COMLEX Flashcards
1
Q
humeral shaft frx damages which nerve
A
radial
2
Q
frx of medial epicondyle damages which nerve
A
ulnar
3
Q
pain over anatomical snuffbox
A
scaphoid frx
4
Q
surgical neck of humerus frx damages which nerve
A
axillary
5
Q
radial nerve damage –>
A
wrist drop
6
Q
ulnar damage –>
A
last 1.5 fingers numb
7
Q
median damage –>
A
first 3.5 fingers numb
8
Q
why do preggers get GDM?
A
human placental lactogen (aka chorionic somatomammotropin) increases insulin resistance
9
Q
tests if you think its B12 def
A
MMA + homocysteine
10
Q
CSF in neisseria meningitis
A
low glucose
high protein
high WBC
11
Q
xanthochromia
A
yellow CSF
subarachnoid hemorrhage
12
Q
abdominal pain after pancreatitis tx
A
think pseudocysts
13
Q
pancreatic pseudocyst tx
A
NPO + observation
14
Q
todd’s paralysis
A
post seizure
transient (min - hours)
hands, arms or legs
15
Q
hemochromatosis heart problems
A
restrictive CM (low voltage EKG) dilated CM (cardiomegaly)
16
Q
ASA overdose tx
A
alkalization of urine (sodium bicarb)
w/in an hour can go gastric lavage
17
Q
LBP radiates to butt/thighs
better in flexion/sitting
worse in stand/walk
A
spinal stenosis
18
Q
dx spinal stenosis
A
MRI
19
Q
long term tx for spinal stenosis
A
weight loss
20
Q
what do you give to kids that only get breast milk
A
Vit D starting after birth
iron after 4 mo
21
Q
tx for GDM
A
- lifestyle
2. + insulin or glyburide
22
Q
corkscrew sign on upper GI series
A
midgut volvulus
23
Q
what will you see on EKG for LVH
A
voltage > 5 large boxes
24
Q
long car ride –> back pain, can’t sit up
A
psoas syndrome
25
psoas syndrome tx
upper lumbar spine
| then psoas
26
steps to dx C. diff
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
27
internal vs external validity
internal: valid to the pop being studied
external: generalizable
28
gout vs pseudogout
pseudo + birefringent crystals (blue rhomboids)
29
musty smelling baby
PKU
30
girl toddler loses speech, autism-y, hand mvmts
Rett
31
when do you do tympanometry
asx middle ear effusions
32
pheo 10s
```
10% recur post surg
10% familial
10% b/l
10% extra adrenal
10% malignant
10% kids
```
33
when is post op fever ok (no workup)
first 48 hrs
34
variants of langerhans
eosinophilic granuloma
Hand-Schuller Christian (kids)
Letterer-Siwe (infants < 2)
35
best confirmatory test for Graves
radioiodine uptake scan
36
newborn: bulging abdomen, cryptorchidism, renal dysplasia/dilated ureters, pulm hypoplasia
prune belly syndrome
37
dandruff aka
seborrheic dermatitis
38
rhabdo management
IV fluids, EKG
39
wilsons tx
penicillamine
40
pheo, clear cell renal carcinoma, hemangioblastomas
von Hippel Lindau
41
ST elevations in I, aVL and V5-6: what kind + which vessel
lateral MI (left circumflex)
42
ST elevations in II, III and aVF: what kind + which vessel
inferior MI (right main coronary)
43
ST elevations in V1-V4: what kind + which vessel
anterior MI (left anterior descending)
44
rocker bottom feet
```
tri 13 (Patau)
tri 18 (Edwards)
```
45
polydactyly in infant
tri 13 (patau)
46
clenched fist in infant
tri 18 (edwards)
47
infant w/ infections, petechiae, dry skin
wiskott-aldrich
48
unilateral, foul smelling nasal discharge (kid)
foreign body (kids are gross)
49
drug a/w rash in mono pts
amoxicillin or ampicillin
50
most important thing to give CKD pts who need contrast studies
vigorous hydration (N-acetylcysteine is good but less vital)
51
what kind of pneumothorax do you get when you change pressures on ventilation pts?
tension pneumo (same as with penetrating trauma)
52
which way does trachea deviate w/ tension pneumo?
opposite
53
distal limb weakness, decreased proprio, decreased DTRs, spinal deformities, pes cavus
charcot-marie-tooth
54
how much folic acid for preggers
normal: 0.4 mg
| high risk: 4 mg
55
HIV defining illnesses
CIN II/III/carcinoma in situ
bacillary angiomatosis
shingles
thrush
56
AIDS defining illnesses
esophageal/tracheal/pulmonary candidiasis
intestinal isosporiasis/cryptosporidiosis
karposi's
cerebral lymphoma
PCP
cerebral toxo
invasive cervical CA
57
why no cervical HVLA in downs
weakness of alar and transverse ligaments
58
ipsilateral dilated pupil: what herniation
uncal (supratentorial)
59
AMS, bleeds, cheyne-stokes breathing: what herniation
central
60
resp and cardiac dysfunction: what herniation
tonsillar herniation (aka downward)
61
what does negative predictive value mean?
chances that a neg result is actually negative (true negs/total negs)
62
what is electrical alternans
big QRS then smaller QRS (seen in cardiac tamponade)
63
when to give RhoGAM
28 wks
64
Still's technique: direct or indirect?
start indirect, finish direct
65
timeline: baby blues vs depression?
2 weeks
66
FAP gene
APC
67
HNPCC/Lynch gene
DNA mismatch repair gene mutation
68
tx: whooping cough
macrolide (azithromycin, erythromycin or clarithromycin)
> 1: w/in first 3 wks of cough
< 1: w/in first 6 wks of cough
69
OCD vs OCDPD
OCD has some insight and is upset by it
70
gold standard for PE dx
pulmonary angiogram
71
therapeutic INR post DVT
2.0 - 3.0
72
tx: diverticulitis
quinolone + MTZ
TMP-SMX + MTZ
amoxicillin-clavulanate
73
patchy, oval hair loss of scalp or generalized loss of body hair
alopecia areata
74
when to add insulin to DM pt
> 8.5 A1C
75
COPD tx
combo:
| LABA + inhaled glucocorticoid (need both)
76
most specific lupus tests
anti ds DNA
| anti Smith
77
vasovagal syncope AKA
neurocardiogenic syncope
78
TCA cardio problems on EKG
widened QRS
prolonged PR
prolonged QTc
sinus tach
79
1st line tx: persistent allergic rhinitis
intranasal corticosteroids
80
fat embolism triad
```
resp changes (tachypnea, cough, hypoxia)
neuro changes
petechial rash
```
81
parasternal lift sign of
right ventricle dilation
82
how do you look for bence jones
urine protein electrophoresis
83
GI stromal tumor: Tx
imatinib
84
what do you test for in 21-hydroxylase def
17-hydroxyprogenterone
85
how to avoid non-hemolytic febrile transfusion reaction
use leukocyte washed blood products
86
what do you do when morning glucose is high?
test again at 3 am to differentiate btwn somogyi (will be hypoglycemic) and dawn effect (will be hyperglycemic)
87
what do you do for dawn effect
give more basal insulin @ dinner
88
ascites tx
furosemide and/or spironolactone
89
cord compression tx
corticosteroids
90
thyroid cancer a/w elevated calcitonin
medullary
91
bleed where you get better for a while then crash
epidural
92
MC pancreatic CA location
pancreatic head
93
tx: croup w/ resp distress
aerosolized racemic epi
94
criteria to determine severity/mortality of pancreatitis
Ranson criteria
95
Ranson criteria
```
poor prognosis:
age > 55
WBC > 16,000
glucose > 200
LDH > 350
AST > 250
```
96
multifocal atrial tachycardia criteria
3+ diff P-wave morphologies in a single lead
| HR > 100
97
wandering pacemaker criteria
3+ diff P-wave morphologies in a single lead
| HR < 100
98
quad screen
triple screen + inhibin A
| hCG, unconjugated estriol, AFP, inhibin A
99
quad screen results: + for Downs
decreased AFP
decreased estriol
increased inhibin
increased hCG
100
management: screening for downs
low risk can get triple screen
high risk (>35, late prenatal) get quad
if + --> genetic counseling
then offer amniocentesis
101
pregger: fever, abd pain and sausage shaped mass near umbilicus
septic pelvic pain thrombophlebitis
102
pregger/laboring: fever, tachy, tender uterus, foul smelling amniotic fluid
chorioamnionitis
103
post partum pelvic pain, foul smelling lochia
endometritis
104
schizos by time
2+ of schizo things
1-6 mo: schizophreniform
6+ mo: schizophrenia
105
tx: superficial thrombophelebitis
NSAIDs, elevation, heat, compression stockings
106
superficial vs suppurative thrombophlebitis
superficial + fever/chills and hx of IV cannulation
107
reasons to commit pts to psych
danger to self
danger to others
inability to care for themselves due to psych illness
108
SVT management
stable: vagal maneuvers and adenosine. diltiazem/labetalol for rate control
unstable: synchronized cardioversion
109
breast mass management
age > 30 --> mammo
if look malignant --> sterotactic bx
age < 30 --> U/S
cystic --> aspirated
fibroadenoma --> < 5 = obs; > 5 = FNA bx
non-fibroadenoma --> bx
110
signs of malignancy in mammo
breast asymmetry
clustered calcification
increased density
mass w/ irregular borders or spiculation
111
MCC prepubertal short stature and pubertal delay
constitutional growth delay (parents usually "late bloomers")
112
delayed puberty definition
girls: > 12 w/o breast growth
boys: > 13 w/o testicular growth
113
cleft lip management
repair w/ surgery @/by 3mo
114
cleft palate management
prescribe special nipple for feeding
| repair w/ surgery @ 9+ months
115
aspiration pneumonia -- where do you see it? which kids?
R lung > L lung
| neuro impaired kids :(
116
cough/tachypnea < 8 wks old
think chlamydia trachomatis
117
MCC CAP in kids (+tx)
strep pneumo, amoxicillin/amp or ceftriaxone
118
guts on the outside of baby
w/o membrane: gastroschisis
| w/ membrane: omphalocele
119
management: omphalocele
1. thorough inspection for other congenital defects
| 2. eventual surgery
120
vag bleeding 20+ weeks: painless vs painful
```
painless = placenta previa or vasa previa
painful = placental abruption
```
121
dx: lactose intolerance
hydrogen breath test
122
pulsatile liver
cor pulmonale
123
cor pulmonale CXR
dilated R atrium/ventricle
| enlarged central pulm arteries
124
cor pulmonale EKG
R vent hypertrophy
R axis dev
RBBB
peaked P waves in lead II
125
steps of asthma control
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
126
tx: akathisia (also wtf is it)
(restlessness a/w antipsych meds)
lower/switch psych meds
beta blocker or benzo
if not, benztropine
127
poison: drooling, mouth burns, dysphagia, vomiting
drain cleaner
128
poison: AMS (lethargy/coma), tachypnea, anion gap acidosis, Ca oxalate cystalluria (late)
ethylene glycol
129
where TF do you find ethylene glycol
antifreeze or hydraulic brake fluid
130
poison: diarrhea, urinary incontinence, miosis, muscle weakness, bronchospasm, bradycardia, emesis, lacrimation, salivation
DUMMBBELS
| organophosphates
131
poison: resp distress, gagging, choking, hypoxia, cyanosis, CNS depression
gasoline
132
poison: AMS (leth/coma), vision loss, anion gap acidosis
methanol
133
where do you find methanol
industrial solvents, pain thinner, moonshine (done wrong)
134
management: kid ingested something caustic
EGD
135
tx: ethylene glycol poisoning
fomepizole
136
tx: methanol poisoning
fomepizole
137
MC location for anal fissure
posterior midline
138
tx: anal abscess
MTZ
139
tx: anal fissures
```
more fiber
sitz bath
NG ointment
topical CCBs
botulinum toxin injections
recurrent --> lateral internal sphincterotomy
```
140
CXR: silicosis (from mining/sand blasting/glass work, etc)
nodular opacities in upper lobe
141
tx: silicosis
glucocorticoids
142
CXR: berylliosis (from nuclear power/metalwork/aerospace
b/l hilar adenopathy (same as sarcoid)
143
tx: berylliosis
glucocorticoids
144
CXR: asbestosis (from shipbuilding, insulation, demolition)
b/l opacities w/ pleural plaques
145
straight leg raise AKA
Lasegue's
146
FABERE test AKA
Patrick's
147
terrible triad
ACL
MCL
medial meniscus
148
how do you get the renal part of hepatorenal syndrome
cirrhosis --> vasodilation
down SVR
kidneys kick in to help --> renal vasoconstriction --> down GFR/renal fail
149
how to evaluate osteomyelitis tx response
ESR and CRP
150
possible problems with babies from DM moms
```
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)
```
151
poison: tremor, ataxia, asymmetric sensory deficits, delirium
mercury
152
tx: mercury poisoning
dimercaprol
153
MCC elevated maternal serum AFP
dating error
154
nature crap someone may be taking that messes with warfarin levels
St. John's wort
| also extra leafy greens or whatever
155
ginko biloba risks
good freaking lord
| lower seizure threshold and increase bleeding problems (anti-platelet)
156
mycosis fungoides
MC cutaneous T-cell lymphoma:
| erythematous plaques + lymphadenopathy
157
which is more common hemophilia A or B
A
158
meralgia paresthetica: wtf is it
entrapment of lateral femoral cutaneous nerve
--> numb/tingle in superior, lateral thigh
worse w/ stand/walk
tap inguinal or extend thigh to reproduce
159
tx: narcolepsy
modafinil (daytime sleepiness)
| fluoxetine or venlafaxine for cataplexy
160
levels in Wilsons
ceruloplasmin decreased (use for dx)
total serum Cu decreased
free serum Cu increased
urinary Cu increased
161
causes of pericarditis
infection (rheumatic fever, coxsackie)
uremia
lupus (or drug induced lupus)
MI
162
tx: SIADH
fluid restriction
163
test for pituitary adenomas
MRI
164
tx: acromegaly
transsphenoidal resection
165
which vessel stroke --> face blindness
posterior cerebral artery
166
first step: suspect endocarditis
blood cx (before abx)
167
anti-centromere abs
CREST
168
anti-histone
drug induced SLE
169
anti-mitochondrial
primary biliary cirrhosis
170
anti-Smith
SLE
171
anti-smooth muscle
autoimmune hepatitis
172
FEV1/FVC for obstructive
< 80
173
ATN FENa (fractional excretion of Na)
> 2%
174
granular or muddy brown casts
ATN
175
Q-angle vs valgus/varus
Q angle up --> valgus (knock-kneed)
| Q angle down --> varus (bow-legged)
176
sickle cell kidney problems
renal papillary necrosis
177
renal papillary necrosis UA
necrotic tissue
178
tx: psoriasis
topical corticosteroids
severe (>10% body): UVB
extreme: acitretin + UVB/PUVA
179
fine white lacy lesions in mouth (name and dz)
Wickham striae
| lichen planus
180
tx: prolactinoma
cabergoline or bromocriptine
(try one then the other)
if neither work --> transsphenoidal resection
181
tx: sigmoid volvulus
nontoxic: endoscopic decompression + elective sigmoidectomy later
toxic/ischemia: Hartmann's procedure (sigmoidectomy + colostomy)
182
kid w/ pancytopenia, recurrent infections, thumb abnormalities, cafe-au-lait spots, renal abnormalities and short stature
fanconi anemia
183
who's got cafe-au-lait spots?
NF 1
McCune-Albright
Fanconi anemia
Bloom syndrome
184
inflammation and narrowing of intrahepatic and/or extrahepatic bile ducts (bead pattern on cholangiography)
primary sclerosing cholangitis
185
pts w/ primary sclerosing cholangitis @ risk for
UC
186
hepatic adenoma RFs
OCPs
anabolic steroids
glycogen storage dz
187
when to resect hepatic adenomas
symptomatic
or > 5 cm
or don't get smaller when stop OCPs
188
what drugs do you get post MI
```
BB*
ACE*
Statin
ASA (+clopidogrel if stented)
* improves mortality
```
189
tx: transudative pleural effusion
thoracentesis
190
tx: empyema
chest tube + empiric abx
191
thyroid levels in preggers
TBG increases so total and bound T4/Ts increase
TSH may go down since hCG is close
free thyroxine is unchanged
192
dx: syphilis
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
193
tx: syphilis
1/2: penicillin G (1 dose)
latent: 3 doses
neurosyphilis: continuous infusion
194
dx: osteomyelitis
initial: x-ray (periosteal elevation)
most sensitive: MRI
most accurate: bx/cx (chose abx)
195
tx: fibroids
```
GnRH agonists (shrinks them)
definitive: hysterectomy or myomectomy (depend on kid-wanting)
```
196
tx: PE
```
IV heparin (if stable)
tPA (if unstable)
```
197
chvostek sign means
hypocalcemia
198
hypocalcemia EKG
prolonged QT
199
what changes w/ warfarin (BT/PT/PTT)
increased PT
200
cranial/sacral mvmt
as cranium (occiput) flexes, sacrum extends (counternutates)
201
when to use the apt test?
diff btwn fetal/maternal blood: neonatal hematemesis, maternal GI/vaginal bleeding
202
what changes w/ DIC (BT/PT/PTT)
acute: increased PT and PTT (and increased d-dimer)
| chronic has normal PT/PTT
203
tx: molluscum contagiosum
self limiting, do nothing
204
management: acetaminophen poisoning
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
205
spike and dome BM on renal bx
membranous glomerulonephritis
206
painless jaundice w/ palpable GB (sign and path)
courvoisier's
| pancreatic adenocarcinoma
207
where to treat CAP?
```
use CURB-65 score:
Confusion
Uremia (BUN >20)
RR (> 30)
BP (sys < 90 or dia < 60)
Age > 65
```
< 2 = outpatient
2 = inpatient
3+ = ICU
208
tx: CAP
azithromycin or moxifloxacin
| add beta-lactam if in ICU
209
newborn male w/ urinary tract obstruction
usually posterior urethral valves
210
dx: posterior urethral valves (newborn)
voiding cystourethrogram
211
tx: mobitz type II AV block
if symptomatic: pacemaker
212
fall on outstretched hand --> what SD
posterior radial head (pronates)
213
nephropathy after viral illness, normal C3, IgA and C3 on staining
IgA nephropathy
214
renal bx: lumpy bumpy pattern on microscopy
post-strep glomerulonephritis
215
PSGN C3 level
low
216
IgA nephropathy C3 level
normal
217
fusion of podocyte foot processes
minimal change disease
218
deafness and hematuria
alports
219
kimmelstiel-wilson nodules
diabetic nephropathy
220
kidney thing a/w HIV
focal sclerosing glomerulonephritis
221
renal bx: apple green birefringence w/ congo red stain
amyloidosis
222
renal bx: tram track BM
membranoproliferative nephropathy
223
nephropathy a/w Hep C
membranoproliferative nephropathy
| also can be membranous
224
MCC epididymitis
< 35: chlamydia
| older: e. coli
225
levels in polycythemia vera
low EPO
| increased RBC, WBC, platelets, bilirubin, B12, uric acid
226
tx: polycythemia vera
phlebotomy + hydroxyurea
227
DEXA results
-1 to - 2.5: osteopenia
| < -2.5: osteoporosis
228
MCC spontaneous bacterial peritonitis
E. coli
229
classic (but not MC) PE EKG finding
S1-Q3-T3
S wave in I
Q and inverted T in III
230
management: thyroid nodule
1. get TSH
2a. TSH normal/high (hypoTh)--> FNA (if > 1 cm)
2b. TSH low (hyperTh)--> scintigraphy
231
tx: 3rd degree burn
excision and skin grafting
232
when to tx shingles
give -cyclovirs w/in 72 hours of lesion appearance
| pain management always
233
tx: NMS
1. stop med
2. IV fluids
3. dantrolene/bromocriptine/amantadine
234
criteria to dx fibromyalgia
TPs above and below waist on both sides
235
tx: fibromyalgia
duloxetine
milnacipran
pregabalin
236
MCC meningitis: born to 3 mo
GBS
237
MCC meningitis: 3 mo - 9 year
strep pneumo
238
MCC meningitis: teen/young adult
N. meningitis
239
MCC meningitis: > 30
strep pneumo
240
tx: restless leg syndrome
dopamine agonists: pramipexole, ropinirole, levo/carbi, bromocriptine
can use gabapentin too if not
241
tx: body dysmorphic disorder
CBT, SSRI
242
iron studies in hemochromatosis
up iron
up ferritin
up transferrin saturation
down TIBC
243
normal fetal HR
110 - 160
244
level of spinal cord lesion: autonomic hyperreflexia (HTN, HA, flushing)
T6 and above
245
where does gastric CA throw mets?
ovaries (Krukenberg's tumor)
246
test to do before placing an arterial line
Allen's test: make sure ulnar circulation is adequate (return in < 10 s)
247
dx: meckel's diverticulum
technetium-99m pertechnetate scan
248
2s of meckel's diverticulum
```
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
recurrent genital/oral ulcers, arthralgia, uveitis
Behcet's
250
mgmt: ASCUS
21 - 24: repeat pap in 12 mo
25+: HPV test
(+)--> colp
(-) --> repeat cyto in 3 years
251
continuous murmur
PDA
252
abdominal pain, arthralgia, palpable purpura
Henoch-Schonlein Purpura (HSP)
253
renal path for HSP
IgA deposits in mesangium --> hematuria
254
BP w/ aortic regurg
wide pulse pressure
255
thumbprint sign on neck x-ray
epiglottitis
256
kid: fever, sore throat, drooling, hot potato voice
epiglottitis
257
c-section: nasal flaring, tachypnea, grunting, cyanosis
transient tachypnea of the newborn (TTN)
258
when do you give people w/ suspected FAP colonoscopies?
annual screen, start @ 12
259
tx: Turner's syndrome
human growth hormone
| estrogen replacement therapy
260
MC location of coarctation of aorta
distal to L subclavian artery
261
EKG changes expected in coarctation of the aorta
LVH (tall R in V5/V6)
262
acute SD characteristics
```
sharp pain
edema
bogginess**
erythema
warmth
```
263
RFs porphyria cutanea tarda
```
Hep C
HIV
alcohol
increased iron
estrogen
```
264
RFs endometrial CA
unopposed estrogen use
DM
age
fam hx
265
most effective dating method first TM
transvaginal sonogram: crown-rump length
266
down Ca
down phos
up PTH
vit D def (2ndary hyperparathyroidism)
267
down Ca
up phos
up PTH
```
renal failure (2ndary hyperparathyroidism)
pseudohypoparathyroidism (a/w Albright's osteodystrophy)
```
268
up Ca
norm phos
down PTH
think paraneoplastic (increased PTH-related protein)
269
up Ca
down phos
up PTH
primary hyperparathyroidism
270
MCCs primary hyperparathyroidism
adenoma*
hyperplasia
carcinoma (rare)
271
describe pleural effusion contents in TB
lymphocytes > 80%
high protein
adenosine deaminase > 40
272
pleural effusion w/ low glucose
RA*
empyema
malignancy
273
bloody pleural effusion
PE or malignancy
274
MC cancer in kids
ALL (peaks in 3 - 5 yos)
275
tx: esophageal varices bleeding prophylaxis
propranalol
276
spondylolisthesis grades
1: 0 - 25%
2: 26 - 50 %
3: 51 - 75 %
4: 75 - 100%
277
tx: sarcoidosis
oral corticosteroids
278
MCC pancreatitis in kids/teens
blunt trauma
279
J waves (osborn waves) on EKG
hypothermia
280
Klatskin tumors
cholangiocarcinoma @ confluence of bile ducts
281
wide fixed split S2
ASD
282
management: lobular carcinoma in situ
1. excisional bx (r/o ductal or invasive CA)
| 2. observe/tamoxifen
283
21-hydroxylase deficiency -- what are the junk like?
males: normal
females: ambiguous
284
tx: 21-hydroxylase def
initially: IV hydrocortisone
| then glucocorticoid and mineralocorticoid therapy for life
285
diaphyseal frx of distal radius w/ disruption of radioulnar joint
Galeazzi's frx
286
ulnar shaft frx
nightstick frx
287
diaphyseal frx of proximal ulna w/ displacement of radial head
Monteggia's frx
288
distal radial frx (often w/ osteoporosis)
Colle's frx (dinner fork deformity)
289
salpingitis complication
hydrosalpinx --> infertility problems
290
type of hyperlipoproteinemia in familial hyperlipoproteinemia
type IIa
291
time frame dysthymic d/o
2+ years
292
signs of increased intraocular pressure
proptosis, eye pain, chemosis (conjunctival edema), blurry vision, limited extraocular motion
293
increased times in vWB
up PTT
| up BT
294
penetrating trauma --> loss of breath sounds
tension pneumo
295
convulsions, coma/confusion + cardiac problems
think TCA overdose
296
sick + sunburn-like rash
think toxic shock syndrome
297
tx: TSS
IV fluids
| IV nafcillin + aminoglycoside (clinda)
298
MC cause posterior dislocation
muscle spasm - seizure
299
what to do when someone w/ rabies vaccine is bitten
irrigation of wound
| 2 doses of vaccine
300
what to do when someone w/o rabies vaccine is bitten
irrigation of wound
rabies immunoglobulin
4 doses of vaccine
301
what is specificity
ability to find true negatives
| % of truly negative people who test negative
302
what is sensitivity
ability to find true positives
| % of positive people who are found by test
303
management: perforated ulcer
```
to start: NG, IVF, IVAbx
then surgery if...
> 70 yo or
hemo unstable or
peritoneal signs
```
304
PDA CXR
increased pulmonary vascular markings
305
levels in CRF
```
anemia (normocytic)
hypocalcemia
hyperphosphatemia
hyperkalemia
azotemia
```
306
why do you get hypocalcemia in ESRD
phos can't get cleared, complexes with Ca
| kidney doesn't hydroxylate as much 25-hydroxyVit D to calcitriol (1,25 dihydroxycholecalciferol)
307
indications for hemodialysis
```
AEIOU
Acidosis
Electrolytes (HK)
Intoxications (Li, ASA, methanol, ethylene glycol)
Overload (CHF)
Uremia (pericarditis)
```
308
trichomoniasis puts at risk for...
HIV and HIV transfer
309
how/when to reevaluate new hypothyroid pts
4-6 weeks
| TSH
310
baby: cyanosis w/ feeding, better with crying
choanal atresia (can't breathe thru nose)
311
what do you give all CHFers w/ EF < 40%
ACE
312
neonate w/ conjunctivitis -- how do you know if it's chlamydia or gonorrhea?
2 - 5 days = gonorrhea (PROFUSE discharge perhaps)
| 5 - 14 days = chlamydia
313
tx: gonococcal conjunctivitis in newborn
IM/IV ceftriaxone
314
tx: chlamydial conjunctivitis in newborn
topical erythromycin
315
tx: idiopathic b/l adrenal hyperplasia causing hyperaldosteronism
spironolactone
316
most specific test for RA
x-ray and anti-CCP
317
management: bloody nipple discharge
apparently surgery
318
tx: primary adrenal insufficiency
glucocorticoids
| fluticasone
319
tx: secondary adrenal insufficiency
glucocorticoids
320
tx: tertiary adrenal insufficiency
glucocorticoids
321
primary vs secondary adrenal insufficiency
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
kid w/ painful limp after URI
transient synovitis
323
which one is Addisons
primary adrenal insufficiency
324
which one is Conn's syndrome
hyperaldosteronism
325
diff btwn HUS and TTP
HUS more in kids
| TTP = HUS + fever + neuro sx
326
conjugated hyperbilirubinemia and increased coproporphyrin (mostly III)
Rotor syndrome
327
unconjugated hyperbilirubinemia
Gilbert's
| Crigler-Najjar
328
conjugated hyperbilirubinemia
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
RBBB criteria
QRS > 120
R' in V1 (and usually V2)
slurred S in I and V6
330
acute dystonia (WTF is it and when do you get it)
```
muscle spasms (including oculogyric crisis)
hours to days after starting anti-psych meds
```
331
tx: EPS - acute dystonia
benztropine
| diphenhydramine
332
tx: EPS - akathisia
propranolol
benzos
then benztropine if nothing else works
333
tx: EPS - parkinsonism
down dosage if possible
benztropine
diphenhydramine
334
tx: EPS - tardive dyskinesia
stop or switch
335
fluid for burns (+ time period)
give LR first 24 hrs
336
body surface %s for adults
```
head: 9
Trunk: 9 (chest), 9 abdomen, 18 (back)
UE: 9 (each)
LE: 18 (each)
junk: 1%
```
337
body surface %s for kids
```
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
Wallenburg test (how and why)
hold head in positions (+ is neuro changes)
| test for vertebral artery insufficiency
339
Spurling test (how and why)
(seriously) pressure one head
| for cervical radiculopathy
340
Adson test (how and why)
put out arm and check pulse
| thoracic outlet syndrome
341
Apley's scratch test (how and why)
scratch back both ways (good fucking lord)
| glenohumeral ROM
342
EKG: fast and wide rhythms (+ txs)
torsades (Mg, shock unstable)
| Vtach (amio, shock unstable)
343
EKG: fast and narrow rhythms (+txs)
SVT (adenosine, shock unstable)
| Afib (BB/CCBs, shock unstable)
344
EKG: slow and narrow rhythms (+txs)
S. brady (atropine, pace)
1st degree AV block (atropine, pace)
2nd degree AV block (atropine type I, pace type I or II)
345
EKG: slow and wide rhythms (+ txs)
3rd degree AV block (pace)
| Idioventricular (IV) (pace)
346
SLE inducing drugs
hydralazine, isoniazid, procainamide
347
osteosarcoma description/location on PE
hard, non mobile pass @ proximal tibia or distal femur
348
dx: cauda equina syndrome
MRI
349
chronic pancreatitis triad
DM
steatorrhea
panc calcifications
350
when to surgery AAAs
sx (any size)
| asx (> 5.5 cm)
351
sinusoidal fetal heart pattern (causes)
anemia (usually from Rh isoimmunization of severe hypoxia)
352
when does odds ratio = relative risk
cohort studies
353
when to use a chi-square test
analyze results which are 2+ proportions (both exposure and outcome are categorical) (ex: % infection with and w/o vaccine)
354
when to use one-way ANOVA
continuous variable in 3+ groups (best w/ bell distribution)
355
when to use a t-test
continuous variable
| 2 independent groups
356
when to use correlation
continuous variable, continuous groups (ex: BP goes up w/ BMI)
357
tx: panic disorder
SSRI
358
sacral axis for cranial/sacral movement
superior transverse
359
diff btwn incomplete and inevitable abortion
inevitable is before passage of tissue , incomplete has some or all tissue passed (both have open os)
360
tx: croup
O2, dexamethasone
| severe: add nebulized epi
361
management: placenta previa
< 36 wks: conservative, repeat U/S before delivery
| > 36 wks: U/S, most --> C-section, ant-marginal --> can try vaginal
362
tremor that gets better with alcohol
essential
363
tx: essential tremor
beta blocker
primidone
benzos
364
tx: 3rd degree AV block
pacemaker
365
spirometry in sarcoidosis
elevated or normal FEV1/FVC
366
silicosis pts @ risk for
TB
367
GI bleed -- nothing on EGD or colonoscopy
btwn lig of treitz and ileocecal valve
| Meckel's
368
upper arm claudication + neuro symptoms w/ UE exercise
subclavian steal syndrome
369
dx: insulinoma
72 hour fast
| stop if gluc < 45
370
when do you see increased urobilinogen?
elevated conjugated hyperbilirubinemia
371
diarrhea, dermatitis and dementia
pellagra (B3/niacin def)
372
conduct d/o vs antisocial personality d/o
conduct < 18
| ASPD > 18
373
eosinophilia + high Cr
think AIN (acute interstitial nephritis)
374
tx: mycoplasma pneumonia
macrolide, FQ or tetracycline
375
risk of high clozapine levels
seizures
376
blue dot sign
see on scrotum
| due to torsion of the appendix testis
377
tx: torsion of the appendix testis
pain meds
bed rest
scrotal support
378
polymyalgia rheumatica a/w?
temporal arteritis
379
tx: OCD
CBT + SSRI/TCA
380
tourette's a/w
ADHD
| OCD
381
elevated 5-HIAA
carcinoid
382
tx: unresectable carcinoid
octreotide
383
midline pharynx swelling + pain on neck extension
retropharyngeal abscess
384
dx: retropharyngeal abscess
neck CT
385
tx: retropharyngeal abscess
IV clinda and ampicillin-sulbactam
| surgery if fail Abx, airway compromise or effing huge
386
tx: aplastic crisis
blood transfusion
387
diff btwn gestational HTN and preeclampsia
preeclampsia has proteinuria or signs of end organ damage
388
when is bed wetting not ok
past 5
389
tx: bed wetting
bed wetting alarm system
| can use imipramine or desmopressin for temporary fix
390
tall kid with gynecomastia, small junk and small firm testicles
think klinefelters (XXY)
391
risks a/w klinefelters
infertility
| extragonadal germ cell tumors (esp mediastinal nonseminous)
392
management: trigeminal neuralgia
anticonvulsant for tx
maybe baclofen as adjunct
do MRI to r/o MS or tumors
393
cherry red spot w/ radiating vessels on colonoscopy
angiodysplasia
394
hypermagnesemia -->
paresthesias, weakness, paralysis --> resp failure
395
tx: hypermagnesemia
Ca gluconate
396
prevention: NSAID induced ulcers
misoprostol
| pepcid?
397
what to do with metformin for IV contrast
stop before
| don't restart for 48 hrs
398
MCC colovesicular fistulas
diverticulitis
399
how does hypothyroidism --> galactorrhea?
low thyroid hormone --> increased TRH and TRH stimulates both TSH and prolactin from pituitary
400
dx: pancreatic cancer
most sensitive: CT
| most specific: ERCP
401
strep pharyngitis criteria
```
2 of these:
tonsillar exudates
no cough
temp > 100.4
anterior cervical adenopathy
```
402
tx: torsades
IV mag sulfate
403
dx: pyloric stenosis
U/S
> 3 - 4 mm thick or
> 15 - 18 mm long
404
CXR: alpha-1 vs COPD
alpha-1: hyperlucency @ bases (panacinar emphysema)
| COPD: hyperlucency @ apices (centrilobular emphysema)
405
tx: zollinger-ellison
PPI
406
nerve affected by Guyon's entrapment
ulnar
407
management: hypercalcemic crisis
NS IVF then furosemide
| if fail, calcitonin or HD
408
tx: hypercalcemia of malignancy
bisphosphonates (chronic management)
409
vit def a/w alopecia, dermatitis, depression, neuropathy, n/v
biotin
410
vit def a/w neutropenia, osteoporosis and hypochromic anemia
copper
411
vit def a/w xeropthalmia and night blindness
vit A
412
how to avoid HIT
use LMWH or fondaparinux
413
tx: spontaneous bacterial peritonitis
ceftriaxone or cefotaxime (3rd gens)
414
describe thoracentesis in empyema
pH < 7.3
hi LDH
low glucose
positive gram stain
415
dx: myasthenia gravis
most specific: Ach receptor Ab test
| initial: Tensilon or ice pack (if there is ptosis)
416
MC adverse effect of vanco
red man syndrome
417
red man syndrome sx
hTN, dyspnea, pruritus + erythema above waist
418
tx: red man syndrome
stop infusion
give at slower rate
+/- antihistamines
419
papules/pustules in finger webs
think scabies
420
allergic rhinitis, asthma, + p-ANCA
churg-strauss
421
hematuria + upper resp or GI
think Berger (IgA)
422
slit lamp: ectopia lentis
Marfan's (MC)
| can also be in Ehlers-Danlos
423
dx: Cushing's
24 hr urine collection/cortisol measurement
dexamethasone suppression test
late night serum/saliva cortisol test
424
which glaucoma is the bad one
closed-angle (acute)
425
angiodysplasia a/w
vWB dz
aortic stenosis
ESRD
426
+ dix hallpike, episodic vertigo
benign paroxysmal positional vertigo
427
vertigo, tinnitus, hearing loss
Meniere's
| apparently can be labyrinthitis too
428
viral infxn then vertigo/hearling loss/nystagmus
labyrinthitis
429
tx: BPPV
Epley maneuver (reposition canalith)
430
tx: Meniere's
acute: benzos or vestibulosuppressants
prevent: diuretics and low salt diet
431
tx: labyrinthitis
steroids
432
UMN and LMN signs
ALS
433
tx: ALS
riluzole to slow progression
434
tx: MS
glatiramer or beta-IFN slow progression
435
meds causing hearing loss
furosemide
salicylates (ASA)
aminoglycosides
436
face redness worse w/ EtOH or spicy
rosacea
437
tx: rosacea
MTZ gel and oral tetracycline
438
kid 9 - 15 w/ knee pain + tibial tubercle prominence
Osgood-Schlatter
439
kid 4 - 9 w/ thigh pain
Legg-Calve-Perthes dz
440
hip pain in fat boy
slipped capital femoral epiphysis
441
Cushing syndrome vs dz
syndrome: paraneoplastic, ectopic ACTH
disease: ant pit makes ACTH
442
chin displacement = what bs cranial thing
toward side of temporal bone external rotation
443
normal CRI
10 - 14
444
technique to increase CRI amplitude
CV4 (aka bulb decompression or whatever TF)
445
Hodgkin's staging
```
Ann Arbor:
I: 1 node involved
II: 2+ same side of diaphragm
III: both sides of diaphragm
IV: extralymphatic (liver, bones, lung)
```
446
dx: hyperPTH adenoma localization
Sestamibi scan
447
normal vaginal pH
3.8 - 4.2
448
candida vaginal pH
normal
449
trichomoniasis vaginal pH
> 4.5
450
scoliosis levels (+ tx)
mild: 5 - 15 (OMT/PT)
mod: 20 - 45 (orthotics, OMT/PT)
severe: > 50 (surgery)
451
scoliosis: when is resp/cardio involved
> 50 get resp stuff
| > 75 get cardio stuff
452
MC breech
frank (butt presents, hips flexed, knees extended)
453
facet orientation: cervical, thoracic, lumbar
BUM (backward, upward, medial)
BUL(backward, upward, lateral)
BUM (backward, upward, medial)
454
a/w polycystic kidney dz
intracerebral berry aneurysms
hepatic cysts
heart valve stuff
thoracic aortic aneurysms
455
tx: rheumatic fever
penicillin
| prednisone for severe cases
456
tx: epididymitis
ceftriaxone and doxy
| add FQ if suspect enteric
457
levels in osteopenia
PTH: normal
AlkPhos: norm
Ca: norm
Phos: norm
458
levels in osteomalacia
PTH: up
AlkPhos: up
Ca: down
Phos: down
459
levels in osteitis fibrosa cystica
PTH: up
AlkPhos: up
Ca: up
Phos: down
460
levels in Paget's dz
PTH: norm
AlkPhos: norm/up
Ca: down
Phos: up
461
levels in hPTH
PTH: down
AlkPhos: norm
Ca: down
Phos: up
462
what does PTH do
up serum Ca
| down serum phos
463
brown cystic tumors
osteitis fibrosa cystica
464
newborn screens
PKU
| hTh
465
tx: low breast milk production
1. increase feedings
2. metoclopramide (D2 antag)
also make sure shes not on combined OCPs
466
kid passes out while crying
apparently thats fine from 2 to 4/8
467
tender utero-sacral nodules
endometriosis
468
dx: endometriosis
laparoscopy (gun-powder lesions)
469
ABI for PAD
< 1
470
claudication but not PAD
think neuroclaudication -- spinal stenosis
471
confusion, ataxia and nystagmus
Wernicke's encephalopathy
472
Klumpke's paralysis
injury to C8-T1
paralysis of intrinsic hand muscles
ulnar nerve numbness
Horner's
473
ball tumor w/ bhCG up
seminomas (germ cell)
474
ball tumor w/ AFP up
non-seminomas (embryonal) (germ cell)
475
ball tumor w/ precocious puberty and gynecomastia
leydig cell tumors (non-germ cell)
476
latent phase of labor
effacement and dilation up to 4 cm
477
prolonged latent phase
null: > 20
multi: > 14
478
active phase of labor
eff/dil from 4 - 10 cm
479
prolonged active phase
null: < 1.2 cm/hr
multi: < 1.5 cm/hr
480
arrested active phase
no dilation in 2 hrs in active phase
481
second phase of labor
from 10 cm to delivery
482
prolonged second phase
null: 2 hrs
multi: 1 hr
483
third stage of labor
baby out to placenta out
484
prolonged third stage
> 30 min
485
cardiogenic shock levels
CO: low
PCWP: high (only shock that's high)FF
SVR: high
486
neurogenic shock levels
CO: low
PCWP: low
SVR: low
487
septic shock levels
CO: high (early)
PCWP: low
SVR: low
488
hypovolemic shock levels
CO: low
PCWP: low
SVR: high
489
anaphylactic shock levels
CO: high (variable)
PCWP: low
SVR: low
490
newborn w/ conjunctivitis in first 24 hrs
chemical conjunctivitis
491
what does viral conjunctivitis in a newborn look like (+when)
6 - 14 days
| conjunctivitis + bilateral lid edema
492
MCC viral conjunctivitis in a newborn
HSV
493
penicillin and kidneys
cause AIN
494
age range: reactive arthritis
> 20
495
how many joints? pauci- vs poly- articular JRA
pauci: 4 or fewer
poly: 5+
496
kid: knee swelling w/ painless limp
JRA
497
JRA complications
uveitis
iridocyclitis
asymmetric leg length
498
tx: gastroparesis
metoclopramide or erythromycin
499
tx: hypocalcemia
> 7.5: oral calcium carbonate
refractory: + calcitriol
< 7.5 or w/ arrhythmia: IV calcium gluconate
500
tx: shigella
cipro
501
dx: cardiac tamponade
EKG or echo
502
procedures requiring infective endocarditis prophylaxis
resp tract procedures
major dental (extractions, root canals)
infected skin/tissue right under skin/MSK tissue
503
management: cervical lesion
cervical bx (colp not good enough)
504
flat shoulder, loss of arm abduction: what nerve?
axillary nerve
505
wrist drop: what nerve?
radial
506
claw hand: what nerve?
ulnar
507
thenar eminence flattening: what nerve?
median
508
string sign on barium swallow
crohns
509
time frame: berger vs PSGN
```
berger = same or days post infxn
PSGN = 10 - 14 days after
```
510
MC compartment for compartment syndrome
anterior
511
6 Ps of compartment syndrome
```
pain
pallor
paresthesias
poikilothermia
pulselessness
paralysis
```
512
whats in the ant compartment
tibialis anterior
extensor hallucis longus
ant tibial artery
deep fibular nerve (innervate space btwn 1/2 toes)
513
complications post bacterial meningitis
```
hearing loss (MC)
seizures
CN palsies
cognitive deficits
ataxia
```
514
when would you not LP suspected meningitis? (+ why not)
```
focal deficits
papilledema
confusion
midline shift/tumor
(up ICP means LP could --> herniation)
```
515
what to do if tooth gets knocked out
rinse with saline and reimplant
| if cant -- take in milk, saliva, saline or Hanks solution
516
autoimmune causes of pulmonary fibrosis
RA
SLE
scleroderma
517
tx: somnambulism (sleep walking)
benzos
| trazodone
518
colon ca + endometrial ca
think HNPCC/Lynch syndrome
519
adenomatous polyps + CNS malignancy
Turcot
520
colon hamartomas + mouth freckles
Peutz-Jegher
521
adenomatous polyps + osteomas/lipomas/fibromas
Gardner
522
MCC hip dislocation
MVA (then sports)
523
mgmt: hip dislocation
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
how long is measles contagious
5 days before rash
| 4 days after
525
tx: dermatitis herpetiformis
gluten-free diet
| dapsone (diaminodiphenyl sulfone)
526
spondylosis
OA of vertebrae (degenerative changes)
527
spondylolysis
pars interarticularis defect (scotty dog)
528
spondylolisthesis
ant displacement of vert (step off)
529
what is "hip drop" test for
lumbar spine sidebending
530
mgmt: testicular torsion
emergent surgical detorsion followed by bilateral orchiopexy to prevent recurrence
> 6 - 12 hrs --> orchiectomy
531
gonorrhea and chlamydia -- when to co-treat?
+chlamydia: just treat the chlam chlam
| +gonorrhea: treat both, go wild
532
floppy baby w/ spared eyes
Werdnig-Hoffman dz (spinal muscular dystrophy type 1)
533
what should you think about with alcoholics w/ heart failure
dilated CM (wet beri beri)
534
drugs that improve mortality in systolic dysfxn
```
ACE/ARB
BB
spironolactone/eplerenone
hydralazine/nitrates
defibrillator
```
535
vomiting followed by retrosternal CP
Boerhaave's syndrome
536
dx: Boerhaave's
gastrograffin esophagram
| if not available: CXR
537
delayed puberty, can't smell
Kallman syndrome
538
palpable testes in labia majora
androgen insensitivity syndrome
539
shiny, peeling areola (breastfeeding)
candidiasis of nipple
540
tx: nipple candadiasis
-azole cream on nipple
| oral azole for baby (thrush)
541
MCC mastitis
staph aureus
542
painless hematuria in smoker
think bladder carcinoma
543
dx: bladder carcinoma
cystoscopy w/ bx
544
Becker's vs Duchenne's muscular dystrophy
Becker is less severe, and less common (insufficient dystrophin vs no functional dystrophin)
545
what are the fontanelles called when they close
anterior: bregma
post: lambda
546
anti-glomerular BM Abs
Goodpasture's syndrome
547
hypercalcemia EKG
short QT
| wide T waves
548
MC location for diverticula
sigmoid colon
549
elevated urine aminolevulinic acid
acute intermittent porphyria
550
diff btwn Niemann-Pick and Tay-Sachs
Tay-Sach's doesn't involve the liver
551
glucagonoma sx/path
necrotizing migratory erythema, DM, glossitis/cheilitis
| panc alpha cells
552
tx: glucagonoma
surgery vs chemo
| octreotide for sx
553
dementia w/ magnetic gait
NPH
554
tx: huntington's chorea
tetrabenazine
| refractory chorea: haloperidol
555
blood types and ulcers? WTF?
duodenal more common in O
gastric more common in A
you cant make this shit up
556
dx: h. pylori
< 50 w/o alarm sx: urea breath test
| if not, EGD
557
WAGR syndrome
Wilm's tumor (nephroblastoma)
Aniridia
GU malformations
Retardation
558
prevention: mammogram
every 2 years starting @ 50
559
leukocytosis post infection, increased leukocyte alkaline phosphatase
leukemoid rxn
560
tx: MS flare
high dose IV corticosteroids
561
MC diverticula bleed location
ascending colon
562
tx: bleeding diverticulosis
IVF
563
who do you screen for syphilis?
high risk: MSM, sex workers, risky business
| + preggos
564
when can you see a gestational sac (BhCG)
transvag: > 1,500
abdominal: > 6,500
565
BhCG growth: normal vs ectopic
normal: double/48 - 72 hrs
ectopic: lower
566
dx: ectopic pregnancy
transvag U/S and serial BhCGs
567
mgmt: ectopic pregnancy
methotrexate
| unstable: surgery
568
what nerve is compressed in lumbar disc herniations?
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
what nerve is compressed in cervical disc herniations?
the nerve of the segment below (since it exits @ level of herniation) goddammit
570
MC herniations
L4/L5
L5/S1
C5/C6
571
screenings for smokers
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
ST elevation during CP, normal when resolve
variant angina
573
tx: variant angina
CCB
| nitrates
574
left vs right scoliosis
named for curve convexity
575
mgmt: LSIL
21-24: no colp
HPV (-): repeat cyto + HPV in 1 year
HPV(+) or not done: colp
576
a/w vitiligo
pernicious anemia
| hypothyroidism
577
withdrawal: tactile hallucinations
alcohol
| cocaine
578
nerve damaged w/ anterior shoulder dislocation
axillary
579
anti-jo
polymyositis/dermatomyositis
580
livedo reticularis, eosinophilia, acute renal failure
cholesterol embolism syndrome (atheroemboli)
581
minimal urine output
30 cc/hr
| 0.5 ml/kg/hr
582
tx: post-herpetic neuralgia
TCA
opioids, gabapentin/pregabalin
topical capsaicin/lidocaine
583
tx: hereditary spherocytosis
splenectomy + pneumo vaccine
584
nerve root injured for Erb-Duchenne's palsy
C5 and C6
585
age of precocious puberty
7 in females
| 8 in males
586
knee injury but can still bear weight
meniscal tear
587
criteria for paracentesis fluid
SAAG (serum ascites albumin gradient)
| > 1.1 = portal HTN
588
RUQ pain, fever, jaundice
cholangitis (charcot's triad)
589
reynold's pentad
cholangitis
| fever, jaundice, RUQ pain, hTN, AMS
590
tetralogy of fallot
pulmonary stenosis
RVH
VSD
overriding aorta
591
self mutilating intellectual disability kid
Lesch-Nyhan
592
RFs for wound dehiscence
```
obesity
steroid use
DM
chemo/radiation
malnutrition
```
593
first thing to do when you suspect rhabdo
EKG
594
fetor hepaticus
sweet, musty, fecal odor to breath (hepatic encephalopathy)
