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Step 2 > COMLEX > Flashcards

COMLEX Flashcards

1
Q

humeral shaft frx damages which nerve

A

radial

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2
Q

frx of medial epicondyle damages which nerve

A

ulnar

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3
Q

pain over anatomical snuffbox

A

scaphoid frx

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4
Q

surgical neck of humerus frx damages which nerve

A

axillary

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5
Q

radial nerve damage –>

A

wrist drop

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6
Q

ulnar damage –>

A

last 1.5 fingers numb

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7
Q

median damage –>

A

first 3.5 fingers numb

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8
Q

why do preggers get GDM?

A

human placental lactogen (aka chorionic somatomammotropin) increases insulin resistance

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9
Q

tests if you think its B12 def

A

MMA + homocysteine

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10
Q

CSF in neisseria meningitis

A

low glucose
high protein
high WBC

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11
Q

xanthochromia

A

yellow CSF

subarachnoid hemorrhage

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12
Q

abdominal pain after pancreatitis tx

A

think pseudocysts

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13
Q

pancreatic pseudocyst tx

A

NPO + observation

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14
Q

todd’s paralysis

A

post seizure
transient (min - hours)
hands, arms or legs

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15
Q

hemochromatosis heart problems

A 
restrictive CM (low voltage EKG)
dilated CM (cardiomegaly)
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16
Q

ASA overdose tx

A

alkalization of urine (sodium bicarb)

w/in an hour can go gastric lavage

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17
Q

LBP radiates to butt/thighs
better in flexion/sitting
worse in stand/walk

A

spinal stenosis

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18
Q

dx spinal stenosis

A

MRI

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19
Q

long term tx for spinal stenosis

A

weight loss

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20
Q

what do you give to kids that only get breast milk

A

Vit D starting after birth

iron after 4 mo

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21
Q

tx for GDM

A
  1. lifestyle

2. + insulin or glyburide

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22
Q

corkscrew sign on upper GI series

A

midgut volvulus

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23
Q

what will you see on EKG for LVH

A

voltage > 5 large boxes

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24
Q

long car ride –> back pain, can’t sit up

A

psoas syndrome

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25
Q

psoas syndrome tx

A

upper lumbar spine

then psoas

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26
Q

steps to dx C. diff

A
  1. C. diff toxin PCR (comes back in an hour)
  2. C. diff toxin EIA assay (comes back in 24 hrs) – more specific
  3. colonoscopy/sig if both neg but high suspicion
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27
Q

internal vs external validity

A

internal: valid to the pop being studied
external: generalizable

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28
Q

gout vs pseudogout

A

pseudo + birefringent crystals (blue rhomboids)

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29
Q

musty smelling baby

A

PKU

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30
Q

girl toddler loses speech, autism-y, hand mvmts

A

Rett

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31
Q

when do you do tympanometry

A

asx middle ear effusions

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32
Q

pheo 10s

A 
10% recur post surg
10% familial
10% b/l
10% extra adrenal
10% malignant
10% kids
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33
Q

when is post op fever ok (no workup)

A

first 48 hrs

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34
Q

variants of langerhans

A

eosinophilic granuloma
Hand-Schuller Christian (kids)
Letterer-Siwe (infants < 2)

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35
Q

best confirmatory test for Graves

A

radioiodine uptake scan

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36
Q

newborn: bulging abdomen, cryptorchidism, renal dysplasia/dilated ureters, pulm hypoplasia

A

prune belly syndrome

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37
Q

dandruff aka

A

seborrheic dermatitis

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38
Q

rhabdo management

A

IV fluids, EKG

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39
Q

wilsons tx

A

penicillamine

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40
Q

pheo, clear cell renal carcinoma, hemangioblastomas

A

von Hippel Lindau

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41
Q

ST elevations in I, aVL and V5-6: what kind + which vessel

A

lateral MI (left circumflex)

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42
Q

ST elevations in II, III and aVF: what kind + which vessel

A

inferior MI (right main coronary)

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43
Q

ST elevations in V1-V4: what kind + which vessel

A

anterior MI (left anterior descending)

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44
Q

rocker bottom feet

A 
tri 13 (Patau)
tri 18 (Edwards)
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45
Q

polydactyly in infant

A

tri 13 (patau)

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46
Q

clenched fist in infant

A

tri 18 (edwards)

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47
Q

infant w/ infections, petechiae, dry skin

A

wiskott-aldrich

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48
Q

unilateral, foul smelling nasal discharge (kid)

A

foreign body (kids are gross)

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49
Q

drug a/w rash in mono pts

A

amoxicillin or ampicillin

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50
Q

most important thing to give CKD pts who need contrast studies

A

vigorous hydration (N-acetylcysteine is good but less vital)

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51
Q

what kind of pneumothorax do you get when you change pressures on ventilation pts?

A

tension pneumo (same as with penetrating trauma)

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52
Q

which way does trachea deviate w/ tension pneumo?

A

opposite

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53
Q

distal limb weakness, decreased proprio, decreased DTRs, spinal deformities, pes cavus

A

charcot-marie-tooth

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54
Q

how much folic acid for preggers

A

normal: 0.4 mg

high risk: 4 mg

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55
Q

HIV defining illnesses

A

CIN II/III/carcinoma in situ
bacillary angiomatosis
shingles
thrush

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56
Q

AIDS defining illnesses

A

esophageal/tracheal/pulmonary candidiasis
intestinal isosporiasis/cryptosporidiosis
karposi’s
cerebral lymphoma
PCP
cerebral toxo
invasive cervical CA

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57
Q

why no cervical HVLA in downs

A

weakness of alar and transverse ligaments

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58
Q

ipsilateral dilated pupil: what herniation

A

uncal (supratentorial)

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59
Q

AMS, bleeds, cheyne-stokes breathing: what herniation

A

central

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60
Q

resp and cardiac dysfunction: what herniation

A

tonsillar herniation (aka downward)

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61
Q

what does negative predictive value mean?

A

chances that a neg result is actually negative (true negs/total negs)

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62
Q

what is electrical alternans

A

big QRS then smaller QRS (seen in cardiac tamponade)

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63
Q

when to give RhoGAM

A

28 wks

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64
Q

Still’s technique: direct or indirect?

A

start indirect, finish direct

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65
Q

timeline: baby blues vs depression?

A

2 weeks

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66
Q

FAP gene

A

APC

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67
Q

HNPCC/Lynch gene

A

DNA mismatch repair gene mutation

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68
Q

tx: whooping cough

A

macrolide (azithromycin, erythromycin or clarithromycin)
> 1: w/in first 3 wks of cough
< 1: w/in first 6 wks of cough

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69
Q

OCD vs OCDPD

A

OCD has some insight and is upset by it

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70
Q

gold standard for PE dx

A

pulmonary angiogram

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71
Q

therapeutic INR post DVT

A

2.0 - 3.0

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72
Q

tx: diverticulitis

A

quinolone + MTZ
TMP-SMX + MTZ
amoxicillin-clavulanate

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73
Q

patchy, oval hair loss of scalp or generalized loss of body hair

A

alopecia areata

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74
Q

when to add insulin to DM pt

A

> 8.5 A1C

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75
Q

COPD tx

A

combo:

LABA + inhaled glucocorticoid (need both)

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76
Q

most specific lupus tests

A

anti ds DNA

anti Smith

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77
Q

vasovagal syncope AKA

A

neurocardiogenic syncope

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78
Q

TCA cardio problems on EKG

A

widened QRS
prolonged PR
prolonged QTc
sinus tach

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79
Q

1st line tx: persistent allergic rhinitis

A

intranasal corticosteroids

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80
Q

fat embolism triad

A 
resp changes (tachypnea, cough, hypoxia)
neuro changes 
petechial rash
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81
Q

parasternal lift sign of

A

right ventricle dilation

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82
Q

how do you look for bence jones

A

urine protein electrophoresis

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83
Q

GI stromal tumor: Tx

A

imatinib

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84
Q

what do you test for in 21-hydroxylase def

A

17-hydroxyprogenterone

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85
Q

how to avoid non-hemolytic febrile transfusion reaction

A

use leukocyte washed blood products

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86
Q

what do you do when morning glucose is high?

A

test again at 3 am to differentiate btwn somogyi (will be hypoglycemic) and dawn effect (will be hyperglycemic)

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87
Q

what do you do for dawn effect

A

give more basal insulin @ dinner

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88
Q

ascites tx

A

furosemide and/or spironolactone

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89
Q

cord compression tx

A

corticosteroids

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90
Q

thyroid cancer a/w elevated calcitonin

A

medullary

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91
Q

bleed where you get better for a while then crash

A

epidural

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92
Q

MC pancreatic CA location

A

pancreatic head

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93
Q

tx: croup w/ resp distress

A

aerosolized racemic epi

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94
Q

criteria to determine severity/mortality of pancreatitis

A

Ranson criteria

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95
Q

Ranson criteria

A 
poor prognosis:
age > 55
WBC > 16,000
glucose > 200
LDH > 350
AST > 250
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96
Q

multifocal atrial tachycardia criteria

A

3+ diff P-wave morphologies in a single lead

HR > 100

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97
Q

wandering pacemaker criteria

A

3+ diff P-wave morphologies in a single lead

HR < 100

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98
Q

quad screen

A

triple screen + inhibin A

hCG, unconjugated estriol, AFP, inhibin A

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99
Q

quad screen results: + for Downs

A

decreased AFP
decreased estriol
increased inhibin
increased hCG

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100
Q

management: screening for downs

A

low risk can get triple screen
high risk (>35, late prenatal) get quad
if + –> genetic counseling
then offer amniocentesis

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101
Q

pregger: fever, abd pain and sausage shaped mass near umbilicus

A

septic pelvic pain thrombophlebitis

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102
Q

pregger/laboring: fever, tachy, tender uterus, foul smelling amniotic fluid

A

chorioamnionitis

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103
Q

post partum pelvic pain, foul smelling lochia

A

endometritis

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104
Q

schizos by time

A

2+ of schizo things
1-6 mo: schizophreniform
6+ mo: schizophrenia

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105
Q

tx: superficial thrombophelebitis

A

NSAIDs, elevation, heat, compression stockings

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106
Q

superficial vs suppurative thrombophlebitis

A

superficial + fever/chills and hx of IV cannulation

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107
Q

reasons to commit pts to psych

A

danger to self
danger to others
inability to care for themselves due to psych illness

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108
Q

SVT management

A

stable: vagal maneuvers and adenosine. diltiazem/labetalol for rate control
unstable: synchronized cardioversion

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109
Q

breast mass management

A

age > 30 –> mammo
if look malignant –> sterotactic bx

age < 30 –> U/S
cystic –> aspirated
fibroadenoma –> < 5 = obs; > 5 = FNA bx
non-fibroadenoma –> bx

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110
Q

signs of malignancy in mammo

A

breast asymmetry
clustered calcification
increased density
mass w/ irregular borders or spiculation

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111
Q

MCC prepubertal short stature and pubertal delay

A

constitutional growth delay (parents usually “late bloomers”)

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112
Q

delayed puberty definition

A

girls: > 12 w/o breast growth
boys: > 13 w/o testicular growth

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113
Q

cleft lip management

A

repair w/ surgery @/by 3mo

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114
Q

cleft palate management

A

prescribe special nipple for feeding

repair w/ surgery @ 9+ months

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115
Q

aspiration pneumonia – where do you see it? which kids?

A

R lung > L lung

neuro impaired kids :(

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116
Q

cough/tachypnea < 8 wks old

A

think chlamydia trachomatis

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117
Q

MCC CAP in kids (+tx)

A

strep pneumo, amoxicillin/amp or ceftriaxone

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118
Q

guts on the outside of baby

A

w/o membrane: gastroschisis

w/ membrane: omphalocele

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119
Q

management: omphalocele

A
  1. thorough inspection for other congenital defects

2. eventual surgery

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120
Q

vag bleeding 20+ weeks: painless vs painful

A 
painless = placenta previa or vasa previa
painful = placental abruption
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121
Q

dx: lactose intolerance

A

hydrogen breath test

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122
Q

pulsatile liver

A

cor pulmonale

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123
Q

cor pulmonale CXR

A

dilated R atrium/ventricle

enlarged central pulm arteries

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124
Q

cor pulmonale EKG

A

R vent hypertrophy
R axis dev
RBBB
peaked P waves in lead II

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125
Q

steps of asthma control

A
  1. SABA prn
  2. low-dose ICS
  3. med-dose ICS
  4. med-dose ICS + LABA or montelukast
  5. hi-dose ICS + LABA or montelukast
  6. hi-dose ICS + LABA or montelukast + oral corticosteroids
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126
Q

tx: akathisia (also wtf is it)

A

(restlessness a/w antipsych meds)
lower/switch psych meds
beta blocker or benzo
if not, benztropine

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127
Q

poison: drooling, mouth burns, dysphagia, vomiting

A

drain cleaner

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128
Q

poison: AMS (lethargy/coma), tachypnea, anion gap acidosis, Ca oxalate cystalluria (late)

A

ethylene glycol

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129
Q

where TF do you find ethylene glycol

A

antifreeze or hydraulic brake fluid

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130
Q

poison: diarrhea, urinary incontinence, miosis, muscle weakness, bronchospasm, bradycardia, emesis, lacrimation, salivation

A

DUMMBBELS

organophosphates

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131
Q

poison: resp distress, gagging, choking, hypoxia, cyanosis, CNS depression

A

gasoline

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132
Q

poison: AMS (leth/coma), vision loss, anion gap acidosis

A

methanol

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133
Q

where do you find methanol

A

industrial solvents, pain thinner, moonshine (done wrong)

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134
Q

management: kid ingested something caustic

A

EGD

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135
Q

tx: ethylene glycol poisoning

A

fomepizole

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136
Q

tx: methanol poisoning

A

fomepizole

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137
Q

MC location for anal fissure

A

posterior midline

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138
Q

tx: anal abscess

A

MTZ

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139
Q

tx: anal fissures

A 
more fiber
sitz bath
NG ointment
topical CCBs
botulinum toxin injections
recurrent --> lateral internal sphincterotomy
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140
Q

CXR: silicosis (from mining/sand blasting/glass work, etc)

A

nodular opacities in upper lobe

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141
Q

tx: silicosis

A

glucocorticoids

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142
Q

CXR: berylliosis (from nuclear power/metalwork/aerospace

A

b/l hilar adenopathy (same as sarcoid)

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143
Q

tx: berylliosis

A

glucocorticoids

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144
Q

CXR: asbestosis (from shipbuilding, insulation, demolition)

A

b/l opacities w/ pleural plaques

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145
Q

straight leg raise AKA

A

Lasegue’s

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146
Q

FABERE test AKA

A

Patrick’s

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147
Q

terrible triad

A

ACL
MCL
medial meniscus

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148
Q

how do you get the renal part of hepatorenal syndrome

A

cirrhosis –> vasodilation
down SVR
kidneys kick in to help –> renal vasoconstriction –> down GFR/renal fail

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149
Q

how to evaluate osteomyelitis tx response

A

ESR and CRP

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150
Q

possible problems with babies from DM moms

A 
resp distress syndrome
hypertrophic CM (elevated insulin)
hypoglycemia (elevated insulin)
hypocalcemia (low PTH)
polycythemia (hi EPO)
hypomagnesemia (Mg excreted by mom kidneys)
hyperbilirubinemia (increased hemolysis)
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151
Q

poison: tremor, ataxia, asymmetric sensory deficits, delirium

A

mercury

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152
Q

tx: mercury poisoning

A

dimercaprol

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153
Q

MCC elevated maternal serum AFP

A

dating error

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154
Q

nature crap someone may be taking that messes with warfarin levels

A

St. John’s wort

also extra leafy greens or whatever

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155
Q

ginko biloba risks

A

good freaking lord

lower seizure threshold and increase bleeding problems (anti-platelet)

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156
Q

mycosis fungoides

A

MC cutaneous T-cell lymphoma:

erythematous plaques + lymphadenopathy

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157
Q

which is more common hemophilia A or B

A

A

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158
Q

meralgia paresthetica: wtf is it

A

entrapment of lateral femoral cutaneous nerve
–> numb/tingle in superior, lateral thigh
worse w/ stand/walk
tap inguinal or extend thigh to reproduce

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159
Q

tx: narcolepsy

A

modafinil (daytime sleepiness)

fluoxetine or venlafaxine for cataplexy

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160
Q

levels in Wilsons

A

ceruloplasmin decreased (use for dx)
total serum Cu decreased
free serum Cu increased
urinary Cu increased

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161
Q

causes of pericarditis

A

infection (rheumatic fever, coxsackie)
uremia
lupus (or drug induced lupus)
MI

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162
Q

tx: SIADH

A

fluid restriction

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163
Q

test for pituitary adenomas

A

MRI

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164
Q

tx: acromegaly

A

transsphenoidal resection

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165
Q

which vessel stroke –> face blindness

A

posterior cerebral artery

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166
Q

first step: suspect endocarditis

A

blood cx (before abx)

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167
Q

anti-centromere abs

A

CREST

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168
Q

anti-histone

A

drug induced SLE

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169
Q

anti-mitochondrial

A

primary biliary cirrhosis

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170
Q

anti-Smith

A

SLE

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171
Q

anti-smooth muscle

A

autoimmune hepatitis

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172
Q

FEV1/FVC for obstructive

A

< 80

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173
Q

ATN FENa (fractional excretion of Na)

A

> 2%

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174
Q

granular or muddy brown casts

A

ATN

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175
Q

Q-angle vs valgus/varus

A

Q angle up –> valgus (knock-kneed)

Q angle down –> varus (bow-legged)

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176
Q

sickle cell kidney problems

A

renal papillary necrosis

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177
Q

renal papillary necrosis UA

A

necrotic tissue

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178
Q

tx: psoriasis

A

topical corticosteroids
severe (>10% body): UVB
extreme: acitretin + UVB/PUVA

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179
Q

fine white lacy lesions in mouth (name and dz)

A

Wickham striae

lichen planus

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180
Q

tx: prolactinoma

A

cabergoline or bromocriptine
(try one then the other)
if neither work –> transsphenoidal resection

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181
Q

tx: sigmoid volvulus

A

nontoxic: endoscopic decompression + elective sigmoidectomy later
toxic/ischemia: Hartmann’s procedure (sigmoidectomy + colostomy)

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182
Q

kid w/ pancytopenia, recurrent infections, thumb abnormalities, cafe-au-lait spots, renal abnormalities and short stature

A

fanconi anemia

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183
Q

who’s got cafe-au-lait spots?

A

NF 1
McCune-Albright
Fanconi anemia
Bloom syndrome

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184
Q

inflammation and narrowing of intrahepatic and/or extrahepatic bile ducts (bead pattern on cholangiography)

A

primary sclerosing cholangitis

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185
Q

pts w/ primary sclerosing cholangitis @ risk for

A

UC

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186
Q

hepatic adenoma RFs

A

OCPs
anabolic steroids
glycogen storage dz

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187
Q

when to resect hepatic adenomas

A

symptomatic
or > 5 cm
or don’t get smaller when stop OCPs

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188
Q

what drugs do you get post MI

A 
BB*
ACE*
Statin
ASA (+clopidogrel if stented)
* improves mortality
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189
Q

tx: transudative pleural effusion

A

thoracentesis

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190
Q

tx: empyema

A

chest tube + empiric abx

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191
Q

thyroid levels in preggers

A

TBG increases so total and bound T4/Ts increase
TSH may go down since hCG is close
free thyroxine is unchanged

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192
Q

dx: syphilis

A

primary: dark field microscopy or direct florescence Ab testing (lesion tissue)

secondary/tertiary: RPR, VDRL; confirm with fluorescent treponemal Ab absorbed test (FTA-ABS)

Neurosyph (CSF): VDRL best

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193
Q

tx: syphilis

A

1/2: penicillin G (1 dose)

latent: 3 doses
neurosyphilis: continuous infusion

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194
Q

dx: osteomyelitis

A

initial: x-ray (periosteal elevation)
most sensitive: MRI
most accurate: bx/cx (chose abx)

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195
Q

tx: fibroids

A 
GnRH agonists (shrinks them)
definitive: hysterectomy or myomectomy (depend on kid-wanting)
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196
Q

tx: PE

A 
IV heparin (if stable)
tPA (if unstable)
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197
Q

chvostek sign means

A

hypocalcemia

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198
Q

hypocalcemia EKG

A

prolonged QT

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199
Q

what changes w/ warfarin (BT/PT/PTT)

A

increased PT

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200
Q

cranial/sacral mvmt

A

as cranium (occiput) flexes, sacrum extends (counternutates)

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201
Q

when to use the apt test?

A

diff btwn fetal/maternal blood: neonatal hematemesis, maternal GI/vaginal bleeding

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202
Q

what changes w/ DIC (BT/PT/PTT)

A

acute: increased PT and PTT (and increased d-dimer)

chronic has normal PT/PTT

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203
Q

tx: molluscum contagiosum

A

self limiting, do nothing

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204
Q

management: acetaminophen poisoning

A

1st hour: give activated charcoal

if after that: take serum levels @ 4, 6, 8 hrs to see if need N-acetylcysteine

> 8 hrs after: N-acetylcysteine

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205
Q

spike and dome BM on renal bx

A

membranous glomerulonephritis

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206
Q

painless jaundice w/ palpable GB (sign and path)

A

courvoisier’s

pancreatic adenocarcinoma

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207
Q

where to treat CAP?

A 
use CURB-65 score:
Confusion
Uremia (BUN >20)
RR (> 30)
BP (sys < 90 or dia < 60)
Age > 65

< 2 = outpatient
2 = inpatient
3+ = ICU

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208
Q

tx: CAP

A

azithromycin or moxifloxacin

add beta-lactam if in ICU

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209
Q

newborn male w/ urinary tract obstruction

A

usually posterior urethral valves

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210
Q

dx: posterior urethral valves (newborn)

A

voiding cystourethrogram

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211
Q

tx: mobitz type II AV block

A

if symptomatic: pacemaker

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212
Q

fall on outstretched hand –> what SD

A

posterior radial head (pronates)

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213
Q

nephropathy after viral illness, normal C3, IgA and C3 on staining

A

IgA nephropathy

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214
Q

renal bx: lumpy bumpy pattern on microscopy

A

post-strep glomerulonephritis

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215
Q

PSGN C3 level

A

low

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216
Q

IgA nephropathy C3 level

A

normal

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217
Q

fusion of podocyte foot processes

A

minimal change disease

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218
Q

deafness and hematuria

A

alports

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219
Q

kimmelstiel-wilson nodules

A

diabetic nephropathy

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220
Q

kidney thing a/w HIV

A

focal sclerosing glomerulonephritis

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221
Q

renal bx: apple green birefringence w/ congo red stain

A

amyloidosis

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222
Q

renal bx: tram track BM

A

membranoproliferative nephropathy

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223
Q

nephropathy a/w Hep C

A

membranoproliferative nephropathy

also can be membranous

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224
Q

MCC epididymitis

A

< 35: chlamydia

older: e. coli

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225
Q

levels in polycythemia vera

A

low EPO

increased RBC, WBC, platelets, bilirubin, B12, uric acid

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226
Q

tx: polycythemia vera

A

phlebotomy + hydroxyurea

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227
Q

DEXA results

A

-1 to - 2.5: osteopenia

< -2.5: osteoporosis

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228
Q

MCC spontaneous bacterial peritonitis

A

E. coli

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229
Q

classic (but not MC) PE EKG finding

A

S1-Q3-T3
S wave in I
Q and inverted T in III

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230
Q

management: thyroid nodule

A
  1. get TSH
    2a. TSH normal/high (hypoTh)–> FNA (if > 1 cm)
    2b. TSH low (hyperTh)–> scintigraphy
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231
Q

tx: 3rd degree burn

A

excision and skin grafting

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232
Q

when to tx shingles

A

give -cyclovirs w/in 72 hours of lesion appearance

pain management always

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233
Q

tx: NMS

A
  1. stop med
  2. IV fluids
  3. dantrolene/bromocriptine/amantadine
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234
Q

criteria to dx fibromyalgia

A

TPs above and below waist on both sides

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235
Q

tx: fibromyalgia

A

duloxetine
milnacipran
pregabalin

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236
Q

MCC meningitis: born to 3 mo

A

GBS

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237
Q

MCC meningitis: 3 mo - 9 year

A

strep pneumo

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238
Q

MCC meningitis: teen/young adult

A

N. meningitis

239
Q

MCC meningitis: > 30

A

strep pneumo

240
Q

tx: restless leg syndrome

A

dopamine agonists: pramipexole, ropinirole, levo/carbi, bromocriptine
can use gabapentin too if not

241
Q

tx: body dysmorphic disorder

A

CBT, SSRI

242
Q

iron studies in hemochromatosis

A

up iron
up ferritin
up transferrin saturation
down TIBC

243
Q

normal fetal HR

A

110 - 160

244
Q

level of spinal cord lesion: autonomic hyperreflexia (HTN, HA, flushing)

A

T6 and above

245
Q

where does gastric CA throw mets?

A

ovaries (Krukenberg’s tumor)

246
Q

test to do before placing an arterial line

A

Allen’s test: make sure ulnar circulation is adequate (return in < 10 s)

247
Q

dx: meckel’s diverticulum

A

technetium-99m pertechnetate scan

248
Q

2s of meckel’s diverticulum

A 
around age 2
2% of pop
only 2% sx
2 ft proximal to ileocecal valve
2 inches long
2 types of tissue (gastric/panc)
2:1 M:F
249
Q

recurrent genital/oral ulcers, arthralgia, uveitis

A

Behcet’s

250
Q

mgmt: ASCUS

A

21 - 24: repeat pap in 12 mo

25+: HPV test
(+)–> colp
(-) –> repeat cyto in 3 years

251
Q

continuous murmur

A

PDA

252
Q

abdominal pain, arthralgia, palpable purpura

A

Henoch-Schonlein Purpura (HSP)

253
Q

renal path for HSP

A

IgA deposits in mesangium –> hematuria

254
Q

BP w/ aortic regurg

A

wide pulse pressure

255
Q

thumbprint sign on neck x-ray

A

epiglottitis

256
Q

kid: fever, sore throat, drooling, hot potato voice

A

epiglottitis

257
Q

c-section: nasal flaring, tachypnea, grunting, cyanosis

A

transient tachypnea of the newborn (TTN)

258
Q

when do you give people w/ suspected FAP colonoscopies?

A

annual screen, start @ 12

259
Q

tx: Turner’s syndrome

A

human growth hormone

estrogen replacement therapy

260
Q

MC location of coarctation of aorta

A

distal to L subclavian artery

261
Q

EKG changes expected in coarctation of the aorta

A

LVH (tall R in V5/V6)

262
Q

acute SD characteristics

A 
sharp pain
edema
bogginess**
erythema
warmth
263
Q

RFs porphyria cutanea tarda

A 
Hep C
HIV
alcohol
increased iron
estrogen
264
Q

RFs endometrial CA

A

unopposed estrogen use
DM
age
fam hx

265
Q

most effective dating method first TM

A

transvaginal sonogram: crown-rump length

266
Q

down Ca
down phos
up PTH

A

vit D def (2ndary hyperparathyroidism)

267
Q

down Ca
up phos
up PTH

A 
renal failure (2ndary hyperparathyroidism) 
pseudohypoparathyroidism (a/w Albright's osteodystrophy)
268
Q

up Ca
norm phos
down PTH

A

think paraneoplastic (increased PTH-related protein)

269
Q

up Ca
down phos
up PTH

A

primary hyperparathyroidism

270
Q

MCCs primary hyperparathyroidism

A

adenoma*
hyperplasia
carcinoma (rare)

271
Q

describe pleural effusion contents in TB

A

lymphocytes > 80%
high protein
adenosine deaminase > 40

272
Q

pleural effusion w/ low glucose

A

RA*
empyema
malignancy

273
Q

bloody pleural effusion

A

PE or malignancy

274
Q

MC cancer in kids

A

ALL (peaks in 3 - 5 yos)

275
Q

tx: esophageal varices bleeding prophylaxis

A

propranalol

276
Q

spondylolisthesis grades

A

1: 0 - 25%
2: 26 - 50 %
3: 51 - 75 %
4: 75 - 100%

277
Q

tx: sarcoidosis

A

oral corticosteroids

278
Q

MCC pancreatitis in kids/teens

A

blunt trauma

279
Q

J waves (osborn waves) on EKG

A

hypothermia

280
Q

Klatskin tumors

A

cholangiocarcinoma @ confluence of bile ducts

281
Q

wide fixed split S2

A

ASD

282
Q

management: lobular carcinoma in situ

A
  1. excisional bx (r/o ductal or invasive CA)

2. observe/tamoxifen

283
Q

21-hydroxylase deficiency – what are the junk like?

A

males: normal
females: ambiguous

284
Q

tx: 21-hydroxylase def

A

initially: IV hydrocortisone

then glucocorticoid and mineralocorticoid therapy for life

285
Q

diaphyseal frx of distal radius w/ disruption of radioulnar joint

A

Galeazzi’s frx

286
Q

ulnar shaft frx

A

nightstick frx

287
Q

diaphyseal frx of proximal ulna w/ displacement of radial head

A

Monteggia’s frx

288
Q

distal radial frx (often w/ osteoporosis)

A

Colle’s frx (dinner fork deformity)

289
Q

salpingitis complication

A

hydrosalpinx –> infertility problems

290
Q

type of hyperlipoproteinemia in familial hyperlipoproteinemia

A

type IIa

291
Q

time frame dysthymic d/o

A

2+ years

292
Q

signs of increased intraocular pressure

A

proptosis, eye pain, chemosis (conjunctival edema), blurry vision, limited extraocular motion

293
Q

increased times in vWB

A

up PTT

up BT

294
Q

penetrating trauma –> loss of breath sounds

A

tension pneumo

295
Q

convulsions, coma/confusion + cardiac problems

A

think TCA overdose

296
Q

sick + sunburn-like rash

A

think toxic shock syndrome

297
Q

tx: TSS

A

IV fluids

IV nafcillin + aminoglycoside (clinda)

298
Q

MC cause posterior dislocation

A

muscle spasm - seizure

299
Q

what to do when someone w/ rabies vaccine is bitten

A

irrigation of wound

2 doses of vaccine

300
Q

what to do when someone w/o rabies vaccine is bitten

A

irrigation of wound
rabies immunoglobulin
4 doses of vaccine

301
Q

what is specificity

A

ability to find true negatives

% of truly negative people who test negative

302
Q

what is sensitivity

A

ability to find true positives

% of positive people who are found by test

303
Q

management: perforated ulcer

A 
to start: NG, IVF, IVAbx
then surgery if...
> 70 yo or
hemo unstable or
peritoneal signs
304
Q

PDA CXR

A

increased pulmonary vascular markings

305
Q

levels in CRF

A 
anemia (normocytic)
hypocalcemia
hyperphosphatemia
hyperkalemia
azotemia
306
Q

why do you get hypocalcemia in ESRD

A

phos can’t get cleared, complexes with Ca

kidney doesn’t hydroxylate as much 25-hydroxyVit D to calcitriol (1,25 dihydroxycholecalciferol)

307
Q

indications for hemodialysis

A 
AEIOU
Acidosis
Electrolytes (HK)
Intoxications (Li, ASA, methanol, ethylene glycol)
Overload (CHF)
Uremia (pericarditis)
308
Q

trichomoniasis puts at risk for…

A

HIV and HIV transfer

309
Q

how/when to reevaluate new hypothyroid pts

A

4-6 weeks

TSH

310
Q

baby: cyanosis w/ feeding, better with crying

A

choanal atresia (can’t breathe thru nose)

311
Q

what do you give all CHFers w/ EF < 40%

A

ACE

312
Q

neonate w/ conjunctivitis – how do you know if it’s chlamydia or gonorrhea?

A

2 - 5 days = gonorrhea (PROFUSE discharge perhaps)

5 - 14 days = chlamydia

313
Q

tx: gonococcal conjunctivitis in newborn

A

IM/IV ceftriaxone

314
Q

tx: chlamydial conjunctivitis in newborn

A

topical erythromycin

315
Q

tx: idiopathic b/l adrenal hyperplasia causing hyperaldosteronism

A

spironolactone

316
Q

most specific test for RA

A

x-ray and anti-CCP

317
Q

management: bloody nipple discharge

A

apparently surgery

318
Q

tx: primary adrenal insufficiency

A

glucocorticoids

fluticasone

319
Q

tx: secondary adrenal insufficiency

A

glucocorticoids

320
Q

tx: tertiary adrenal insufficiency

A

glucocorticoids

321
Q

primary vs secondary adrenal insufficiency

A

primary: in adrenals, affects aldosterone too, ACTH high to try and help
secondary: in pituitary usually, ACTH low because it’s not working, aldosterone not affected

322
Q

kid w/ painful limp after URI

A

transient synovitis

323
Q

which one is Addisons

A

primary adrenal insufficiency

324
Q

which one is Conn’s syndrome

A

hyperaldosteronism

325
Q

diff btwn HUS and TTP

A

HUS more in kids

TTP = HUS + fever + neuro sx

326
Q

conjugated hyperbilirubinemia and increased coproporphyrin (mostly III)

A

Rotor syndrome

327
Q

unconjugated hyperbilirubinemia

A

Gilbert’s

Crigler-Najjar

328
Q

conjugated hyperbilirubinemia

A

Dubin-Johnson
(look for dark liver, normal coproporphyrin, most of it I)
Rotor syndrome (also has increased coproporphyrin (mostly III) and normal colored liver)

329
Q

RBBB criteria

A

QRS > 120
R’ in V1 (and usually V2)
slurred S in I and V6

330
Q

acute dystonia (WTF is it and when do you get it)

A 
muscle spasms (including oculogyric crisis)
hours to days after starting anti-psych meds
331
Q

tx: EPS - acute dystonia

A

benztropine

diphenhydramine

332
Q

tx: EPS - akathisia

A

propranolol
benzos
then benztropine if nothing else works

333
Q

tx: EPS - parkinsonism

A

down dosage if possible
benztropine
diphenhydramine

334
Q

tx: EPS - tardive dyskinesia

A

stop or switch

335
Q

fluid for burns (+ time period)

A

give LR first 24 hrs

336
Q

body surface %s for adults

A 
head: 9
Trunk: 9 (chest), 9 abdomen, 18 (back)
UE: 9 (each)
LE: 18 (each)
junk: 1%
337
Q

body surface %s for kids

A 
for kids under 10
head: 18 (-1 for each yr over 1)
trunk: 18 (front) + 18 (back)
UE: 9 (each)
LE: 14 (+0.5 for each yr over 1)
338
Q

Wallenburg test (how and why)

A

hold head in positions (+ is neuro changes)

test for vertebral artery insufficiency

339
Q

Spurling test (how and why)

A

(seriously) pressure one head

for cervical radiculopathy

340
Q

Adson test (how and why)

A

put out arm and check pulse

thoracic outlet syndrome

341
Q

Apley’s scratch test (how and why)

A

scratch back both ways (good fucking lord)

glenohumeral ROM

342
Q

EKG: fast and wide rhythms (+ txs)

A

torsades (Mg, shock unstable)

Vtach (amio, shock unstable)

343
Q

EKG: fast and narrow rhythms (+txs)

A

SVT (adenosine, shock unstable)

Afib (BB/CCBs, shock unstable)

344
Q

EKG: slow and narrow rhythms (+txs)

A

S. brady (atropine, pace)
1st degree AV block (atropine, pace)
2nd degree AV block (atropine type I, pace type I or II)

345
Q

EKG: slow and wide rhythms (+ txs)

A

3rd degree AV block (pace)

Idioventricular (IV) (pace)

346
Q

SLE inducing drugs

A

hydralazine, isoniazid, procainamide

347
Q

osteosarcoma description/location on PE

A

hard, non mobile pass @ proximal tibia or distal femur

348
Q

dx: cauda equina syndrome

A

MRI

349
Q

chronic pancreatitis triad

A

DM
steatorrhea
panc calcifications

350
Q

when to surgery AAAs

A

sx (any size)

asx (> 5.5 cm)

351
Q

sinusoidal fetal heart pattern (causes)

A

anemia (usually from Rh isoimmunization of severe hypoxia)

352
Q

when does odds ratio = relative risk

A

cohort studies

353
Q

when to use a chi-square test

A

analyze results which are 2+ proportions (both exposure and outcome are categorical) (ex: % infection with and w/o vaccine)

354
Q

when to use one-way ANOVA

A

continuous variable in 3+ groups (best w/ bell distribution)

355
Q

when to use a t-test

A

continuous variable

2 independent groups

356
Q

when to use correlation

A

continuous variable, continuous groups (ex: BP goes up w/ BMI)

357
Q

tx: panic disorder

A

SSRI

358
Q

sacral axis for cranial/sacral movement

A

superior transverse

359
Q

diff btwn incomplete and inevitable abortion

A

inevitable is before passage of tissue , incomplete has some or all tissue passed (both have open os)

360
Q

tx: croup

A

O2, dexamethasone

severe: add nebulized epi

361
Q

management: placenta previa

A

< 36 wks: conservative, repeat U/S before delivery

> 36 wks: U/S, most –> C-section, ant-marginal –> can try vaginal

362
Q

tremor that gets better with alcohol

A

essential

363
Q

tx: essential tremor

A

beta blocker
primidone
benzos

364
Q

tx: 3rd degree AV block

A

pacemaker

365
Q

spirometry in sarcoidosis

A

elevated or normal FEV1/FVC

366
Q

silicosis pts @ risk for

A

TB

367
Q

GI bleed – nothing on EGD or colonoscopy

A

btwn lig of treitz and ileocecal valve

Meckel’s

368
Q

upper arm claudication + neuro symptoms w/ UE exercise

A

subclavian steal syndrome

369
Q

dx: insulinoma

A

72 hour fast

stop if gluc < 45

370
Q

when do you see increased urobilinogen?

A

elevated conjugated hyperbilirubinemia

371
Q

diarrhea, dermatitis and dementia

A

pellagra (B3/niacin def)

372
Q

conduct d/o vs antisocial personality d/o

A

conduct < 18

ASPD > 18

373
Q

eosinophilia + high Cr

A

think AIN (acute interstitial nephritis)

374
Q

tx: mycoplasma pneumonia

A

macrolide, FQ or tetracycline

375
Q

risk of high clozapine levels

A

seizures

376
Q

blue dot sign

A

see on scrotum

due to torsion of the appendix testis

377
Q

tx: torsion of the appendix testis

A

pain meds
bed rest
scrotal support

378
Q

polymyalgia rheumatica a/w?

A

temporal arteritis

379
Q

tx: OCD

A

CBT + SSRI/TCA

380
Q

tourette’s a/w

A

ADHD

OCD

381
Q

elevated 5-HIAA

A

carcinoid

382
Q

tx: unresectable carcinoid

A

octreotide

383
Q

midline pharynx swelling + pain on neck extension

A

retropharyngeal abscess

384
Q

dx: retropharyngeal abscess

A

neck CT

385
Q

tx: retropharyngeal abscess

A

IV clinda and ampicillin-sulbactam

surgery if fail Abx, airway compromise or effing huge

386
Q

tx: aplastic crisis

A

blood transfusion

387
Q

diff btwn gestational HTN and preeclampsia

A

preeclampsia has proteinuria or signs of end organ damage

388
Q

when is bed wetting not ok

A

past 5

389
Q

tx: bed wetting

A

bed wetting alarm system

can use imipramine or desmopressin for temporary fix

390
Q

tall kid with gynecomastia, small junk and small firm testicles

A

think klinefelters (XXY)

391
Q

risks a/w klinefelters

A

infertility

extragonadal germ cell tumors (esp mediastinal nonseminous)

392
Q

management: trigeminal neuralgia

A

anticonvulsant for tx
maybe baclofen as adjunct
do MRI to r/o MS or tumors

393
Q

cherry red spot w/ radiating vessels on colonoscopy

A

angiodysplasia

394
Q

hypermagnesemia –>

A

paresthesias, weakness, paralysis –> resp failure

395
Q

tx: hypermagnesemia

A

Ca gluconate

396
Q

prevention: NSAID induced ulcers

A

misoprostol

pepcid?

397
Q

what to do with metformin for IV contrast

A

stop before

don’t restart for 48 hrs

398
Q

MCC colovesicular fistulas

A

diverticulitis

399
Q

how does hypothyroidism –> galactorrhea?

A

low thyroid hormone –> increased TRH and TRH stimulates both TSH and prolactin from pituitary

400
Q

dx: pancreatic cancer

A

most sensitive: CT

most specific: ERCP

401
Q

strep pharyngitis criteria

A 
2 of these:
tonsillar exudates
no cough
temp > 100.4
anterior cervical adenopathy
402
Q

tx: torsades

A

IV mag sulfate

403
Q

dx: pyloric stenosis

A

U/S
> 3 - 4 mm thick or
> 15 - 18 mm long

404
Q

CXR: alpha-1 vs COPD

A

alpha-1: hyperlucency @ bases (panacinar emphysema)

COPD: hyperlucency @ apices (centrilobular emphysema)

405
Q

tx: zollinger-ellison

A

PPI

406
Q

nerve affected by Guyon’s entrapment

A

ulnar

407
Q

management: hypercalcemic crisis

A

NS IVF then furosemide

if fail, calcitonin or HD

408
Q

tx: hypercalcemia of malignancy

A

bisphosphonates (chronic management)

409
Q

vit def a/w alopecia, dermatitis, depression, neuropathy, n/v

A

biotin

410
Q

vit def a/w neutropenia, osteoporosis and hypochromic anemia

A

copper

411
Q

vit def a/w xeropthalmia and night blindness

A

vit A

412
Q

how to avoid HIT

A

use LMWH or fondaparinux

413
Q

tx: spontaneous bacterial peritonitis

A

ceftriaxone or cefotaxime (3rd gens)

414
Q

describe thoracentesis in empyema

A

pH < 7.3
hi LDH
low glucose
positive gram stain

415
Q

dx: myasthenia gravis

A

most specific: Ach receptor Ab test

initial: Tensilon or ice pack (if there is ptosis)

416
Q

MC adverse effect of vanco

A

red man syndrome

417
Q

red man syndrome sx

A

hTN, dyspnea, pruritus + erythema above waist

418
Q

tx: red man syndrome

A

stop infusion
give at slower rate
+/- antihistamines

419
Q

papules/pustules in finger webs

A

think scabies

420
Q

allergic rhinitis, asthma, + p-ANCA

A

churg-strauss

421
Q

hematuria + upper resp or GI

A

think Berger (IgA)

422
Q

slit lamp: ectopia lentis

A

Marfan’s (MC)

can also be in Ehlers-Danlos

423
Q

dx: Cushing’s

A

24 hr urine collection/cortisol measurement
dexamethasone suppression test
late night serum/saliva cortisol test

424
Q

which glaucoma is the bad one

A

closed-angle (acute)

425
Q

angiodysplasia a/w

A

vWB dz
aortic stenosis
ESRD

426
Q

+ dix hallpike, episodic vertigo

A

benign paroxysmal positional vertigo

427
Q

vertigo, tinnitus, hearing loss

A

Meniere’s

apparently can be labyrinthitis too

428
Q

viral infxn then vertigo/hearling loss/nystagmus

A

labyrinthitis

429
Q

tx: BPPV

A

Epley maneuver (reposition canalith)

430
Q

tx: Meniere’s

A

acute: benzos or vestibulosuppressants
prevent: diuretics and low salt diet

431
Q

tx: labyrinthitis

A

steroids

432
Q

UMN and LMN signs

A

ALS

433
Q

tx: ALS

A

riluzole to slow progression

434
Q

tx: MS

A

glatiramer or beta-IFN slow progression

435
Q

meds causing hearing loss

A

furosemide
salicylates (ASA)
aminoglycosides

436
Q

face redness worse w/ EtOH or spicy

A

rosacea

437
Q

tx: rosacea

A

MTZ gel and oral tetracycline

438
Q

kid 9 - 15 w/ knee pain + tibial tubercle prominence

A

Osgood-Schlatter

439
Q

kid 4 - 9 w/ thigh pain

A

Legg-Calve-Perthes dz

440
Q

hip pain in fat boy

A

slipped capital femoral epiphysis

441
Q

Cushing syndrome vs dz

A

syndrome: paraneoplastic, ectopic ACTH
disease: ant pit makes ACTH

442
Q

chin displacement = what bs cranial thing

A

toward side of temporal bone external rotation

443
Q

normal CRI

A

10 - 14

444
Q

technique to increase CRI amplitude

A

CV4 (aka bulb decompression or whatever TF)

445
Q

Hodgkin’s staging

A 
Ann Arbor:
I: 1 node involved
II: 2+ same side of diaphragm
III: both sides of diaphragm
IV: extralymphatic (liver, bones, lung)
446
Q

dx: hyperPTH adenoma localization

A

Sestamibi scan

447
Q

normal vaginal pH

A

3.8 - 4.2

448
Q

candida vaginal pH

A

normal

449
Q

trichomoniasis vaginal pH

A

> 4.5

450
Q

scoliosis levels (+ tx)

A

mild: 5 - 15 (OMT/PT)
mod: 20 - 45 (orthotics, OMT/PT)
severe: > 50 (surgery)

451
Q

scoliosis: when is resp/cardio involved

A

> 50 get resp stuff

> 75 get cardio stuff

452
Q

MC breech

A

frank (butt presents, hips flexed, knees extended)

453
Q

facet orientation: cervical, thoracic, lumbar

A

BUM (backward, upward, medial)
BUL(backward, upward, lateral)
BUM (backward, upward, medial)

454
Q

a/w polycystic kidney dz

A

intracerebral berry aneurysms
hepatic cysts
heart valve stuff
thoracic aortic aneurysms

455
Q

tx: rheumatic fever

A

penicillin

prednisone for severe cases

456
Q

tx: epididymitis

A

ceftriaxone and doxy

add FQ if suspect enteric

457
Q

levels in osteopenia

A

PTH: normal
AlkPhos: norm
Ca: norm
Phos: norm

458
Q

levels in osteomalacia

A

PTH: up
AlkPhos: up
Ca: down
Phos: down

459
Q

levels in osteitis fibrosa cystica

A

PTH: up
AlkPhos: up
Ca: up
Phos: down

460
Q

levels in Paget’s dz

A

PTH: norm
AlkPhos: norm/up
Ca: down
Phos: up

461
Q

levels in hPTH

A

PTH: down
AlkPhos: norm
Ca: down
Phos: up

462
Q

what does PTH do

A

up serum Ca

down serum phos

463
Q

brown cystic tumors

A

osteitis fibrosa cystica

464
Q

newborn screens

A

PKU

hTh

465
Q

tx: low breast milk production

A
  1. increase feedings
  2. metoclopramide (D2 antag)
    also make sure shes not on combined OCPs
466
Q

kid passes out while crying

A

apparently thats fine from 2 to 4/8

467
Q

tender utero-sacral nodules

A

endometriosis

468
Q

dx: endometriosis

A

laparoscopy (gun-powder lesions)

469
Q

ABI for PAD

A

< 1

470
Q

claudication but not PAD

A

think neuroclaudication – spinal stenosis

471
Q

confusion, ataxia and nystagmus

A

Wernicke’s encephalopathy

472
Q

Klumpke’s paralysis

A

injury to C8-T1
paralysis of intrinsic hand muscles
ulnar nerve numbness
Horner’s

473
Q

ball tumor w/ bhCG up

A

seminomas (germ cell)

474
Q

ball tumor w/ AFP up

A

non-seminomas (embryonal) (germ cell)

475
Q

ball tumor w/ precocious puberty and gynecomastia

A

leydig cell tumors (non-germ cell)

476
Q

latent phase of labor

A

effacement and dilation up to 4 cm

477
Q

prolonged latent phase

A

null: > 20
multi: > 14

478
Q

active phase of labor

A

eff/dil from 4 - 10 cm

479
Q

prolonged active phase

A

null: < 1.2 cm/hr
multi: < 1.5 cm/hr

480
Q

arrested active phase

A

no dilation in 2 hrs in active phase

481
Q

second phase of labor

A

from 10 cm to delivery

482
Q

prolonged second phase

A

null: 2 hrs
multi: 1 hr

483
Q

third stage of labor

A

baby out to placenta out

484
Q

prolonged third stage

A

> 30 min

485
Q

cardiogenic shock levels

A

CO: low
PCWP: high (only shock that’s high)FF
SVR: high

486
Q

neurogenic shock levels

A

CO: low
PCWP: low
SVR: low

487
Q

septic shock levels

A

CO: high (early)
PCWP: low
SVR: low

488
Q

hypovolemic shock levels

A

CO: low
PCWP: low
SVR: high

489
Q

anaphylactic shock levels

A

CO: high (variable)
PCWP: low
SVR: low

490
Q

newborn w/ conjunctivitis in first 24 hrs

A

chemical conjunctivitis

491
Q

what does viral conjunctivitis in a newborn look like (+when)

A

6 - 14 days

conjunctivitis + bilateral lid edema

492
Q

MCC viral conjunctivitis in a newborn

A

HSV

493
Q

penicillin and kidneys

A

cause AIN

494
Q

age range: reactive arthritis

A

> 20

495
Q

how many joints? pauci- vs poly- articular JRA

A

pauci: 4 or fewer
poly: 5+

496
Q

kid: knee swelling w/ painless limp

A

JRA

497
Q

JRA complications

A

uveitis
iridocyclitis
asymmetric leg length

498
Q

tx: gastroparesis

A

metoclopramide or erythromycin

499
Q

tx: hypocalcemia

A

> 7.5: oral calcium carbonate
refractory: + calcitriol
< 7.5 or w/ arrhythmia: IV calcium gluconate

500
Q

tx: shigella

A

cipro

501
Q

dx: cardiac tamponade

A

EKG or echo

502
Q

procedures requiring infective endocarditis prophylaxis

A

resp tract procedures
major dental (extractions, root canals)
infected skin/tissue right under skin/MSK tissue

503
Q

management: cervical lesion

A

cervical bx (colp not good enough)

504
Q

flat shoulder, loss of arm abduction: what nerve?

A

axillary nerve

505
Q

wrist drop: what nerve?

A

radial

506
Q

claw hand: what nerve?

A

ulnar

507
Q

thenar eminence flattening: what nerve?

A

median

508
Q

string sign on barium swallow

A

crohns

509
Q

time frame: berger vs PSGN

A 
berger = same or days post infxn
PSGN = 10 - 14 days after
510
Q

MC compartment for compartment syndrome

A

anterior

511
Q

6 Ps of compartment syndrome

A 
pain
pallor
paresthesias
poikilothermia
pulselessness
paralysis
512
Q

whats in the ant compartment

A

tibialis anterior
extensor hallucis longus
ant tibial artery
deep fibular nerve (innervate space btwn 1/2 toes)

513
Q

complications post bacterial meningitis

A 
hearing loss (MC)
seizures
CN palsies
cognitive deficits
ataxia
514
Q

when would you not LP suspected meningitis? (+ why not)

A 
focal deficits
papilledema
confusion
midline shift/tumor
(up ICP means LP could --> herniation)
515
Q

what to do if tooth gets knocked out

A

rinse with saline and reimplant

if cant – take in milk, saliva, saline or Hanks solution

516
Q

autoimmune causes of pulmonary fibrosis

A

RA
SLE
scleroderma

517
Q

tx: somnambulism (sleep walking)

A

benzos

trazodone

518
Q

colon ca + endometrial ca

A

think HNPCC/Lynch syndrome

519
Q

adenomatous polyps + CNS malignancy

A

Turcot

520
Q

colon hamartomas + mouth freckles

A

Peutz-Jegher

521
Q

adenomatous polyps + osteomas/lipomas/fibromas

A

Gardner

522
Q

MCC hip dislocation

A

MVA (then sports)

523
Q

mgmt: hip dislocation

A
  1. sedation/closed reduction
    if doesn’t work
  2. CT to check for bone frags/soft tissue in jnt space
  3. maybe open then
524
Q

how long is measles contagious

A

5 days before rash

4 days after

525
Q

tx: dermatitis herpetiformis

A

gluten-free diet

dapsone (diaminodiphenyl sulfone)

526
Q

spondylosis

A

OA of vertebrae (degenerative changes)

527
Q

spondylolysis

A

pars interarticularis defect (scotty dog)

528
Q

spondylolisthesis

A

ant displacement of vert (step off)

529
Q

what is “hip drop” test for

A

lumbar spine sidebending

530
Q

mgmt: testicular torsion

A

emergent surgical detorsion followed by bilateral orchiopexy to prevent recurrence
> 6 - 12 hrs –> orchiectomy

531
Q

gonorrhea and chlamydia – when to co-treat?

A

+chlamydia: just treat the chlam chlam

+gonorrhea: treat both, go wild

532
Q

floppy baby w/ spared eyes

A

Werdnig-Hoffman dz (spinal muscular dystrophy type 1)

533
Q

what should you think about with alcoholics w/ heart failure

A

dilated CM (wet beri beri)

534
Q

drugs that improve mortality in systolic dysfxn

A 
ACE/ARB
BB
spironolactone/eplerenone
hydralazine/nitrates
defibrillator
535
Q

vomiting followed by retrosternal CP

A

Boerhaave’s syndrome

536
Q

dx: Boerhaave’s

A

gastrograffin esophagram

if not available: CXR

537
Q

delayed puberty, can’t smell

A

Kallman syndrome

538
Q

palpable testes in labia majora

A

androgen insensitivity syndrome

539
Q

shiny, peeling areola (breastfeeding)

A

candidiasis of nipple

540
Q

tx: nipple candadiasis

A

-azole cream on nipple

oral azole for baby (thrush)

541
Q

MCC mastitis

A

staph aureus

542
Q

painless hematuria in smoker

A

think bladder carcinoma

543
Q

dx: bladder carcinoma

A

cystoscopy w/ bx

544
Q

Becker’s vs Duchenne’s muscular dystrophy

A

Becker is less severe, and less common (insufficient dystrophin vs no functional dystrophin)

545
Q

what are the fontanelles called when they close

A

anterior: bregma
post: lambda

546
Q

anti-glomerular BM Abs

A

Goodpasture’s syndrome

547
Q

hypercalcemia EKG

A

short QT

wide T waves

548
Q

MC location for diverticula

A

sigmoid colon

549
Q

elevated urine aminolevulinic acid

A

acute intermittent porphyria

550
Q

diff btwn Niemann-Pick and Tay-Sachs

A

Tay-Sach’s doesn’t involve the liver

551
Q

glucagonoma sx/path

A

necrotizing migratory erythema, DM, glossitis/cheilitis

panc alpha cells

552
Q

tx: glucagonoma

A

surgery vs chemo

octreotide for sx

553
Q

dementia w/ magnetic gait

A

NPH

554
Q

tx: huntington’s chorea

A

tetrabenazine

refractory chorea: haloperidol

555
Q

blood types and ulcers? WTF?

A

duodenal more common in O
gastric more common in A
you cant make this shit up

556
Q

dx: h. pylori

A

< 50 w/o alarm sx: urea breath test

if not, EGD

557
Q

WAGR syndrome

A

Wilm’s tumor (nephroblastoma)
Aniridia
GU malformations
Retardation

558
Q

prevention: mammogram

A

every 2 years starting @ 50

559
Q

leukocytosis post infection, increased leukocyte alkaline phosphatase

A

leukemoid rxn

560
Q

tx: MS flare

A

high dose IV corticosteroids

561
Q

MC diverticula bleed location

A

ascending colon

562
Q

tx: bleeding diverticulosis

A

IVF

563
Q

who do you screen for syphilis?

A

high risk: MSM, sex workers, risky business

+ preggos

564
Q

when can you see a gestational sac (BhCG)

A

transvag: > 1,500
abdominal: > 6,500

565
Q

BhCG growth: normal vs ectopic

A

normal: double/48 - 72 hrs
ectopic: lower

566
Q

dx: ectopic pregnancy

A

transvag U/S and serial BhCGs

567
Q

mgmt: ectopic pregnancy

A

methotrexate

unstable: surgery

568
Q

what nerve is compressed in lumbar disc herniations?

A

the nerve of the segment below (yes even though the nerve of the segment above is exiting thru that space)
ex: L3/L4 herniation compresses L4 nerve root

569
Q

what nerve is compressed in cervical disc herniations?

A

the nerve of the segment below (since it exits @ level of herniation) goddammit

570
Q

MC herniations

A

L4/L5
L5/S1
C5/C6

571
Q

screenings for smokers

A

CT: 55 - 80 w/ 30 pack-year hx who smoke or quit < 15 yrs ago
males: 65 - 75 ever smoked get abdominal U/S for AAA

572
Q

ST elevation during CP, normal when resolve

A

variant angina

573
Q

tx: variant angina

A

CCB

nitrates

574
Q

left vs right scoliosis

A

named for curve convexity

575
Q

mgmt: LSIL

A

21-24: no colp
HPV (-): repeat cyto + HPV in 1 year
HPV(+) or not done: colp

576
Q

a/w vitiligo

A

pernicious anemia

hypothyroidism

577
Q

withdrawal: tactile hallucinations

A

alcohol

cocaine

578
Q

nerve damaged w/ anterior shoulder dislocation

A

axillary

579
Q

anti-jo

A

polymyositis/dermatomyositis

580
Q

livedo reticularis, eosinophilia, acute renal failure

A

cholesterol embolism syndrome (atheroemboli)

581
Q

minimal urine output

A

30 cc/hr

0.5 ml/kg/hr

582
Q

tx: post-herpetic neuralgia

A

TCA
opioids, gabapentin/pregabalin
topical capsaicin/lidocaine

583
Q

tx: hereditary spherocytosis

A

splenectomy + pneumo vaccine

584
Q

nerve root injured for Erb-Duchenne’s palsy

A

C5 and C6

585
Q

age of precocious puberty

A

7 in females

8 in males

586
Q

knee injury but can still bear weight

A

meniscal tear

587
Q

criteria for paracentesis fluid

A

SAAG (serum ascites albumin gradient)

> 1.1 = portal HTN

588
Q

RUQ pain, fever, jaundice

A

cholangitis (charcot’s triad)

589
Q

reynold’s pentad

A

cholangitis

fever, jaundice, RUQ pain, hTN, AMS

590
Q

tetralogy of fallot

A

pulmonary stenosis
RVH
VSD
overriding aorta

591
Q

self mutilating intellectual disability kid

A

Lesch-Nyhan

592
Q

RFs for wound dehiscence

A 
obesity
steroid use
DM
chemo/radiation
malnutrition
593
Q

first thing to do when you suspect rhabdo

A

EKG

594
Q

fetor hepaticus

A

sweet, musty, fecal odor to breath (hepatic encephalopathy)

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