 leads determines axis

lead I and AVF

axis I and AVF nl

+/+

axis I and AVF LAD

+/-

axis I and AVF RAD

-/+

RSR prime in leads V5 or V6

dx?

LBBB

worse LBBB or RBBB

new LBBB is a STEMI

RBBB normally not a problem

med class to lower triglycerides

fibrin acid derivatives

tall peaked P waves

dx?

R atrial enlargement

list 3 causes of RAE

pulmonary htn
severe lung disease
pulmonary valve stenosis

which leads to dx an anterolateral MI

V5 and V6

3 inferior leads

II, III and AVF

lateral wall MI which artery

left circumflex artery

depressions greater then 1mm on EKG -

ischemia

rheumatic fever most commonly affects which valve

mitral valve

cyanotic congenital heart disease

tetralogy of fallot

EKG shows early wide QRS complex with no P wave
then pause and NSR
term 1 beat?

PVC

definitive tx recurrent VT

implanted defibrillator

EKG gradually lengthening PR interval and then a missed QRS complex, repeats
what AV block?

mobitz I or wenckebach

side effects of digoxin

N/V
anorexia
confusion
arrhythmias (sinus brady, av block)
fatigue
vision disturbances

1st line tx for torsades de pointes

magnesium sulfate

why tx actinic keratosis

it may progress to squamous cell carcinoma

1st line tx for rosacea

metronidazole

tetracycline 2nd

where are 90% of basal cell lesions found on the body

on the head and neck

purple pruritic polygonal papule on PE

dx?

lichen planus

ABCDE of melanoma

asymmetry
border
color
diameter
elevation/irregular
evolving

+ auspitz sign

psoriasis

auspitz sign

Auspitz’s sign is the appearance of punctate bleeding spots when psoriasis scales are scraped off
This happens because there is thinning of the epidermal layer overlying the tips of the dermal papillae and blood vessels within the papillae are dilated and tortuous, which bleed readily when the scale is removed

key indicator for the prognosis of melanoma

thickness of the lesion

tx melaonma

wide local excision

waxy stuck on appearance

dx?

seborrheic keratosis

5yo in jan with a red itchy rash behind knees and on flexor surfaces of elbows
dx?

atopic dermatitis

term satellite lesion

candida diaper rash

coin shaped plaques

nummular eczema

30 yo female with pustules on face that spare vermillion border
hx using topical steroids
dx

perioral dermatitis

pt presents with flaky skin in the nasolabial folds and in hair
dx

seborrheic dermatitis

tx stasis dermatitis

compression stockings

tapioca blisters

dx?

dyshidrosis

usually on the hands and feet

tx dyshidrosis

topical steroids

giant cells on tzanck smear

herpes simplex virus

tx lichen simplex chronicus

get the pt to stop scratching it

herald patch

pityriasis rosea

tx pityriasis rosea

reassurance

pt with hx herpes now with target lesion

erythema multiforme

rhinophyma

acne rosacea

silvery scales

psoriasis

teardrop lesion after a course of strep throat

guttate psoriasis

are lesions from psoriasis found on flexor or extensor surfaces

extensor

1st line tx for tine corporis

topical azoles

2 most common organisms for cellulitis

strep and staph

pitting nails

psoriasis

nummular eczema is most like what?

atopic dermatitis

honey colored crusts

impetigo

2 herpes viruses for condyloma aceminata

6 and 11

double comedone

hiradenitis suppurativa

tx molluscum contagiosum

self limiting but can removed

tx for seborrheic keratosis

benign no need to treat it

can be removed if unsightly

hyper pigmented velvety plaques

acanthosis nigricans

melanoma most common which pts

women of childbearing age

extremely pruritic lesions with burrows in runs

scabies

1st step in tx atopic dermatitis

behavioral modifications
reduce bathing
only use soap on face and genitals
natural breathable fabrics

tx for bad brown recluse spider bite

debridement

venom causes tissue necrosis

salmon - colored scales

psoriasis

depigmented patches of skin

vitiligo

spaghetti and meatball on KOH

tinea versicolor

What dermatologic finding is associated with insulin insensitivity

acanthosis nigricans

slowly growing nodule with a central depression and a pearly border
dx

basal cell carcinoma

dermatologic findings associated with asthma

atopic dermatitis

christmas tree pattern

pityriasis rosea

oval patches of hair loss

alopecia areata

1st line tx genital warts

imiquimod (aldara)

pearly dome shaped lesions with a central umbilication

molluscum contagiousum

best test scabies

microscopic exam under oil immersion

2 hormones are secreted by posterior pituitary

oxytocin
antidiuretic hormone (adh, vasopressin)

sheehans syndrome

ischemia of the pituitary due to volume depletion during or after childbirth

how do giltazones work

they improve insulin sensitivity

most common pituitary adenoma

prolactinoma

large doughy hands

gigantism

DM insipid us is caused by a deficiency of which hormone

vasopressin

how much more potent is T3 than T4

3-4x

1st line tx for pheochromocytoma

alpha blocker

never use a pure beta blocker

best imaging for a thyroid nodule

pt with ED and complains of some numbness in feet
also with significant polyuria and polydipsia
dx

diabetic neuropathy

pretibial myxedema

graves disease

35 yo F heat intolerance, wt loss and palpitations

hyperthyroidism

1st line tx for pt with palpitations and nervous with hyperthyroidism

beta blockers

hashimoto’s disease

an autoimmune cause of hypothyroid

how does levothyroxine work

it is a synthetic T4

most common thyroid cancer

papillary makes 80% of thyroid cancers

pt with hyperthyroidism, tsh elevated or decreased

decreased

how do fib rates work to affect the lipid profile

inhibit synthesis of VLDL and elevate lipoprotein lipase

med prior to thyroidectomy in a pt with hyperthyroidism

methimazole or

PTU propylthiouracil

while’s triad of hypoglycemia

hx of previous hypoglycemia
serum glucose of <40
immediate recovery upon admin of glucose

+ antithyroid peroxidase and antithyroglobulin antibodies

hashimoto’s

tx for myxedema

levothyroxine and slow warming

most common cause hypoparathyroid

post thyoidectomy with the complication of parathyroidectomy

chvostek’s sign

tap on facial nerve and get a twitch with low Ca

cortical adrenal insufficiency aka

addison’s disease

trousseau’s sign

inflate BP cuff and hold for 3 minutes

pt with low Ca will get carpel tunnel sxs

most common cause of hyperparathyroidism

single parathyroid ademona in 80% of cases

cushing’s disease is ACTH elevated or decreased

elevated

graves disease

most common cause of hyperthyroidism

an autoimmune disease

what specific breathing pattern is associated with diabetic ketoacidosis

kussmaul respirations

least aggressive thyroid cancer

papillary

2 tests you might use to rule out cushing’s

24hr free cortisol urine test and dexamethasone suppression test

3 ectopic tumors that may produce ACTH and give a patient cushing’s sndrome

small cell lung cancer
pancreatic islet cells
thymomas

tx for addison’s disease

hydrocortidone or prednisone

test to begin with if you suspect pheochromocytoma

24 hour urine for catecholamines

exophthalmos

hyperthyroidism

%dm in US type 2

80-90%

HLA-DR gene is a marker for what endocrine disorder

DM type 1

main function of parathyroid hormone

increase serum ca

4 diagnostic criteria for dm

random glucose >200
fasting glucose >126
2hr postprandial >200
HgA1c > 6.5%

moans, groans, stones and bones

what dx

hyperparathyroid

stocking glove should make you think of what dx

diabetic neuropathy and B12 deficiency neuropathy

fruity breath

DKA

dawn phenomenon

reduced insulin response between 5 and 8am

most common cause of hypopituitarism

tumor

how does metformin work

decreases the hepatic glucose production and increases peripheral glucose uptake

how do sulfonylureas meds work

stimulate the production of insulin

what class of meds does pioglitazone (actos) fall into

thiazolidinediones also known as glitazones

suffix associated with sulfonylureas

ide

ex: glipizide, tolbutamide, tolazamide

1st med in DM 2

metformin

how ofter do u check HgbA1c goal?

every 3 months
(rbi life 90-120 days)
below 6.5%

5 criteria for metabolic syndrome

HDL 135/85
Triglycerides >150
Fasting glucose >100
waist >40 men, >35 women

1st class of meds for lowering LDL

statins

lipid med may cause flushing

niacin

life threatening side effect of statins

rhabdomyolysis

does niacin increase or decrease HDL

increase

class of med is metformin (glucophage)

biguanide

5 insulins in order of peak efficacy

lispro 1-2 hrs
regular 2-4 hrs
NPH 5-7 hours
lente 4-8 hrs
ultralente 8-14hrs

metformin contra or indicated in renal failure

contraindicated

most common cause of DM type 1

autoimmune destruction of the islet cells in the pancreas

PE in cushings (6)

moon face
buffalo hump
purple striae
central obesity
suprclavicular fat pads
easy bruising

propranolol what class meds

beta blockers

while pregnant tx for hyperthyroidism

PTU

4 thyroid cancers

papillary
follicular
medullary
anaplastic

what heparin complication is relevant to endo

adrenal infarct leading to a Cushing’s syndrome

how does nicotinic acid work to affect the lipid profile

it inhibits secretion of VLDL

hyper pigmentation of the skin along creases

dx?

addison’s disease

most agressive thyroid cancer

anaplastic

how do statins work to affect the lipid profile?

they slow the rate limiting step of cholesterol synthesis

will ACTH be elevated for decreased in Addison’s

elevated if the problem is at the adrenal glands

what role does C-peptide play in the diagnosis of DM

it is a marker of insulin production

Elevated C-peptide points to DM2

Decreased C-peptide points to DM 1

2 most common pathogens acute sinusitis

strep pneumoniae

haemophilus infuenzae

oral herpes is best treated with systemic or topical antivirals

topical is 1st line

systemic antivirals will help but are only indicated for severe cases

pt with several episodes of vertigo over the past several weeks

intermittent unilateral hearing loss and a “blowing” in his ears
dx?

meniere’s disease

white oral lesion which cannot be scraped off

dx?

oral leukoplakia

what type of hearing loss is associated with aging

sensory

which is the most commonly affected sinus in acute sinusitis

maxillary

pt with a hot potato or muffled voice

dx?

peritonsillar abscess

time frame for chronic sinusitis

> 3 months

list the time of year when each of the following allergens is most prominent:
pollen, grass, mold and ragweed

spring: pollen from trees and flowers

Summer: grasses

Fall: mold and ragweed

how long pressure for nose bleed

15 mins

4 things that suggest group A beta-hemolytic strep

fever
tender anterior cervical adenopathy
no cough
exudate in the throat

child with erythematous sandpaper rash

scarlet fever

pt with sensorineural hearing loss what will be the results of the weber test

pt will hear the sound louder in the unaffected ear

4 complications of untreated strep throat

scarlet fever
glomerulonephritis
rheumatic fever
local abscess

pt with round ulcer in her mouth that is yellow-grey with a red halo
on buccal mucosa
painful
dx?

aphthous ulcers

pt with drooling, stidor and in tripod position

dx? treatment?

epiglottitis

2nd or 3rd gen cephalosporin like cefuroxime or ceftriaxone

oral lesions that can be scraped off leaving punctate bleeding
dx?

oral candida

3 treatments for peritonsillar abscess

needle aspiration
I&D
tonsillectomy

virus that causes mumps

paramyxovirus

tx for allergic rhinitis

intranasal corticosteroid

antihistamines

tx for strep throat

penicillin
amoxicillin
erythromycin

unilateral hearing loss and decrease in speech discrimination
difficulty with balance over a week
dx?

acoustic neuroma

acute swelling and pain in the cheek that increases at meals

dx?

sialadenitis
salivary gland infection
staph aureus

when is watchful waiting with a dx of acoustic neuroma an appropriate plan

if tumor is very slow growing

watching a small tumor in an elderly pt is appropriate tx

what type of hearing loss would be caused by cerumen impaction

conductive

how do you administer the weber hearing test

tuning fork placed in the middle of the forehead

14 yo with adenopathy, white purple exudates in throat and palpable spleen
dx

mononucleosis

how do you administer the weber hearing test

tuning fork on the mastoid and then move it next to the ear

results of a weber hearing test in pt with conductive hearing loss

pt will report sound louder in the affected ear

x-ray of the skull reveals coalescence of mastoid air cells

dx?

mastoiditis

abc 1st line sinusitis

amoxicillin or bactrim

45 yo female complains of feeling the ground rolling under her feet at times
dx?

vertigo

pt with hx of smoking presents with new onset hoarseness, persistent for 2 weeks
dx?

laryngeal squamous cell carcinoma

pt presents with acute onset of continuous severe vertigo for the past 5 days
hx URI 2 weeks ago
dx

labrynthitis

what does kiesselbach’s plexus refer to

group of veins in the anterior nose which bleed a lot

small grouped vesicles on the vermillion border

herpes

most common type kidney stones

calcium 85% of stones

most specific imaging for kidney stones

will a spermatocele transillumnate

yes

a stone of what size will likely pass

less than 5mm

3 possible treatments for stress incontinence in women

kegels
estrogen therapy
surgical placement of a urethral sling

65 yo male presents with frequency
on rectal exam elastic moderateley enlarged prostate
dx

BPH

a PSA above what is concerning

> 4

risk factors for ED

DM, htn, depression, CAD

1 major risk factor for bladder cancer

smoking

paraphimosis

foreskin is retracted and cannot be reduced

which is an emergency phimosis or paraphimosis

paraphimosis

phimosis

the inability to retract the skin (foreskin or prepuce) covering the head (glans) of the penis.

what is the name of the condition that involves fibrous scar tissue in the penis causing a curvature of the erect penis

peyronie’s disease

both testicles should be descended by what age

3 months

feeling a bag of worms in the scrotum

dx?

varicocele

fluid filled painless mass found in the scrotum which transilluminates
dx?

hydrocele

1st line treatment for a variocele

watchful waiting unless there is a question of fertility

prehn’s sign

decreased pain with scrotal elevation

meaning prehn’s sign

the physical lifting of the testicles relieves the pain of epididymitis but not pain caused by testicular torsion

maltese crosses in the urine

dx?

nephrotic syndrome

imaging for bladder cancer

cystoscopy and bx

free floating, painless, cystic mass found posterior and superior to the testis
dx?

spermatocele

age range is typically associated with testicular torsion

10-20 yo

where is the epididymis found

posterior upper pole

best imaging to rule out testicular torsion

doppler US for decreased blood flow to the testes

2 most common causes epididymitis

gonorrhea

chlamydia

med classes to prevent chronic renal failure in DM pts

ACEIs or ARBs

will epididymitis feel better with scrotal elevation

yes

nl level serum bicarb

tx epididymitis

ceftriaxone and doxy

1st line abc for cystitis

bactrim

most common organism for bladder infection

E.Coli

1st line abx for postatitis

bactrim 4-6 weeks

risk factors for prostate cancer

advancing age
african american
+ family hx
high fat diet

what do you feel on a digital rectal exam on a pt with prostate ca

enlarged prostate

hard nodules

priapism

painful persistent erection

how many samples from a prostate bx

6 to 12

painless hematuria

bladder cancer

most common bladder cancer

transitional cell cancer

phimosis

foreskin can not be retracted

head of the penis curves downward for upward at the junction of the head and shaft of the penis

chordee

often associated with hypospadias

tx urethritis

ceftriaxone and doxy

3 yo boy with hematuria and a painless and mass

wilms tumor

3 possible causes of pre renal renal failure

CHF
severe dehydration
hemorrhage

most common cause post renal failure

BPH

post renal renal failure is secondary to an outflow obstruction

muddy brown sediment in the urine

acute tubular necrosis

tea colored urine with red cell casts

glomerulonephritis

2 common predisposing factors in chronic renal failure

HTN

sponge like prostate on rectal

prostatitis

you can cause sepsis with a rectal exam

is serum potassium decreased or elevated in renal failure

elevated

urine protein of >3.5 gm/day

nephrotic syndrome

hereditary of polycyctic kidney disease

autosomal dominant

nl ph of blood

7.35-7.45

how to dx urethritis

urine PCR

nl PCO2

abg shows 
ph 7.2
bicarb 25
pco2 50
respiratory or metabolic acidosis

respiratory co2 is elevated

WBC casts

pyelo

what area of the prostate is affected by BPH

transitional zone

what area of the prostate is the primary side for prostate cancer

peripheral zone

involuntary loss of urine during coughing or laughing

stress incontinence

nl bladder function but can not get to the bathroom

functional incontinence

what type of incontinence is seen with BPH

overflow incontinence

the bladder can not empty sufficiently

at what age do you start screening for prostate cancer, how?

50 with rectal and PSA

often caused by chlamydia what syndrome is characterized by urethritis, arthritis and conjunctivitis

reiter’s syndrome

most common type of testicular cancer

nonseminoma

nl range for MCV

80-100

most common microcytic anemia

iron deficiency anemia

anemia of chronic disease is

normocytic

2 main causes of a macrocytic anemia

malnutrition

severe blood loss

does an increase in reticulocytes indicate a decrease or an increase in RBC production

an increase

reticulocytes are newly released baby RBCs

auer rods

dx?

acute myeloid leukemia

what molecule binds iron in the blood stream

transferrin

koilonychia

spoon shaped nails

microcytic anemia

will the serum ferritin be high or low in a patient with iron deficient anemia

almost always be low

a low retic count and a normal serum ferritin

dx?

anemia of chronic disease

what level consider transfusion

asplenism secondary to sickle cell disease increases a patient’s risk for what type of infections

capsulated organisms like strep pneumo and H flu

AA teen presents with avascular necrosis of the R femoral head
dx?

sickle cell disease

tx for sickle cell

fluids
oxygen
pain meds
transfusion

in sickle cell unconjugated bill high or low

high

which anemia has Howell-Jolly bodies

sickle cell
due to the functional asplenia

also in folic acid deficiency

G6PD inheritance

X-linked

3dx for Heinz bodies

G6PD deficiency anemia
chronic liver disease
alpha thalassemia

pica?

eating non-food items

target cells in mild or severe iron deficiency anemia

severe

also in
alpha thalassemia
chronic liver disease
asplenia

level of iron in iron deficiency anemia

B12 deficiency anemia

micro, normo or macrocytic

macrocytic

4 regions for alpha thalassemia

southeast asia
china
middle east
africa

mediterranean descent which anemia

beta thalassemia

level of folic acid in folic acid deficiency

< 150

pica which anemia?

iron deficiency anemia

inability to absorb vitamin B12 due to lack of intrinsic factor
dx?

pernicious anemia

stocking glove paresthesias

2dx?

B12 deficiency neuropathy

diabetic neuropathy

RBCs size in B12 deficient anemia

macrocytes

retic count in B12 deficient anemia

retic count will be low

schilling’s test used for

test for the cause of B12 deficiency

Strict vegans are at risk for which anemia

B12 deficiency anemia

sickle cell

micro, macro or normocytic

microcytic

will hemolytic anemia have elevated or decreased retic count

elevated

4 dx with basophilic stippling

lead poisoning
beta or alpha thalassemia
sideroblastic anemia
arsenic poisoning

anemia of pregnancy

iron deficiency

dx?

philadelphia chromosome

chronic myeloid leukemia

white curd like vaginal dc

dx?

yeast

owl eye inclusion bodies

dx?

CMV

cytomegalovirus

+ blood cultures for canidida

1st line drug?

amphotericin B

tx for pertussis

erythromycin x 7 days

a leukemia pt has a CT of the liver which shows punched out lesions
dx?

hepatosplenic candida

what disease does rickettsia rickettsii cause

Rocky mountain spotted fever

india ink stain showing cysts

dx?

cryptococcosis

COPD pt has apical cavities and calcified nodes on CXR, he has a pet bat and a few birds
dx?

histoplasmosis

HIV pt with a nonproductive cough and CXR with diffuse interstitial infiltrates
dx?

PCJ / PCP

pneumocystis jiroveci pneumonia

honey and babies

botulism

what type organism causes botulism

gram + rod

clostridium botulinum

tx for botulism

antitoxin

ER pt with acute progressive weakness, diplopia and very dry mouth
dx?

clostridium botulinum

rice water stool

dx?

cholera

is diphtheria a gram + or negative organism

gram-positive

a stuck on grey membrane in the pharynx

dx?

diphtheria

4 steps in treating diphtheria

antitoxin
pcn
remove membrane
report case to CDC

clinical name for whooping cough

pertussis

what type organism for tetanus

gram + rod

clostridium tetani

pt ate out last pm today with cramping and bloody diarrhea

organism?

salmonella

diarrhea with blood and mucus

dx?

shigella

best test to dx malaria

peripheral blood smear

organism for reactive arthritis

shigella

reactive arthritis has a + HLA-B27

tx for shigella

bacterium or fluroquinolones and hydration

organism for lyme disease

borrelia burgdorferi

minimum Amt of time needed for a tick to transfer lyme disease to a human

24 hours

drug of choice to treat lyme disease in kids or pregnant women

amoxicillin

drug to treat C. difficile

flagyl

pt in woods yesterday and today with erythema migrains

lyme disease

drug to treat or prophylaxis of malaria

chloroquine

pt was camping a few days ago
now has rash that began on his wrists and ankles
dx

rocky mountain spotted fever

drug of choice for rocky mountain spotted fever

doxycycline

drug of choice for syphilis

pcn

any reference to dark field microscopy should make you think what organism

treponema pallidum

staph gram + or -

gram +

pt being treated with pen for syphilis
develops fever, chills, muscle pain and ha
do u stop tx?

this is a jarisch-herxheimer rxn
pt must be closely monitored

it is a response to released endotoxin from the death of the spirochetes and not an allergic reaction

what organism is believed to cause PUD

h. pylori

painless, clean base chancre

primary syphilis

pseudomonas

gram + or -

gram -

rash on palms and soles
fever, chills
painless chancre a few weeks ago
dx?

secondary syphilis

most contagious

tx for cholera

fluids

drug of choice for cytomegalovirus

ganciclovir

herpes virus that causes epistein-barr

herpes 4

pt education for mono

no contact sports - splenic rupture

no kissing - contagious

exudative sore throat, malaise
PE- posterior chain lymphadenopathy, mild splenomegaly
dx?

epstein-barr virus

1st sxs rabies infection

pain and anesthesia at the site of the bite

definitively dx rabies

pathology of the brain of the animal using fluorescent antibody stain

pt bit by rabies animal

what days do you give human diploid cells

0, 3, 7, 14, 28

diaper rash with satellite lesions

canidida

3 serious reactions to vancomycin

nephrotoxicity
ototoxicity
stevens-johnson

tests done to screen for HIV

ELISA and then if +

confirm with western blot test

drug of choice for lyme disease

doxycycline

trismus?

lock jaw

often secondary to tetanus

tx amebiasis

flagyl

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