Challenge Bowl #3 Flashcards by Shelby W

Exam of a pregnant woman: bluish cervix. What is this sign called?

Chadwick’s sign

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A potentially life threatening of anti-psychotic therapy characterized by fever and muscle rigidity?

neuroleptic malignant syndrome

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What are the names of the specific physical exam findings that are positive in carpal tunnel syndrome?

Phalen’s and tinel’s

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Which class of commonly used asthma medication has the most rapid and slowest onset of effect?

Short acting beta2 agonists

Inhaled corticosteroids

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What is the most common presenting sign of hodgkin’s disease?

Painless lymphadenopathy

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What three drugs or drug classes can be used to slow the ventricular rate in a. fib?

CCB - nondihydropyradine
Beta blockers
Digoxin

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What is the name given to avascular necrosis of the capital femoral epiphysis in children?

Leg calf perthes

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A woman has been on the same OCP x 4months and complains to early - mid cycle bleeding? What should you do?

Increase estrogen and check adherence

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Pt presents with chronic back pain, you find dec’d proprioception and vibration. Which portion of spinal column?

posterior columns

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What two categories or class of medications can be used to tx an acute manic episode in a pt with BPAD?

mood stabilizers (Li, VPA)
atypical antipsychotics

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Pg pt, where would you expect to find the fundus at 12 weeks and 20 weeks?

12 weeks: just outisde the pelvis
20 weeks: at the level of the umbilicus
1 cm qweek following

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What is considered first line for GAD?

SSRI or SNRI

Benzo if rapid response

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Distant heart sounds, midline trachea, and diffuse hyperresonance to percussion indicate what condition?

COPD

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Pg woman develops DVT and is d/c on what anticoagulant therapy?

LMWH (Lovenox)

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During the luteal phase what hormones are affecting the menstrual cycle?

Predominantly progesterone, as well as estrogen

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What empiric tx is recommended in pts 1month - 50yrs for meningitis

Ceftriaxone and vanco

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Name three RF for developing PE

Virchow’s triad: immobility, hypercoagulable state, endovascular injury

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Three clinical uses for TCA’s?

depression, neuropathy, migraines

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A dendritic ulcer on the eye is characteristic of what infection?

Herpes opthalmicus

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What is the MC finding of a pt with long standing HTN on an EKG

LVH

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T or F? Starting ibuprofen on a pt on warfarin will cause the INR to inc?

F - increased bleeding risk because antiplatelet, but not anticoagulation.

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Name 4 IADL’s

Finances
Laundry
Shopping
Telephone
cooking

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How long should sutures be left in place on the face?

3-5 days

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For which condition is prostatic massage CI and why?

Acute prostatitis because risk of bacteremia

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A mother brings her 3 month old infant; single red vascular, nodular growth on back; enlarges slightly but causes no impairment. Dx? Pt Ed?

Hemangioma; not causing problem should watch and let involute on its own

Pt with GDM, needs medication therapy should be treated with what?

Insulin

10y.o. obese boy presents with knee pain. X-ray shows posteriorly displaced femoral head.

SCFE | slipped capital femoral epiphysis

What type of hernia develops at the internal inguinal ring?

Indirect

What is the MC cause of community acquired pneumonia in kids >5yrs?

m. pneumo | s. pneumo (MC overall)

What endocrine AE monitoring is recommended for atypical antipsychotics?

Lipids, BG, BMI, and BP

What are the three main components of advanced directives?

Health care agent Living will DNR

40y.o. female has multiple painful ulcerative lesions on her labia. Dx?

HSV

Child presents with complaints of sore throat: small vesicles with punched out lesions, vesicles on hands and feet.

Coxsackie virus; Hand foot and mouth

When does the moro reflex start to disappear?

3-6 months

Name three antihypertensive classes that can cause hyperkalemia?

K+ sparing diuretics | ACEI, ARBs

What physical exam finding is specific for pericarditis?

Pericardial friction rub?

Name two drugs that can cause kernicterus in neonates

TMP/SMX | Ceftriaxone

Describe the features of the Colle's fx

Transverse fx of distal radius with dorsal displacement

What type of sz is characterized by periods of lack of awareness

Absence

What AED is renally eliminated and can also be used to tx neuropathic pain?

gabapentin

Pt presents with knee pain and laxity in valgus stress. Most likely injury?

MCL

4 RF for pressure ulcers

dec'd mobility nutrition incontinence friction, moisture

which typical findings would be revealed on a colonoscopy with crohn's

skip lesions | rectal sparing

what are apropriate first line tx options for smoking cessation

nicotine replacement bupropion chantix behavioral therapy

what does the macula provide in regards to vision

sharp vision central vision acuity color - cones

What are the three components of the human balance system?

biomechanical sensory, ne

What is the MC traumatic head in jury in the elderly

subdural

H. pylori positive pt should have what components of tx

antisecretory drug and antibiotics

Kidney stone associated with pseudomonas

Struvite

LDL, BP and A1C goals in DM

130/80, LDL 100, <7

Swan neck deformity is associated with what autoimmune condition

What med should a pt with persistent asthma be on?

SABA and ICS

What is the MC extrahepatic source of an elevated alk phos?

Bone | Comes from several different places: also placenta

What is the endocrinologic manifested by anorexia, wt loss, low plasma cortisol levels, and hyperpigmentation

Addison's disease

TCA's have high anticholinergic effects. What are some examples of these?

Anti-SLUD: dry mouth, dry eyes/blurred vision, constipation, urinary retention

What organism causes botulism?

Clostridium botulinum

What agent tx's obesity by decreasing dietary fat absorption?

orlistat

What skin condition is a greasy yellowish flaky collection involving the scalp?

Seborrheic dermatitis

Which aminoglycoside is most effective against pseudomonas?

Tobramycin

What is the best way to remove a tick?

Use a pick up to grasp the head

Which generation of FQ's has the best gram positive coverage?

4th generation (respiratory FQ's)

What are the two phases of roseola?

``` Fever phase x 3-5 days Rash phase (on neck and trunk) ```

Which class of medications are not recommended to tx Parkinson's dz in pts >60y.o.?

anticholinergics because they can be sedating

How many DTaPs and polio vaccines should be given by age 7?

5 DTaPs and 4 polios

What are 4 recommended txs of osteoporosis?

Bisphosphonates Calcium 1500mg Vitamin D 800 IU Wt bearing exercise

What are 4 physical findings of kawasaki disease?

``` fever erythema and edema of the hands and feet desquamation of the hands and feet cervical lymphadenopathy Fissuring of the mouth/lips Strawberry tongue Conjunctivitis Joint pain Abd pain/N/D ```

Most significant different in the pharmacodynamics in older adults?

Dec'd renal clearance

Pt presents with coryza, conjunctivitis, severe cough, Koplik spots, and fever. What is the dx?

measles

What is the initial tx for a pt bitten by a black widow?

Antivenom

Only indication for oral vancomycin?

c. diff

Neonates have their eyes tx'd at birth to tx what infx?

N. gonorrhea

What is the tx for a pt with a severe MS exacerbation?

prednisone (PO/IV)

Why does polyuria occur in pts with untx'd diabetes?

osmotic diuresis

When does the grasp reflex disappear?

3-6months